harman and Tobacco-Use-Disorder

This review evaluates the presumed contribution of acetaldehyde to tobacco smoke addiction. In rodents, acetaldehyde induces reinforcing effects, and acts in concert with nicotine. Harman and salsolinol, condensation products of acetaldehyde and biogenic amines, may be responsible for the observed reinforcing effect of acetaldehyde. Harman and salsolinol inhibit monoamine oxidase (MAO), and some MAO-inhibitors are known to increase nicotine self-administration and maintain behavioural sensitization to nicotine. Harman is formed in cigarette smoke, and blood harman levels appear to be 2-10 times higher compared to non-smokers. Since harman readily passes the blood-brain barrier and has sufficient MAO-inhibiting potency, it may contribute to the lower MAO-activity observed in the brain of smokers. In contrast, the minor amounts of salsolinol that can be formed in vivo most likely do not contribute to tobacco addiction. Thus, acetaldehyde may increase the addictive potential of tobacco products via the formation of acetaldehyde-biogenic amine adducts in cigarette smoke and/or in vivo, but further research is necessary to substantiate this hypothesis.

Topics: Acetaldehyde; Animals; Behavior, Animal; Harmine; Humans; Salsoline Alkaloids; Tetrahydroisoquinolines; Tobacco Use Disorder

Greater prefrontal cortex and anterior cingulate cortex monoamine oxidase A (MAO-A) binding is associated with depressed mood. Substances in cigarette smoke, such as harman, inhibit MAO-A, and cigarette withdrawal is associated with depressed mood. Dysphoria during cigarette withdrawal predicts relapse. It is unknown whether MAO-A binding increases during early cigarette withdrawal.. To measure prefrontal and anterior cingulate cortex MAO-A binding during acute cigarette withdrawal and to assess the relationship with smoking severity, plasma levels of harman, and severity of depression.. Study via positron emission tomography of healthy control and cigarette-smoking individuals.. Twenty-four healthy nonsmoking and 24 otherwise healthy cigarette-smoking individuals underwent positron emission tomography with harmine labeled with carbon 11. Healthy nonsmoking individuals underwent scanning once. Cigarette-smoking individuals underwent scanning after acute withdrawal and after active cigarette smoking. Cigarette smoking was heavy (≥25 cigarettes per day) or moderate (15-24 cigarettes per day).. Tertiary care psychiatric hospital.. An index of MAO-A density, MAO-A V(T), was measured in the prefrontal and anterior cingulate cortices.. In heavy-smoking individuals, prefrontal and anterior cingulate cortex MAO-A V(T) was greater during withdrawal (23.7% and 33.3%, respectively; repeated-measures multivariate analysis of variance, F(1,22) = 25.58, P < .001). During withdrawal from heavy smoking, prefrontal and anterior cingulate cortex MAO-A V(T) was greater than in healthy controls (25.0% and 25.6%, respectively; multivariate analysis of variance, F(2,33) = 6.72, P = .004). The difference in MAO-A V(T) in the prefrontal cortex and anterior cingulate cortex between withdrawal and active, heavy smoking covaried with change in plasma harman levels in the prefrontal cortex and anterior cingulate cortex (multivariate analysis of covariance, F(1,10) = 9.97, P = .01). The change in MAO-A V(T) between withdrawal and active, heavy smoking also covaried with severity of depression (multivariate analysis of covariance, F(1,10) = 11.91, P = .006).. The increase in prefrontal and anterior cingulate cortex MAO-A binding and associated reduction in plasma harman level represent a novel, additional explanation for depressed mood during withdrawal from heavy cigarette smoking. This finding resolves a longstanding paradox regarding the association of cigarette smoking with depression and suicide and argues for additional clinical trials on the effects of MAO-A inhibitors on quitting heavy cigarette smoking.

Topics: Adult; Carbon Radioisotopes; Depression; Diagnosis, Dual (Psychiatry); Female; Gyrus Cinguli; Harmine; Humans; Male; Monoamine Oxidase; Positron-Emission Tomography; Prefrontal Cortex; Severity of Illness Index; Smoking; Substance Withdrawal Syndrome; Tobacco Use Disorder