Journal
ACTA NEUROPSYCHIATRICA
Volume 33, Issue 1, Pages 1-8Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/neu.2020.41
Keywords
addiction; calcidiol; calcitriol; vitamin D Receptor; dopaminergic neurotransmission
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Vitamin D deficiency may affect patients with addictions, but research on its mechanistic role in addiction is still insufficient. Studies suggest a possible influence of vitamin D on dopaminergic transmission, with vitamin D status depending on genetic variants and other involved genes.
Objective: Vitamin D deficiency may be a clinical problem in patients with addictions. The authors systematically searched for studies addressing vitamin D and addiction and develop a hypothesis which can direct future research of the possible mechanistic role of vitamin D in the process of addiction. Methods: Systematic review of the literature found in PubMed and EMBASE followed by narrative review combined with clinical experiences leading to hypotheses for future research. Results: Only five articles were identified about a role of vitamin D in the pathophysiology of addiction. Their results are in line with a possible influence of vitamin D in dopaminergic transmission. The cerebral vitamin D status depends on the functionality of genetic variants of vitamin D receptor and other involved genes. Routine serum calcidiol levels may not adequately reflect cerebral vitamin D status. Uncertainty exists regarding appropriate calcidiol blood levels and proper dosages for affecting the central nervous system (CNS). Conclusions: The putative pathophysiological role of vitamin D in substance abuse has been insufficiently studied which calls to more studies how to measure cerebral vitamin D status in clinical practice. Research is indicated whether vitamin D supplementation should use higher dosages and aim to reach higher calcidiol serum levels. Measuring dopaminergic functioning within the prefrontal cortex as reflected by neuropsychological tests selected as suitable could be a appropriate proxy for the cerebral vitamin D status when studying the pharmacogenomics of this functionality in patients.
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