Polymorphisms of the DRD2 , ANKK1 , DAT1 , DBH , and DRD4 genes have been found to moderate the effects of pharmacotherapy  of alcohol , opioid , and cocaine use disorders .
The integration of genetic information with clinical data will inform health professionals of the most efficacious pharmacotherapeutic intervention for substance use disorders .
Substance use disorders have significant personal , familial , and societal consequences .
Despite the serious consequences of substance use , only a few therapies are effective in treating substance use disorders , thus highlighting a need for improved treatment practice s. Substance use treatment response depends on multiple factors such as genetic , biological , and social factors .
It is essential that each component is represented in treatment plans .
The dopaminergic system plays a critical role in the pharmacotherapy for addictions , and an underst and ing of the role of variation of genes involved in this system is essential for its success .
Bromocriptine reduces cigarette smoking.
AIMS Animal studies have shown that nicotine releases dopamine , a neurotransmitter implicated in drug reinforcement . We hypothesized that bromocriptine would decrease smoking behavior in humans . DESIGN The study was conducted double blind and subjects ' order of dose exposure was r and omized . PARTICIPANTS The smoking behavior of 20 heavy smokers was recorded for 5 hours after ingesting placebo or one of two doses of bromocriptine ( 2.50 mg , 3.75 mg ) over three sessions ( one dose per session ) . FINDINGS There was a significant negative linear trend by dosage indicating shorter total puffing time with increasing bromocriptine dosages ( p < 0.02 ) . Other significant negative linear trends by increasing dosage include fewer number of puffs , fewer number of cigarettes smoked and mean latency to smoke after 3 hours ( expected CMAX on the drug ( all ps < 0.05 ) . There was a negative significant linear trend showing decreased plasma nicotine ( p < 0.02 ) and cotinine ( p < 0.005 ) with increasing dosages of bromocriptine . Shiffman/Jarvik Withdrawal Scale ( SJWS ) cigarette craving subscale scores decreased significantly across increasing dosages ( linear trend p < 0.02 ) . There was a significant negative linear trend ( p < 0.05 ) on the Profile of Mood States ( POMS ) Vigor and Depression subscales , with subjects reporting decreased vigor and depression with increasing bromocriptine doses . No other mood effects were observed . CONCLUSION These results support the hypothesis that dopaminergic mechanisms mediate cigarette smoking reinforcement
Polymorphisms of the DRD2 , ANKK1 , DAT1 , DBH , and DRD4 genes have been found to moderate the effects of pharmacotherapy  of alcohol , opioid , and cocaine use disorders .
The integration of genetic information with clinical data will inform health professionals of the most efficacious pharmacotherapeutic intervention for substance use disorders .
Substance use disorders have significant personal , familial , and societal consequences .
Despite the serious consequences of substance use , only a few therapies are effective in treating substance use disorders , thus highlighting a need for improved treatment practice s. Substance use treatment response depends on multiple factors such as genetic , biological , and social factors .
It is essential that each component is represented in treatment plans .
The dopaminergic system plays a critical role in the pharmacotherapy for addictions , and an underst and ing of the role of variation of genes involved in this system is essential for its success .