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Psychic dependence? A different formulation of the problem with a view to the reorientation of therapy for chronic drug addiction

Disputing the concept of “psychic dependence”, the authors review six motivations to use addictive drugs, four of which pertain to the moment of assumption of the habit, and two of which, identifiable with physical and psychic dependence, dependence, depend on breaking of the habit. While physical dependence is linked to withdrawal syndrome, psychic dependence, in the authors' opinion, is related to a long‐standing previous state of true or masked endogenous depression (in this case it would be well termed “neuropsychological dependence”), and the drug taking is only a maladaptive self‐medication. This thesis is substantiated by the literature reporting, in chronic drug addicts, the use of the whole series of antidepressants (i.e. tricyclics, doxepine, lithium, etc.) with noticeable therapeutical success. In accordance with other reports and with personal experience, the authors assign great importance to the drugs acting, directly or indirectly, on GABA, i.e. L‐glutamine, piracetam, and, particularly, N‐dipropylacetic acid.