Taylor J R, Lewis V O, Elsworth J D, Pivirotto P, Roth R H, Redmond D E
Neurobehavioral Laboratory, Yale University School of Medicine, New Haven, CT 06510.
Psychopharmacology (Berl). 1991;103(3):407-14. doi: 10.1007/BF02244297.
Noradrenergic neuronal hyperactivity following chronic morphine administration has been postulated to cause withdrawal signs and symptoms. Suppression of this hyperactivity, for example, by clonidine attenuates withdrawal. It might follow, therefore, that the prevention of suppression of noradrenergic systems during chronic morphine administration might diminish hyperactivity and prevent withdrawal. If the normalization of noradrenergic activity during opioid administration did not also suppress analgesia, it might be of medical and theoretical interest. To test this hypothesis, we gave the alpha-2-antagonist yohimbine to rats in order to increase noradrenergic activity during morphine treatment and then subsequently precipitated morphine withdrawal with naloxone. Six groups were examined: saline controls (N = 11), morphine (N = 11), morphine + 2.0 mg/kg/day yohimbine (N = 15), morphine + 3.0 mg/kg/day yohimbine (N = 5), 2.0 mg/kg/day yohimbine (N = 11) and 3.0 mg/kg/day yohimbine (N = 5). Subjects received 75 mg morphine pellets implanted on day 1,4 and 6 of the treatment or sham implantation. Yohimbine was delivered throughout the morphine treatment by subcutaneously implanted osmotic pumps. On day 7, all subjects were given 1.0 mg/kg naloxone and rated for behavioral signs of withdrawal. Analgesia was measured by observing tail flick latencies (TFL) before and after chronic drug treatments. Naloxone-precipitated withdrawal was characterized by irritability, ptosis, penile erection, diarrhea, rhinorrhea, abnormal posture, wet-dog shakes, jumping, and teeth chattering, none of which were observed in groups receiving only saline or yohimbine. Withdrawal behavior was attenuated in a dose-dependent manner when yohimbine was administered during morphine treatment but analgesia was not attenuated.(ABSTRACT TRUNCATED AT 250 WORDS)
长期给予吗啡后去甲肾上腺素能神经元的活动亢进被认为会导致戒断症状。例如,可乐定抑制这种活动亢进可减轻戒断反应。因此可以推断,在长期给予吗啡期间预防去甲肾上腺素能系统的抑制可能会减轻活动亢进并预防戒断反应。如果在给予阿片类药物期间去甲肾上腺素能活性恢复正常但不抑制镇痛作用,这可能具有医学和理论意义。为了验证这一假设,我们给大鼠注射α-2拮抗剂育亨宾,以在吗啡治疗期间增加去甲肾上腺素能活性,然后随后用纳洛酮诱发吗啡戒断反应。研究了六组:生理盐水对照组(N = 11)、吗啡组(N = 11)、吗啡 + 2.0毫克/千克/天育亨宾组(N = 15)、吗啡 + 3.0毫克/千克/天育亨宾组(N = 5)、2.0毫克/千克/天育亨宾组(N = 11)和3.0毫克/千克/天育亨宾组(N = 5)。在治疗的第1、4和6天给受试动物植入75毫克吗啡丸剂或假植入。在整个吗啡治疗期间通过皮下植入渗透泵给予育亨宾。在第7天,给所有受试动物注射1.0毫克/千克纳洛酮,并对戒断行为体征进行评分。通过观察慢性药物治疗前后的甩尾潜伏期(TFL)来测量镇痛作用。纳洛酮诱发的戒断反应表现为易怒、眼睑下垂、阴茎勃起、腹泻、流涕、异常姿势、湿狗样抖动、跳跃和牙齿打颤,在仅接受生理盐水或育亨宾的组中均未观察到这些表现。当在吗啡治疗期间给予育亨宾时,戒断行为以剂量依赖的方式减弱,但镇痛作用未减弱。(摘要截短于250字)