Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, 27710, USA.
Ethismos Research, Inc, Cambridge, MA, USA.
Psychopharmacology (Berl). 2020 Jun;237(6):1681-1689. doi: 10.1007/s00213-020-05489-w. Epub 2020 Mar 3.
A variety of neural systems are involved in drug addiction, and some of these systems are shared across different addictive drugs. We have found several different types of drug treatments that successfully reduce nicotine self-administration.
The current set of studies is the first in a series to determine if drug treatments that have been found to significantly reduce nicotine self-administration would reduce opiate self-administration.
Amitifadine, a triple reuptake inhibitor of dopamine, norepinephrine, and serotonin, was assessed in female Sprague-Dawley rats to determine whether it significantly reduces remifentanil self-administration with either acute or chronic treatment.
Acutely, amitifadine doses of 5, 10, and 20 mg/kg each significantly reduced remifentanil self-administration. In a chronic study, repeated treatment with 10 mg/kg of amitifadine continued to reduce remifentanil self-administration, even after the cessation of treatment. However, amitifadine was not found to attenuate the rise in remifentanil self-administration with continued access. This study and our earlier one showed that the 10 mg/kg amitifadine dose did not significantly affect food motivated responding. Amitifadine did not attenuate remifentanil-induced antinociception as measured on the hot plate test but extended and maintained antinociceptive effects.
These studies show the promise of amitifadine as a treatment for countering opiate self-administration for adjunctive use with opioids for analgesia. Further studies are needed to determine the possible efficacy of amitifadine for combating opiate addiction or preventing it in humans during adjunctive use with opioids for chronic pain.
多种神经系统参与药物成瘾,其中一些系统在不同的成瘾药物中共享。我们已经发现了几种不同类型的药物治疗方法,这些方法都能成功减少尼古丁的自我给药。
当前这一系列研究旨在首次确定,已被发现能显著减少尼古丁自我给药的药物治疗方法是否能减少阿片类药物的自我给药。
阿米替林,一种多巴胺、去甲肾上腺素和 5-羟色胺三重再摄取抑制剂,在雌性 Sprague-Dawley 大鼠中进行评估,以确定其是否能显著减少瑞芬太尼的自我给药,无论是急性还是慢性治疗。
急性给药时,阿米替林 5、10 和 20mg/kg 剂量均显著减少瑞芬太尼的自我给药。在一项慢性研究中,重复给予 10mg/kg 的阿米替林继续减少瑞芬太尼的自我给药,即使在治疗停止后也是如此。然而,阿米替林并没有发现能减弱继续使用时瑞芬太尼自我给药的增加。本研究和我们之前的一项研究表明,10mg/kg 剂量的阿米替林不会显著影响食物驱动的反应。阿米替林不能减弱瑞芬太尼引起的热板测试中的镇痛作用,但能延长并维持镇痛作用。
这些研究表明,阿米替林作为一种治疗方法具有前景,可以作为阿片类药物自我给药的辅助治疗方法,与阿片类药物联合用于镇痛。需要进一步的研究来确定阿米替林在辅助使用阿片类药物治疗慢性疼痛时,预防或治疗阿片类药物成瘾的可能疗效。