Carisoprodol tolerance and precipitated withdrawal

AIMS

Carisoprodol is a muscle relaxant that acts at the GABA(A) receptor. Concerns about the abuse liability of carisoprodol are increasing, but evidence that carisoprodol produces tolerance and a significant withdrawal syndrome has yet to be established. The purpose of the current study was to determine if repeated administration of carisoprodol produces tolerance and withdrawal signs in a mouse model.

METHODS

Carisoprodol (0, 100, 200, 300, or 500 mg/kg bid, i.p.) was administered to Swiss-Webster mice for 4 days and loss-of-righting reflex was measured 20-30 min following each administration. On the fourth day, bemegride (20 mg/kg), flumazenil (20 mg/kg), or vehicle was administered following carisoprodol and withdrawal signs were measured. Separate groups of mice receiving the same treatment regimen and dose range were tested for spontaneous withdrawal at 6, 12 and 24 h after the last dose of carisoprodol.

RESULTS

The righting reflex was dose-dependently impaired following the first administration of carisoprodol. A 75-100% decrease in the magnitude of the impairment occurred over the four days of exposure, indicating the development of tolerance to the carisoprodol-elicited loss-of-righting reflex. Withdrawal signs were not observed within 24h following spontaneous withdrawal; however, bemegride and flumazenil each precipitated withdrawal within 15-30 min of administration.

CONCLUSIONS

Carisoprodol treatment resulted in tolerance and antagonist-precipitated withdrawal, suggesting it may have an addiction potential similar to that of other long-acting benzodiazepine or barbiturate compounds.

Noradrenergic mechanisms in neurodegenerative diseases: a theory

A deficiency in the noradrenergic system of the brain, originating largely from cells in the locus coeruleus (LC), is theorized to play a critical role in the progression of a family of neurodegenerative disorders that includes Parkinson's disease (PD) and Alzheimer's disease (AD). Consideration is given here to evidence that several neurodegenerative diseases and syndromes share common elements, including profound LC cell loss, and may in fact be different manifestations of a common pathophysiological process. Findings in animal models of PD indicate that the modification of LC-noradrenergic activity alters electrophysiological, neurochemical and behavioral indices of neurotransmission in the nigrostriatal dopaminergic system, and influences the response of this system to experimental lesions. In models related to AD, noradrenergic mechanisms appear to play important roles in modulating the activity of the basalocortical cholinergic system and its response to injury, and to modify cognitive functions including memory and attention. Mechanisms by which noradrenaline may protect or promote recovery from neural damage are reviewed, including effects on neuroplasticity, neurotrophic factors, neurogenesis, inflammation, cellular energy metabolism and excitotoxicity, and oxidative stress. Based on evidence for facilitatory effects on transmitter release, motor function, memory, neuroprotection and recovery of function after brain injury, a rationale for the potential of noradrenergic-based approaches, specifically alpha2-adrenoceptor antagonists, in the treatment of central neurodegenerative diseases is presented.

Effects of the alpha 2-adrenoreceptor antagonist dexefaroxan on neurogenesis in the olfactory bulb of the adult rat in vivo: selective protection against neuronal death

A dysfunction of noradrenergic mechanisms originating in the locus coeruleus has been hypothesised to be the critical factor underlying the evolution of central neurodegenerative diseases [Colpaert FC (1994) Noradrenergic mechanism Parkinson's disease: a theory. In: Noradrenergic mechanisms in Parkinson's disease (Briley M, Marien M, eds) pp 225-254. Boca Raton, FL, USA: CRC Press Inc.]. alpha(2)-Adrenoceptor antagonists, presumably in part by facilitating central noradrenergic transmission, afford neuroprotection in vivo in models of cerebral ischaemia, excitotoxicity and devascularization-induced neurodegeneration. The present study utilised the rat olfactory bulb as a model system for examining the effects of the selective alpha(2)-adrenoceptor antagonist dexefaroxan upon determinants of neurogenesis (proliferation, survival and death) in the adult brain in vivo. Cell proliferation (5-bromo-2'-deoxyuridine labelling) and cell death associated with DNA fragmentation (terminal dideoxynucleotidyl transferase-catalysed 2'-deoxyuridine-5'-triphosphate nick end-labelling assay) were quantified following a 7-day treatment with either vehicle or dexefaroxan (0.63 mg/kg i.p., three times daily), followed by a 3-day washout period. The number of terminal dideoxynucleotidyl transferase-catalysed 2'-deoxyuridine-5'-triphosphate nick end-labelling-positive nuclei in the olfactory bulb was lower in dexefaroxan-treated rats, this difference being greatest and significant in the subependymal layer (-52%). In contrast, 5-bromo-2'-deoxyuridine-immunoreactive nuclei were more numerous (+68%) in the bulbs of dexefaroxan-treated rats whilst no differences were detected in the proliferating region of the subventricular zone. Terminal dideoxynucleotidyl transferase-catalysed 2'-deoxyuridine-5'-triphosphate nick end-labelling combination with glial fibrillary acidic protein or neuronal-specific antigen immunohistochemistry revealed that terminal dideoxynucleotidyl transferase-catalysed 2'-deoxyuridine-5'-triphosphate nick end-labelling-positive nuclei were associated primarily with a neuronal cell phenotype. These findings suggest that dexefaroxan increases neuron survival in the olfactory bulb of the adult rat in vivo, putatively as a result of reducing the apoptotic fate of telencephalic stem cell progenies.

Effects of acute and subchronic administration of dexefaroxan, an alpha(2)-adrenoceptor antagonist, on memory performance in young adult and aged rodents

The present study examined the influence of dexefaroxan, a potent and selective alpha(2)-adrenoceptor antagonist, on cognitive performance in rodents. In young adult rats, dexefaroxan reversed the deficits induced by UK 14304 [5-bromo-N-(4,5-dihydro-1-H-imidazol-2-yl)-6-quinoxalinamine], scopolamine, and diazepam in a passive avoidance task. In this test, dexefaroxan also attenuated the spontaneous forgetting induced by a 15-week training-testing interval. Moreover, dexefaroxan, given immediately after training, increased the memory performance of rats trained with a weak electric footshock in the passive avoidance test, facilitated spatial memory processes in the Morris water maze task in rats, and increased the performance of mice in an object recognition test. Thus, dexefaroxan appears to have a promnesic effect in these tests by facilitating the processes of memory retention, rather than acquisition or other noncognitive influences. The facilitatory effects of dexefaroxan in young adult rats persisted even after a 21- to 25-day constant subcutaneous infusion by using osmotic minipumps, indicating that tolerance to the promnesic effect of the drug did not occur during this prolonged treatment interval. Furthermore, in the passive avoidance and Morris water maze tests, dexefaroxan ameliorated the age-related memory deficits of 24-month-old rats to a level that was comparable to that of young adult animals, and reversed the memory deficits induced by excitotoxin lesions of the nucleus basalis magnocellularis region. Together, these findings support a potential utility of dexefaroxan in the treatment of cognitive deficits occurring in Alzheimer's disease.

New 2-substituted 1,2,3,4-tetrahydrobenzofuro[3,2-c]pyridine having highly active and potent central alpha 2-antagonistic activity as potential antidepressants

The synthesis and biological activity of a series of benzofuro[3,2-c]pyridines and a benzothieno[3,2-c]pyridine are described. These compounds exhibit high affinity for the alpha 2-adrenoceptor, with high selectivity versus the alpha 1-receptor. Compound 1 also shows potent in vivo central activity and has been selected for further biological and clinical evaluation.

Neuroprotective effects of the alpha2-adrenoceptor antagonists, (+)-efaroxan and (+/-)-idazoxan, against quinolinic acid-induced lesions of the rat striatum

A deficient control of neuronal repair mechanisms by noradrenergic projections originating from the locus coeruleus may be a critical factor in the progression of neurodegenerative diseases. Blockade of presynaptic inhibitory alpha2-adrenergic autoreceptors can disinhibit this system, facilitating noradrenaline release. In order to test the neuroprotective potential of this approach in a model involving excitotoxicity, the effects of treatments with the alpha2-adreneceptor antagonists, (+)-efaroxan (0.63 mg/kg i.p., thrice daily for 7 days) or (+/-)-idazoxan (2.5 mg/kg i.p., thrice daily for 7 days), were evaluated in rats which received a quinolinic acid-induced lesion of the left striatum. Both drug treatments resulted in a reduced ipsiversive circling response to apomorphine and a reduced choline acetyltransferase deficit in the lesioned striatum. The mechanisms underlying this effect are not known for certain, but may include noradrenergic receptor modulation of glial cell function, growth factor synthesis and release, activity of glutamatergic corticostriatal afferents, and/or events initiated by NMDA receptor activation. These results suggest a therapeutic potential of alpha2-adrenoceptor antagonists in neurodegenerative disorders where excitotoxicity has been implicated.

Antipsychotic-like profile of alstonine

Although recently developed drugs have brought significant improvement, the treatment of psychotic disorders still presents serious drawbacks. Because inherent complexity and lack of satisfactory understanding of the underlying pathophysiology impose limits for rational drug design, resourceful approaches in the search for antipsychotics are pertinent. This article reports pharmacological properties of alstonine, a heteroyohimbine-type alkaloid, which exhibited an antipsychotic-like profile, inhibiting amphetamine-induced lethality, apomorphine-induced stereotypy, and potentiating barbiturate-induced sleeping time. Atypical features of alstonine were the prevention of haloperidol-induced catalepsy and lack of direct interaction with D1, D2 and 5-HT2A receptors, classically linked to antipsychotic mechanism of action.

The alpha 2-adrenoceptor antagonist, (+)-efaroxan, enhances acetylcholine release in the rat cortex in vivo

Noradrenergic modulation of the cortical cholinergic system in vivo was studied by examining the effect of the selective alpha 2-adrenoceptor antagonist (+)-efaroxan on cortical acetylcholine outflow in the conscious rat, using the microdialysis technique. (+)-Efaroxan produced a dose-dependent increase in acetylcholine outflow (up to 300% at 0.63 mg/kg) which persisted for up to 3 h and which was stereospecific. The results demonstrate that rat cortical acetylcholine release can be augmented by (+)-efaroxan and that alpha 2-adrenoceptors may be involved. (+)-Efaroxan may have therapeutic potential in disorders in which cortical acetylcholine release is deficient.

Has iprindole an alpha adrenergic activity?

1. Acute administration of iprindole potentiated the toxicity of 1-norepinephrine and increased the intensity of oxotremorine-induced tremors. 2. On the forced swimming test combination iprindole with imipramine reduced the duration of immobility. 3. The action of yohimbine on the locomotor activity was antagonized by a pre-injection of iprindole. 4. Iprindole increased and prolonged exophthalmia and loss of righting reflex induced by xylazine. 5 All these results seems indicate that iprindole has an indirect alpha 1 and alpha 2 adrenergic activity.

Alpha 2 receptors mediate the antinociceptive action of 8-OH-DPAT in the hot-plate test in mice

The prototypical 5-HT1A agonist, 8-OH-DPAT, dose-dependently (0.16-10.0 mg/kg, s.c.) elicited a pronounced antinociception in the hot-plate test in mice. This action was not affected by the 5-HT1A antagonists, BMY 7378, (-)-pindolol and (-)-alprenolol nor by selective antagonists at 5-HT1C, 5-HT2 and 5-HT3 receptors. It was also resistant to antagonists at D1, D2, alpha 1 and opioid receptors. In contrast, it was blocked by the alpha 2 antagonists, idazoxan, rauwolscine and yohimbine. L 659,066, a selective alpha 2 antagonist which does not enter the CNS, was ineffective. The action of 8-OH-DPAT was mimicked by the centrally acting alpha 2 agonists, UK 14,304 and guanabenz whereas ST 91, which does not penetrate the blood-brain barrier, was inactive. The action of UK 14,304 and guanabenz was also blocked by idazoxan, rauwolscine and yohimbine but not by L 659,066. These data indicate that the antinociceptive properties of 8-OH-DPAT in the hot-plate test in mice are mediated by CNS-localized alpha 2 receptors, rather than 5-HT1A receptors.

Effects of xylazine on cerebrospinal fluid catecholamines in the rhesus monkey

The i.v. administration of xylazine, a potent, selective alpha 2-adrenergic receptor agonist, resulted in a 76% decrease in cerebrospinal fluid (CSF) norepinephrine in chair-adapted rhesus monkeys. A significant decrease was observed within 1.5 h of administration and continued through the 3 h course of sampling. Dopamine was maximally decreased by 24% at 1.5 h. Epinephrine was not significantly decreased following xylazine administration. These data suggest that norepinephrine release into monkey CSF, as an index of central or peripheral norepinephrine turnover, is more sensitive to alpha 2-adrenergic agonists than in CSF dopamine or epinephrine.