5-HT3 agonist-induced dopamine overflow during withdrawal from continuous or intermittent cocaine administration

Mirtazapine decreased cocaine-induced c-fos expression and dopamine release in rats

Introduction

Chronic cocaine exposure induces an increase in dopamine release and an increase in the expression of the Fos protein in the rat striatum. It has been suggested that both are necessary for the expression of cocaine-induced alterations in behavior and neural circuitry. Mirtazapine dosing attenuated the cocaine-induced psychomotor and reinforcer effects.

Methods

The study evaluates the effect of chronic dosing of mirtazapine on cocaine-induced extracellular dopamine levels and Fos protein expression in rats. Male Wistar rats received cocaine (10 mg/Kg; i.p.) during the induction and expression of locomotor sensitization. The mirtazapine (30 mg/Kg; MIR), was administered 30 minutes before cocaine during the cocaine withdrawal. After each treatment, the locomotor activity was recorded for 30 minutes. Animals were sacrificed after treatment administration. Dopamine levels were determined by high-performance liquid chromatographic (HPLC) in the ventral striatum, the prefrontal cortex (PFC), and the ventral tegmental area (VTA) in animals treated with mirtazapine and cocaine. The quantification of c-fos immunoreactive cells was carried out by stereology analysis.

Results

Mirtazapine generated a decrease in cocaine-induced locomotor activity. In addition, mirtazapine decreased the amount of cocaine-induced dopamine and the number of cells immunoreactive to the Fos protein in the striatum, PFC, and VTA.

Discussion

These data suggest that mirtazapine could prevent the consolidation of changes in behavior and the cocaine-induced reorganization of neuronal circuits. It would explain the mirtazapine-induced effects on cocaine behavioral sensitization. Thus, these data together could support its possible use for the treatment of patients with cocaine use disorder.

Mirtazapine-induced decrease in cocaine sensitization is enhanced by environmental enrichment in rats

Several studies have reported that mirtazapine attenuated the induction and expression of cocaine-induced locomotor sensitization. Animals placed in enriched housing environments have shown a decrease in cocaine-induced locomotor activity and sensitization. In addition, it has been suggested that a pharmacological treatment combined with a behavioral intervention increases the efficacy of the former. Thus, the objective of this study was to determine if dosing of mirtazapine in an enriched housing environment enhanced the mirtazapine-induced decrease on the induction and expression of cocaine-induced locomotor sensitization. Wistar male rats were dosed with cocaine (10 mg/kg, i.p.). During the drug-withdrawal phase, mirtazapine (30 mg/kg, i.p.) was administered under standard and enriched housing environmental conditions. The environmental enrichment consisted of housing the animals in enclosures with plastic toys, tunnels, and running wheels. After each administration, locomotor activity for each animal was recorded for 30 min. The study found that treatment with mirtazapine in an enriched housing environment produced an enhanced and persistent attenuation of the induction and expression of cocaine-induced locomotor sensitization. Additionally, it reduced the duration of cocaine-induced locomotor activity in the expression phase of locomotor sensitization. Dosing of mirtazapine in an enriched housing environment enhanced the effectiveness of mirtazapine to decrease cocaine-induced locomotor sensitization. This suggests the potential use of enriched environments to enhance the effect of mirtazapine.

Role of 5-HT3 Receptors in the Antidepressant Response

Serotonin (5-HT)₃ receptors are the only ligand-gated ion channel of the 5-HT receptors family. They are present both in the peripheral and central nervous system and are localized in several areas involved in mood regulation (e.g., hippocampus or prefrontal cortex). Moreover, they are involved in regulation of neurotransmitter systems implicated in the pathophysiology of major depression (e.g., dopamine or GABA). Clinical and preclinical studies have suggested that 5-HT₃ receptors may be a relevant target in the treatment of affective disorders. 5-HT₃ receptor agonists seem to counteract the effects of antidepressants in non-clinical models, whereas 5-HT₃ receptor antagonists, such as ondansetron, present antidepressant-like activities. In addition, several antidepressants, such as mirtazapine, also target 5-HT₃ receptors. In this review, we will report major advances in the research of 5-HT₃ receptor's roles in neuropsychiatric disorders, with special emphasis on mood and anxiety disorders.

The role of 5-HT3 receptors in drug abuse and as a target for pharmacotherapy

Alcohol and drug abuse continue to be a major public health problem in the United States and other industrialized nations. Extensive preclinical research indicates the mesolimbic dopamine (DA) pathway and associated regions mediate the rewarding and reinforcing effects of drugs of abuse and natural rewards, such as food and sex. The serotonergic (5-HT) system, in concert with others neurotransmitter systems, plays a key role in modulating neuronal systems within the mesolimbic pathway. A substantial portion of this modulation is mediated by activity at the 5-HT3 receptor. The 5-HT3 receptor is unique among the 5-HT receptors in that it directly gates an ion channel inducing rapid depolarization that, in turn, causes the release of neurotransmitters and/or peptides. Preclinical findings indicate that antagonism of the 5-HT3 receptor in the ventral tegmental area, nucleus accumbens or amygdala reduces alcohol self-administration and/or alcohol-associated effects. Less is known about the effects of 5-HT3 receptor activity on the self-administration of other drugs of abuse or their associated effects. Clinical findings parallel the preclinical findings such that antagonism of the 5-HT3 receptor reduces alcohol consumption and some of its subjective effects. This review provides an overview of the structure, function, and pharmacology of 5-HT3 receptors, the role of these receptors in regulating DA neurotransmission in mesolimbic brain areas, and discusses data from animal and human studies implicating 5-HT3 receptors as targets for the development of new pharmacological agents to treat addictions.

Pharmacologic mechanisms of serotonergic regulation of dopamine neurotransmission

The neurotransmitter dopamine (DA) has a long association with normal functions such as motor control, cognition, and reward, as well as a number of syndromes including drug abuse, schizophrenia, and Parkinson's disease. Studies show that serotonin (5-HT) acts through several 5-HT receptors in the brain to modulate DA neurons in all 3 major dopaminergic pathways. There are at least fourteen 5-HT receptor subtypes, many of which have been shown to play some role in mediating 5-HT/DA interactions. Several subtypes, including the 5-HT1A, 5-HT1B, 5-HT2A, 5-HT3 and 5-HT4 receptors, act to facilitate DA release, while the 5-HT2C receptor mediates an inhibitory effect of 5-HT on DA release. Most 5-HT receptor subtypes only modulate DA release when 5-HT and/or DA neurons are stimulated, but the 5-HT2C receptor, characterized by high levels of constitutive activity, inhibits tonic as well as evoked DA release. This review summarizes the anatomical evidence for the presence of each 5-HT receptor subtype in dopaminergic regions of the brain and the neuropharmacological evidence demonstrating regulation of each DA pathway. The relevance of 5-HT receptor modulation of DA systems to the development of therapeutics used to treat schizophrenia, depression, and drug abuse is discussed. Lastly, areas are highlighted in which future research would be maximally beneficial to the treatment of these disorders.

Intracranial self-administration of cocaine within the posterior ventral tegmental area of Wistar rats: evidence for involvement of serotonin-3 receptors and dopamine neurons

The rewarding properties of cocaine have been postulated to be regulated, in part, by the mesolimbic dopamine (DA) system. The present study assessed whether adult female Wistar rats would self-administer cocaine directly into the ventral tegmental area (VTA). Following guide cannulae surgery aimed at either the posterior or anterior VTA, subjects were placed in an operant box equipped with an active lever that caused the delivery of the infusate and an inactive lever that did not. Posterior and anterior VTA subjects were randomly assigned to one of six groups that self-administered either artificial cerebrospinal fluid (aCSF) or 25 to 400 pmol cocaine/100 nl in aCSF for the first four sessions, aCSF in sessions 5 and 6, and the acquisition dose of infusate during session 7. Additionally, the effects of increasing the time-out period, higher concentrations of cocaine, coadministration of a 5HT3 antagonist, and coadministration of a D2/3 agonist on self-infusion of cocaine were determined. Self-infusions were maintained when the time-out period was extended from 5 to 25 s. Coinfusion of a 5HT3 antagonist or D2/3 agonist blocked the self-infusion of cocaine. In contrast, rats did not self-administer 25 to 400 pmol/100 nl cocaine into the anterior VTA. Additionally, rats did not self-administer either 800 or 1600 pmol/100 nl cocaine into the posterior or anterior VTA. Overall, the data indicate that the VTA is functionally heterogeneous with regard to the rewarding actions of cocaine and that the reinforcing effects of cocaine within the posterior VTA are mediated by activation 5-HT3 receptors and DA neurons.

The effects of continuous cocaine dose, treatment, and withdrawal duration on the induction of behavioral tolerance and dopamine autoreceptor function

The present experiment evaluated the interactions between continuous cocaine dose, duration of administration, and duration of withdrawal on the induction of behavioral tolerance and changes in dopamine autoreceptor (DA) function. In the current experiments, rats were exposed to a pretreatment regimen involving the continuous administration of 0, 5, or 20 mg/kg/day cocaine for either 3 or 7 days. All subjects were then withdrawn from the pretreatment regimen for 1 or 7 days. For the experiments examining behavioral tolerance, the subjects received 15.0 mg/kg ip cocaine. For the experiments examining alterations in DA function, the subjects received a 0.063 mg/kg ip quinpirole injection, followed 5 min later by a 15.0 mg/kg ip cocaine injection. For all experiments, the subjects were placed in activity monitors, and ambulation was measured for 60 min. The results indicated that all continuous cocaine durations induced significant changes in cocaine-induced behavior at the 1-day withdrawal period. However, for tolerance to be exhibited on the 7-day withdrawal period, either high-dose or long-duration continuous cocaine had to be administered. This tolerance was associated with an increase in DA sensitivity. However, the change in DAs was dose- or duration-dependently related to tolerance. Overall, the literature suggests that behavioral tolerance following continuous cocaine administration may be mediated by multiple, time-dependent mechanisms that operate in an all-or-none manner.

Differential Modulation of Clock Speed by the Administration of Intermittent Versus Continuous Cocaine

The roles that psychostimulant sensitization and tolerance play in temporal perception in the seconds-to-minutes range were assessed in rats. Cocaine (20 mg/kg/day) was administered for 2 weeks either intermittently via daily injections (induces sensitization) or continuously via an osmotic minipump (induces tolerance). Interval timing was evaluated throughout administration and withdrawal. Injections of cocaine caused immediate, proportional, leftward shifts in peak times, indicating an increase in the speed of an internal clock. These shifts grew progressively larger with repeated administration, indicating that stimulant-induced increases in clock speed can be sensitized. Continuous cocaine administration produced no reliable effects. These results suggest that the mechanisms of sensitization may play a considerable role in drug-induced alterations of the perception of time.

The effects of continuous 5-HT(3) receptor antagonist administration on the subsequent behavioral response to cocaine

A functional down-regulation of central serotonin3 (5-HT(3)) receptors represents a partial mechanism of the tolerance to cocaine induced by the continuous administration of cocaine. Blocking this down-regulation by co-administering continuous cocaine and daily injections of 5-HT(3) receptor antagonists blocks the development of tolerance. The present experiment evaluated the ability of continuously administered 5-HT(3) receptor antagonists, to induce sensitization (reverse tolerance) to the behavioral effects of cocaine, based on the hypothesis that chronic blockade of 5-HT(3) receptors should induce an up-regulation of these receptors. In all experiments, rats received a 14 day pretreatment involving the continuous administration of tropisetron (0.0, 1.0, 4.0, or 8.0 mg/kg/day) or LY 278584 (0.001, 0.01, or 0.1 mg/kg/day). The rats were withdrawn for 7 days from this pretreatment regimen. On day 7 of withdrawal from the pretreatment regiment, the rats received a 0.0, 7.5, or 15.0 mg/kg i.p. cocaine challenge. Ambulatory behavior was automatically recorded for 60 min. Both continuous tropisetron and LY 278584, opposite to the initial hypothesis, induced tolerance, and not sensitization, to the behavioral effects of cocaine. The results clearly indicate that central 5-HT(3) receptors are critical for the effects of chronic cocaine administration.

The effects of continuous cocaine duration on the induction of behavioral tolerance and dopamine autoreceptor function

The current experiment evaluated the duration-dependent nature of the induction of behavioral tolerance and changes in dopamine autoreceptor function by continuously administering cocaine for different durations. For all experiments, rats were exposed to a pretreatment regimen involving the continuous administration of 40 mg/kg/day cocaine. The pretreatment regimen lasted 3, 7, or 14 days. All subjects were then withdrawn from the pretreatment regimen for 7 days. The subjects were placed in activity monitors and ambulation measured. In experiment 1, the subjects were challenged with 0.0, 7.5, or 15.0 mg/kg i.p. cocaine on day 7 of withdrawal from the continuous cocaine administration regimen. The results indicated that all continuous cocaine durations induced significant tolerance to the 7.5 and 15.0 mg/kg cocaine challenge, relative to the control group. However, the magnitude of tolerance was not duration dependent. In experiment 2, the subjects were challenged with 0.063 or 0.125 mg/kg quinpirole. The results indicated that the 0.063 mg/kg quinpirole challenge inhibited activity in both pretreatment groups, while the 0.125 mg/kg quinpirole challenge enhanced behavior in the saline control, but not the cocaine, pretreatment group. In experiment 3, the subjects were challenged with the same doses of quinpirole in combination with 7.5 mg/kg i.p. cocaine. Both quinpirole challenge doses inhibited cocaine-induced hyperactivity. The results suggest that the induction of tolerance by continuous cocaine administration is not duration-dependent. Continuous cocaine administration did induce dopamine autoreceptor supersensitivity. Different continuous cocaine durations may induce differential degrees of dopamine autoreceptor supersensitivity.

The effects of continuous cocaine dose on the induction of behavioral tolerance and dopamine autoreceptor function

The current experiment evaluated the dose-dependent nature of the induction of behavioral tolerance, and changes in dopamine autoreceptor function, by continuously administering different doses of cocaine. For all experiments, rats were exposed to a 14-day pretreatment regimen involving the continuous administration of either 0, 5, 10, 20, or 40 mg/kg/day cocaine. All subjects were then withdrawn from the pretreatment regimen for 7 days. The subjects were placed in activity monitors, and ambulation measured. In experiment 1, the subjects were challenged with 0.0, 7.5, or 15.0 mg/kg i.p. cocaine on day 7 of withdrawal from the continuous cocaine administration regimen. The results indicated that all continuous cocaine doses induced significant tolerance to the 15.0 mg/kg cocaine challenge, relative to the control group. Furthermore, the 5.0 mg/kg/day group exhibited significantly less tolerance than the 40.0 mg/kg/day group. In experiment 2, the subjects were challenged with 0.0, 0.063, or 0.125 mg/kg quinpirole. The results indicated that the 0.063-mg/kg quinpirole challenge inhibited activity, while the 0.125 mg/kg quinpirole challenge enhanced behavior. The results further suggested that the inhibition of behavior was greater in the cocaine-pretreated subjects than in the saline control group. In experiment 3, the subjects were challenged with the same doses of quinpirole in combination with 15 mg/kg i.p. cocaine. The low quinpirole challenge dose inhibited cocaine-induced hyperactivity, while the higher challenge dose enhanced cocaine-induced hyperactivity. The results suggest that the induction of tolerance by continuous cocaine administration is dose-dependent. Continuous cocaine administration did induce dopamine autoreceptor supersensitivity. However, different continuous cocaine doses did not induce differential degrees of dopamine autoreceptor supersensitivity.

Blockade of accumbens 5-HT3 receptor down-regulation by ondansetron administered during continuous cocaine administration

The present experiment examined whether ondansetron, co-administered with continuous cocaine, would block the down regulation of accumbens 5-HT3 receptors. Rats were exposed to a 14-day pretreatment regimen that involved the continuous infusion of 40 mg kg(-1) day(-1) cocaine or 0.9% saline via a subcutaneously implanted osmotic minipump. In addition to the continuous cocaine or saline administration, all subjects received daily subcutaneous (s.c.) injections of either vehicle or 0.1 mg kg(-1) ondansetron for the entire 14-day pretreatment regimen. The rats were then withdrawn from this pretreatment regimen for seven days, and slices from the nucleus accumbens obtained. The slices were perfused with 25 mM K+ in the absence and presence of 0, 12.5, 25, or 50 microM m-Chlorophenyl-biguanide HCl (mCPBG). The efflux samples were assayed for dopamine content by high pressure liquid chromatography (HPLC) with electrochemical detection. Continuous cocaine administration significantly attenuated the ability of mCPBG to facilitate K+-induce dopamine overflow compared to saline control rats. In addition, the rats that received ondansetron and cocaine during the 14-day pretreatment period, the ability of mCPBG to enhance K+ stimulated dopamine release was not significantly different from the saline control subjects. For all groups except the cocaine alone group, the effects of mCPBG on K+ stimulated dopamine release were Ca2+ dependent, suggesting that these effects are receptor mediated. These results suggest that continuous cocaine administration functionally down-regulates 5-HT3 receptors in the nucleus accumbens, and that this down-regulation can be blocked by chronic ondansetron administration. Hence, a functional down regulation of accumbens 5-HT3 receptors represents a significant contribution to the tolerance induced by continuous cocaine administration.