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Yates JR. Pharmacological Treatments for Methamphetamine Use Disorder: Current Status and Future Targets. Subst Abuse Rehabil 2024; 15:125-161. [PMID: 39228432 PMCID: PMC11370775 DOI: 10.2147/sar.s431273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 08/15/2024] [Indexed: 09/05/2024] Open
Abstract
The illicit use of the psychostimulant methamphetamine (METH) is a major concern, with overdose deaths increasing substantially since the mid-2010s. One challenge to treating METH use disorder (MUD), as with other psychostimulant use disorders, is that there are no available pharmacotherapies that can reduce cravings and help individuals achieve abstinence. The purpose of the current review is to discuss the molecular targets that have been tested in assays measuring the physiological, the cognitive, and the reinforcing effects of METH in both animals and humans. Several drugs show promise as potential pharmacotherapies for MUD when tested in animals, but fail to produce long-term changes in METH use in dependent individuals (eg, modafinil, antipsychotic medications, baclofen). However, these drugs, plus medications like atomoxetine and varenicline, may be better served as treatments to ameliorate the psychotomimetic effects of METH or to reverse METH-induced cognitive deficits. Preclinical studies show that vesicular monoamine transporter 2 inhibitors, metabotropic glutamate receptor ligands, and trace amine-associated receptor agonists are efficacious in attenuating the reinforcing effects of METH; however, clinical studies are needed to determine if these drugs effectively treat MUD. In addition to screening these compounds in individuals with MUD, potential future directions include increased emphasis on sex differences in preclinical studies and utilization of pharmacogenetic approaches to determine if genetic variances are predictive of treatment outcomes. These future directions can help lead to better interventions for treating MUD.
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Affiliation(s)
- Justin R Yates
- Department of Psychological Science, Northern Kentucky University, Highland Heights, KY, USA
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Calma ID, Persons AL, Napier TC. Mitochondrial function influences expression of methamphetamine-induced behavioral sensitization. Sci Rep 2021; 11:24529. [PMID: 34972820 PMCID: PMC8720100 DOI: 10.1038/s41598-021-04301-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 12/13/2021] [Indexed: 12/21/2022] Open
Abstract
Repeated methamphetamine use leads to long lasting brain and behavioral changes in humans and laboratory rats. These changes have high energy requirements, implicating a role for mitochondria. We explored whether mitochondrial function underpins behaviors that occur in rats months after stopping methamphetamine self-administration. Accordingly, rats self-administered intravenous methamphetamine for 3 h/day for 14 days. The mitochondrial toxin rotenone was administered as (1 mg/kg/day for 6 days) via an osmotic minipump starting at 0, 14 or 28 days of abstinence abstinence. On abstinence day 61, expression of methamphetamine-induced behavioral sensitization was obtained with an acute methamphetamine challenge in rotenone-free rats. Rotenone impeded the expression of sensitization, with the most robust effects obtained with later abstinence exposure. These findings verified that self-titration of moderate methamphetamine doses results in behavioral (and thus brain) changes that can be revealed months after exposure termination, and that the meth-initiated processes progressed during abstinence so that longer abstinence periods were more susceptible to the consequences of exposure to a mitochondrial toxin.
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Affiliation(s)
- I. Daphne Calma
- grid.240684.c0000 0001 0705 3621Departments of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL 60612 USA ,grid.240684.c0000 0001 0705 3621Center for Compulsive Behavior and Addiction, Rush University Medical Center, Chicago, IL 60612 USA
| | - Amanda L. Persons
- grid.240684.c0000 0001 0705 3621Departments of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL 60612 USA ,grid.240684.c0000 0001 0705 3621Departments of Physician Assistant Studies, Rush University Medical Center, Chicago, IL 60612 USA ,grid.240684.c0000 0001 0705 3621Center for Compulsive Behavior and Addiction, Rush University Medical Center, Chicago, IL 60612 USA
| | - T. Celeste Napier
- grid.240684.c0000 0001 0705 3621Departments of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL 60612 USA ,grid.240684.c0000 0001 0705 3621Center for Compulsive Behavior and Addiction, Rush University Medical Center, Chicago, IL 60612 USA ,grid.240684.c0000 0001 0705 3621Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Suite 424, Cohn Research Building, 1735 W. Harrison Street, Chicago, IL 60610 USA
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Ombach HJ, Scholl LS, Bakian AV, Renshaw KT, Sung YH, Renshaw PF, Kanekar S. Association between altitude, prescription opioid misuse, and fatal overdoses. Addict Behav Rep 2019; 9:100167. [PMID: 31193784 PMCID: PMC6542744 DOI: 10.1016/j.abrep.2019.100167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 01/10/2019] [Accepted: 02/01/2019] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Prescription opioid misuse and fatal overdoses have increased significantly over the last two decades. Living at altitude has been linked to greater reward benefits of other drugs of abuse, and living at altitude may also exacerbate the respiratory depression linked to opioid use. Therefore, we examined the relationships between living at altitude, and prescription opioid misuse and fatal overdoses. METHOD State-level past year rates of prescription opioid misuse were retrieved from the Substance Abuse and Mental Health Services Administration. County-level overdose data were extracted from the Centers for Disease Control and Prevention. Multiple linear regression models were fit to determine the relationship between average state elevation and state rates of opioid misuse. Logistic regression models were fit to determine the relationship between county elevation and county-level fatal opioid overdose prevalence. RESULTS After controlling for state opioid prescribing rates and other confounders, we identified a significant positive association between mean state altitude and state-level opioid misuse rates for women, but not men. We also found a significant positive association between county-level altitude and prevalence of fatal opioid overdose. CONCLUSIONS Living at altitude is thus demographically associated with increasing rates of misuse of prescription opioids, as well as of cocaine and methamphetamine. Animal studies suggest that the hypobaric hypoxia exposure involved with living at altitude may disrupt brain neurochemistry, to increase reward benefits of drugs of abuse. This increased misuse of both stimulants and opioids may increase likelihood of overdose at altitude, with overdoses by opioid use also potentially facilitated by altitude-related hypoxia.
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Affiliation(s)
- Hendrik J. Ombach
- Department of Psychiatry, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT, 84108, United States
| | - Lindsay S. Scholl
- Department of Psychiatry, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT, 84108, United States
| | - Amanda V. Bakian
- Department of Psychiatry, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT, 84108, United States
| | - Kai T. Renshaw
- Department of Psychiatry, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT, 84108, United States
| | - Young-Hoon Sung
- Department of Psychiatry, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT, 84108, United States
| | - Perry F. Renshaw
- Department of Psychiatry, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT, 84108, United States
- Utah Science Technology and Research (USTAR) Initiative, Salt Lake City, UT, 84108, United States
- Rocky Mountain VISN19 Mental Illness Research, Education, and Clinical Centers (MIRECC), 500 Foothill Drive, Salt Lake City, UT, 84148, United States
- Salt Lake City Veterans Affairs Health Care System, 500 Foothill Drive, Salt Lake City, UT, 84148, United States
| | - Shami Kanekar
- Department of Psychiatry, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT, 84108, United States
- Rocky Mountain VISN19 Mental Illness Research, Education, and Clinical Centers (MIRECC), 500 Foothill Drive, Salt Lake City, UT, 84148, United States
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Lehner M, Gryz M, Wisłowska-Stanek A, Turzyńska D, Sobolewska A, Skórzewska A, Płaźnik A. The amphetamine-associated context exerts a stronger motivational effect in low-anxiety rats than in high-anxiety rats. Behav Brain Res 2017; 330:97-107. [PMID: 28479265 DOI: 10.1016/j.bbr.2017.05.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 04/27/2017] [Accepted: 05/03/2017] [Indexed: 11/28/2022]
Abstract
This study used the conditioned place preference test to explore the effects of subchronic amphetamine administration on drug-associated cues in rats with different emotional reactivity. We also examined the changes in markers of dopaminergic activity in brain regions in response to the amphetamine-paired context, after a withdrawal period preceded by subchronic amphetamine treatment. We used low-anxiety (LR) and high-anxiety (HR) rats, which are known to exhibit distinct levels of susceptibility to amphetamine. Compared to HR rats, LR rats spent significantly more time in the amphetamine-paired compartment after the withdrawal period preceded by subchronic amphetamine treatment. Compared to HR control rats, LR control rats showed higher expression of the D1 receptor in the nucleus accumbens core (NAC core) and basolateral amygdala and higher expression of the D2 receptor in the NAC core. After the amphetamine treatment and withdrawal period, the LR rats showed higher D1 receptor expression in the NAC core, an increased level of homovanilic acid (HVA) in the prefrontal cortex, the NAC and the central amygdala than HR rats, as well as lower D2 receptor expression in the NAC core and the amygdala than LR control rats. These results indicate that the differences in the activity of the dopaminergic mesolimbic system in the HR and LR rats are maintained and even enhanced after a multi-day break in the use of the drug, indicating the occurrence of sensitisation. These findings show that the innate reactivity of the limbic dopaminergic innervations, dependent on the level of emotional reactivity, may significantly and chronically modify the development and maintenance of sensitisation to amphetamine.
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Affiliation(s)
- Małgorzata Lehner
- Department of Neurochemistry, Institute of Psychiatry and Neurology, 9 Sobieskiego Street, 02-957 Warsaw, Poland.
| | - Marek Gryz
- Department of Neurochemistry, Institute of Psychiatry and Neurology, 9 Sobieskiego Street, 02-957 Warsaw, Poland
| | - Aleksandra Wisłowska-Stanek
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Centre for Preclinical Research and Technology CEPT, 1B Banacha Streeet, 02-097 Warsaw, Poland
| | - Danuta Turzyńska
- Department of Neurochemistry, Institute of Psychiatry and Neurology, 9 Sobieskiego Street, 02-957 Warsaw, Poland
| | - Alicja Sobolewska
- Department of Neurochemistry, Institute of Psychiatry and Neurology, 9 Sobieskiego Street, 02-957 Warsaw, Poland
| | - Anna Skórzewska
- Department of Neurochemistry, Institute of Psychiatry and Neurology, 9 Sobieskiego Street, 02-957 Warsaw, Poland
| | - Adam Płaźnik
- Department of Neurochemistry, Institute of Psychiatry and Neurology, 9 Sobieskiego Street, 02-957 Warsaw, Poland; Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Centre for Preclinical Research and Technology CEPT, 1B Banacha Streeet, 02-097 Warsaw, Poland
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Role of GABA(B) receptors in learning and memory and neurological disorders. Neurosci Biobehav Rev 2016; 63:1-28. [PMID: 26814961 DOI: 10.1016/j.neubiorev.2016.01.007] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 12/31/2015] [Accepted: 01/21/2016] [Indexed: 01/13/2023]
Abstract
Although it is evident from the literature that altered GABAB receptor function does affect behavior, these results often do not correspond well. These differences could be due to the task protocol, animal strain, ligand concentration, or timing of administration utilized. Because several clinical populations exhibit learning and memory deficits in addition to altered markers of GABA and the GABAB receptor, it is important to determine whether altered GABAB receptor function is capable of contributing to the deficits. The aim of this review is to examine the effect of altered GABAB receptor function on synaptic plasticity as demonstrated by in vitro data, as well as the effects on performance in learning and memory tasks. Finally, data regarding altered GABA and GABAB receptor markers within clinical populations will be reviewed. Together, the data agree that proper functioning of GABAB receptors is crucial for numerous learning and memory tasks and that targeting this system via pharmaceuticals may benefit several clinical populations.
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Cunningham JJ, Orr E, Lothian BC, Morgen J, Brebner K. Effects of fendiline on cocaine-seeking behavior in the rat. Psychopharmacology (Berl) 2015; 232:4401-10. [PMID: 26345344 DOI: 10.1007/s00213-015-4061-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 08/27/2015] [Indexed: 11/26/2022]
Abstract
RATIONALE L-type Ca(2+) channels (LTCC) and GABAB receptors are both possible targets in the development of new pharmacological compounds for cocaine addiction. Drugs that target either receptor attenuate a wide range of cocaine-seeking behaviors in the rat. However, there is no current human-approved pharmacotherapeutic intervention for psychostimulant addiction. OBJECTIVES This study examined the effects of a human-approved LTCC blocker, fendiline, on cocaine-taking and cocaine-seeking behavior in rats. The effects of combining fendiline with the GABAB receptor agonist baclofen on cocaine self-administration were also tested. METHODS Male Wistar rats were trained to self-administer cocaine, and the effects of fendiline pretreatment (vehicle, 1.78, 3.16, 5.62 mg/kg, intraperitoneal (IP)) were tested on progressive ratio responding and cue- and drug-induced reinstatement. The effects of baclofen (vehicle, 0.56, 1.78, 3.16, 5.62 mg/kg, IP) combined with fendiline (5.62 mg/kg, IP) were tested on progressive ratio responding. Control experiments measured locomotor activity and lever pressing for food in rats that received both baclofen and fendiline prior to the test session. RESULTS Acute injections of fendiline prior to cue- or drug-induced reinstatement significantly attenuated lever-pressing behavior (p < 0.05). Fendiline and baclofen, but not fendiline alone, not only significantly attenuated breakpoints, but also impaired general motor behavior and naturalistic reinforcement (p < 0.05). CONCLUSION These data suggest that the LTCC blocker fendiline may represent a novel pharmacotherapeutic intervention to prevent reinstatement to cocaine seeking. Also, co-administration of fendiline and baclofen not only can attenuate the motivation to take cocaine, but also impairs general motor behavior and naturalistic reinforcement.
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Affiliation(s)
- Jonathan J Cunningham
- Department of Psychiatry, University of British Columbia, Detwiller Pavilion, 2255 Wesbrook Mall, Vancouver, British Columbia, V6T 2A1, Canada.
| | - Erin Orr
- Department of Psychology, St. Francis Xavier University, 2320 Notre Dame Blvd., Antigonish, Nova Scotia, B2G 2W5, Canada
| | - Barbara C Lothian
- Department of Psychology, St. Francis Xavier University, 2320 Notre Dame Blvd., Antigonish, Nova Scotia, B2G 2W5, Canada
| | - Jennifer Morgen
- Department of Psychology, St. Francis Xavier University, 2320 Notre Dame Blvd., Antigonish, Nova Scotia, B2G 2W5, Canada
| | - Karen Brebner
- Department of Psychology, St. Francis Xavier University, 2320 Notre Dame Blvd., Antigonish, Nova Scotia, B2G 2W5, Canada.
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Dimatelis JJ, Russell VA, Stein DJ, Daniels WM. Methamphetamine reversed maternal separation-induced decrease in nerve growth factor in the ventral hippocampus. Metab Brain Dis 2014; 29:433-9. [PMID: 24407463 DOI: 10.1007/s11011-014-9481-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2013] [Accepted: 01/03/2014] [Indexed: 10/25/2022]
Abstract
Stress has been suggested to predispose individuals to drug abuse. The early life stress of maternal separation (MS) is known to alter the response to drugs of abuse later in life. Exposure to either stress or methamphetamine has been shown to alter neurotrophic factors in the brain. Changes in neurotrophin levels may contribute to the underlying molecular mechanisms responsible for drug use- and stress-induced behaviours. The purpose of the present study was to investigate the individual effects of MS and methamphetamine administration during adolescence and the combined effects of both stressors on brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) levels in the dorsal and ventral hippocampus (HC) in adulthood. Methamphetamine administration (1 mg/kg, daily from postnatal day (PND) 33 to 36 and from PND 39 to 42), MS and the combination of the two stressors resulted in decreased BDNF levels in both the dorsal and ventral HC. MS decreased NGF levels in the ventral HC which was restored by methamphetamine administration in adolescence. In the dorsal HC, NGF remained unaltered by either stressor alone or in combination. We propose that the restoration of NGF levels in the ventral HC may reflect a possible compensatory mechanism in response to methamphetamine exposure in adolescence following the early life stress of MS.
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Affiliation(s)
- J J Dimatelis
- Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, South Africa, 7925,
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