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Goins A, Patel K, Alles SRA. The gabapentinoid drugs and their abuse potential. Pharmacol Ther 2021; 227:107926. [PMID: 34171338 DOI: 10.1016/j.pharmthera.2021.107926] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/11/2021] [Accepted: 05/24/2021] [Indexed: 01/19/2023]
Abstract
The gabapentinoid drugs, gabapentin and pregabalin, are first-line treatments for neuropathic pain. The epidemics of chronic pain and opioid misuse have given rise to the widespread use of non-opioid drugs such as the gabapentinoids for treatment. Unfortunately, the widespread use of gabapentinoid drugs has resulted in reports of misuse and abuse. Here we summarize the clinical reports of gabapentinoid abuse in different patient populations to help inform clinical practice of chronic pain management.
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Affiliation(s)
- Aleyah Goins
- Department of Anesthesiology & Critical Care Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Keisha Patel
- Department of Anesthesiology & Critical Care Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Sascha R A Alles
- Department of Anesthesiology & Critical Care Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA.
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Inserra A, De Gregorio D, Gobbi G. Psychedelics in Psychiatry: Neuroplastic, Immunomodulatory, and Neurotransmitter Mechanisms. Pharmacol Rev 2020; 73:202-277. [PMID: 33328244 DOI: 10.1124/pharmrev.120.000056] [Citation(s) in RCA: 100] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Mounting evidence suggests safety and efficacy of psychedelic compounds as potential novel therapeutics in psychiatry. Ketamine has been approved by the Food and Drug Administration in a new class of antidepressants, and 3,4-methylenedioxymethamphetamine (MDMA) is undergoing phase III clinical trials for post-traumatic stress disorder. Psilocybin and lysergic acid diethylamide (LSD) are being investigated in several phase II and phase I clinical trials. Hence, the concept of psychedelics as therapeutics may be incorporated into modern society. Here, we discuss the main known neurobiological therapeutic mechanisms of psychedelics, which are thought to be mediated by the effects of these compounds on the serotonergic (via 5-HT2A and 5-HT1A receptors) and glutamatergic [via N-methyl-d-aspartate (NMDA) and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors] systems. We focus on 1) neuroplasticity mediated by the modulation of mammalian target of rapamycin-, brain-derived neurotrophic factor-, and early growth response-related pathways; 2) immunomodulation via effects on the hypothalamic-pituitary-adrenal axis, nuclear factor ĸB, and cytokines such as tumor necrosis factor-α and interleukin 1, 6, and 10 production and release; and 3) modulation of serotonergic, dopaminergic, glutamatergic, GABAergic, and norepinephrinergic receptors, transporters, and turnover systems. We discuss arising concerns and ways to assess potential neurobiological changes, dependence, and immunosuppression. Although larger cohorts are required to corroborate preliminary findings, the results obtained so far are promising and represent a critical opportunity for improvement of pharmacotherapies in psychiatry, an area that has seen limited therapeutic advancement in the last 20 years. Studies are underway that are trying to decouple the psychedelic effects from the therapeutic effects of these compounds. SIGNIFICANCE STATEMENT: Psychedelic compounds are emerging as potential novel therapeutics in psychiatry. However, understanding of molecular mechanisms mediating improvement remains limited. This paper reviews the available evidence concerning the effects of psychedelic compounds on pathways that modulate neuroplasticity, immunity, and neurotransmitter systems. This work aims to be a reference for psychiatrists who may soon be faced with the possibility of prescribing psychedelic compounds as medications, helping them assess which compound(s) and regimen could be most useful for decreasing specific psychiatric symptoms.
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Affiliation(s)
- Antonio Inserra
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Danilo De Gregorio
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Gabriella Gobbi
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
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3
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Aguilar MA, García-Pardo MP, Parrott AC. Of mice and men on MDMA: A translational comparison of the neuropsychobiological effects of 3,4-methylenedioxymethamphetamine ('Ecstasy'). Brain Res 2020; 1727:146556. [PMID: 31734398 DOI: 10.1016/j.brainres.2019.146556] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 11/09/2019] [Accepted: 11/12/2019] [Indexed: 11/19/2022]
Abstract
MDMA (3,4-methylendioxymethamphetamine), also known as Ecstasy, is a stimulant drug recreationally used by young adults usually in dance clubs and raves. Acute MDMA administration increases serotonin, dopamine and noradrenaline by reversing the action of the monoamine transporters. In this work, we review the studies carried out over the last 30 years on the neuropsychobiological effects of MDMA in humans and mice and summarise the current knowledge. The two species differ with respect to the neurochemical consequences of chronic MDMA, since it preferentially induces serotonergic dysfunction in humans and dopaminergic neurotoxicity in mice. However, MDMA alters brain structure and function and induces hormonal, psychomotor, neurocognitive, psychosocial and psychiatric outcomes in both species, as well as physically damaging and teratogen effects. Pharmacological and genetic studies in mice have increased our knowledge of the neurochemical substrate of the multiple effects of MDMA. Future work in this area may contribute to developing pharmacological treatments for MDMA-related disorders.
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Affiliation(s)
- Maria A Aguilar
- Department of Psychobiology, Faculty of Psychology, Valencia University, Valencia, Spain.
| | | | - Andrew C Parrott
- Department of Psychology, Swansea University, Swansea, United Kingdom; Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia
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Sungur AÖ, Redecker TM, Andres E, Dürichen W, Schwarting RKW, Del Rey A, Wöhr M. Reduced Efficacy of d-Amphetamine and 3,4-Methylenedioxymethamphetamine in Inducing Hyperactivity in Mice Lacking the Postsynaptic Scaffolding Protein SHANK1. Front Mol Neurosci 2018; 11:419. [PMID: 30505269 PMCID: PMC6250831 DOI: 10.3389/fnmol.2018.00419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 10/26/2018] [Indexed: 02/02/2023] Open
Abstract
Genetic defects in the three SH3 and multiple ankyrin repeat domains (SHANK) genes (SHANK1, SHANK2, and SHANK3) are associated with multiple major neuropsychiatric disorders, including autism spectrum disorder (ASD), schizophrenia (SCZ), and bipolar disorder (BPD). Psychostimulant-induced hyperactivity is a commonly applied paradigm to assess behavioral phenotypes related to BPD and considered to be the gold standard for modeling mania-like elevated drive in mouse models. Therefore, the goal of our present study was to test whether Shank1 plays a role in the behavioral effects of psychostimulants and whether this is associated with genotype-dependent neurochemical alterations. To this aim, male and female null mutant Shank1-/- mice were treated with d-amphetamine (AMPH; 2.5 mg/kg) and 3,4-methylenedioxymethamphetamine (MDMA, commonly known as ecstasy; 20 mg/kg), and psychostimulant-induced hyperactivity was compared to heterozygous Shank1+/- and wildtype Shank1+/+ littermate controls. Results show that Shank1-/- mice display reduced psychostimulant-induced hyperactivity, although psychostimulants robustly stimulated locomotor activity in littermate controls. Shank1 deletion effects emerged throughout development, were particularly prominent in adulthood, and seen in response to both psychostimulants, i.e., AMPH and MDMA. Specifically, while AMPH-induced hyperactivity was reduced but still detectable in Shank1-/- mice, MDMA-induced hyperactivity was robustly blocked and completely absent in Shank1-/- mice. Reduced efficacy of psychostimulants to stimulate hyperactivity in Shank1-/- mice might be associated with alterations in the neurochemical architecture in prefrontal cortex, nucleus accumbens, and hypothalamus. Our observation that psychostimulant-induced hyperactivity is reduced rather than enhanced in Shank1-/- mice clearly speaks against a behavioral phenotype with relevance to BPD. Lack of BPD-like phenotype is consistent with currently available human data linking mutations in SHANK2 and SHANK3 but not SHANK1 to BPD.
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Affiliation(s)
- A Özge Sungur
- Behavioral Neuroscience, Experimental and Biological Psychology, Philipps University of Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, Philipps University of Marburg, Marburg, Germany
| | - Tobias M Redecker
- Behavioral Neuroscience, Experimental and Biological Psychology, Philipps University of Marburg, Marburg, Germany
| | - Elena Andres
- Research Group Immunophysiology, Division of Neurophysiology, Institute of Physiology and Pathophysiology, Philipps University of Marburg, Marburg, Germany
| | - Wiebke Dürichen
- Behavioral Neuroscience, Experimental and Biological Psychology, Philipps University of Marburg, Marburg, Germany
| | - Rainer K W Schwarting
- Behavioral Neuroscience, Experimental and Biological Psychology, Philipps University of Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, Philipps University of Marburg, Marburg, Germany
| | - Adriana Del Rey
- Research Group Immunophysiology, Division of Neurophysiology, Institute of Physiology and Pathophysiology, Philipps University of Marburg, Marburg, Germany
| | - Markus Wöhr
- Behavioral Neuroscience, Experimental and Biological Psychology, Philipps University of Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, Philipps University of Marburg, Marburg, Germany
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García‐Pardo MP, Miñarro J, Llansola M, Felipo V, Aguilar MA. Role ofNMDAandAMPAglutamatergic receptors in the effects of social defeat on the rewarding properties ofMDMAin mice. Eur J Neurosci 2018; 50:2623-2634. [DOI: 10.1111/ejn.14190] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 09/14/2018] [Accepted: 09/20/2018] [Indexed: 12/12/2022]
Affiliation(s)
- M. P. García‐Pardo
- Unidad de Investigación Psicobiología de las Drogodependencias Departamento de Psicobiología Facultad de Psicología Universidad de Valencia Avda. Blasco Ibáñez, 21 46010 Valencia Spain
- Unitat Predepartamental de Medicina Facultat de Ciències de la Salut Universitat Jaume I. Castelló de la Plana Castelló Spain
| | - J. Miñarro
- Unidad de Investigación Psicobiología de las Drogodependencias Departamento de Psicobiología Facultad de Psicología Universidad de Valencia Avda. Blasco Ibáñez, 21 46010 Valencia Spain
| | - M. Llansola
- Laboratory of Neurobiology Centro Investigación Príncipe Felipe Valencia Spain
| | - V. Felipo
- Laboratory of Neurobiology Centro Investigación Príncipe Felipe Valencia Spain
| | - M. A. Aguilar
- Unidad de Investigación Psicobiología de las Drogodependencias Departamento de Psicobiología Facultad de Psicología Universidad de Valencia Avda. Blasco Ibáñez, 21 46010 Valencia Spain
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