Amlodipine, a calcium channel inhibitor, and cocaine and ethanol's reinforcing effects

Differential Roles for L-Type Calcium Channel Subtypes in Alcohol Dependence

It has previously been shown that the inhibition of L-type calcium channels (LTCCs) decreases alcohol consumption, although the contribution of the central LTCC subtypes Cav1.2 and Cav1.3 remains unknown. Here, we determined changes in Cav1.2 (Cacna1c) and Cav1.3 (Cacna1d) mRNA and protein expression in alcohol-dependent rats during protracted abstinence and naive controls using in situ hybridization and western blot analysis. Functional validation was obtained by electrophysiological recordings of calcium currents in dissociated hippocampal pyramidal neurons. We then measured alcohol self-administration and cue-induced reinstatement of alcohol seeking in dependent and nondependent rats after intracerebroventricular (i.c.v.) injection of the LTCC antagonist verapamil, as well as in mice with an inducible knockout (KO) of Cav1.2 in Ca²⁺/calmodulin-dependent protein kinase IIα (CaMKIIα)-expressing neurons. Our results show that Cacna1c mRNA concentration was increased in the amygdala and hippocampus of alcohol-dependent rats after 21 days of abstinence, with no changes in Cacna1d mRNA. This was associated with increased Cav1.2 protein concentration and L-type calcium current amplitudes. Further analysis of Cacna1c mRNA in the CA1, basolateral amygdala (BLA), and central amygdala (CeA) revealed a dynamic regulation over time during the development of alcohol dependence. The inhibition of central LTCCs via i.c.v. administration of verapamil prevented cue-induced reinstatement of alcohol seeking in alcohol-dependent rats. Further studies in conditional Cav1.2-KO mice showed a lack of dependence-induced increase of alcohol-seeking behavior. Together, our data indicate that central Cav1.2 channels, rather than Cav1.3, mediate alcohol-seeking behavior. This finding may be of interest for the development of new antirelapse medications.

Development of medications for alcohol use disorders: recent advances and ongoing challenges

During the past decade, efforts to develop medications for alcoholism have burgeoned. Three agents, disulfiram, naltrexone and acamprosate, are now approved in a large number of countries. Although many patients have benefited from existing medications, their effects are moderate, and some alcoholics fail to respond to them. A host of new agents are currently under active investigation. Critical barriers must be overcome to ensure that future efforts in the development of medications for alcohol use disorders reach full fruition. These challenges include: establishing key targets for drug discovery; validating animal and human screening models; and developing biomarkers to help predict treatment success. In addition, it is important to formulate methodological and statistical strategies to efficiently conduct alcohol pharmacotherapy trials; to specify genetic and phenotypic patient characteristics associated with efficacy and safety for lead compounds; to forge productive alliances among governmental agencies, the pharmaceutical industry and academic researchers to further drug development; and, ultimately and perhaps most difficult, to engage the practitioner community to incorporate medications into the alcohol treatment process.

A fatal case of amlodipine poisoning

A fatal overdose of amlodipine, a calcium channel blocker, in a 50-year-old man is described. Biological samples obtained at autopsy were screened for common drugs and narcotics. The amlodipine determination was made by HPLC with diode-array detection and a post-mortem blood concentration of 2.3 mg/kg was determined. The only other drug detected was a blood alcohol concentration of 0.008%. The presence of amlodipine was confirmed in other tissues and in the stomach content. The overdose is assumed to be an accumulation of amlodipine due to the long half-life of this drug.

Effects of conditioned food aversions on nutritional behavior in humans

Conditioned food aversion (CFA) and taste aversion (CTA) are widely occurring phenomena mediating rejection of solids or liquids, the ingestion of which has induced the onset of post-ingestional malaise. It is a powerful and durable imprint learning that may influence food choice and intake in all animals, including humans. For ethical reasons, CTA has been extensively investigated in a wide variety of laboratory animal's species but only incidentally in humans. Nevertheless, convincing evidence has been provided that CFA and CTA learning are possible in a wide range of human subjects. The results in humans may have some limitations in accuracy since data are sparse, sometimes indirect, and poorly controlled. There is only limited information on the extent of CFA in the elderly since most studies have employed questionnaire and/or interview methods on young people (i.e. college students). The present review evaluates the literature derived both from laboratory animals and humans. In the first instance, the salient features of food and taste aversion learning and the neural mechanisms involved in this learning behavior will be examined. Then, the problems encountered when trying to assess the role of learned food and taste aversions in the nutritional status of healthy as well as sick young or elderly people will be considered. In particular, the importance of CFA on the nutritional status of cancer patients and treatment of alcoholism will be examined. It is concluded that the data are compelling enough to warrant further research and, some indications and recommendations are suggested.