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Clinical Studies Using NMDA Receptor Antagonists in Cocaine and Opioid Dependence

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Glutamate and Addiction

Abstract

In the last 10 yr, a substantial amount of preclinical research has been dedicated to studying the role of excitatory amino acids, in particular, glutamate, in laboratory models of alcohol and drug dependence (1–4). As a result, we now have a wealth of information suggesting that glutamatergic neurotransmission is a major component of the neuroadaptive changes that mediate the development, maintenance, and expression of patterns of animal behavior that are believed to be a model of human alcohol and drug dependence. The data are sufficient to warrant further research that would apply this preclinical knowledge to the clinical field and advance the development of potential pharmacotherapeutics (cf. ref. 5). In this chapter, background information will be presented on the stages of clinical medication development and will review available human data relevant for the medication development for opioid and cocaine dependence.

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References

  1. Herman, B. H., Vocci, F., and Bridge, P. (1995) The effects of NMDA receptor antagonists and nitric oxide synthase inhibitors on opioid tolerance and withdrawal. Medication development issues for opiate addiction. Neuropsychophannacology 13, 269–293.

    Article  PubMed  CAS  Google Scholar 

  2. Trujillo, K. A. (1995) Effects of noncompetitive N-methyl-n-aspartate receptor antagonists on opiate tolerance and physical dependence. Neuropsychopharmacology 13, 301–307.

    Article  PubMed  CAS  Google Scholar 

  3. Bisaga, A. and Popik, P. (2000) In search of a new pharmacological treatment for drug and alcohol addiction: N-methyl-naspartate ( NMDA) antagonists. Drug Alcohol Depend. 59, 1–15.

    Article  PubMed  CAS  Google Scholar 

  4. Bisaga, A., et al. (2000) Therapeutic potential of NMDA receptor antagonists in the treatment of alcohol and substance use disorders. Expert Opin. Investig. Drugs 9, 2233–2248.

    Article  PubMed  CAS  Google Scholar 

  5. Herman, B. H., et al. (2001) Glutamate and Addiction (Herman, B. H., ed.), Human, Totowa, NJ.

    Google Scholar 

  6. Bergman, J., et al. (2000) Agonist efficacy, drug dependence, and medications development: preclinical evaluation of opioid, dopaminergic, and GABAA-ergic ligands. Psychopharmacology (Ber.) 153, 67–84.

    Article  CAS  Google Scholar 

  7. McCance-Katz, E. F., Kosten, T. A., and Kosten, T. R. (2001) Going from the bedside back to the bench with ecopipam: a new strategy for cocaine pharmacotherapy development. Psychopharmacology (Ber) 155, 327–329.

    Article  CAS  Google Scholar 

  8. McCance-Katz, E. F. (1997) Medication development for the treatment of cocaine dependence: issues in clinical efficacy trials. NIDA Res. Monogr. 175, 36–72.

    Google Scholar 

  9. Fischman, M. W. and Foltin, R. W. (1998) Cocaine self-administration research: implication for rational pharmacotherapy, in Cocaine Abuse: Behavior, Pharmacology, and Clinical Applications ( Higgins, S. T. and Katz, J. L., eds.), Academic, San Diego, CA, pp. 181–207.

    Chapter  Google Scholar 

  10. Nunes, E. V. (1997) Methodologie recommendations for cocaine abuse clinical trials: a clinician-researcher’s perspective. NIDA Res Monogr 175, 73–95.

    PubMed  CAS  Google Scholar 

  11. Bigelow, G. E. and Walsh, S. L. (1998) Evaluation of potential pharmacotherapies: response to cocaine challenge in the human laboratory, in Cocaine Abuse: Behavior, Pharmacology, and Clinical Applications ( Higgins, S. T. and Katz, J. L., eds.) Academic, San Diego, CA, pp. 209–238.

    Chapter  Google Scholar 

  12. Comer, S. D., Collins, E. D., and Fischman, M. W. (2001) Buprenorphine sublingual tablets: effects on IV heroin self-administration by humans. Psychopharmacology (Ber) 154, 28–37.

    Article  CAS  Google Scholar 

  13. Ernst, M. and London, E. D. (1997) Brain imaging studies of drug abuse: therapeutic implications. Semin. Neurosci. 9, 120–130.

    Article  Google Scholar 

  14. Kosten, T. A. (1992) Pharmacotherapies, in Clinician’s Guide to Cocaine Addiction: Theory, Research, and Treatment ( Kosten, T.A. and Kleber, H.D., eds.), Guilford, New York.

    Google Scholar 

  15. Kolb, L. and Himmelsbach, C. K. (1938) A critical review of the withdrawal treatments with method of evaluating abstinence syndromes. Am. J. Psychiatry 94, 759–799.

    Google Scholar 

  16. Fraser, H. F. and Isbell, H. (1960) Human pharmacology and addction liabilities of pentazocine and levophenacylmorphan. Bull. Narcot. 12, 15–23.

    CAS  Google Scholar 

  17. Jasinski, D. R., Martin, W. R., and Haertzen, C. A. (1967) The human pharmacology and abuse potential of N-allylnoroxymorphone (naloxone). J. Pharmacol. Exp. Ther. 157, 420–426.

    PubMed  CAS  Google Scholar 

  18. Rosen, M. I., McMahon, T. J., Hameedi, F. A., Pearsall, H. R., Woods, S. W., Kreek, M. J., and Kosten, T. R. (1996) Effect of clonidine pretreatment on naloxone-precipitated opiate withdrawal. J. Pharmacol. Exp. Ther. 276, 1128–1135.

    PubMed  CAS  Google Scholar 

  19. Isbell, H. and Fraser, H. F. (1953) Actions and addiction liabilities of dromoran derivatives in man. J. Pharmacol. Exp. Ther. 106, 524–530.

    Google Scholar 

  20. Rosen, M. I., McMahon, T. J., Woods, S. W., Pearsall, H. R., and Kosten, T. R. (1996) A pilot study of dextromethorphan in naloxone-precipitated opiate withdrawal. Eur. J. Pharmacol. 307, 251–257.

    Article  PubMed  CAS  Google Scholar 

  21. Steinberg, G. K., Bell, T. E., and Yenari, M. A. (1996) Dose escalation safety and tolerance study of the N-methyl-D-aspartate antagonist dextromethorphan in neurosurgery patients. J. Neurosurg. 84, 860–866.

    Article  PubMed  CAS  Google Scholar 

  22. Cornish, J. W., Herman, B. H., Ehrman, R. N., Robbins, S. J., Childress, A. R., Bead, V., Esmonde, C. A., Martz, K., Poole, S., Caruso, F. S., Vocci, F., and O’Brien, P. A randomized, double-bline, placebo-controlled safety study of high-dose dextromethorphan in methadone-maintained male patients. Drug Alcohol Depend., in press.

    Google Scholar 

  23. Jasinski, D. R. (2000) Abuse potential of morphine/dextromethorphan combinations..1. Pain Symptom Manage. 19, (Suppl) 26 - S30.

    Article  Google Scholar 

  24. Bisaga, A., Comer, S. D., Ward, A. S., Popik, P., Kleber, H. D., and Fischman, M. W. (2001) The NMDA antagonist memantine attenuates the expression of opioid physical dependence in humans. Psychopharmacology (Berl.) 157(1), 1–10.

    Article  CAS  Google Scholar 

  25. Rosen, M. I., Persall, H. R., and Kosten, T. R. (1998) The effect of lamotrigine on naloxone-precipitated opiate withdrawal. Drug Alcohol Depend. 52, 173–176.

    Article  PubMed  CAS  Google Scholar 

  26. Mello, N. K., Mendelson, J. H., Kuehnle, J. C., and Sellers, M. S. (1981) Operant analysis of human heroin self-administration and the effects of naltrexone. J. Pharmacol. Exp. Ther. 216, 45–54.

    CAS  Google Scholar 

  27. Collins, E. D., Ward, A. S., McDowell, D. M., Foltin, R. W., and Fischman, M. W. (1998) The effects of memantine on the subjective, reinforcing and cardiovascular effects of cocaine in humans. Behay. pharmacol. 9 (7): 587–598.

    Article  CAS  Google Scholar 

  28. Hyytia, P., Backstrom, P., and Liljequist, S. (1999) Site-specific NMDA receptor antagonists produce differential effects on cocaine self-administration in rats. Eur. J. Pharmacol. 378, 9–16.

    Article  PubMed  CAS  Google Scholar 

  29. Pulvirenti, L., Balducci, C., and Koob, G. F. (1997) Dextromethorphan reduces intravenous cocaine self-administration in the rat. Eur. J. Pharmacol. 321, 279–283.

    Article  PubMed  CAS  Google Scholar 

  30. Kantak, K. M., Edwards, M. A., and O’Connor, T. P. (1998) Modulation of the discriminative stimulus and rate-altering effects of cocaine by competitive and noncompetitive N-methyl-D-aspartate antagonists. Pharmacol. Biocheyn. Behay. 59, 159–169.

    Article  CAS  Google Scholar 

  31. Herman, B. H. and O’Brien, C. P. (1997) Clinical medication development for opiate addiction: focus on nonopioids and opioid antagonists for the amelioration of opiate withdrawal symptoms and relapse prevention. Semin. Neurosci. 9, 158–172.

    Google Scholar 

  32. Koyuncuoglu, H. and Saydam, B. (1990) The treatment of heroin addicts with dextromethorphan. A double-blind comparison of dextromethorphan with chloropromazine. Int. J. Clin. Pharmacol. Ther. 28, 147–152.

    CAS  Google Scholar 

  33. Koyuncuoglu, H. (1991) The treatment with dextromethorphan of heroin addicts, in Drug Addiction and AIDS ( Loimer, N., Schmid, R., and Springer, A., eds.), Springer-Verlog, Vienna, pp. 320–329.

    Chapter  Google Scholar 

  34. Koyuncuoglu, H. (1995) The combination of tizanidine markedly improves the treatment with dextromethorphan of heroin addicted outpatients. Int. J. Clin. Pharmacol. Ther. 33, 13–19.

    PubMed  CAS  Google Scholar 

  35. O’Connor, P. G., Carroll, K. M., Shi, J. M., Schottenfeld, R. S., Kosten, T. R., and Rounsaville, B. J. (1997) Three methods of opioid detoxification in a primary care setting. A randomized trial. Ann. Intern. Med. 127, 526–530.

    Article  PubMed  Google Scholar 

  36. Washton, A. M. and Resnick, R. B. (1980) Clonidine for opiate detoxification: outpatient clinical trials. Am. J. Psychiatry 137, 1121–1122.

    PubMed  CAS  Google Scholar 

  37. Bisaga, A., Gianelli, P., and Popik, P. (1997) Opiate withdrawal with dextromethorphan. Am. J. Psychiatry 154, 584.

    PubMed  CAS  Google Scholar 

  38. Bisaga, A., Comer, S. D., Akerele, E. O., Kleber, H. D., and Fischman, M. W. (1999) The clinical use of memantine in opioid detoxification. NIDA Res. Monogr. 180, 227.

    Google Scholar 

  39. Popik, P., Layer, R. T., and Skolnick, P. (1995) 100 years of ibogaine: neurochemical and pharmacological actions of a putative anti-addictive drug. Pharmacol. Rev. 47, 235–253.

    PubMed  CAS  Google Scholar 

  40. De Rienzo, P., Beal, D., and Staff, P. M. (1997) The Ibogaine Story: Report on the Staten Island Project. Autonomedia, Brooklyn, NY.

    Google Scholar 

  41. Alper, K. R., Lostof, H. S., Frenken, G. M., Luciano, D. J., and Bastiaans, J. (1999) Treatment of acute opioid withdrawal with ibogaine. Am. J. Addict. 8, 234–242.

    Article  PubMed  CAS  Google Scholar 

  42. Kovera, C. A., Kovera, M. B., Singleton, E. G., Ervin, F. R., Williams, I. C., and Mash, D. C. (1998) Decreased drug craving during inpatient detoxification with ibogaine. NIDA Res. Monogr. 179, 294.

    Google Scholar 

  43. Mash, D. C., et al. (2000) Ibogaine: complex pharmacokinetics, concerns for safety, and preliminary efficacy measures. Ann. NYAcad. Sci. 914, 394–401.

    Article  CAS  Google Scholar 

  44. Sheppard, S. G. (1994) A preliminary investigation of ibogaine: case reports and recommendations for further study. J. Subst. Abuse Treat. 11, 379–385.

    Article  PubMed  CAS  Google Scholar 

  45. Kornhuber, J., Weller, M., Schoppmeyer, K., and Riederer, P. (1994) Amantadine and memantine are NMDA receptor antagonists with neuroprotective properties. J. Neural Transm. 43(SuppL), 91–104.

    CAS  Google Scholar 

  46. Giannini, A. J., Folts, D. J., Feather, J. N., and Sullivan, B. S. (1989) Bromocriptine and amantadine in cocaine detoxification. Psychiatry Res. 29, 11–16.

    Article  PubMed  CAS  Google Scholar 

  47. Tennant, F. S., Jr. and Sagherian, A. A. (1987) Double-blind comparison of amantadine and bromocriptine for ambulatory withdrawal from cocaine dependence. Arch. Intern. Med. 147, 109–112.

    Article  PubMed  Google Scholar 

  48. Gawin, F. H., Morgan, C., Kosten, T. R., and Kleber, H. D. (1989) Double-blind evaluation of the effect of acute amantadine on cocaine craving. Psychopharmacology (Ber.) 97, 402–403.

    Article  CAS  Google Scholar 

  49. Morgan, C., Kosten, T., Gawin, F., and Kleber, H. (1988) A pilot trial of amantadine for ambulatory withdrawal for cocaine dependence. NIDA Res. Monogr. 81, 81–85.

    PubMed  CAS  Google Scholar 

  50. Thompson, D. F. (1992) Amantadine in the treatment of cocaine withdrawal. Ann. Pharmacother. 26, 933–934.

    PubMed  CAS  Google Scholar 

  51. Kampman, K. M., Volpicelli, J. R., Alterman, A. I., Cornish, J., and O’Brien, C. P. (2000) Amantadine in the treatment of cocaine-dependent patients with severe withdrawal symptoms. Am. J. Psychiatry 157, 2052–2054.

    Article  PubMed  CAS  Google Scholar 

  52. Bespalov, A., Zvartau, E. E., Krupitsky, E. M., Mosolov, D. V., and Burakov, A. M. (2001) A pilot study of memantine for the treatment of heroin dependence. Drug Alcohol Depend63, 14 (abstract).

    Google Scholar 

  53. Alterman, A. I., Droba, M., Antelo, R. E., Cornish, J. W., Sweeney, K. K., Parikh, G. A., and O’Brien, C. P. (1992) Amantadine may facilitate detoxification of cocaine addicts. Drug Alcohol Depend. 31, 19–29.

    Article  PubMed  CAS  Google Scholar 

  54. Ziedonis, D. M. and Kosten, T. R. (1991) Pharmacotherapy improves treatment outcome in depressed cocaine addicts. J. Psychoactive Drugs 23, 417–425.

    Article  PubMed  CAS  Google Scholar 

  55. Shoptaw, S., Kintaudi, K., Charuvastra, V. C., Rawson, R. A., and Ling, W. (1998) Amantadine hydrochloride is effective treatment for cocaine dependence. NIDA Res. Monogr. 179, 55.

    Google Scholar 

  56. Kolar, A. F., Brown, B. S., Weddington, W. W., Haertzen, C. C., Michaelson, B. S., and Jaffe, J. H. (1992) Treatment of cocaine dependence in methadone maintenance clients: a pilot study comparing the efficacy of desipramine and amantadine. Int. J. Addict. 27, 849–868.

    PubMed  CAS  Google Scholar 

  57. Kosten, T. R., Morgan, C. M., Falcione, J., and Schottenfeld, R. S. (1992) Pharmacotherapy for cocaine-abusing methadone-maintained patients using amantadine or desipramine. Arch. Gen. Psychiatry 49, 894–898.

    Article  PubMed  CAS  Google Scholar 

  58. Weddington, W. W., Brown, B. S., Haertzen, C. A., Hess, J. M., Kolar, A. F., and Mahaffey, J. R. (1989) Comparison of amantadine and desipramine combined with psychotherapy for treatment of cocaine dependence. NIDA Res. Monogr. 95, 483–484.

    PubMed  CAS  Google Scholar 

  59. Handelsman, L., Limpitlaw, L., Williams, D., Schmeidler, J., Paris, P., and Stimmet, B. (1995) Amantadine does not reduce cocaine use or craving in cocaine-dependent methadone maintenance patients. Drug Alcohol Depend. 39, 173–180.

    Article  PubMed  CAS  Google Scholar 

  60. Kampman, K., Volpicelli, J. R., Alterman, A., Cornish, J., Weinreib, R., Epperson, L., Sparkman, T., and O’Brien, C. P. (1996) Amantadine in the early treatment of cocaine dependence: a double-blind, placebo-controlled trial. Drug Alcohol Depend. 41, 25–33.

    Article  PubMed  CAS  Google Scholar 

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Bisaga, A., Fischman, M.W. (2002). Clinical Studies Using NMDA Receptor Antagonists in Cocaine and Opioid Dependence. In: Herman, B.H., Frankenheim, J., Litten, R.Z., Sheridan, P.H., Weight, F.F., Zukin, S.R. (eds) Glutamate and Addiction. Contemporary Clinical Neuroscience. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-306-4_17

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  • DOI: https://doi.org/10.1007/978-1-59259-306-4_17

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-234-6

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