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Vol. 280, Issue 2, 854-865, 1997
Institute of Pharmacology, Polish Academy of Sciences, Sm
tna
12, 31-343 Kraków, Poland (P.P.), and the
Department of
Pharmacology, Merz+Co. GmbH & CO, Eckenheimer Landstrasse 100-104,
D-60318 Frankfurt am Main, Germany (W.D.)
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Abstract |
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The present study focused on the effects of 1-amino-3,5-dimethyladamantane (memantine), a clinically used, low-affinity N-methyl-D-aspartate channel blocker, on the motivational impact of morphine and morphine withdrawal syndrome. Memantine (7.5 mg/kg) inhibited the acquisition as well as the expression of morphine-induced conditioned place preference. However, memantine did not affect significantly the acquisition or expression of conditioned place preference induced by food presentation. In addition, at the dose that blocked morphine-induced conditioned place preference, memantine by itself produced neither conditioned place preference nor conditioned place aversion. Memantine attenuated the negative motivational aspects of morphine withdrawal as assessed by conditioned place aversion produced by a low dose (0.1 mg/kg) of naloxone in morphine-dependent rats. Drug discrimination studies revealed that the inhibitory effects of memantine on morphine-induced conditioned place preference could not be attributed to the attenuation by memantine of the interoceptive cue produced by morphine. In addition, the inhibitory effects of memantine on the expression of morphine-induced conditioned place preference seemed not to be related to effects on memory retrieval, as revealed in the Morris water maze spatial task. These data suggest that memantine at a low, pharmacologically relevant dose of 7.5 mg/kg blocks the reinforcing effects of morphine and aversive effects of morphine withdrawal in rats, which suggests a new potential clinical indication for this agent in the treatment of opioid abuse.
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Introduction |
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The treatment of drug abuse
focuses on prevention of the development of addiction, elimination of
existing addiction and suppression of symptoms associated with drug
withdrawal (Jaffe, 1987
). Current pharmacotherapies usually target
specific neurotransmitter systems, which are presumed to mediate the
effects of a given class of abused substances. These "targeted,"
specific pharmacotherapies are used in spite of striking similarities
concerning the long-term consequences produced by all of known drugs of
abuse such as drug addiction. Moreover, opioid antagonists and agonists
are used in the treatment of opioid abuse despite the fact that some
therapies (e.g., naltrexone) are not only ineffective, but,
in addition, are consistently refused by addicted individuals. In
opioid substitution therapy (e.g., with methadone), Ball and
Ross (1991)
reported a recidivism rate after discontinuation of
treatment of ~80%. Dopaminergic pathways, particularly of the
mesolimbic system, have been associated with the motivational
(reinforcing) aspects of drug abuse. However, to date, antiaddictive
therapies targeting dopaminergic neurotransmission have failed to
produce a therapeutic breakthrough (Pulvirenti and Koob, 1994
).
The pharmacological terms tolerance, sensitization, dependence and
withdrawal characterize the clinical term "drug addiction." Drug
tolerance refers to the state in which repeated administration of the
same dose of a given drug elicits a diminishing effect or the need for
an increasing drug dose to produce the same effect. Sensitization
(reversed tolerance) refers to the opposite situation in which repeated
administration of the same drug dose elicits an escalating effect.
Chronic treatment with many drugs, including opioid agonists, produces
gradually developing dependence that is defined as the need for
continued reexposure to avoid a withdrawal syndrome. The withdrawal
syndrome is characterized by physical and motivational disturbances
that are the expression of ongoing drug dependence. The term "the
maintenance of opioid dependence" refers to the situation in which
one can precipitate withdrawal syndrome a long time after the
administration of opioid agonist has been discontinued. Contemporary
theories of drug addiction consider addictive substances as potent
reinforcers. In turn, chronic exposure to these reinforcing drugs can
lead to drug addiction, which is best defined as compulsive drug
seeking and taking behavior despite adverse consequences. Because such
effects are common for all of drugs of abuse (despite the diversity of
their chemical structures and plethora of acute pharmacological
actions), it is believed that the common neurobiological substrates
mediate the motivational impact of drugs producing drug addiction (Eddy et al., 1965
; Goudie, 1991
; Robinson and Berridge, 1993
).
The NMDA receptor complex is a ligand-gated cationic channel, which
consists of a pentameric assembly of subunits that contains several
regulatory sites. Thus, apart from a recognition site for a primary
transmitter (glutamate) it includes sites sensitive to glycine (which
is obligatory for receptor activation), polyamines, zinc, redox state
and protons (Danysz et al., 1995a
; Kutsuwada et
al., 1992
). It should be noted that agents acting at these sites
have not yet been deeply investigated in clinical settings. NMDA
receptor function can also be inhibited by blockade of the open ion
channel (Danysz et al., 1995a
; Kutsuwada et al.,
1992
). In contrast to the other NMDA antagonists, several open channel (uncompetitive) blockers have been tested in clinical settings, and
some of them are being used for medical purposes. Unfortunately, the
majority of the high-affinity open channel NMDA receptor antagonists, e.g., phencyclidine or MK-801 (dizocilpine), produce side
effects, including confusion, psychotomimetic activity and memory
disturbances (Luby et al., 1959
; Troupin et al.,
1986
), that render them unacceptable for a clinical use. In contrast,
low-affinity, strongly voltage-dependent uncompetitive NMDA receptor
antagonists have been suggested to produce less side effects, perhaps
because of weaker effects when the level of NMDA receptor activation is
in the physiological range (Chen et al., 1992
; Parsons
et al., 1993
; Rogawski, 1993
). One such low-affinity NMDA
channel blocker, memantine, has been used clinically for many years in
Europe, and is apparently devoid of these side effects if dosed
properly, i.e., in gradually increasing doses until
therapeutic concentrations are achieved (Ditzler, 1991
;
Görtelmeyer and Erbler, 1992
). A similar favorable
therapeutic profile holds true for other agents of this kind, such as
amantadine and dextromethorphan (Danysz et
al., 1995a
; Rogawski, 1993
). It seems that the use of NMDA
antagonists possessing a relatively credible clinical profile
(memantine, dextromethorphan) in novel applications (in
this case, the treatment of drug abuse) should be preferred over the
use of novel agents that have no such long clinical history.
Converging lines of evidence indicate the essential involvement of NMDA
receptors in phenomena related to drug addiction. In preclinical
studies, NMDA receptor antagonists decrease tolerance to the locomotor
effects of alcohol (Khanna et al., 1993
) and sedatives (File
and Fernandes, 1994
), attenuate sensitization (reverse tolerance) to
stimulants (Pudiak and Bozarth, 1993
; Wolf and Khansa, 1991
) and modify
adaptive changes caused by nicotine treatment (Shoaib and Stolerman,
1992
). Moreover, NMDA receptor antagonists affect opioid tolerance and
dependence processes. Several studies indicated that NMDA receptor
antagonists decrease tolerance to the analgesic effects of opiates
(Ben-Eliyahu et al., 1992
; Bhargava and Matwyshyn, 1993
;
Elliott et al., 1994
; Kolesnikov et al., 1993
,
1994
; Tiseo and Inturrisi, 1993
; Tiseo et al., 1994
;
Trujillo and Akil, 1991
). Similarly, reduction of the physical as well
as motivational aspects of the expression of morphine dependence
(measured by naloxone-precipitated morphine withdrawal syndrome) has
been shown by many investigators (Cappendijk et al., 1993
;
Higgins et al., 1992
; Popik et al., 1995
;
Rasmussen et al., 1991
; Tanganelli et al., 1991
;
Trujillo and Akil, 1991
). In addition, NMDA receptor antagonists
inhibit the development of morphine dependence (Elliott et
al., 1994
; Tiseo and Inturrisi, 1993
; Tiseo et al.,
1994
; Trujillo and Akil, 1991
) as well as its maintenance (Popik and
Skolnick, 1996
). "Antiaddictive" effects of NMDA receptor
antagonists (dextromethorphan, ibogaine) have been
reported also in initial clinical trials (Koyuncuoglu and Saydam, 1990
;
Lotsof, 1995
).
In spite of intensive efforts, the mechanism of the inhibitory effects
of NMDA receptor antagonists in various measures modeling drug
addiction remains highly speculative. This is in part caused by the
fact that the molecular and physiological mechanism(s) underlying drug
dependence and addiction are per se not well understood. Although drug dependence (defined by withdrawal syndrome) is
traditionally considered to be a major factor in the maintenance of
compulsive drug use (Eddy et al., 1965
), contemporary
theories stress the importance of the reinforcing (incentive)
properties of abused substances (Robinson and Berridge, 1993
) in the
development and maintenance of drug addiction. Thus, it might be
hypothesized that antiaddictive treatments should inhibit ongoing
drug-seeking through a decrease of the reinforcing impact of drugs of
abuse, rather than by attenuating solely the severity of the withdrawal syndrome.
Recently, Bespalov et al. (1994)
demonstrated that the
nonselective glutamate receptor antagonist, kynurenic acid, attenuates the acquisition and expression of CPP induced by morphine. The same
treatment inhibits morphine-induced facilitation of responding in the
electrical intracranial self-stimulation paradigm (Bespalov et
al., 1994
). Similar attenuation of the development of
morphine-induced CPP has been recently shown for MK-801 (dizocilpine)
and CGP-37849, which are uncompetitive and competitive NMDA receptor
antagonists, respectively (Tzschentke and Schmidt, 1995
). The ability
to induce CPP and to facilitate intracranial self-stimulation, as well
as to induce and maintain self-administration, defines in animal models
reinforcing properties of drugs and, according to several theories of
drug addiction, potential abuse in humans (for review, see Goudie,
1991
). Thus, it seems likely that treatments decreasing these
reinforcing actions of drugs in animal models would be effective in
diminishing intake of drugs of abuse in humans.
CPP offers a reliable measure for assessing the reinforcing value of
pharmacological treatments and other reinforcers, including food. In
the case of pharmacological manipulations, during training a drug
supposed to have reinforcing properties is paired with a distinctive
compartment, whereas its vehicle is paired with the other compartment
of the same training apparatus. After completing the association phase,
drug-free animals explore both compartments. It is assumed that an
increase of the time spent in a compartment associated with a given
treatment reflects the incentive (positively reinforcing) value of that
treatment (Bindra, 1978
), whereas a decrease suggests aversive
properties (Carr et al., 1989
; Mucha et al.,
1982
). Numerous studies indicate that in addition to the reinforcement,
associative learning must occur for the development of CPP
(e.g., White and Carr, 1985
). CPP induced by opiates is stereospecific, can be blocked by opioid antagonists and is probably mediated by action at mu rather than kappa opioid
receptors (Mucha and Herz, 1985
). In addition, dopaminergic mesolimbic
pathways have been reported to participate in opioid-induced CPP
(Spyraki et al., 1983
).
The objective of the present experiments was to determine whether the
NMDA receptor antagonist memantine could affect the reinforcing impact
of morphine as well as the motivational aspects of morphine withdrawal
in a CPP paradigm. Memantine was selected for the present studies,
because it is a use-dependent NMDA receptor antagonist
(IC50= 0.5-3.0 µM [Bormann, 1989
; Chen et
al., 1992
; Kornhuber et al., 1989
; Parsons et
al., 1993
] that currently is clinically used in Germany in the
treatment of senile dementia and spasticity (Ditzler, 1991
;
Görtelmeyer and Erbler, 1992
). More specifically, memantine's
effects on both acquisition and expression of CPP induced by morphine
were assessed in the first experiment. The specificity of memantine's
effect was tested subsequently in the CPP paradigm in which rats were
reinforced by food, rather than morphine injection. The next experiment
was carried out to find if memantine may influence the motivational
aspect of naloxone-precipitated morphine withdrawal, as measured in the
CPA paradigm. Because the impact of memantine on acquisition/expression
of CPP could also be explained by its effects on learning and memory,
experiments were performed in which memantine was given to rats
acquiring and retrieving spatial information in the water maze. In
addition, because the effects of memantine on morphine-induced CPP
could be interpreted as a diminution of the subjective (interoceptive) effect of morphine, in the last experiment we investigated the influence of memantine on the interoceptive cue produced by morphine in
a drug-discrimination paradigm.
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Materials and Methods |
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Subjects. Male Wistar rats (approximately 300 g of weight at the beginning of the experiment) were housed under standard laboratory conditions for at least 2 weeks before experiments started. Animals were kept in plastic cages, four rats per cage (58 × 37 × 19 cm) in the animal room with a controlled light-dark cycle (lights on, 7:00 A.M.; off, 7:00 P.M.). Water and commercial food were available ad libitum, unless otherwise stated.
Drugs. Morphine HCl (Polfa), naloxone HCl (Endo), memantine HCl (Merz and Co.), (+)-morphine and etonitazene (both gifts of Dr. K. Rice, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD) were dissolved in physiological saline. Saline was used as placebo. The doses of morphine, naloxone and etonitazene correspond to the doses calculated as base for all other agents as respective salts. All injections were given in a volume of 1 ml/kg i.p., except in the drug discrimination experiment in which all agents except memantine were injected subcutaneously.
Induction of CPP.
The CPP procedure was similar to that
described previously by Papp and Moryl (1994)
. Four identical wooden
boxes with white and black chambers (30 × 20 × 25 cm each)
were used. The chambers had distinct floor textures (plain wood in the
white chamber and wire mesh in the black chamber, respectively). The
gray central area (12 × 20 × 25 cm) constituted a
"neutral" chamber. The CPP procedure consisted of
adaptation, pretest, acquisition of a conditioned response and the posttest. During the first 3 days of
training (adaptation phase), the rats were placed individually in the
apparatus to freely explore it for 10 min daily. These trials as well
as preliminary studies indicated that almost all subjects preferred the
black chamber over the white one. On day 4 (pretest), the time spent in
the white chamber during a 10-min free exploration session was measured
and recorded. This measure was used as an initial preference score for
each subject.
Induction of CPA. The CPA procedure was conceptually based on the work of Higgins and colleagues (1991, 1992). Rats were injected with morphine (10 mg/kg, twice daily, at 9:00 A.M. and 5:00 P.M.) for 8 days. On days 3, 4 and 5 of morphine treatment, adaptation sessions (10 min of unobserved, free exploration) were carried out at least 2 hr after the morning dose of morphine. On day 6 of morphine treatment, the pretest session was performed, as described for the CPP procedure, with the exception that the time in the black chamber was measured. On day 7, at least 90 min after the morning injection of morphine, rats were injected with placebo and 30 min later again injected with placebo. Immediately after the second injection, subjects were placed in the white chamber of the apparatus for 30 min. On day 8, at least 90 min after the morning injection of morphine, rats were injected with vehicle, 3.75 or 7.5 mg/kg of memantine, and 30 min later they received a 0.1 mg/kg naloxone injection. Immediately after the naloxone injection, rats were placed in the black chamber of the apparatus for 30 min. No more morphine injections were given to the animals. On day 9, the posttest was performed, during which the time spent in the black chamber was recorded during a session lasting for 10 min. The number of rats in each group was 10 to 15.
Effects of memantine on the acquisition and retention of spatial
learning and memory.
Rats were trained to find a metal platform
that was submerged 1 cm below the water surface in the swimming pool
(50 cm high, 180 cm in diameter) (Popik et al., 1994a
,b
).
The platform was positioned half-way between the wall and the center of
the circular pool and remained in this position throughout the 4 training days. There were six trials on each training day. Each trial
started from one of the four compass points around the pool perimeter, with the sequence, e.g., N, E, S, W, N, E. Rats were gently
placed into the water, facing the wall; the latency to find the
platform was measured for each rat. Subjects were kept on the platform for 30 sec, after which the next trial started. After completion of the
six swimming trials, rats were transferred to the "drying" cage and
later to their home cages. The experimental room contained numerous
visual cues and had dispersed illumination that allowed videotaping.
Effects of memantine on morphine-produced interoceptive cue as
measured in a drug-discrimination paradigm.
The Morris water maze
as described above was used to train rats (n = 8) to
discriminate between placebo (physiological saline) and (
)-morphine
HCl interoceptive cue (3.5 mg/kg). Rats were injected with placebo or
morphine 20 to 30 min before being gently placed in the tank at either
NE or SW compass starting point. Subjects were given four trials per
day, usually 6 to 7 days a week. The sequence of starting points was
random throughout the experiment and independent from treatment
conditions; however, in a given day a sequence of either the NE, SW,
NE, SW or SW, NE, SW, NE of starting points was used. During the
training, only one submerged platform was present inside the tank and
only one treatment was given. Half of the subjects were required to
associate placebo injection with the platform positioned in the NW
quadrant and morphine injection with the platform positioned in the SE quadrant. For the remaining half of the subjects, the assignment of
platforms was reversed. Typically, a double alternation scheme of
training was used, with rats receiving
placebo-placebo-morphine-morphine injections on subsequent days.
Subjects were kept on the platform for 30 sec, after which the next
trial started. After completion of the four swimming trials, rats were
transferred to the "drying" cage and later to their home cages. It
took approximately 40 training days for a rat to achieve the criterion
of "good" performance, defined as eight out of nine consecutive
first correct swimming trials. A trial was considered
"correct" if the rat swum from the starting point to the respective
platform without swimming in the vicinity (an area about two times
bigger than the size of platform) of the platform associated with the
alternative treatment (see fig. 1 for details).
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Data analysis and statistics. In the CPP and CPA studies, the preference scores were expressed as a percent increase or decrease of time spent by a rat in a given chamber of the apparatus on pretest and posttest. Data were analyzed by ANOVA, followed by Duncan or Student-Newmann-Keuls tests.
The changes in the latencies to find the platform during learning trials in the water maze task were analyzed by repeated measures ANOVA. One-way between subjects ANOVAs were used to analyze several parameters of the paths recorded during the probe trial. For establishing the ED50 dose of morphine in the drug-discrimination paradigm, the Litchfield and Wilcoxon (1949)| |
Results |
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Effects of memantine on the CPP induced by morphine. During the CPP pretest there were no differences in the time spent in the white chamber of the apparatus among groups (ANOVA, P = .23). However, the preference scores to that chamber after conditioning varied greatly among groups (F(8,97) = 4.09, P = .0003). Rats injected with morphine in the white (initially nonpreferred) chamber demonstrated a marked preference for this chamber during the drug-free posttest. To assess the effects of memantine on the acquisition of CPP, rats were injected with memantine before every conditioning session.
Memantine dose-dependently attenuated the acquisition of morphine-induced CPP, because at a dose of 7.5 mg/kg it produced statistically significant diminution of CPP as compared with placebo treatment (fig. 2). To assess the effects of memantine on the expression of CPP, rats that were previously conditioned to morphine received memantine (1.88, 3.75 or 7.5 mg/kg) before the posttest. Memantine dose-dependently attenuated the expression of morphine-induced CPP (fig. 2). As in the acquisition study, a dose of 7.5 mg/kg produced statistically significant inhibition of CPP expression. Control experiments demonstrated that rats injected in the white chamber with memantine (7.5 mg/kg) instead of morphine did not acquire preference to the memantine-associated chamber (fig. 2, dotted bar). In addition, memantine given at the same dose did not produce aversion to the memantine-associated chamber. Thus, whereas although rats treated with placebo in the black chamber demonstrated 76.8 ± 8.3% (n = 12) of the preference to that compartment, subjects treated with memantine in the black chamber demonstrated 76.6 ± 24.7% (n = 10) preference on the posttest compared with their pretest values.
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Effects of memantine on the CPP induced by food.
Rats that
received placebo injections both during conditioning and before the
posttest acquired CPP to the chamber associated with food (fig.
3).
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Effects of memantine on the CPA induced by naloxone-precipitated
morphine withdrawal.
Placebo-pretreated, naloxone-challenged
control rats demonstrated ~75% of their initial preference to the
black chamber, whereas morphine-dependent naloxone-challenged animals
showed significantly lower preference to that chamber (fig.
5). ANOVA demonstrated significant differences among
groups (F(4,51) = 2.91; P = .031).
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Morris water maze procedure: Effects of memantine on acquisition
and retention of spatial learning and memory.
All placebo-treated
rats trained in the Morris water maze demonstrated rapid acquisition of
the spatial memory (fig. 6). Two-way repeated measures
ANOVA performed on the swimming latencies data for all 24 trials
demonstrated significant effects of the treatment (F(2,483) = 16.54; P < .001), trial number (F(23,483) = 26.88; P < .001) and interaction (F(46,483) = 1.92; P < .001). Significant differences among groups (memantine vs.
vehicle) were detected when data were analyzed separately for the first
(P < .001), second (P < .001) and third (P < .01),
but not the fourth day of training.
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Effects of memantine on morphine-produced interoceptive cue as
measured in the drug-discrimination paradigm.
Rats tested the day
after the morphine training dose responded to the graded doses of
morphine with an ED50 of 0.74 mg/kg, whereas on the day
after placebo training the ED50 was 1.23 mg/kg (see table 2
for raw data). These dose-response curves were not different from each
other as calculated with the Litchfield and Wilcoxon (1949)
procedure.
Therefore, the ED50 of the combined data from both groups
was 0.98 mg/kg with confidence limits of 0.64 to 1.51 mg/kg.
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)-morphine (table 3). In contrast, 3.5 mg/kg of (+)-morphine did not produce morphine-positive responses.
Higher doses of (+)-morphine were not used because of shortage of the
material.
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Discussion |
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The present findings demonstrate that memantine in a dose-dependent fashion attenuated the acquisition and expression of morphine-induced CPP, but had no significant effect on the acquisition or expression of CPP induced by food presentation. Moreover, memantine partially inhibited acquisition of motivational aspects of naloxone-precipitated morphine withdrawal as measured in the CPA paradigm. In addition, at the dose that blocked morphine-induced CPP, memantine by itself produced neither CPP nor CPA. We failed to demonstrate that memantine at doses effective in CPP and CPA paradigms modified the interoceptive cue produced by morphine. Although, initially, memantine attenuated the acquisition of spatial learning, this effect was tolerated after 3 days, and no interference with the retrieval of spatial memory was found in the present experiments.
Consonant with previous studies (for reviews see Carr et
al., 1989
; Goudie, 1991
) the present experiments revealed that
morphine produced clear-cut CPP. Memantine inhibited both the
acquisition and expression of morphine-induced CPP. Similar inhibition
was found previously for kynurenic acid (Bespalov et al.,
1994
), a nonselective antagonist of excitatory amino acid receptors.
Recently, Tzschentke and Schmidt (1995)
demonstrated that dizocilpine
and CGP 37849, uncompetitive and competitive NMDA receptor antagonists, respectively, attenuate the acquisition of morphine-induced CPP.
The reduction of morphine-induced CPP by an NMDA receptor antagonist
(memantine) found in the present study could be related to several
effects that were not explicitly ruled out in the previous studies.
First, uncompetitive NMDA receptor antagonists are known to exert
inhibitory effects on associative learning (see Danysz et
al., 1995b
, for review). Because the establishment of CPP involves associative learning, it is likely that treatments inhibiting plastic
processes would inhibit CPP as well. However, it is generally agreed
that NMDA receptor antagonists affect the acquisition of new
information but not the storage or recall of associations that are well
established (Caramanos and Shapiro, 1994
; Danysz et al.,
1995b
; Shapiro and Caramanos, 1990
). Moreover, the amnestic effects of
memantine are usually seen at higher doses (10-20 mg/kg; Misztal
et al., 1995
), which suggests that the learning impairment is not of major importance for antagonism of morphine-induced CPP in
which a lower dose was used. Although memantine initially increased
latencies to find the hidden platform (which likely reflects
disturbances in swimming behavior and/or initial attenuation of spatial
learning acquisition), these effects were not longer apparent on the
last day of training (fig. 6). Thus, even if memantine were initially
to impair the acquisition of morphine-induced CPP, the purported
amnestic actions of this compound, by analogy, should cease by day 3 of
conditioning, whereas the association phase in the CPP experiments
lasted for 6 days. Further evidence against strong amnestic effects
comes from the analysis of swimming paths recorded during the probe
trial that specifically measures the strength of spatial memory. Thus,
table 1 demonstrates no differences between spatial navigation behavior
of rats treated with memantine or placebo during the acquisition of the
Morris spatial task. In agreement with our data, Barnes et
al. (1996)
reported that rats treated chronically with food
containing memantine (30 mg/kg/day) show increased maintenance of
long-term potentiation in vivo and normal learning in the
Morris maze. Other studies indicate that memantine infused at doses
leading to serum concentrations observed in humans has no effects in
naive animals and actually improves radial maze learning in rats after
entorhinal cortex lesion (Zajaczkowski et al., 1996
).
Moreover, Ditzler (1991)
, as well as Görtelmeyer and Erbler
(1992)
, reported positive cognitive effects of memantine in demented
patients.
Memantine at the dose inhibiting acquisition of morphine-induced CPP did not significantly affect food-induced CPP (fig. 3), which suggests that memantine-treated rats were able to associate food reinforcement with a distinctive environment. It should be mentioned that although statistical analysis (ANOVA, P > .05) indicated that memantine affected neither acquisition nor expression of food-induced CPP, the data presented in fig. 3 suggest that inhibitory effects of memantine might have been detected if a different statistical approach had been used. Such inhibitory effect may likely be related to the initial decrease of food intake seen in memantine-treated rats (fig. 4) and/or initial attenuation of learning processes as revealed in the Morris water maze (fig. 6). It remains an open question whether these factors contributed to memantine-induced attenuation of acquisition of morphine-induced CPP (fig. 2). Nonetheless, these factors are unlikely to explain the inhibitory effects of memantine on the expression of morphine-induced CPP, because memantine did not affect the retrieval of spatial memory (table 1).
It has been suggested recently that the treatments attenuating the
rewarding aspects of drugs of abuse may have aversive properties by
themselves, which confounds the interpretation of the results of CPP
studies. Such aversive effects were demonstrated for the L-type calcium
channel blockers (Pizzi and Cook, 1996
) which inhibit, e.g.,
cocaine-induced CPP (Pani et al., 1991
). To rule out this interpretation, the experiment was performed in which memantine (7.5 mg/kg) was administered to the rats in the black compartment of CPP
apparatus. If memantine would have aversive actions, it is likely that
rats would avoid the memantine-associated chamber. The data presented
under "Results" demonstrate the lack of aversive effects of
memantine, thus making the "aversive" interpretation unlikely.
Memantine could also decrease morphine-induced CPP by attenuating the
interoceptive cue produced by morphine and perhaps related to its
reinforcing action. Morphine possesses clear discriminative properties
(Colpaert, 1977
; Shannon and Holtzman, 1979
; Young et al.,
1992
) that are thought to contribute to its abuse liability (Jaffe,
1987
; Martin and Jasinski, 1969
). The correct choice of the
drug-associated compartment in the CPP procedure is based, among
others, on the recognition of spatial cues, whereas the most
often used procedures for measuring discriminative properties of drugs
are based on operant conditioning. Spatial learning and operant conditioning tasks use different forms of memory; and, perhaps
because of this fact, they are affected differently by amnestic
treatments (Danysz et al., 1995b
; Wessinger, 1994
). It was
therefore reasonable to compare the effects of memantine on morphine-induced CPP in a task relying on similar cognitive processes. Thus, for the present experiments a drug-discrimination procedure has
been developed that is based on the ability of rats to associate the
spatial position of a hidden platform with the interoceptive cue
produced by the drug. Spatial learning paradigms based on water T-maze
learning have been used previously for studying discriminative effects
of drugs (Henriksson and Jarbe, 1972
; Jarbe, 1987
).
Several earlier studies indicate that the cue produced by morphine in
drug discrimination paradigms arises from central drug actions and is
independent from its peripheral effects (Colpaert et al.,
1975
; Gianutsos and Lal, 1975
, 1976
). In the drug discrimination procedure used in the present study, rats were able to discriminate 3.5 mg/kg of morphine from placebo, a finding in accordance with numerous
previous studies that used operant conditioning techniques. To check
the reliability of the present version of the drug-discrimination paradigm, we investigated whether the discriminative effect of morphine: 1) is similar 1 day after morphine treatment as well as 1 day
after placebo treatment; 2) is stereospecific; 3) if another opioid
mu agonist will substitute for the morphine interoceptive cue and 4) if the discriminative effect of morphine could be blocked by
a specific antagonist. The data presented (tables 2 and 3) demonstrate
that the water maze could be used successfully as a tool for studying
discriminative effects of drugs. Thus, 1) the ED50 value
for the morphine interoceptive cue appeared not to be different the day
after the morphine training dose from the day after placebo treatment;
2) (+)-morphine, an unnatural isomer that is devoid of opioid effects
(Adams et al., 1991
; Van der Kooy et al., 1982
)
did not substitute for the (
)-morphine interoceptive cue; and 3)
etonitazene, a mu agonist ~1000 times more potent than
morphine in behavioral and neurochemical assays (Rice et
al., 1983
; Wikler et al., 1963
) substituted for the
morphine interoceptive cue with respectively higher potency than
morphine itself. In addition, a low dose of naloxone abolished the
discriminative cue produced by morphine. However, subjects injected
with morphine and memantine behaved similarly to rats injected with
morphine only (table 4). Thus, the present data suggest that it is
unlikely that memantine decreased the morphine interoceptive cue and
thereby inhibited acquisition of morphine-induced CPP. In agreement
with our data, Bespalov and colleagues (1995) reported recently in abstract form that a nonselective glutamate receptor antagonist, kynurenic acid, did not affect the heroin discriminative cue.
Since most probably, memantine did not inhibit the acquisition of
morphine-induced CPP through learning impairment or attenuation of the
morphine interoceptive cue, it is likely that it attenuated the
reinforcing impact of morphine. This observation is supported by the
fact that memantine also inhibited the expression of morphine-induced CPP, which suggests that this compound diminished the conditioned (secondarily reinforcing) properties of the morphine-associated environment. The inhibitory action of NMDA receptor antagonists on the
reinforcement produced by morphine are far from being fully understood.
Nevertheless, the inhibitory effects of memantine on morphine-induced
CPP but lack of effect on morphine discrimination may be explained by
differential involvement of dopaminergic transmission in these two
phenomena. For example, it is generally agreed that opioid (morphine
and heroine)-induced CPP depends critically on dopamine mesolimbic
systems, whereas no specific central site has been ascribed a primary
role in the morphine discriminative cue (cf. Joharchi
et al., 1993
). Moreover, Spyraki et al. (1983)
found that disruption of dopaminergic transmission by
6-hydroxydopamine-induced lesions of the nucleus accumbens or by
haloperidol treatment blocks CPP induced by opioids including morphine.
On the other hand, no agreement exists on the involvement of
dopaminergic transmission in the mediation of interoceptive properties
of opioids. Thus, complete generalization to a morphine cue after
amphetamine pretreatment has been reported in some (Shannon and
Holtzman, 1979
) but not all studies (Joharchi et al., 1993
).
Similarly, it appears that dopaminergic antagonists do not block the
opioid discriminative stimulus (Colpaert et al., 1976
;
Colpaert, 1977
).
The differential involvement of dopaminergic pathways in opioid-induced
CPP and drug discrimination of opioid compounds prompt consideration of
an interaction between glutamatergic and dopaminergic neurotransmission
as a potential basis of the inhibitory effects of memantine on
morphine-induced CPP. Several findings indicate that the mesolimbic
dopaminergic pathways are the anatomical substrate of drug
reinforcement (Di Chiara and Imperato, 1988
; Phillips and Le Paine,
1980
; also see Koob, 1992
; Robinson and Berridge, 1993
for reviews)
where dopaminergic and glutamatergic transmission interact mutually
(Jedema and Moghaddam, 1994
; Kalivas et al., 1989
; Krebs
et al., 1991
; Moghaddam and Bolinao, 1994
; Wolf et al., 1994
). In the striatum and nucleus accumbens glutamatergic afferents can increase dopamine release through interaction with NMDA
receptors (Di Chiara and Imperato, 1988
; Krebs et al.,
1991
). Increased locomotor activity has been observed after
intra-accumbens injection of glutamate; this effect is blocked by
dopaminergic antagonists (Donzanti and Uretsky, 1983
). Because
mesolimbic dopaminergic transmission is inevitably involved in the
regulation of drug reward (for reviews see Koob, 1992
), it is likely
that its modulation may affect the reinforcing properties of opioids.
It remains intriguing why the noncompetitive NMDA receptor antagonists
that have stimulant actions and increase activity of the mesolimbic
system, as evidenced by biochemical (Bubser et al., 1992
)
and electrophysiological data (French, 1994
), evoke inhibitory effects
on the reinforcing effects of morphine.
In contrast to another uncompetitive NMDA receptor antagonist,
dizocilpine that by itself produces clear CPP (Layer et al., 1993
; Papp and Moryl, 1994
), memantine seemed devoid of these reinforcing effects (fig. 3). This result was unexpected, but it should
be noted that dizocilpine exerts this reinforcing effect in a narrow
dose range (Layer et al., 1993
); and, as already mentioned, the blockade of NMDA receptor channel by memantine is characterized by
much faster kinetics (Chen et al., 1992
) and stronger
voltage dependence (Parsons et al., 1993
). In general, it
can be argued that lower affinity directly translates into faster
channel blocking kinetics and, within a certain range, into a more
favorable side-effects profile. However, too low affinity usually
results in a loss of selectivity which, in turn, can result in an
increase of side effects (see Parsons et al., 1995
for
discussion). The dose of memantine effective in the present study (7.5. mg/kg) would be expected to produce serum concentrations of ~1.5 µM
(see Danysz et al., 1994
for discussion), and a somewhat
(40-50%) lower concentration would be predicted to occur in the
cerebrospinal fluid (Danysz et al., 1994
). In demented
patients treated with memantine, serum concentrations of ~0.4 to 0.5 µM are observed (Kornhuber and Quack, 1995
). Based on patch-clamp
studies (Parsons et al., 1993
) such concentrations should be
sufficient to inhibit NMDA receptors in the brain. Hence, the failure
to demonstrate CPP after memantine was not caused by insufficient
dosing, which is also supported by the finding indicating that
neuroprotective activity is observed at doses leading to serum levels
of ~1 µM (Misztal et al., 1996
; Wenk et al.,
1995
).
Converging lines of evidence indicate that NMDA receptor antagonists
are effective in inhibiting the physical aspects of the expression of
morphine dependence (Cappendijk et al., 1993
; Popik et
al., 1995
; Rasmussen et al., 1991
; Tanganelli et
al., 1991
; Trujillo and Akil, 1991
). Such effects have also been
demonstrated recently for memantine at doses expected to affect
primarily, if not solely, NMDA receptors (Popik and Skolnick, 1996
). It
is worth noting that the inhibitory effects of memantine on the
expression of morphine withdrawal was attenuated by glycine
administration (Popik and Skolnick, 1996
), which suggests the
involvement of NMDA receptors. The expression of morphine dependence is
typically measured by precipitating morphine withdrawal syndrome with
an opioid antagonist. Although contemporary theories of drug addiction do not attribute a major motivational role of physical withdrawal syndrome to the maintenance of opioid dependence (Robinson and Berridge, 1993
; Wise and Bozarth, 1987
), the abrupt cessation of opioid
administration produces a state of extremely unpleasant sensations that
may motivate addicts to maintain illicit drug use (Eddy et
al., 1965
). The difference in physical and psychological aspects
of withdrawal syndrome is illustrated by the poor long-term effectiveness of clonidine treatment of abstinence syndrome in humans.
Clonidine, an alpha-2 adrenergic agonist, decreases the opioid abstinence syndrome in addicted individuals (Gold et
al., 1978
); however, it principally alleviates the physical but
not psychological (motivational) consequences of opioid withdrawal (Charney et al., 1981
; Jasinski et al., 1985
). It
might be hypothesized that the poor overall outcome (i.e.,
success rate of approximately 40% [Rounsaville et al.,
1985
]) of clonidine treatment of opioid abuse is caused by the fact
that clonidine fails to affect the motivational aspects of opioid
withdrawal syndrome. Therefore pharmacological manipulations that would
diminish the motivational aspects of opioid withdrawal may be
considered as more beneficial treatments of opioid dependence. Such
inhibitory effects on motivational aspects of opioid withdrawal
syndrome as demonstrated in the CPA procedure have been shown
previously for dizocilpine (Higgins et al., 1992
) and for
memantine in the present experiments (fig. 5). Clinical trials with
other uncompetitive NMDA receptor antagonists, dextromethorphan and ibogaine, in opioid addicts were
reported to be successful (Koyuncuoglu and Saydam, 1990
; Koyuncuoglu,
1995
; Sheppard, 1994
).
In conclusion, the present study demonstrates that in rats memantine
may attenuate the reinforcing aspects of morphine and of morphine
withdrawal syndrome, being inactive by itself in the CPP or CPA
paradigms. It remains to be established if the diminution of the
physical (Popik and Skolnick, 1996
) as well as motivational (present
study) signs of expression of opioid withdrawal produced by memantine
also can be seen in humans.
| |
Acknowledgments |
|---|
The authors would like to thank Dr. Parsons for linguistic corrections.
| |
Footnotes |
|---|
Accepted for publication October 28, 1996.
Received for publication July 15, 1996.
1 This study was partially supported by State Committee for Scientific Research grant 4. PO5A.116.10 to P.P.
Send reprint requests to: Dr. Piotr Popik, Institute of
Pharmacology, Polish Academy of Sciences, Sm
tna 12, 31-343
Kraków, Poland. E-mail:
nfpopik{at}cyf-kr.edu.pl
| |
Abbreviations |
|---|
CGP-37849, DL-(E)-2-amino-4-methyl-5-phosphono-3-pentanoic acid; CPA, conditioned place aversion; CPP, conditioned place preference; MK-801, (+)-5-methyl-10,11-dihydro-5H-dibenzocyclohepten-5,10-imine maleate, dizocilpine; NMDA, N-methyl-D-aspartate; ANOVA, analysis of variance.
| |
References |
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|
|---|
-opioids.
Pain
56: 69-75, 1994[Medline].