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Bershad AK, de Wit H. Social Psychopharmacology: Novel Approaches to Treat Deficits in Social Motivation in Schizophrenia. Schizophr Bull 2023; 49:1161-1173. [PMID: 37358825 PMCID: PMC10483474 DOI: 10.1093/schbul/sbad094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
BACKGROUND AND HYPOTHESIS Diminished social motivation is a negative symptom of schizophrenia and leads to severe functional consequences for many patients suffering from the illness. However, there are no effective medications available to treat this symptom. Despite the lack of approved treatments for patients, there is a growing body of literature on the effects of several classes of drugs on social motivation in healthy volunteers that may be relevant to patients. The aim of this review is to synthesize these results in an effort to identify novel directions for the development of medications to treat reduced social motivation in schizophrenia. STUDY DESIGN In this article, we review pharmacologic challenge studies addressing the acute effects of psychoactive drugs on social motivation in healthy volunteers and consider how these findings may be applied to deficits in social motivation in schizophrenia. We include studies testing amphetamines and 3,4-methylenedioxymethamphetamine (MDMA), opioids, cannabis, serotonergic psychedelics, antidepressants, benzodiazepines, and neuropeptides. STUDY RESULTS We report that amphetamines, MDMA, and some opioid medications enhance social motivation in healthy adults and may represent promising avenues of investigation in schizophrenia. CONCLUSIONS Given the acute effects of these drugs on behavioral and performance-based measures of social motivation in healthy volunteers, they may be particularly beneficial as an adjunct to psychosocial training programs in patient populations. It remains to be determined how these medications affect patients with deficits in social motivation, and in which contexts they may be most effectively administered.
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Affiliation(s)
- Anya K Bershad
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles Semel Institute for Neuroscience and Human Behavior, Los Angeles, CAUSA
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, ILUSA
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2
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Hallucinations and Hallucinogens: Psychopathology or Wisdom? Cult Med Psychiatry 2023; 47:576-604. [PMID: 36633720 PMCID: PMC9838303 DOI: 10.1007/s11013-022-09814-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/27/2022] [Indexed: 01/13/2023]
Abstract
Hallucinations are currently associated almost exclusively with psychopathological states. While it is evident that hallucinations can indicate psychopathology or neurological disorders, we should remember that hallucinations also commonly occur in people without any signs of psychopathology. A similar case occurs in the case of hallucinogenic drugs, which have been long associated with psychopathology and insanity. However, during the last decades a huge body of research has shown that certain kinds of hallucinations, exerted by hallucinogenic drugs, may serve to improve mental health. We propose that, in light of historical, epidemiological, and scientific research, hallucinations can be better characterized as a common phenomenon associated sometimes with psychopathology but also with functional and even beneficial outcomes. In the last sections of the manuscript, we extend our argument, suggesting that hallucinations can offer a via regia to knowledge of the mind and the world. This radical shift in the cultural interpretation of hallucinations could have several implications for fields such as drug policy, civil law, and psychiatry, as well as for the stigma associated with mental disorders.
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3
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The Altered States Database: Psychometric data from a systematic literature review. Sci Data 2022; 9:720. [PMID: 36418335 PMCID: PMC9684144 DOI: 10.1038/s41597-022-01822-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 11/01/2022] [Indexed: 11/26/2022] Open
Abstract
In this paper, we present the development of the Altered States Database (ASDB), an open-science project based on a systematic literature review. The ASDB contains psychometric questionnaire data on subjective experiences of altered states of consciousness (ASC) induced by pharmacological and non-pharmacological methods. The systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Scientific journal articles were identified through PubMed and Web of Science. We included studies that examined ASC using the following validated questionnaires: Altered States of Consciousness Rating Scale (APZ, 5D-ASC, 11-ASC), Phenomenology of Consciousness Inventory (PCI), Hallucinogen Rating Scale (HRS), or Mystical Experience Questionnaire (MEQ30). The systematic review resulted in the inclusion of a total of 165 journal articles, whereof questionnaire data was extracted and is now available on the Open Science Framework (OSF) website (https://osf.io/8mbru) and on the ASDB website (http://alteredstatesdb.org), where questionnaire data can be easily retrieved and visualized. This data allows the calculation of comparable psychometric values of ASC experiences and of dose-response relationships of substances inducing ASC. Measurement(s) | Psychometric questionnaire data | Technology Type(s) | Systematic literature review (PRISMA) | Sample Characteristic - Organism | Human |
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4
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Dourron HM, Strauss C, Hendricks PS. Self-Entropic Broadening Theory: Toward a New Understanding of Self and Behavior Change Informed by Psychedelics and Psychosis. Pharmacol Rev 2022; 74:982-1027. [DOI: 10.1124/pharmrev.121.000514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 11/22/2022] Open
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5
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Dalefield ML, Scouller B, Bibi R, Kivell BM. The Kappa Opioid Receptor: A Promising Therapeutic Target for Multiple Pathologies. Front Pharmacol 2022; 13:837671. [PMID: 35795569 PMCID: PMC9251383 DOI: 10.3389/fphar.2022.837671] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Abstract
Kappa-opioid receptors (KOR) are widely expressed throughout the central nervous system, where they modulate a range of physiological processes depending on their location, including stress, mood, reward, pain, inflammation, and remyelination. However, clinical use of KOR agonists is limited by adverse effects such as dysphoria, aversion, and sedation. Within the drug-development field KOR agonists have been extensively investigated for the treatment of many centrally mediated nociceptive disorders including pruritis and pain. KOR agonists are potential alternatives to mu-opioid receptor (MOR) agonists for the treatment of pain due to their anti-nociceptive effects, lack of abuse potential, and reduced respiratory depressive effects, however, dysphoric side-effects have limited their widespread clinical use. Other diseases for which KOR agonists hold promising therapeutic potential include pruritis, multiple sclerosis, Alzheimer’s disease, inflammatory diseases, gastrointestinal diseases, cancer, and ischemia. This review highlights recent drug-development efforts targeting KOR, including the development of G-protein–biased ligands, mixed opioid agonists, and peripherally restricted ligands to reduce side-effects. We also highlight the current KOR agonists that are in preclinical development or undergoing clinical trials.
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6
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Doss MK, Madden MB, Gaddis A, Nebel MB, Griffiths RR, Mathur BN, Barrett FS. Models of psychedelic drug action: modulation of cortical-subcortical circuits. Brain 2022; 145:441-456. [PMID: 34897383 PMCID: PMC9014750 DOI: 10.1093/brain/awab406] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 08/10/2021] [Accepted: 10/05/2021] [Indexed: 12/15/2022] Open
Abstract
Classic psychedelic drugs such as psilocybin and lysergic acid diethylamide (LSD) have recaptured the imagination of both science and popular culture, and may have efficacy in treating a wide range of psychiatric disorders. Human and animal studies of psychedelic drug action in the brain have demonstrated the involvement of the serotonin 2A (5-HT2A) receptor and the cerebral cortex in acute psychedelic drug action, but different models have evolved to try to explain the impact of 5-HT2A activation on neural systems. Two prominent models of psychedelic drug action (the cortico-striatal thalamo-cortical, or CSTC, model and relaxed beliefs under psychedelics, or REBUS, model) have emphasized the role of different subcortical structures as crucial in mediating psychedelic drug effects. We describe these models and discuss gaps in knowledge, inconsistencies in the literature and extensions of both models. We then introduce a third circuit-level model involving the claustrum, a thin strip of grey matter between the insula and the external capsule that densely expresses 5-HT2A receptors (the cortico-claustro-cortical, or CCC, model). In this model, we propose that the claustrum entrains canonical cortical network states, and that psychedelic drugs disrupt 5-HT2A-mediated network coupling between the claustrum and the cortex, leading to attenuation of canonical cortical networks during psychedelic drug effects. Together, these three models may explain many phenomena of the psychedelic experience, and using this framework, future research may help to delineate the functional specificity of each circuit to the action of both serotonergic and non-serotonergic hallucinogens.
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Affiliation(s)
- Manoj K Doss
- Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, 21224, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21224, USA
| | - Maxwell B Madden
- Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Andrew Gaddis
- Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, 21224, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21224, USA
| | - Mary Beth Nebel
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, 21205, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Roland R Griffiths
- Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, 21224, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21224, USA
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Brian N Mathur
- Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Frederick S Barrett
- Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, 21224, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21224, USA
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Department of Psychological and Brain Sciences, Johns Hopkins University, Baltimore, MD 21218, USA
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7
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Abraham AD, Casello SM, Schattauer SS, Wong BA, Mizuno GO, Mahe K, Tian L, Land BB, Chavkin C. Release of endogenous dynorphin opioids in the prefrontal cortex disrupts cognition. Neuropsychopharmacology 2021; 46:2330-2339. [PMID: 34545197 PMCID: PMC8580977 DOI: 10.1038/s41386-021-01168-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/20/2021] [Accepted: 08/21/2021] [Indexed: 02/06/2023]
Abstract
Following repeated opioid use, some dependent individuals experience persistent cognitive deficits that contribute to relapse of drug-taking behaviors, and one component of this response may be mediated by the endogenous dynorphin/kappa opioid system in neocortex. In C57BL/6 male mice, we find that acute morphine withdrawal evokes dynorphin release in the medial prefrontal cortex (PFC) and disrupts cognitive function by activation of local kappa opioid receptors (KORs). Immunohistochemical analyses using a phospho-KOR antibody confirmed that both withdrawal-induced and optically evoked dynorphin release activated KOR in PFC. Using a genetically encoded sensor based on inert KOR (kLight1.2a), we revealed the in vivo dynamics of endogenous dynorphin release in the PFC. Local activation of KOR in PFC produced multi-phasic disruptions of memory processing in an operant-delayed alternation behavioral task, which manifest as reductions in response number and accuracy during early and late phases of an operant session. Local pretreatment in PFC with the selective KOR antagonist norbinaltorphimine (norBNI) blocked the disruptive effect of systemic KOR activation during both early and late phases of the session. The early, but not late phase disruption was blocked by viral excision of PFC KORs, suggesting an anatomically dissociable contribution of pre- and postsynaptic KORs. Naloxone-precipitated withdrawal in morphine-dependent mice or optical stimulation of pdynCre neurons using Channelrhodopsin-2 disrupted delayed alternation performance, and the dynorphin-induced effect was blocked by local norBNI. Our findings describe a mechanism for control of cortical function during opioid dependence and suggest that KOR antagonism could promote abstinence.
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Affiliation(s)
- Antony D. Abraham
- grid.34477.330000000122986657Center for Neurobiology of Addiction, Pain, and Emotion, University of Washington, Seattle, WA USA ,grid.34477.330000000122986657Department of Pharmacology, University of Washington, Seattle, WA USA
| | - Sanne M. Casello
- grid.34477.330000000122986657Department of Pharmacology, University of Washington, Seattle, WA USA
| | - Selena S. Schattauer
- grid.34477.330000000122986657Center for Neurobiology of Addiction, Pain, and Emotion, University of Washington, Seattle, WA USA ,grid.34477.330000000122986657Department of Pharmacology, University of Washington, Seattle, WA USA
| | - Brenden A. Wong
- grid.34477.330000000122986657Department of Bioengineering, University of Washington, Seattle, WA USA
| | - Grace O. Mizuno
- grid.27860.3b0000 0004 1936 9684Department of Biochemistry and Molecular Medicine, University of California, Davis, Davis, CA USA
| | - Karan Mahe
- grid.27860.3b0000 0004 1936 9684Department of Biochemistry and Molecular Medicine, University of California, Davis, Davis, CA USA
| | - Lin Tian
- grid.27860.3b0000 0004 1936 9684Department of Biochemistry and Molecular Medicine, University of California, Davis, Davis, CA USA
| | - Benjamin B. Land
- grid.34477.330000000122986657Center for Neurobiology of Addiction, Pain, and Emotion, University of Washington, Seattle, WA USA ,grid.34477.330000000122986657Department of Pharmacology, University of Washington, Seattle, WA USA
| | - Charles Chavkin
- Center for Neurobiology of Addiction, Pain, and Emotion, University of Washington, Seattle, WA, USA. .,Department of Pharmacology, University of Washington, Seattle, WA, USA.
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8
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Ona G, Sampedro F, Romero S, Valle M, Camacho V, Migliorelli C, Mañanas MÁ, Antonijoan RM, Puntes M, Coimbra J, Ballester MR, Garrido M, Riba J. The Kappa Opioid Receptor and the Sleep of Reason: Cortico-Subcortical Imbalance Following Salvinorin-A. Int J Neuropsychopharmacol 2021; 25:54-63. [PMID: 34537829 PMCID: PMC8756086 DOI: 10.1093/ijnp/pyab063] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 08/25/2021] [Accepted: 09/15/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The mechanisms through which kappa opioid receptor (KOR) agonists induce psychotomimetic effects are largely unknown, although the modulation of this receptor has attracted attention for its clinical use. In this work, we characterize the neuropharmacological effects of salvinorin-A, a highly selective KOR agonist. METHODS Changes in multimodal electroencephalography, single-photon emission computed tomography, and subjective effects following the acute administration of salvinorin-A are reported. The study included 2 sub-studies that employed a double-blind, crossover, randomized, placebo-controlled design. RESULTS The electroencephalography measures showed a marked increase in delta and gamma waves and a decrease in alpha waves while subjects were under the effect of salvinorin-A. Regarding single-photon emission computed tomography measures, significant decreases in regional cerebral blood flow were detected in multiple regions of the frontal, temporal, parietal, and occipital cortices. Significant regional cerebral blood flow increases were observed in some regions of the medial temporal lobe, including the amygdala, the hippocampal gyrus, and the cerebellum. The pattern of subjective effects induced by salvinorin-A was similar to those observed in relation to other psychotomimetic drugs but with an evidently dissociative nature. No dysphoric effects were reported. CONCLUSION The salvinorin-A-mediated KOR agonism induced dramatic psychotomimetic effects along with a generalized decrease in cerebral blood flow and electric activity within the cerebral cortex.
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Affiliation(s)
- Genís Ona
- Human Neuropsychopharmacology Group, Sant Pau Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain
| | - Frederic Sampedro
- Sant Pau Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain,Correspondence: Frederic Sampedro, PhD, Hospital de Sant Pau Research Institute, Sant Quintí Street number 77, 08041 Barcelona, Spain ()
| | - Sergio Romero
- Department of Automatic Control (ESAII), Biomedical Engineering Research Center (CREB), Universitat Politècnica de Catalunya (UPC), Barcelona, Spain,Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain
| | - Marta Valle
- Departament de Farmacologia i Terapèutica, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Valle Camacho
- Nuclear Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Carolina Migliorelli
- Department of Automatic Control (ESAII), Biomedical Engineering Research Center (CREB), Universitat Politècnica de Catalunya (UPC), Barcelona, Spain,Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain
| | - Miguel Ángel Mañanas
- Department of Automatic Control (ESAII), Biomedical Engineering Research Center (CREB), Universitat Politècnica de Catalunya (UPC), Barcelona, Spain,Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain
| | - Rosa Maria Antonijoan
- Departament de Farmacologia i Terapèutica, Universitat Autònoma de Barcelona, Barcelona, Spain,Centre d’Investigació de Medicaments, Sant Pau Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain,Servei de Farmacologia Clínica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain
| | - Montserrat Puntes
- Centre d’Investigació de Medicaments, Sant Pau Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain
| | - Jimena Coimbra
- Centre d’Investigació de Medicaments, Sant Pau Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain
| | - Maria Rosa Ballester
- Centre d’Investigació de Medicaments, Sant Pau Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain,Blanquerna School of Health Science, Universitat Ramon Llull, Barcelona, Spain
| | - Maite Garrido
- Centre d’Investigació de Medicaments, Sant Pau Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain
| | - Jordi Riba
- Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht,the Netherlands
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9
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Losing the Self in Near-Death Experiences: The Experience of Ego-Dissolution. Brain Sci 2021; 11:brainsci11070929. [PMID: 34356163 PMCID: PMC8307473 DOI: 10.3390/brainsci11070929] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/30/2021] [Accepted: 07/08/2021] [Indexed: 12/12/2022] Open
Abstract
Many people who have had a near-death experience (NDE) describe, as part of it, a disturbed sense of having a “distinct self”. However, no empirical studies have been conducted to explore the frequency or intensity of these effects. We surveyed 100 NDE experiencers (Near-Death-Experience Content [NDE-C] scale total score ≥27/80). Eighty participants had their NDEs in life-threatening situations and 20 had theirs not related to life-threatening situations. Participants completed the Ego-Dissolution Inventory (EDI) and the Ego-Inflation Inventory (EII) to assess the experience of ego dissolution and inflation potentially experienced during their NDE, respectively. They also completed the Nature-Relatedness Scale (NR-6) which measures the trait-like construct of one’s self-identification with nature. Based on prior hypotheses, ratings of specific NDE-C items pertaining to out-of-body experiences and a sense of unity were used for correlational analyses. We found higher EDI total scores compared with EII total scores in our sample. Total scores of the NDE-C scale were positively correlated with EDI total scores and, although less strongly, the EII and NR-6 scores. EDI total scores were also positively correlated with the intensity of OBE and a sense of unity. This study suggests that the experience of dissolved ego-boundaries is a common feature of NDEs.
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de Abreu MS, Costa F, Giacomini ACVV, Demin KA, Petersen EV, Rosemberg DB, Kalueff AV. Exploring CNS effects of American traditional medicines using zebrafish models. Curr Neuropharmacol 2021; 20:550-559. [PMID: 34254921 DOI: 10.2174/1570159x19666210712153329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 05/23/2021] [Accepted: 05/28/2021] [Indexed: 11/22/2022] Open
Abstract
Although American traditional medicine (ATM) has been practiced for millennia, its complex multi-target mechanisms of therapeutic action remain poorly understood. Animal models are widely used to elucidate the therapeutic effects of various ATMs, including their modulation of brain and behavior. Complementing rodent models, the zebrafish (Danio rerio) is a promising novel organism in translational neuroscience and neuropharmacology research. Here, we emphasize the growing value of zebrafish for testing neurotropic effects of ATMs and outline future directions of research in this field. We also demonstrate the developing utility of zebrafish as complementary models for probing CNS mechanisms of ATM action and their potential to treat brain disorders.
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Affiliation(s)
- Murilo S de Abreu
- Laboratory of Cell and Molecular Biology and Neurobiology, Moscow Institute of Physics and Technology, Moscow, Russian Federation
| | - Fabiano Costa
- Toxicological Biochemistry, Natural and Exact Sciences Center, Federal University of Santa Maria, Brazil
| | - Ana C V V Giacomini
- Laboratory of Cell and Molecular Biology and Neurobiology, Moscow Institute of Physics and Technology, Moscow, Russian Federation
| | | | - Elena V Petersen
- Laboratory of Cell and Molecular Biology and Neurobiology, Moscow Institute of Physics and Technology, Moscow, Russian Federation
| | - Denis B Rosemberg
- The International Zebrafish Neuroscience Research Consortium (ZNRC), Slidell, LA, United States
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11
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Pharmacokinetics and Pharmacodynamics of Salvinorin A and Salvia divinorum: Clinical and Forensic Aspects. Pharmaceuticals (Basel) 2021; 14:ph14020116. [PMID: 33546518 PMCID: PMC7913753 DOI: 10.3390/ph14020116] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/26/2021] [Accepted: 01/29/2021] [Indexed: 01/13/2023] Open
Abstract
Salvia divinorum Epling and Játiva is a perennial mint from the Lamiaceae family, endemic to Mexico, predominantly from the state of Oaxaca. Due to its psychoactive properties, S. divinorum had been used for centuries by Mazatecans for divinatory, religious, and medicinal purposes. In recent years, its use for recreational purposes, especially among adolescents and young adults, has progressively increased. The main bioactive compound underlying the hallucinogenic effects, salvinorin A, is a non-nitrogenous diterpenoid with high affinity and selectivity for the κ-opioid receptor. The aim of this work is to comprehensively review and discuss the toxicokinetics and toxicodynamics of S. divinorum and salvinorin A, highlighting their psychological, physiological, and toxic effects. Potential therapeutic applications and forensic aspects are also covered in this review. The leaves of S. divinorum can be chewed, drunk as an infusion, smoked, or vaporised. Absorption of salvinorin A occurs through the oral mucosa or the respiratory tract, being rapidly broken down in the gastrointestinal system to its major inactive metabolite, salvinorin B, when swallowed. Salvinorin A is rapidly distributed, with accumulation in the brain, and quickly eliminated. Its pharmacokinetic parameters parallel well with the short-lived psychoactive and physiological effects. No reports on toxicity or serious adverse outcomes were found. A variety of therapeutic applications have been proposed for S. divinorum which includes the treatment of chronic pain, gastrointestinal and mood disorders, neurological diseases, and treatment of drug dependence. Notwithstanding, there is still limited knowledge regarding the pharmacology and toxicology features of S. divinorum and salvinorin A, and this is needed due to its widespread use. Additionally, the clinical acceptance of salvinorin A has been hampered, especially due to the psychotropic side effects and misuse, turning the scientific community to the development of analogues with better pharmacological profiles.
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12
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Fatur K. Peculiar plants and fantastic fungi: An ethnobotanical study of the use of hallucinogenic plants and mushrooms in Slovenia. PLoS One 2021; 16:e0245022. [PMID: 33412556 PMCID: PMC7790546 DOI: 10.1371/journal.pone.0245022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 12/18/2020] [Indexed: 11/18/2022] Open
Abstract
The present study examined the patterns of use among a sample of 68 users of hallucinogenic plants and mushrooms in Slovenia. In compiling the lists of all the participants, 26 different plants/mushrooms, mixtures, or products were found to have been used. The main reason for beginning to use these substances was curiosity, and most people began using them in their 20s. The most used were Psilocybe spp., being mentioned by approximately 91% of the participants; 50% of the respondents in the study had made use of no other natural hallucinogens besides these. Many of the plants or mushrooms were used only a small number of times. No matter what items had been used, the internet often played a role in first hearing about them. Dosing and the means of using the various hallucinogens were often quite varied, as were the settings where they were taken. Knowledge of the dangers of these hallucinogenic plants and mushrooms as well as their occurrence in nature were likewise vastly varied. Though public opinion often associates the use of mind-altering substances with problematic drug use and partying, the majority of the individuals interviewed seemed to present a greater desire to experience the interesting effects, to overcome personal difficulties, and for individual and spiritual growth.
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Affiliation(s)
- Karsten Fatur
- Univerza v Ljubljani, Fakulteta za farmacijo, Ljubljana, Slovenia
- * E-mail:
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13
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Flores-Tolentino M, Lara-Cabrera SI, Villaseñor JL. Distribution, richness and conservation of the genus Salvia (Lamiaceae) in the State of Michoacán, Mexico. Biodivers Data J 2020; 8:e56827. [PMID: 33199965 PMCID: PMC7644648 DOI: 10.3897/bdj.8.e56827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 10/13/2020] [Indexed: 11/17/2022] Open
Abstract
Little attention has been paid in Mexico to species’ geographical distribution, particularly documenting geographic ranges, as a tool to estimate their conservation status. The objective of this study was to review known species distribution and propose potential and conservation status for Salvia species in Michoacán sState using Ecological Niche Models (ENM). We reviewed taxonomic studies for Salvia in Michoacán to compile an initial species checklist, built upon with recently-described species; all the specimens deposited in the National Herbarium were reviewed. The collection data allowed us to build niche models of Salvia species reported for Michoacán. ENM were generated for the species listed using Maxent. In order to minimise collinearity, environmental variables were selected using a Pearson correlation test. Individual models were statistically evaluated and the potential distribution models for each individual species were stacked to obtain the map of richness potential distribution in the State. A total of 66 species of Salvia are listed for Michoacán; however, ENM could only be constructed for 42 of those with ≥ 5 specimens. The environmental variable that most strongly contributed to the models was annual average temperature. The models estimated that Salvia species occupy an area of 23,541 km2 in the State, 72% in the Trans-Mexican Volcanic Belt and a second richest ecoregion is the Sierra Madre del Sur. Although only 3% of the potential distribution area for Salvia in Michoacán is within Protected Areas (PAs), nonetheless, no PA includes rare species. It will therefore be necessary to consider new protection areas or expand existing ones in order to adequately conserve Salvia richness and rarity in the State.
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Affiliation(s)
- Mayra Flores-Tolentino
- Universidad Nacional Autónoma de México, Ciudad de México, Mexico Universidad Nacional Autónoma de México Ciudad de México Mexico
| | - Sabina I Lara-Cabrera
- Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Mexico Universidad Michoacana de San Nicolás de Hidalgo Morelia Mexico
| | - José Luis Villaseñor
- Universidad Nacional Autónoma de México, Ciudad de México, Mexico Universidad Nacional Autónoma de México Ciudad de México Mexico
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14
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Jacobson ML, Browne CA, Lucki I. Kappa Opioid Receptor Antagonists as Potential Therapeutics for Stress-Related Disorders. Annu Rev Pharmacol Toxicol 2020; 60:615-636. [DOI: 10.1146/annurev-pharmtox-010919-023317] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Exposure to stressful stimuli activates kappa opioid receptor (KOR) signaling, a process known to produce aversion and dysphoria in humans and other species. This endogenous opioid system is dysregulated in stress-related disorders, specifically in major depressive disorder (MDD). These findings serve as the foundation for a growing interest in the therapeutic potential of KOR antagonists as novel antidepressants. In this review, data supporting the hypothesis of dysregulated KOR function in MDD are considered. The clinical data demonstrating the therapeutic efficacy and safety of selective and mixed opioid antagonists are then presented. Finally, the preclinical evidence illustrating the induction of behaviors relevant to the endophenotypes of MDD and KOR antagonist activity in stress-naïve and stress-exposed animals is evaluated. Overall, this review highlights the emergent literature supporting the pursuit of KOR antagonists as novel therapeutics for MDD and other stress-related disorders.
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Affiliation(s)
- Moriah L. Jacobson
- Department of Pharmacology & Molecular Therapeutics, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, USA
| | - Caroline A. Browne
- Department of Pharmacology & Molecular Therapeutics, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, USA
| | - Irwin Lucki
- Department of Pharmacology & Molecular Therapeutics, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, USA
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, USA
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15
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Russo M, Carrarini C, Dono F, Rispoli MG, Di Pietro M, Di Stefano V, Ferri L, Bonanni L, Sensi SL, Onofrj M. The Pharmacology of Visual Hallucinations in Synucleinopathies. Front Pharmacol 2019; 10:1379. [PMID: 31920635 PMCID: PMC6913661 DOI: 10.3389/fphar.2019.01379] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 10/30/2019] [Indexed: 12/13/2022] Open
Abstract
Visual hallucinations (VH) are commonly found in the course of synucleinopathies like Parkinson's disease and dementia with Lewy bodies. The incidence of VH in these conditions is so high that the absence of VH in the course of the disease should raise questions about the diagnosis. VH may take the form of early and simple phenomena or appear with late and complex presentations that include hallucinatory production and delusions. VH are an unmet treatment need. The review analyzes the past and recent hypotheses that are related to the underlying mechanisms of VH and then discusses their pharmacological modulation. Recent models for VH have been centered on the role played by the decoupling of the default mode network (DMN) when is released from the control of the fronto-parietal and salience networks. According to the proposed model, the process results in the perception of priors that are stored in the unconscious memory and the uncontrolled emergence of intrinsic narrative produced by the DMN. This DMN activity is triggered by the altered functioning of the thalamus and involves the dysregulated activity of the brain neurotransmitters. Historically, dopamine has been indicated as a major driver for the production of VH in synucleinopathies. In that context, nigrostriatal dysfunctions have been associated with the VH onset. The efficacy of antipsychotic compounds in VH treatment has further supported the notion of major involvement of dopamine in the production of the hallucinatory phenomena. However, more recent studies and growing evidence are also pointing toward an important role played by serotonergic and cholinergic dysfunctions. In that respect, in vivo and post-mortem studies have now proved that serotonergic impairment is often an early event in synucleinopathies. The prominent cholinergic impairment in DLB is also well established. Finally, glutamatergic and gamma aminobutyric acid (GABA)ergic modulations and changes in the overall balance between excitatory and inhibitory signaling are also contributing factors. The review provides an extensive overview of the pharmacology of VH and offers an up to date analysis of treatment options.
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Affiliation(s)
- Mirella Russo
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Claudia Carrarini
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Fedele Dono
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Marianna Gabriella Rispoli
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Martina Di Pietro
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Vincenzo Di Stefano
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Laura Ferri
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Laura Bonanni
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Stefano Luca Sensi
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
- Behavioral Neurology and Molecular Neurology Units, Center of Excellence on Aging and Translational Medicine—CeSI-MeT, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
- Departments of Neurology and Pharmacology, Institute for Mind Impairments and Neurological Disorders—iMIND, University of California, Irvine, Irvine, CA, United States
| | - Marco Onofrj
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
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16
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Kaski SW, White AN, Gross JD, Trexler KR, Wix K, Harland AA, Prisinzano TE, Aubé J, Kinsey SG, Kenakin T, Siderovski DP, Setola V. Preclinical Testing of Nalfurafine as an Opioid-sparing Adjuvant that Potentiates Analgesia by the Mu Opioid Receptor-targeting Agonist Morphine. J Pharmacol Exp Ther 2019; 371:487-499. [PMID: 31492823 DOI: 10.1124/jpet.118.255661] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 07/16/2019] [Indexed: 01/11/2023] Open
Abstract
Mu opioid receptor (MOR)-targeting analgesics are efficacious pain treatments, but notorious for their abuse potential. In preclinical animal models, coadministration of traditional kappa opioid receptor (KOR)-targeting agonists with MOR-targeting analgesics can decrease reward and potentiate analgesia. However, traditional KOR-targeting agonists are well known for inducing antitherapeutic side effects (psychotomimesis, depression, anxiety, dysphoria). Recent data suggest that some functionally selective, or biased, KOR-targeting agonists might retain the therapeutic effects of KOR activation without inducing undesirable side effects. Nalfurafine, used safely in Japan since 2009 for uremic pruritus, is one such functionally selective KOR-targeting agonist. Here, we quantify the bias of nalfurafine and several other KOR agonists relative to an unbiased reference standard (U50,488) and show that nalfurafine and EOM-salvinorin-B demonstrate marked G protein-signaling bias. While nalfurafine (0.015 mg/kg) and EOM-salvinorin-B (1 mg/kg) produced spinal antinociception equivalent to 5 mg/kg U50,488, only nalfurafine significantly enhanced the supraspinal analgesic effect of 5 mg/kg morphine. In addition, 0.015 mg/kg nalfurafine did not produce significant conditioned place aversion, yet retained the ability to reduce morphine-induced conditioned place preference in C57BL/6J mice. Nalfurafine and EOM-salvinorin-B each produced robust inhibition of both spontaneous and morphine-stimulated locomotor behavior, suggesting a persistence of sedative effects when coadministered with morphine. Taken together, these findings suggest that nalfurafine produces analgesic augmentation, while also reducing opioid-induced reward with less risk of dysphoria. Thus, adjuvant administration of G protein-biased KOR agonists like nalfurafine may be beneficial in enhancing the therapeutic potential of MOR-targeting analgesics, such as morphine.
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Affiliation(s)
- Shane W Kaski
- Departments of Physiology and Pharmacology (S.W.K., A.N.W., J.D.G., K.W., D.P.S., V.S.), Neuroscience, and Behavioral Medicine and Psychiatry (V.S.), West Virginia University School of Medicine, Morgantown, West Virginia; Department of Psychology, West Virginia University Eberly College of Arts and Sciences, Morgantown, West Virginia (K.R.T., S.G.K.); Department of Medicinal Chemistry, The University of Kansas School of Pharmacy, Lawrence, Kansas (T.E.P.); Division of Chemical Biology and Medicinal Chemistry, The University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina (A.A.H., J.A.); and Department of Pharmacology, The University of North Carolina School of Medicine, Chapel Hill, North Carolina (T.K.)
| | - Allison N White
- Departments of Physiology and Pharmacology (S.W.K., A.N.W., J.D.G., K.W., D.P.S., V.S.), Neuroscience, and Behavioral Medicine and Psychiatry (V.S.), West Virginia University School of Medicine, Morgantown, West Virginia; Department of Psychology, West Virginia University Eberly College of Arts and Sciences, Morgantown, West Virginia (K.R.T., S.G.K.); Department of Medicinal Chemistry, The University of Kansas School of Pharmacy, Lawrence, Kansas (T.E.P.); Division of Chemical Biology and Medicinal Chemistry, The University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina (A.A.H., J.A.); and Department of Pharmacology, The University of North Carolina School of Medicine, Chapel Hill, North Carolina (T.K.)
| | - Joshua D Gross
- Departments of Physiology and Pharmacology (S.W.K., A.N.W., J.D.G., K.W., D.P.S., V.S.), Neuroscience, and Behavioral Medicine and Psychiatry (V.S.), West Virginia University School of Medicine, Morgantown, West Virginia; Department of Psychology, West Virginia University Eberly College of Arts and Sciences, Morgantown, West Virginia (K.R.T., S.G.K.); Department of Medicinal Chemistry, The University of Kansas School of Pharmacy, Lawrence, Kansas (T.E.P.); Division of Chemical Biology and Medicinal Chemistry, The University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina (A.A.H., J.A.); and Department of Pharmacology, The University of North Carolina School of Medicine, Chapel Hill, North Carolina (T.K.)
| | - Kristen R Trexler
- Departments of Physiology and Pharmacology (S.W.K., A.N.W., J.D.G., K.W., D.P.S., V.S.), Neuroscience, and Behavioral Medicine and Psychiatry (V.S.), West Virginia University School of Medicine, Morgantown, West Virginia; Department of Psychology, West Virginia University Eberly College of Arts and Sciences, Morgantown, West Virginia (K.R.T., S.G.K.); Department of Medicinal Chemistry, The University of Kansas School of Pharmacy, Lawrence, Kansas (T.E.P.); Division of Chemical Biology and Medicinal Chemistry, The University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina (A.A.H., J.A.); and Department of Pharmacology, The University of North Carolina School of Medicine, Chapel Hill, North Carolina (T.K.)
| | - Kim Wix
- Departments of Physiology and Pharmacology (S.W.K., A.N.W., J.D.G., K.W., D.P.S., V.S.), Neuroscience, and Behavioral Medicine and Psychiatry (V.S.), West Virginia University School of Medicine, Morgantown, West Virginia; Department of Psychology, West Virginia University Eberly College of Arts and Sciences, Morgantown, West Virginia (K.R.T., S.G.K.); Department of Medicinal Chemistry, The University of Kansas School of Pharmacy, Lawrence, Kansas (T.E.P.); Division of Chemical Biology and Medicinal Chemistry, The University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina (A.A.H., J.A.); and Department of Pharmacology, The University of North Carolina School of Medicine, Chapel Hill, North Carolina (T.K.)
| | - Aubrie A Harland
- Departments of Physiology and Pharmacology (S.W.K., A.N.W., J.D.G., K.W., D.P.S., V.S.), Neuroscience, and Behavioral Medicine and Psychiatry (V.S.), West Virginia University School of Medicine, Morgantown, West Virginia; Department of Psychology, West Virginia University Eberly College of Arts and Sciences, Morgantown, West Virginia (K.R.T., S.G.K.); Department of Medicinal Chemistry, The University of Kansas School of Pharmacy, Lawrence, Kansas (T.E.P.); Division of Chemical Biology and Medicinal Chemistry, The University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina (A.A.H., J.A.); and Department of Pharmacology, The University of North Carolina School of Medicine, Chapel Hill, North Carolina (T.K.)
| | - Thomas E Prisinzano
- Departments of Physiology and Pharmacology (S.W.K., A.N.W., J.D.G., K.W., D.P.S., V.S.), Neuroscience, and Behavioral Medicine and Psychiatry (V.S.), West Virginia University School of Medicine, Morgantown, West Virginia; Department of Psychology, West Virginia University Eberly College of Arts and Sciences, Morgantown, West Virginia (K.R.T., S.G.K.); Department of Medicinal Chemistry, The University of Kansas School of Pharmacy, Lawrence, Kansas (T.E.P.); Division of Chemical Biology and Medicinal Chemistry, The University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina (A.A.H., J.A.); and Department of Pharmacology, The University of North Carolina School of Medicine, Chapel Hill, North Carolina (T.K.)
| | - Jeffrey Aubé
- Departments of Physiology and Pharmacology (S.W.K., A.N.W., J.D.G., K.W., D.P.S., V.S.), Neuroscience, and Behavioral Medicine and Psychiatry (V.S.), West Virginia University School of Medicine, Morgantown, West Virginia; Department of Psychology, West Virginia University Eberly College of Arts and Sciences, Morgantown, West Virginia (K.R.T., S.G.K.); Department of Medicinal Chemistry, The University of Kansas School of Pharmacy, Lawrence, Kansas (T.E.P.); Division of Chemical Biology and Medicinal Chemistry, The University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina (A.A.H., J.A.); and Department of Pharmacology, The University of North Carolina School of Medicine, Chapel Hill, North Carolina (T.K.)
| | - Steven G Kinsey
- Departments of Physiology and Pharmacology (S.W.K., A.N.W., J.D.G., K.W., D.P.S., V.S.), Neuroscience, and Behavioral Medicine and Psychiatry (V.S.), West Virginia University School of Medicine, Morgantown, West Virginia; Department of Psychology, West Virginia University Eberly College of Arts and Sciences, Morgantown, West Virginia (K.R.T., S.G.K.); Department of Medicinal Chemistry, The University of Kansas School of Pharmacy, Lawrence, Kansas (T.E.P.); Division of Chemical Biology and Medicinal Chemistry, The University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina (A.A.H., J.A.); and Department of Pharmacology, The University of North Carolina School of Medicine, Chapel Hill, North Carolina (T.K.)
| | - Terry Kenakin
- Departments of Physiology and Pharmacology (S.W.K., A.N.W., J.D.G., K.W., D.P.S., V.S.), Neuroscience, and Behavioral Medicine and Psychiatry (V.S.), West Virginia University School of Medicine, Morgantown, West Virginia; Department of Psychology, West Virginia University Eberly College of Arts and Sciences, Morgantown, West Virginia (K.R.T., S.G.K.); Department of Medicinal Chemistry, The University of Kansas School of Pharmacy, Lawrence, Kansas (T.E.P.); Division of Chemical Biology and Medicinal Chemistry, The University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina (A.A.H., J.A.); and Department of Pharmacology, The University of North Carolina School of Medicine, Chapel Hill, North Carolina (T.K.)
| | - David P Siderovski
- Departments of Physiology and Pharmacology (S.W.K., A.N.W., J.D.G., K.W., D.P.S., V.S.), Neuroscience, and Behavioral Medicine and Psychiatry (V.S.), West Virginia University School of Medicine, Morgantown, West Virginia; Department of Psychology, West Virginia University Eberly College of Arts and Sciences, Morgantown, West Virginia (K.R.T., S.G.K.); Department of Medicinal Chemistry, The University of Kansas School of Pharmacy, Lawrence, Kansas (T.E.P.); Division of Chemical Biology and Medicinal Chemistry, The University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina (A.A.H., J.A.); and Department of Pharmacology, The University of North Carolina School of Medicine, Chapel Hill, North Carolina (T.K.)
| | - Vincent Setola
- Departments of Physiology and Pharmacology (S.W.K., A.N.W., J.D.G., K.W., D.P.S., V.S.), Neuroscience, and Behavioral Medicine and Psychiatry (V.S.), West Virginia University School of Medicine, Morgantown, West Virginia; Department of Psychology, West Virginia University Eberly College of Arts and Sciences, Morgantown, West Virginia (K.R.T., S.G.K.); Department of Medicinal Chemistry, The University of Kansas School of Pharmacy, Lawrence, Kansas (T.E.P.); Division of Chemical Biology and Medicinal Chemistry, The University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina (A.A.H., J.A.); and Department of Pharmacology, The University of North Carolina School of Medicine, Chapel Hill, North Carolina (T.K.)
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17
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Onofrj M, Espay AJ, Bonanni L, Delli Pizzi S, Sensi SL. Hallucinations, somatic-functional disorders of PD-DLB as expressions of thalamic dysfunction. Mov Disord 2019; 34:1100-1111. [PMID: 31307115 DOI: 10.1002/mds.27781] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 04/30/2019] [Accepted: 05/24/2019] [Indexed: 12/12/2022] Open
Abstract
Hallucinations, delusions, and functional neurological manifestations (conversion and somatic symptom disorders) of Parkinson's disease (PD) and dementia with Lewy bodies increase in frequency with disease progression, predict the onset of cognitive decline, and eventually blend with and are concealed by dementia. These symptoms share the absence of reality constraints and can be considered comparable elements of the PD-dementia with Lewy bodies psychosis. We propose that PD-dementia with Lewy bodies psychotic disorders depend on thalamic dysfunction promoting a theta burst mode and subsequent thalamocortical dysrhythmia with focal cortical coherence to theta electroencephalogram rhythms. This theta electroencephalogram activity, also called fast-theta or pre-alpha, has been shown to predict cognitive decline and fluctuations in Parkinson's disease with dementia and dementia with Lewy bodies. These electroencephalogram alterations are now considered a predictive marker for progression to dementia. The resulting thalamocortical dysrhythmia inhibits the frontal attentional network and favors the decoupling of the default mode network. As the default mode network is involved in integration of self-referential information into conscious perception, unconstrained default mode network activity, as revealed by recent imaging studies, leads to random formation of connections that link strong autobiographical correlates to trivial stimuli, thereby producing hallucinations, delusions, and functional neurological disorders. The thalamocortical dysrhythmia default mode network decoupling hypothesis provides the rationale for the design and testing of novel therapeutic pharmacological and nonpharmacological interventions in the context of PD, PD with dementia, and dementia with Lewy bodies. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Marco Onofrj
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Italy
| | - Alberto J Espay
- Department of Neurology, James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA
| | - Laura Bonanni
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Italy
| | - Stefano Delli Pizzi
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Italy
| | - Stefano L Sensi
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Italy.,Departments of Neurology and Pharmacology, Institute for Mind Impairments and Neurological Disorders, University of California - Irvine, Irvine, California, USA
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18
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Terpou BA, Harricharan S, McKinnon MC, Frewen P, Jetly R, Lanius RA. The effects of trauma on brain and body: A unifying role for the midbrain periaqueductal gray. J Neurosci Res 2019; 97:1110-1140. [PMID: 31254294 DOI: 10.1002/jnr.24447] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/09/2019] [Accepted: 05/06/2019] [Indexed: 12/18/2022]
Abstract
Post-traumatic stress disorder (PTSD), a diagnosis that may follow the experience of trauma, has multiple symptomatic phenotypes. Generally, individuals with PTSD display symptoms of hyperarousal and of hyperemotionality in the presence of fearful stimuli. A subset of individuals with PTSD; however, elicit dissociative symptomatology (i.e., depersonalization, derealization) in the wake of a perceived threat. This pattern of response characterizes the dissociative subtype of the disorder, which is often associated with emotional numbing and hypoarousal. Both symptomatic phenotypes exhibit attentional threat biases, where threat stimuli are processed preferentially leading to a hypervigilant state that is thought to promote defensive behaviors during threat processing. Accordingly, PTSD and its dissociative subtype are thought to differ in their proclivity to elicit active (i.e., fight, flight) versus passive (i.e., tonic immobility, emotional shutdown) defensive responses, which are characterized by the increased and the decreased expression of the sympathetic nervous system, respectively. Moreover, active and passive defenses are accompanied by primarily endocannabinoid- and opioid-mediated analgesics, respectively. Through critical review of the literature, we apply the defense cascade model to better understand the pathological presentation of defensive responses in PTSD with a focus on the functioning of lower-level midbrain and extended brainstem systems.
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Affiliation(s)
- Braeden A Terpou
- Department of Neuroscience, Western University, London, Ontario, Canada
| | | | - Margaret C McKinnon
- Mood Disorders Program, St. Joseph's Healthcare, Hamilton, Ontario, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Homewood Research Institute, Guelph, Ontario, Canada
| | - Paul Frewen
- Department of Psychology, Western University, London, Ontario, Canada
| | - Rakesh Jetly
- Canadian Forces, Health Services, Ottawa, Canada
| | - Ruth A Lanius
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada
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19
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Browne CA, Lucki I. Targeting opioid dysregulation in depression for the development of novel therapeutics. Pharmacol Ther 2019; 201:51-76. [PMID: 31051197 DOI: 10.1016/j.pharmthera.2019.04.009] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 04/23/2019] [Indexed: 02/07/2023]
Abstract
Since the serendipitous discovery of the first class of modern antidepressants in the 1950's, all pharmacotherapies approved by the Food and Drug Administration for major depressive disorder (MDD) have shared a common mechanism of action, increased monoaminergic neurotransmission. Despite the widespread availability of antidepressants, as many as 50% of depressed patients are resistant to these conventional therapies. The significant length of time required to produce meaningful symptom relief with these medications, 4-6 weeks, indicates that other mechanisms are likely involved in the pathophysiology of depression which may yield more viable targets for drug development. For decades, no viable candidate target with a different mechanism of action to that of conventional therapies proved successful in clinical studies. Now several exciting avenues for drug development are under intense investigation. One of these emerging targets is modulation of endogenous opioid tone. This review will evaluate preclinical and clinical evidence pertaining to opioid dysregulation in depression, focusing on the role of the endogenous ligands endorphin, enkephalin, dynorphin, and nociceptin/orphanin FQ (N/OFQ) and their respective receptors, mu (MOR), delta (DOR), kappa (KOR), and the N/OFQ receptor (NOP) in mediating behaviors relevant to depression and anxiety. Finally, putative opioid based antidepressants that are under investigation in clinical trials, ALKS5461, JNJ-67953964 (formerly LY2456302 and CERC-501) and BTRX-246040 (formerly LY-2940094) will be discussed. This review will illustrate the potential therapeutic value of targeting opioid dysregulation in developing novel therapies for MDD.
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Affiliation(s)
- Caroline A Browne
- Department of Pharmacology and Molecular Therapeutics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, United States of America
| | - Irwin Lucki
- Department of Pharmacology and Molecular Therapeutics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, United States of America.
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20
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Silva AR, Grosso C, Delerue-Matos C, Rocha JM. Comprehensive review on the interaction between natural compounds and brain receptors: Benefits and toxicity. Eur J Med Chem 2019; 174:87-115. [PMID: 31029947 DOI: 10.1016/j.ejmech.2019.04.028] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 04/10/2019] [Accepted: 04/11/2019] [Indexed: 02/06/2023]
Abstract
Given their therapeutic activity, natural products have been used in traditional medicines throughout the centuries. The growing interest of the scientific community in phytopharmaceuticals, and more recently in marine products, has resulted in a significant number of research efforts towards understanding their effect in the treatment of neurodegenerative diseases, such as Alzheimer's (AD), Parkinson (PD) and Huntington (HD). Several studies have shown that many of the primary and secondary metabolites of plants, marine organisms and others, have high affinities for various brain receptors and may play a crucial role in the treatment of diseases affecting the central nervous system (CNS) in mammalians. Actually, such compounds may act on the brain receptors either by agonism, antagonism, allosteric modulation or other type of activity aimed at enhancing a certain effect. The current manuscript comprehensively reviews the state of the art on the interactions between natural compounds and brain receptors. This information is of foremost importance when it is intended to investigate and develop cutting-edge drugs, more effective and with alternative mechanisms of action to the conventional drugs presently used for the treatment of neurodegenerative diseases. Thus, we reviewed the effect of 173 natural products on neurotransmitter receptors, diabetes related receptors, neurotrophic factor related receptors, immune system related receptors, oxidative stress related receptors, transcription factors regulating gene expression related receptors and blood-brain barrier receptors.
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Affiliation(s)
- Ana R Silva
- Centre of Molecular and Environmental Biology (CBMA), Department of Biology (DB), University of Minho (UM), Campus Gualtar, P-4710-057, Braga, Portugal
| | - Clara Grosso
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 431, P-4249-015, Porto, Portugal.
| | - Cristina Delerue-Matos
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 431, P-4249-015, Porto, Portugal
| | - João M Rocha
- Centre of Molecular and Environmental Biology (CBMA), Department of Biology (DB), University of Minho (UM), Campus Gualtar, P-4710-057, Braga, Portugal; REQUIMTE/LAQV, Grupo de investigação de Química Orgânica Aplicada (QUINOA), Laboratório de polifenóis alimentares, Departamento de Química e Bioquímica (DQB), Faculdade de Ciências da Universidade do Porto (FCUP), Rua do Campo Alegre, s/n, P-4169-007, Porto, Portugal
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21
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Coffeen U, Pellicer F. Salvia divinorum: from recreational hallucinogenic use to analgesic and anti-inflammatory action. J Pain Res 2019; 12:1069-1076. [PMID: 30962708 PMCID: PMC6434906 DOI: 10.2147/jpr.s188619] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Salvia divinorum is a herbal plant native to the southwest region of Mexico. Traditional preparations of this plant have been used in illness treatments that converge with inflammatory conditions and pain. Currently, S. divinorum extracts have become popular in several countries as a recreational drug due to its hallucinogenic effects. Its main active component is a diterpene named salvinorin A (SA), a potent naturally occurring hallucinogen with a great affinity to the κ opioid receptors and with allosteric modulation of cannabinoid type 1 receptors. Recent biochemical research has revealed the mechanism of action of the anti-inflammatory and analgesic effect of SA at the cellular and molecular level. Nevertheless, because of their short-lasting and hallucinogenic effect, the research has focused on discovering a new analogue of SA that is able to induce analgesia and reduce inflammation with a long-lasting effect but without the hallucinatory component. In this review, we explore the role of S. divinorum, SA and its analogues. We focus mainly on their analgesic and anti-inflammatory roles but also mention their psychoactive properties.
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Affiliation(s)
- Ulises Coffeen
- Research in Neurosciences, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, México,
| | - Francisco Pellicer
- Research in Neurosciences, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, México,
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Urdaneta KE, Castillo MA, Montiel N, Semprún-Hernández N, Antonucci N, Siniscalco D. Autism Spectrum Disorders: Potential Neuro-Psychopharmacotherapeutic Plant-Based Drugs. Assay Drug Dev Technol 2018; 16:433-444. [PMID: 30427697 DOI: 10.1089/adt.2018.848] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Over the years, scientific researches have validated the healing benefits of many psychopharmacotherapeutic plant-based drugs to ameliorate psychiatric disorders. In contrast, the use of chemical procedures to isolate and purify specific compounds from plants that have been used to treat autism spectrum disorders (ASDs) and its clinical features may contribute to improve the quality of life of many patients. Also, herbal pharmacological treatments could improve the core symptoms of autism with fewer side effects. This review will focus on the uses and actions of phytopharmaceuticals in the behavioral conditions of ASDs. A large number of natural compound-based plant drugs have been tested in murine models of autism and in clinical trials with remarkable success in reversing the core and associated behaviors with autism such as flavonoids, cannabinoids, curcuminoids, piperine, resveratrol, and bacosides. This plant-based drug alternative is safer given that many psychiatric disorders and neurodegenerative pathologies do not often respond well to currently prescribed medications or have significant side effects. However, it is noteworthy to consider the need for large clinical trials to determine safety and efficacy. Many results are based on case reports or small size samples, and often the studies are open label. Standardization of procedures (i.e., purity and concentrations) and quality controls are strictly required to ensure the absence of side effects.
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Affiliation(s)
| | | | - Nola Montiel
- Cátedra Libre de Autismo, Vicerrectorado Académico, Universidad del Zulia, Maracaibo, Venezuela
| | | | - Nicola Antonucci
- Biomedical Centre for Autism Research and Treatment, Bari, Italy
| | - Dario Siniscalco
- Department of Experimental Medicine, University of Campania, Naples, Italy.,Italian Group for Studying Autism-GISA, Brescia, Italy
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23
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Schneider I, Kugel H, Redlich R, Grotegerd D, Bürger C, Bürkner PC, Opel N, Dohm K, Zaremba D, Meinert S, Schröder N, Straßburg AM, Schwarte K, Schettler C, Ambrée O, Rust S, Domschke K, Arolt V, Heindel W, Baune BT, Zhang W, Dannlowski U, Hohoff C. Association of Serotonin Transporter Gene AluJb Methylation with Major Depression, Amygdala Responsiveness, 5-HTTLPR/rs25531 Polymorphism, and Stress. Neuropsychopharmacology 2018; 43:1308-1316. [PMID: 29114103 PMCID: PMC5916353 DOI: 10.1038/npp.2017.273] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 10/23/2017] [Accepted: 10/27/2017] [Indexed: 12/16/2022]
Abstract
DNA methylation profiles of the serotonin transporter gene (SLC6A4) have been shown to alter SLC6A4 expression, drive antidepressant treatment response and modify brain functions. This study investigated whether methylation of an AluJb element in the SLC6A4 promotor was associated with major depressive disorder (MDD), amygdala reactivity to emotional faces, 5-HTTLPR/rs25531 polymorphism, and recent stress. MDD patients (n=122) and healthy controls (HC, n=176) underwent fMRI during an emotional face-matching task. Individual SLC6A4 AluJb methylation profiles were ascertained and associated with MDD, amygdala reactivity, 5-HTTLPR/rs25531, and stress. SLC6A4 AluJb methylation was significantly lower in MDD compared to HC and in stressed compared to less stressed participants. Lower AluJb methylation was particularly found in 5-HTTLPR/rs25531 risk allele carriers under stress and correlated with less depressive episodes. fMRI analysis revealed a significant interaction of AluJb methylation and diagnosis in the amygdala, with MDD patients showing lower AluJb methylation associated with decreased amygdala reactivity. While no joint effect of AluJb methylation and 5-HTTLPR/rs25531 existed, risk allele carriers showed significantly increased bilateral amygdala activation. These findings suggest a role of SLC6A4 AluJb methylation in MDD, amygdala reactivity, and stress reaction, partly interwoven with 5-HTTLPR/rs25531 effects. Patients with low methylation in conjunction with a shorter MDD history and decreased amygdala reactivity might feature a more stress-adaptive epigenetic process, maybe via theoretically possible endogenous antidepressant-like effects. In contrast, patients with higher methylation might possibly suffer from impaired epigenetic adaption to chronic stress. Further, the 5-HTTLPR/rs25531 association with amygdala activation was confirmed in our large sample.
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Affiliation(s)
- Ilona Schneider
- Department of Psychiatry, University of Münster, Münster, Germany,Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster, Germany
| | - Harald Kugel
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - Ronny Redlich
- Department of Psychiatry, University of Münster, Münster, Germany
| | | | - Christian Bürger
- Department of Psychiatry, University of Münster, Münster, Germany
| | | | - Nils Opel
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Katharina Dohm
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Dario Zaremba
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Susanne Meinert
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Nina Schröder
- Department of Psychiatry, University of Münster, Münster, Germany
| | | | - Kathrin Schwarte
- Department of Psychiatry, University of Münster, Münster, Germany
| | | | - Oliver Ambrée
- Department of Psychiatry, University of Münster, Münster, Germany,Department of Behavioural Biology, University of Osnabrück, Osnabrück, Germany
| | - Stephan Rust
- Department of Pediatrics, University of Münster, Münster, Germany
| | - Katharina Domschke
- Department of Psychiatry, University of Münster, Münster, Germany,Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Volker Arolt
- Department of Psychiatry, University of Münster, Münster, Germany,Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster, Germany
| | - Walter Heindel
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - Bernhard T Baune
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Weiqi Zhang
- Department of Psychiatry, University of Münster, Münster, Germany,Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster, Germany
| | - Udo Dannlowski
- Department of Psychiatry, University of Münster, Münster, Germany,Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster, Germany
| | - Christa Hohoff
- Department of Psychiatry, University of Münster, Münster, Germany,Department of Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, Münster 48149 Germany, Tel: +49-251-8357122, Fax: +49-251-8357123, E-mail:
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24
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Passie T, Brandt SD. Self-Experiments with Psychoactive Substances: A Historical Perspective. Handb Exp Pharmacol 2018; 252:69-110. [PMID: 30478735 DOI: 10.1007/164_2018_177] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The purpose of this chapter is to highlight the rich tradition of self-experiments (SEs) with psychoactive substances carried out by scientists and therapists for more than a century. Scientifically inspired controlled SEs dominated until the end of the twentieth century, when ethical requirements minimized controlled SEs and "wild" SEs expanded particularly with the emergence of new psychoactive substances. The review focuses on laughing gas (nitrous oxide), cannabis, cocaine, hallucinogens, entactogens, and dissociative hallucinogens. This is due to the fact that substances that induce "complex" effects such as alteration of space/time experience, ego dissolution, and increased feelings and insights (e.g., hallucinogens, entactogens) represent by far the majority of SEs, whereas SEs with substances inducing "simple" effects such as euphoria, anxiolysis, dissociation, or emotional blunting (e.g., cocaine, opioids) are much rarer or even absent (e.g., benzodiazepines). Complex drug effects are much harder to describe, thus allowing SEs to fulfill a more important function.SEs with psychoactive drugs appeared to emerge in the mid-eighteenth century, which triggered a long-standing tradition throughout the nineteenth and early twentieth century. SEs have been de facto performed for a variety of reasons, ranging from establishing scientific knowledge and gaining philosophical insights to compensating for personal deficits. Self-experimenters can be divided into two general types. Besides their scientific intentions, "exploratory" self-experimenters intend to expand awareness and insight, whereas "compensatory" self-experimenters might aim for coping with psychiatric symptoms or personality deficits. Scientific limitations of SEs are obvious when compared to double-blind, randomized, placebo-controlled trials. Whereas the former might lead to more "realistic" detailed description of subjective effects, the latter lead to more solid results in respect to objectively measurable "average" effects. Possible adverse effects of SEs were identified that resulted in loss of scientific objectivity and decreased control over substance use and addiction, development of isolation, problematic group dynamics, and "social autism."
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Affiliation(s)
- Torsten Passie
- Senckenberg Institute for History and Ethics in Medicine, Goethe-University Frankfurt/Main, Frankfurt, Germany.
| | - Simon D Brandt
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK
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25
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Butelman ER, Kreek MJ. Discriminative Stimulus Properties of Opioid Ligands: Progress and Future Directions. Curr Top Behav Neurosci 2018; 39:175-192. [PMID: 27225498 DOI: 10.1007/7854_2016_9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Opioid receptors (MOP-r, KOP-r, DOP-r, as well as NOP-r) and their endogenous neuropeptide agonist systems are involved in diverse neurobiological and behavioral functions, in health and disease. These functions include pain and analgesia, addictions, and psychiatric diseases (e.g., depression-, anxiety-like, and stress-related disorders). Drug discrimination assays have been used to characterize the behavioral pharmacology of ligands with affinity at MOP-r, KOP-r, or DOP-r (and to a lesser extent NOP-r). Therefore, drug discrimination studies with opioid ligands have an important continuing role in translational investigations of diseases that are affected by these neurobiological targets and their pharmacotherapy.
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Affiliation(s)
- Eduardo R Butelman
- Laboratory on the Biology of Addictive Diseases, The Rockefeller University, 1230 York Avenue, Box 171, New York, NY, 10065, USA.
| | - Mary Jeanne Kreek
- Laboratory on the Biology of Addictive Diseases, The Rockefeller University, 1230 York Avenue, Box 171, New York, NY, 10065, USA
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Calderon SN, Hunt J, Klein M. A regulatory perspective on the evaluation of hallucinogen drugs for human use. Neuropharmacology 2017; 142:135-142. [PMID: 29180224 DOI: 10.1016/j.neuropharm.2017.11.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/25/2017] [Accepted: 11/17/2017] [Indexed: 01/21/2023]
Abstract
In recent years, there is renewed interest in the study of various hallucinogens for their potential therapeutic effects. In the United States of America (USA), the abuse potential assessment of a drug is carried out as part of the general safety and efficacy evaluation of a drug. Additionally, the abuse potential assessment is taken under consideration in determining if a drug needs to be subject to controls to minimize the abuse of the drug once on the market. This assessment is conducted for all new drugs with central nervous system (CNS) activity, that are chemically or pharmacologically similar to other drugs with known abuse potential, or drugs that produce psychoactive effects predictive of abuse, such as euphoria and hallucinations. This paper describes the regulatory framework for evaluating the abuse potential of new drugs, with emphasis on hallucinogens. The paper discusses the role of the United States Food and Drug Administration (FDA) in the evaluation of the abuse potential of drugs and its role in drug control, and provides an overview of the controlled status of hallucinogens and the requirements to conduct research with Schedule I substances in the USA. This article is part of the Special Issue entitled 'Psychedelics: New Doors, Altered Perceptions'.
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Affiliation(s)
- Silvia N Calderon
- Controlled Substance Staff, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA.
| | - Joshua Hunt
- Controlled Substance Staff, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
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27
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Sellers EM, Romach MK, Leiderman DB. Studies with psychedelic drugs in human volunteers. Neuropharmacology 2017; 142:116-134. [PMID: 29162429 DOI: 10.1016/j.neuropharm.2017.11.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 10/31/2017] [Accepted: 11/17/2017] [Indexed: 12/20/2022]
Abstract
Scientific curiosity and fascination have played a key role in human research with psychedelics along with the hope that perceptual alterations and heightened insight could benefit well-being and play a role in the treatment of various neuropsychiatric disorders. These motivations need to be tempered by a realistic assessment of the hurdles to be cleared for therapeutic use. Development of a psychedelic drug for treatment of a serious psychiatric disorder presents substantial although not insurmountable challenges. While the varied psychedelic agents described in this chapter share some properties, they have a range of pharmacologic effects that are reflected in the gradation in intensity of hallucinogenic effects from the classical agents to DMT, MDMA, ketamine, dextromethorphan and new drugs with activity in the serotonergic system. The common link seems to be serotonergic effects modulated by NMDA and other neurotransmitter effects. The range of hallucinogens suggest that they are distinct pharmacologic agents and will not be equally safe or effective in therapeutic targets. Newly synthesized specific and selective agents modeled on the legacy agents may be worth considering. Defining therapeutic targets that represent unmet medical need, addressing market and commercial issues, and finding treatment settings to safely test and use such drugs make the human testing of psychedelics not only interesting but also very challenging. This article is part of the Special Issue entitled 'Psychedelics: New Doors, Altered Perceptions'.
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Affiliation(s)
- Edward M Sellers
- Departments of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada; Medicine, University of Toronto, Toronto, ON, Canada; Psychiatry, University of Toronto, Toronto, ON, Canada; Surgery, University of Toronto, Toronto, ON, Canada; DL Global Partners Inc, Toronto, ON, Canada.
| | - Myroslava K Romach
- Psychiatry, University of Toronto, Toronto, ON, Canada; Surgery, University of Toronto, Toronto, ON, Canada; DL Global Partners Inc, Toronto, ON, Canada
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28
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Simón-Arceo K, González-Trujano ME, Coffeen U, Fernández-Mas R, Mercado F, Almanza A, Contreras B, Jaimes O, Pellicer F. Neuropathic and inflammatory antinociceptive effects and electrocortical changes produced by Salvia divinorum in rats. JOURNAL OF ETHNOPHARMACOLOGY 2017; 206:115-124. [PMID: 28502907 DOI: 10.1016/j.jep.2017.05.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 05/02/2017] [Accepted: 05/10/2017] [Indexed: 05/29/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Salvia divinorum is a medicinal plant traditionally used in hallucinogenic ethnopharmacological practices and for its analgesic and antinflammatory properties. Its active compounds include diterpenes known as salvinorins which act as potent κ opioid receptor agonists. AIM OF THE STUDY Given its effects in acute animal models of pain, as well as its antinflammatory attributes, we decided to investigate the analgesic effects of an SD extract in neuropathic (sciatic loose nerve ligature) and inflammatory (intra plantar carrageenan) pain models in rats. We also determined in this study the electrocorticographic changes to correlate similar hallucinogenic state and behavior as those produced in humans. MATERIAL AND METHODS Mechanical and thermonociceptive responses, plantar test and von Frey assay, respectively, were measured in adult Wistar rats 30min, 3h and 24h after the intraperitoneal administration of saline or an hydroponic SD extract. We also evaluated carbamazepine and celecoxib, as gold reference drugs, to compare its antinociceptive effects. RESULTS Our results showed that administration of SD extract induced antialgesic effects in both neuropathic and inflammatory pain models. All those effects were blocked by nor-binaltorphimine (a Kappa opioid receptor antagonist). Moreover, it was observed an increase of the anterior power spectral density and a decrease in the posterior region as electrocorticographic changes. CONCLUSION The present investigation give evidence that SD is capable to reduce algesic response associated to neuropathic and inflammatory nociception. This study support therapeutic alternatives for a disabling health problem due to the long term pain with high impact on population and personal and social implications.
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Affiliation(s)
- Karina Simón-Arceo
- Laboratorio de Neurofisiología Integrativa, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calzada México Xochimilco 101, San Lorenzo Huipulco, Tlalpan, CP 14370 Ciudad de México, México.
| | - Ma Eva González-Trujano
- Laboratorio de Neurofarmacología de Productos Naturales, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calzada México Xochimilco 101, San Lorenzo Huipulco, Tlalpan, CP 14370 Ciudad de México, México.
| | - Ulises Coffeen
- Laboratorio de Neurofisiología Integrativa, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calzada México Xochimilco 101, San Lorenzo Huipulco, Tlalpan, CP 14370 Ciudad de México, México.
| | - Rodrigo Fernández-Mas
- Laboratorio de Neurofisiología del Control y la Regulación, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calzada México Xochimilco 101, San Lorenzo Huipulco, Tlalpan, CP 14370 Ciudad de México, México.
| | - Francisco Mercado
- Laboratorio de Fisiología Celular, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calzada México Xochimilco 101, San Lorenzo Huipulco, Tlalpan, CP 14370 Ciudad de México, México.
| | - Angélica Almanza
- Laboratorio de Fisiología Celular, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calzada México Xochimilco 101, San Lorenzo Huipulco, Tlalpan, CP 14370 Ciudad de México, México.
| | - Bernardo Contreras
- Laboratorio de Neurofisiología Integrativa, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calzada México Xochimilco 101, San Lorenzo Huipulco, Tlalpan, CP 14370 Ciudad de México, México.
| | - Orlando Jaimes
- Laboratorio de Neurofisiología Integrativa, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calzada México Xochimilco 101, San Lorenzo Huipulco, Tlalpan, CP 14370 Ciudad de México, México.
| | - Francisco Pellicer
- Laboratorio de Neurofisiología Integrativa, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calzada México Xochimilco 101, San Lorenzo Huipulco, Tlalpan, CP 14370 Ciudad de México, México.
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Millière R. Looking for the Self: Phenomenology, Neurophysiology and Philosophical Significance of Drug-induced Ego Dissolution. Front Hum Neurosci 2017; 11:245. [PMID: 28588463 PMCID: PMC5441112 DOI: 10.3389/fnhum.2017.00245] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 04/25/2017] [Indexed: 12/17/2022] Open
Abstract
There is converging evidence that high doses of hallucinogenic drugs can produce significant alterations of self-experience, described as the dissolution of the sense of self and the loss of boundaries between self and world. This article discusses the relevance of this phenomenon, known as “drug-induced ego dissolution (DIED)”, for cognitive neuroscience, psychology and philosophy of mind. Data from self-report questionnaires suggest that three neuropharmacological classes of drugs can induce ego dissolution: classical psychedelics, dissociative anesthetics and agonists of the kappa opioid receptor (KOR). While these substances act on different neurotransmitter receptors, they all produce strong subjective effects that can be compared to the symptoms of acute psychosis, including ego dissolution. It has been suggested that neuroimaging of DIED can indirectly shed light on the neural correlates of the self. While this line of inquiry is promising, its results must be interpreted with caution. First, neural correlates of ego dissolution might reveal the necessary neurophysiological conditions for the maintenance of the sense of self, but it is more doubtful that this method can reveal its minimally sufficient conditions. Second, it is necessary to define the relevant notion of self at play in the phenomenon of DIED. This article suggests that DIED consists in the disruption of subpersonal processes underlying the “minimal” or “embodied” self, i.e., the basic experience of being a self rooted in multimodal integration of self-related stimuli. This hypothesis is consistent with Bayesian models of phenomenal selfhood, according to which the subjective structure of conscious experience ultimately results from the optimization of predictions in perception and action. Finally, it is argued that DIED is also of particular interest for philosophy of mind. On the one hand, it challenges theories according to which consciousness always involves self-awareness. On the other hand, it suggests that ordinary conscious experience might involve a minimal kind of self-awareness rooted in multisensory processing, which is what appears to fade away during DIED.
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Affiliation(s)
- Raphaël Millière
- Faculty of Philosophy, University of OxfordOxford, United Kingdom
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30
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Abstract
This paper is the thirty-eighth consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2015 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior, and the roles of these opioid peptides and receptors in pain and analgesia, stress and social status, tolerance and dependence, learning and memory, eating and drinking, drug abuse and alcohol, sexual activity and hormones, pregnancy, development and endocrinology, mental illness and mood, seizures and neurologic disorders, electrical-related activity and neurophysiology, general activity and locomotion, gastrointestinal, renal and hepatic functions, cardiovascular responses, respiration and thermoregulation, and immunological responses.
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, Flushing, NY 11367, United States.
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Taylor GT, Manzella F. Kappa Opioids, Salvinorin A and Major Depressive Disorder. Curr Neuropharmacol 2016; 14:165-76. [PMID: 26903446 PMCID: PMC4825947 DOI: 10.2174/1570159x13666150727220944] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 06/11/2015] [Accepted: 07/24/2015] [Indexed: 12/13/2022] Open
Abstract
Opioids are traditionally associated with pain, analgesia and drug abuse. It is now clear,
however, that the opioids are central players in mood. The implications for mood disorders, particularly
clinical depression, suggest a paradigm shift from the monoamine neurotransmitters to the opioids either
alone or in interaction with monoamine neurons. We have a special interest in dynorphin, the last of
the major endogenous opioids to be isolated and identified. Dynorphin is derived from the Greek word
for power, dynamis, which hints at the expectation that the neuropeptide held for its discoverers. Yet,
dynorphin and its opioid receptor subtype, kappa, has always taken a backseat to the endogenous b-endorphin and the
exogenous morphine that both bind the mu opioid receptor subtype. That may be changing as the dynorphin/ kappa system
has been shown to have different, often opposite, neurophysiological and behavioral influences. This includes major
depressive disorder (MDD). Here, we have undertaken a review of dynorphin/ kappa neurobiology as related to behaviors,
especially MDD. Highlights include the unique features of dynorphin and kappa receptors and the special relation of a
plant-based agonist of the kappa receptor salvinorin A. In addition to acting as a kappa opioid agonist, we conclude that
salvinorin A has a complex pharmacologic profile, with potential additional mechanisms of action. Its unique neurophysiological
effects make Salvinorina A an ideal candidate for MDD treatment research.
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Affiliation(s)
| | - Francesca Manzella
- Behavioral Neuroscience/ Psychology Univ. Missouri - St. Louis, One University Blvd, St. Louis, MO 63121 USA.
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32
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Abstract
Hallucinogens fall into several different classes, as broadly defined by pharmacological mechanism of action, and chemical structure. These include psychedelics, entactogens, dissociatives, and other atypical hallucinogens. Although these classes do not share a common primary mechanism of action, they do exhibit important similarities in their ability to occasion temporary but profound alterations of consciousness, involving acute changes in somatic, perceptual, cognitive, and affective processes. Such effects likely contribute to their recreational use. However, a growing body of evidence indicates that these drugs may have therapeutic applications beyond their potential for abuse. This review will present data on several classes of hallucinogens with a particular focus on psychedelics, entactogens, and dissociatives, for which clinical utility has been most extensively documented. Information on each class is presented in turn, tracing relevant historical insights, highlighting similarities and differences between the classes from the molecular to the behavioral level, and presenting the most up-to-date information on clinically oriented research with these substances, with important ramifications for their potential therapeutic value. (PsycINFO Database Record
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Affiliation(s)
- Albert Garcia-Romeu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Brennan Kersgaard
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Peter H. Addy
- Department of Medical Informatics, Department of Veterans Affairs, West Haven, CT
- Department of Medical Informatics, Yale University School of Medicine, New Haven, CT
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Collybolide is a novel biased agonist of κ-opioid receptors with potent antipruritic activity. Proc Natl Acad Sci U S A 2016; 113:6041-6. [PMID: 27162327 DOI: 10.1073/pnas.1521825113] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Among the opioid receptors, the κ-opioid receptor (κOR) has been gaining considerable attention as a potential therapeutic target for the treatment of complex CNS disorders including depression, visceral pain, and cocaine addiction. With an interest in discovering novel ligands targeting κOR, we searched natural products for unusual scaffolds and identified collybolide (Colly), a nonnitrogenous sesquiterpene from the mushroom Collybia maculata. This compound has a furyl-δ-lactone core similar to that of Salvinorin A (Sal A), another natural product from the plant Salvia divinorum Characterization of the molecular pharmacological properties reveals that Colly, like Sal A, is a highly potent and selective κOR agonist. However, the two compounds differ in certain signaling and behavioral properties. Colly exhibits 10- to 50-fold higher potency in activating the mitogen-activated protein kinase pathway compared with Sal A. Taken with the fact that the two compounds are equipotent for inhibiting adenylyl cyclase activity, these results suggest that Colly behaves as a biased agonist of κOR. Behavioral studies also support the biased agonistic activity of Colly in that it exhibits ∼10-fold higher potency in blocking non-histamine-mediated itch compared with Sal A, and this difference is not seen in pain attenuation by these two compounds. These results represent a rare example of functional selectivity by two natural products that act on the same receptor. The biased agonistic activity, along with an easily modifiable structure compared with Sal A, makes Colly an ideal candidate for the development of novel therapeutics targeting κOR with reduced side effects.
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Johnson MW, MacLean KA, Caspers MJ, Prisinzano TE, Griffiths RR. Time course of pharmacokinetic and hormonal effects of inhaled high-dose salvinorin A in humans. J Psychopharmacol 2016; 30:323-9. [PMID: 26880225 PMCID: PMC5289219 DOI: 10.1177/0269881116629125] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Salvinorin A is a kappa opioid agonist and the principal psychoactive constituent of the Salvia divinorum plant, which has been used for hallucinogenic effects. Previous research on salvinorin A pharmacokinetics likely underestimated plasma levels typically resulting from the doses administered due to inefficient vaporization and not collecting samples during peak drug effects. Six healthy adults inhaled a single high dose of vaporized salvinorin A (n = 4, 21 mcg/kg; n = 2, 18 mcg/kg). Participant- and monitor-rated effects were assessed every 2 min for 60 min post-inhalation. Blood samples were collected at 13 time points up to 90 min post-inhalation. Drug levels peaked at 2 min and then rapidly decreased. Drug levels were significantly, positively correlated with participant and monitor drug effect ratings. Significant elevations in prolactin were observed beginning 5 min post-inhalation and peaking at 15 min post-inhalation. Cortisol showed inconsistent increases across participants. Hormonal responses were not well correlated with drug levels. This is the first study to demonstrate a direct relationship between changes in plasma levels of salvinorin A and drug effects in humans. The results confirm the efficacy of an inhalation technique for salvinorin A.
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Affiliation(s)
- Matthew W. Johnson
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224-6823, USA
| | - Katherine A. MacLean
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224-6823, USA
| | - Michael J. Caspers
- Department of Medicinal Chemistry, The University of Kansas, Lawrence, KS 66045-7582, USA
| | - Thomas E. Prisinzano
- Department of Medicinal Chemistry, The University of Kansas, Lawrence, KS 66045-7582, USA
| | - Roland R. Griffiths
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224-6823, USA,Department of Neuroscience, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224-6823, USA
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Akaberi M, Iranshahi M, Mehri S. Molecular Signaling Pathways Behind the Biological Effects of Salvia Species Diterpenes in Neuropharmacology and Cardiology. Phytother Res 2016; 30:878-93. [PMID: 26988179 DOI: 10.1002/ptr.5599] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 01/29/2016] [Accepted: 02/02/2016] [Indexed: 12/14/2022]
Abstract
The genus Salvia, from the Lamiaceae family, has diverse biological properties that are primarily attributable to their diterpene contents. There is no comprehensive review on the molecular signaling pathways of these active components. In this review, we investigated the molecular targets of bioactive Salvia diterpenes responsible for the treatment of nervous and cardiovascular diseases. The effects on different pathways, including apoptosis signaling, oxidative stress phenomena, the accumulation of amyloid beta plaques, and tau phosphorylation, have all been considered to be mechanisms of the anti-Alzheimer properties of Salvia diterpenes. Additionally, effects on the benzodiazepine and kappa opioid receptors and neuroprotective effects are noted as neuropharmacological properties of Salvia diterpenes, including tanshinone IIA, salvinorin A, cryptotanshinone, and miltirone. Tanshinone IIA, as the primary diterpene of Salvia miltiorrhiza, has beneficial activities in heart diseases because of its ability to scavenge free radicals and its effects on transcription factors, such as nuclear transcription factor-kappa B (NF-κB) and the mitogen-activated protein kinases (MAPKs). Additionally, tanshinone IIA has also been proposed to have cardioprotective properties including antiarrhythmic activities and effects on myocardial infarction. With respect to the potential therapeutic effects of Salvia diterpenes, comprehensive clinical trials are warranted to evaluate these valuable molecules as lead compounds. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- M Akaberi
- Student Research Committee, Department of Pharmacognosy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M Iranshahi
- Biotechnology Research Center and School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - S Mehri
- Pharmaceutical Research Center, Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
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Maqueda AE, Valle M, Addy PH, Antonijoan RM, Puntes M, Coimbra J, Ballester MR, Garrido M, González M, Claramunt J, Barker S, Lomnicka I, Waguespack M, Johnson MW, Griffiths RR, Riba J. Naltrexone but Not Ketanserin Antagonizes the Subjective, Cardiovascular, and Neuroendocrine Effects of Salvinorin-A in Humans. Int J Neuropsychopharmacol 2016; 19:pyw016. [PMID: 26874330 PMCID: PMC4966277 DOI: 10.1093/ijnp/pyw016] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Accepted: 02/05/2016] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Salvinorin-A is a terpene found in the leaves of the plant Salvia divinorum. When administered to humans, salvinorin-A induces an intense but short-lasting modified state of awareness, sharing features with those induced by the classical serotonin-2A receptor agonist psychedelics. However, unlike substances such as psilocybin or mescaline, salvinorin-A shows agonist activity at the kappa-opioid receptor rather than at the serotonin-2A receptor. Here, we assessed the involvement of kappa-opioid receptor and serotonin-2A agonism in the subjective, cardiovascular, and neuroendocrine effects of salvinorin-A in humans. METHODS We conducted a placebo-controlled, randomized, double-blind study with 2 groups of 12 healthy volunteers with experience with psychedelic drugs. There were 4 experimental sessions. In group 1, participants received the following treatment combinations: placebo+placebo, placebo+salvinorin-A, naltrexone+placebo, and naltrexone+salvinorin-A. Naltrexone, a nonspecific opioid receptor antagonist, was administered at a dose of 50mg orally. In group 2, participants received the treatment combinations: placebo+placebo, placebo+salvinorin-A, ketanserin+placebo, and ketanserin+salvinorin-A. Ketanserin, a selective serotonin-2A antagonist, was administered at a dose of 40mg orally. RESULTS Inhalation of 1mg of vaporized salvinorin-A led to maximum plasma concentrations at 1 and 2 minutes after dosing. When administered alone, salvinorin-A severely reduced external sensory perception and induced intense visual and auditory modifications, increased systolic blood pressure, and cortisol and prolactin release. These effects were effectively blocked by naltrexone, but not by ketanserin. CONCLUSIONS Results support kappa opioid receptor agonism as the mechanism of action underlying the subjective and physiological effects of salvinorin-A in humans and rule out the involvement of a serotonin-2A-mediated mechanism.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jordi Riba
- Human Neuropsychopharmacology Group, Sant Pau Institute of Biomedical Research (IIB-Sant Pau), Sant Antoni María Claret, Barcelona, Spain (Ms Maqueda and Dr Riba); Centre d'Investigació de Medicaments, Servei de Farmacologia Clínica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain (Dr Valle, Dr Puntes, Dr Coimbra, Ms Ballester, Ms Garrido, Ms González, Ms Claramunt, and Dr Riba); Departament de Farmacologia i Terapèutica, Universitat Autònoma de Barcelona, Barcelona, Spain (Drs Valle, Antonijoan, and Riba); Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain (Drs Valle, Antonijoan, and Riba); Pharmacokinetic and Pharmacodynamic Modelling and Simulation, IIB Sant Pau, Sant Antoni María Claret, Barcelona, Spain (Dr Valle); Medical Informatics, VA Connecticut Healthcare System, West Haven, CT (Dr Addy); Medical Informatics, Yale University School of Medicine, New Haven, CT (Dr Addy); Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Skip Bertman Drive at River Road, Baton Rouge, LA (Drs Barker, Lomnicka, and Waguespack); Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD (Drs Johnson and Griffiths); Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD (Dr Griffiths).
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