Apomorphine provoked stereotype in the dog

The Many Faces of Apomorphine: Lessons from the Past and Challenges for the Future

Apomorphine is now recognized as the oldest antiparkinsonian drug on the market. Though still underused, it is increasingly prescribed in Europe for patients with advanced Parkinson's disease (PD) with motor fluctuations. However, its history is far from being limited to movement disorders. This paper traces the history of apomorphine, from its earliest empirical use, to its synthesis, pharmacological development, and numerous indications in human and veterinary medicine, in light of its most recent uses and newest challenges. From shamanic rituals in ancient Egypt and Mesoamerica, to the treatment of erectile dysfunction, from being discarded as a pharmacological tool to becoming an essential antiparkinsonian drug, the path of apomorphine in the therapeutic armamentarium has been tortuous and punctuated by setbacks and groundbreaking discoveries. Throughout history, three main clinical indications stood out: emetic (gastric emptying, respiratory disorders, aversive conditioning), sedative (mental disorders, clinical anesthesia, alcoholism), and antiparkinsonian (fluctuations). New indications may arise in the future, both in PD (palliative care, nonmotor symptoms, withdrawal of oral dopaminergic medication), and outside PD, with promising work in neuroprotection or addiction.

Effect of apomorphine on the conflict-induced jumping stereotypy in bank voles

In conventional laboratory cages, bank voles (Clethrionomys glareolus) develop a jumping up-and-down stereotypy already before the age of one month. Central DA systems are thought to be involved in the expression of these conflict-induced stereotypies (CIS). Stereotypies can also be elicited pharmacologically, most commonly by amphetamine and apomorphine. Hence, administration of apomorphine to jumping bank voles provides the opportunity to compare pharmacologically-induced stereotypies (PHIS) and CIS in that species. A pilot study showed that apomorphine induced stereotyped licking that is qualitatively different from the CIS elicited by captivity. The present study investigated whether apomorphine has an effect on CIS-levels. The lowest dose (0.625 mg/kg) did not elicit licking but neither influenced jumping levels. Higher doses (0.938 and 1.094 mg/kg) lead to the occurrence of licking but also suppressed CIS-levels. However, the discordance in time profiles of licking and jumping argues against a shift from jumping to licking due to further stimulation of already activated DA systems. Therefore, expression of jumping seems to depend on stimulation of other DA receptor subtypes or jumping may even be DA independent.

A sex difference in turning bias in humans

A large body of literature has documented the existence of individual preferences in turning direction among rodents which appear to be dependent on striatal dopaminergic mechanisms. Recent work has indicated that humans also demonstrate individual turning preferences, and that these preferences may also be related to the nigrostriatal dopamine system. We describe here a new method for measuring turning preferences in humans and report a sex difference in the magnitude of the directional preference. While both males and females tended to turn towards the right, this tendency was significantly stronger among females. Analyses of test-retest reliability across two sessions (1-2 weeks apart) indicated that, in general, the rotation task elicited consistent turning biases. However, the turning biases of males and of females using oral contraceptives were significantly more consistent than those of regularly cycling females. These results are compatible with the animal literature and provide indirect evidence that ovarian hormones may modulate the mechanism(s) underlying this motor asymmetry.

Pharmacological differentiation of dopamine D-1 and D-2 antagonists after single and repeated administration

In single-dose experiments neuroleptics antagonize dopamine (DA)-agonist-induced stereotypies in animals. The antagonistic potency correlates with their clinical antipsychotic effects. In a series of experiments where DA-agonist-induced stereotyped gnawing in mice and rats was inhibited by neuroleptics it was shown that the antagonistic effect of butyrophenones was greatly attenuated by concomitant treatment with anticholinergics. The effect of phenothiazines was slightly attenuated and that of thioxanthenes and SCH 23390 remained unchanged. After repeated administration a differentiation is also seen in the ability of the antagonists to suppress DA-agonist-induced stereotypies. The differentiation in these experiments is similar to that seen in dopamine D-1 and D-2 receptor binding. The compounds can be classified into three pharmacological subgroups: butyrophenones (e.g., haloperidol) with affinity for D-2 receptors; phenothiazines (e.g., fluphenazine and perphenazine) with affinity for both D-2 and D-1 receptors but with preference for the D-2 receptors; and thioxanthenes (e.g., cis(Z)-flupentixol and cis(Z)-clopenthixol) with equal affinity for D-1 and D-2 receptors, and the selective D-1 antagonist SCH 23390. This compound has the same antistereotypic effect as is seen with the neuroleptics. We have also investigated the effect of the above-mentioned neuroleptics and SCH 23390 after 12 days' treatment and 3-5 days withdrawal. They were given either alone or in combination. When they were given alone a clear differentiation was seen between the groups when mice were tested for methylphenidate antagonism. The thioxanthenes and SCH 23390 retain their ability to antagonize the stereotyped gnawing; the phenothiazines show a reduced effect; and the butyrophenones have almost lost their ability to antagonize the stereotyped behavior.

Pharmacological effects of a specific dopamine D-1 antagonist SCH 23390 in comparison with neuroleptics

Neuroleptics such as thioxanthenes (cis(Z)-flupentixol and cis(Z)-clopenthixol) and phenothiazines (fluphenazine and perphenazine), which block both dopamine (DA) D-1 and D-2 receptors and the butyrophenones (haloperidol and spiroperidol), which block D-2 receptors only, are equipotent both behaviorally and clinically. A new compound SCH 23390 which selectively blocks DA D-1 receptors, resembles many neuroleptics in its pharmacological profile: antistereotypic effects in mice, rats and dogs, cataleptogenic effect and inhibitory effect on amphetamine circling. In contrast SCH 23390 has no effect on apomorphine-induced vomiting in dogs and little effects on 6-OHDA-denervated supersensitive DA receptors, stimulated by the DA agonist 3-PPP. In a series of experiments where methylphenidate-induced stereotyped gnawing in mice was inhibited by neuroleptics, it was shown that concomitant treatment with scopolamine or diazepam attenuated the effect of butyrophenones (D-2 antagonists). The same treatment attenuated the effect of phenothiazines, to a lesser extent, and hardly attenuated the effect of thioxanthenes and SCH 23390 at all. It is concluded that DA D-1 receptors are as important as D-2 receptors for the expression of neuroleptic activity in most animal models believed to be predictive of antipsychotic and extrapyramidal side-effect potential. However, the D-1 antagonist is less sensitive than D-2 antagonists to antimuscarinic compounds and benzodiazepines.

Amphetamine-induced rotation in normal cats

Amphetamine elicited dose-related rotation (circling behavior) in 9 naive cats; all cats also rotated, at lower rates, during non-drug sessions. The direction of rotation was consistent for each cat, with 6 cats rotating to the right and 3 to the left. The results extend the generality of previous findings involving rodents and suggest that an endogenous asymmetry in striatal dopamine activity may be a common characteristic of many animal species.

Apomorphine: effects on the timing and sequencing of pecking behavior in chicks

Stereotyped behavior induced by apomorphine is thought to be "autistic", that is, impervious to environmental influence. This assumption is tested by analyzing the patterning of pecks at two differently colored stimuli in three-day old chicks treated with either 0.3 mg-kg-1 or 0.4 mg-kg-1 apomorphine. While normal chicks strongly prefer one stimulus over the other, apomorphine appears to render the choice behavior of chicks insensitive to differences between the stimuli. This result might suggest that apomorphine-treated chicks no longer perceive differences between the stimuli, but an analysis of the timing of pecks reveals that differences are still perceived since the two stimuli elicit different rates of pecking.

Effects of apomorphine on elicited and operant pecking in pigeons

The effects of apomorphine (0.001--32.0 mg/kg) on elicited and operant pecking were studied in pigeons. Elicited pecking was measured in a 1-h observation test. Apomorphine caused dose-related increases in the pecking elicited by the drug in all the subjects, with maximal responding at 3.2 mg/kg. In contrast, operant responding on a multiple, 5 min fixed interval, 30 response fixed-ratio schedule revealed individual differences in sensitivity to the drug. A dose of 0.32 mg/kg eliminated key pecking in fixed-interval and fixed-ratio components in 4 (group 1) of the 15 subjects while 3.2 mg/kg eliminated responding in 9 other subjects (group 2), and 2 of the subjects (group 3) required 32.0 mg/kg to eliminate responding. The 13 birds in groups 1 and 2 showed decreases in operant responding with concomitant increases in elicited pecking. For the 2 remaining birds, increases in operant behavior were highly correlated with increased stereotypy. The effects of apomorphine on operant behavior appeared to depend on induced stereotypy, with rate-decreasing effects resulting from the disruption of ongoing behavior by stereotyped pecking aimed elsewhere in the chamber, and rate increases resulting from the redirection of elicited pecking towards the operant key.

[Psychopharmacological profile of a new dopaminergic agonist, RU 24213 (author's transl)]

The psychopharmacological properties of RU 24213 were compared to those of other dopaminergic agonists (apomorphine, dexamphetamine, bromocriptine and L-dopa) in various behavioural tests. In naive mice the drug reduced the locomotor hyperactivity in the primary exploratory phase and produced stimulation in the subsequent stabilized activity period. In rats it provoked dose-related stereotypies, specially gnawing and sniffing. It delayed the cataleptic state induced by prochlorperazine without affecting its intensity. In animals unilaterally lesioned with 6-OHDA in the nigro-striatal pathway, RU 24213 caused contralateral turning. It exhibited relatively weak emetic and anorexic effects in dogs. Core temperature recordings in rats revealed a biphasic hypo- and hyperthermic activity. In drug interaction studies it was obsers in rats with unilateral electrolytical striatal lesion. The results obtained suggest that RU 24213 stimulates dopamine receptors both directly and indirectly. In this respect it could be compared to bromocriptine but unlike this latter compound it has an immediate effect which is of shorter duration.

Antagonism of apomorphine-induced hyperthermia in MAOI-pretreated rabbits as a sensitive model of neuroleptic activity

Apomorphine induced dose-dependent hyperthermia when applied intravenously to rabbits pretreated with a monoamine oxidase inhibitor. Inhibition of the synthesis of catecholamines (by alpha-MT) did not influence on apomorphine-induced hyperthermia, whereas 5-HT synthesis inhibition (by PCPA) completely abolished the hyperthermic response. Some neuroleptics and a 5-HT receptor blocking agent inhibited the hyperthermia in very low doses. A highly significant correlation was registered between the antagonism of apomorphine hyperthermia of 15 neuroleptics and their clinically useful doses. It is concluded that apomorphine-induced hyperthermia most likely is a result of direct stimulation of dopamine receptors and release of 5-HT, and that abolition of this response represents a very sensitive in-vivo model for neuroleptic substances. Antagonism of apomorphine-induced hyperthermia may be achieved by either dopamine or 5-HT receptor blockade.

Long term effect of teflutixol on apomorphine-induced stereotypy and vomiting in dogs

Dose--response relationships to apomorphine-induced vomiting and stereotyped running behaviour have been determined in dogs before, and up to 24 and 28 days respectively, after daily oral treatment with 2.5 mg/kg of teflutixol or 12 days. The ED50 values for apomorphine-induced vomiting after teflutixol were not different from those obtained before treatment. Stereotyped running behaviour of increasing intensity was seen 4--12 days after teflutixol treatment. The intensity then declined and returned to normal. The results suggest that the nigro-neostriatal dopamine system in dogs became hypersensitive after prolonged teflutixol treatment, while the dopamine receptors of the emetic chemotrigger zone did not.

The pharmacology of a new potent, long acting neuroleptic, piflutixol

Piflutixol, 6-fluoro-9-[3-(4-(2-hydroxyethyl)piperidino)propylidene]-2-trifluoromethyl-thioxanthene, has been shown to have pronounced neuroleptic properties. It is a very potent inhibitor of methylphenidate-induced stereotypies in mice, amphetamine and apomorphine-induced stereotypies in rats, apomorphine-induced stereotypies and vomiting in dogs. Furthermore piflutixol causes cataleptic reaction in small doses and inhibits conditioned avoidance reaction in rats. The compound is equally potent orally and parenterally and has a prolonged effect. Piflutixol has up to the present proved to be the most potent inhibitor of dopamine-stimulated adenylate cyclase in rat striatum in vitro. Piflutixol has a stron sedative effect (inhibition of spontaneous motor activity, induction of ptosis and potentiation of barbiturate anaesthesia) and in addition inhibits reticular arousal reaction in very low doses. Thus piflutixol constitutes a unique combination of potent anti-stereotyped activity with potent sedative effects. This means that piflutixol may prove to be a low-dose basic neuroleptic with long duration of action.

Actions of amphetamine and antagonists on pupil diameter in the chronic sympathectomized dog

The left superior cervical ganglia were removed from 5 dogs. Beginning 30 days postoperatively, epinephrine (10 microgram/kg/min), norepinephrine (10 microgram/kg/min), and d-amphetamine (1.0 mg/kg) were infused i.v. for 10 min following either vehicle, phenoxybenzamine, pimozide, or haloperidol. Epinephrine and norepinephrine dilated the pupil and retracted the nictitating membrane of the denervated side, whereas amphetamine dilated both pupils and retracted both nictitating membranes. Phenoxybenzamine (4 mg/kg) constricted primarily the pupil of the innervated iris and completely antagonized the effects of the catecholamines on the irides and amphetamine on the nictitating membranes, but only partially antagonized amphetamine-induced mydriasis. Haloperidol (1.0 mg/kg) constricted both pupils, possessed only modest alpha-adrenergic blocking activity, and was as effective as phenoxybenzamine in antagonizing amphetamine-induced mydriasis. Pimozide (0.1 mg/kg) constricted both pupils, had no significant alpha-adrenergic blocking activity, and did not antagonize amphetamine-induced mydriasis. Pimozide and haloperidol, but not phenoxybenzamine, blocked amphetamine-induced stereotyped head bobbing. These results suggest that amphetamine produces mydriasis in the dog through a peripheral sympathetic action and also through a central mechanism involving inhibition of the oculomotor nucleus. However, the role of dopamine is not clear.

Clinical studies with dopamine-receptor stimulants

Oral administration of ET-495 was found to cause worsening of psychiatric status in 4 out of 7 schizophrenic patients, and to induce a paranoid state and a syndrome of auditory hallucinosis in 2 non-schizophrenics. These observations were compatible with the hypothesized role of dopamine in schizophrenia. However, these psychotogenic effects were far less dramatic than those noted in other studies with amphetamine, methylphenidate or L-Dopa. Possible explanations for this differing psychotogenic potency of receptor stimulators versus presynaptic agonists are presented. Intravenous ET-495 and apomorphine did not show psychotogenic effects.

Dopaminergic nature of amphetamine-induced pecking in pigeons

d-Amphetamine was found to induce a pecking response in pigeons. The pecking response induced by d-amphetamine was antagonized by chlorpromazine, haloperidol or bulbocapnine indicating that this pecking response was caused by dopaminergic receptor stimulation. Pretreatment of pigeons with alpha-methyltyrosine (alpha-MT) reduced d-amphetamine-induced pecking, while the combined treatment of pigeons with alpha-MT and L-dihydroxyphenylalanine (L-DOPA, 100 mg/kg) partially restored the pecking response. d-Amphetamine-induced pecking was not reduced by a dopamine-beta-hydroxylase inhibitor, 1-phenyl-3-(2-thiazolyl)-2-thiourea (U-14,624). Alpha-MT reduced brain dopamine but not norepinephrine level, whereas U-14,624 decreased brain norepinephrine but not dopamine. Thus there is a correlation between brain dopamine level and d-amphetamine-induced pecking response. It is concluded that d-amphetamine-induced pecking is mediated indirectly by the release of dopamine.

Effects of penfluridol and other drugs on apomorphine-induced stereotyped behavior in monkeys

The effects of some drugs on apomorphine-induced stereotyped behavior were studied in male cynomolgus monkeys. Apomorphine produced the dose-dependent stereotyped behavior characterized mainly by continuous licking and biting, and repetitive movements of the hands, head and body in the monkeys. Penfluridol as well as haloperidol showed a clear antagonistic effect on the apomorphine-induced stereotyped behavior, while chlorpromazine was less antagonistic than haloperidol. The antagonistic effect of penfluridol lasted longer than that of haloperidol. Reserpine did not inhibit the apomorphine-induced stereotyped behavior though the drug elicited markedly the behavioral depression and alpha-methyl-p-tyrosine also did not block the stereotyped behavior. Nialamide did not depress the apomorphine-induced stereotyped behavior. In provoking the stereotyped behavior in monkeys, apomorphine probably acts directly on dopamine receptors in the extrapyramidal system, and penfluridol is suggested to act as a dopamine receptor blocker with a long action. The results indicate that protection against apomorphine-induced stereotyped behavior in monkeys may be a useful method for evaluating neuroleptic drugs.