Combined administration of buprenorphine and naltrexone produces antidepressant-like effects in mice

Opiates have been used historically for the treatment of depression. Renewed interest in the use of opiates as antidepressants has focused on the development of kappa opioid receptor (κ-receptor) antagonists. Buprenorphine acts as a partial µ-opioid receptor agonist and a κ-receptor antagonist. By combining buprenorphine with the opioid antagonist naltrexone, the activation of µ-opioid receptors will be reduced and the κ-antagonist properties enhanced. We have established that a combination dose of buprenorphine (1 mg/kg) with naltrexone (1 mg/kg) functions as a short-acting κ-antagonist in the mouse tail withdrawal test. Furthermore, this dose combination is neither rewarding nor aversive in the conditioned place preference paradigm, and is without significant locomotor effects. We have shown for the first time that systemic co-administration of buprenorphine (1 mg/kg) with naltrexone (1 mg/kg) in CD-1 mice produced an antidepressant-like response in behaviours in both the forced swim test and novelty induced hypophagia task. Behaviours in the elevated plus maze and light dark box were not significantly altered by treatment with buprenorphine alone, or in combination with naltrexone. We propose that the combination of buprenorphine with naltrexone represents a novel, and potentially a readily translatable approach, to the treatment of depression.

[1]  C. O'brien,et al.  Current status of co-occurring mood and substance use disorders: a new therapeutic target. , 2015, The American journal of psychiatry.

[2]  M. Fava,et al.  Evaluation of Opioid Modulation in Major Depressive Disorder , 2014, Neuropsychopharmacology.

[3]  I. Lucki,et al.  Effects of buprenorphine on behavioral tests for antidepressant and anxiolytic drugs in mice , 2014, Psychopharmacology.

[4]  H. Surratt,et al.  Factors contributing to the rise of buprenorphine misuse: 2008-2013. , 2014, Drug and alcohol dependence.

[5]  B. Mulsant,et al.  Safety, tolerability, and clinical effect of low-dose buprenorphine for treatment-resistant depression in midlife and older adults. , 2014, The Journal of clinical psychiatry.

[6]  R. Guy,et al.  A non‐rewarding, non‐aversive buprenorphine/naltrexone combination attenuates drug‐primed reinstatement to cocaine and morphine in rats in a conditioned place preference paradigm , 2014, Addiction biology.

[7]  S. Husbands,et al.  Characterization of BU09059: a novel potent selective κ-receptor antagonist. , 2014, ACS chemical neuroscience.

[8]  W. Carlezon,et al.  Role of kappa-opioid receptors in stress and anxiety-related behavior , 2013, Psychopharmacology.

[9]  J. V. Aldrich,et al.  The macrocyclic tetrapeptide [D‐Trp]CJ‐15,208 produces short‐acting κ opioid receptor antagonism in the CNS after oral administration , 2013, British journal of pharmacology.

[10]  B. Kieffer,et al.  Opioid receptors: distinct roles in mood disorders , 2013, Trends in Neurosciences.

[11]  W. Carlezon,et al.  Development of κ opioid receptor antagonists. , 2013, Journal of medicinal chemistry.

[12]  S. Husbands,et al.  In vivo and in vitro characterization of naltrindole-derived ligands at the κ-opioid receptor , 2013, Journal of psychopharmacology.

[13]  I. Sora,et al.  Active behaviours produced by antidepressants and opioids in the mouse tail suspension test. , 2013, The international journal of neuropsychopharmacology.

[14]  T. F. Murray,et al.  Novel opioid cyclic tetrapeptides: Trp isomers of CJ‐15,208 exhibit distinct opioid receptor agonism and short‐acting κ opioid receptor antagonism , 2012, British journal of pharmacology.

[15]  J. Cryan,et al.  The age of anxiety: role of animal models of anxiolytic action in drug discovery , 2011, British journal of pharmacology.

[16]  Julia C. Lemos,et al.  Selective p38α MAPK Deletion in Serotonergic Neurons Produces Stress Resilience in Models of Depression and Addiction , 2011, Neuron.

[17]  J. Homberg,et al.  Animal models of depression and anxiety: What do they tell us about human condition? , 2011, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[18]  Gregory W. Kauffman,et al.  Design and discovery of a selective small molecule κ opioid antagonist (2-methyl-N-((2'-(pyrrolidin-1-ylsulfonyl)biphenyl-4-yl)methyl)propan-1-amine, PF-4455242). , 2011, Journal of medicinal chemistry.

[19]  M. F. Peters,et al.  Identification of short-acting κ-opioid receptor antagonists with anxiolytic-like activity. , 2011, European journal of pharmacology.

[20]  E. Nunes,et al.  The association between naltrexone treatment and symptoms of depression in opioid-dependent patients , 2011, The American journal of drug and alcohol abuse.

[21]  S. Leucht,et al.  Opioid antagonists for alcohol dependence. , 2010, The Cochrane database of systematic reviews.

[22]  I. Maremmani,et al.  Buprenorphine-based regimens and methadone for the medical management of opioid dependence: selecting the appropriate drug for treatment. , 2010, The American journal on addictions.

[23]  M. Bruchas,et al.  Kinase cascades and ligand-directed signaling at the kappa opioid receptor , 2010, Psychopharmacology.

[24]  A. Marrazzo Opiate Receptors and Antagonists: From Bench to Clinic. Edited by R. Dean, E. J. Bilsky, and S. S. Negus. , 2010 .

[25]  J. Szentágothai,et al.  Brain Research , 2009, Experimental Neurology.

[26]  Brian Johnson Depression and Addiction , 2009 .

[27]  C. Schwarzer,et al.  Prodynorphin-Derived Peptides Are Critical Modulators of Anxiety and Regulate Neurochemistry and Corticosterone , 2009, Neuropsychopharmacology.

[28]  E. Meloni,et al.  Anxiolytic-Like Effects of κ-Opioid Receptor Antagonists in Models of Unlearned and Learned Fear in Rats , 2007, Journal of Pharmacology and Experimental Therapeutics.

[29]  J. Fichna,et al.  Antidepressant-Like Effect of Endomorphin-1 and Endomorphin-2 in Mice , 2007, Neuropsychopharmacology.

[30]  V. Lelong-Boulouard,et al.  Interactions of buprenorphine and dipotassium clorazepate on anxiety and memory functions in the mouse. , 2006, Drug and alcohol dependence.

[31]  Shuang Li,et al.  Social Defeat Stress-Induced Behavioral Responses are Mediated by the Endogenous Kappa Opioid System , 2006, Neuropsychopharmacology.

[32]  Y. Nagumo,et al.  Chronic Pain Induces Anxiety with Concomitant Changes in Opioidergic Function in the Amygdala , 2006, Neuropsychopharmacology.

[33]  G. Gerra,et al.  Naltrexone and buprenorphine combination in the treatment of opioid dependence , 2006, Journal of psychopharmacology.

[34]  Cécile Béguin,et al.  Depressive-Like Effects of the κ-Opioid Receptor Agonist Salvinorin A on Behavior and Neurochemistry in Rats , 2006, Journal of Pharmacology and Experimental Therapeutics.

[35]  R. Hen,et al.  Recent advances in animal models of chronic antidepressant effects: The novelty-induced hypophagia test , 2005, Neuroscience & Biobehavioral Reviews.

[36]  A. Cowan,et al.  Buprenorphine: a unique drug with complex pharmacology. , 2004, Current neuropharmacology.

[37]  Masaaki Iwata,et al.  Stress increases dynorphin immunoreactivity in limbic brain regions and dynorphin antagonism produces antidepressant‐like effects , 2004, Journal of neurochemistry.

[38]  C. Bouza,et al.  Efficacy and safety of naltrexone and acamprosate in the treatment of alcohol dependence: a systematic review. , 2004, Addiction.

[39]  C. Chavkin,et al.  κ Opioid Receptor Antagonism and Prodynorphin Gene Disruption Block Stress-Induced Behavioral Responses , 2003, The Journal of Neuroscience.

[40]  Philip S. Portoghese,et al.  Antidepressant-Like Effects of κ-Opioid Receptor Antagonists in the Forced Swim Test in Rats , 2003, Journal of Pharmacology and Experimental Therapeutics.

[41]  Athina Markou,et al.  Assessing antidepressant activity in rodents: recent developments and future needs. , 2002, Trends in pharmacological sciences.

[42]  A Cowan,et al.  Comparison of pharmacological activities of buprenorphine and norbuprenorphine: norbuprenorphine is a potent opioid agonist. , 2001, The Journal of pharmacology and experimental therapeutics.

[43]  T. Sumpter,et al.  Methocinnamox is a potent, long-lasting, and selective antagonist of morphine-mediated antinociception in the mouse: comparison with clocinnamox, beta-funaltrexamine, and beta-chlornaltrexamine. , 2000, The Journal of pharmacology and experimental therapeutics.

[44]  B. H. Hill,et al.  An open-label study of a functional opioid κ antagonist in the treatment of opioid dependence , 2000 .

[45]  H. Matthes,et al.  Quantitative autoradiographic mapping of μ-, δ- and κ-opioid receptors in knockout mice lacking the μ-opioid receptor gene , 1997, Brain Research.

[46]  Michael Rickels,et al.  Active behaviors in the rat forced swimming test differentially produced by serotonergic and noradrenergic antidepressants , 1995, Psychopharmacology.

[47]  S. Lukas,et al.  Buprenorphine treatment of refractory depression. , 1995, Journal of clinical psychopharmacology.

[48]  H. Yamamura,et al.  Extremely long-lasting antagonistic actions of nor-binaltorphimine (nor-BNI) in the mouse tail-flick test. , 1992, The Journal of pharmacology and experimental therapeutics.

[49]  T. Endoh,et al.  Nor-binaltorphimine: a potent and selective kappa-opioid receptor antagonist with long-lasting activity in vivo. , 1992, Archives internationales de pharmacodynamie et de therapie.

[50]  T. Cicero,et al.  Antagonist-induced up-regulation of the putative epsilon opioid receptor in rat brain: comparison with kappa, mu and delta opioid receptors. , 1990, The Journal of pharmacology and experimental therapeutics.

[51]  P. O'Neil,et al.  Naltrexone and dysphoria: A double-blind placebo controlled trial , 1987, Biological Psychiatry.

[52]  H. Emrich,et al.  POSSIBLE ANTIDEPRESSIVE EFFECTS OF OPIOIDS: ACTION OF BUPRENORPHINE , 1982, Annals of the New York Academy of Sciences.

[53]  A. Kastin,et al.  Enkephalin and other peptides reduce passiveness , 1978, Pharmacology Biochemistry and Behavior.

[54]  B. Cohen,et al.  Medicinal Chemistry of Kappa Opioid Receptor Antagonists , 2009 .

[55]  P J Mitchell,et al.  Animal models of depressive illness: the importance of chronic drug treatment. , 2005, Current pharmaceutical design.

[56]  Richard Muscat,et al.  An animal model of anhedonia: attenuation of sucrose consumption and place preference conditioning by chronic unpredictable mild stress , 2005, Psychopharmacology.

[57]  Michel Bourin,et al.  Forced swimming test in mice: a review of antidepressant activity , 2004, Psychopharmacology.

[58]  Prof. Dr. W. Wolfgang Fleischhacker,et al.  Neuropsychopharmacology , 2003, Journal of Neural Transmission. Supplementa.

[59]  B. H. Hill,et al.  An open-label study of a functional opioid kappa antagonist in the treatment of opioid dependence. , 2000, Journal of substance abuse treatment.

[60]  H. Akil,et al.  Kappa 1 receptor mRNA distribution in the rat CNS: comparison to kappa receptor binding and prodynorphin mRNA. , 1994, Molecular and cellular neurosciences.

[61]  Y G ARBATSKY,et al.  Current neuropharmacology. , 1962, I. C. R. S. medical reports.