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enzyme inhibitors neurotransmitter transport inhibitors Bi / CNS 150 Lecture 13 Monday, October 28, 2013 Recreational drugs Henry Lester This material is scattered throughout Kandel; see Nestler et al http://site.ebrary.com/lib/caltech/docDetail.action?docID=10251590 Disclaimer 1. Do not alter your pattern of prescription drug compliance as a result of this course. 2. Consult a medical professional for further guidance about prescription drugs. H. A. L. is not aware of all trends in current medical practice, is not a physician, and cannot prescribe. 2 Week 3: Recreational drugs Addictive drugs Abused drugs Illegal drugs Coca Harvest in Bolivia, ca. 1950 4 cocaine in the test tube cocaine base: directly extracted from the plant with organic solvents treatment with acid (HCl) cocaine hydrochloride: a salt, readily soluble treatment with base: ammonia or Na bicarbonate, then heat to drive off HCl 5 cocaine in the body H+ blood, CSF Lipid barrier, e. g. membrane(s) lungs, nose, stomach cocaine base (crack) cocaine hydrochloride H+ South American Indians use Ca(OH)2 from limestone to shift this equilibrium 6 Targets for Recreational Drugs amphetamine ketamine cocaine nicotine neurotransmitter transporters ligand-activated channels GPCRs enzymes N C LSD a G protein-activated channels morphine-heroin tetrahydrocannabinol caffeine* ?alcohol? (*= intracellular target) From Previous Lectures Na+-coupled cell membrane neurotransmitter transporters: major targets for drugs of therapy and abuse Antidepressants (“SSRIs” = serotonin-selective reuptake inhibitors): Prozac, Zoloft, Paxil, Celexa, Luvox Drugs of abuse: MDMA Na+-coupled cell membrane serotonin transporter Attention-deficit disorder medications: Trademarks: Ritalin, Dexedrine, Adderall Presynaptic terminals Drugs of abuse: cocaine amphetamine Na+-coupled cell membrane dopamine transporter cytosol NH 3+ HO outside HO N H HO H2 C C H2 NH3+ 8 Endogenous ligand morphine-heroin agonist endorphins (peptides) THC agonist anandamide nicotine agonist acetylcholine cocaine antagonist dopamine amphetamine & derivatives antagonist, false substrate noradrenaline, serotonin, dopamine ethanol agonist ?G protein? LSD agonist serotonin caffeine inhibitor cyclic AMP (intracellular) ketamine antagonist glutamate Primary Target Class Details morphine-heroin GPCR (G protein-coupled receptor) (Gi) m-opioid receptor THC GPCR (Gi) cannabinoid receptor nicotine agonist-activated channel a4b2 nicotinic acetylcholine receptor cocaine plasma membrane neurotransmitter transporter dopamine transporter amphetamine & derivatives vesicular & plasma membrane neurotransmitter transporter vesicular monoamine transporter (VMAT) ethanol ? K channel ? G protein-gated inward rectifier GIRK1/2 LSD GPCR (Gq) serotonin 5-HT2a receptor caffeine enzyme cyclic AMP phosphodiesterase ketamine ligand-activated channel NMDA glutamate receptor Knockout mice and one application for them Hypothesis: the response to a drug requires your favorite molecule Gene (DNA) Interrupt the gene with a detectable protein (knock out the gene) EGFP Replace the mouse gene with the altered gene Breed many identical mice Select the mouse with the altered gene measure drug response vs 11 Knockout mice in pharmacology (Behavioral observations) 1. The m-opioid receptor m-opioid receptor KOs specifically lack responses to certain types of pain (next slide). 2. The a4b2 nicotinic receptor a4 or b2 nicotinic receptor knockouts: (1) respond less to nicotine in pain tests (next slide) (2) fail to self-administer nicotine (next slide). 3. The dopamine transporter Dopamine transporter knockout mice: (1) are hyperactive, (2) show less response to cocaine, (3) self-administer cocaine less 4. Cannabinoid receptors Cannabinoid receptor knockouts have little overt differences to normal mice. They don’t show these effects of THC and anandamide: (1) decreased pain responses and (2) decreased heart rate. --------------------------------------------------5. But NMDA receptor knockouts die at birth: an uninformative result 12 Two behavioral tests often used on knockout mice Pain: Mice are placed on a hotplate at 55o C. The experimenter notes the time to lick paws, jump, etc. The experiment terminates at 30 s, regardless of the outcome. A pain-relieving drug increases the time to react No permanent harm to the mouse . . . Carefully regulated: http://www.olar.caltech.edu/iacuc-sops.htm Self-administration of a drug 13 Source (species: morphine-heroin Papaver somniferum tetrahydrocannabinol Cannabis sativa, C. indica nicotine Nicotiana tabacum cocaine Erythroxylum coca tobacco coca synthetic LSD ketamine marijuana, hemp yeast ethanol caffeine “poppy that brings sleep” (opium) synthetic amphetamine Coffea sp., Camellia sinensis ) Jean Nicot, French ambassador to Portugal based on plant Saccharomyces cerevisiae (fermentation) ergot coffee tea synthetic grain fungus; Salem witch trials? Caporael, Science, 1976 Gordon A. Alles noted the properties of Ephedra vulgaris, used against asthma. He synthesized amphetamine (Benzedrine). Caltech BS, 1922; MS, 1924; PhD, 1926. Research Associate in Biology, 19391963 15 MDMA or Amphetamines Release Transmitter into the External Medium O H N O CH3 H2C 3,4-methylenedioxy-N-methamphetamine (MDMA, “ecstasy”, “XTC”, “molly”) pKa ~ 8.5 CH3 ATP-driven proton pump proton-coupled vesicular serotonin transporter depleted serotonin vesicle vesicle serotonin cytosol MDMA is a “false substrate” for two transporters H+ MDMA MDMA-H+ MDMA-H+ MDMA MDMA dissipates the vesicle’s H+ store, preventing the vesicle from pumping serotonin SERT serotonin Rudnick & Wall, PNAS 1992 A modified patch clamp circuit and pipette allow us to detect dopamine electrochemically by oxidizing the adjacent hydroxyl groups of dopamine A cytosol synaptic cleft carbon fiber HO HO H2 C C H2 NH3+ 17 In dopamine transporter knockout mice (“DAT -/-”), presynaptic stimuli (“^”) lead to longer individual dopamine release pulses; but amphetamine fails to release dopamine Amphetamine Jones et al J Neurosci 18, p 1979 18 Routes into the body Eat / drink Inhale Smoke Inject morphine-heroin tetrahydrocannabinol nicotine chew cocaine amphetamine & derivatives ethanol LSD caffeine ketamine Most recreational drugs act at < 10-5 M. Ethanol is an exception Active Concentration morphine-heroin ~ 1 mM tetrahydrocannabinol ~ 1 mM nicotine ~ 1 mM cocaine ~ 1 mM amphetamine ~ 1 mM ethanol LSD > 1 mM ~ 10 nM ~ 10 mM caffeine phencyclidine ~ 1 mM 20 Dopaminergic Neurons: “pleasure / reward / well-being” system highlighted. Several recreational drugs affect this system Nestler Figure 6-1 21 Only a few thousand neurons in the brain make noradrenaline Nestler Figure 6-7 22 System-level Action Dopamine “Pleasure” system morphine-heroin Noradrenaline “Readiness” system nicotine cocaine amphetamine ethanol ? ketamine LSD “Decreased neuronal activity” tetrahydrocannabinol caffeine “PerceptionAssociation” system Serotonergic neurons project to many higher brain regions, and also descend to spinal cord raphe nuclei simplified from Nestler Figure 6-10 24 Recreational drugs have varying overall effects Overall Action morphine-heroin inhibitory tetrahydrocannabinol inhibitory nicotine excitatory cocaine excitatory amphetamine & derivatives excitatory ethanol inhibitory LSD caffeine ketamine hallucinations excitatory hallucinations, antidepressant fMRI measurements on a hallucinogenic 5-HT2A agonist in human brain psilocybin → psilocin from mushrooms: First, subjects’ Reports: Carhart-Harris et al, PNAS 2012 Authors suggest that psilocin activates some GABA neurons, decreasing overall activity of the more numerous glutamatergic neurons. Left hemisphere midline Right hemisphere Decreased cerebral blood flow after psilocybin v. after placebo Thalamus Thalamus placebo Thalamus placebo Anterior cingulate psilocybin placebo psilocybin Anterior cingulate Posterior Anterior cingulate cingulate Posterior cingulate psilocybin Infusion Infusion Most active regions before psilocybin become least active during the drug! pre-infusion torelative change flow blood % cerebral pre-infusion tochange relative change flow blood % cerebral to pre-infusion relative change flow blood cerebral % to pre-infusion flowrelative blood cerebral % “Journal Club”: fMRI measurements on a hallucinogenic 5-HT2A agonist in human brain Posterior cingulateTime (min) Carhart-Harris et al, PNAS 2012 Legal status of Recreational Drugs in the USA, late 2013 Recreational use Prescription use* Non-prescription (“over the counter”) use morphine-heroin Illegal Schedule II pain control Weaker analogs: cough & diarrhea tetrahydrocannabinol 28.5 g, (CO, WA); > 21; taxed 20 states incl. CA; taxed nicotine Taxed; no sales to minors cocaine Illegal ear, nose & throat surgery amphetamine & derivatives Illegal Schedule II ADD / ADHD; narcolepsy ethanol Taxed; no sales to minors Rare, detox (methanol or ethylene glycol) LSD Illegal caffeine Legal In some migraine medications ketamine Illegal Schedule III Smoking cessation: gum, lozenge, patch, inhaler Diet pills With antihistamines *Pharmaceutical companies may promote only "on label" use. Physicians may prescribe according to the standard of care, which may be "off label" use. H 3C O O CH 3 N N N N CH 3 caffeine What changes occur in the brain during chronic exposure to an addictive drug? Today’s lecture is only the first step in such studies. End of Lecture 13 29