I would like to suggest an extension to the intriguing proposal by Ciccocioppo et al. (
1
) that high-dose buprenorphine reduces alcohol drinking by acting as an agonist/partial
agonist at the nociceptin/orphanin FQ (NOP) receptor. Several clinical trials have
found that high-dose (12 to 16 mg daily as sublingual solution, bioequivalent to 24
to 32 mg as tablet) buprenorphine significantly reduces cocaine use by dually opiate-dependent
and cocaine-dependent outpatients (
2
,
3
). This effect is not seen at lower doses, at which buprenorphine’s μ-opioid receptor
agonist action would predominate (
4
). I suggest that buprenorphine’s anticocaine effect at high doses, like its antialcohol
effect, may also be mediated by activation of the NOP receptor.To read this article in full you will need to make a payment
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References
- Buprenorphine reduces alcohol drinking through activation of the nociceptin/orphanin FQ-NOP receptor system.Biol Psychiatry. 2007; 61: 4-12
- Randomized trial of buprenorphine for treatment of concurrent opiate and cocaine dependence.Clin Pharmacol Ther. 2004; 75: 34-48
- Buprenorphine: Dose-related effects on cocaine and opioid use in cocaine-abusing opioid-dependent humans.Biol Psychiatry. 1993; 34: 66-74
- Buprenorphine as a pharmacotherapy for cocaine abuse: A review of the evidence.J Addict Dis. 1995; 14: 97-114
- Orphanin FQ/nociceptin but not Ro 65-6570 inhibits the expression of cocaine-induced conditioned place preference.Behav Pharmacol. 2002; 13: 229-235
- Central administration of nociceptin/orphanin FQ blocks the acquisition of conditioned place preference to morphine and cocaine, but not conditioned place aversion to naloxone in mice.Psychopharmacology (Berl). 2004; 172: 129-136
- Orphanin FQ/nociceptin blocks cocaine-induced behavioral sensitization in rats.Psychopharmacology (Berl). 2002; 164: 168-176
- Orphanin FQ/nociceptin attenuates motor stimulation and changes in nucleus accumbens extracellular dopamine induced by cocaine in rats.Psychopharmacology (Berl). 2001; 154: 1-7
Article info
Publication history
Published online: May 29, 2007
Footnotes
The author has no competing financial interests to declare.
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Copyright
© 2007 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
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- ReplyBiological PsychiatryVol. 62Issue 6
- PreviewWe find Dr. Gorelick’s proposition quite appealing. He is correct in pointing out that no controlled human data are available, but anecdotal clinical reports from patients treated with high doses of buprenorphine support his proposition. An interesting aspect to consider is that activation of nociceptin/orphanin FQ (NOP) receptors may act at or beyond a point of convergence for several pathways important in addiction. It has previously been demonstrated that reinstatement of alcohol seeking, an animal model of relapse, is triggered in rats either by alcohol-associated cues or stress.
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