Reinforcing effects of oral cocaine: contextual determinants.

RATIONALE: Although the behavioral, subjective, and physiological effects of oral cocaine have been investigated, its reinforcing effects have not been demonstrated. OBJECTIVE: The primary aims of this study were to examine the reinforcing effects of oral cocaine and determine whether such effects can be influenced by manipulating behavioral requirements following drug ingestion. METHODS: Nine adult volunteers with histories of cocaine abuse were trained to discriminate between orally administered cocaine (100 mg/70 kg) and placebo capsules under double-blind conditions. Following acquisition of cocaine vs placebo discrimination (80% correct), the reinforcing effects of cocaine were determined using two different choice conditions (dependent and independent). Volunteers were first exposed to cocaine and placebo once each with a relaxation activity (sitting in a cushioned chair) and a vigilance activity (performing a computer task). Following exposure to each drug with each activity, volunteers began the dependent choice condition. Every 2 days volunteers chose which drug (cocaine or placebo) they ingested with the vigilance and relaxation activities. Volunteers could not choose the same drug with both activities. This procedure occurred 5 times over a 10-day period. The independent choice condition took place over 2 days. On one day, volunteers chose which drug (cocaine or placebo) they ingested with the relaxation activity and, on the other day (in counterbalanced order), which drug they ingested with the vigilance activity. Volunteers were allowed to select the same drug with both activities. RESULTS: All volunteers successfully acquired the cocaine vs placebo discrimination. In the dependent choice condition, all volunteers significantly chose cocaine over placebo with the vigilance activity and chose placebo over cocaine with the relaxation activity. In the independent choice condition, volunteers significantly chose cocaine over placebo with the vigilance activity (i.e., cocaine functioned as a positive reinforcer in the vigilance context). Interestingly, the independent choice condition also showed that volunteers chose placebo over cocaine with the relaxation activity (i.e., cocaine functioned as a negative reinforcer because it was avoided relative to placebo). CONCLUSION: The study shows that the behavioral requirements following drug ingestion can be a determinant of whether or not oral cocaine functions as a reinforcer in volunteers with histories of cocaine abuse.

Intravenous nicotine and caffeine: subjective and physiological effects in cocaine abusers.

The subjective and physiological effects of intravenously administered caffeine and nicotine were compared in nine subjects with histories of using caffeine, tobacco, and cocaine. Subjects abstained from tobacco cigarette smoking for at least 8 h before each session. Dietary caffeine was eliminated throughout the study; however, to maintain consistency with the nicotine intake, subjects were administered caffeine (150 mg/70 kg b.i.d.) in capsules, with the last dose administered 15 to 18 h before each session. Under double-blind conditions, subjects received placebo, caffeine (100, 200, and 400 mg/70 kg), and nicotine (0.75, 1.5, and 3.0 mg/70 kg) in mixed order. Physiological and subjective data were collected before and repeatedly after drug or placebo administration. Compared with the highest dose of caffeine, the highest dose of nicotine produced greater subjective ratings on a number of scales. At doses that produced comparable ratings of drug effect (1.5 mg/70 kg of nicotine and 400 mg/70 kg of caffeine), both drugs produced similar increases in ratings of good effect, liking, high, stimulated, and bad effect. Nicotine showed a somewhat faster time to peak subjective effects than caffeine (2 versus 4 min). Subjective ratings that differentiated caffeine and nicotine were ratings of rush, blurry vision, and stimulant identification (elevated by nicotine) and ratings of unusual smell and/or taste (elevated by caffeine). Both caffeine and nicotine decreased skin temperature and increased diastolic blood pressure; however, caffeine decreased whereas nicotine increased heart rate. The study documents both striking similarities and some notable differences between caffeine and nicotine, which are among the most widely used mood-altering drugs.

Tobacco addiction and pharmacological interventions.

Even though its health consequences are well known, tobacco use continues to kill millions of smokers worldwide every year. In the US alone, tobacco use kills > 430,000 people each year. The global mortality toll is approximately 5 million annually and this is increasing. It is the powerful grip of tobacco addiction that sustains high levels of daily smoke intake and persistent smoking, with > 90% of all cigarette smokers who quit, resuming smoking within 1 year. Tobacco addiction, which places tremendous health and economic burdens on individual societies, is also becoming a global epidemic. Although tobacco addiction is a complex phenomenon, it is treatable and several effective medications are now available. In the mid-1980s, the US FDA approved nicotine gum, the first of these effective pharmacological aids. Other effective medications have subsequently become available, including nicotine transdermal patches, nasal spray, oral vapour inhaler, sublingual nicotine tablets and bupropion. These medications and the potential for development of new medications will be reviewed.

Studies of selected phenyltropanes at monoamine transporters.

3-Phenyltropane analogues of cocaine are useful neurobiologic tools for examining mechanisms of neurotransmitter transporters and psychostimulant drugs. They are also potential substitute medications for psychostimulant abuse. In this study, 18 3-phenyltropane analogues were characterized in uptake and binding studies at dopamine (DAT), norepinephrine (NET) and serotonin (SERT) transporters from the rat, and in binding at DAT in rat, rhesus monkey, and human brain tissue. In rat brain tissue, potency in inhibiting uptake generally correlated with the potency in inhibiting binding at all three transporters suggesting that none of these compounds have antagonist properties. At the DAT, there was a significant correlation of inhibitory potencies between the rat and monkey, the monkey and human, and the rat and human transporters although some compounds showed some species difference. These findings suggest that with regard to the 3-phenyltropane series, there is generally little pharmacologic difference between DATs from the three species examined, although binding data from rat may not be a perfect predictor of uptake inhibition in human.

Subjective and physiological effects of intravenous nicotine and cocaine in cigarette smoking cocaine abusers.

The subjective and physiological effects of intravenously administered cocaine and nicotine were compared in 10 cigarette-smoking cocaine abusers. Subjects abstained from smoking at least 8 h before each session. Under double blind conditions, subjects received placebo, cocaine (10, 20, and 40 mg/70 mg), or nicotine (0.75, 1.5, 3.0 mg/70 kg) in mixed order. Physiological and subjective data were collected before and repeatedly after each intravenous drug administration. Subjects also completed a drug versus money multiple-choice procedure in which they chose between that day's drug and 44 monetary values. Both drugs increased blood pressure and heart rate and decreased skin temperature. Nicotine showed a more rapid onset of subjective effects than cocaine. Overall, although both cocaine and nicotine increased subjective ratings of "drug effect", "rush", "good effects", "liking", "high", and "stimulated", only nicotine increased ratings of "bad effects" and "jittery". Although the highest nicotine dose produced greater effects than the highest cocaine dose on most subjective measures, the highest cocaine dose produced somewhat greater ratings of drug liking. At doses that produced comparable ratings of drug effect (40 mg/70 kg cocaine versus 1.5 mg/70 kg nicotine), cocaine produced significantly greater good effects, whereas nicotine produced greater bad effects. All three cocaine doses and the intermediate and high nicotine doses were frequently categorized as producing effects similar to those of cocaine or amphetamine. The drug versus money measure showed that the highest cocaine dose was worth twice as much as the highest nicotine dose. Thus, intravenous cocaine and nicotine can be differentiated by their subjective and reinforcing effects.

Physical dependence increases the relative reinforcing effects of caffeine versus placebo.

Using a within-subject cross-over design, this study examined the role of physical dependence in caffeine reinforcement by experimentally manipulating physical dependence. Each subject was exposed to two chronic drug phases (300 mg/70 kg/day caffeine and placebo) for 9-12 days, with order of phases counterbalanced across subjects. On 2 separate days immediately following each of the chronic drug exposures, subjects received acute doses of either caffeine (300 mg/70 kg) or placebo in counterbalanced order. The reinforcing effects of these drugs were then determined by using a multiple-choice procedure in which subjects made a series of discrete choices between receiving varying amounts of money or receiving the drug again, and a choice between the two drugs. To ensure that subjects completed the form carefully, following exposure to both of the acute drug administrations, one of the subject's previous choices from the multiple-choice form was randomly selected and the consequence of that choice was implemented. When subjects were maintained on chronic caffeine, they were willing to forfeit significantly more money and showed significant increases in typical withdrawal symptoms (e.g. fatigue, mood disturbance) after receiving placebo as compared to the other three conditions. When subjects were maintained on chronic caffeine, they also chose to receive caffeine over placebo twice as often than when they were maintained on chronic placebo. These findings provide the strongest evidence to date indicating that caffeine physical dependence increases the relative reinforcing effects of caffeine versus placebo.

The role of dopamine in the behavioral effects of caffeine in animals and humans.

Dopamine has been proposed to mediate some of the behavioral effects of caffeine. This review discusses cellular mechanisms of action that could explain the role of dopamine in the behavioral effects of caffeine and summarizes the results of behavioral studies in both animals and humans that provide evidence for a role of dopamine in these effects. Caffeine is a competitive antagonist at adenosine receptors and produces a range of central and physiological effects that are opposite those of adenosine. Recently, caffeine has been shown to enhance dopaminergic activity, presumably by competitive antagonism at adenosine receptors that are colocalized and interact functionally with dopamine receptors. Thus, caffeine, as a competitive antagonist at adenosine receptors, may produce its behavioral effects by removing the negative modulatory effects of adenosine from dopamine receptors, thus stimulating dopaminergic activity. Consistent with this interpretation, preclinical behavioral studies show that caffeine produces behavioral effects similar to classic dopaminergically mediated stimulants such as cocaine and amphetamine, including increased locomotor activity, increased turning behavior in 6-hydroxydopamine-lesioned animals, stimulant-like discriminative stimulus effects, and self-administration. Furthermore, caffeine potentiates the effects of dopamine-mediated drugs on these same behaviors, and some of caffeine's effects on these behaviors can be blocked by dopamine receptor antagonists. Although more limited in scope, human studies also show that caffeine produces subjective, discriminative stimulus and reinforcing effects that have some similarities to those produced by cocaine and amphetamine.

Comparison of the effects of prototypical behavioral stimulants on locomotor activity and rotational behavior in rats.

The present study was performed to characterize on rotational behavior the dose- and time-effect relationship of four prototypical behavioral stimulants that interact with dopamine systems via different mechanisms of action. Drug effects on rotational behavior was compared with effects on locomotor activity. The drugs examined were apomorphine (0.03-1.0 mg/kg), d-amphetamine (0.1-3.0 mg/kg), cocaine (3.0-56 mg/kg), and caffeine (10-100 mg/kg). SKF-38393 (0.3-10 mg/kg), a dopamine receptor agonist that has only modest effects on locomotor activity, was tested as a comparison. In rats with unilateral 6-hydroxydopamine (6-OHDA)-induced lesions of the nigrostriatal tract, d-amphetamine and cocaine dose dependently increased both the duration and the maximum number of turns/10 min, whereas apomorphine and caffeine increased only the duration of turning. There was a significant correlation of the effects of the four drugs on rotational behavior with effects on locomotor activity, but effects across drugs were not identical. Dose-response curves revealed potency differences among drugs in their effects on the two behaviors (e.g., apomorphine stimulated rotational behavior at a lower dose than it stimulated locomotor activity, whereas the converse was true with caffeine). Different mechanisms of action of these drugs might account for the differences in their effects on these behaviors.

The effects of dopamine agonists on rotational behavior in non-tolerant and caffeine-tolerant rats.

Tolerance develops to caffeine-induced stimulation of both locomotor activity and rotational behavior. The role of dopamine in tolerance to the locomotor stimulant effects of caffeine has been documented. However, the role of dopamine in caffeine-induced turning behavior remains to be elucidated. Therefore, the present study determined the role of dopamine receptors in tolerance to caffeine-induced rotational behavior. Rats with a unilateral lesion of the nigrostriatal tract, induced by 6-hydroxydopamine (6-OHDA), were treated chronically with either caffeine (1.0mg/ml) or with drug-free tap water, by a method of scheduled access. Agonists with and without selectivity for dopamine receptor sub-types were tested in both groups of rats (nonselective: apomorphine, d-amphetamine; D1 selective: SKF-38393, SKF-77434; D2 selective: R(-)-propylnorapomorphine (NPA), quinpirole). All drugs produced dose-dependent increases in turning that, with the exception of quinpirole, were comparable in both groups. Quinpirole produced a smaller effect in rats treated with caffeine than in control rats. Thus, there was significant cross-tolerance only to the effects of quinpirole. The concurrent administration of SKF-38393 with NPA produced a synergistic interaction on rotational behavior in control rats, to which cross-tolerance did not develop in caffeine-treated rats. In contrast to what occurs with locomotor activity, in control rats the selective D1 dopamine receptor antagonist SCH 23390 completely blocked SKF-38393-induced turning behavior and the selective D2 dopamine receptor antagonist eticlopride partially attenuated this effect. NPA-induced turning behavior was blocked only by eticlopride; SCH 23390 was without effect. Both SCH 23390 and eticlopride blocked d-amphetamine-induced rotational behavior. The results of this study suggest that D1 dopamine receptors are not involved in tolerance to caffeine-induced rotational behavior. The role of D2 dopamine receptors in this effect is unresolved. Results obtained from rotational behavior studies generally do not parallel those obtained from locomotor activity studies, suggesting that different mechanisms underlie the effects of caffeine on these two behaviors.

Effects of acute and chronic morphine on rotational behavior in nigral-lesioned rats.

Stimulation of mu-opioid receptors located on dopaminergic neurons in the striatum and the nucleus accumbens increases dopamine release, which may account for some of the behavioral effects of morphine. In this study, we examined the effects of acute and chronic morphine treatment on rotational behavior in rats with unilateral 6-hydroxydopamine dopamine (6-OHDA)-induced lesions of the nigrostriatal pathway. Rats receiving morphine acutely (0.3-10 mg/kg) did not show a significant bias toward contralateral or ipsilateral turning. Mini osmotic pumps dispensing morphine continuously (20-24 mg/kg/day) were implanted s.c. in these animals. This treatment induced tolerance to the behavioral depression produced by the highest dose of morphine (10 mg/kg) when it was given acutely. A slight but significant increase in ipsilateral turning occurred over the range of morphine doses examined. The effects of morphine on rotational behavior are slight, and do not correlate well with the reported increase in locomotor activity or extraneural dopamine in the striatum that are produced by doses of morphine similar to the ones tested in this study.

Does adenosine receptor blockade mediate caffeine-induced rotational behavior?

Caffeine, a competitive antagonist at adenosine receptors, produces contralateral turning in rats with unilateral 6-hydroxydopamine-induced lesions of the nigrostriatal pathway. Adenosine A2a and dopamine D2 receptors are negatively coupled in the striatum; blockade of these adenosine receptors is a possible mechanism of caffeine-induced rotational behavior. The present study had three objectives: 1) to evaluate the role of adenosine receptor blockade in the rotational behavior elicited by caffeine in rats. This was done by determining the dose-response functions for turning behavior induced by caffeine, by six other methylxanthine adenosine antagonists and by CGS 15943 [9-chloro-2-(2-furanyl)-5,6-dihydro-1,2,4-triazolo[1,5- c]quinazolin-5-imine], a potent nonxanthine adenosine antagonist; 2) to determine if selective dopamine receptor antagonist block caffeine-induced rotational behavior; and 3) to determine if tolerance develops to caffeine-induced rotational behavior as it does to caffeine-induced stimulation of locomotor activity. Theophylline, paraxanthine, caffeine and beta-hydroxytheophylline, in that order of potency, produced contralateral turning, but 3-isobutyl-1-methylxanthine, 8-chlorotheophylline, theobromine and CGS 15943 did not. Caffeine-induced turning was blocked by eticlopride (dopamine D2 antagonist), but not by SCH 23390 [R-(+)-7-chloro-8-hydroxy-3-methyl-1-phenyl-2,3,4,5-tetrahydro-1H- 3-benzazepine] (dopamine D1 receptor antagonist), suggesting involvement of the dopamine D2 receptor. Rats treated chronically with an p.o. caffeine solution (75 mg/kg/day average intake) were tolerant to turning induced by caffeine and cross-tolerant to turning induced by theophylline.(ABSTRACT TRUNCATED AT 250 WORDS)

Caffeine cross-tolerance to selective dopamine D1 and D2 receptor agonists but not to their synergistic interaction.

This study examined the role of dopamine systems in tolerance to caffeine-induced stimulation of motor activity in the rat. Selective dopamine D1 and D2 receptor agonists were tested alone and combined in rats receiving caffeine chronically by a method of scheduled access to a caffeine solution or in control rats receiving no caffeine. Rats treated chronically with oral caffeine were tolerant to the motor stimulant effects of caffeine (3.0-100 mg/kg, i.p.). The partial dopamine D1 receptor agonist SKF-77434 (1.0-30 mg/kg, s.c.) and the dopamine D2 receptor agonists quinpirole (0.03-10 mg/kg, s.c.) and R(-)-pro-pylnorapomorphine (NPA, 0.03-1.0 mg/kg, s.c.) dose-dependently increased activity in control rats. Caffeine-treated rats were cross-tolerant to the locomotor stimulant effect of these selective dopamine D1 and D2 receptor agonist. The concurrent administration of the partial dopamine D1 receptor agonist SKF-38393 (10 mg/kg, s.c.) with the dopamine D2 receptor agonists quinpirole and R(-)-propylnorapomorphine had a synergistic effect on locomotor activity in both control and caffeine-treated rats. This synergistic effect was also seen when the partial dopamine D1 receptor agonist SKF-77434 (1.0 and 10 mg/kg, s.c.) was given in combination with quinpirole. There was little or no cross-tolerance to the concurrent administration of selective dopamine D1 and D2 receptor agonists. It appears that tolerance to the locomotor stimulant effect of caffeine is mediated by both dopamine D1 and D2 receptor sub-types. Cross-tolerance occurs to drugs that activate a single type of dopamine receptor but not to drug combinations that concurrently activate more than one type of receptor.

D1 and D2 dopamine receptor antagonists block caffeine-induced stimulation of locomotor activity in rats.

The mechanism of action for the behavioral stimulant effects of caffeine has been extensively studied, but results have been ambiguous and inconsistent. The present study examined the role of dopamine in caffeine-induced stimulation of locomotor activity in rats. d-Amphetamine was also tested for comparison. Locomotor activity of male Sprague-Dawley rats (300-350 g) was measured using two-channel electronic activity monitors. Activity counts were recorded for 30 min following a 30-min pretreatment with either caffeine (3.0-100 mg/kg, IP) or d-amphetamine (0.1-3.0 mg/kg, IP) alone and in combination with the D1 dopamine antagonist SCH23390 (0.01 and 0.003 mg/kg, SC) or the D2 dopamine antagonists sulpiride (30 mg/kg, SC) or eticlopride (0.03 mg/kg, SC). Caffeine and d-amphetamine dose dependently increased locomotor activity. This effect of both caffeine and d-amphetamine was blocked by SCH23390 as well as by eticlopride. Sulpiride blocked the stimulatory effects of caffeine but not d-amphetamine. These results suggest that the locomotor stimulant effect of caffeine, like that of d-amphetamine, is mediated through dopaminergic systems; both D1 and D2 receptors appear to be involved.