The CB1 Neutral Antagonist AM4113 Retains the Therapeutic Efficacy of the Inverse Agonist Rimonabant for Nicotine Dependence and Weight Loss with Better Psychiatric Tolerability.

BACKGROUND: Multiple studies suggest a pivotal role of the endocannabinoid system in regulating the reinforcing effects of various substances of abuse. Rimonabant, a CB1 inverse agonist found to be effective for smoking cessation, was associated with an increased risk of anxiety and depression. Here we evaluated the effects of the CB1 neutral antagonist AM4113 on the abuse-related effects of nicotine and its effects on anxiety and depressive-like behavior in rats. METHODS: Rats were trained to self-administer nicotine under a fixed-ratio 5 or progressive-ratio schedules of reinforcement. A control group was trained to self-administer food. The acute/chronic effects of AM4113 pretreatment were evaluated on nicotine taking, motivation for nicotine, and cue-, nicotine priming- and yohimbine-induced reinstatement of nicotine-seeking. The effects of AM4113 in the basal firing and bursting activity of midbrain dopamine neurons were evaluated in a separate group of animals treated with nicotine. Anxiety/depression-like effects of AM4113 and rimonabant were evaluated 24h after chronic (21 days) pretreatment (0, 1, 3, and 10mg/kg, 1/d). RESULTS: AM4113 significantly attenuated nicotine taking, motivation for nicotine, as well as cue-, priming- and stress-induced reinstatement of nicotine-seeking behavior. These effects were accompanied by a decrease of the firing and burst rates in the ventral tegmental area dopamine neurons in response to nicotine. On the other hand, AM4113 pretreatment did not have effects on operant responding for food. Importantly, AM4113 did not have effects on anxiety and showed antidepressant-like effects. CONCLUSION: Our results indicate that AM4113 could be a promising therapeutic option for the prevention of relapse to nicotine-seeking while lacking anxiety/depression-like side effects.

Translational strategies for therapeutic development in nicotine addiction: rethinking the conventional bench to bedside approach.

Tobacco produces an impressive burden of disease resulting in premature death in half of users. Despite effective smoking cessation medications (nicotine replacement therapies, bupropion and varenicline), there is a very high rate of relapse following quit attempts. The use of efficient strategies for the development of novel treatments is a necessity. A 'bench to bedside strategy' was initially used to develop cannabinoid CB1 receptor antagonists for the treatment of nicotine addiction. Unfortunately, after being tested on experimental animals, what seemed to be an interesting approach for the treatment of nicotine addiction resulted in serious unwanted side effects when tested in humans. Current research is focusing again on pre-clinical models in an effort to eliminate unwanted side effects while preserving the initially observed efficacy. A 'bed side to bench strategy' was used to study the role of the insula (part of the frontal cortex) in nicotine addiction. This line of research started based on clinical observations that patients suffering stroke-induced lesions to the insula showed a greater likelihood to report immediate smoking cessation without craving or relapse. Subsequently, animal models of addiction are used to explore the role of insula in addiction. Due to the inherent limitations existing in clinical versus preclinical studies, the possibility of close interaction between both models seems to be critical for the successful development of novel therapeutic strategies for nicotine dependence.

Extinction bursts in rats trained to self-administer nicotine or food in 1-h daily sessions.

Extinction bursts are characterized by a temporary increase in responding when drug access is withheld from rats trained to self-administer drugs of abuse. Thus far, one study has examined extinction bursts for nicotine self-administration using a 23-h access paradigm [1]. Here we examined extinction bursts using previously published and unpublished data in which rats were trained to self-administer nicotine (0.03mg/kg/infusion) or food pellets (as a comparator) in 1-h sessions under an FR5 schedule of reinforcement followed by 1-h extinction sessions. Analysis of response rates during nicotine self-administration (NSA) was indicative of a loading phase, as response rates were significantly higher at the beginning of the session, which was not observed for food self-administration. At the start of extinction for both food and nicotine, although sessional response rates did not increase, there was an increase in response rate during the first 5-min of the first extinction session relative to self-administration. This transient extinction burst following nicotine was observed in a minority of subjects and correlated with the number of nicotine infusions obtained during self-administration. This transient extinction burst following food was observed in all subjects. Nicotine and food produce more transient extinction bursts compared to other drugs of abuse and only for a minority of animals in the case of nicotine. This study supports the presence of a loading phase in rats trained to self-administer nicotine in 1-r daily sessions and the presence of a transient extinction burst.