Treating Cocaine Addiction by Reducing Our Appetite for Drugs?

A new study in Biological Psychiatry

Philadelphia, PA, March 16, 2017

The hypocretin/orexin (HCRT) system of the brain is best known for promoting wakefulness and appetite. A new paper in Biological Psychiatry suggests that blocking hypocretin signaling via the HCRT-1 receptor (HCRT-R1) might also reduce the appetite for cocaine. The study, led by first author Dr. Brooke Schmeichel in George Koob’s laboratory at the National Institute on Drug Abuse (NIDA), Intramural Research Program, Baltimore, Maryland, suggests that blocking hypocretin signaling may provide a new avenue for treating cocaine addiction.

“The more that we learn about the brain, the more that we learn that brain signaling mechanisms that play a particular defined function, such as a role in wakefulness or appetite, often play important roles in other functions, such as addiction,” said professor John Krystal, Editor of Biological Psychiatry.

HCRT signaling has been implicated in stress and high-arousal conditions, linking it to cocaine’s strong arousal-inducing effects and stress-induced relapse of drug seeking. To better understand how the HCRT system contributes cocaine addiction, Schmeichel, along with colleagues at The Scripps Research Institute, La Jolla, California, provided rats with short (1 hour) or long (6 hours) access to cocaine, which the rats could self-administer through an IV by pressing a lever. Long access to the drug induces compulsive-like cocaine seeking behavior in the rats, in contrast to more stable use by rats provided short access.

Blocking hypocretin signaling throughout the brain with an HCRT-R1 antagonist reduced cocaine intake only in the rats allowed long access to cocaine self-administration. The researchers saw the same effect when the antagonist was administered directly to the central amygdala, a region of the brain involved in stress and anxiety, which also blocked stress-induced reinstatement of cocaine seeking. The findings finger HCRT neurotransmission within the central amygdala as a key contributor to compulsive-like cocaine taking.

Rats allowed long access to cocaine also had an overactive GABAergic system in the central amygdala, which was modulated by the HCRT system. Importantly, the rampant GABA signaling was restored by blocking HCRT-R1. Reversal of the cocaine-induced neuroadaptations in the central amygdala has important implications for efforts to curb compulsive-like cocaine intake associated with addiction.

“The results of this study would suggest that the hypocretin system could be considered a pharmacological target, with the hopes that a medication designed to target hypocretin receptors could be used in combination with cognitive behavioral therapies as part of a cocaine abuse treatment strategy,” said Dr. Schmeichel.

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Notes for editors
The article is "Hypocretin Neurotransmission Within the Central Amygdala Mediates Escalated Cocaine Self-Administration and Stress-Induced Reinstatement in Rats," by Brooke E. Schmeichel, Melissa A. Herman, Marisa Roberto, and George F. Koob (http://dx.doi.org/10.1016/j.biopsych.2016.06.010). It appears in Biological Psychiatry, volume 81, issue 7 (2017), published by Elsevier.

Copies of this paper are available to credentialed journalists upon request; please contact Rhiannon Bugno at +1 214 648 0880 or biol.psych@utsouthwestern.edu. Journalists wishing to interview the authors may contact the NIDA Press Office at 301-443-6245 or media@nida.nih.gov.

The authors’ affiliations, and disclosures of financial and conflicts of interests are available in the article.

John H. Krystal, M.D., is Chairman of the Department of Psychiatry at the Yale University School of Medicine, Chief of Psychiatry at Yale-New Haven Hospital, and a research psychiatrist at the VA Connecticut Healthcare System. His disclosures of financial and conflicts of interests are available here.

About Biological Psychiatry
Biological Psychiatry
is the official journal of the Society of Biological Psychiatry, whose purpose is to promote excellence in scientific research and education in fields that investigate the nature, causes, mechanisms and treatments of disorders of thought, emotion, or behavior. In accord with this mission, this peer-reviewed, rapid-publication, international journal publishes both basic and clinical contributions from all disciplines and research areas relevant to the pathophysiology and treatment of major psychiatric disorders.

The journal publishes novel results of original research which represent an important new lead or significant impact on the field, particularly those addressing genetic and environmental risk factors, neural circuitry and neurochemistry, and important new therapeutic approaches. Reviews and commentaries that focus on topics of current research and interest are also encouraged.

Biological Psychiatry is one of the most selective and highly cited journals in the field of psychiatric neuroscience. It is ranked 5th out of 140 Psychiatry titles and 11th out of 256 Neurosciences titles in the Journal Citations Reports® published by Thomson Reuters. The 2015 Impact Factor score for Biological Psychiatry is 11.212.

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Media contact
Rhiannon Bugno
Editorial Office, Biological Psychiatry
+1 214 648 0880
biol.psych@utsouthwestern.edu