Psychoactive Drugs - Brookes Flashcards

1
Q

What are some methods for studying CNS disorders?

A
  • Imaging techniques
  • Studying electrical signals from the brain
  • Indirect ‘markers’ for changes in neurotransmitter function
  • Post-mortem studies
  • Human genetics

Usable models:
- Cellular
- Animal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the benefits of using imaging techniques to study CNS disorders?

A

You can study humans

They are non-invasive

They are longitudinal (can be repeated over time)

Can visualise affect of drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a negative of using imaging techniques to study CNS disorders?

A

No intervention studies possible
- You can take a patient and knock out a gene

They also only give out certain types of information

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some imaging techniques that are used?

A

Computed Tomography (CT scan)

Magnetic Resonance Imaging (MRI)

Functional Magnetic Resonance Imaging (fMRI)

Diffusion Tensor Imaging (DTI)

Positron Emission Spectroscopy (PET)

Single Photo Positron Emission Spectroscopy (SPEC)

Electroencephalography (EEG)

Magnetoencephalography (MEG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a CT scan?

A

Computed tomography

Spatial resolution is not great, it is of several mm

Used for things such as viewing ventricular size

Not generally used in research

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is MRI and fMRI?

A

Magnetic Resonance Imaging and Functional Magnetic Resonance Imaging

Has a resolution of less than 1mm

They are able to reveal patterns of activity in the intact brain

Activity utilises oxygen - microvasculature increases blood flow to active regions

Widely used in research

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is DTI?

A

Diffusion Tensor Imaging

Uses the properties of water which is constrained within neural cells

Good for mapping white matter tracts

Allows the mapping of pathways and investigation of aberrant connectivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is PET and SPEC?

A

PET is Positron Emission Tomography

SPEC is Single Photon Positron Emission Tomography (main advantage does not require on site cyclotron)

To work, an unstable positron emission isotope is created in a cyclotron (e.g. O^15)

The isotope is then injected and distributed according to the relative activity of the brain regions

Very good spatial resolution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is EEG and MEG?

A

Electroencephalography and Magnetoencephalography

Measures electrical signals from brain

Good for looking at surface activities

Not good for deeper brain signals

Spatial resolution is not good

Very good temporal resolution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the ENIGMA?

A

International consortia that are specifically looking at different types of modalities within CNS disorders

Able to look at much larger cohorts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some indirect markers for changes in neurotransmitter function?

A

Levels of neurotransmitters/metabolites:

  • In cerebrospinal fluid
  • In plasma
  • In urine (e.g. decreased dopamine (and metabolites) in Parkinson’s disease)
  • Binding to platelets
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the advantages and limitations of studying a post mortem brain?

A

Ability to study via imaging AND biochemistry
- Includes analysis of protein (e.g. receptor) levels, RNA levels, localisation of proteins/RNA

Culture of human tissue and electrophysiological analysis

It is now possible to culture human brain and keep it alive in a dish for up to 6 weeks

Limitations:
- Endpoint analysis only
- Time post-death to freeze/fix/analyse
- Variability between samples
- Cause of death
- Patient may have been on medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some model organisms used in modelling CNS disorders?

A

Model organisms:
- Drosophila
- C.Elegans
- Mice
- Rats
- Primates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some advantages and disadvantages of using model organisms to model CNS disorders?

A

Advantages
- Malleable
- Drug screening
- Can do studies with multiple time points, interventions
- Often used after genetic studies have been carried out so specific genes can be knocked in or out
- Able to mimic environmental/neurochemical changes seen in disease

Disadvantages
- Mimic some but not all human

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the definition of:
Psychotomimetic
Psychotropic
Psychoactive

A

Psychotomimetic:
- This term refers to drugs that mimic the symptoms of psychosis, such as hallucinations, delusions, or paranoia.

Psychotropic:
- This is a broader term that refers to drugs that affect mood, perception, or behavior by acting on the central nervous system.

Psychoactive:
- This is the broadest term, referring to any substance that alters brain function, resulting in changes in mood, consciousness, perception, or behavior.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some hallucinogens and their active ingredients?

A

Naturally Occuring:
- Ayahuasca (Harmaline)
- Peyote (Mescaline)
- Magic Mushrooms (Psilocybin)

Synthesised:
- Lysergic Acid Diethylamide (LSD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the difference between the potency of LSD and other naturally occurring hallucinogens?

A

Psilocybin: 250ug/kg dose lasts for 3 hours
Mescaline: 15mg/kg dose lasts for 12 hours
LSD: 3ug/kg dose lasts for 10 hours

LSD significantly more potent

It is so potent it is most likely to act very specifically at receptor sites within the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Why was LSD synthesised?

A

Ergotism is a disease that presents with gangrene and psychosis

It is caused by eating rye bread contaminated with fungus

The fungus releases ergot alkaloids which cause peripheral vasoconstriction

The aim was to derive a substance with a similar action to treat haemorrhage

In 1943 Albert Hoffmann synthesised LSD for the first time, and accidentally ingested it, resulting in psychotic event

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the affects of LSD?

A

Somatic
Perceptual
Psychological

The distortion of sensory perception indicates an effect in pathways that process sensory information

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How was the LSD mechanism of action discovered?

A

There is a cross tolerance between LSD and mescaline (taking one or the other requires larger dose of the latter)

This suggests that both psychotomimetics act at the same class of receptor site

The structures of LSD and mescaline are similar to 5-HT

Early in vitro pharmacological studies showed that LSD interacts with 5-HT receptors in the peripheral vasculature

In the brain: LSD is a 5-HT receptor agonist/partial agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Importance of raphe neurones in LSD mechanism

A

LSD decreases firing rate of Raphe Neurones (5-HT1A receptor)

Raphe Neurones send extensive projection to the forebrain

BUT… mescaline shows cross tolerance with LSD…and does not affect raphe neurone firing, so there is more to it

In addition, rats are able to detect LSD in their system with raphe neurones ablated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Importance of the locus coeruleus in LSD mechanism?

A

Also acts at the Locus Coeruleus

LSD increases activity in locus coeruleus neurons

LSD increases activity of subsets of neurons in the cortex

5-HT2A receptors in cortex and thalamus modulate signal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which 5-HT receptors does LSD work through?

A

Because LSD and mescaline have cross tolerance, it is possible to determine which receptors LSD work through by finding out which receptors BOTH drugs work through

Both LSD and mescaline work through 5-HT2a/2c receptors

It was also found that LSD has a very high affinity for 5-HT2A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Importance of 5-HT2A neurones in the brain?

A

5-HT2A neurones are highly expressed on pyramidal neurones in the cortex, which is where sensory information is processed

LSD increases the activity of layer V pyramidal neurones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Provide a summary for the potential sites of action for LSD?

A

Decreases firing rate of raphe neurones

Increases activity in locus coeruleus neurones

Increases activity of layer V pyramidal neurones in the cortex

Expanded primary visual cortex functional connectivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is Phencyclidine?

A

It is a psychotomimetic drug

Phencyclidine (PCP) is a ‘dissociative’ anaesthetic

Same class as Ketamine

Causes a catatonic-like state without muscle relaxation

Withdrawn from clinical use in 1965 due to ‘emergence phenomenon’W

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the effects of PCP?

A
  • Altered body image ‘my arms and legs feel distant’
  • Feeling of isolation
  • Cognitive disorganisation
  • Drowsiness and apathy
  • Negativism and/or hostility
  • Euphoria and inebriation
  • Hypnagogic (dreamlike) states

Exacerbated symptoms of psychotic patients

PCP intoxication associated with drug-induced hallucinations

28
Q

Where does PCP act?

A

Radioligand binding studies have shown that PCP interacts with:

  • Sigma opiate receptor - modulates NAdr release
  • NMDA glutamate receptor (non-competitive antagonist)
29
Q

How is PCP and LSD used in disease modelling?

A

Both LSD and PCP have been used in animal studies as drug-induced models for schizophrenia

30
Q

Can psychoactive drugs be used in treatment?

A

In Australia and New Zealand: Since 1 July 2023, psychiatrists can be authorised to prescribe products containing psychoactive drugs.

  • Psilocybin may be prescribed for use in psychedelic-assisted psychotherapy for treatment-resistant depression.
31
Q

What is addiction?

A

“Persistent disorder of brain function in which compulsive drug use occurs despite serious negative consequences for the afflicted individual”

Physical and psychological dependence can occur

32
Q

What are the features of addiction?

A

Features of disease:
- Compulsion to take drug
- Tolerance (decreased response to repeated administration)
- Withdrawal syndrome (opposite effects to those experienced in presence of drug)

33
Q

Where do psychoactive drugs with abuse potential act on the brain?

A

Psychoactive drugs with abuse potential have
common actions on the limbic system of the brain

Specifically:
- Amygdala
- Ventral tegmental area
- Nucleus accumbens

34
Q

What is reward?

A

Reward is a pleasurable experience

Selection of behaviours appropriate for survival is achieved by ‘reward’ and ‘punishment’ systems

These systems are fundamental to motivation and avoidance

Inappropriate activation of these systems underlies addictive behaviour

35
Q

How were the reward centres of the brain initially discovered?

A

James Olds and Peter Milner (1954)

Rat implanted with stimulating electrodes, self-administer (ICSS)

“The results indicate that various places exist in the brain where electrical stimulation is rewarding in the sense that the experimental animal will stimulate itself in these places frequently and regularly for long periods of time if permitted to do so.”

The behaviour is called REINFORCEMENT

The region where the electrodes were implanted when this behaviour was viewed is the septal area (now known as the medial forebrain bundle)

36
Q

What is the medial forebrain bundle?

A

Medial forebrain bundle contains a mixture of axonsthat originate in the midbrain/medulla, andproject anteriorly to innervate areas throughout the brain including:

  • 5-HT axons from raphe neurons
  • Noradrenergic axons from locus coeruleus neurons
  • Dopaminergic axons from ventral tegmental area
37
Q

What are optogenetics?

A

“Temporarily precise, noninvasive control of activity in well defined neuronal populations”

Uses cell type specific microbial opsins (light responsive channels) injected into certain class of neurones`

So if you place the opsin in a neurone and activate the channel with light, the neurone becomes active

38
Q

Where is the reinforcing system in the brain?

A

The reinforcing system seems to involve the dopamine axons in the medial forebrain bundle

These axons project to the nucleus accumbens

39
Q

What is cocaine?

A

It is a plant compound

Stimulant and also local anesthetic

Anesthetic action through blocking voltage-gated sodium channels

40
Q

Actions of cocaine

A

Local anaesthetic

Causes euphoria

Appetite suppressant

Increasing the dose can elicit tremors, convulsions, CNS depression

In susceptible individuals, cocaine may precipitate psychosis

41
Q

Cocaine mechanism of action

A

Cocaine affects catecholamine neurotransmission

Cocaine binds with high affinity to monoamine, including dopamine, transporters and blocks them on presynaptic terminal

Prevents recycling of catecholamines

Increased levels of catecholamine in synaptic space

42
Q

What is the Conditioned Place Preference (CPP) Task?

A

CPP measures drug reward by associating a substance with a specific environment

Mice are conditioned to a drug-paired chamber, and preference for this chamber indicates the drug’s rewarding effects

43
Q

How was the conditioned place preference task used to show that cocaine acts through dopamine receptors?

A

Mice with DA transporter knockout have chronically elevated synaptic dopamine and increased locomotor activity:

  • Cocaine administered to these animals produces no change in base-line DA (also no increase in locomotor activity)
  • BUT these animals will self-administer cocaine, and display conditioned place preference (CPP) to cocaine

So in instead mice with cocaine-insensitive DA transporter knock-in were used:
- F105important forhigh affinitycocaine binding,but not for DAtransport
- Cocaine in the mutant DAT knock-in micedid not elevate extracellular dopamine orincrease locomotion and did not produce reinforcement as measured by CPP

Proves cocaine acts through dopamine

44
Q

How can we prove dopamine pathways for cocaine in humans?

A

Using PET imaging with radioactive 11C-raclopride to label dopamine receptors (D2)

As you can see in the image, dopamine receptors in the basal ganglia are lit up, and are less in cocaine user

There is a dowregulation inD2 receptorsincocaine abusers

This suggest cocaine DOES act through dopamine pathway

Rewardsystem compromised

This is maintained afterdetoxification

45
Q

What is amphetamine and what are its actions?

A

It is a stimulant

Actions of amphetamine:
- Appetite suppressant
- Euphoria
- Raises blood pressure
- Can also cause psychosis

Acts on dopamine

46
Q

How is amphetamine used medically?

A

Uses:
- Weight control
- Narcolepsy
- Attention deficit disorder

47
Q

What is amphetamines mechanism of action?

A

Similar to cocaine in such that it blocks reuptake of dopamine into presynaptic terminal

However, they are not blocking the transporter like cocaine, instead, the amphetamine itself is transported into the presynaptic terminal and replaces dopamine

This results in an increased level of catecholamine (dopamine) in the synaptic space

48
Q

What is a common mechanism of reinforcement/addiction?

A

Addictive drugs increase the release of dopamine in the nucleus accumbens
- opiates, ethanol, nicotine, amphetamine, cocaine

Aversive drugs do not

49
Q

What are the common pathways for the mechanisms of reinforcement/addiction?

A

PATHWAYS
- Evidence for common involvement of limbic system
- Evidence for common involvement of dopamine signalling especially the VTA projection to the nucleus accumbens

NEUROTRANSMITTERS
- Evidence for involvement of dopamine in the action of cocaine (direct)

50
Q

Dopaminergic pathways of addictive drugs?

A

Dopamine neurone is either acted on directly by drugs or acted upon by other neurones that are acted on by drugs

This dopamine neurone has an inhibitory affect on the nucleus accumbens

The nucleus accumbens ordinarily sends inhibitory neurone projections to the cortex

This means that with an increase of dopamine acting inhibitarily on the nucleus accumbens due to the drugs action, the nucleus accumbens inhibitory neuronal projections into the cortex will be less

Results in increased activity of the cortex

51
Q

What is the difference between the impulsive stage and the compulsive stage of addiction?

A

Both feedback loops

Impulsive stage is the craving of pleasurable experience, a craving of a reward

Compulsive stage is in line with withdrawal symptoms

Compulsive stage is a craving for reward AND a craving for relief of withdrawal symptoms

This is due to long term changes within the brain caused by heavy use

52
Q

How does dopamine signaling lead to long-term changes in neurons?

A

Dopamine activates D1 and D2 receptors, influencing adenylate cyclase activity

D1 activation increases cAMP, which activates PKA. PKA phosphorylates CREB, a transcription factor that drives the expression of immediate early genes, potentially altering receptor levels and synapse formation

This process can also involve neuropeptides like dynorphin, which modulate neurotransmission by binding to kappa opioid receptors and reducing glutamate release.

53
Q

What is epigenetics and how does cocaine affect it?

A

Changes in chromatin structure associated with alterations in gene expression

Directly and indirectly altered by cocaine

Contribute to aberrant cellular function

Mediate effects of lifetime exposures

54
Q

Proof that cocaine causes histone acetylation?

A

Cocaine induces histone acetylation in the nucleus accumbens

Loss of CBP (a histone acetyltransferase) in the NAc prevents cocaine-induced locomotion and CPP

55
Q

What is C-Fos?

A

C-Fos is a protein and gene that’s a marker for neuronal activity and is involved in a number of cellular processes

56
Q

Affect of cocaine on C-Fos

A

Acute stimulant exposure results in rapid induction of genes including C-Fos

Loss of CBP (a histone acetyltransferase) in nucleus accumbens neurones results in decreased histone acetylation and significantly altered C-Fosexpression in response to stimulants

Change in C-Fos levels are desensitised after chronic stimulant

57
Q

Why is C-Fos desensitised after chronic stimulant use?

A

Due to a gene called DeltaFosB

DeltaFosB expression is also upregulated in the nucleus accumbens after stimulant exposure

DeltaFosB is a transcription factors that binds to DNA and binds to C-Fos

Amphetamine exposure causes more DeltaFosB to bind to the C-Fos promoter than normal

This causes a down regulation in C-Fos expression in repeated exposures to stimulants

58
Q

What happens if you down regulate or up regulate expression of FosB in a cocaine user?

A

Down regulate:
- Less of an increase in locomotion after stimulant exposure

Up regulate:
- Increased locomotion activity after stimulant exposure

This is because higher levels of FosB, which promotes the expression of genes that enhance the response of neurones to dopamine

59
Q

What are msP rats?

A

Genetically bred rats that prefer alcohol over water

Innate or acquired hyperactivity of extrahypothalamic CRF systems is associated with high alcohol preference

60
Q

What happens to the extrahypothalamic CRF systems with high alcohol preference rats?

A

There is an innate or acquired hyperactivity

61
Q

What are the attempted targets for treating stimulant use disorder?

A
  • Stimulants’ ability to block reuptake of catecholamine out of the synaptic cleft
  • Molecular chaperone σ1R which binds to DAT and regulates dopamine signalling
  • Opioid system
  • GABA transmission
  • Psychedelics
62
Q

What is the sigma 1 receptor (σ1R)?

A

It is a endoplasmic reticulum chaperone protein

It is widely expressed throughout the brain including the midbrain and the striatum

It interacts with methamphetamine & cocaine at relevant concentrations

Methamphetamine or cocaine exposure increases σ1R levels in DAT-expressing brain regions

63
Q

Targeting of sigma 1 receptor (σ1R) for cocaine?

A

When targeted with an antagonist:

  • Blocking σ1R prevents cocaine-induced CPP
  • Blocking σ1R prevents cocaine stimulated locomotion
  • σ1R siRNA prevented the effect of cocaine in potentiating D1R agonist-induced cAMP production
64
Q

Targeting of sigma 1 receptor (σ1R) for methamphetamine?

A

σ1R activation decreases METH-stimulated dopamine efflux without affecting basal dopamine neurotransmission

σ1R activation decreases methamphetamine-induced locomotion, motivated behavior, and enhancement of brain reward function

65
Q

Use of hallucinogens in treating cocaine and methamphetamine abuse disorder?

A

There is some evidence that hallucinogens such as psilocybin are beneficial in the treatment of substances abuse disorders

The idea is potentially that drugs like psilocybin have neuroplasticity inducing properties that allow the brain to make connections in areas they would not normally make

66
Q

Epigenetic targeting for drug abuse?

A

Epigenetic-based therapies aim to control gene expression directly at the pre-transcriptional level

‘drugging the epigenome’

e.g.
- Targeting repressors
- Hijacking bacterial system to target specific loci

67
Q
A