Neural bases for attenuation of morphine withdrawal by Heantos-4: role of l-tetrahydropalmatine

Sci Rep. 2020 Dec 4;10(1):21275. doi: 10.1038/s41598-020-78083-x.

Abstract

Severe withdrawal symptoms triggered by cessation of long-term opioid use deter many individuals from seeking treatment. Opioid substitution and α2-adrenergic agonists are the current standard of pharmacotherapy for opioid use disorder in western medicine; however, each is associated with significant complications. Heantos-4 is a non-opioid botanical formulation used to facilitate opioid detoxification in Vietnam. While ongoing clinical use continues to validate its safety and effectiveness, a mechanism of action accounting for these promising effects remains to be specified. Here, we assess the effects of Heantos-4 in a rat model of morphine-dependence and present evidence that alleviation of naloxone-precipitated somatic withdrawal signs is related to an upregulation of mesolimbic dopamine activity and a consequent reversal of a hypodopaminergic state in the nucleus accumbens, a brain region implicated in opioid withdrawal. A central dopaminergic mechanism is further supported by the identification of l-tetrahydropalmatine as a key active ingredient in Heantos-4, which crosses the blood-brain barrier and shows a therapeutic efficacy comparable to its parent formulation in attenuating withdrawal signs. The anti-hypodopaminergic effects of l-tetrahydropalmatine may be related to antagonism of the dopamine autoreceptor, thus constituting a plausible mechanism contributing to the effectiveness of Heantos-4 in facilitating opioid detoxification.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analgesics, Opioid / adverse effects
  • Animals
  • Berberine Alkaloids / metabolism
  • Berberine Alkaloids / pharmacology
  • Berberine Alkaloids / therapeutic use*
  • Dopamine / metabolism
  • Dopamine Antagonists / metabolism
  • Dopamine Antagonists / pharmacology
  • Dopamine Antagonists / therapeutic use*
  • Drug Evaluation, Preclinical
  • Male
  • Morphine / adverse effects
  • Nucleus Accumbens / drug effects*
  • Nucleus Accumbens / metabolism
  • Phytotherapy
  • Plant Extracts / metabolism
  • Plant Extracts / pharmacology
  • Plant Extracts / therapeutic use*
  • Quinpirole
  • Rats, Sprague-Dawley
  • Substance Withdrawal Syndrome / drug therapy*

Substances

  • Analgesics, Opioid
  • Berberine Alkaloids
  • Dopamine Antagonists
  • Plant Extracts
  • heantos
  • Quinpirole
  • tetrahydropalmatine
  • Morphine
  • Dopamine

Grants and funding