NMDA-receptor antagonists and opioid receptor interactions as related to analgesia and tolerance

A model proposing that N-methyl-D-aspartate (NMDA) receptor and opioid receptor mechanisms overlap and interact within the same dorsal horn nociceptive neurons makes several predictions. First, hyperalgesia should be associated with opioid tolerance. Second, both hyperalgesia and tolerance to opioid...

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Bibliographic Details
Published in:Journal of pain and symptom management 2000-01, Vol.19 (1 Suppl), p.S7-11
Main Authors: Price, D D, Mayer, D J, Mao, J, Caruso, F S
Format: Article
Language:English
Subjects:
Analgesia
Animals
Drug Tolerance
Excitatory Amino Acid Antagonists - therapeutic use
Narcotics - therapeutic use
Receptors, N-Methyl-D-Aspartate - antagonists & inhibitors
Receptors, Opioid - drug effects
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Summary:A model proposing that N-methyl-D-aspartate (NMDA) receptor and opioid receptor mechanisms overlap and interact within the same dorsal horn nociceptive neurons makes several predictions. First, hyperalgesia should be associated with opioid tolerance. Second, both hyperalgesia and tolerance to opioid-analgesia should be blocked by an NMDA-receptor antagonist. Results from our laboratory and others support these predictions and point to several clinical implications. One is that, in addition to preventing tolerance and dependence, combining NMDA-receptor antagonists with both opioid and nonopioid analgesics may increase their analgesic potency. Preclinical animal studies demonstrate these advantages and underscore the practicality of the combined administration of nontoxic NMDA-receptor antagonists with various types of analgesic drugs.
ISSN:0885-3924
DOI:10.1016/S0885-3924(99)00121-9