There and back again: a tale of norepinephrine and drug addiction

Neuropsychopharmacology. 2007 Jul;32(7):1433-51. doi: 10.1038/sj.npp.1301263. Epub 2006 Dec 13.

Abstract

Fueled by anatomical, electrophysiological, and pharmacological analyses of endogenous brain reward systems, norepinephrine (NE) was identified as a key mediator of both natural and drug-induced reward in the late 1960s and early 1970s. However, reward experiments from the mid-1970s that could distinguish between the noradrenergic and dopaminergic systems resulted in the prevailing view that dopamine (DA) was the primary 'reward transmitter' (a belief holding some sway still today), thereby pushing NE into the background. Most damaging to the NE hypothesis of reward were studies demonstrating that NE receptor antagonists and NE reuptake inhibitors failed to impact drug self-administration. In recent years new tools, such as genetically engineered mice, and new experimental paradigms, such as reinstatement of drug seeking following withdrawal, have propelled NE back into the awareness of addiction researchers. Of particular interest is disulfiram, an inhibitor of the NE biosynthetic enzyme dopamine beta-hydroxylase, which has demonstrated promising efficacy in the treatment of cocaine dependence in preliminary clinical trials. The purpose of this review is to synthesize the new data linking NE to critical aspects of DA signaling and drug addiction, with a focus on psychostimulants (eg, cocaine), opiates (eg, morphine), and alcohol.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Analgesics, Opioid / pharmacology
  • Animals
  • Brain / drug effects*
  • Brain / metabolism*
  • Brain / physiopathology
  • Central Nervous System Stimulants / pharmacology
  • Dopamine / metabolism*
  • Ethanol / pharmacology
  • Humans
  • Norepinephrine / biosynthesis*
  • Reward
  • Substance Withdrawal Syndrome / metabolism
  • Substance Withdrawal Syndrome / physiopathology
  • Substance-Related Disorders / drug therapy
  • Substance-Related Disorders / metabolism*
  • Substance-Related Disorders / physiopathology

Substances

  • Analgesics, Opioid
  • Central Nervous System Stimulants
  • Ethanol
  • Dopamine
  • Norepinephrine