Abstract
Objective: To investigate the potential role of apomorphine as a treatment for addiction disorders.
Background: 19.7 million American adults suffered from a substance abuse disorder in 2017 (National Survey on Drug Use and Health). To date, effective treatment for addiction is still lacking, and many of the programs often fail to keep patients drug-free. Considering the health, social and economic burden of addiction, new strategies are needed. Drug repurposing may be one option, with candidates such as apomorphine. Currently prescribed in Parkinson’s disease, apomorphine has already been used as a treatment for addiction, mainly to alcohol (but also opiates), between the beginning of the 20th century and the late 1970’s. If aversion therapy was the most common approach, some clinicians suspected another action, based on possible anti-craving properties.
Design/Methods: A nonsystematic database (PubMed, Google Scholar, JSTOR, Internet Archive, BnF Gallica) search for French and English articles related to the use of apomorphine in addiction (regardless of the type) was undertaken.
Results: Several historical reports (starting as early as 1899) suggest that apomorphine may play a role in relieving alcoholic craving. These empirical assumptions are supported by recent data from animal models. The dopaminergic and serotonergic (5-HT1 & 5-HT3 receptors) systems, both involved in alcohol dependence, are targeted by apomorphine stimulation. Apomorphine upregulates NGF and GDNF synthesis in cell cultures: these neurotrophic factors are known to modulate addictive behavior. Additionally, apomorphine displays neuroprotective properties against ethanol-induced neurodegeneration in the adult rat cortex. Finally, a recent review on smoking cessation suggested that apomorphine might be a useful treatment.
Conclusions: There is now a considerable body of both historical and neuromolecular evidence to support further research studying the role of apomorphine in addiction.
Disclosure: Dr. Auffret has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Britannia, EverPharma. Dr. Auffret has received research support from France Développement Electronique (FDE), Homeperf, LVL. Dr. Verin has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Britannia. Dr. Verin has received research support from Homeperf, LVL, FDE. Dr. Lees has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Britannia Pharmaceuticals, Profile Pharma, UCB, Roche, BIAL, STADA, Nordiclnfu Care, and NeuroDerm. Dr. Lees has received personal compensation in an editorial capacity for Britannia Pharmaceuticals- kinetic Journal.
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