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Unique pharmacodynamic properties and low abuse liability of the µ-opioid receptor ligand (S)-methadone

Study Author Marjorie Levinstein

Study Author Marjorie Levinstein

Featured Paper of the Month – June 2024

Published in Molecular Psychiatry by Marjorie Levinstein and Michael Michaelides, et al. of the NIDA IRP Biobehavioral Imaging and Molecular Neuropsychopharmacology Section.

Summary

In this article we performed an in depth in vivo, in vitro, and in silico analysis of (R,S)-methadone and its enantiomers. (S)-methadone is currently in phase III trials as an antidepressant and is frequently referred to as an N-methyl-D-aspartate receptor (NMDAR) antagonist, like ketamine. Here we show that (S)-methadone, like (R)-methadone and (R,S)-methadone is an agonist at the mu opioid receptor (MOR) and does not bind to NMDARs at physiologically relevant concentrations. We also show that while (S)-methadone produces full analgesia like other opioids, it has very low abuse liability. We find that (S)-methadone generally acts as an agonist at MOR, but it acts as an antagonist at the MOR-galanin1 (Gal1) receptor heteromers of the ventral tegmental area and prevents opioid-induced mesolimbic dopamine release. We also used modeling to derive a potential mechanism to explain this functional change.

Publication Information

Levinstein, Marjorie R; Oliveira, Paulo A De; Casajuana-Martin, Nil; Quiroz, Cesar; Budinich, Reece C; Rais, Rana; Rea, William; Ventriglia, Emilya N; Llopart, Natàlia; Casadó-Anguera, Verònica; Moreno, Estefanía; Walther, Donna; Glatfelter, Grant C; Weinshenker, David; Zarate, Carlos A; Casadó, Vicent; Baumann, Michael H; Pardo, Leonardo; Ferré, Sergi; Michaelides, Michael

Unique pharmacodynamic properties and low abuse liability of the µ-opioid receptor ligand (S)-methadone Journal Article

In: Mol Psychiatry, 2023, ISSN: 1476-5578.

Abstract | Links

@article{pmid38145984,
title = {Unique pharmacodynamic properties and low abuse liability of the µ-opioid receptor ligand (S)-methadone},
author = {Marjorie R Levinstein and Paulo A De Oliveira and Nil Casajuana-Martin and Cesar Quiroz and Reece C Budinich and Rana Rais and William Rea and Emilya N Ventriglia and Natàlia Llopart and Verònica Casadó-Anguera and Estefanía Moreno and Donna Walther and Grant C Glatfelter and David Weinshenker and Carlos A Zarate and Vicent Casadó and Michael H Baumann and Leonardo Pardo and Sergi Ferré and Michael Michaelides},
url = {https://pubmed.ncbi.nlm.nih.gov/38145984/},
doi = {10.1038/s41380-023-02353-z},
issn = {1476-5578},
year = {2023},
date = {2023-12-01},
urldate = {2023-12-01},
journal = {Mol Psychiatry},
abstract = {(R,S)-methadone ((R,S)-MTD) is a µ-opioid receptor (MOR) agonist comprised of (R)-MTD and (S)-MTD enantiomers. (S)-MTD is being developed as an antidepressant and is considered an N-methyl-D-aspartate receptor (NMDAR) antagonist. We compared the pharmacology of (R)-MTD and (S)-MTD and found they bind to MORs, but not NMDARs, and induce full analgesia. Unlike (R)-MTD, (S)-MTD was a weak reinforcer that failed to affect extracellular dopamine or induce locomotor stimulation. Furthermore, (S)-MTD antagonized motor and dopamine releasing effects of (R)-MTD. (S)-MTD acted as a partial agonist at MOR, with complete loss of efficacy at the MOR-galanin Gal receptor (GalR) heteromer, a key mediator of the dopaminergic effects of opioids. In sum, we report novel and unique pharmacodynamic properties of (S)-MTD that are relevant to its potential mechanism of action and therapeutic use. One-sentence summary: (S)-MTD, like (R)-MTD, binds to and activates MORs in vitro, but (S)-MTD antagonizes the MOR-GalR heteromer, decreasing its abuse liability.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}

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(R,S)-methadone ((R,S)-MTD) is a µ-opioid receptor (MOR) agonist comprised of (R)-MTD and (S)-MTD enantiomers. (S)-MTD is being developed as an antidepressant and is considered an N-methyl-D-aspartate receptor (NMDAR) antagonist. We compared the pharmacology of (R)-MTD and (S)-MTD and found they bind to MORs, but not NMDARs, and induce full analgesia. Unlike (R)-MTD, (S)-MTD was a weak reinforcer that failed to affect extracellular dopamine or induce locomotor stimulation. Furthermore, (S)-MTD antagonized motor and dopamine releasing effects of (R)-MTD. (S)-MTD acted as a partial agonist at MOR, with complete loss of efficacy at the MOR-galanin Gal receptor (GalR) heteromer, a key mediator of the dopaminergic effects of opioids. In sum, we report novel and unique pharmacodynamic properties of (S)-MTD that are relevant to its potential mechanism of action and therapeutic use. One-sentence summary: (S)-MTD, like (R)-MTD, binds to and activates MORs in vitro, but (S)-MTD antagonizes the MOR-GalR heteromer, decreasing its abuse liability.

Close

  • https://pubmed.ncbi.nlm.nih.gov/38145984/
  • doi:10.1038/s41380-023-02353-z

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