Although benzodiazepines (BZs) are considered to be among the safest prescription drugs in modern medicine, their utility is constrained by a number of side effects, including the liability for abuse, and recent epidemiological research suggests BZ abuse is on the rise in the U.S. The overall goal of this application is to investigate the extent to which GABAA receptor subtypes are differentially involved in self-administration vs. anxiolytic-like effects of BZ ligands, with the goal of developing medications to treat BZ addiction. This renewal application builds on our work from past project periods that has implicated unique roles for ?1, ?2, and ?3 subunit-containing GABAA receptors (?1GABAA, ?2GABAA, ?3GABAA receptors, respectively) in the anxiolytic-like effects and abuse potential of BZs. The key findings from our work include: (1) compounds lacking efficacy at ?1GABAA receptors and relatively low efficacy at ?2GABAA/?3GABAA receptors may have reduced abuse potential compared with conventional BZs, but retain robust anxiolytic-like effects; and (2) antagonists that target ?1GABAA, ?2GABAA, and ?3GABAA receptors, but not ?5GABAA receptors, can block the reinforcing effects of BZs. In addition, we have obtained enough data and novel ligands to propose the development of pharmacotherapies for BZ addiction, i.e., medication-assisted treatment. Nevertheless, significant knowledge gaps remain before lead compounds can be selected and optimized. Using relevant nonhuman primate models, our proposed studies specifically will evaluate the hypotheses that (1) the anxiolytic-like effects of BZs are mediated by ?2GABAA receptor subtypes; (2) intrinsic efficacy at ?1GABAA receptor subtypes is a key determinant of the reinforcing effectiveness of BZ-type ligands; and (3) different levels of intrinsic efficacy at GABAA receptor subtypes determine the extent to which subtype-selective ligands alter the reinforcing effects of abused BZs. Anxiolytic activity will be evaluated in rhesus monkeys using conflict procedures in which food- maintained behavior is concurrently suppressed by response-produced presentations of an aversive stimulus. Abuse potential will be assessed using behavioral economics and progressive-ratio schedules, in conjunction with quantitative pharmacological analysis. Our approach to identifying receptor mechanisms and therapeutic strategies may have a profound and long-lasting impact on not just the scientific field, but also the treatment- provider community and, most importantly, the patients struggling with BZ addiction.
Valium and related drugs, referred to as ?benzodiazepines? are prescribed widely for the treatment of anxiety disorders, one of the most common psychiatric disorders in the U.S. Benzodiazepines are considered to be among the safest prescription drugs in modern medicine, but they unfortunately are also drugs of abuse. The overall goal of this application is to uncover mechanisms that control the beneficial effects as well as the abuse of benzodiazepines, with the hope of developing drugs for treating BZ addiction.
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