title: Evaluation of the cardiovascular and subjective effects of rivastigmine in combination with methamphetamine in methamphetamine-dependent human volunteers.
abstract: Acetylcholine (ACh) has been implicated in the reinforcing and locomotor-activating effects produced by methamphetamine (Meth). Of interest, recent data suggest that acetylcholinesterase (AChE) inhibitors attenuate Meth-seeking behaviour in rats. We conducted this study in order to determine the safety (adverse events, mood changes, cardiovascular effects) and preliminary efficacy (subjective effects) of the AChE inhibitor rivastigmine (Riv) when tested in combination with Meth. Twenty-three non-treatment-seeking Meth-dependent participants resided in an in-patient unit at UCLA for 2mg i.v.) and Meth (day 5, 30mg, n=7) or Riv (1.5mg, n=9). On day 11, the subjects received saline and Meth infusions again (randomized to either 11:30 or 14:30 hours), under double-blind conditions. The data analyses compared across-study measures of adverse events and mood, and a post-randomization analysis of cardiovascular and subjective effects (on day 11). The data reveal that rivastigmine was not associated with increased adverse events or alterations in mood. As expected, acute Meth exposure (30mg, significantly attenuated Meth-induced increases in diastolic blood pressure, and self-reports of and (p<0.05). Taken together, the findings in the current report suggest that pharmacological manipulations that enhance brain ACh warrant continued investigation as potential treatments for Meth addiction.
authors.affiliation: David Geffen School of Medicine, University of California, Los Angeles, CA, USA. rdlgarza@mednet.ucla.edu
authors.forename: Richard
authors.initials: R
authors.lastname: De La Garza
authors.forename: Steve
authors.initials: S
authors.lastname: Shoptaw
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Newton
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect / Q000187:drug effects; D000704:Analysis of Variance; D001794:Blood Pressure / Q000187:drug effects; D002319:Cardiovascular System / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005069:Evaluation Studies as Topic; D006339:Heart Rate / Q000187:drug effects; D006805:Human Experimentation; D006801:Humans; D008297:Male; D008694:Methamphetamine / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D010147:Pain Measurement; D048448:Phenylcarbamates / Q000627:therapeutic use*; D000068836:Rivastigmine; D019966:Substance-Related Disorders / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology; D013997:Time Factors
chemical_list: D018696:Neuroprotective Agents; D048448:Phenylcarbamates; D008694:Methamphetamine; D000068836:Rivastigmine