Mirzaii Dizgah I, Karimian M, Zarrindast M.r, Sohanaki H,
Volume 65, Issue 3 (6-2007)
Abstract
Background: Opiate-induced addiction is a main social problem in Iran. As treatment of this problem is a health priority among the medical community, studies on this topic are very crucial. The exact mechanism of dependence on opiates and their withdrawal syndrome remain unclear. It seems that dopaminergic system and locus coeruleus (LC) have an important role in the expression of somatic signs during opioids withdrawal. The LC has been shown to contain significant levels of dopamine (DA). In the present study, the effects of different D2 dopaminergic receptor agonist and antagonist administration in the LC on withdrawal sign expression in morphine dependence is investigated in rats.
Methods: Adult male Wistar rats, weighing 220–280 g were divided into eight groups (n=8). Two cannulae were stereotaxically implanted bilaterally into the LC of each rat. After a one-week recovery, seven groups were rendered dependent on morphine by subcutaneous injection during a seven-day period. Non-dependent control animals received saline according to the same protocol. Animals received bilateral intra-LC injections of saline (1 μg/site) and quinpirole (0.1, 0.3 and 0.5 μg/site, a D2 agonist) 15 min and sulpiride (5, 15 and 30 μg/site, a D2 antagonist) 30 min prior to naloxone injection about 24 hours after the last dose of morphine or saline according to their respective group. To calculate the total withdrawal score, as an index of withdrawal syndrome, 20 different withdrawal signs were assessed and the scores of the intensity of these withdrawal signs were added.
Results: Total withdrawal scores were significantly decreased by quinpirole (0.1µg/site) and sulpiride (15 and 30 µg/site).
Conclusion: The D2 dopaminergic system in the LC may be involved in the morphine-induced dependency in rats. Further studies are needed to define the mechanism of this dependency in order to improve methods for the rehabilitation of addicts.
Borna H, Borna S,
Volume 70, Issue 6 (9-2012)
Abstract
Background: Tramadol is a synthetics 4-phenyl-piperidine analogue of codeine used for treating moderate to severe pain. Tramadol is a FDA pregnancy category C medication which induces release of serotonin and inhibits the reuptake of norepinephrine. Chronic use of this drug during pregnancy may lead to physical dependency and withdrawal syndrome in the neonate.
Case presentation: We report the newborn of a woman admitted in the delivery ward of Mostafa Khomeini Hospital in Tehran, Iran in 2011. The mother suffered from chronic low back pain and headache and frequently took tramadol during pregnancy. The infant had a gestational age of 38.5 w, a birth weight of 2950 gr and an Apgar score of 9/10 at 1 and 5 minutes after birth.
The first signs of withdrawal syndrome occurred after 24 h with nausea, vomiting, poor feeding, and tremor. Later, agitation, tremor, hyprertonicity, and repeated multifocal myoclonus, and generalized tonic-clonic seizures developed. Clinical signs of withdrawal syndrome waned under phenobarbital therapy.
Conclusion: Drug withdrawal syndrome should be considered in the neonates of pregnant mothers who chronically take tramadol. Tramadol administration during pregnancy should be restricted to carefully selected cases.
