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ORIGINAL ARTICLE
Year : 2015  |  Volume : 35  |  Issue : 5  |  Page : 194-200

Clinical manifestations of combined methamphetamine with morphine and their effects on brain dopamine and 5-hydroxytryptamine release in mice


1 Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan, ROC
2 Institute of Pharmacology, College of Medicine, National Taiwan University, Taipei, Taiwan, ROC
3 Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan, ROC
4 Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC

Correspondence Address:
Kuo-Cheng Lan
No. 325, Section 2, Cheng-Kong Road, Taipei 114, Taiwan
ROC
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1011-4564.167740

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Background: Methamphetamine (MA) is often mixed with morphine by polydrug addicts, and polydrug abuse has become a serious health problem worldwide. The purpose of this study was to investigate the major signs and symptoms of combined MA and morphine abuse in the Emergency Department (ED). In addition, we used a mouse model to study their effects on the release of dopamine (DA) and 5-hydroxytryptamine (5-HT) in the central nervous system. Materials and Methods: Seventy-two patients with combined MA and morphine abuse were collected during a 3-year period, and their medical records were reviewed. Mice were intraperitoneally administered MA (0.75 and 2.5 mg/kg/day) and morphine (5 mg/kg/day) either alone or in combination for 5 consecutive days. The mechanisms underlying the interaction between MA and morphine were explored by measuring the extracellular levels of DA and 5-HT in the shell of the nucleus accumbens using an in vivo microdialysis technique. Results: The most common manifestations of combined MA and morphine abuse included tachypnea, tachycardia, confusion, anxiety, delirium, insomnia, and diaphoresis in the ED. Of those, 25% of acute intoxication required hospitalization for intensive care. The group of mice treated with a combination of MA and morphine had higher concentrations of DA and 5-HT in the accumbens than with either drug alone. Conclusion: These findings suggest that MA pharmacologically interacts with morphine to induce characteristic signs and symptoms. Our preclinical results also implicate the involvement of increased DAergic and 5-HTergic neurotransmission among polydrug abusers with a combination of MA and morphine.


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