dopamine reuptake inhibitor

{{Short description|Class of drug}}

{{redirect|DARI|other uses|Dari (disambiguation)}}

{{Infobox drug class

| Name =

| Image =

| Alt =

| Caption =

| Pronounce =

| Synonyms =

| Use = Major depressive disorder, attention-deficit hyperactivity disorder, narcolepsy

| ATC_prefix =

| Mode_of_action =

| Mechanism_of_action =

| Biological_target = Dopamine transporter

| Chemical_class =

| Drugs.com =

| Consumer_Reports =

| medicinenet =

| rxlist =

| MeshID =

}}

A dopamine reuptake inhibitor (DRI) is a class of drug which acts as a reuptake inhibitor of the monoamine neurotransmitter dopamine by blocking the action of the dopamine transporter (DAT). Reuptake inhibition is achieved when extracellular dopamine not absorbed by the postsynaptic neuron is blocked from re-entering the presynaptic neuron. This results in increased extracellular concentrations of dopamine and increase in dopaminergic neurotransmission.{{cite journal|last1=Song|first1=R.|last2=Zhang|first2=H.-Y.|last3=Li|first3=X.|last4=Bi|first4=G.-H.|last5=Gardner|first5=E. L.|last6=Xi|first6=Z.-X.|title=Increased vulnerability to cocaine in mice lacking dopamine D3 receptors|journal=Proceedings of the National Academy of Sciences|volume=109|issue=43|year=2012|pages=17675–17680|issn=0027-8424|doi=10.1073/pnas.1205297109|pmid=23045656|pmc=3491487|bibcode=2012PNAS..10917675S|doi-access=free}}

DRIs are used in the treatment of attention-deficit hyperactivity disorder (ADHD) and narcolepsy for their psychostimulant effects, and in the treatment of obesity and binge eating disorder for their appetite suppressant effects. They are sometimes used as antidepressants in the treatment of mood disorders, but their use as antidepressants is limited given that strong DRIs have a high abuse potential and legal restrictions on their use. Lack of dopamine reuptake and the increase in extracellular levels of dopamine have been linked to increased susceptibility to addictive behavior given increase in dopaminergic neurotransmission.{{Citation needed|date=January 2015}} The dopaminergic pathways are considered to be strong reward centers.{{Citation not found|date=October 2021}} Many DRIs such as cocaine are drugs of abuse due to the rewarding effects evoked by elevated synaptic concentrations of dopamine in the brain.{{Dubious|This is vague and questionable|date=February 2025}}

Medical uses

The following drugs have DRI action and have been or are used clinically specifically for this property: amineptine, dexmethylphenidate, difemetorex, fencamfamine, lefetamine, levophacetoperane, medifoxamine, mesocarb, methylphenidate, nomifensine, pipradrol, prolintane, and pyrovalerone.

The following drugs are or have been used clinically and possess only weak DRI action, which may or may not be clinically-relevant: adrafinil, armodafinil, bupropion, mazindol, modafinil, nefazodone, sertraline, and sibutramine.

The following drugs are or have been clinically used but only coincidentally have DRI properties: benzatropine, diphenylpyraline, etybenzatropine, ketamine, nefopam, pethidine (meperidine), and tripelennamine.

The following are a selection of some particularly notably abused DRIs: cocaine, ketamine, MDPV, naphyrone, and phencyclidine (PCP). Amphetamines, including amphetamine, methamphetamine, MDMA, cathinone, methcathinone, mephedrone, and methylone, are all DRIs as well, but are distinct in that they also behave, potentially more potently, as dopamine releasing agents (DRAs) (due to Yerkes–Dodson's law, 'more potently stimulated' may not equal more optimally functionally stimulated). There are very distinct differences in the mode of action between dopamine releasers/substrates & dopamine re-uptake inhibitors; the former are functionally entropy-driven (i.e., relating to hydrophobicity) and the latter are enthalpy-driven (i.e., relating conformational change).{{cite journal | doi = 10.1002/chin.200020238 | url = https://www.erowid.org/archive/rhodium/pdf/cocaineanalogs.pdf#4 | volume=31 | issue=20 | title=ChemInform Abstract: Chemistry, Design, and Structure-Activity Relationship of Cocaine Antagonists | year=2010 | journal=ChemInform | author=Singh Satendra | pages = no }}. Page 928 (4th of article) 1st paragraph. Lines 8—11. [https://www.scribd.com/doc/77191354/Satendra-Singh-Chemistry-Design-and-Structure-Activity-Relationship-of-Cocaine-Antagonists Mirror hotlink.]{{cite journal |vauthors = Bonnet JJ, Benmansour S, Costentin J, Parker EM, Cubeddu LX |title=Thermodynamic analyses of the binding of substrates and uptake inhibitors on the neuronal carrier of dopamine labeled with [3H]GBR 12783 or [3H]mazindol |journal=J. Pharmacol. Exp. Ther. |volume=253 |issue=3 |pages=1206–14 |year=1990 |doi=10.1016/S0022-3565(25)13223-0 |pmid=2141637 }} Reuptake inhibitors such as cocaine induce hyperpolarization of cloned human DAT upon oocytes that are naturally found on neurons, whereas releasing agents induce de-polarization of the neuron membrane.{{Dubious |reason=Misinterpretation. Oocytes are not known on neurons|date=September 2019}}{{cite journal | pmc=3881434 | pmid=23371489 | doi=10.1007/s00213-013-2967-2 | volume=227 | issue=3 | title=Mephedrone and methylenedioxypyrovalerone (MDPV), major constituents of "bath salts," produce opposite effects at the human dopamine transporter |vauthors=Cameron K, Kolanos R, Vekariya R, De Felice L, Glennon RA | journal=Psychopharmacology | pages=493–9| year=2013 }}{{cite journal | pmid = 2361170 | pmc=1917549 | volume=99 | issue=4 | title=Actions of cocaine on rat dopaminergic neurones in vitro | date=April 1990 |vauthors=Lacey MG, Mercuri NB, North RA | journal=Br. J. Pharmacol. | pages=731–5 | doi=10.1111/j.1476-5381.1990.tb12998.x}}

The wakefulness-promoting agent modafinil and its analogues (e.g., adrafinil, armodafinil) have been approved to treat narcolepsy and shift work sleep disorder.{{cite journal |vauthors = Kesselheim AS, Myers JA, Solomon DH, Winkelmayer WC, Levin R, Avorn J |title=The prevalence and cost of unapproved uses of top-selling orphan drugs |journal=PLOS ONE |volume=7 |issue=2 |pages=e31894 |year=2012 |pmid=22363762 |pmc=3283698 |doi=10.1371/journal.pone.0031894 |bibcode=2012PLoSO...731894K |doi-access=free }} These act as weak (micromolar) DRIs,{{cite journal|last=Loland|first=C.J. |author2=M. Mereu |author3=O.M. Okunola |author4=J. Cao |author5=T.E. Prisinzano |author6=T. Kopajtic |author7=L. Shi |author8=J.L. Katz |author9=G. Tanda |author10=A.H. Newman|title=R-modafinil (armodafinil): a unique dopamine uptake inhibitor and potential medication for psychostimulant abuse.|journal=Biol. Psychiatry|date=1 September 2012|pmid=22537794|doi=10.1016/j.biopsych.2012.03.022|volume=72|issue=5|pages=405–13|pmc=3413742}} but this effect does not correlate with wakefulness-promoting effects, suggesting the effect is too weak to be of clinical significance.{{Citation needed|date=January 2025}} The conclusion is that these drugs promote wakefulness via some other mechanism.{{cite journal | vauthors = Wise RA | title = Neurobiology of addiction | journal = Curr. Opin. Neurobiol. | volume = 6 | issue = 2 | pages = 243–51 | year = 1996 | pmid = 8725967 | doi = 10.1016/S0959-4388(96)80079-1| s2cid = 25378856 }}{{Disputed inline|date=July 2016|reason=This claim is poorly supported by the current literature on the subject.}}

DRIs have been explored as potential antiaddictive agents in the context of replacement therapy strategies, analogous to nicotine replacement for treating tobacco addiction and methadone replacement in the case of opioid addiction. DRIs have been explored as treatment for cocaine addiction, and have shown to alleviate cravings and self-administration.{{cite journal |vauthors=Carroll FI, Howard JL, Howell LL, Fox BS, Kuhar MJ |title=Development of the dopamine transporter selective RTI-336 as a pharmacotherapy for cocaine abuse |journal=AAPS J |volume=8 |issue=1 |pages=E196–203 |year=2006 |pmid=16584128 |pmc=2751440 |doi=10.1208/aapsj080124 }}

Monoamine reuptake inhibitors, including DRIs, have proven quite effective in managing excessive food consumption and regulating appetite in obese patients. Though such pharmacotherapy is still available, the majority of stimulant anorectics marketed for this purpose have been withdrawn or discontinued due to adverse side effects such as hypertension, valvulopathy, and drug dependence.{{cite book|last=Kintscher|first=U|title=Appetite Control|chapter=Reuptake Inhibitors of Dopamine, Noradrenaline, and Serotonin|series=Handbook of Experimental Pharmacology|year=2012|volume=209|issue=209|pages=339–347|doi=10.1007/978-3-642-24716-3_15|pmid=22249822|isbn=978-3-642-24715-6}}

Pharmacology

{{See also|Monoamine releasing agent#DAT "inverse agonists"}}

DRIs may be divisible into two different types with different effects: (1) typical or conventional DRIs like cocaine, WIN-35428 (β-CFT), and methylphenidate that produce potent psychostimulant, euphoric, and reinforcing effects; and (2) atypical DRIs like vanoxerine (GBR-12909), modafinil, benztropine, and bupropion, which do not produce such effects or have greatly reduced such effects.{{cite journal | vauthors = Heal DJ, Gosden J, Smith SL | title = Dopamine reuptake transporter (DAT) "inverse agonism"--a novel hypothesis to explain the enigmatic pharmacology of cocaine | journal = Neuropharmacology | volume = 87 | issue = | pages = 19–40 | date = December 2014 | pmid = 24953830 | doi = 10.1016/j.neuropharm.2014.06.012 }} Moreover, atypical DRIs are often dysphoric at high doses.{{Cite journal |last1=Heal |first1=David J. |last2=Gosden |first2=Jane |last3=Smith |first3=Sharon L. |date=2014-12-01 |title=Dopamine reuptake transporter (DAT) "inverse agonism" – A novel hypothesis to explain the enigmatic pharmacology of cocaine |url=https://www.sciencedirect.com/science/article/abs/pii/S0028390814002342 |journal=Neuropharmacology |series=CNS Stimulants |volume=87 |pages=19–40 |doi=10.1016/j.neuropharm.2014.06.012 |pmid=24953830 |issn=0028-3908|url-access=subscription }}

Typical DRIs may actually be acting as dopamine releasing agent (DRA)-like agents that have been referred to as dopamine transporter (DAT) "inverse agonists" rather than as simple competitive reuptake inhibitors (which is what atypical DRIs are proposed to be). Typical DRIs are similar to substrate-type DRAs in their effects on brain dopamine levels and in their subjective and behavioral effects.

In terms of maximal brain dopamine elevations, typical DRIs or DAT "inverse agonists" can increase levels by 500 to 1,500%, substrate-type DRAs by more than 1,000% (as high as 5,000% or more), and atypical DRIs or competitive reuptake inhibitors by less than or equal to 500%.{{cite journal | vauthors = Heal DJ, Smith SL, Gosden J, Nutt DJ | title = Amphetamine, past and present--a pharmacological and clinical perspective | journal = J Psychopharmacol | volume = 27 | issue = 6 | pages = 479–496 | date = June 2013 | pmid = 23539642 | pmc = 3666194 | doi = 10.1177/0269881113482532 | url = }}

History

Until the 1950s, dopamine was thought to only contribute to the biosynthesis of norepinephrine and epinephrine. It was not until dopamine was found in the brain in similar levels as norepinephrine that the possibility was considered that its biological role might be other than the synthesis of the catecholamines.{{cite book|title=The Biochemical Basis of Neuropharmacology|year=1996|publisher=Oxford University Press, Inc|author=Jack R. Cooper|edition=7th|author2=Floyd E. Bloom|author3=Robert H. Roth|page=293|chapter=9}}

List of DRIs

{{See also|Dopamine transporter#Ligands and modulators}}

Only DRIs which are selective for the DAT over the other monoamine transporters (MATs) are listed below. For a list of DRIs that act at multiple MATs, see other monoamine reuptake inhibitor pages such as NDRI and SNDRI.{{Disputed inline|date=July 2016|reason=This is broadly incorrect as the second list contains several examples of notable DRIs that have primary action as inhibitors of other monoamine transporters (e.g., bupropion, venlafaxine, etc). However these DRIs are notable enough that they should likely be mentioned here.}}

=Selective dopamine reuptake inhibitors=

File:Neurotransmitter transporters inhibitors.png transporter inhibitors}}]]

=DRIs with substantial activity at other sites=

  • Amantadine (also a weak NMDA receptor antagonist)
  • Benztropine (also a muscarinic antagonist)
  • Bupropion (also a more potent NRI and likely NRA due to bupropion's major metabolite hydroxybupropion)
  • Cocaine
  • Fluorenol (extremely weak)
  • Medifoxamine (relatively weak)
  • Metaphit (irreversible; depletes dopamine)
  • Methylphenidate (has a mild degree of selectivity for dopamine over norepinephrine reuptake inhibition, although it significantly affects both)
  • Dexmethylphenidate (the dextro diastereomer (R,R steriomer) of methylphenidate; is theorized to be more potent (twice as potent on a milli-to-milli basis) than racemic methylphenidate{{cite journal |last1=Markowitz |first1=JS |last2=Patrick |first2=KS |title=Differential pharmacokinetics and pharmacodynamics of methylphenidate enantiomers: does chirality matter? |journal=Journal of Clinical Psychopharmacology |date=June 2008 |volume=28 |issue=3 Suppl 2 |pages=S54-61 |doi=10.1097/JCP.0b013e3181733560 |pmid=18480678 |url=https://journals.lww.com/psychopharmacology/abstract/2008/06002/differential_pharmacokinetics_and_pharmacodynamics.4.aspx |access-date=28 May 2024|url-access=subscription }})
  • Nomifensine (also a norepinephrine reuptake inhibitor; is used for the treatment of clinical depression, attention deficit hyperactivity disorder (ADHD), narcolepsy, and Parkinson's disease).
  • Phenylpiracetam
  • Isopropylphenidate{{Cite journal |last1=Markowitz |first1=John S. |last2=Zhu |first2=Hao-Jie |last3=Patrick |first3=Kennerly S. |date=2013-12-18 |title=Isopropylphenidate: An Ester Homolog of Methylphenidate with Sustained and Selective Dopaminergic Activity and Reduced Drug Interaction Liability |url=https://pubmed.ncbi.nlm.nih.gov/24261661/ |journal=Journal of Child and Adolescent Psychopharmacology |language=en |volume=23 |issue=10 |pages=648–654 |doi=10.1089/cap.2013.0074 |issn=1044-5463 |pmid=24261661|hdl=2027.42/140321 |hdl-access=free }}
  • Rimcazole
  • Venlafaxine (weak)
  • Solriamfetol (also a norepinephrine reuptake inhibitor)

=Other DRIs=

  • Chaenomeles speciosa (Flowering quince){{cite journal |vauthors=Zhao G, Jiang ZH, Zheng XW, Zang SY, Guo LH |title=Dopamine transporter inhibitory and antiparkinsonian effect of common flowering quince extract |journal=Pharmacology Biochemistry and Behavior |volume=90 |issue=3 |pages=363–71 |date=September 2008 |pmid=18485464 |doi=10.1016/j.pbb.2008.03.014|s2cid=40114711 }}
  • Oroxylin A (found in Oroxylum indicum and Scutellaria baicalensis (Skullcap)){{cite journal|last1=Yoon|first1=Seo Young|last2=dela Peña|first2=Ike|last3=Kim|first3=Sung Mok|last4=Woo|first4=Tae Sun|last5=Shin|first5=Chan Young|last6=Son|first6=Kun Ho|last7=Park|first7=Haeil|last8=Lee|first8=Yong Soo|last9=Ryu|first9=Jong Hoon|last10=Jin|first10=Mingli|last11=Kim|first11=Kyeong-Man|last12=Cheong|first12=Jae Hoon|title=Oroxylin A improves attention deficit hyperactivity disorder-like behaviors in the spontaneously hypertensive rat and inhibits reuptake of dopamine in vitro|journal=Archives of Pharmacal Research|volume=36|issue=1|year=2013|pages=134–140|issn=0253-6269|doi=10.1007/s12272-013-0009-6|pmid=23371806|s2cid=23927252}}

See also

References

{{Reflist|30em}}

{{Stimulants}}

{{ADHD pharmacotherapies}}

{{Anorectics}}

{{Euphoriants}}

{{Monoamine reuptake inhibitors}}

{{Use dmy dates|date=April 2017}}

{{DEFAULTSORT:Dopamine Reuptake Inhibitor}}