Functional observation after morphine withdrawal: effects of SJP-005

• Published in: Psychopharmacology Vol. 238; no. 6; pp. 1449 - 1460
• Main Authors: Verster, Joris C., Scholey, Andrew, Dahl, Thomas A., Iversen, Jacqueline M.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.06.2021; Springer; Springer Nature B.V
• Subjects: Biomedical and Life Sciences; Biomedicine; Drug addiction; Drug withdrawal; Hypersensitivity; Ibuprofen; Morphine; Neurosciences; Nonsteroidal anti-inflammatory drugs; Opioids; Original Investigation; Pharmacology/Toxicology; Placebos; Psychiatry; Statistical analysis; Netherlands; Treatment; Buprenorphine; Opioid dependence; SJP-005; Clonidine; Methadone; Opioid use disorder; Lofexidine; Opioid withdrawal
• ISSN: 0033-3158; 1432-2072
• DOI: 10.1007/s00213-021-05771-5

Rationale and objective SJP-005 (ketotifen and ibuprofen) is being developed as a potential new treatment for opioid withdrawal. Three studies were conducted to evaluate the early phase (acute, day 1) and late phase (days 2–12) effects of SJP-005 on discontinuation-induced morphine withdrawal. Methods Sprague-Dawley rats received subcutaneous morphine twice daily for 18 days and ceased on day 19. Twice daily, oral dosages of placebo or SJP-005 (1 mg/kg ketotifen and 15 mg/kg ibuprofen) were administered starting 4 days before (study 1), 2 days before (study 2), or immediately after (study 3) morphine cessation. Functional observations were made up to 12 h after treatment cessation on day 19 (early phase), and immediately after treatment on days 20–30 (late phase). Treatment effects (mean overall score, and individual symptoms) were compared with placebo using ANOVA, and Tukey’s tests in case of multiple comparisons. Results Across the studies, the number of withdrawal signs on day 19 (early phase) and days 20–30 (late phase) was lower with SJP-005 compared with placebo. The effects of SJP-005 when treatment was initiated 2 days before morphine cessation by discontinuation were most pronounced and statistically significant in the late phase ( F (1,18) = 14.10, p = 0.001). In particular, a significant reduction was observed in hypersensitivity to touch ( F (1,18) = 13.65, p = 0.002). A 50% reduction in withdrawal symptoms was observed 9.0 days after placebo versus 4.5 days after SJP-005. After 9.0 days, all withdrawal symptoms were absent in the SJP-005 group, while symptoms in the placebo group were still evident on day 18. Conclusion Compared to placebo, SJP-005 significantly reduced the incidence and duration of discontinuation-induced morphine withdrawal symptoms when treatment was initiated 2 days before morphine cessation.