약물 의존에서 Cannabinoid 1 수용체 길항 약물

Cannabinoid 1 Receptor Antagonists in Substance Dependence

It is now being elucidated that the endocannabinoid system is one of the neurotransmitter system normally existed in our brain. Anandamide, one of the main endocannabinoids, act as a retrograde messenger in the synapse through cannabinoid 1 receptor, and it modulates the activities of synaptic transmission by decreasing the function s of presynaptic neuron. The process is so-called long-term depolarization. Therefore the endocannabinoid system is believed to do a pivotal role in the formations of memory process and habit formation. Furthermore, the endocannabinoid system is thought to be involved into the development, maintenance and relapse of the syndromes in substance dependence, by the endocannabinoid system itself or by the interaction with other neurotransmitter system. By the selective cannabinoid 1 receptor antagonists, the repetitive behaviors of animals or humans toward addictive substance like nicotine, alcohol, opioids, and cocaine were changed. It could mean that not only the brain reward circuit through mesolimbic dopaminergic pathway but also the alternations of neurons by endocannabinoid system will be on the important position in the neurobiologic backgrounds of addiction. Several CB1 receptor antagonists were in developing (e.g., Rimonabant) to treat the substance dependence. According to the outcomes of clinical trials, some of the pharmacological agents will be applied to our patients. Until now, clinically approved medications in addiction fields were just an aversive agent (e.g., disulfiram) and anticraving agents (e.g., naltrexone and acamprosate). It will be meaningful for us to have another therapeutic tools with novel mechanism.