Background and history ofScopolamine Detoxification Technique(SDT)
The therapeutic use of scopolamine can betraced back to ancient times, when herbal medicine was the only choice. Hyocyamusniger(henbane), Atropa belladonna (deadly nightshade), Datura strammonium (known asjimson weed in the USA) and mandrake root were used for their analgesic effect, incombination with poppy, by ancient predecessors as early as 2500 BC. The specialindications of D. strammonium described by Harvey Wickes Felter (1922) included theopioid habit, and Niederkorn (1905), in his thesis, mentioned A. belladonna as an antidoteto opioid. The main effective alkaloids extracted from these herbs are scopolamine,atropine and hyoscyamine, all of which are muscarinic receptor antagonists, and from theearly 1900s, henbane has been known to have therapeutic potential in the treatment ofdiseases related to opioid.During heroin
detoxification with SDT, scopolamine results in: (1) inhibiting of the cerebral cortex,causing sedation and antivertigo; (2) inhibiting the secretion of respiration tract andlacrimal gland; (3) stimulating the respiratory center, antagonizing the inhibitory action ofmorphine or pethidine; (4) antispasm and analgesia; (5) antiparkinsonism and platycoria；(6) Promoting the metabolism and excretion of morphine, accelerating detoxification[1, 2]. Heroin addicts withdraw from heroin in SDT-induced anesthesia and abstinencesyndromes decline without respiration system and blood circulation system disturbances.Chlorpromazine has subsidiary effects during using scopolamine for detoxification ofheroin addiction. Chlorpromazine is one of the 3 listed medicines for treating psychoticdisorders in the World Health Organization’s Essential Drug List. It is used across theglobe for the 1% of people who suffer from this illness. Chlorpromazine works on avariety of receptors in the central nervous system, producing anticholinergic,antidopaminergic, antihistaminic, and weak antiadrenergic effects[3]. The clinicalindications of Chlorpromazine are determined by this broad action: its anticholinergicproperties cause constipation, sedation, and hypotension, and help relieve nausea. It alsohas anxiolytic (anxiety-relieving) properties[3]. Two drugs can be used together withoutduplicating or canceling out the effects of each other. Chlorpromazine not only hassubsidiary effects during using scopolamine for detoxification of heroin addiction, butantagonizes the untoward-effects of scopolamine during heroin detoxification: (1)although scopolamine can stimulate the circulatory and respiratory center, it may causeconvulsions as well as an elevation of body the temperature [2]. In contrast,chlorpromazine has therapeutic effects such as sedation, antimania and decreasing bodytemperature; (2) Chlorpromazine, both as a supressor of brain stem reticular formationand as a blocker for the transmission of the ascending activating system of the cerebralcortex, can subsidize scopolamine positively in drug induced sleeping; (3)chlorpromazineexhibits a safeguard effect in the drug withdrawal, for the two drugs are antagonistic toone another in their untoward effects. For instance, chlorpromazine antagonizesscopolamine in tranquilizing the patients of their restlessness due to the overactivity ofthe subcortical system caused by scopolamine. Chlorpromazine is antagonized in itsinhibition of respiration and blood circulation by scopolamine. Chlorpromazine is used inthe treatment of disorganized and psychotic thinking, also used to help treat falseperceptions (e.g. hallucinations or delusions) [4]. Therefore, scopolamine andchlorpromazine are antagonists to each other in untoward effects but are synergists inheroin withdrawal symptoms.
References
1. GolanDE, Tashjian AH, Armstrong EJ. Principles in Pharmacology. LippincottWilliams & Wilkins (LWW), 2011
2. Renner UD, Oertel R, Kirch W. Pharmacokinetics and pharmacodynamics in clinicaluse of scopolamine. Ther Drug Monit 2005 Oct; 27(5):655-65
3. Gilman A, Goodman LS, Hardman JG, et al. Goodman & Gilman's thepharmacological basis of therapeutics (10th ed.). McGraw-Hill, New York, 2011
4. Frontali M, Amorico L, De Acetis L, et al. A pharmacological analysis of processesunderlying differential responding: a review and further experiments withscopolamine, amphetamine, lysergic acid diethylamide (LSD-25), chlordiazepoxide,physostigmine, and chlorpromazine. Behav Biol 1976 Sep; 18(1):1-74