Cited by 61Pain Mechanisms and TreatmentsCannabis and Cannabinoid ResearchSpinal Cord Injury Research

Cannabinoid receptor-mediated antinociception with acetaminophen drug combinations in rats with neuropathic spinal cord injury pain

Open access
Hama, Aldric T., Sagen, Jacqueline·2010·Neuropharmacology

Abstract

Pre-clinical evidence demonstrates that neuropathic spinal cord injury (SCI) pain is maintained by a number of neurobiological mechanisms, suggesting that treatments directed at several pain-related targets may be more advantageous compared to a treatment focused on a single target. The current study evaluated the efficacy of the non-opiate analgesic acetaminophen, which has several putative analgesic mechanisms, combined with analgesic drugs used to treat neuropathic pain in a rat model of below-level neuropathic SCI pain. Following an acute compression of the mid-thoracic spinal cord, rats exhibited robust hind paw hypersensitivity to innocuous mechanical stimulation. Fifty percent antinociceptive doses of gabapentin, morphine, tramadol or memantine were combined with an ineffective dose of acetaminophen; acetaminophen alone was not antinociceptive. The combination of acetaminophen with either tramadol or memantine resulted in an additive antinociceptive effect. Acetaminophen combined with either morphine or gabapentin, however, resulted in supra-additive (synergistic) efficacy. One of the analgesic mechanisms of acetaminophen is inhibiting the uptake of endocannabinoids from the extracellular space. Pre-treatment with AM251, a cannabinoid-1 receptor (CB1) antagonist, significantly diminished the antinociceptive effect of the acetaminophen + gabapentin combination. Pre-treatment with AM630, a cannabinoid-2 receptor (CB2) antagonist, did not have an effect on this combination. By contrast, both AM251 and AM630 reduced the efficacy of the acetaminophen + morphine combination. None of the active drugs alone were affected by either CB receptor antagonist. The results imply that modulation of the endocannabinoid system in addition to other mechanisms mediate the synergistic antinociceptive effects of acetaminophen combinations. Despite the presence of a cannabinoid mechanism, synergism was not present in all acetaminophen combinations. The combination of currently available drugs may be an appropriate option in ameliorating neuropathic SCI pain if single drug therapy is ineffective.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/j.neuropharm.2009.12.010

Cites

80 of 80 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The expected synergism between paracetamol and opiates is attenuated in mice pretreated with a selective CB1 antagonist.

    “The expected synergism between paracetamol and opiates was also attenuated in mice pretreated with selective CB1 antagonist.57”

    From An Updated Review on the Metabolite (AM404)-Mediated Central Mechanism of Action of Paracetamol (Acetaminophen): Experimental Evidence and Potential Clinical Impact (2023) · cites this paper as [57]

    The Abstract reports synergistic antinociception from acetaminophen plus morphine and reduced efficacy of that combination after CB1-antagonist pretreatment. But the study was in rats with neuropathic spinal cord injury pain, not mice, and its Results (§3.5; page unavailable) describe acetaminophen plus tramadol as additive rather than synergistic. The paper supports the point for morphine, not opiates generally. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

2 of the 82 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Tallarida RJ Murray RB 1981 Manual of Pharmacological Calculations with Computer Programs Springer-Verlag New York, NY

Cited by

Sorted by citations

Authors
Hama, A. T., & Sagen, J.
Affiliations
University of Miami (US)
Corresponding author
Hama, Aldric T.
Venue
Neuropharmacology
Publisher
Elsevier BV
Published
2010-03
Volume
58
Issue
4-5
Pages
758-766
ISSN
0028-3908 (ISSN-L)
OpenAlex
W2160265565
Cited by
61
References
82
Citations by year
2026: 1 · 2025: 4 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 3 · 2020: 2 · 2018: 5 · 2017: 3 · 2016: 4 · 2015: 4 · 2014: 6 · 2013: 7 · 2012: 9
FWCI
3.77
Type
journal article
Language
en
Open access
Locations
  • Neuropharmacology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Neurological Disorders and Stroke (R21NS061172, NS61172)
Topics
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
  • Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Spinal Cord Injury Research
Keywords
paracetamol, neuropathic pain, spinal cord injury, antinociception, combination therapy, endocannabinoid system, cannabinoid 1 receptor, cannabinoid 2 receptor, gabapentin, morphine, tramadol, memantine, synergistic effect, AM251, AM630, mechanical allodynia
MeSH terms
Acetaminophen, Analgesics, Opioid, Animals, Dose-Response Relationship, Drug, Drug Therapy, Combination, Male, Neuralgia, Pain, Pain Measurement, Spinal Cord Injuries, Rats, Sprague-Dawley, Analgesics, Non-Narcotic, Receptors, Cannabinoid, Rats, In Vitro Techniques

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review