Abstract

The mechanism(s) of analgesic action of paracetamol (acetaminophen; N-acetyl-p-aminophenol) remains controversial. Previous studies on rats suggested that the antinociceptive action of paracetamol might involve the central descending inhibitory pain pathways recruiting both a serotoninergic and an opioidergic system. This study explores this issue in mice using paroxetine, the most potent selective serotonin re-uptake inhibitor, and the nonselective opioid pure antagonist naloxone. Animals were divided into two main groups for two separate experiments, each subdivided into 3 subgroups. In both experiments; the first group served as control, the second group received paracetamol (200 mg/kg, i.p). In one experiment, the third group received paroxetine (20 mg/kg p.o for 7 days) before paracetamol. In the other experiment, animals of the third group were pretreated with naloxone (5 mg/kg, i.p) 30 min before paracetamol. The antinociceptive effect of paracetamol was tested using the hot plate test. Paracetamol displayed a significant antinociceptive activity that was augmented by pretreatment with paroxetine as was shown by maintenance of its effect beyond that shown by paracetamol alone. On the other hand, pretreatment with naloxone abolished paracetamol’s antinociceptive activity in the hot-plate test. These results extended the previous observation in rats that the antinociceptive effect of paracetamol involved activation of a central descending pain inhibitory pathway with serotonin and opioidergic peptides being potential mediators recruited.

Highlights

  • More than 100 years after its synthesis, the mechanism of analgesic action of paracetamol remains controversial

  • Previous studies on rats suggested that the antinociceptive action of paracetamol might involve the central descending inhibitory pain pathways recruiting both a serotoninergic and an opioidergic system. This study explores this issue in mice using paroxetine, the most potent selective serotonin re-uptake inhibitor, and the nonselective opioid pure antagonist naloxone

  • Pretreatment with naloxone abolished paracetamol’s antinociceptive activity in the hot-plate test. These results extended the previous observation in rats that the antinociceptive effect of paracetamol involved activation of a central descending pain inhibitory pathway with serotonin and opioidergic peptides being potential mediators recruited

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Summary

Introduction

More than 100 years after its synthesis, the mechanism of analgesic action of paracetamol (acetaminophen; N-acetyl-p-aminophenol) remains controversial. Its inhibitory activity on the synthesis of prostaglandin is more evident on cyclo-oxygenase 1 than on cyclooxygenase 2 [4], both peripherally and within the CNS, even though the exact antinociceptive mechanism of action of this drug is still not completely clear [5]. Its biochemical properties, such as its weak inhibitory activity on the synthesis of peripheral prostaglandins, its low plasma-protein binding, its liposolubility and its ability to cross the blood-brain barrier suggest a central activity, which has been reported in several studies both in animals [6] and in humans [7]. The inhibition of cyclo-oxygenase may not be solely responsible for the central analgesic effect of non steroidal anti-inflammatory drugs (NSAIDs) [9]

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