# Synergistic effects of levo-tetrahydropalmatine and low-dose naltrexone on nicotine conditioned place preference in mice: a dual-target strategy based on dopamine and opioid systems

**Authors:** Kun Feng, Yiran Zhao, Lu Liu, Shan Kang, Mingming Yu, Sherwin K. B. Sy, Zhihua Lv, Meixing Yan

PMC · DOI: 10.3389/fphar.2026.1697258 · Frontiers in Pharmacology · 2026-01-14

## TL;DR

Combining two drugs that target dopamine and opioid systems reduces nicotine addiction behaviors in mice, suggesting a new treatment approach.

## Contribution

A dual-target strategy using l-THP and LDN synergistically reduces nicotine-seeking behavior in mice.

## Key findings

- Combining l-THP and LDN significantly reduced nicotine-induced conditioned place preference in mice.
- The combination therapy increased plasma β-endorphin levels, indicating opioid system modulation.
- l-THP alone at 10 mg/kg was effective, while LDN alone had no significant effect.

## Abstract

Nicotine addiction is a major public health challenge, with existing pharmacological interventions often limited by suboptimal efficacy, adverse effects and withdrawal symptoms.

This study explores the effects of combining levo-tetrahydropalmatine (l-THP), a dopamine receptor antagonist, with low-dose naltrexone (LDN), an opioid receptor antagonist, on nicotine-induced conditioned place preference (CPP) in mice.

The combined therapeutic effects of l-THP and LDN on nicotine was evaluated using a mouse CPP paradigm. Male Kunming mice were subjected to nicotine-induced CPP, followed by treatment with l-THP, LDN, or their combination. Behavioral assessments were conducted, and plasma β-endorphin levels were measured using enzyme linked immunosorbent assay.

A 10 mg/kg l-THP alone significantly attenuated CPP, while LDN alone showed no significant effect. The combination of 10 mg/kg l-THP and 0.3 mg/kg LDN produced a synergistic reduction in nicotine-seeking behavior, effectively reversing the CPP effect. The combination therapy was associated with an increased plasma β-endorphin levels, suggesting a modulation of the endogenous opioid system.

These findings indicate that the combination therapy based on dual-action mechanism of l-THP and LDN, targeting both dopamine and opioid pathways, effectively attenuates nicotine-induced CPP in mice, which may offer a potential treatment for nicotine addiction. The combination enhances therapeutic efficacy within the nicotine-induced CPP paradigm and correlates with an elevation of β-endorphin levels.

Illustration depicting the effects of levo-tetrahydropalmatine and low-dose naltrexone on nicotine-conditioned place preference in mice. A mouse receives nicotine, activating the brain’s nucleus accumbens and ventral tegmental area, increasing dopamine release. Levo-tetrahydropalmatine competes at dopamine receptors, reducing dopamine signaling and inhibiting reward pathways. Low-dose naltrexone competes at opioid receptors, boosting β-endorphin levels, restoring endorphin balance, and stabilizing the reward system. This process attenuates nicotine-induced conditioned place preference.

## Linked entities

- **Chemicals:** levo-tetrahydropalmatine (PubChem CID 72301), naltrexone (PubChem CID 5360515), nicotine (PubChem CID 942)
- **Diseases:** nicotine addiction (MONDO:0008575)
- **Species:** Mus musculus (taxon 10090)

## Full-text entities

- **Genes:** Pomc (pro-opiomelanocortin-alpha) [NCBI Gene 18976] {aka ACTH, BE, Beta-LPH, Clip, Gamma-LPH, Npp}
- **Diseases:** Nicotine addiction (MESH:D014029)
- **Chemicals:** naltrexone (MESH:D009271), l-THP (MESH:C014215), dopamine (MESH:D004298), LDN (-), nicotine (MESH:D009538)
- **Species:** Mus musculus (house mouse, species) [taxon 10090]

## Full text

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## Figures

7 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12847241/full.md

## References

48 references — full list in the complete paper: https://tomesphere.com/paper/PMC12847241/full.md

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Source: https://tomesphere.com/paper/PMC12847241