In a rodent study published in the June 2009 issue of Anesthesiology, Ren et al begins to separate the analgesic from the respiratory effects of narcotics. They found that administration of Ampakine CX717 attenuated (when given before) or reversed (when given after) an intraperiotoneal dose of fentanyl that would produce apnea. The authors note that the compound used is considered safe for primate studies and clinical trials for cognitive disorders. It also crosses the blood brain barrier. The effect of CX717 does not directly reverse the effect of the narcotic on the respiratory center but rather it accentuates a pathway that is important to generating the respiratory rhythm within the preBotzinger complex. Ren J et al: Ampakine CX717 protects against fentanyl-induced respiratory depression and lethal apnea in rats. Anesthesiology 2009;110:1364-70.
David S. Smith, M.D., Ph.D.