Elucidation of the Mechanism of Action of Carisoprodol at GABAA Receptors

Carisoprodol is an increasingly abused, centrally-acting muscle relaxant. Its sedative effects, which contribute to its therapeutic and recreational use, are attributed to its metabolite, meprobamate, a controlled substance with barbiturate-like activity at GABAA receptors (GABAARs). GABAARs are ion channel-coupled protein complexes underlying the majority of fast synaptic inhibition in the central nervous system. Recent evidence suggests carisoprodol may act independently of meprobamate. Thus, we used behavioral and pharmacological approaches to investigate carisoprodol’s effects on GABAAR function with the ultimate goal of elucidating its mechanism of action at these receptors. In mice, the time course of locomotor depression was comparable for carisoprodol (intraperitoneal or oral) versus meprobamate (intraperitoneal). GABAergic ligands substituted for carisoprodol in drug discrimination studies using carisoprodol trained rats. As observed in vitro, carisoprodol’s effects were antagonized by bemegride, a barbiturate antagonist, but not by the benzodiazepine site antagonist flumazenil, suggesting carisoprodol produces barbiturate-like effects in vivo. Moreover, whole-cell patch clamp recordings were obtained from HEK293 cells expressing human α1β2 and αxβzγ2 (where x = 1-4 and z = 1-2) GABAARs. Each receptor configuration was directly activated and allosterically modulated by carisoprodol in a barbiturate-like manner. Carisoprodol efficacy, but not potency, was subunit-dependent with α and β isoforms contributing to carisoprodol site(s) of action. Notably, carisoprodol was more efficacious at α1-containing receptors, consistent with its sedative effects and abuse potential. Homomeric glycine α1 and GABA ρ1 receptors were carisoprodol-insensitive. Despite similarities between carisoprodol and barbiturates, their sites of action are likely not equivalent as barbiturate-sensitive ρ1W328M subunits were carisoprodol-insensitive. However, chimeric ρ1/α1 receptors gained sensitivity to modulation, but not direct activation by carisoprodol. Our findings indicate carisoprodol modulates GABAARs in a subunit- and receptor-dependent manner, contributing to its pharmacological profile and possibly its abuse potential. Furthermore, partial restoration of modulation, but not direct gating by carisoprodol suggests this drug may mediate its effects via multiple sites on GABAARs.