Serotonin-4 receptor antagonists reverse cocaine-induced cardiac arrhythmia.

The effect of the 5-HT4 antagonists GR113808A and GR125487D on cocaine-induced cardiac arrhythmia was examined in the rat. Cocaine alone, given i.v. at a rate of 2 mg/kg every 5 min, produced an initial increase in blood pressure followed by a severe drop in pressure and bradycardia. Sustained ventricular fibrillation was noted after 6-12 mg/kg cocaine and quickly progressed to asystole. Pretreatment with both GR113808A and GR125487D antagonized these effects in a dose-dependent manner. When given after the onset of arrhythmia, both drugs reversed the cocaine-induced arrhythmia's. Thus, the 5-HT4 antagonists may be useful in the treatment of cocaine toxicity.