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Despite oxymorphone being a more potent opioid\u2010receptor agonist, its contribution to oxycodone analgesia may be minor because of low peripheral production, low blood\u2013brain barrier permeability and central nervous system efflux. CYP2D metabolism within the brain may contribute to variation in central oxycodone and oxymorphone levels, thereby affecting analgesia. Brain CYP2D expression and activity are subject to exogenous regulation; nicotine induces rat brain, but not liver, CYP2D consistent with higher brain CYP2D in smokers. We assessed the role of rat brain CYP2D in orally administered oxycodone metabolism (<jats:italic>in vivo<\/jats:italic>brain microdialysis) and analgesia (tail\u2010flick test) by inhibiting brain CYP2D selectively with intracerebroventricular propranolol (mechanism\u2010based inhibitor) and inducing brain CYP2D with nicotine. Inhibiting brain CYP2D increased brain oxycodone levels (1.8\u2010fold;<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.03) and analgesia (1.5\u2010fold AUC<jats:sub>0\u201360<\/jats:sub>;<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) after oxycodone, while inducing brain CYP2D increased brain oxymorphone levels (4.6\u2010fold;<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and decreased analgesia (0.8\u2010fold;<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.02). Inhibiting the induced brain CYP2D reversed the change in oxycodone levels (1.2\u2010fold;<jats:italic>P<\/jats:italic>\u00a0&gt;\u00a00.1) and analgesia (1.1\u2010fold;<jats:italic>P<\/jats:italic>\u00a0&gt;\u00a00.3). Brain, but not plasma, metabolic ratios were affected by pre\u2010treatments. Peak analgesia was inversely correlated with<jats:italic>ex vivo<\/jats:italic>brain (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.003), but not hepatic (<jats:italic>P<\/jats:italic>\u00a0&gt;\u00a00.9), CYP2D activity. Altering brain CYP2D did not affect analgesia from oral oxymorphone (<jats:italic>P<\/jats:italic>\u00a0&gt;\u00a00.9 for AUC<jats:sub>0\u201360<\/jats:sub>across all groups), which is not a CYP2D substrate. Thus, brain CYP2D metabolism alters local oxycodone levels and response, suggesting that people with increased brain CYP2D activity may have reduced oxycodone response. Factors that alter individual oxycodone response may be useful for optimizing treatment and minimizing abuse liability.<\/jats:p>","DOI":"10.1111\/adb.12590","type":"journal-article","created":{"date-parts":[[2017,12,21]],"date-time":"2017-12-21T12:34:53Z","timestamp":1513859693000},"page":"228-238","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Rat brain<scp>CYP2D<\/scp>activity alters<i>in vivo<\/i>central oxycodone metabolism, levels and resulting analgesia"],"prefix":"10.1111","volume":"24","author":[{"given":"Douglas M.","family":"McMillan","sequence":"first","affiliation":[{"name":"Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH) and Department of Pharmacology and Toxicology University of Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Miksys","sequence":"additional","affiliation":[{"name":"Campbell Family 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