Wiborg O, Krüger T, Jakobsen S N
Department of Biological Psychiatry, Psychiatric Hospital, Risskov, Denmark.
Pharmacol Toxicol. 1999 Feb;84(2):88-93. doi: 10.1111/j.1600-0773.1999.tb00879.x.
The effect of lithium and carbamazepine in the treatment of bipolar affective disorder is well established. Although a number of biochemical effects have been found, the exact molecular mechanisms underlying their therapeutic actions have not been elucidated nor are the target regions in the brain identified. Taken into account the important role of the cyclic AMP second messenger system in the regulation of neuronal exitability and the indications of its involvement in the patophysiology of bipolar affective disorder, we have focused on the drug effects on cyclic AMP levels. The objectives of this investigation were to measure the effects on basal cyclic AMP levels, and to locate target regions within the rat brain after long-term administration of lithium and carbamazepine. Drug treatments were carried out for a period of 28 days. After either drug treatment the cyclic AMP level was increased 3-4 times in frontal cortex but unchanged in hippocampus, hypothalamus, thalamus, amygdala and in cerebellum. In neostriatum the cyclic AMP level was decreased to about 30% after treatment with lithium. We suggest the common region-selective effect, observed for both drugs in frontal cortex, to be essential for the therapeutic actions of lithium and carbamazepine.
锂盐和卡马西平治疗双相情感障碍的效果已得到充分证实。尽管已发现了一些生化效应,但其治疗作用背后的确切分子机制尚未阐明,大脑中的靶区域也未明确。考虑到环磷酸腺苷(cAMP)第二信使系统在调节神经元兴奋性中的重要作用以及其参与双相情感障碍病理生理学的迹象,我们着重研究了药物对cAMP水平的影响。本研究的目的是测量对基础cAMP水平的影响,并在长期给予锂盐和卡马西平后定位大鼠脑内的靶区域。药物治疗持续28天。两种药物治疗后,额叶皮质中的cAMP水平升高了3至4倍,但海马体、下丘脑、丘脑、杏仁核和小脑中的cAMP水平未发生变化。用锂盐治疗后,新纹状体中的cAMP水平降至约30%。我们认为,两种药物在额叶皮质中观察到的共同区域选择性效应对于锂盐和卡马西平的治疗作用至关重要。