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(-)-替他洛尔、(-)-喷布洛尔和(±)-吲哚洛尔与帕罗西汀联合使用对突触前5-羟色胺功能的影响:一项体内微透析和电生理学研究。

Effects of (-)-tertatolol, (-)-penbutolol and (+/-)-pindolol in combination with paroxetine on presynaptic 5-HT function: an in vivo microdialysis and electrophysiological study.

作者信息

Gartside S E, Clifford E M, Cowen P J, Sharp T

机构信息

Oxford University Department of Clinical Pharmacology, Radcliffe Infirmary.

出版信息

Br J Pharmacol. 1999 May;127(1):145-52. doi: 10.1038/sj.bjp.0702546.

Abstract

The antidepressant efficacy of selective serotonin reuptake inhibitors (SSRIs) might be enhanced by co-administration of 5-HT1A receptor antagonists. Thus, we have recently shown that the selective 5-HT1A receptor antagonist, WAY 100635, blocks the inhibitory effect of an SSRI on 5-HT cell firing, and enhances its ability to elevate extracellular 5-HT in the forebrain. Here we determined whether the beta-adrenoceptor/5-HT1A receptor ligands (+/-)-pindolol, (-)-tertatolol and (-)-penbutolol, interact with paroxetine in a similar manner. Both (-)-tertatolol (2.4 mg kg(-1) i.v.) and (-)-penbutolol (2.4 mg kg(-1) i.v.) enhanced the effect of paroxetine (0.8 mg kg(-1) i.v.) on extracellular 5-HT in the frontal cortex, whilst (+/-)-pindolol (4 mg kg(-1) i.v.) did not. (-)-Tertatolol (2.4 mg kg(-1) i.v.) alone caused a slight increase in 5-HT however, (-)-penbutolol (2.4 mg kg(-1) i.v.) alone had no effect. In electrophysiological studies (-)-tertatolol (2.4 mg kg(-1) i.v.) alone had no effect on 5-HT cell firing but blocked the inhibitory effect of paroxetine. In contrast, (-)-penbutolol (0.1-0.8 mg kg(-1) i.v.) itself inhibited 5-HT cell firing, and this effect was reversed by WAY 100635 (0.1 mg kg(-1) i.v.). We have recently shown that (+/-)-pindolol inhibits 5-HT cell firing via a WAY 100635-sensitive mechanism. Our data suggest that (-)-tertatolol enhances the effect of paroxetine on forebrain 5-HT via blockade of 5-HT1A autoreceptors which mediate paroxetine-induced inhibition of 5-HT cell firing. In comparison, the mechanisms by which (-)-penbutolol enhances the effect of paroxetine on extracellular 5-HT is unclear, since (-)-penbutolol itself appears to have agonist properties at the 5-HT1A autoreceptor. Indeed, the agonist action of (+/-)-pindolol at 5-HT1A autoreceptors probably explains its inability to enhance the effect of paroxetine on 5-HT in the frontal cortex. Overall, our data suggest that both (-)-tertatolol and (-)-penbutolol are superior to (+/-)-pindolol in terms of enhancing the effect of an SSRI on extracellular 5-HT. Both (-)-tertatolol and (-)-penbutolol are worthy of investigation for use as adjuncts to SSRIs in the treatment of major depression.

摘要

5-羟色胺1A受体拮抗剂与选择性5-羟色胺再摄取抑制剂(SSRI)联合使用可能会增强其抗抑郁疗效。因此,我们最近发现,选择性5-羟色胺1A受体拮抗剂WAY 100635可阻断SSRI对5-羟色胺能神经元放电的抑制作用,并增强其提高前脑细胞外5-羟色胺水平的能力。在此,我们确定β-肾上腺素能受体/5-羟色胺1A受体配体(±)-吲哚洛尔、(-)-替他洛尔和(-)-喷布洛尔是否以类似方式与帕罗西汀相互作用。(-)-替他洛尔(静脉注射2.4 mg·kg⁻¹)和(-)-喷布洛尔(静脉注射2.4 mg·kg⁻¹)均可增强帕罗西汀(静脉注射0.8 mg·kg⁻¹)对额叶皮质细胞外5-羟色胺水平的影响,而(±)-吲哚洛尔(静脉注射4 mg·kg⁻¹)则无此作用。单独使用(-)-替他洛尔(静脉注射2.4 mg·kg⁻¹)可使5-羟色胺水平略有升高,然而,单独使用(-)-喷布洛尔(静脉注射2.4 mg·kg⁻¹)则无作用。在电生理研究中,单独使用(-)-替他洛尔(静脉注射2.4 mg·kg⁻¹)对5-羟色胺能神经元放电无影响,但可阻断帕罗西汀的抑制作用。相反,(-)-喷布洛尔(静脉注射0.1 - 0.8 mg·kg⁻¹)本身可抑制5-羟色胺能神经元放电,而WAY 100635(静脉注射0.1 mg·kg⁻¹)可逆转此作用。我们最近发现,(±)-吲哚洛尔通过WAY 100635敏感机制抑制5-羟色胺能神经元放电。我们的数据表明,(-)-替他洛尔通过阻断介导帕罗西汀诱导的5-羟色胺能神经元放电抑制作用的5-羟色胺1A自身受体,增强帕罗西汀对前脑5-羟色胺的作用。相比之下,(-)-喷布洛尔增强帕罗西汀对细胞外5-羟色胺作用的机制尚不清楚,因为(-)-喷布洛尔本身在5-羟色胺1A自身受体上似乎具有激动剂特性。实际上,(±)-吲哚洛尔在5-羟色胺1A自身受体上的激动剂作用可能解释了其无法增强帕罗西汀对额叶皮质5-羟色胺作用的原因。总体而言,我们的数据表明,在增强SSRI对细胞外5-羟色胺的作用方面,(-)-替他洛尔和(-)-喷布洛尔均优于(±)-吲哚洛尔。(-)-替他洛尔和(-)-喷布洛尔作为SSRI辅助药物用于治疗重度抑郁症值得研究。

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