Linnér Love, Wiker Charlotte, Wadenberg Marie Louise, Schalling Martin, Svensson Torgny H
Section of Neuropsychopharmacology, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
Neuropsychopharmacology. 2002 Nov;27(5):691-8. doi: 10.1016/S0893-133X(02)00350-0.
We have previously observed that addition of an alpha(2)-adrenoceptor antagonist to a selective dopamine (DA) D(2) receptor antagonist enhances the antipsychotic-like effect of the D(2) blocker and also selectively increases DA output in the medial prefrontal cortex (mPFC) in rats. These data also correlate well with previous clinical trials showing augmentation by an equivalent drug combination in schizophrenia. Since the selective noradrenaline reuptake inhibitor reboxetine was found to cause similar effects on the mesolimbocortical DA system as alpha(2)-adrenoceptor antagonists, the present study was undertaken to explore whether also reboxetine might augment the effect of the DA D(2) receptor antagonist raclopride in the same preclinical model of antipsychotic activity, the conditioned avoidance response (CAR) test. We also investigated the effect of this combination in the catalepsy test for extrapyramidal side effect liability, as well as on DA output in the mPFC and the nucleus accumbens, respectively. Reboxetine (6 mg/kg, i.p.) significantly enhanced the suppressant effect of raclopride (0.1 mg/kg, s.c.) on CAR without affecting catalepsy. Administration of raclopride (0.1 mg/kg, s.c.) to rats pretreated with reboxetine (6 mg/kg, i.p.) resulted in a greatly enhanced effect on DA output in the mPFC but not in the nucleus accumbens when compared with raclopride alone. Consequently, these results suggest that noradrenaline reuptake inhibition may provide means of augmenting the efficacy of classical D(2)-antagonists in the treatment of schizophrenia, and, in principle, to generate an atypical antipsychotic drug profile.
我们之前观察到,在选择性多巴胺(DA)D₂受体拮抗剂中添加α₂-肾上腺素能受体拮抗剂可增强D₂阻滞剂的抗精神病样作用,并且还能选择性地增加大鼠内侧前额叶皮质(mPFC)中的DA输出。这些数据也与之前的临床试验结果高度相关,该试验表明在精神分裂症患者中使用等效药物组合可增强疗效。由于发现选择性去甲肾上腺素再摄取抑制剂瑞波西汀对中脑边缘皮质DA系统产生的作用与α₂-肾上腺素能受体拮抗剂相似,因此本研究旨在探讨瑞波西汀是否也能在抗精神病活性的相同临床前模型——条件性回避反应(CAR)试验中增强DA D₂受体拮抗剂雷氯必利的作用。我们还研究了该组合在用于评估锥体外系副作用倾向的僵住试验中的作用,以及分别对mPFC和伏隔核中DA输出的影响。瑞波西汀(6毫克/千克,腹腔注射)显著增强了雷氯必利(0.1毫克/千克,皮下注射)对CAR的抑制作用,且不影响僵住反应。与单独使用雷氯必利相比,给预先用瑞波西汀(6毫克/千克,腹腔注射)处理的大鼠注射雷氯必利(0.1毫克/千克,皮下注射)后,对mPFC中DA输出的影响显著增强,但对伏隔核中DA输出无影响。因此,这些结果表明,去甲肾上腺素再摄取抑制可能为增强经典D₂拮抗剂治疗精神分裂症的疗效提供一种方法,并且原则上可产生非典型抗精神病药物的特征。