D'Aquila Paolo S, Peana Alessandra T, Panin Francesca, Grixoni Chiara, Cossu Maria, Serra Gino
Dipartimento di Scienze del Farmaco, Università di Sassari, via Muroni 23/a, 07100, Sassari, Italy.
Eur J Pharmacol. 2003 Jan 1;458(1-2):129-34. doi: 10.1016/s0014-2999(02)02731-0.
Chronic antidepressant treatments enhance dopaminergic neurotransmission in the mesolimbic dopamine system. We suggested that this potentiation might underlie both the antidepressant therapeutic effect and the antidepressant-induced switch from depression to mania, which in turn, might be involved in the development of rapid cycling in bipolar patients. In this study, we investigated the changes occurring in the sensitivity of the mesolimbic dopamine system up to 40 days after antidepressant withdrawal. Male Sprague-Dawley rats were treated for 3 weeks with imipramine (20 mg/kg) and tested for motor activity 24 h, 12, 33 and 40 days after treatment withdrawal. Ambulatory activity and rearing counts were recorded after challenge with the dopamine D2-like receptor agonist quinpirole (0.15 mg/kg). Imipramine increased the motor response to quinpirole, 24 h after treatment discontinuation. No relevant differences between the groups were found after 12 and 33 days. After 40 days, a decreased level of rearing was observed in the group treated with imipramine. These results show a reversal of the imipramine-induced dopaminergic supersensitivity after 40 days of chronic imipramine withdrawal and suggest that the mood-switches observed in bipolar patients following antidepressant treatment and subsequent withdrawal, i.e. mania followed by rebound depression, might depend upon parallel changes in the mesolimbic dopamine system sensitivity.
慢性抗抑郁治疗可增强中脑边缘多巴胺系统中的多巴胺能神经传递。我们认为,这种增强作用可能是抗抑郁治疗效果以及抗抑郁药诱发的从抑郁向躁狂转变的基础,而这反过来可能与双相情感障碍患者快速循环发作的发展有关。在本研究中,我们调查了抗抑郁药撤药后长达40天中脑边缘多巴胺系统敏感性的变化。雄性Sprague-Dawley大鼠用丙咪嗪(20 mg/kg)治疗3周,并在撤药后24小时、12天、33天和40天测试运动活性。用多巴胺D2样受体激动剂喹吡罗(0.15 mg/kg)激发后记录自主活动和竖毛次数。撤药后24小时,丙咪嗪增加了对喹吡罗的运动反应。12天和33天后,各组之间未发现相关差异。40天后,丙咪嗪治疗组的竖毛水平降低。这些结果表明,慢性丙咪嗪撤药40天后,丙咪嗪诱导的多巴胺能超敏反应发生了逆转,并提示双相情感障碍患者在抗抑郁治疗及随后撤药后观察到的情绪转换,即躁狂后出现反弹性抑郁,可能取决于中脑边缘多巴胺系统敏感性的平行变化。