Luszczki Jarogniew J, Czuczwar Stanislaw J
Department of Pathophysiology, Skubiszewski Medical University of Lublin, Jaczewskiego 8, 20-950 Lublin, Poland.
Naunyn Schmiedebergs Arch Pharmacol. 2004 Nov;370(5):369-80. doi: 10.1007/s00210-004-0983-9. Epub 2004 Oct 23.
The anticonvulsant effects of lamotrigine (LTG) and clonazepam (CZP) and combinations thereof against maximal electroshock (MES)-induced seizures in mice were investigated using three-dimensional (3D) isobolographic analysis. With this method, the doses of fixed-ratio combinations of the drugs (1:3, 1:1 and 3:1) that elicited 16, 50 and 84% of the maximum anticonvulsant effect were determined. Additionally, to evaluate the characteristics of interactions observed with 3D isobolography, the brain concentrations of both drugs were verified pharmacokinetically. The 3D isobolographic analysis showed that LTG and CZP combined at the fixed ratios of 3:1 and 1:1 interacted synergistically in the MES test for all anticonvulsant effects between 16% and 84% of maximum. In contrast, the combination of LTG and CZP at the fixed ratio of 1:3 showed only pure additivity for all estimated effects in 3D isobolography. Moreover, none of the examined antiepileptic drugs altered the brain concentrations of the coadministered drug, so the observed interactions in the MES test are of a pharmacodynamic nature. The 3D isobolographic findings suggest that in epilepsy therapy, increased efficacy of seizure control (synergistic interaction) might be achieved by using LTG and CZP in combination. In this study, some important problems and assumptions related to statistical analysis of data in 3D isobolography are discussed.
采用三维(3D)等效线图分析法,研究了拉莫三嗪(LTG)和氯硝西泮(CZP)及其组合对小鼠最大电休克(MES)诱导惊厥的抗惊厥作用。通过该方法,确定了能产生最大抗惊厥作用的16%、50%和84%的药物固定比例组合(1:3、1:1和3:1)的剂量。此外,为了评估3D等效线图观察到的相互作用特征,对两种药物的脑内浓度进行了药代动力学验证。3D等效线图分析表明,在MES试验中,LTG和CZP以3:1和1:1的固定比例联合使用时,在最大作用的16%至84%之间的所有抗惊厥作用中均表现出协同作用。相比之下,LTG和CZP以1:3的固定比例联合使用时,在3D等效线图中所有估计作用仅表现为单纯相加。此外,所检测的抗癫痫药物均未改变同时给药药物的脑内浓度,因此在MES试验中观察到的相互作用具有药效学性质。3D等效线图研究结果表明,在癫痫治疗中,联合使用LTG和CZP可能会提高癫痫控制的疗效(协同相互作用)。在本研究中,还讨论了与3D等效线图数据统计分析相关的一些重要问题和假设。