Gould Georgianna G, Altamirano Alfonso V, Javors Martin A, Frazer Alan
Department of Pharmacology, University of Texas Health Science Center at San Antonio, Texas 78229-3900, USA.
Biol Psychiatry. 2006 Mar 1;59(5):408-14. doi: 10.1016/j.biopsych.2005.07.011. Epub 2005 Sep 2.
Venlafaxine blocks both serotonin and norepinephrine transporters (SERT and NET), with higher affinity for SERT. Serotonergic effects occur with lower doses, whereas both serotonergic and noradrenergic effects occur with higher doses of venlafaxine. Chronic treatment of rats with selective serotonin reuptake inhibitors decreases SERT binding sites, whereas similar treatment with selective norepinephrine reuptake inhibitors decreases NET binding sites. We hypothesized that venlafaxine would affect monoamine transporters dose-dependently, with low doses causing selective reduction of SERT binding sites and higher doses reducing both SERT and NET binding sites.
Rats were treated for 21 days with a low (15 mg/kg/day) or high (70 mg/kg/day) dose of venlafaxine, vehicle, or other antidepressants. The SERT and NET density was determined by quantitative autoradiography.
Neither dose of venlafaxine nor amitriptyline reduced binding to either the SERT or NET. In rats with noradrenergic terminals destroyed by 6-hydroxydopamine, venlafaxine still failed to reduce SERT binding. Also, rats treated simultaneously with sertraline plus desipramine exhibited reductions in both SERT and NET binding.
Chronic venlafaxine treatment affected SERT and NET binding differently from paroxetine or desipramine. The inability of venlafaxine to reduce SERT or NET binding sites is not due to its dual uptake inhibiting properties.
文拉法辛可同时阻断5-羟色胺和去甲肾上腺素转运体(SERT和NET),对SERT具有更高的亲和力。较低剂量时会出现5-羟色胺能效应,而较高剂量的文拉法辛则会同时出现5-羟色胺能和去甲肾上腺素能效应。用选择性5-羟色胺再摄取抑制剂对大鼠进行长期治疗会减少SERT结合位点,而用选择性去甲肾上腺素再摄取抑制剂进行类似治疗会减少NET结合位点。我们推测文拉法辛会以剂量依赖方式影响单胺转运体,低剂量会导致SERT结合位点选择性减少,高剂量会减少SERT和NET结合位点。
用低剂量(15毫克/千克/天)或高剂量(70毫克/千克/天)的文拉法辛、赋形剂或其他抗抑郁药对大鼠进行21天治疗。通过定量放射自显影法测定SERT和NET密度。
文拉法辛的任一剂量以及阿米替林均未降低与SERT或NET的结合。在去甲肾上腺素能终末被6-羟基多巴胺破坏的大鼠中,文拉法辛仍未能降低SERT结合。此外,同时用舍曲林加地昔帕明治疗的大鼠,其SERT和NET结合均减少。
文拉法辛长期治疗对SERT和NET结合的影响与帕罗西汀或地昔帕明不同。文拉法辛无法降低SERT或NET结合位点并非因其双重摄取抑制特性所致。