Fahey Jeanne M, Pritchard Gary A, Reddi Jyoti M, Pratt John S, Grassi Jeffrey M, Shader Richard I, Greenblatt David J
Department of Pharmacology and Experimental Therapeutics, Tufts University School of Medicine and the Division of Clinical Pharmacology, Tufts-New England Medical Center, Boston, MA 02111, USA.
Brain Res. 2006 Nov 6;1118(1):13-24. doi: 10.1016/j.brainres.2006.08.017. Epub 2006 Sep 20.
To assess benzodiazepine tolerance in aged animals, lorazepam or vehicle was administered chronically to male Crl: CD-1(ICR)BR mice. Pharmacodynamic and neurochemical endpoints were examined on days 1 and 14 of drug administration. There was no age-related significant difference in plasma lorazepam levels. Young and middle-aged animals demonstrated behavioral tolerance to lorazepam, while the aged animals showed a similar trend which failed to reach significance. In addition, aged animals also showed a trend toward tolerance to the anticonvulsant effects of lorazepam. There were no changes in alpha1 mRNA levels in cortex or hippocampus following administration of lorazepam when compared to vehicle-treated animals in any age group. Aged animals, however, had an initial increase in alpha1 mRNA expression in cortex and hippocampus on day 1 of vehicle treatment followed by decreased expression on day 14. These age-related changes were abolished by lorazepam administration. In summary, age-related sensitivity to the effects of lorazepam was not demonstrated in the present study. However, comparison of these data to other studies indicates that the effect of chronic benzodiazepine treatment may be specific to the benzodiazepine administered, the technique used to quantify mRNA expression changes, the subunits of the GABA(A) receptor investigated and the brain region analyzed. The phenomenon of benzodiazepine sensitivity in the elderly is an area of research which remains controversial and may well be compound specific. Determining benzodiazepines that do not produce pharmacodynamic sensitivity, such as lorazepam, may allow more careful prescribing and dosing of these drugs, and perhaps even the development of specific agents which could avoid this sensitivity.
为评估老年动物对苯二氮䓬类药物的耐受性,将劳拉西泮或赋形剂长期给予雄性Crl:CD-1(ICR)BR小鼠。在给药的第1天和第14天检查药效学和神经化学终点指标。血浆劳拉西泮水平无年龄相关的显著差异。年轻和中年动物对劳拉西泮表现出行为耐受性,而老年动物呈现出类似趋势,但未达到显著水平。此外,老年动物对劳拉西泮的抗惊厥作用也表现出耐受性趋势。与任何年龄组的赋形剂处理动物相比,给予劳拉西泮后皮质或海马中的α1 mRNA水平均无变化。然而,老年动物在赋形剂处理第1天皮质和海马中的α1 mRNA表达最初增加,随后在第14天表达下降。给予劳拉西泮可消除这些与年龄相关的变化。总之,本研究未证明对劳拉西泮作用存在年龄相关敏感性。然而,将这些数据与其他研究进行比较表明,慢性苯二氮䓬类药物治疗的效果可能特定于所给予的苯二氮䓬类药物、用于量化mRNA表达变化的技术、所研究的GABA(A)受体亚基以及所分析 的脑区。老年人对苯二氮䓬类药物敏感的现象是一个仍有争议的研究领域,很可能是药物特异性的。确定不会产生药效学敏感性的苯二氮䓬类药物,如劳拉西泮,可能会使这些药物的处方和给药更加谨慎,甚至可能开发出能够避免这种敏感性的特异性药物。