Chen Yi-Chyan, Holmes Andrew
Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Neuropsychopharmacology. 2009 May;34(6):1454-66. doi: 10.1038/npp.2008.182. Epub 2008 Oct 8.
Compounds with anti-glutamatergic properties currently in clinical use for various indications (eg Alzheimer's disease, epilepsy, psychosis, mood disorders) have potential utility as novel treatments for alcoholism. Enhanced sensitivity to certain acute intoxicating effects (ataxia, sedative) of alcohol may be one mechanism by which anti-glutamatergic drugs modulate alcohol use. We examined the effects of six compounds (memantine, dextromethorphan, haloperidol, lamotrigine, oxcarbazepine, and topiramate) on sensitivity to acute intoxicating effects of ethanol (ataxia, hypothermia, sedation/hypnosis) in C57BL/6J mice. Analysis of topiramate was extended to determine the influence of genetic background (by comparison of the 129S1, BALB/cJ, C57BL/6J, DBA/2J inbred strains) and prior stress history (by chronic exposure of C57BL/6J to swim stress) on topiramate's effects on ethanol-induced sedation/hypnosis. Results showed that one N-methyl-D-aspartate receptor (NMDAR) antagonist, memantine, but not another, dextromethorphan, potentiated the ataxic but not hypothermic or sedative/hypnotic effects of ethanol. Haloperidol increased ethanol-induced ataxia and sedation/hypnosis to a similar extent as the prototypical NMDAR antagonist MK-801. Of the anticonvulsants tested, lamotrigine accentuated ethanol-induced sedation/hypnosis, whereas oxcarbazepine was without effect. Topiramate was without effect per se under baseline conditions in C57BL/6J, but had a synergistic effect with MK-801 on ethanol-induced sedation/hypnosis. Comparing inbred strains, topiramate was found to significantly potentiate ethanol's sedative/hypnotic effects in BALB/cJ, but not 129S1, C57BL/6J, or DBA/2J strains. Topiramate also increased ethanol-induced sedation/hypnosis in C57BL/6J after exposure to chronic stress exposure. Current data demonstrate that with the exception of MK-801 and haloperidol, the compounds tested had either no significant or assay-selective effects on sensitivity to acute ethanol under baseline conditions in C57BL/6J. However, significant effects of topiramate were revealed as a function of co-treatment with an NMDAR blocker, genetic background, or prior stress history. These findings raise the possibility that topiramate and possibly other anti-glutamatergic drugs could promote the acute intoxicating effects of ethanol in specific subpopulations defined by genetics or life history.
目前临床上用于各种适应症(如阿尔茨海默病、癫痫、精神病、情绪障碍)的具有抗谷氨酸能特性的化合物,具有作为酒精中毒新疗法的潜在效用。对酒精某些急性中毒作用(共济失调、镇静)的敏感性增强可能是抗谷氨酸能药物调节酒精使用的一种机制。我们研究了六种化合物(美金刚、右美沙芬、氟哌啶醇、拉莫三嗪、奥卡西平和托吡酯)对C57BL/6J小鼠对乙醇急性中毒作用(共济失调、体温过低、镇静/催眠)的敏感性的影响。对托吡酯的分析进行了扩展,以确定遗传背景(通过比较129S1、BALB/cJ、C57BL/6J、DBA/2J近交系)和既往应激史(通过将C57BL/6J长期暴露于游泳应激)对托吡酯对乙醇诱导的镇静/催眠作用的影响。结果表明,一种N-甲基-D-天冬氨酸受体(NMDAR)拮抗剂美金刚,但另一种右美沙芬则不然,增强了乙醇的共济失调作用,但没有增强体温过低或镇静/催眠作用。氟哌啶醇增加乙醇诱导的共济失调和镇静/催眠作用的程度与典型的NMDAR拮抗剂MK-801相似。在所测试的抗惊厥药中,拉莫三嗪增强了乙醇诱导的镇静/催眠作用,而奥卡西平则无作用。在C57BL/6J小鼠的基线条件下,托吡酯本身无作用,但与MK-801对乙醇诱导的镇静/催眠作用有协同作用。比较近交系发现,托吡酯在BALB/cJ小鼠中显著增强了乙醇的镇静/催眠作用,但在129S1、C57BL/6J或DBA/2J小鼠中则不然。在长期应激暴露后,托吡酯也增加了C57BL/6J小鼠中乙醇诱导的镇静/催眠作用。目前的数据表明,除MK-801和氟哌啶醇外,在所测试的化合物中,在C57BL/6J小鼠的基线条件下,对急性乙醇敏感性要么没有显著影响,要么具有检测选择性作用。然而,托吡酯的显著作用表现为与NMDAR阻滞剂联合治疗、遗传背景或既往应激史的函数。这些发现增加了一种可能性,即托吡酯以及可能的其他抗谷氨酸能药物可能会在由遗传学或生活史定义的特定亚群中促进乙醇的急性中毒作用。