Development Research Laboratories, Research Division, Kyowa Hakko Kirin Co., Ltd., Shizuoka, Japan.
Pharmacol Biochem Behav. 2013 Dec;114-115:23-30. doi: 10.1016/j.pbb.2013.10.022. Epub 2013 Nov 4.
Depression is common in Parkinson's disease (PD) but its response to classical antidepressants is not clear. The adenosine A2A antagonist istradefylline is effective in the treatment of the motor symptoms of PD but inhibition of the adenosine A2A receptor may also induce antidepressant-like effects.
We have investigated whether istradefylline might be effective in treating depression in PD using the forced swimming test (FST) and the tail suspension test (TST) in rodents.
Istradefylline significantly decreased immobility time in the FST in both rats and mice (0.16mg/kg and higher) with comparable efficacy to an equivalent dose of the tricyclic antidepressants, desipramine and imipramine. Both 8-OH-DPAT (5-HT1A agonist) and quinpirole (D2 agonist) also reduced the immobility time. The istradefylline-induced reduction of immobility time was attenuated by corticosterone. In addition, the combined use of a sub-threshold dose of istradefylline and the serotonin-noradrenaline reuptake inhibitor venlafaxine ameliorated depression-like behavior in the mouse FST. In the mouse TST, istradefylline (0.08mg/kg and higher) decreased immobility time. Moreover, co-administration of istradefylline with paroxetine or fluoxetine (selective serotonin reuptake inhibitors) or deprenyl (MAO-B inhibitor) at doses that did not show antidepressant-like effects when administered alone, resulted in a significant reduction in immobility time.
Istradefylline alone or co-administered with currently available antidepressants, may be useful for the treatment of depression as well as motor symptoms of PD. Its effects might be, at least in part, attributable to modulation of hypothalamic-pituitary-adrenal axis.
抑郁症在帕金森病(PD)中很常见,但对经典抗抑郁药的反应尚不清楚。腺苷 A2A 拮抗剂伊曲茶碱在治疗 PD 的运动症状方面有效,但抑制腺苷 A2A 受体也可能诱导抗抑郁样作用。
我们通过在啮齿动物中进行强迫游泳试验(FST)和悬尾试验(TST),研究伊曲茶碱是否可能对 PD 中的抑郁有效。
伊曲茶碱(0.16mg/kg 及更高剂量)可显著降低 FST 中大鼠和小鼠的不动时间,疗效与三环类抗抑郁药等效,如去甲丙咪嗪和丙咪嗪。5-HT1A 激动剂 8-OH-DPAT 和 D2 激动剂喹吡罗也降低了不动时间。皮质酮可减弱伊曲茶碱诱导的不动时间减少。此外,阈下剂量的伊曲茶碱与 5-羟色胺-去甲肾上腺素再摄取抑制剂文拉法辛联合使用可改善小鼠 FST 中的抑郁样行为。在小鼠 TST 中,伊曲茶碱(0.08mg/kg 及更高剂量)降低了不动时间。此外,当单独使用时,伊曲茶碱与帕罗西汀或氟西汀(选择性 5-羟色胺再摄取抑制剂)或deprenyl(MAO-B 抑制剂)联合使用时,不会产生抗抑郁样作用,但剂量增加时,可显著减少不动时间。
伊曲茶碱单独使用或与现有的抗抑郁药联合使用,可能对治疗 PD 的运动症状和抑郁都有用。其作用至少部分归因于对下丘脑-垂体-肾上腺轴的调节。