Johnson A M
Beecham Pharmaceuticals Research Division, Medicinal Research Centre, Harlow, Essex, United Kingdom.
Acta Psychiatr Scand Suppl. 1989;350:14-20. doi: 10.1111/j.1600-0447.1989.tb07161.x.
Animal studies show that paroxetine is a potent and selective inhibitor of 5-hydroxytryptamine (5-HT) neuronal uptake. It shows excellent activity after oral administration, and pharmacological studies on its principal metabolites indicate that they are much less active than the parent compound. Paroxetine possesses no overt sedative or antihistaminergic properties and it does not potentiate the effects of alcohol. Weak activating properties are observed in EEG studies in animals at doses generally greater than those required to inhibit 5-HT uptake in the CNS, and the activated EEG in rats is associated with slight locomotor stimulation. However, specific studies indicate that this activation is not amphetamine-like. Paroxetine does not inhibit monoamine oxidase in vitro. Paroxetine is well tolerated by the cardiovascular system, being qualitatively and quantitatively less cardiotoxic than amitriptyline. The weak affinity of paroxetine for muscarinic cholinergic receptors in vitro is associated with mydriasis in vivo, but only at doses well in excess of those required to potentiate the effects of 5-HT in the CNS. It is therefore concluded that paroxetine should be an effective antidepressant with a reduced propensity to induce the adverse events that are characteristic of the tricyclic class of antidepressants.
动物研究表明,帕罗西汀是一种强效且选择性的5-羟色胺(5-HT)神经元摄取抑制剂。口服给药后它显示出优异的活性,对其主要代谢物的药理学研究表明,它们的活性远低于母体化合物。帕罗西汀没有明显的镇静或抗组胺特性,也不会增强酒精的作用。在动物的脑电图研究中,在通常高于抑制中枢神经系统中5-HT摄取所需剂量的情况下观察到微弱的激活特性,并且大鼠的激活脑电图与轻微的运动刺激有关。然而,具体研究表明这种激活并非类似苯丙胺的作用。帕罗西汀在体外不抑制单胺氧化酶。帕罗西汀在心血管系统中耐受性良好,在定性和定量上比阿米替林的心脏毒性更小。帕罗西汀在体外对毒蕈碱胆碱能受体的弱亲和力与体内瞳孔散大有关,但仅在远高于增强中枢神经系统中5-HT作用所需的剂量时才会出现。因此可以得出结论,帕罗西汀应该是一种有效的抗抑郁药,诱发三环类抗抑郁药所特有的不良事件的倾向较低。