Skolnick Phil, Kos Tomasz, Czekaj Janusz, Popik Piotr
1Division of Pharmacotherapies & Medical Consequences of Drug Abuse,NIDA,NIH,Bethesda,MD,USA.
2Behavioral Neuroscience and Drug Development Institute of Pharmacology,Polish Academy of Sciences,Kraków,Poland.
Acta Neuropsychiatr. 2015 Aug;27(4):228-34. doi: 10.1017/neu.2015.14. Epub 2015 Apr 10.
OBJECTIVE: The N-methyl-d-aspartate receptor (NMDAR) antagonist ketamine, produces rapid and enduring antidepressant effect in patients with treatment-resistant depression. Similar dramatic effects have not been observed in clinical trials with other NMDAR antagonists indicating ketamine may possess unique pharmacological properties. Tetrabenazine induces ptosis (a drooping of the eyelids), and the reversal of this effect, attributed to a sympathomimetic action, has been used to detect first-generation antidepressants, as well as ketamine. Because the actions of other NMDAR antagonists have not been reported in this measure, we examined whether reversal of tetrabenazine-induced ptosis was unique to ketamine, or a class effect of NMDAR antagonists. METHODS: The effects of ketamine and other NMDAR antagonists to reverse tetrabenazine-induced ptosis were examined and compared with their antidepressant-like effects in the tail suspension test (TST) in mice. RESULTS: All the NMDAR antagonists tested produced a partial reversal of tetrabenazine-induced ptosis and, as expected, reduced immobility in the TST. Ketamine, memantine, MK-801 and AZD6765 were all about half as potent in reversing tetrabenazine-induced ptosis compared to reducing immobility in the TST, while an NR2B antagonist (Ro 25-6981) and a glycine partial agonist (ACPC) were equipotent in both tests. CONCLUSION: The ability to reverse tetrabenazine-induced ptosis is a class effect of NMDAR antagonists. These findings are consistent with the hypothesis that the inability of memantine, AZD6765 (lanicemine) and MK-0657 to reproduce the rapid and robust antidepressant effects of ketamine in the clinic result from insufficient dosing rather than a difference in mechanism of action among these NMDAR antagonists.
目的:N-甲基-D-天冬氨酸受体(NMDAR)拮抗剂氯胺酮可在难治性抑郁症患者中产生快速且持久的抗抑郁作用。在其他NMDAR拮抗剂的临床试验中未观察到类似的显著效果,这表明氯胺酮可能具有独特的药理特性。丁苯那嗪可诱发上睑下垂(眼睑下垂),而这种作用的逆转归因于拟交感神经作用,已被用于检测第一代抗抑郁药以及氯胺酮。由于尚未有其他NMDAR拮抗剂在此检测方法中的作用报道,我们研究了丁苯那嗪诱发的上睑下垂的逆转是氯胺酮所特有的,还是NMDAR拮抗剂的类效应。 方法:研究并比较了氯胺酮和其他NMDAR拮抗剂逆转丁苯那嗪诱发的上睑下垂的作用及其在小鼠悬尾试验(TST)中的类抗抑郁作用。 结果:所有测试的NMDAR拮抗剂均能部分逆转丁苯那嗪诱发的上睑下垂,并且正如预期的那样,减少了TST中的不动时间。与减少TST中的不动时间相比,氯胺酮、美金刚、MK-801和AZD6765在逆转丁苯那嗪诱发的上睑下垂方面的效力均约为一半,而NR2B拮抗剂(Ro 25-6981)和甘氨酸部分激动剂(ACPC)在两项试验中的效力相当。 结论:逆转丁苯那嗪诱发的上睑下垂的能力是NMDAR拮抗剂的类效应。这些发现与以下假设一致,即美金刚、AZD6765(拉尼西明)和MK-0657在临床上无法重现氯胺酮快速且强大的抗抑郁作用是由于给药不足,而非这些NMDAR拮抗剂作用机制的差异。
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