Heintz R, Casey D E
Department of Psychiatry, Oregon Health Sciences University, Portland.
Psychopharmacology (Berl). 1987;93(2):207-13. doi: 10.1007/BF00179935.
The neuropharmacologic mechanisms underlying neuroleptic-induced extrapyramidal syndromes (EPS) were studied using a nonhuman primate model. Twenty-six Cebus albifrons monkeys were given weekly challenges of haloperidol (0.025 mg/kg IM), and half of the animals received the monoamine oxidase (MAO) inhibitor pargyline (5 mg/kg PO) daily for 17 consecutive days during the protocol. Pargyline caused no changes in baseline behaviors, but significantly reduced haloperidol-induced acute dystonia (AD) (-67%, P less than 0.002) and parkinsonism (-56%, P less than 0.005). The majority (8 of 13) of the experimental group had complete prevention of neuroleptic-induced EPS during cotreatment with pargyline. Behavioral scores returned to baseline levels after stopping pargyline, and did not show the further sensitization to haloperidol-induced AD that occurred in the control group. The possible mechanisms by which an MAO inhibitor might influence neuroleptic-induced AD were considered. The most likely explanation would appear to involve facilitation of striatal dopamine (DA) neurotransmission by inhibition of intra- and extraneuronal MAO, thus supporting the hypothesis that AD is due to decreased striatal DA function with secondary cholinergic hyperfunction.
使用非人类灵长类动物模型研究了抗精神病药物所致锥体外系综合征(EPS)的神经药理学机制。给26只白额卷尾猴每周注射氟哌啶醇(0.025mg/kg,肌肉注射),在实验过程中,一半动物连续17天每天口服单胺氧化酶(MAO)抑制剂帕吉林(5mg/kg)。帕吉林对基线行为无影响,但显著降低了氟哌啶醇所致的急性肌张力障碍(AD)(-67%,P<0.002)和帕金森综合征(-56%,P<0.005)。实验组的大多数动物(13只中的8只)在与帕吉林联合治疗期间完全预防了抗精神病药物所致的EPS。停用帕吉林后行为评分恢复到基线水平,且未表现出对照组中出现的对氟哌啶醇所致AD的进一步敏感化。探讨了MAO抑制剂可能影响抗精神病药物所致AD的机制。最可能的解释似乎是通过抑制神经元内和神经元外的MAO来促进纹状体多巴胺(DA)神经传递,从而支持了AD是由于纹状体DA功能降低继发胆碱能功能亢进的假说。