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选择性5-羟色胺再摄取抑制剂长期给药后5-羟色胺系统的适应性动力学:一项荟萃分析。

Adaptive dynamics of the 5-HT systems following chronic administration of selective serotonin reuptake inhibitors: a meta-analysis.

作者信息

Fritze Stefan, Spanagel Rainer, Noori Hamid R

机构信息

Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

Neuronal Convergence Group, Max Planck Institute for Biological Cybernetics, Tübingen, Germany.

出版信息

J Neurochem. 2017 Sep;142(5):747-755. doi: 10.1111/jnc.14114. Epub 2017 Jul 14.

Abstract

Selective serotonin reuptake inhibitors (SSRIs) are the most frequently prescribed antidepressants. However, a major concern is their delayed onset of action, which is hypothesized to be associated with the time required for serotonin (5-HT) autoreceptors to desensitize, which should be reflected by actual neurochemical changes. Numerous in vivo microdialysis studies have been published that report on 5-HT levels in different brain sites following SSRI administration. Here, we performed a meta-analysis on dynamic changes of 5-HT neurotransmission during the course of chronic SSRI treatment. We conducted a meta-analysis on research articles of 5-HT neurotransmission measured by in vivo microdialysis in rat brain after subchronic and chronic SSRI administrations. In total, data from 42 microdialysis studies (798 rats) were analyzed. Within the first week of SSRI treatment, extracellular 5-HT concentrations drop in frontal cortex. Over the next 2 weeks of treatment, a linear increase in extracellular 5-HT levels up to 350% of prior treatment baseline is evident (n = 269). However, in hippocampus, prefrontal cortex, nucleus accumbens, and ventral tegmental area we found increased 5-HT levels within the first 3 days of SSRI administration. The time course of 5-HT dynamics in frontal cortex is in line with the hypothesis that 5-HT autoreceptors desensitize over 2-3 weeks of SSRI treatment and thereby enhanced extracellular 5-HT levels ensue. Yet, in other regions we did not find evidence supporting the traditional autoreceptor-mediated feedback loops hypothesis and thus other neurobiological adaptation mechanisms may also play a role in the delayed onset of SSRI action.

摘要

选择性5-羟色胺再摄取抑制剂(SSRIs)是最常被处方的抗抑郁药。然而,一个主要问题是它们起效延迟,据推测这与5-羟色胺(5-HT)自身受体脱敏所需的时间有关,这应该通过实际的神经化学变化来体现。已经发表了大量的体内微透析研究,报道了服用SSRI后不同脑区的5-HT水平。在此,我们对慢性SSRI治疗过程中5-HT神经传递的动态变化进行了荟萃分析。我们对亚慢性和慢性给予SSRI后大鼠脑中通过体内微透析测量的5-HT神经传递的研究文章进行了荟萃分析。总共分析了来自42项微透析研究(798只大鼠)的数据。在SSRI治疗的第一周内,额叶皮质的细胞外5-HT浓度下降。在接下来的2周治疗中,细胞外5-HT水平呈线性增加,最高可达先前治疗基线的350%(n = 269)。然而,在海马体、前额叶皮质、伏隔核和腹侧被盖区,我们发现给予SSRI后的头3天内5-HT水平升高。额叶皮质中5-HT动态变化的时间进程与以下假设一致,即5-HT自身受体在SSRI治疗的2 - 3周内脱敏,从而导致细胞外5-HT水平升高。然而,在其他区域,我们没有找到支持传统自身受体介导的反馈回路假设的证据,因此其他神经生物学适应机制可能也在SSRI作用起效延迟中发挥作用。

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