Boyda Heidi N, Ho Amanzo A, Tse Lurdes, Procyshyn Ric M, Yuen Jessica W Y, Kim David D, Honer William G, Barr Alasdair M
Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Front Psychiatry. 2020 Dec 1;11:617428. doi: 10.3389/fpsyt.2020.617428. eCollection 2020.
Antipsychotic drugs represent the most effective treatment for chronic psychotic disorders. The newer second generation drugs offer the advantage of fewer neurological side-effects compared to prior drugs, but many cause serious metabolic side-effects. The underlying physiology of these side-effects is not well-understood, but evidence exists to indicate that the sympathetic nervous system may play an important role. In order to examine this possibility further, we treated separate groups of adult female rats acutely with either the first generation antipsychotic drug haloperidol (0.1 or 1 mg/kg) or the second generation drugs risperidone (0.25 or 2.5 mg/kg), clozapine (2 or 20 mg/kg), olanzapine (3 or 15 mg/kg) or vehicle by intraperitoneal injection. Blood samples were collected prior to drug and then 30, 60, 120, and 180 mins after treatment. Plasma samples were assayed by HPLC-ED for levels of norepinephrine, epinephrine, and dopamine. Results confirmed that all antipsychotics increased peripheral catecholamines, although this was drug and dose dependent. For norepinephrine, haloperidol caused the smallest maximum increase (+158%], followed by risperidone (+793%), olanzapine (+952%) and clozapine (+1,684%). A similar pattern was observed for increases in epinephrine levels by haloperidol (+143%], olanzapine (+529%), risperidone (+617%) then clozapine (+806%). Dopamine levels increased moderately with olanzapine [+174%], risperidone [+271%], and clozapine [+430%]. Interestingly, levels of the catecholamines did not correlate strongly with each other prior to treatment at baseline, but were increasingly correlated after treatment as time proceeded. The results demonstrate antipsychotics can potently regulate peripheral catecholamines, in a manner consistent with their metabolic liability.
抗精神病药物是治疗慢性精神障碍最有效的方法。与先前的药物相比,新一代的第二代药物具有神经副作用较少的优点,但许多药物会引起严重的代谢副作用。这些副作用的潜在生理机制尚未完全了解,但有证据表明交感神经系统可能起重要作用。为了进一步研究这种可能性,我们通过腹腔注射分别用第一代抗精神病药物氟哌啶醇(0.1或1mg/kg)或第二代药物利培酮(0.25或2.5mg/kg)、氯氮平(2或20mg/kg)、奥氮平(3或15mg/kg)或赋形剂急性处理成年雌性大鼠组。在给药前以及治疗后30、60、120和180分钟采集血样。通过高效液相色谱-电化学检测法测定血浆样品中去甲肾上腺素、肾上腺素和多巴胺的水平。结果证实,所有抗精神病药物均增加外周儿茶酚胺,尽管这取决于药物和剂量。对于去甲肾上腺素,氟哌啶醇引起的最大增加最小(+158%),其次是利培酮(+793%)、奥氮平(+952%)和氯氮平(+1684%)。氟哌啶醇(+143%)、奥氮平(+529%)、利培酮(+617%)然后氯氮平(+806%)引起的肾上腺素水平升高也观察到类似模式。奥氮平(+174%)、利培酮(+271%)和氯氮平(+430%)使多巴胺水平适度升高。有趣的是,在基线治疗前,儿茶酚胺水平彼此之间没有很强的相关性,但随着时间的推移,治疗后相关性越来越强。结果表明,抗精神病药物可以有效地调节外周儿茶酚胺,其方式与其代谢负担一致。