Warner-Schmidt Jennifer, Pittenger Christopher, Stogniew Martin, Mandell Blake, Olmstead Sarah J, Kelmendi Benjamin
Transcend Therapeutics, New York, NY, United States.
Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.
Front Psychiatry. 2023 Jan 10;13:1041277. doi: 10.3389/fpsyt.2022.1041277. eCollection 2022.
Selective serotonin reuptake inhibitor (SSRI) antidepressants represent first-line pharmacological treatment for a variety of neuropsychiatric illnesses, including major depressive disorder (MDD), anxiety, and post-traumatic stress disorder (PTSD), which show high rates of comorbidity. SSRIs have a delayed onset of action. Most patients do not show significant effects until 4-8 weeks of continuous treatment, have impairing side effects and as many as 40% of patients do not respond. Methylone (3,4-methylenedioxy--methylcathinone; MDMC, βk-MDMA, M1) is a rapid-acting entactogen that showed significant benefit in a clinical case series of PTSD patients and was well-tolerated in two Phase 1 studies of healthy volunteers. Based on these early observations in humans, in the current study we tested the hypothesis that methylone has antidepressant-like and anxiolytic effects in preclinical tests.
For all studies, 6-8-week-old male Sprague Dawley rats ( = 6-16) were used. We employed the Forced Swim Test (FST), a classic and widely used screen for antidepressants, to explore the effects of methylone and to probe dose-response relationships, durability of effect, and potential interactions with combined SSRI treatment. We compared the effect of methylone with the prototypical SSRI fluoxetine.
Three doses of fluoxetine (10 mg/kg) given within 24 h before FST testing caused a 50% reduction in immobility compared with controls that lasted less than 24 h. In contrast, a single dose of methylone (5-30 mg/kg) administered 30 min prior to testing produced a rapid, robust, and durable antidepressant-like response in the FST, greater in magnitude than fluoxetine. Immobility was reduced by nearly 95% vs. controls and effects persisted for at least 72 h after a single dose (15 mg/kg). Effects on swimming and climbing behavior in the FST, which reflect serotonergic and noradrenergic activity, respectively, were consistent with studies showing that methylone is less serotoninergic than MDMA. Fluoxetine pretreatment did not change methylone's antidepressant-like effect in the FST, suggesting the possibility that the two may be co-administered. In addition, methylone (5-30 mg/kg) exhibited anxiolytic effects measured as increased time spent in the center of an open field.
Taken together, and consistent with initial clinical findings, our study suggests that methylone may have potential for treating depression and anxiety.
选择性5-羟色胺再摄取抑制剂(SSRI)类抗抑郁药是多种神经精神疾病的一线药物治疗手段,这些疾病包括重度抑郁症(MDD)、焦虑症和创伤后应激障碍(PTSD),它们的共病率很高。SSRI起效延迟。大多数患者在连续治疗4 - 8周之前不会表现出显著疗效,还会有不良副作用,多达40%的患者无反应。3,4-亚甲基二氧基甲基卡西酮(甲酮;MDMC、βk - MDMA、M1)是一种速效致幻剂,在PTSD患者的临床病例系列中显示出显著疗效,并且在两项针对健康志愿者的1期研究中耐受性良好。基于这些在人体上的早期观察结果,在本研究中我们检验了甲酮在临床前试验中具有抗抑郁样和抗焦虑作用的假设。
对于所有研究,使用6 - 8周龄的雄性斯普拉格 - 道利大鼠(n = 6 - 16)。我们采用强迫游泳试验(FST),这是一种经典且广泛用于筛选抗抑郁药的试验,以探究甲酮的作用并研究剂量 - 反应关系、效应的持续性以及与联合使用SSRI治疗的潜在相互作用。我们将甲酮的作用与典型的SSRI氟西汀进行了比较。
在FST测试前24小时内给予三次剂量的氟西汀(10毫克/千克),与对照组相比,不动时间减少了50%,但持续时间不到24小时。相比之下,在测试前30分钟给予单次剂量的甲酮(5 - 30毫克/千克)在FST中产生了快速、强烈且持久的抗抑郁样反应,其强度大于氟西汀。与对照组相比,不动时间减少了近95%,单次剂量(15毫克/千克)后效应持续至少72小时。FST中对游泳和攀爬行为的影响分别反映了5-羟色胺能和去甲肾上腺素能活性,这与表明甲酮的5-羟色胺能比MDMA弱的研究结果一致。氟西汀预处理并未改变甲酮在FST中的抗抑郁样作用,这表明两者可能可以联合使用。此外,甲酮(5 - 30毫克/千克)表现出抗焦虑作用,表现为在旷场中央停留时间增加。
综上所述,与最初的临床研究结果一致,我们的研究表明甲酮可能具有治疗抑郁症和焦虑症的潜力。