Gallager D W, Lakoski J M, Gonsalves S F, Rauch S L
Nature. 1984;308(5954):74-7. doi: 10.1038/308074a0.
Benzodiazepines exert most of their pharmacological effects by a selective facilitation of the postsynaptic actions of GABA. Clinical, behavioural and electrophysiological studies have shown reduced drug response following chronic benzodiazepine administration. We present here electrophysiological evidence for decreased postsynaptic sensitivity to GABA following chronic benzodiazepine administration as measured by the direct iontophoretic application of GABA and serotonin onto serotonergic cells in the midbrain dorsal raphe nucleus (DRN), known to receive GABAergic input. The subsensitivity to GABA was found to be dose dependent and was seen when diazepam administration was three weeks or longer. Further, acute injection of the specific benzodiazepine antagonist, Ro15-1788, was found to reverse rapidly the decrease in GABA sensitivity observed in chronically diazepam-treated animals without altering GABA sensitivity in vehicle-treated rats. Decreased response to chronic benzodiazepines does not appear to be consistently related to alterations in the number or affinity of receptors for benzodiazepines. Our studies of radioligand-binding showed a decrease in the ability of GABA to enhance benzodiazepine binding in cerebral cortical membranes from chronic diazepam-treated animals without significant changes in benzodiazepine binding site density or affinity.
苯二氮䓬类药物的大部分药理作用是通过选择性促进γ-氨基丁酸(GABA)的突触后作用来实现的。临床、行为学和电生理学研究表明,长期服用苯二氮䓬类药物后药物反应会降低。我们在此展示电生理学证据,即通过将GABA和5-羟色胺直接离子导入中脑背侧缝际核(DRN)中的5-羟色胺能细胞(已知该细胞接受GABA能输入)来测量,长期服用苯二氮䓬类药物后对GABA的突触后敏感性降低。发现对GABA的敏感性降低呈剂量依赖性,且当给予地西泮三周或更长时间时即可观察到。此外,发现急性注射特异性苯二氮䓬拮抗剂Ro15 - 1788可迅速逆转在长期接受地西泮治疗的动物中观察到的GABA敏感性降低,而不改变用赋形剂处理的大鼠的GABA敏感性。对长期苯二氮䓬类药物反应降低似乎与苯二氮䓬类药物受体数量或亲和力的改变并无一致关联。我们的放射性配体结合研究表明,在长期接受地西泮治疗的动物的大脑皮质膜中,GABA增强苯二氮䓬类药物结合的能力降低,而苯二氮䓬类药物结合位点密度或亲和力无显著变化。