Tricyclic antidepressants: long-term treatment increases responsivity of rat forebrain neurons to serotonin

Effects of chronic desipramine treatment on rat brain noradrenergic responses to alpha-adrenergic drugs

It has been previously reported that long-term tricyclic antidepressant treatment in the rat causes a subsensitivity of central beta-receptor-stimulated adenylate cyclase along with alterations of brain norepinephrine (NE) content and metabolism. We have confirmed earlier findings that after one week of desipramine treatment (5.0 mg/kg b.i.d.) brain NE levels decline while NE metabolism is similar to control animals, but is above control after 12 days of treatment. Single cell recordings from noradrenergic neurons of the locus coeruleus (LC) show that after one week of desipramine treatment, neuronal firing rate is lower than in control rats but greater than that seen in response to acutely administered drug. Furthermore, desipramine injection in a dose which profoundly altered LC impulse flow in control rats produced little or no effect on impulse flow in chronically treated rats. Of 25 or 250 microgram/kg doses of clonidine, which are equieffective for decreasing brain NE metabolism in control animals, only the larger dose decreased NE metabolism in 12 day desipramine-treated rats. The postsynaptic alpha-antagonist prazosin (5.0 mg/kg) increased NE metabolism in both groups. These results suggest that presynaptic (alpha 2) adrenoreceptors become subsensitive during long-term desipramine treatment, thus allowing recovery of noradrenergic impulse flow in the presence of NE uptake inhibition.

Differential effects of antidepressant treatment on brain monoaminergic receptors

Chronic (21 days) antidepressant administration to rats results in a decrease in both serotonin and beta-adrenergic, but not cholinergic muscarinic, receptor binding in selected brain regions, with the frontal cortex appearing to be somewhat more sensitive to this effect. Neither nisoxetine nor fluoxetine, potent and specific inhibitors of norepinephrine and serotonin uptake respectively, caused receptor binding changes after chronic administration, suggesting that inhibition of transmitter uptake, in itself, is insufficient to cause receptor subsensitivity. In vitro experiments indicated that antidepressants are relatively weak alpha 2-receptor blocking agents, but some are potent on the alpha 1-receptor system indicating that the norepinephrine releasing potency of some antidepressants may not be mediated by blockade of presynaptic autoreceptors.

Enhancement of 5-hydroxytryptamine-induced behavioral effects following chronic administration of antidepressant drugs

It has been shown recently that chronic administration of tricyclic antidepressant drugs results in enhanced responsiveness of neurones to iontophoretically applied 5-hydroxytryptamine (5-HT) in rat forebrain regions. The present investigation tested whether this efect is accompanied by an enhancement of behavioral effects of the amine. Behavioral signs of sleep in young chicks following systemic administration of 5-HT were used as an index of the acion of the amine at central receptor sites. Imipramine, desipramine, amitryptiline, pizotifen, and mianserin given 30 min before 5-HT all reduced the duration of 5-HT-induced behavioral depression. However, 6-8 day pretreatment with the same drugs resulted in an increased duration of the 5-HT-induced depression. The results suggest that the antidepressant drugs can block 5-HT receptors in the central nervous system (CNS) and that chronic blockade resulting from repeated administration of the drugs results in an increase in number or sensitivity of 5-HT receptors.

Phase advance of the circadian sleep-wake cycle as an antidepressant

Sleep in depressed patients resembles sleep in normal subjects whose circadian rhythms of temperature and rapid-eye-movement sleep are phase-advanced (shifted earlier) relative to their sleep schedules. If this analogy is relevant to the pathophysiology of depressive illness, advancing the time of sleep and awakening should temporarily compensate for the abnormal timing of depressed patients' circadian rhythms. Four of seven manic-depressive patients studied longitudinally spontaneously advanced their times of awakening (activity onset) as they emerged from the depressive phase of their illness. In a phase-shift experiment, a depressed manic-depressive woman was twice brought out of depression for 2 weeks by advancing her sleep period so that she went to sleep and arose 6 hours earlier than usual. The antidepressant effect of the procedure was temporary and similar in duration to circadian desynchronization induced by jet lag in healthy subjects. This result supports the hypothesis that abnormalities of sleep patterns in some types of depression are due to abnormal internal phase relationships of circadian rhythms.

Modulation of dopamine-mediated behavioural responses by antidepressants: effects of single and repeated treatment

The study concerned the effects of maprotiline, imipramine, clomipramine and amitriptyline on the stereotyped and turning behaviour induced by apomorphine in rats. At either single or repeated doses of 25 mg/kg i.p. neither maprotiline nor imipramine changed the stereotyped responses induced by apomorphine. Clomipramine showed in contrast an inhibitory effect which increased after 7 daily injections of the drug. Moderate suppression of stereotypies was also observed after repeated administration of amitriptyline. In rats with unilateral 6-OHDA lesions of the s.nigra apomorphine-induced contralateral turning was markedly suppressed (70%) after a single 25 mg/kg i.p. injection of maprotiline. A tolerance to this effect developed after 7 daily injections of the drug. Clomipramine and amitriptyline caused an inhibition of turning which was markedly increased after repeated treatment. These results suggest that antidepressants do not uniformly affect the behavioural responses mediated by dopamine. Clomipramine and amitriptyline appear to possess dopamine receptor blocking properties which may become more pronounced after chronic treatment. In contrast, the dopamine receptor blockade by maprotiline diminished and disappeared under such conditions. Among the drugs investigated imipramine was the one which seemed to have the weakest influence on dopaminergic receptors.

The effects of chronic treatment with the 5-hydroxytryptamine uptake blocker zimelidine on central 5-hydroxytryptamine mechanisms. Evidence for the induction of a low affinity binding site for 5-hydroxytryptamine

Male rats were treated with saline or the 5-hydroxytryptamine (5-HT) uptake inhibitor zimelidine (10 mumol/kg postoperatively) twice daily for a period of 14 days. The effects of this treatment on [5-3H]HT binding in the cerebral cortex and hypothalamus and on 5-HT synthesis were examined. Long-term treatment with zimelidine induced a low affinity site for 5-HT (Kd approximately 20 nM) in both areas and a reduced number of high affinity binding sites in the hypothalamus. Long-term zimelidine treatment did not attenuate the feed-back mediated inhibition of 5-HT synthesis. These findings suggest that chronic zimelidine treatment could result in a reduced activity at postsynaptic 5-HT receptor sites.

Failure of chronic lithium treatment to block tricyclic antidepressant-induced 5-HT supersensitivity

The ability of chronic lithium administration to modify tricylic antidepressant-induced supersensitivity development in cells receiving 5-hydroxytryptamine (5-HT) input was investigated using microiontophoretic techniques. In these experiments, chronic chlorimipramine (or imipramine) administration for a period of 14 days resulted in a 5-fold increase in the sensitivity of hippocampal pyramidal cells to iontophoretically applied 5-HT. This supersensitivity was not blocked by the concurrent administration of lithium. The data suggests that blockade of supersensitivity development by lithium as previously demonstrated in the dopamine system may not be generalized to all central amine systems.

Reevaluation of the indoleamine hypothesis of depression. Evidence for a reduction of functional activity of central 5-HT systems by antidepressant drugs

The effects of antidepressant drugs on central 5-HT receptor activity were studied in rats and mice. Antidepressant drugs were evaluated for their ability to displace 3H-5-HT and 3H-d-LSD from membrane binding sites in the dorsal neocortex of rats in vitro and for their ability to block 5-HTP and d-LSD induced behavioral effects in mice. The degree of blockade of head-twitches in mice produced by the antidepressants was highly correlated with their affinity for 3H-d-LSD binding sites. A number of antidepressant drugs such as amitriptyline, nortriptyline, mianserine, doxepine, nomifensine and dibenzepine appear to possess marked 5-HT receptor blocking activity at some type of 5-HT receptors in brain. New antidepressant drugs such as zimelidine, which specifically inhibit 5-HT reuptake and do not block 5-HT receptor sites, may after chronic treatment also reduce the functional activity of 5-HT systems by producing adaptive changes in postsynaptic 5-HT mechanisms. Thus, a new indoleamine hypothesis of depression is presented: the therapeutic action of antidepressant drugs may in part be due to a reduced functional acitivity of some central 5-HT systems.