Single and repeated administration of neuroleptic drugs to rats: effects on striatal dopamine-sensitive adenylate cyclase and locomotor activity produced by tranylcypromine and L-tryptophan or L-Dopa

Review of the pharmacology and clinical pharmacology of 3,4-methylenedioxymethamphetamine (MDMA or "Ecstasy")

3,4-Methylenedioxymethamphetamine (MDMA or "Ecstasy") was first synthesised 80 years ago, but has recently received prominence as an illegally synthesised recreational drug of abuse. There is a widely held belief among misusers that it is safe. In the last 2-3 years there have been a number of reports of the drug producing severe acute toxicity and death and there are concerns that it may cause long term toxic damage to 5-hydroxytryptamine (5-HT) nerve terminals. There is a considerable literature on the acute pharmacological effects of MDMA in experimental animals, and this is reviewed. The drug produces both hyperthermia and the "serotonin syndrome", a series of behavioural changes which result from increased 5-HT function. Acute clinical toxicity problems following MDMA ingestion also include hyperthermia and the appearance of the serotonin syndrome. The hyperthermia appears to precipitate other severe clinical problems and the outcome can be fatal. In agreement with others, we suggest that the recent increase in the number of reports of MDMA toxicity probably results from the widespread use of the drug at all night dance parties or "raves". The phenomenon of amphetamine aggregation toxicity in mice was reported 40 years ago. If applicable to MDMA-induced toxicity in humans, all the conditions necessary to induce or enhance toxicity are present at raves: crowded conditions (aggregation), high ambient temperature, loud noise and dehydrated subjects. Administration of MDMA to rodents and non-human primates results in a long term neurotoxic decrease in 5-HT content in several brain regions and there is clear biochemical and histological evidence that this reflects neurodegeneration of 5-HT terminals. Unequivocal data demonstrating that similar changes occur in human brain do not exist, but limited and indirect clinical evidence gives grounds for concern. There are also data suggesting that long term psychiatric changes can occur, although there are problems of interpretation and these are reviewed. Suggestions for the rational treatment of the acute toxicity are made on the basis of both pharmacological studies in animals and current clinical practice. Cases presenting clinically are usually emergencies and unlikely to allow carefully controlled studies. Proposals include decreasing body temperature (possibly with ice), the use of dantrolene and anticonvulsant and sedative medication, particularly benzodiazepines. The use of neuroleptics requires care because of the theoretical risk of producing the neuroleptic malignant syndrome and the possibility of precipitating seizures. In rats, chlormethiazole antagonises the hyperthermia produced by MDMA and has been shown clinically to block MDMA-induced convulsive activity.

Clozapine's functional mesolimbic selectivity is not duplicated by the addition of anticholinergic action to haloperidol: a brain stimulation study in the rat

This study examined whether the anticholinergic potency of the clinically superior antipsychotic drug clozapine contributes to clozapine's anatomically-selective functional inhibition of the mesolimbic dopamine (DA) system, using an electrical brain-stimulation reward (BSR) paradigm in rats that has been previously shown to be highly sensitive to clozapine's mesolimbic functional selectivity. Rats were chronically administered saline, clozapine, haloperidol, or haloperidol plus the anticholinergic compound trihexyphenidyl, and threshold sensitivity of the mesolimbic and nigrostriatal DA systems was assessed using the BSR paradigm, to infer degree of functional DA blockade produced by the chronic drug regimens. Chronic saline produced no change in either DA system. Congruent with previous findings, chronic clozapine powerfully inhibited the mesolimbic DA system but spared the nigrostriatal DA system. Also congruent with previous findings, chronic haloperidol powerfully inhibited both DA systems. Compared to chronic haloperidol alone, chronic haloperidol plus chronic trihexyphenidyl exerted diminished anti-DA action in both the mesolimbic and nigrostriatal DA systems. These results suggest that clozapine's anticholinergic potency is not an adequate explanation for its functional mesolimbic selectivity.

Effects of long-term administration of antidepressants and neuroleptics on receptors in the central nervous system

1. A review of the effects of long-term administration of antidepressants and neuroleptics on receptors in the central nervous system is presented. 2. The effects of antidepressants on adenylate cyclase activity and on receptor binding in brain tissue are discussed. Effects on a variety of receptor types are considered. 3. The utilization of electrophysiological, behavioral, and neurochemical studies to assess receptor function after chronic antidepressant administration is discussed, as is the use of peripheral receptor estimations in clinical studies. 4. Animal studies on the actions of chronic administration of neuroleptics on pre- and postsynaptic dopamine receptors are reviewed. Effects of these drugs on dopamine receptors in humans are considered from the following perspectives: postmortem and in vivo binding studies in schizophrenia, tardive dyskinesia, and central versus peripheral receptor estimation.

Relationship between extracellular 5-hydroxytryptamine and behaviour following monoamine oxidase inhibition and L-tryptophan

1. The present study investigates the effects of selective and a non-selective monoamine oxidase (MAO) inhibitors combined with L-tryptophan on MAO-A and -B activity, hypothalamic extracellular 5-hydroxytryptamine (5-HT) in vivo and the occurrence of the 5-HT behavioural syndrome. 2. Selective inhibition of intraneuronal MAO-A with MDL 72394 (0.5 mg kg-1, i.p.) had no effect on extracellular 5-HT and following administration of L-tryptophan (50 mg kg-1, i.p.) the 5-HT behavioural syndrome was not induced. 3. Selective inhibition of MAO-A at all sites with clorgyline (5 mg kg-1, i.p.) increased extracellular 5-HT but did not induce the 5-HT behavioural syndrome when combined with L-tryptophan administration. 4. Selective inhibition of MAO-B with selegiline (10 mg kg-1, i.p.) had no effect on extracellular 5-HT and the 5-HT behavioural syndrome was not observed after L-tryptophan administration. 5. Inhibition of MAO-A and -B with a higher and therefore non-selective, dose of MDL 72394 (2 mg kg-1) markedly increased extracellular 5-HT but failed to induce the 5-HT behavioural syndrome after L-tryptophan administration. 6. Inhibition of MAO-A and -B at all sites in the brain (tranylcypromine 20 mg kg-1, i.p. or clorgyline 5 mg kg-1 plus selegiline 10 mg kg-1) increased extracellular 5-HT and induced the behavioural syndrome on administration of L-tryptophan. 7. The results demonstrate that inhibition of MAO-A and -B both within amine neurones and elsewhere in the brain is essential for the development of the 5-HT behavioural syndrome. Whilst the syndrome is associated with increased extracellular 5-HT this does not appear necessarily to result in the syndrome and may indicate that increased extracellular 5-HT is not solely involved in the induction of the '5-HT behavioural syndrome'. Whilst the syndrome is associated with increased extracellular 5-HT this does not appear necessarily to result in the syndrome and may indicate that increased extracellular 5-HT is not solely involved in the induction of the '5-HT behavioural syndrome'.

Interactions of drugs and electroshock treatment on cerebral monoaminergic systems

The interaction of EST and drugs on the CSF levels of several monoamine metabolites was studied with four drugs that have been used in the treatment of psychiatric disorders, namely, lithium, carbamazepine, imipramine, and haloperidol. EST-drug interactions were observed with each of these drugs on one or more monoaminergic systems. All interactions were antagonistic in nature. Changes in the CSF levels of monoamine metabolites did not always reflect corresponding changes in the monoamine turnover; the increase in 5HIAA seen after chronic Li was due to slower removal of this metabolite from the CSF. However, the changes in the CSF levels of DA and 5HT metabolites following chronic HLDL reflected changes in the turnover of the parent amine in the brain. The effects of both HLDL and EST on DA metabolism in the intact brain could be related to alterations by these treatments of the responsiveness of DA presynaptic receptors. Similarly, the effect of HLDL on 5HT turnover and the antagonistic interaction of EST on this HLDL-induced effect were associated with changes in 3H-IMI binding sites that label the 5HT transporter in serotonergic presynaptic terminals. The results are discussed with the aid of a model that depicts possible relationships between pre- and postsynaptic variables and their influence on each other. According to this model an increase in the neurotransmitter turnover is associated with "down regulation" of both pre- and postsynaptic receptors whereas a decrease in turnover is associated with receptor "up regulation." However, "up regulation" of receptors is not necessarily associated with augmented postsynaptic response. Analysis of the model variables by the "binding equation" which obeys the Clark occupancy principle revealed that receptor "up regulation" which is associated with decreased turnover may result in either an augmented or a depressed postsynaptic response (related to the number of occupied receptors). The direction of the response depends on the ratio between the rate of receptor "up regulation" and the rate of decrease in neurotransmitter turnover.

Differential alterations in striatal dopamine receptor sensitivity induced by repeated administration of clinically equivalent doses of haloperidol, sulpiride or clozapine in rats

Rats received therapeutically equivalent doses of either haloperidol (1.7-1.9 mg/kg/day), sulpiride (112-116 mg/kg/day) or clozapine 30-35 mg/kg/day) continuously for 4 weeks. Treatment with haloperidol, but not sulpiride or clozapine, caused inhibition of stereotyped behaviour induced by apomorphine (0.125-0.25 mg/kg SC). Following drug withdrawal for up to 7 days, haloperidol and sulpiride, but not clozapine treatment caused an exaggeration of stereotyped behaviour induced by apomorphine. Bmax values for striatal 3H-spiperone binding were elevated in animals treated for 2 and 4 weeks with haloperidol, but not with sulpiride or clozapine. Following drug withdrawal, haloperidol, but not sulpiride or clozapine, treatment caused an increase in Bmax for striatal 3H-spiperone binding. Bmax values for striatal 3H-NPA binding revealed no change during haloperidol or clozapine treatment. Sulpiride treatment for 1 week caused an increase in Bmax for 3H-NPA binding, which returned to control levels at 2 and 4 weeks. Following drug withdrawal, there was an increase in Bmax for 3H-NPA binding in rats treated with haloperidol and sulpiride, but not clozapine. On continuous treatment and following withdrawal from haloperidol, sulpiride, or clozapine the ability of dopamine to stimulate striatal adenylate cyclase activity did not differ from that in control animals. Repeated administration of sulpiride or clozapine may not induce striatal dopamine receptor supersensitivity when given in clinically relevant doses, although haloperidol does.

Changes in apomorphine-induced stereotypy as a result of subacute neuroleptic treatment correlates with increased D-2 receptors, but not with increases in D-1 receptors

Administration of haloperidol (5 mg/kg i.p.), cis-flupenthixol (2.5 mg/kg i.p.) or sulpiride (2 X 100 mg/kg i.p.) daily for 21 days followed by a 3-day drug withdrawal period caused equivalent cerebral dopamine receptor supersensitivity as judged by enhanced apomorphine-induced stereotypy. These treatments also produced equivalent rises in the number of adenylate cyclase-independent dopamine receptors (D-2) in both striatal and mesolimbic tissue as assessed by specific [3H]spiperone and [3H]N,n-propylnorapomorphine (NPA) binding. No change in the dissociation constant (KD) was apparent in response to neuroleptic treatment. However, only repeated administration of cis-flupenthixol caused an increase in the number of adenylate cyclase-linked dopamine receptors (D-1) in striatum as assessed by enhanced [3H]piflutixol binding and increased dopamine-stimulated cyclic AMP formation. The dissociation constant for [3H]piflutixol binding was unchanged by cis-flupenthixol administration. No change in D-1 receptor numbers or dopamine stimulation of adenylate cyclase occurred in mesolimbic tissue. Repeated treatment with sulpiride or haloperidol was without effect on either [3H]piflutixol binding to D-1 receptors or cyclic AMP formation. In conclusion, increased apomorphine-induced stereotypy following subacute neuroleptic treatment correlates with changes in D-2 receptor numbers, but not with changes in D-1 receptors.

Roles of dopamine and 5-hydroxytryptamine in stereotyped and non-stereotyped behaviour

The roles of dopamine (DA) and 5-hydroxytryptamine (5-HT) in stereotyped and non-stereotyped components of the classical behavioural syndromes induced by 5-HT and DA were investigated by studying (a) behavioural interactions between the DA agonist apomorphine and the 5-HT agonist 5-methoxy-N,N-dimethyltryptamine (5-MeODMT) and (b) the effects of depletion of 5-HT on the behavioural responses to amphetamine and p-chloroamphetamine. In agreement with evidence [Andrews, Fernando and Curzon (1982) Neuropharmacology 21:63-68] that non-stereotyped (i.e. body shakes and hind limb abduction) and stereotyped (i.e. head weaving and reciprocal forepaw treading) behaviour induced by d-amphetamine (25 mg/kg, i.p.) were inhibited and enhanced respectively by DA, apomorphine inhibited two non-stereotyped behavioural responses induced by 5-MeODMT (hind limb abduction and Straub tail) but enhanced reciprocal forepaw treading. However, head weaving was inhibited. Evidence indicated that behaviour induced by DA (whether stereotyped or not) was inhibited by 5-HT. Thus, the induction by apomorphine of sniffing and mouth movements was enhanced when the synthesis of 5-HT was inhibited. Also, p-chloroamphetamine caused sniffing and mouth movements only when 5-HT synthesis was inhibited. Under the latter conditions, while most classical behavioural responses associated with 5-HT did not occur, hind limb abduction persisted. Similarly, amphetamine (25 mg/kg) caused hind limb abduction and forepaw treading even when 5-HT was almost completely depleted. These results may indicate that the amine releasers have some direct 5-HT agonist properties. Results in general indicate the multiplicity of behavioural interactions between DA and 5-HT.

The effect of chronic neuroleptic administration on cerebral dopamine receptor function

Acute administration of neuroleptic drugs causes blockade of cerebral dopamine receptors. It has been discovered that chronic administration of neuroleptic drugs may have different effects on cerebral dopamine systems. Initial antagonism of dopamine mediated behaviour, such as stereotypy, disappears and may be replaced by supersensitivity to dopamine agonists. Changes also occur in biochemical indices of dopamine receptors, such as in the number and affinity of specific binding sites identified by 3H-ligands labelling D-2 receptors, and in dopamine-stimulated adenylate cyclase activity. All these changes occur obviously in the striatum in response to chronic administration of a range of neuroleptic drugs. Lesser changes take place in the mesolimbic dopamine system. What happens in the mesocortical dopamine pathways is unknown. The consequence of such adaptive responses to chronic neuroleptic therapy may be of importance to understanding of tardive dyskinesia and schizophrenia.

Drug discrimination in rats: evidence for amphetamine-like cue state following chronic haloperidol

Two groups of male Sprague-Dawley rats were trained to discriminate which of two levers to press for milk reinforcement on a VI-20 sec schedule of reinforcement on the basis of whether they were injected intraperitoneally with d-amphetamine (0.50 mg/kg or 1.50 mg/kg) or saline 15 min prior to daily 30 min training sessions. Following acquisition of the discrimination, dose-response functions were generated for both training-dose groups during 5 min test sessions. All subjects were then injected with 1.0 mg/kg of haloperidol for ten consecutive days and retested on either saline or intermediate doses of amphetamine on days 1, 2, 4 and 7 following the final haloperidol injection. The results indicated that chronic haloperidol enhanced the discriminative stimulus properties of amphetamine in both training groups. More importantly, when tested on saline, subjects in both training groups made significantly more responses on the d-amphetamine lever than observed prior to chronic haloperidol. On the basis of linear regression analysis of the dose-response curves it was shown that rats in both groups responded as though they had been injected with 0.18 mg/kg of d-amphetamine. In a second experiment this increase in amphetamine-lever responding when animals were tested with saline following chronic haloperidol was replicated and in addition it was observed that chronic amphetamine had the opposite effect on this measure.

Repeated administration of sulpiride for three weeks produces behavioural and biochemical evidence for cerebral dopamine receptor supersensitivity

Administration of sulpiride (2 X 100 mg/kg i.p.) or haloperidol (5 mg/kg i.p.) to rats for 3 weeks with subsequent withdrawal for 3 or 4 days induced cerebral dopamine receptor supersensitivity. Apomorphine-induced stereotyped behaviour after drug withdrawal was enhanced by pretreatment with either haloperidol or sulpiride both of which increased the number of specific striatal binding sites (Bmax) for [3H]spiperone, [3H]N,n-propylnorapomorphine and [3H]sulpiride. Neither drug altered the dissociation constant (KD) for the ligand binding assays. Striatal dopamine sensitive adenylate cyclase activity was unaltered by such a pretreatment with either haloperidol or sulpiride. The data show that sulpiride, like haloperidol, is capable of inducing behavioural and biochemical supersensitivity of cerebral dopamine receptors.

Differential involvement of dopamine-containing tracts in 5-hydroxytryptamine-dependent behaviours caused by amphetamine in large doses

Dopamine (DA) concentrations in the rat striatum and/or nucleus accumbens were decreased by lesions in the nigra, ventral tegmentum, striatum and accumbens induced by 6-hydroxydopamine. These affected a range of DA- and 5-hydroxytryptamine-(5HT) dependent behaviours induced by 25 mg/kg of D-amphetamine as follows. Changes in DA-dependent behaviour (forward locomotion, head bobbing) occurred which were consistent with DA terminals in the accumbens and striatum being required for locomotor and stereotypical behaviour, respectively. A repetitive 5HT-dependent behaviour (head weaving) was decreased by lesions which depleted striatal DA. A 5HT-dependent behaviour with repetitive and locomotor elements (reciprocal forepaw treading) was only decreased by the nigral and tegmental lesions which depleted DA in both the striatum and the accumbens (and presumably also in other regions). These results suggest that 5HT-dependent behaviours of stereotypical character also require DA. Conversely, two 5HT-dependent behaviours, without obvious stereotypical or locomotor elements (body shakes, hind limb abduction), were not decreased by any of the lesions (and increased by some). Backward walking was markedly inhibited by lesions which decreased striatal DA. The above evidence for different relationships between each of the 5HT-dependent behaviours studied and DA-containing systems implies that these behaviours are separately mediated. It may clarify previous disagreement on the role of DA in these behaviours.

Human platelet function as a model for investigating the clinical efficacy of chlorpromazine

1 Enhancement of platelet aggregation response (PAR) to 5-hydroxytryptamine (5-HT) in some schizophrenic patients receiving chlorpromazine (CPZ) may provide a biological index for the efficacy of this drug. 2 In a double-blind study 33 schizophrenic patients hospitalized following their first psychotic breakdown were followed up clinically with concurrent assessment of their PAR to 5-HT. The patients followed a standardized treatment schedule with (CPZ) as the sole antipsychotic medication. 3 Twelve patients (Group A) developed an enhanced biphasic 5-HT PAR, within 2-3 weeks and improved clinically by the sixth week. In most cases, the appearance of the enhanced biphasic PAR preceded clinical improvement. Twenty-one patients (Group B) did not have enhanced biphasic PAR to 5-HT by the sixteenth week of treatment. However, twelve subjects from this group showed clinical response to CPZ by the end of this period, while the remaining patients did not improve. 4 The enhanced PAR to 5-HT in Group A discriminated best between good and bad outcome cases when Feighner's research diagnostic criteria were used. We could not confirm the previous reports of platelet aggregation response to dopamine in pre- or post-chlorpromazine treatment.

A behavioural and biochemical study in rats of 5-hydroxytryptamine receptor agonists and antagonists, with observations on structure-activity requirements for the agonists

1 The effect of the putative 5-hydroxytryptamine (5-HT) receptor antagonists, methysergide, methergoline, mianserin, cyproheptadine, cinanserin (all at 10 mg/kg), methiothepin (5 mg/kg) and (-)-propranolol (20 mg/kg) on the behavioural responses to tranylcypromine (10 mg/kg) followed 30 min later by L-tryptophan (100 mg/kg) was examined.2 Methysergide, methergoline, methiothepin and (-)-propranolol inhibited head weaving, forepaw treading and hind-limb abduction. Methysergide and methergoline increased reactivity. In contrast, cypropheptadine, cinanserin and mianserin had no effects on the behaviour.3 Similar findings were obtained when the behaviours were elicited by administration of tranylcypromine (10 mg/kg) followed by the putative 5-HT receptor agonist, 5-methoxy-N,N-dimethyltryptamine (5-MeODMT) (2 mg/kg).4 When the behaviours were elicited by the putative 5-HT receptor agonist, quipazine (50 mg/kg), all the drugs effectively inhibited head weaving and forepaw treading.5 When the dose of cypropheptadine was doubled to 20 mg/kg an inhibition of the tranylcypromine/L-tryptophan induced behaviours was seen.6 Methiothepin produced a marked inhibition of apomorphine-induced locomotor activity whilst all the others enhanced this response, suggesting that only methiothepin inhibits the 5-HT behaviours by dopamine antagonism and that the increased reactivity seen following tranylcypromine/L-tryptophan after pretreatment with methysergide or methergoline might be due to enhanced dopamine function.7 Pretreatment with p-chlorophenylalanine resulted in enhanced behavioural responses to both 5-MeODMT and quipazine.8 Both methergoline and methiothepin decreased the rate of 5-HT synthesis in whole brain but not spinal cord and methergoline decreased spinal cord 5-HIAA concentration. None of the other drugs had any significant effects on the concentration of 5-HT, 5-HIAA or 5-HT synthesis rate in brain or spinal cord.9 Experiments with compounds structurally related to quipazine and with molecular models suggested that quipazine produces behavioural changes probably by stimulating the 5-HT receptor in a similar way to 5-HT but that it would bind weakly, in agreement with ligand-receptor binding studies.10 It is suggested, therefore, that cyproheptadine, cinanserin and mianserin fail to inhibit 5-HT and 5-MeODMT-induced behaviours because they are weak antagonists whilst they are able to inhibit the same behaviours induced by quipazine because it is a weak agonist.11 These data indicate that extreme care should be taken in accepting or rejecting 5-HT as a mediator of behaviours or of other responses unless several antagonists or agonists have been examined.

5-Hydroxytryptamine-induced hypothermia in rats as an in vivo model for the quantitative study of 5-hydroxytryptamine receptors

Intrahypothalamic injection of 5-hydroxytryptamine (5-HT) caused a fall in core temperature in lightly restrained rats maintained at an ambient temperature of 17 degrees C. The hypothermia was blocked by 5-HT antagonists with a relative potency of methiothepin greater than methergoline greater than methysergide greater than cinanserin greater than cyproheptadine. The peripheral 5-HT antagonist, xylamidine, was not an antagonist, suggesting the hypothermia was of central origin. Other neurotransmitter antagonists, haloperidol, atropine, phentolamine, and propranolol failed to prevent 5-HT-induced hypothermia. This suggests that the hypothermic response to 5-HT can be used for a quantitative study of drug action at central 5-HT receptors.

Cerebral dopamine function in rats following withdrawal from one year of continuous neuroleptic administration

Continuous administration of trifluoperazine (2.5--3.5 mg/kg/day) or thioridazine (30--40 mg/kg/day) to rats for 12 months enhanced the stereotyped response to apomorphine (0.5 mg/kg s.c.), increased dopamine 1--150 muM) stimulation of striatal adenylate cyclase, increased KD and Bmax for dopamine (10(-4) M) specific 3H-spiperone striatal binding and produced spontaneous mouthing movements. On drug withdrawal, spontaneous locomotor activity was enhanced after 2 weeks and the enhanced stereotyped response was maintained for up to 1 month. Spontaneous mouthing had disappeared 2 weeks after drug withdrawal. The increase in Bmax for 3H-spiperone binding was maintained for up to 3 months after drug removal, but KD reverted to control levels by 2 weeks. In contrast, the dopamine stimulation of striatal adenylate cyclase remained enhanced for the 6 month withdrawal period. Administration of trifluoperazine (0.7--0.9 mg/kg/day) or thioridazine (6--8 mg/kg/day) for 12 months produced a less marked effect than administration of the higher dose. No enhancement of effect was observed on drug withdrawal and the initial changes disappeared rapidly on removal of drug. Supersensitivity of striatal dopamine mechanisms produced by continuous long-term neuroleptic administration differs from that produced by shorter treatment periods since no enhancement of effect occurs on drug withdrawal. The behavioural and biochemical components of the supersensitivity show variable time courses and in particular the enhanced stimulation of striatal adenylate cyclase persists for at least 6 months. Such effects may be of relevance to tardive dyskinesias in man.

The pathophysiology of extrapyramidal side-effects of neuroleptic drugs

The mechanisms responsible for the production of major extrapyramidal side-effects (parkinsonism, akathisia, acute dystonic reactions, chronic tardive dyskinesias) are reviewed in the light of the complex effects of these drugs on cerebral dopamine systems.

Apomorphine-induced stereotypic cage climbing in mice as a model for studying changes in dopamine receptor sensitivity

We have previously confirmed in mice that apomorphine (APO) induces dopamine specific stereotypic cage climbing. Apparent changes in dopamine receptor sensitivity induced by chronic drug administration appear to be measurable by this technique. In the present experiments, murine stereotypic cage climbing was evauated as a model system for assessing the dopamine receptor supersensitivity induced by chronic administration of the potent butyrophenone neuroleptic spiroperidol. Spiroperidol induced a significantly enhanced response induced by APO (about a 7-fold increase) manifest by 48 hr (but not 24 hr) following cessation of the last chronic injection. Time-response analyses demonstrated that the action of test doses of APO (1.0 or 4.5 mg/kg, IP) was significantly prolonged in the chronic-spiroperidol animals relative to controls. The supersensitivity in the spiroperidol-treated animals lasted more than three weeks for each dose of the neuroleptic and the APO dose-response curve was shifted to the left in spiroperidol-treated animals. Results are discussed in terms of the utility of the model for establishing dose-response, time-course, and duration of effect data within the same group of animals.

Interactions between central monoaminergic systems: dopamine-serotonin

Concentration of dopamine and serotonin metabolites (HVA and 5-HIAA) in the CSF was evaluated before and after pharmacological treatment in 19 patients with different neuropsychiatric diseases. In every case a reciprocal modification of the two metabolites occurred after treatment. The result supports the hypothesis of a functional balance between the monoaminergic systems in the central nervous system.

Enhancement of self-stimulation behavior in rats and monkeys after chronic neuroleptic treatment: evidence for mesolimbic supersensitivity

The effect of chronic neuroleptic drug treatment on self-stimulation of the mesolimbic dopamine system was tested. Rats with electrodes implanted into the ventral tegmental nucleus (A10 cell body area) were treated with haloperidol for three weeks. Afterwards, the rats showed a 35% increase in self-stimulation rate, as compared to pre-drug control rates. This increase persisted for three weeks after drug withdrawal before returning to baseline rates. Rats treated for three weeks with the atypical neuroleptic, clozapine, also showed an increase, the duration and magnitude of which was similar to that seen in the haloperidol group. In addition, four rhesus monkeys with electrodes in the nucleus accumbens (one of the terminal projection areas of the A10 mesolimbic dopamine system) were given a three week treatment with haloperidol, after which all animals showed a significant, long-lasting decrease in self-stimulation threshold, as measured by a rate-independent reward paradigm. Taken together, these results suggest the induction of receptor supersensitivity in the mesolimbic dopamine system by long-term treatment with neuroleptic drugs.

Backward walking and circling: behavioural responses induced by drug treatments which cause simultaneous release of catecholamines and 5-hydroxytryptamine

1 The roles of catecholamine and 5-hydroxytryptamine (5-HT) release in mediating backward walking and circling were studied in rats. 2 These behaviours occurred in animals given 15 mg/kg intraperitoneally of (+)-amphetamine (which predominantly releases catecholamines) or either p-chloroamphetamine or fenfluramine (which predominantly release 5-HT). They also occurred when smaller doses of (+)-amphetamine (5 mg/kg) and either p-chloroamphetamine (2--5 mg/kg) or fenfluramine (5 mg/kg) were given together. 3 Characteristic dopamine-dependent behaviours (rearing, licking, gnawing) resulting from (+)-amphetamine injection were greatly reduced by p-chloroamphetamine or fenfluramine. 4 Characteristic 5-HT-dependent behaviours (wet dog shake, hind limb abduction) resulting from injection of either p-chloroamphetamine or fenfluramine were unaffected by (+)-amphetamine. 5 Fragmentary backward walking and circling resulting from levallorphan injection (50 mg/kg s.c.) were decreased by (+)-amphetamine at low dosage. 6 Results in general strengthen previous evidence that backward walking and circling are mediated by simultaneous dopamine and 5-HT release. 7 The possible relevance of the above findings to hallucinogenic activity, amphetamine psychosis, schizophrenia and abnormal movements due to L-DOPA treatment is discussed.

The effects of drugs on the processes regulating the functional activity of brain monoamines

1. By study of the synthesis and turnover of brain monoamines and with the use of behavioral models which indicate the functional activity of brain 5HT and dopamine, it is possible to unravel the mechanisms by which some drugs produce behavioral effects. 2. Using these techniques the acute and chronic effects of certain neuroleptics, propranolol and other beta-adrenergic blocking agents, repeated electroconvulsive shock, and lithium upon the functional activity of brain 5HT and dopamine are examined. 3. The clinical relevance of these studies is discussed.

Dopaminergic supersensitivity after neuroleptics: time-course and specificity

It is known that a single dose of a neuroleptic can elicit dopaminergic supersensitivity in animals. On the other hand, the clinical syndrome of tardive dyskinesia takes many months of years to develop. To resolve this apparent discrepancy, it is possible that subclinical or latent tardive dyskinesia is fully compensated in most patients taking neuroleptics. In others, where the tardive dyskinesia is full-blown and grossly apparent, the dopaminergic supersensitivity may be decompensated. Such compensatory and decompensatory phases have been proposed earlier by Hornykiewicz (1974), in the case of Parkinson's Disease. Dopaminergic supersensitivity persists for a period proportional to the lenght of the neuroleptic treatment. It is not yet clear whether the relation between the length of treatment and the persistence of supersensitivity holds for very long treatments, but in principle the relationship might account for the persistence of tardive dyskinesia after years of neuroleptic pretreatment.

beta-Adrenoceptor antagonists inhibit the behavioural responses of rats to increased brain 5-hydroxytryptamine

1 The effect of various beta-adrenoceptor blocking agents on the 5-hydroxytryptamine (5-HT)-induced hyperactivity response produced in rats by administration of tranylcypromine (10 mg/kg i.p.) followed by L-tryptophan (50 mg/kg i.p.) has been investigated. 2 (+/-)-Alprenolol, (+/-)-timolol, (+/-)-sotalol, (+/-)-pindolol (all at 40 mg/kg) all inhibited the hyperactivity response to some degree when given 45 min before the tranylcypromine, as did (+/-)-oxprenolol when given after the L-tryptophan. 3 beta-Adrenoceptor antagonists that are not found in the brain appreciable amount after peripheral injection, (+/-)-atenolol, (+/-)-practolol, (+/-)-labetalol and (+/-)-acebutalol, did not inhibit the 5-HT-mediated behaviour. 4 Neither the beta1-selective drug (+/-)-metoprolol, nor the beta2-selective drug (+/-)-butoxamine inhibited the behavioral response. 5 The drugs that blocked the 5-HT-mediated behaviour did not alter brain 5-HT concentrations, synthesis rate or the accumulation of 5-HT following tranylcypromine/L-tryptophan. However, they did inhibit the hyperactivity produced by the suggested 5-HT agonist, 5-methoxy N,N-dimethyltryptamine, indicating that the beta-adrenoceptor blocking drugs were inhibiting the post-synaptic 5-HT-mediated response. 6 Circling produced by methamphetamine (3 mg/kg) in unilateral nigro-striatal lesioned rats was not altered by alprenolol, sotalol, pindolol or metaprolol, indicating that these drugs do not alter dopamine-mediated behaviour. 7 It is concluded that non-selective (beta1 and beta2) adrenoceptor antagonists which have a high brain/blood ratio following their peripheral injection, block 5-HT-mediated behavioural responses in the rat.

The effect of haloperidol, spiperone and pimozide on the flexor reflex of the hind limb of the spinal rat

It was found that spiperone and pimozide in doses which themselves do not influence the flexor reflex of the hind limb of the spinal rat inhibit stimulation of this reflex induced by serotoninomimetic drugs (LSD and fenfluramine). Higher doses of spiperone depress the flexor reflex and inhibit the stimulating effect of clonidine. Pimozide has no such effect. Haloperidol in doses which do not influence the action of LSD and fenfluramine produces a depression of the flexor reflex and antagonizes the action of clonidine. Our findings indicate that, irrespective of their antidopamine action, spiperone has a central antiserotonin effect and an antinoradrenaline one, pimozide--an antiserotonin one and haloperidol--an antinoradrenaline one.

Neuroleptic drugs block both the hyperactivity and the increase in caudate nucleus cyclic AMP concentration produced by the administration of tranylcypromine and L-dopa to rats

Injection of rats with tranylcypromine and L-dopa increased brain dopamine concentrations and produced a behavioural syndrome that includes hyperactivity. It also elevated caudate nucleus cyclic AMP concentrations by approximately 50% in vivo, probably by stimulating dopamine receptors. Pretreatment with chlorpromazine inhibited both the tranylcypromine/L-dopa-induced behaviour and elevated cyclic AMP concentrations in a dose-dependent manner. Haloperidol and alpha-flupenthixol also inhibited both effects, while beta-flupenthixol and pimozide were without effect. Since none of these drugs altered the tranylcypromine/L-dopa-induced rise of brain dopamine, it is likely that they produced their effect by inhibiting dopamine-sensitive adenylate cyclase. A good correlation was found to exist between the neuroleptic inhibition of both the increased behavioural activity and the increased caudate nucleus cyclic AMP concentrations produced by tranylcypromine and L-dopa.

Repeated chlorpromazine administration increases a behavioural response of rats to 5-hydroxytryptamine receptor stimulation

1 The hyperactivity syndrome produced in rats by administration of tranylcypromine (20 mg/kg i.p.) followed 30 min later by L-tryptophan (50 mg/kg i.p.) is generally considered to be due to increased 5-hydroxytryptamine (5-HT) functional activity. It is inhibited by chlorpromazine (30 mg/kg i.p.) injected 60 min before the tranylcypromine. However, chlorpromazine injection for 4 days either at a dose of 30 mg/kg once daily or 5 mg/kg twice daily results in an enhanced hyperactivity response to tranylcypromine and L-tryptophan administration 24 h after the final dose of chlorpromazine. 2 One injection of chlorpromazine (30 mg/kg) did not produce enhancement 24 h later and the inhibition of the tranylcypromine/L-tryptophan hyperactivity observed after acute chlorpromazine injection was seen if the rats were given tranylcypromine and L-tryptophan 1 h after the fourth chlorpromazine (30 mg/kg) dose. 3 Chlorpromazine (30 mg/kg) once daily or 5 mg/kg twice daily for 4 days resulted in rats displaying enhanced behavioral responses to the suggested 5-HT agonist 5-methoxy N,N-dimethyltryptamine (2 mg/kg) on day 5. 4 Chlorpromazine (30 mg/kg) once daily for 4 days produces a slight increase in brain 5-hydroxytryptamine (5-HT) concentration on day 5, but no difference in the rate of brain 5-HT synthesis or the rate of 5-HT accumulation after tranylcypromine and L-tryptophan administration. 5. There is some evidence that chlorpromazine blocks 5-HT receptors. It has also been observed that several other neuroleptic drugs do not produce enhanced 5-HT responses after repeated administration. It is suggested therefore that the enhanced behavioural response to 5-HT receptor stimulation following repeated chlorpromazine administration may be because this drug blocks 5-HT receptors.