Circadian fluctuation of susceptibility to haloperidol under constant conditions

Effect of Haloperidol on mPer1 Gene Expression in Mouse Suprachiasmatic Nuclei

The effect of a typical neuroleptic haloperidol (Hal) on mPer1 gene expression was investigated in mouse suprachiasmatic nuclei (SCN). Hal induced mPer1 mRNA levels both in vivo and in cultured SCN cells. For mechanisms underlying Hal-induced mPer1 expression, N-methyl-d-aspartate (NMDA) glutamate receptor subtype, the phosphorylation form of the transcription factor, and the Ser-133 phosphorylation form of cAMP-responsive element-binding protein (CREB) played an important role, because the induction of mPer1 mRNA significantly decreased after pretreatment with a non-competitive NMDA receptor antagonist, such as MK-801 or CREB antisense. These results suggest that Hal may increase CREB phosphorylation and mPer1 expression according to the activation of the NMDA receptor through the dopaminergic pathways. Although the injection of Hal during the light period increased the amplitude of mPer1 mRNA rhythmicity in a nondrug state, the injection of the drug during the dark period disturbed the rhythmic pattern of mPer1 mRNA. These results suggest that the rhythmicity of clock genes in SCN may be disturbed depending on the dosing time of Hal. On the other hand, because the induction of mPer1 mRNA by Hal seems to be at least partly caused by the NMDA receptor, showing a phase shift or resetting effect of the circadian clock, Hal may also cause such phase shift effects.

Changing the dosing schedule minimizes the disruptive effects of interferon on clock function

The effectiveness and toxicity of many drugs vary depending on the relationship between the dosing schedule and the 24-hour rhythms of biochemical, physiological and behavioral processes. In addition, several drugs can cause alterations to the 24-hour rhythms leading to illness and altered homeostatic regulation. However, the mechanisms of this drug-based disruption of circadian 'clock' genes remain unclear. Here, we show the disruptive effect of interferon-alpha on the rhythm of locomotor activity, body temperature and clock-gene mRNA expression in the periphery and suprachiasmatic nuclei, a primary circadian pacemaker. The rhythmicity of clock genes and the photic induction of the Per gene in suprachiasmatic nuclei were disturbed by the repetitive administration of interferon-alpha. Moreover, alteration of clock function, a new concept of adverse effects, can be overcome by optimizing the dosing schedule to minimize adverse drug effects.

Influences of biological rhythms on the effects of psychotropic drugs

The efficacy of psychotropic drugs varies depending on the time of administration. This phenomenon is observed with antipsychotics, antidepressants, mood stabilizers, benzodiazepines, barbiturates, and psychostimulants. The presence or absence of this phenomenon and the rhythm phase in the efficacy of each drug varies depending on the drug, dose, parameter measured, animal species, and strain. A recent study demonstrating circannual changes in the phases of circadian rhythm of drug efficacy suggests that discrepancies between studies may be considerably explained by the presence of a circannual rhythm. The rhythms in drug effects are suggested not to be due to rhythmic changes in the pharmacokinetics of the drugs but rather to an endogenous rhythm in drug susceptibility resulting from a circadian rhythm in the intracerebral neurotransmission system. The presence of this phenomenon and its law have been demonstrated to a considerable extent in animals, but corresponding clinical reports in humans remain insufficient despite its clinical importance. Further study in humans is certainly warranted.

Drugs and the sleep-wakefulness continuum

The circadian cycle of sleep and wakefulness in humans is controlled by the activity of many neurotransmitters. Studies of the effects of drugs on the central nervous system have elucidated some of the mechanisms that may be involved. Some transmitters are concerned with the basic control of sleep and wakefulness, influencing both alertness during the day and the pattern of nocturnal sleep. On the other hand, there are other transmitters that appear to be concerned primarily with the manifestation of wakefulness and vigilance, without a direct role in the process of sleep.

Chronopharmacology of psychotropic drugs: circadian rhythms in drug effects and its implications to rhythms in the brain

The effects of many kinds of psychotropic drugs have been shown in animal studies to follow a circadian rhythm. Trials for the clinical application of this circadian rhythm have already been undertaken. Although the mechanisms underlying this phenomenon are still unclear, chronological changes in the levels of drugs in the blood and brain suggest that it is primarily due to rhythms in the brain's susceptibility to drugs. Rhythms are present in the level of intracerebral neurotransmitters, receptors and second messengers. Each of these rhythms may cause other rhythms within each system of neurotransmitters, which in turn induces a rhythm in the susceptibility to drugs.

Double-blind study of the chronopharmacotherapy of depression

To investigate the possibility of chronotherapy with antidepressants for patients with depression, we gave single daily doses of clomipramine 150 mg/day to 30 patients with depression at three different times of day, i.e., morning, noon, or before bedtime, using a double-blind method over a 4-week period. Beneficial effects differed according to the administration time of day, with the most effective result being found for the administration at noon. Time-dependent differences in side effects were observed in tremors and dryness of mouth. An additional 10 patients were administered their medications three times a day by traditional, equally divided doses, and the efficacy was inferior than daily single doses at noon. The study results showed the significance of the administration time of day for the benefits and side effects of antidepressant therapy for depression.

Dopaminergic transmission and the sleep-wakefulness continuum in man

Modulation of dopaminergic transmission on daytime alertness and performance and on nocturnal sleep were studied in man using 30, 60 and 90 mg pemoline, a dopamimetic drug, and 2, 4 and 6 mg pimozide, a dopamine receptor antagonist. Pemoline lengthened daytime sleep latencies and improved attention, and increased wakefulness during nocturnal sleep. Rapid eye movement (REM) sleep was reduced with 90 mg pemoline, but this was due entirely to increased wakefulness. Pimozide had little effect on overnight sleep, but increased the tendency to fall asleep and impaired performance during the day. These studies suggest that the effects of certain drugs which modulate the activity of neurotransmitters, involved in the control of sleep and wakefulness, may be related to the inherent level of activity of the central nervous system. Modulation of the dopaminergic system can have a profound influence on the manifestation of wakefulness and vigilance, but is unlikely to modify directly the elaboration of REM sleep in man.