Myo-inositol attenuates the enhancement of the serotonin syndrome by lithium

A narrative synthesis of research with 5-MeO-DMT

BACKGROUND

5-Methoxy-N,N-dimethyltryptamine (5-MeO-DMT) is a naturally occurring, short-acting psychedelic tryptamine, produced by a variety of plant and animal species. Plants containing 5-MeO-DMT have been used throughout history for ritual and spiritual purposes. The aim of this article is to review the available literature about 5-MeO-DMT and inform subsequent clinical development.

METHODS

We searched PubMed database for articles about 5-MeO-DMT. Search results were cross-checked against earlier reviews and reference lists were hand searched. Findings were synthesised using a narrative synthesis approach. This review covers the pharmacology, chemistry and metabolism of 5-MeO-DMT, as well epidemiological studies, and reported adverse and beneficial effects.

RESULTS

5-MeO-DMT is serotonergic agonist, with highest affinity for 5-HT_1A receptors. It was studied in a variety of animal models, but clinical studies with humans are lacking. Epidemiological studies indicate that, like other psychedelics, 5-MeO-DMT induces profound alterations in consciousness (including mystical experiences), with potential beneficial long-term effects on mental health and well-being.

CONCLUSION

5-MeO-DMT is a potentially useful addition to the psychedelic pharmacopoeia because of its short duration of action, relative lack of visual effects and putatively higher rates of ego-dissolution and mystical experiences. We conclude that further clinical exploration is warranted, using similar precautions as with other classic psychedelics.

Interactions of lithium and drugs that affect signal transduction on behaviour in rats

The therapeutic mechanism of the action of lithium in the treatment of bipolar affective disorder is not known, in spite of a burgeoning number of biochemical studies linking lithium to signal transduction processes. This article reviews a decade of studies examining the behavioural manifestations of manipulating inositol, cyclic adenosine monophosphate (cAMP) and G proteins in rats. Inositol, forskolin, dibutyryl cAMP and pertussis toxin all interacted with lithium when rearing behavior was measured. Lithium potentiated the increase in locomotion induced by injections of cholera toxin into the nucleus accumbens, consistent with the hypothesis that it inactivates inhibitory G proteins. More specific interactions were found between lithium and inositol following cholinergic and serotonergic stimulation. Inositol, but not forskolin, attenuated lithium-pilocarpine seizures and the enhancement of the serotonin syndrome; however, inositol had no effect on lithium-induced attenuation of wet dog shakes following an injection of 5-hydroxytryptophan. Behavioural evidence supports biochemical findings suggesting that lithium's interactions with the phoshphatidyl inositol and cyclic AMP signal transduction systems may be relevant to its therapeutic effects in bipolar disorder. Further research on more specific behaviours may elucidate the relevant pharmacological mechanisms underlying the therapeutic effect of lithium.

Effects of lithium treatment on extracellular serotonin levels in the dorsal hippocampus and wet-dog shakes in the rat

In the present study wet-dog shakes in rats were induced by local potassium (K+) depolarization in the dorsal hippocampus. Concurrently, changes in extracellular concentrations of cyclic AMP (cAMP) and serotonin (5-HT) were assessed by microdialysis. It has been well-established that lithium influences the synthesis of cAMP in the brain via effects on adenylate cyclases. In this study, the effect of chronic lithium treatment on the number of wet-dog shakes and the release of 5-HT was investigated. Wet-dog shakes, formation of cAMP and release of 5-HT were induced by perfusing a Ringer solution containing 60 mM K+ through the microdialysis probe for 20 min. Under some conditions, this high K+ solution also contained 20 microM forskolin. The number of wet-dog shakes and the formation of cAMP induced by K+ depolarization were enhanced by forskolin, while the K+ -stimulated release of 5-HT was unaffected by forskolin. Chronic lithium treatment, yielding a plasma lithium level of 0.78+/-0.09 mmol/l, decreased the number of wet-dog shakes but did not affect the extracellular level of 5-HT in the dorsal hippocampus. Chronic lithium treatment may affect the serotonergic wet-dog shake syndrome in the rat partly via the cAMP signalling system but does not seem to influence this syndrome by changing the release of 5-HT from nerve terminals in the dorsal hippocampus.

Lithium enhancement of the prolactin response to 5-hydroxytryptophan is not reversible by inositol

1. Two hundred male albino Sprague-Dawley rats were studied for the lithium and/or inositol effect on 5-HTP induced prolactin release. 2. Lithium demonstrated a clear augmentation of 5-HTP induced prolactin levels, however no effect of inositol was demonstrated on lithium augmentation of 5-HTP induced prolactin release.