Influence of initial use of serotonergic antidepressants on antiparkinsonian drug use in levodopa-using patients

Depression and Parkinson's disease: current knowledge

Depressive disturbances are common in patients with Parkinson's disease (PD) and influence many other clinical aspects of the disease. In addition to causing inherent emotional distress, depressive disorders negatively impact quality of life, motor and cognitive deficits, functional disability, and other psychiatric comorbidities in patients with PD. Knowledge of the pathophysiology of PD depression remains limited. However, clinical studies demonstrate the efficacy of medications and psychotherapies for PD depression, underscoring the importance of their timely detection and concerted management.

Effect of selective serotonin reuptake inhibitors via 5-HT1A receptors on L-DOPA-induced rotational behavior in a hemiparkinsonian rat model

L-Dihydroxyphenylalanine (L-DOPA) is considered the gold standard for the treatment of Parkinson's disease (PD). However, long-term administration of L-DOPA can induce abnormal side effects. On the other hand, selective serotonin reuptake inhibitors (SSRIs) including fluoxetine have gained tremendous popularity in the treatment of depression in PD. SSRIs are thought to influence motor function in PD via pharmacological modification of interactions between serotonergic and dopaminergic networks, which are complex and not yet fully understand. In this study, intranigral injection of 6-hydroxydopamine (6-OHDA) in rats caused a significant loss of tyrosine hydroxylase immunoreactivity in the striatum and substantia nigra. However, tryptophan hydroxylase immunoreactivity of the striatum and raphe nucleus was unaffected by 6-OHDA. Immunohistochemical analysis reveal that the serotonergic system was unaffected by the injection of 6-OHDA. We demonstrated also that pre-treatment with fluoxetine significantly suppressed L-DOPA-induced rotational behavior. Additionally, fluoxetine suppressed L-DOPA-induced ERK1/2 and histone H3 phosphorylation. These effects of fluoxetine were abolished by pre-treatment with WAY 100135, a 5-HT(1A) antagonist. These results suggest that fluoxetine may influence motor function in PD via pharmacological modification of interactions between serotonergic and dopaminergic neuronal networks.

Dopaminergic and serotoninergic deficiencies in young adult rats prenatally exposed to the bacterial lipopolysaccharide

We have reported previously that prenatal bacterial lipopolysaccharide (LPS) exposure at the gestation window of vulnerability could consistently lead to dopamine (DA) neuron loss in the substantia nigra (SN). Thus, we suggested that prenatal LPS exposure might represent as a risk factor for the development of Parkinson's disease (PD). Here, we report that the same exposure could lead to tryptophan hydroxylase (TPH, a serotonin neuron marker) immunoreactive cell loss in the dorsal raphe nucleus (DRN). Twenty two pups born to saline or LPS-injected gravid female rats at E10.5 were used in the current study. Twelve male pups at age of 4 months (6 from each of two prenatal groups) were used for the tyrosine hydroxylase (TH) and tryptophan hydroxylase (TPH) immunochemistry studies. The other 10 (5 from each of two prenatal groups) males were used in the biochemistry studies. A 29% THir neuron loss in the substantia nigra (F(1,11)=17.573, P=0.002) and a 31% TPHir neuron loss (F(1,11)=44.005, P<0.001) in the DRN were seen. Significant DA and 5-hydroxytryptamine (5-HT) reductions (P<0.05) were found in the frontal cortex, nucleus accumbens, striatum, amygdala, hippocampus, and hypothalamus. The losses of DA and 5-HT were accompanied by the significant increases in homovanillic acid over DA and 5-hydroxyindoleacetic acid over 5-HT ratios in the most areas tested. These data further validate prenatal LPS exposure as a model of PD since DA and 5-HT changes similar to those seen in PD patients. They also suggest that prenatal LPS might be a risk factor for other diseases including mood disorders.