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Zink CF, Giegerich M, Prettyman GE, Carta KE, van Ginkel M, O’Rourke MP, Singh E, Fuchs EJ, Hendrix CW, Zimmerman E, Breakey J, Marzinke MA, Hummert P, Pillai JJ, Weinberger DR, Bigos KL. Nimodipine improves cortical efficiency during working memory in healthy subjects. Transl Psychiatry 2020; 10:372. [PMID: 33139710 PMCID: PMC7606375 DOI: 10.1038/s41398-020-01066-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/11/2020] [Accepted: 06/18/2020] [Indexed: 02/01/2023] Open
Abstract
The L-type calcium channel gene, CACNA1C, is a validated risk gene for schizophrenia and the target of calcium channel blockers. Carriers of the risk-associated genotype (rs1006737 A allele) have increased frontal cortical activity during working memory and higher CACNA1C mRNA expression in the prefrontal cortex. The aim of this study was to determine how the brain-penetrant calcium channel blocker, nimodipine, changes brain activity during working memory and other cognitive and emotional processes. We conducted a double-blind randomized cross-over pharmacoMRI study of a single 60 mg dose of oral nimodipine solution and matching placebo in healthy men, prospectively genotyped for rs1006737. With performance unchanged, nimodipine significantly decreased frontal cortical activity by 39.1% and parietal cortical activity by 42.8% during the N-back task (2-back > 0-back contrast; PFWE < 0.05; n = 28). Higher peripheral nimodipine concentrations were correlated with a greater decrease in activation in the frontal cortex. Carriers of the risk-associated allele, A (n = 14), had a greater decrease in frontal cortical activation during working memory compared to non-risk allele carriers. No differences in brain activation were found between nimodipine and placebo for other tasks. Future studies should be conducted to test if the decreased cortical brain activity after nimodipine is associated with improved working memory performance in patients with schizophrenia, particularly those who carry the risk-associated genotype. Furthermore, changes in cortical activity during working memory may be a useful biomarker in future trials of L-type calcium channel blockers.
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Affiliation(s)
- Caroline F. Zink
- grid.417125.40000 0000 9558 9225Baltimore Research and Education Foundation, Baltimore, MD United States ,grid.429552.dLieber Institute for Brain Development, Baltimore, MD United States ,grid.21107.350000 0001 2171 9311Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD United States
| | - Mellissa Giegerich
- grid.429552.dLieber Institute for Brain Development, Baltimore, MD United States ,Veterans Administration, San Diego, CA United States
| | - Greer E. Prettyman
- grid.429552.dLieber Institute for Brain Development, Baltimore, MD United States ,grid.25879.310000 0004 1936 8972Department of Neuroscience, University of Pennsylvania, Philadelphia, PA United States
| | - Kayla E. Carta
- grid.429552.dLieber Institute for Brain Development, Baltimore, MD United States ,grid.21107.350000 0001 2171 9311Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore, MD United States
| | - Marcus van Ginkel
- grid.429552.dLieber Institute for Brain Development, Baltimore, MD United States ,grid.21107.350000 0001 2171 9311Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore, MD United States
| | - Molly P. O’Rourke
- grid.429552.dLieber Institute for Brain Development, Baltimore, MD United States ,grid.25879.310000 0004 1936 8972School of Nursing, University of Pennsylvania, Philadelphia, PA United States
| | - Eesha Singh
- grid.429552.dLieber Institute for Brain Development, Baltimore, MD United States ,grid.267301.10000 0004 0386 9246College of Medicine, University of Tennessee, Memphis, TN United States
| | - Edward J. Fuchs
- grid.21107.350000 0001 2171 9311Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore, MD United States
| | - Craig W. Hendrix
- grid.21107.350000 0001 2171 9311Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore, MD United States ,grid.21107.350000 0001 2171 9311Department of Pharmacology and Molecular Science, Johns Hopkins School of Medicine, Baltimore, MD United States ,grid.21107.350000 0001 2171 9311Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD United States ,grid.21107.350000 0001 2171 9311Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD United States
| | - Eric Zimmerman
- grid.21107.350000 0001 2171 9311Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore, MD United States
| | - Jennifer Breakey
- grid.21107.350000 0001 2171 9311Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore, MD United States
| | - Mark A. Marzinke
- grid.21107.350000 0001 2171 9311Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore, MD United States ,grid.21107.350000 0001 2171 9311Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD United States
| | - Pamela Hummert
- grid.21107.350000 0001 2171 9311Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore, MD United States
| | - Jay J. Pillai
- grid.21107.350000 0001 2171 9311Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore, MD United States ,grid.21107.350000 0001 2171 9311Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, MD United States
| | - Daniel R. Weinberger
- grid.429552.dLieber Institute for Brain Development, Baltimore, MD United States ,grid.21107.350000 0001 2171 9311Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD United States ,grid.21107.350000 0001 2171 9311Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD United States ,grid.21107.350000 0001 2171 9311Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD United States ,grid.21107.350000 0001 2171 9311The McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore, MD United States
| | - Kristin L. Bigos
- grid.429552.dLieber Institute for Brain Development, Baltimore, MD United States ,grid.21107.350000 0001 2171 9311Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD United States ,grid.21107.350000 0001 2171 9311Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore, MD United States ,grid.21107.350000 0001 2171 9311Department of Pharmacology and Molecular Science, Johns Hopkins School of Medicine, Baltimore, MD United States
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Antidepressant-like and memory-enhancing effects of the N-type calcium channel blocker ziconotide in rats. Behav Brain Res 2020; 390:112647. [PMID: 32428635 DOI: 10.1016/j.bbr.2020.112647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 04/01/2020] [Accepted: 04/06/2020] [Indexed: 02/03/2023]
Abstract
The lack of oral or injectable formulations of ziconotide (ω-conotoxin peptide), a novel analgesic agent, limits research on potential neurobehavioral protective properties of this substance, including antidepressant-like effects. Here we expose rats to a stress paradigm that induces depression and memory impairment to assess the effects of ziconotide treatment. Ziconotide was administered intracerebroventricular (i.c.v.) to rats undergoing stereotaxic surgery at a single dose (1 μg/rat) or in repeated long-term applications (dosage groups: 0.1, 0.3, and 1 μg/rat). The antidepressant activity and memory-enhancing effects of ziconotide were examined via the forced swimming test, the Morris water maze test, and the passive avoidance learning test. Behavioral results showed that long-term i.c.v. ziconotide administration significantly decreased the immobility time and delayed the latency period to immobility in a dose-dependent manner compared to controls. In the passive avoidance learning test, the latency period increased, and in the Morris water maze test, the platform location latency time decreased. A single dose of ziconotide (1 μg/rat) did not show a significant effect on memory function or depression parameters during the same tests. Animals were sacrificed immediately after behavioral testing, and both hippocampi were removed and prepared for BDNF evaluation. Hippocampal BDNF levels were significantly increased in rats receiving long-term i.c.v. ziconotide compared to controls. Our results suggest that long-term consumption of ziconotide may attenuate the severity of depression-like behavior and could be useful for preventing memory impairments in various learning models by elevating BDNF levels.
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Lauterbach EC. Dextromethorphan as a potential rapid-acting antidepressant. Med Hypotheses 2011; 76:717-9. [PMID: 21367535 DOI: 10.1016/j.mehy.2011.02.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Accepted: 02/04/2011] [Indexed: 11/25/2022]
Abstract
Dextromethorphan shares pharmacological properties in common with antidepressants and, in particular, ketamine, a drug with demonstrated rapid-acting antidepressant activity. Pharmacodynamic similarities include actions on NMDA, μ opiate, sigma-1, calcium channel, serotonin transporter, and muscarinic sites. Additional unique properties potentially contributory to an antidepressant effect include actions at ß, alpha-2, and serotonin 1b/d receptors. It is therefore, hypothesized that dextromethorphan may have antidepressant efficacy in bipolar, unipolar, major depression, psychotic, and treatment-resistant depressive disorders, and may display rapid-onset of antidepressant response. An antidepressant response may be associated with a positive family history of alcoholism, prediction of ketamine response, increased AMPA-to-NMDA receptor activity ratio, antidepressant properties in animal models of depression, reward system activation, enhanced erythrocyte magnesium concentration, and correlation with frontal μ receptor binding potential. Clinical trials of dextromethorphan in depressive disorders, especially treatment-resistant depression, now seem warranted.
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Affiliation(s)
- Edward C Lauterbach
- Department of Psychiatry and Behavioral Sciences, Mercer University School of Medicine, 1550 College Street, Macon, GA 31201, USA.
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Casamassima F, Hay AC, Benedetti A, Lattanzi L, Cassano GB, Perlis RH. L-type calcium channels and psychiatric disorders: A brief review. Am J Med Genet B Neuropsychiatr Genet 2010; 153B:1373-90. [PMID: 20886543 DOI: 10.1002/ajmg.b.31122] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2009] [Accepted: 07/28/2010] [Indexed: 01/11/2023]
Abstract
Emerging evidence from genome-wide association studies (GWAS) support the association of polymorphisms in the alpha 1C subunit of the L-type voltage-gated calcium channel gene (CACNA1C) with bipolar disorder. These studies extend a rich prior literature implicating dysfunction of L-type calcium channels (LTCCs) in the pathophysiology of neuropsychiatric disorders. Moreover, calcium channel blockers reduce Ca(2+) flux by binding to the α1 subunit of the LTCC and are used extensively for treating hypertension, preventing angina, cardiac arrhythmias and stroke. Calcium channel blockers have also been studied clinically in psychiatric conditions such as mood disorders and substance abuse/dependence, yielding conflicting results. In this review, we begin with a summary of LTCC pharmacology. For each category of disorder, this article then provides a review of animal and human data. In particular, we extensively focus on animal models of depression and clinical trials in mood disorders and substance abuse/dependence. Through examining rationale and study design of published clinical trials, we provide some of the possible reasons why we still do not have definitive evidence of efficacy of calcium-channel antagonists for mood disorders. Refinement of genetic results and target phenotypes, enrollment of adequate sample sizes in clinical trials and progress in physiologic and pharmacologic studies to synthesize tissue and isoform specific calcium channel antagonists, are all future challenges of research in this promising field. © 2010 Wiley-Liss, Inc.
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Abstract
In contrast to mania, bipolar depression is usually characterised by longer-lasting episodes and a higher incidence of treatment refractoriness. Additionally, the risks of antidepressive standard treatment regimens are increasingly recognised, especially the risk of a switch into mania or induction of a rapid cycling course. Mood stabilisers, e.g. lithium, and some anticonvulsants, appear to have at least some antidepressant efficacy, which, however, may not be sufficient for treating severe depression. Currently, their use as a monotherapy of mild depression and at the start as a co-medication to antidepressants in severe depression is under consideration. The potential usefulness and risks of currently applied antidepressive treatment strategies as well as potential future developments will be reviewed in this article. At this stage, at least in severe depression, the use of true antidepressants still appears to be mandatory, especially because of the risk of suicide. However, initial combination with a mood stabiliser can be recommended. The treatment of depressive episodes only responsive to ECT should include combination with a mood stabiliser, in this case lithium, right from the start. In patients with lithium refractoriness, mood stabilising anticonvulsants should be initiated directly after the end of the ECT cycle. In order to reach sufficient plasma levels and thus reduce the risk of a switch, a loading therapy is recommended.
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Affiliation(s)
- H Grunze
- Department of Psychiatry, Ludwig-Maximilians-University, Nussbaumstrasse 7, 80336 Munich, Germany
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Hollister LE, Trevino ES. Calcium channel blockers in psychiatric disorders: a review of the literature. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 1999; 44:658-64. [PMID: 10500866 DOI: 10.1177/070674379904400702] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To review the published literature of the past 15 years regarding use of calcium channel blockers (CCBs) in psychiatric practice. These drugs, especially verapamil, have been recommended as possible treatments for mania and other disorders. METHODS The Cumulative Medical Index and other databases were searched and back-tracked to locate relevant articles. Sixty-one such articles were uncovered: 37 anecdotal reports, 7 partially controlled reports, and 17 controlled trials. RESULTS Most studies involved treatment of mania using verapamil. Although anecdotal reports were generally favourable, results from partially controlled reports or controlled clinical trials were mixed. Generally, verapamil was less effective than was lithium or placebo. Treatment of depression with CCBs was not very successful, regardless of the type of trial; the best trial was negative. The same was true for the treatment of schizophrenia, although the cases studied were extremely chronic and treatment-resistant. Evidence for efficacy in other illnesses, such as Alzheimer's disease or tardive dyskinesia was scanty but suggested that further trials might be in order. CONCLUSIONS CCBs do not at present have an established place in psychiatric treatment. Nonetheless, clinicians faced with a manic patient not responsive to other antimanic drugs, either alone or in combination, might consider adding verapamil as an adjunct. A study bearing on this specific issue is needed to determine whether or not such off-label use would really be justified.
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Affiliation(s)
- L E Hollister
- University of Texas Health Science Center at Houston, USA
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Walden J, von Wegerer J, Winter U, Berger M, Grunze H. Effects of kawain and dihydromethysticin on field potential changes in the hippocampus. Prog Neuropsychopharmacol Biol Psychiatry 1997; 21:697-706. [PMID: 9194150 DOI: 10.1016/s0278-5846(97)00042-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
1. The kava-pyrones kawain and dihydromethysticin are constituents of Piper methysticum which exert anticonvulsant, analgesic and anxiolytic properties. 2. In the present study the effect of these kava-pyrones were tested on field potential changes (fp) induced by omission of the extracellular Mg2+, recorded from the area CA1 and CA3 of the hippocampal slice preparation of guinea pigs. These fp are generated by an activation of NMDA receptors and voltage dependent calcium channels. 3. Kawain and dihydromethysticin reduced reversibly the frequency of occurrence of fp in a concentration range from 5 to 40 mumol/l and 10 to 40 mumol/l, respectively. 4. Reduction of the fp frequency after addition of subthreshold concentrations of 5 mumol/l kawain and 10 mumol/l dihydromethysticin indicated additive actions of both drugs. 5. Since the serotonin-1A agonist ipsapirone also exerts anxiolytic effects, subthreshold concentrations of kawain or dihydromethysticin were combined with a subthreshold concentration of ipsapirone in another set of experiments. Combining kawain and ipsapirone or dihydromethysticin and ipsapirone caused a reduction of the rate of fp to 0.76 and 0.81 of the baseline value, respectively. 6. The findings suggest that (i) single constituents of Piper methysticum may have additive actions, (ii) that the two components kawain and dihydromethysticin may enhance the effects of the anxiolytic serotonin-1A agonist ipsapirone and (iii) that activation of NMDA receptors and/or voltage dependent calcium channels may be involved in the elementary mechanism of action of some kava-pyrones.
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Affiliation(s)
- J Walden
- Dept. of Psychiatry, University of Freiburg, Germany
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von Wegerer J, Hesslinger B, Berger M, Walden J. A calcium antagonistic effect of the new antiepileptic drug lamotrigine. Eur Neuropsychopharmacol 1997; 7:77-81. [PMID: 9169293 DOI: 10.1016/s0924-977x(96)00384-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The new antiepileptic drug lamotrigine (LTG; 3,5-diamino-6-(2,3-dichlorophenyl)-1,2,4-triazine) has been shown to be effective in the treatment of focal epilepsies with or without secondary generalization. Furthermore, some case reports indicate an efficacy in the treatment of bipolar affective disorders. It has been suggested that the main mechanism of action of LTG is the inhibition of glutamate release through blockade of voltage sensitive sodium channels and stabilisation of the neuronal membrane. Since some antidepressant drugs and the antiepileptic substance carbamazepine have calcium antagonistic properties, which may be of significance in the pathophysiology of epilepsies and affective disorders, the interaction of lamotrigine with carbamazepine and the organic calcium channel blocker verapamil was analyzed in the low Mg(2+)-induced model epilepsy which has been shown to be suppressed specifically by organic calcium antagonists. Lamotrigine reduced the frequency of occurrence of low-magnesium induced field potentials in CA1 and CA3 areas of the hippocampus slice preparation (guinea pigs) in a dose-dependent manner. The subthreshold concentrations which yielded no effect were 1 mumol/l for lamotrigine, 10 mumol/l for carbamazepine and 2 mumol/l for verapamil. Combinations of these subthreshold concentrations elicited a reduction in the repetition rate of field potentials. The results indicate that lamotrigine behaves additive with verapamil and carbamazepine what can be due to a common action on the same subtype of calcium channels. It can be assumed that lamotrigine may have besides its action on high-frequency sodium dependent action potentials also effects on calcium channels.
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Affiliation(s)
- J von Wegerer
- Universität Freiburg, Abt. Psychiatrie und Psychotherapie, Germany
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