Factors modulating brain serotonin turnover

Psychedelics in Psychiatry: Neuroplastic, Immunomodulatory, and Neurotransmitter Mechanisms

Mounting evidence suggests safety and efficacy of psychedelic compounds as potential novel therapeutics in psychiatry. Ketamine has been approved by the Food and Drug Administration in a new class of antidepressants, and 3,4-methylenedioxymethamphetamine (MDMA) is undergoing phase III clinical trials for post-traumatic stress disorder. Psilocybin and lysergic acid diethylamide (LSD) are being investigated in several phase II and phase I clinical trials. Hence, the concept of psychedelics as therapeutics may be incorporated into modern society. Here, we discuss the main known neurobiological therapeutic mechanisms of psychedelics, which are thought to be mediated by the effects of these compounds on the serotonergic (via 5-HT_2A and 5-HT_1A receptors) and glutamatergic [via N-methyl-d-aspartate (NMDA) and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors] systems. We focus on 1) neuroplasticity mediated by the modulation of mammalian target of rapamycin-, brain-derived neurotrophic factor-, and early growth response-related pathways; 2) immunomodulation via effects on the hypothalamic-pituitary-adrenal axis, nuclear factor ĸB, and cytokines such as tumor necrosis factor-α and interleukin 1, 6, and 10 production and release; and 3) modulation of serotonergic, dopaminergic, glutamatergic, GABAergic, and norepinephrinergic receptors, transporters, and turnover systems. We discuss arising concerns and ways to assess potential neurobiological changes, dependence, and immunosuppression. Although larger cohorts are required to corroborate preliminary findings, the results obtained so far are promising and represent a critical opportunity for improvement of pharmacotherapies in psychiatry, an area that has seen limited therapeutic advancement in the last 20 years. Studies are underway that are trying to decouple the psychedelic effects from the therapeutic effects of these compounds. SIGNIFICANCE STATEMENT: Psychedelic compounds are emerging as potential novel therapeutics in psychiatry. However, understanding of molecular mechanisms mediating improvement remains limited. This paper reviews the available evidence concerning the effects of psychedelic compounds on pathways that modulate neuroplasticity, immunity, and neurotransmitter systems. This work aims to be a reference for psychiatrists who may soon be faced with the possibility of prescribing psychedelic compounds as medications, helping them assess which compound(s) and regimen could be most useful for decreasing specific psychiatric symptoms.

Increasing blood oxygen increases an index of 5-HT synthesis in human brain as measured using alpha-[(11)C]methyl-L-tryptophan and positron emission tomography

The main objective of this investigation was to test the hypothesis that brain serotonin (5-HT) synthesis, as measured by trapping of alpha-[(11)C]methyl-L-tryptophan (alpha-MTrp) using positron emission tomography (PET), can be modulated by changes in blood oxygen. The study involved six healthy participants (three male and three female), who breathed a 15% or 60% oxygen mixture starting 15 min before the injection of tracer and continuing during the entire acquisition period. Participants were injected with up to 12m Ci of alpha-MTrp. Two sets of PET images were acquired while the participants were breathing each of the oxygen mixtures and, after reconstruction, all images were converted into brain functional images illustrating the brain trapping constant K(*) (microL/g/min). The K(*) values were obtained for 12 regions of interest outlined on the magnetic resonance images. The K(*) values obtained at high and low blood oxygen content were compared by paired statistics using Tukey's post hoc correction. As there were no difference in plasma tryptophan concentrations, these K(*) values are directly related to regional 5-HT synthesis. The results showed highly significant increases (50% on average) in brain serotonin synthesis (K(*) values) at high (mean value of 223+/-41 mmHg) relative to low (mean value 77.1+/-7.7 mmHg) blood oxygen levels. This suggests that tryptophan hydroxylase is not saturated with oxygen in the living human brain and that increases in blood oxygen can elevate brain serotonin synthesis.

Effect of lisuride and other ergot derivatives on monoaminergic mechanisms in rat brain

The effects of the ergot derivative lisuride hydrogen maleate on synthesis, turnover and receptor activity of monoamines were compared with those of LSD, methysergide, yohimbine and methiothepin. In the dopamine (DA) rich areas, c. striatum and mesolimbic forebrain, lisuride, (30-100 mug/kg) decreased the rate of dopa formation after inhibition of the aromatic amino acid decarboxylase with NSD 1015, 100 mg/kp i.p. After axotomy of the ascending monoaminergic fibers, lisuride (0.5 mg/kg) antagonized the accumulation of dopa in c. striatum and mesolimbic forebrain even on the lesioned side; haloperidol effectively counteracted this lisuride-induced decrease in dopa formation. In the predominantly noradrenaline (NA)-innervated neocortex, lisuride in doses of 0.3 and 1.0 mg/kg increased dopa accumulation. Methysergide, yohimbine and methiothepin also stimulated tyrosine hydroxylation. After inhibition of catecholamine synthesis with alpha-methyl-p-tyrosine methylester HCl, lisuride decelerated DA disappearance and accelerated NA disappearance. 3-Methoxytryramine (3-MY) accumulating after inhibition of monoamine axidase with pargyline HCl (100 mg/kg) was used as an indicator of DA release. Lisuride and LSD, 50 mug/kg administered twice, reduced 3-MT formation while methysergide, 50 mg/kp i.p. had no effect on 3-MT accumulation. All compounds except methiothepin reduced 5-hydroxytryptophan (5-HTP) accumulation in whole brain after NSD 1015. In addition, lisuride caused an increase in 5-hydroxytryptamine (5-HT) and a decrease in 5-hydroxyindole acetic acid concentration. In spinal reserpinized rats, lisuride was indistinguishable from LSD in inducing extension and athetoid movements of the hind legs. The data support the view that lisuride stimulates pre- and postsynaptic DA and 5-HT receptors and suggest that lisuride blocks NA receptors in the central nervous system.

The effect of oxygen on the enzymes concerned in the metabolism of 5-hydroxytryptamine by rat brain and liver preparations

1. The effect of oxygen concentration at 1 atm on rat enzyme systems concerned in the synthesis and degradation of 5-hydroxytryptamine was studied in vitro. 2. Oxygen activated tryptophan hydroxylase and the deamination of both 5-hydroxytryptamine and tyramine by monoamine oxidase. 3. Oxygen did not affect the activities of 5-hydroxytryptophan decarboxylase or peroxidase.

Effects of single and multiple dose LSD on endogenous levels of brain tyrosine and catecholamines

The effects on brain catecholamines of seven daily doses of d-LSD 520 mug/kg injected i.p. to Sprague-Dawley rats on a tolerance dosage schedule (L X 7) were compared with the effects of a single dose of LSD (L X 1) 520 mug/kg or 1040 mug/kg, over a 90 min time course. Compared to saline controls, after a single dose of 520 mug/kg LSD, there was a significant decrease in brain norepinephrine at 30 to 60 min, a rise in dopamine at 60 min, and a small rise in brain tyrosine at early time points followed by significant decline from control levels after 60 min. The effects of a single dose of 1040 mug/kg LSD were similar to the 520 mug/kg dose but were greater in both magnitude and duration of the brain catecholamine changes. After a tolerance dosage schedule there were significant changes in the response of brain catecholamines to 520 mug/kg LSD. The rise in brain dopamine at 60 min was abolished, brain tyrosine was uniformly below both saline and L times 1 animals, and brain norepinephrine returned to control levels slightly faster.

Effect of benzodiazepine compounds on brain amine metabolism

In mice, chlordiazepoxide, diazepam and flurazepam reduced 5-HT synthesis and metabolism in the teldiencephalon following an i.v. injection of 3H-tryptophan. Only diazepam produced a significant effect in the brainstem. The steady state level of brain 5-HT or of tryptophan was not altered by any of the drugs. Chlordiazepoxide and diazepam, but not flurazepam, decreased the rate of norepinephrine loss from the brain following inhibition of synthesis with alpha-methyltyrosine.

Brain tryptophan hydroxylation: dependence on arterial oxygen tension

The accumulation of cerebral 5-hydroxytryptophan after decarboxylase inhibition was decreased in rats maintained at arterial O(2) tensions below 60 mm-Hg. In contrast, brain lactate was stable above 40 mm-Hg and brain adenosine triphosphate, adenosine diphosphate, and adenosine monophosphate were unchanged above 30 mm-Hg. There was a linear correlation of brain 5-hydroxytryptophan accumulation to cerebral venous O(2) tension. Cerebral tryptophan hydroxylase appears to have a poor affinity for oxygen and to be affected by slight hypoxia. The resultant decreases in monoamine neurotransmitter metabolism may explain the behavioral changes of mild oxygen deprivation.

Effect of p-nitromethylamphetamine on biogenic amines and their amino-acid precursors in rat brain

1. Low doses of p-nitromethylamphetamine caused small increases in the concentrations of brain noradrenaline and dopamine in the rat; a dose of 60 mg/kg however, caused a decrease in the concentrations of both amines. p-Nitromethylamphetamine caused behavioural hyperexcitability only at doses which approximated to half the LD50 (68 mg/kg).2. p-Nitromethylamphetamine potentiated the action of 4,alpha-dimethyl-m-tyramine in depleting brain noradrenaline. This suggests that it may affect brain noradrenaline concentrations by utilizing a reserpine resistant uptake mechanism.3. p-Nitromethylamphetamine decreased the concentration of brain 5-hydroxytryptamine.4. Changes in the blood and brain concentrations of tyrosine and gamma-amino-n-butyric acid concentration in the brain could not be correlated with the changes in brain amines. However, a rise in the concentration of brain tryptophan appeared to be correlated with the fall in brain 5-hydroxytryptamine.

Persistent increase in brain serotonin turnover after chronic administration of LSD in the rat

Lysergic acid diethylamide at doses of 20 micrograms per kilogram per day was administered orally to rats for I month. Eighteen hours after the final dose a 25 to 30 percent increase in the synthesis and turnover of serotonin was noted, as well as a moderate but significant increase in the concentration of tryptophan (18 percent) and serotonin (13 percent) in the brain.

Antagonism of 5-hydroxytryptamine by LSD 25 in the central nervous system: a possible neuronal basis for the actions of LSD 25

1. 5-Hydroxytryptamine (5-HT), acetylcholine (ACh), noradrenaline (NA), glutamate, D,L-homocysteic acid (DLH), glycine and gamma-aminobutyric acid (GABA) were applied to single neurones in the brain stem of decerebrate cats by microiontophoresis. The abilities of D-lysergic acid diethylamide tartrate (LSD 25), methysergide maleate (UML 491) and 2-bromo-lysergic acid diethylamide (BOL 148) to antagonize the actions of these compounds were studied.2. LSD 25 antagonized 5-HT excitation of single neurones when applied iontophoretically or administered intravenously. LSD 25 also antagonized glutamate excitation of neurones which could be excited by 5-HT. Inhibitory effects of 5-HT, the action of glutamate on neurones which could be inhibited by 5-HT and the actions of all the other compounds tested were unaffected by LSD 25.3. Iontophoretically applied UML 491 was also a specific antagonist to 5-HT and glutamate excitation but was less potent than LSD 25, and BOL 148 rarely exhibited antagonism.4. It is suggested that antagonism to 5-HT and glutamate excitation of brain stem neurones may be the basis of the psychotomimetic action of LSD 25. It is also suggested that there may be similarities in the mechanisms by which 5-HT and glutamate produce excitation where they act on the same neurone.

In vivo conversion of 3H-L-tryptophan into 3H-serotonin in brain areas of adrenalectomized rats

Rats were adrenalectomized 10 days before we estimated in vivo the conversion index of (3)H-tryptophan into radioactive serotonin in brainstem and telediencephalon. We found that the conversion index in the brainstem of adrenalectomized rats is smaller than in the same area of sham-operated rats. Conversely, the conversion index in the telediencephalon was similar in the two groups of rats. The serotonin concentrations were unchanged by adrenalectomy, which suggests that in brainstem the decrease of tryptophan hydroxylase is reflected by the conversion index estimation and not by measurement of serotonin steady-state concentrations.

Corticosterone regulation of tryptophan hydroxylase in midbrain of the rat

The tryptophan hydroxylase activity in the rat midbrain decreases after adrenalectomy and is restored by treatment with corticosterone. Cycloheximide, adminiistered intracisternally, prevents the restoration of the enzyme activity by corticosterone. Cycloheximide administration to adrenalectomized rats resutlts in a further decrease in the enzyme activity. an indication that the enzyme has a rapid turnover even in the absence of corticosterone.

Lysergic acid diethylamide: role in conversion of plasma tryptophan to brain serotonin (5-hydroxytryptamine)

Injections of D-lysergic acid diethylamide decrease the turnover rate of 5-hydroxytryptamine of rat brain, as measured from the conversion of (14)C-tryptophan into (14)C-5-hydroxytryptamine. The 2-bromolysergic acid diethylamide given in doses fivefold greater than those of lysergic acid diethylamide fails to change the rate of (14)C-tryptophan conversion into (14)C-5-hydroxytryptamine. The effect of D-lysergic acid diethylamide is discussed with regard to its action on brain serotonergic neurons and its psychotomimetic effects.

A study of the role of noradrenaline in behavioral changes produced in the rat by psychotomimetic drugs

1. LSD-25, psilocybin and JB-329 reduced the noradrenaline content of the rat hypothalamus.2. All three drugs affected the acquisition of a conditioned avoidance response, LSD-25 and psilocybin retarding and JB-329 enhancing the acquisition. With the exception of JB-329, doses affecting the acquisition of a conditioned avoidance response were lower than those required to decide hypothalamic noradrenaline concentrations. The time of peak drug effect on the acquisition of a conditioned avoidance response occurred approximately 1.5 hr after injection as opposed to 3 hr in the case of noradrenaline content.3. The amount of LSD-25, psilocybin and JB-329 necessary to elicit gross behavioural excitation was similar to the dose producing noradrenaline depletion. Here also the peak behavioural effect was detected earlier.4. Pretreatment with reserpine and alpha-MT had no effect on the intensity of gross behavioural excitation induced by LSD-25 and psilocybin but shortened the duration of the response. The excitation induced by JB-329 was abolished by reserpine pretreatment and was markedly reduced both in intensity and duration by the prior injection of alpha-MT.