1
|
Capuzzi E, Caldiroli A, Quitadamo C, Butturini F, Surace T, Clerici M, Buoli M. Novel pharmacotherapy targeting the positive symptoms of schizophrenia. Expert Opin Pharmacother 2023; 24:1623-1648. [PMID: 37401388 DOI: 10.1080/14656566.2023.2231346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 06/27/2023] [Indexed: 07/05/2023]
Abstract
INTRODUCTION The severity of positive symptoms in schizophrenia is associated with poor prognosis. About one-third of schizophrenia patients partially respond to treatment with available antipsychotics. The purpose of the present manuscript is to provide an updated overview of novel pharmacotherapy targeting positive symptoms in schizophrenia. AREAS COVERED A comprehensive research on the main database sources (PubMed, PsychINFO, Isi Web of Knowledge, MEDLINE, and EMBASE) was performed to obtain original articles published till 31st January 2023 about new pharmacological strategies for the treatment of positive symptoms in schizophrenia. EXPERT OPINION The most promising compounds include: lamotrigine, pro-cognitive-compounds (donepezil - in the short term, idazoxan and piracetam) and drugs acting partially or totally outside the Central Nervous System (CNS) (anti-inflammatory drugs: celecoxib, methotrexate; cardiovascular compounds: L-theanine, mononitrate isosorbide, propentofylline, sodium nitroprusside; metabolic regulators: diazoxide, allopurinol; others: bexarotene, raloxifene [in women]). The effectiveness of the latter compounds indicates that other biological systems, such as immunity or metabolism can be object of future research to identify pharmacological targets for positive symptoms of schizophrenia. Mirtazapine could be useful for treating negative symptoms without increasing the risk of a worsening of delusions/hallucinations. Nevertheless, the lack of replication of studies prevents to draw definitive conclusions and future studies are needed to confirm the findings presented in this overview.
Collapse
Affiliation(s)
- Enrico Capuzzi
- Fondazione IRCCS, Department of Mental Health and Addiction, San Gerardo Dei Tintori, Monza, Italy
| | - Alice Caldiroli
- Fondazione IRCCS, Department of Mental Health and Addiction, San Gerardo Dei Tintori, Monza, Italy
| | - Cecilia Quitadamo
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, MB, Italy
| | - Francesco Butturini
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, MB, Italy
| | - Teresa Surace
- Fondazione IRCCS, Department of Mental Health and Addiction, San Gerardo Dei Tintori, Monza, Italy
| | - Massimo Clerici
- Fondazione IRCCS, Department of Mental Health and Addiction, San Gerardo Dei Tintori, Monza, Italy
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, MB, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| |
Collapse
|
2
|
Liu S, Tian H, Niu Y, Yu C, Xie L, Jin Z, Niu W, Ren J, Fu L, Yao Z. Combined cell grafting and VPA administration facilitates neural repair through axonal regeneration and synaptogenesis in traumatic brain injury. Acta Biochim Biophys Sin (Shanghai) 2022; 54:1289-1300. [PMID: 36148950 PMCID: PMC9828309 DOI: 10.3724/abbs.2022123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Neuronal regeneration and functional recovery are severely compromised following traumatic brain injury (TBI). Treatment options, including cell transplantation and drug therapy, have been shown to benefit TBI, although the underlying mechanisms remain elusive. In this study, neural stem cells (NSCs) are transplanted into TBI-challenged mice, together with olfactory ensheathing cells (OECs) or followed by valproic acid (VPA) treatment. Both OEC grafting and VPA treatment facilitate the differentiation of NSCs into neurons (including endogenous and exogenous neurons) and significantly attenuate neurological functional defects in TBI mice. Combination of NSCs with OECs or VPA administration leads to overt improvement in axonal regeneration, synaptogenesis, and synaptic plasticity in the cerebral cortex in TBI-challenged mice, as shown by retrograde corticospinal tract tracing, electron microscopy, growth-associated protein 43 (GAP43), and synaptophysin (SYN) analyses. However, these beneficial effects of VPA are reversed by local delivery of N-methyl-D-aspartate (NMDA) into tissues surrounding the injury epicenter in the cerebral cortex, accompanied by a pronounced drop in axons and synapses in the brain. Our findings reveal that increased axonal regeneration and synaptogenesis evoked by cell grafting and VPA fosters neural repair in a murine model of TBI. Moreover, VPA-induced neuroprotective roles are antagonized by exogenous NMDA administration and its concomitant decrease in the number of neurons of local brain, indicating that increased neurons induced by VPA treatment mediate axonal regeneration and synaptogenesis in mice after TBI operation. Collectively, this study provides new insights into NSC transplantation therapy for TBI.
Collapse
Affiliation(s)
- Sujuan Liu
- Department of Anatomy and EmbryologySchool of Basic Medical ScienceTianjin Medical UniversityTianjin300070China
| | - Haili Tian
- School of KinesiologyShanghai University of SportShanghai200438China
| | - Yanmei Niu
- Department of RehabilitationSchool of Medical TechnologyTianjin Medical UniversityTianjin300070China
| | - Chunxia Yu
- Department of Physiology and PathophysiologySchool of Basic Medical ScienceTianjin Medical UniversityTianjin300070China
| | - Lingjian Xie
- Department of Physiology and PathophysiologySchool of Basic Medical ScienceTianjin Medical UniversityTianjin300070China
| | - Zhe Jin
- Tianjin Yaohua Binhai SchoolTianjin300000China
| | - Wenyan Niu
- Key Laboratory of Immune Microenvironment and Disease (Ministry of Education)Department of ImmunologySchool of Basic Medical ScienceTianjin Medical UniversityTianjin300070China
| | - Jun Ren
- Department of CardiologyZhongshan Hospital Fudan UniversityShanghai Institute of Cardiovascular DiseasesShanghai200032China,Department of Laboratory Medicine and PathologyUniversity of WashingtonSeattleWA98195USA,Correspondence address. Tel: +86-22-83336819; (Z.Y.) / Tel: +86-22-83336107; (L.F.) / Tel: +86-21-64041990; (J.R.) @
| | - Li Fu
- Department of RehabilitationSchool of Medical TechnologyTianjin Medical UniversityTianjin300070China,Department of Physiology and PathophysiologySchool of Basic Medical ScienceTianjin Medical UniversityTianjin300070China,Correspondence address. Tel: +86-22-83336819; (Z.Y.) / Tel: +86-22-83336107; (L.F.) / Tel: +86-21-64041990; (J.R.) @
| | - Zhi Yao
- Key Laboratory of Immune Microenvironment and Disease (Ministry of Education)Department of ImmunologySchool of Basic Medical ScienceTianjin Medical UniversityTianjin300070China,Correspondence address. Tel: +86-22-83336819; (Z.Y.) / Tel: +86-22-83336107; (L.F.) / Tel: +86-21-64041990; (J.R.) @
| |
Collapse
|
3
|
Ketamine and Lamotrigine Combination in Psychopharmacology: Systematic Review. Cells 2022; 11:cells11040645. [PMID: 35203296 PMCID: PMC8869907 DOI: 10.3390/cells11040645] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/28/2022] [Accepted: 02/09/2022] [Indexed: 01/05/2023] Open
Abstract
Background and Objectives: Ketamine is a rapid-acting antidepressant with proven efficacy as an add-on agent in unipolar and bipolar treatment-resistant depression. Although many studies have been published, there is still not enough data on the effect of ketamine in combination with other medications. Particularly interesting is the combination of ketamine and lamotrigine, and its potential role in bipolar depression. The aim of this review was to identify animal and human studies in which ketamine and lamotrigine were used together in order to find out if there is scientific ground for combining ketamine and lamotrigine in the treatment of mood disorders. Directions for future studies are presented. Materials and Methods: PubMed and Web of Science were searched. Preferred Reporting Items for Systematic Reviews and Meta-Analyses PRISMA 2020 methodology was applied. Results: Seventeen studies were included for review. Animal studies using models of depression suggested a synergistic effect of ketamine and lamotrigine in combination. Studies on healthy humans showed a reduction in ketamine-induced dissociative symptoms with lamotrigine pretreatment. In a study on patients with depression, ketamine and lamotrigine did not have a stronger antidepressant effect than ketamine alone, but in this study only one ketamine infusion was administered. One case series described the antidepressant and anti-suicidal effect of the combination in two bipolar patients. Available clinical studies on patients with mood disorders did not support the hypothesis that lamotrigine reduces ketamine-induced dissociative symptoms. Conclusions: The results of the analyzed studies were not sufficient to answer any of the stated questions; however, they allowed us to delineate future research directions. The identified animal studies suggested a possible synergistic antidepressant effect of ketamine and lamotrigine. The available clinical studies were not conclusive. No controlled studies on large groups of bipolar patients with multiple ketamine infusions combined with lamotrigine treatment have been published so far. There is some evidence for the reduction of ketamine’s side effects by lamotrigine, and there are reports suggesting that lamotrigine can reduce ketamine craving. More studies with follow-up are needed in order to investigate the ketamine–lamotrigine combination in bipolar patients.
Collapse
|
4
|
Zhao M, Liu T, Qi S, Li W, Liu X, Li X, Xun G. Individuals with Bipolar Disorder Have a Higher Level of Homocysteine Than Major Depressive Disorder: A Retrospective Chart Review and Observational Study. Neuropsychiatr Dis Treat 2022; 18:2671-2682. [PMID: 36411779 PMCID: PMC9675348 DOI: 10.2147/ndt.s387063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/04/2022] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Previous studies suggest that homocysteine (Hcy) may be involved in the pathogenesis of bipolar disorder (BD) and major depressive disorder (MDD) by influencing glutamatergic transmission, inflammation, and other mechanisms. There are no established biomarkers to distinguish BD from MDD. This study aims to compare Hcy levels between BD and MDD. PATIENTS AND METHODS We collected medical records of patients aged 14-75 admitted to the hospital from January 1 to July 1, 2022 with a discharge diagnosis of MDD or BD, including all examinations of patients at admission (acute phase) and discharge (non-acute phase). We measured Hcy levels in healthy controls (HC). RESULTS The analysis included 104 patients with MDD, 103 patients with BD, and 80 HC. Hcy levels were higher in the MDD and BD group than in the HC group and higher in the BD group than in the MDD group, both in the acute and non-acute phases (all P < 0.05). There was no significant difference in Hcy levels between the psychotropic medication users and non-users in the BD or MDD group (all P > 0.05). Multivariate logistic regression analysis only for the MDD and BD group indicated that the likelihood of BD diagnosis was significantly associated with Hcy levels (in the acute phase: OR = 1.052, P = 0.016; in the non-acute phase: OR = 1.101, P < 0.001) after controlling for gender, age, and metabolic indicators. CONCLUSION Our study suggests that Hcy levels were elevated in MDD and BD patients and were higher in BD patients than in MDD patients, which provides evidence for a possible relationship between one-carbon metabolism and the pathogenesis of BD. Besides, Hcy may be one of the potential biomarkers to distinguish BD from MDD.
Collapse
Affiliation(s)
- Miao Zhao
- Department of Psychiatry, Shandong Mental Health Center, Shandong University, Jinan, People's Republic of China
| | - Tengteng Liu
- Department of Psychiatry, Shandong Mental Health Center, Shandong University, Jinan, People's Republic of China
| | - Sufang Qi
- Department of Psychiatry, Shandong Mental Health Center, Shandong University, Jinan, People's Republic of China
| | - Wenjie Li
- Department of Psychiatry, Shandong Mental Health Center, Shandong University, Jinan, People's Republic of China
| | - Xin Liu
- Department of Psychiatry, Shandong Mental Health Center, Shandong University, Jinan, People's Republic of China
| | - Xinming Li
- Department of Psychiatry, Shandong Mental Health Center, Shandong University, Jinan, People's Republic of China
| | - Guanglei Xun
- Department of Psychiatry, Shandong Mental Health Center, Shandong University, Jinan, People's Republic of China
| |
Collapse
|
5
|
Dynamics of Cyclooxygenase-1 Positive Microglia/Macrophage in the Retina of Pathological Model Mice as a Biomarker of the Retinal Inflammatory Diseases. Int J Mol Sci 2021; 22:ijms22073396. [PMID: 33806238 PMCID: PMC8036698 DOI: 10.3390/ijms22073396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 03/22/2021] [Indexed: 11/18/2022] Open
Abstract
In an intraocular inflammatory state, microglia residing in the retina become active and migrate inside the retina. In this study, we investigated whether cyclooxygenase-1 (COX-1) expressed by retinal microglia/macrophage can be a biomarker for the diagnosis of retinal diseases. COX-1 was immunopositive in microglia/macrophage and neutrophils, while COX-2 was immunopositive in astrocytes and neurons in the inner layer of normal retina. The number of COX-1 positive cells per section of the retinal tissue was 14 ± 2.8 (mean ± standard deviation) in normal mice, which showed significant increase in the lipopolysaccharide (LPS)-administrated model (62 ± 5.0, p = 8.7 × 10−9). In addition to microglia, we found neutrophils that were positive for COX-1. In the early stage of inflammation in the experimental autoimmune uveoretinitis (EAU), COX-1 positive cells, infiltrating from the ciliary body into the retinal outer nuclear layer, were observed. The number of infiltrating COX-1 positive cells correlated with the severity of EAU. Taken together, the increased number of COX-1 positive microglia/macrophage with morphological changes were observed in the retinas of retinal inflammatory disease models. This suggests that COX-1 can be a marker of disease-related activities of microglia/macrophage, which should be useful for the diagnosis of retinal diseases.
Collapse
|
6
|
Higazy IM. Brain targeting stealth lipomers of combined antiepileptic-anti-inflammatory drugs as alternative therapy for conventional anti-Parkinson's. Saudi Pharm J 2020; 28:33-57. [PMID: 31920431 PMCID: PMC6950972 DOI: 10.1016/j.jsps.2019.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 11/02/2019] [Indexed: 10/28/2022] Open
Abstract
This study presents an alternative therapy to conventional anti-Parkinson's treatment strategies; where motor and non-motor symptomatic complications are considered. Thus; providing sustainability, patient compliance, therapeutic safety and efficiency, based on triggering secretion of endogenous dopamine (DA). Exogenous DA has long been considered the best therapy, however, its poor blood brain barrier (BBB) permeability, fluctuated plasma levels, and non-motor complications negligence, decreased response to therapy with time. Consequently; brain targeting Tween®80-coated pegylated lipomers were tailored for intravenous administration (IV) of L-Dopa, and two drugs of reported neuroprotective effect: lamotrigine (LTG) and tenoxicam (TX). Single-step nanoprecipitation method was used; for its reproducibility and ease of scaling-up. Formulation targeting and anti-PD efficiency was evaluated against marketed standards and L-Dopa. In-vitro and in-vivo pharmacokinetic and dynamic studies were carried out for setting optimization standards upon varying inter-components ratio. Results revealed that lipomers are, generally, significantly efficient in brain targeting compared to oral tablets. LTG-lipomers (LF20) showed the maximum anti-PD compared to its TX and L-Dopa analogues. Combining LTG and TX had synergistic effect; highlighting a new prescription for both drugs. Thus; offering a safe, targeted, and therapeutically efficient sustained dosage form, capable of mitigating PD risk and treating it though weekly administration. Hence; presenting a novel promising anti-neurodegenerative strategy; on employing various mechanisms that were previously achieved through additional therapeutic supplements.
Collapse
|
7
|
Miranda ASD, Miranda ASD, Teixeira AL. Lamotrigine as a mood stabilizer: insights from the pre-clinical evidence. Expert Opin Drug Discov 2018; 14:179-190. [PMID: 30523725 DOI: 10.1080/17460441.2019.1553951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Lamotrigine (LTG) is a well-established anticonvulsant that is also approved for the prevention of mood relapses in bipolar disorder. However, the mechanisms underlying LTG mood stabilizing effects remain unclear. Areas covered: Herein, the pre-clinical evidence concerning LTG's' mode of action in depression and mania is reviewed. Bottlenecks and future perspectives for this expanding and promising field are also discussed. Pre-clinical studies have indicated that neurotransmitter systems, especially serotoninergic, noradrenergic and glutamatergic, as well as non-neurotransmitter pathways such as inflammation and oxidative processes might play a role in LTG's antidepressant effects. The mechanisms underlying LTG's anti-manic properties remain to be fully explored, but the available pre-clinical evidence points out to the role of glutamatergic neurotransmission, possibly through AMPA-receptors. Expert opinion: A major limitation of current pre-clinical investigations is that there are no experimental models that recapitulate the complexity of bipolar disorder. Significant methodological differences concerning time and dose of LTG treatment, administration route, animal strains, and behavioral paradigms also hamper the reproducibility of the findings, leading to contradictory conclusions. Moreover, the role of other mechanisms (e.g. inositol phosphate and GSK3β pathways) implicated in the mode of action of different mood-stabilizers must also be consolidated with LTG.
Collapse
Affiliation(s)
- Aline Silva de Miranda
- a Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina , Universidade Federal de Minas Gerais , Belo Horizonte , Brazil.,b Laboratório de Neurobiologia, Departamento de Morfologia, Instituto de Ciências Biológicas , Universidade Federal de Minas Gerais , Belo Horizonte , Brasil
| | - Amanda Silva de Miranda
- c Departamento de Química , Instituto de Ciências Exatas, Universidade Federal de Minas Gerais , Belo Horizonte , Brasil
| | - Antônio Lúcio Teixeira
- a Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina , Universidade Federal de Minas Gerais , Belo Horizonte , Brazil.,d Neuropsychiatry Program & Immuno-Psychiatry Lab, Department of Psychiatry & Behavioral Sciences, McGovern Medical School , University of Texas Health Science Center at Houston , Houston , USA
| |
Collapse
|
8
|
ANDO A, SATOMI Y. A Simple and Highly Sensitive Quantitation of Eicosanoids in Biological Samples Using Nano-flow Liquid Chromatography/Mass Spectrometry. ANAL SCI 2018; 34:177-182. [DOI: 10.2116/analsci.34.177] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Ayumi ANDO
- Integrated Technology Research Laboratories, Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited
| | - Yoshinori SATOMI
- Integrated Technology Research Laboratories, Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited
| |
Collapse
|
9
|
Izadpanah F, Arab F, Zarghami A, Bijani A, Kazemi S, Moghadamnia AA. The effect of lamotrigine on learning in mice using the passive avoidance model. Epilepsy Behav 2017; 69:1-6. [PMID: 28213162 DOI: 10.1016/j.yebeh.2016.11.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 11/19/2016] [Accepted: 11/21/2016] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Lamotrigine (LTG) is an antiepileptic drug that inhibits the release of glutamate by blocking sodium channels. The present study was conducted to evaluate the effect of LTG in different stages of memory using a passive avoidance learning task in mice. METHODS Male albino mice in the weight range 20-25g were used. They were divided into four groups (control group and three groups receiving various doses of LTG). LTG was given in three doses of 10, 25, and 50mg/kg as intraperitoneal (IP) injections. The doses of LTG were used in three injection groups: before acquisition, after consolidation, and before retrieval at 24h. The retention latency times in each group were recorded using a step-through passive avoidance task 24h and one week after consolidation. RESULTS Retention latency in the group receiving a high dose of LTG (25mg/kg) after one week was significantly increased in comparison to the group receiving a low dose of LTG (10mg/kg) (267±49.96 vs. 198.87±57.22, P=0.015). With injection of LTG after consolidation, the retention latency times were increased in all doses after a one-week retrieval compared to the control (P=0.023). Kaplan-Mayer surveillance analysis also showed significant differences in the latencies of the LTG-receiving group after 24h and one week's retrieval (P=0.041). Administration of LTG before retrieval at 24h showed a significant difference in retention latency time, which was increased for two doses of LTG (10 and 50mg/kg) after one week (203.5±63.67 vs. 270.25±19.78, P=0.024). CONCLUSION LTG at higher doses may facilitate the learning process in mice and appears to improve memory function at different stages.
Collapse
Affiliation(s)
- Fatemeh Izadpanah
- Department of Pharmacology, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Arab
- Department of Pharmacology, Babol University of Medical Sciences, Babol, Iran
| | - Amin Zarghami
- Department of Pharmacology, Babol University of Medical Sciences, Babol, Iran
| | - Ali Bijani
- Social Determinant of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Sohrab Kazemi
- Neuroscience Research Center, Department of Pharmacology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran; Cellular and Molecular Biology Research Center, Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Ali Akbar Moghadamnia
- Department of Pharmacology, Babol University of Medical Sciences, Babol, Iran; Neuroscience Research Center, Department of Pharmacology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran.
| |
Collapse
|
10
|
Pharmacological evidence for the involvement of the NMDA receptor and nitric oxide pathway in the antidepressant-like effect of lamotrigine in the mouse forced swimming test. Biomed Pharmacother 2016; 82:713-21. [PMID: 27470415 DOI: 10.1016/j.biopha.2016.05.035] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 05/23/2016] [Indexed: 01/14/2023] Open
Abstract
Lamotrigine is an anticonvulsant agent that shows clinical antidepressant properties. The aim of the present study was to investigate the involvement of N-methyl-d-aspartate (NMDA) receptors and nitric oxide-cyclic guanosine monophosphate (NO-cGMP) synthesis in possible antidepressant-like effect of lamotrigine in forced swimming test (FST) in mice. Intraperitoneal administration of lamotrigine (10mg/kg) decreased the immobility time in the FST (P<0.01) without any effect on locomotor activity in the open-field test (OFT), while higher dose of lamotrigine (30mg/kg) reduced the immobility time in the FST (P<0.001) as well as the number of crossings in the OFT. Pretreatment of animals with NMDA (75mg/kg), l-arginine (750mg/kg, a substrate for nitric oxide synthase [NOS]) or sildenafil (5mg/kg, a phosphodiesterase [PDE] 5 inhibitor) reversed the antidepressant-like effect of lamotrigine (10mg/kg) in the FST. Injection of l-nitroarginine methyl ester (l-NAME, 10mg/kg, a non-specific NOS inhibitor), 7-nitroindazole (30mg/kg, a neuronal NOS inhibitor), methylene blue (20mg/kg, an inhibitor of both NOS and soluble guanylate cyclase [sGC]), or MK-801 (0.05mg/kg), ketamine (1mg/kg), and magnesium sulfate (10mg/kg) as NMDA receptor antagonists in combination with a sub-effective dose of lamotrigine (5mg/kg) diminished the immobility time of animals in the FST compared with either drug alone. None of the drugs produced significant effects on the locomotor activity in the OFT. Based on our findings, it is suggested that the antidepressant-like effect of lamotrigine might mediated through inhibition of either NMDA receptors or NO-cGMP synthesis.
Collapse
|
11
|
Prabhavalkar KS, Poovanpallil NB, Bhatt LK. Management of bipolar depression with lamotrigine: an antiepileptic mood stabilizer. Front Pharmacol 2015; 6:242. [PMID: 26557090 PMCID: PMC4615936 DOI: 10.3389/fphar.2015.00242] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 10/08/2015] [Indexed: 11/13/2022] Open
Abstract
The efficacy of lamotrigine in the treatment of focal epilepsies have already been reported in several case reports and open studies, which is thought to act by inhibiting glutamate release through voltage-sensitive sodium channels blockade and neuronal membrane stabilization. However, recent findings have also illustrated the importance of lamotrigine in alleviating the depressive symptoms of bipolar disorder, without causing mood destabilization or precipitating mania. Currently, no mood stabilizers are available having equal efficacy in the treatment of both mania and depression, two of which forms the extreme sides of the bipolar disorder. Lamotrigine, a well established anticonvulsant has received regulatory approval for the treatment and prevention of bipolar depression in more than 30 countries worldwide. Lamotrigine, acts through several molecular targets and overcomes the major limitation of other conventional antidepressants by stabilizing mood from “below baseline” thereby preventing switches to mania or episode acceleration, thus being effective for bipolar I disorder. Recent studies have also suggested that these observations could also be extended to patients with bipolar II disorder. Thus, lamotrigine may supposedly fulfill the unmet requirement for an effective depression mood stabilizer.
Collapse
Affiliation(s)
- Kedar S Prabhavalkar
- Department of Pharmacology, Dr. Bhanuben Nanavati College of Pharmacy , Mumbai, India
| | - Nimmy B Poovanpallil
- Department of Pharmacology, Dr. Bhanuben Nanavati College of Pharmacy , Mumbai, India
| | - Lokesh K Bhatt
- Department of Pharmacology, Dr. Bhanuben Nanavati College of Pharmacy , Mumbai, India
| |
Collapse
|
12
|
León-Caballero J, Pacchiarotti I, Murru A, Valentí M, Colom F, Benach B, Pérez V, Dalmau J, Vieta E. Bipolar disorder and antibodies against the N-methyl-d-aspartate receptor: A gate to the involvement of autoimmunity in the pathophysiology of bipolar illness. Neurosci Biobehav Rev 2015; 55:403-12. [PMID: 26014349 DOI: 10.1016/j.neubiorev.2015.05.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 05/04/2015] [Accepted: 05/11/2015] [Indexed: 01/15/2023]
Abstract
The high prevalence of comorbidity between bipolar disorder (BD) and other medical conditions, including autoimmune diseases, supports the hypothesis of the nature of BD as a biological illness category. Hence, an immune dysregulation process may play an important role in the development of at least certain subtypes of BD. Increasing evidence also suggests that the N-methyl-d-aspartate receptor (NMDAR) may be relevant in the pathophysiology of BD. A possible key mechanism underlying the physiopathology of certain autoimmune diseases that may present with affective symptoms might be the production of anti-NMDAR auto-antibodies (auto-Abs). The best characterized autoimmune anti-NMDAR disease is the anti-NMDAR encephalitis. It has been found that 4% of these patients present isolated, mostly affective, psychiatric manifestations during their illness. An interesting suggestion emerged from this overview is that the same mechanisms that trigger affective symptoms in patients with increased anti-NMDAR auto-Abs levels could be involved in the physiopathology of at least a subgroup of BD. Future studies are needed to characterize the relationship between anti-NMDAR auto-Abs and BD.
Collapse
Affiliation(s)
- J León-Caballero
- Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, CIBERSAM, Universidad Autonoma de Barcelona, Barcelona, Catalonia, Spain
| | - I Pacchiarotti
- Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A Murru
- Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - M Valentí
- Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - F Colom
- Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - B Benach
- Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - V Pérez
- Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, CIBERSAM, Universidad Autonoma de Barcelona, Barcelona, Catalonia, Spain
| | - J Dalmau
- Catalan Institution for Research and Advanced Studies (ICREA), IDIBAPS, University of Barcelona; Department of Neurology, University of Pennsylvania
| | - E Vieta
- Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
| |
Collapse
|
13
|
The Potential Role of the NLRP3 Inflammasome as a Link between Mitochondrial Complex I Dysfunction and Inflammation in Bipolar Disorder. Neural Plast 2015; 2015:408136. [PMID: 26075098 PMCID: PMC4444590 DOI: 10.1155/2015/408136] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 11/06/2014] [Indexed: 02/06/2023] Open
Abstract
Mitochondrial dysfunction and activation of the inflammatory system are two of the most consistently reported findings in bipolar disorder (BD). More specifically, altered levels of inflammatory cytokines and decreased levels of mitochondrial complex I subunits have been found in the brain and periphery of patients with BD, which could lead to increased production of mitochondrial reactive oxygen species (ROS). Recent studies have shown that mitochondrial production of ROS and inflammation may be closely linked through a redox sensor known as nod-like receptor pyrin domain-containing 3 (NLRP3). Upon sensing mitochondrial release of ROS, NLRP3 assembles the NLRP3 inflammasome, which releases caspase 1 to begin the inflammatory cascade. In this review, we discuss the potential role of the NLRP3 inflammasome as a link between complex I dysfunction and inflammation in BD and its therapeutic implications.
Collapse
|
14
|
Salvamoser JD, Avemary J, Luna-Munguia H, Pascher B, Getzinger T, Pieper T, Kudernatsch M, Kluger G, Potschka H. Glutamate-Mediated Down-Regulation of the Multidrug-Resistance Protein BCRP/ABCG2 in Porcine and Human Brain Capillaries. Mol Pharm 2015; 12:2049-60. [PMID: 25898179 DOI: 10.1021/mp500841w] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Breast cancer resistance protein (BCRP) functions as a major molecular gatekeeper at the blood-brain barrier. Considering its impact on access to the brain by therapeutic drugs and harmful xenobiotics, it is of particular interest to elucidate the mechanisms of its regulation. Excessive glutamate concentrations have been reported during epileptic seizures or as a consequence of different brain insults including brain ischemia. Previously, we have demonstrated that glutamate can trigger an induction of the transporter P-glycoprotein. These findings raised the question whether other efflux transporters are affected in a comparable manner. Glutamate exposure proved to down-regulate BCRP transport function and expression in isolated porcine capillaries. The reduction was efficaciously prevented by coincubation with N-methyl-d-aspartate (NMDA) receptor antagonist MK-801. The involvement of the NMDA receptor in the down-regulation of BCRP was further confirmed by experiments showing an effect of NMDA exposure on brain capillary BCRP transport function and expression. Pharmacological targeting of cyclooxygenase-1 and -2 (COX-1 and -2) using the nonselective inhibitor indomethacin, COX-1 inhibitor SC-560, and COX-2 inhibitor celecoxib revealed a contribution of COX-2 activity to the NMDA receptor's downstream signaling events affecting BCRP. Translational studies were performed using human capillaries isolated from surgical specimens of epilepsy patients. The findings confirmed a glutamate-induced down-regulation of BCRP transport activity in human capillaries, which argued against major species differences. In conclusion, our data reveal a novel mechanism of BCRP down-regulation in porcine and human brain capillaries. Moreover, together with previous data sets for P-glycoprotein, the findings point to a contrasting impact of the signaling pathway on the regulation of BCRP and P-glycoprotein. The effect of glutamate and arachidonic acid signaling on BCRP function might have implications for brain drug delivery and for radiotracer brain access in epilepsy patients and patients with other brain insults.
Collapse
Affiliation(s)
- Josephine D Salvamoser
- †Institute of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilians-University, Koeniginstrasse 16, D-80539 Munich, Germany
| | - Janine Avemary
- †Institute of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilians-University, Koeniginstrasse 16, D-80539 Munich, Germany
| | - Hiram Luna-Munguia
- †Institute of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilians-University, Koeniginstrasse 16, D-80539 Munich, Germany
| | | | | | | | | | | | - Heidrun Potschka
- †Institute of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilians-University, Koeniginstrasse 16, D-80539 Munich, Germany
| |
Collapse
|
15
|
Tkatcheva V, Poirier D, Chong-Kit R, Furdui VI, Burr C, Leger R, Parmar J, Switzer T, Maedler S, Reiner EJ, Sherry JP, Simmons DBD. Lithium an emerging contaminant: bioavailability, effects on protein expression, and homeostasis disruption in short-term exposure of rainbow trout. AQUATIC TOXICOLOGY (AMSTERDAM, NETHERLANDS) 2015; 161:85-93. [PMID: 25678467 DOI: 10.1016/j.aquatox.2015.01.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 01/29/2015] [Accepted: 01/31/2015] [Indexed: 06/04/2023]
Abstract
Worldwide production of lithium (Li) has increased dramatically during the past decade, driven by the demand for high charge density batteries. Information about Li in the aquatic environment is limited. The present study was designed to explore the effects of Li in rainbow trout (Oncorhynchus mykiss). Juvenile trout were exposed to a nominal concentration of 1.0mg Li/L in three separate exposures. Major ion concentrations were measured in brain and plasma by ion chromatography. Plasma proteins and fatty acids were measured by HPLC-MS/MS. Lithium accumulated in the brain and plasma. Arachidonic acid was elevated in plasma after 48h. Elevated concentrations of Li in brain were associated with depressed concentrations of sodium, magnesium, potassium and ammonium relative to the control. In plasma, sodium and calcium were also depressed. Several changes occurred to plasma proteins corresponding to Li exposure: inhibition of prostaglandin synthase (Ptgs2), increased expression of copper transporting ATP synthases, and Na(+)/K(+) ATPase. To our knowledge, ours is the first study to demonstrate elevated Li concentrations in fish brain, with associated effects on ion regulation.
Collapse
Affiliation(s)
- Victoria Tkatcheva
- Laboratory Service Branch (LaSB), Ontario Ministry of Environment and Climate Change (MOECC), Etobicoke, ON M9P 3V6, Canada.
| | - David Poirier
- Laboratory Service Branch (LaSB), Ontario Ministry of Environment and Climate Change (MOECC), Etobicoke, ON M9P 3V6, Canada
| | - Richard Chong-Kit
- Laboratory Service Branch (LaSB), Ontario Ministry of Environment and Climate Change (MOECC), Etobicoke, ON M9P 3V6, Canada
| | - Vasile I Furdui
- Laboratory Service Branch (LaSB), Ontario Ministry of Environment and Climate Change (MOECC), Etobicoke, ON M9P 3V6, Canada
| | - Christopher Burr
- Laboratory Service Branch (LaSB), Ontario Ministry of Environment and Climate Change (MOECC), Etobicoke, ON M9P 3V6, Canada
| | - Ray Leger
- Laboratory Service Branch (LaSB), Ontario Ministry of Environment and Climate Change (MOECC), Etobicoke, ON M9P 3V6, Canada
| | - Jaspal Parmar
- Laboratory Service Branch (LaSB), Ontario Ministry of Environment and Climate Change (MOECC), Etobicoke, ON M9P 3V6, Canada
| | - Teresa Switzer
- Laboratory Service Branch (LaSB), Ontario Ministry of Environment and Climate Change (MOECC), Etobicoke, ON M9P 3V6, Canada
| | - Stefanie Maedler
- Laboratory Service Branch (LaSB), Ontario Ministry of Environment and Climate Change (MOECC), Etobicoke, ON M9P 3V6, Canada; University of Toronto, Department of Chemistry, 80 St. George Street, Toronto, ON M5S 3H6, Canada
| | - Eric J Reiner
- Laboratory Service Branch (LaSB), Ontario Ministry of Environment and Climate Change (MOECC), Etobicoke, ON M9P 3V6, Canada; University of Toronto, Department of Chemistry, 80 St. George Street, Toronto, ON M5S 3H6, Canada
| | - James P Sherry
- Aquatic Contaminants Research Division, Environment Canada, Burlington, ON L7R 4A6, Canada
| | - Denina B D Simmons
- Aquatic Contaminants Research Division, Environment Canada, Burlington, ON L7R 4A6, Canada
| |
Collapse
|
16
|
The role of NMDA receptors in the pathophysiology and treatment of mood disorders. Neurosci Biobehav Rev 2014; 47:336-58. [PMID: 25218759 DOI: 10.1016/j.neubiorev.2014.08.017] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 08/08/2014] [Accepted: 08/28/2014] [Indexed: 12/31/2022]
Abstract
Mood disorders such as major depressive disorder and bipolar disorder are chronic and recurrent illnesses that cause significant disability and affect approximately 350 million people worldwide. Currently available biogenic amine treatments provide relief for many and yet fail to ameliorate symptoms for others, highlighting the need to diversify the search for new therapeutic strategies. Here we present recent evidence implicating the role of N-methyl-D-aspartate receptor (NMDAR) signaling in the pathophysiology of mood disorders. The possible role of NMDARs in mood disorders has been supported by evidence demonstrating that: (i) both BPD and MDD are characterized by altered levels of central excitatory neurotransmitters; (ii) NMDAR expression, distribution, and function are atypical in patients with mood disorders; (iii) NMDAR modulators show positive therapeutic effects in BPD and MDD patients; and (iv) conventional antidepressants/mood stabilizers can modulate NMDAR function. Taken together, this evidence suggests the NMDAR system holds considerable promise as a therapeutic target for developing next generation drugs that may provide more rapid onset relief of symptoms. Identifying the subcircuits involved in mood and elucidating the role of NMDARs subtypes in specific brain circuits would constitute an important step toward the development of more effective therapies with fewer side effects.
Collapse
|
17
|
Rapoport SI. Lithium and the other mood stabilizers effective in bipolar disorder target the rat brain arachidonic acid cascade. ACS Chem Neurosci 2014; 5:459-67. [PMID: 24786695 DOI: 10.1021/cn500058v] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
This Review evaluates the arachidonic acid (AA, 20:4n-6) cascade hypothesis for the actions of lithium and other FDA-approved mood stabilizers in bipolar disorder (BD). The hypothesis is based on evidence in unanesthetized rats that chronically administered lithium, carbamazepine, valproate, or lamotrigine each downregulated brain AA metabolism, and it is consistent with reported upregulated AA cascade markers in post-mortem BD brain. In the rats, each mood stabilizer reduced AA turnover in brain phospholipids, cyclooxygenase-2 expression, and prostaglandin E2 concentration. Lithium and carbamazepine also reduced expression of cytosolic phospholipase A2 (cPLA2) IVA, which releases AA from membrane phospholipids, whereas valproate uncompetitively inhibited in vitro acyl-CoA synthetase-4, which recycles AA into phospholipid. Topiramate and gabapentin, proven ineffective in BD, changed rat brain AA metabolism minimally. On the other hand, the atypical antipsychotics olanzapine and clozapine, which show efficacy in BD, decreased rat brain AA metabolism by reducing plasma AA availability. Each of the four approved mood stabilizers also dampened brain AA signaling during glutamatergic NMDA and dopaminergic D2 receptor activation, while lithium enhanced the signal during cholinergic muscarinic receptor activation. In BD patients, such signaling effects might normalize the neurotransmission imbalance proposed to cause disease symptoms. Additionally, the antidepressants fluoxetine and imipramine, which tend to switch BD depression to mania, each increased AA turnover and cPLA2 IVA expression in rat brain, suggesting that brain AA metabolism is higher in BD mania than depression. The AA hypothesis for mood stabilizer action is consistent with reports that low-dose aspirin reduced morbidity in patients taking lithium, and that high n-3 and/or low n-6 polyunsaturated fatty acid diets, which in rats reduce brain AA metabolism, were effective in BD and migraine patients.
Collapse
Affiliation(s)
- Stanley I. Rapoport
- Brain Physiology and Metabolism Section, Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Bethesda, Maryland 20892, United States
| |
Collapse
|
18
|
Basselin M, Ramadan E, Rapoport SI. Imaging brain signal transduction and metabolism via arachidonic and docosahexaenoic acid in animals and humans. Brain Res Bull 2012; 87:154-71. [PMID: 22178644 PMCID: PMC3274571 DOI: 10.1016/j.brainresbull.2011.12.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Revised: 12/01/2011] [Accepted: 12/02/2011] [Indexed: 02/05/2023]
Abstract
The polyunsaturated fatty acids (PUFAs), arachidonic acid (AA, 20:4n-6) and docosahexaenoic acid (DHA, 22:6n-3), important second messengers in brain, are released from membrane phospholipid following receptor-mediated activation of specific phospholipase A(2) (PLA(2)) enzymes. We developed an in vivo method in rodents using quantitative autoradiography to image PUFA incorporation into brain from plasma, and showed that their incorporation rates equal their rates of metabolic consumption by brain. Thus, quantitative imaging of unesterified plasma AA or DHA incorporation into brain can be used as a biomarker of brain PUFA metabolism and neurotransmission. We have employed our method to image and quantify effects of mood stabilizers on brain AA/DHA incorporation during neurotransmission by muscarinic M(1,3,5), serotonergic 5-HT(2A/2C), dopaminergic D(2)-like (D(2), D(3), D(4)) or glutamatergic N-methyl-d-aspartic acid (NMDA) receptors, and effects of inhibition of acetylcholinesterase, of selective serotonin and dopamine reuptake transporter inhibitors, of neuroinflammation (HIV-1 and lipopolysaccharide) and excitotoxicity, and in genetically modified rodents. The method has been extended for the use with positron emission tomography (PET), and can be employed to determine how human brain AA/DHA signaling and consumption are influenced by diet, aging, disease and genetics.
Collapse
Affiliation(s)
- Mireille Basselin
- Brain Physiology and Metabolism Section, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Epolia Ramadan
- Brain Physiology and Metabolism Section, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Stanley I. Rapoport
- Brain Physiology and Metabolism Section, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| |
Collapse
|
19
|
Savitz J, Preskorn S, Teague TK, Drevets D, Yates W, Drevets W. Minocycline and aspirin in the treatment of bipolar depression: a protocol for a proof-of-concept, randomised, double-blind, placebo-controlled, 2x2 clinical trial. BMJ Open 2012; 2:e000643. [PMID: 22357572 PMCID: PMC3289990 DOI: 10.1136/bmjopen-2011-000643] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION New medication classes are needed to improve treatment effectiveness in the depressed phase of bipolar disorder (BD). Extant evidence suggests that BD is characterised by neural changes such as dendritic remodelling and glial and neuronal cell loss. These changes have been hypothesised to result from chronic inflammation. The principal aims of the proposed research is to evaluate the antidepressant efficacy in bipolar depression of minocycline, a drug with neuroprotective and immune-modulating properties, and of aspirin, at doses expected to selectively inhibit cyclooxygenase 1 (COX-1). METHODS AND ANALYSIS 120 outpatients between 18 and 55 years of age, who meet DSM-IV-TR criteria for BD (type I or II) and for a current major depressive episode will be recruited to take part in a randomised, double-blind, placebo-controlled, parallel-group, proof-of-concept clinical trial following a 2×2 design. As adjuncts to existing treatment, subjects will be randomised to receive one of the four treatment combinations: placebo-minocycline plus placebo-aspirin, active-minocycline plus placebo-aspirin, placebo-minocycline plus active-aspirin or active-minocycline plus active-aspirin. The dose of minocycline and aspirin is 100 mg twice daily and 81 mg twice daily, respectively. Antidepressant response will be evaluated by assessing changes in the Montgomery-Asberg Depression Rating Scale scores between baseline and the end of the 6-week trial. As secondary outcome measures, the anti-inflammatory effects of minocycline and aspirin will be tested by measuring pre-treatment and post-treatment levels of C reactive protein and inflammatory cytokines. ETHICS AND DISSEMINATION Minocycline has been widely used as an antibiotic in doses up to 400 mg/day. Low-dose aspirin has been safely used on a worldwide scale for its role as an antithrombotic and thrombolytic. The study progress will be overseen by a Data, Safety and Monitoring Board, which will meet once every 6 months. Results of the study will be published in peer-reviewed publications. TRIAL REGISTRATION NUMBER Clinical Trials.gov: NCT01429272.
Collapse
Affiliation(s)
- Jonathan Savitz
- Laureate Institute for Brain Research (LIBR), Tulsa, Oklahoma, USA
- Department of Medicine, Tulsa School of Community Medicine, University of Tulsa, Tulsa, Oklahoma, USA
| | - Sheldon Preskorn
- University of Kansas Clinical Research Institute, Wichita, Kansas, USA
| | - T Kent Teague
- Department of Surgery, University of Oklahoma College of Medicine, Tulsa, Oklahoma, USA
- Department of Psychiatry, University of Oklahoma College of Medicine, Tulsa, Oklahoma, USA
- Department of Pharmaceutical Sciences, University of Oklahoma College of Pharmacy, Tulsa, Oklahoma, USA
- Department of Microbiology and Biochemistry, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Douglas Drevets
- Department of Medicine, Oklahoma University Health Sciences Center, and the Oklahoma City VAMC, Oklahoma City, Oklahoma, USA
| | - William Yates
- Laureate Institute for Brain Research (LIBR), Tulsa, Oklahoma, USA
| | - Wayne Drevets
- Laureate Institute for Brain Research (LIBR), Tulsa, Oklahoma, USA
- Department of Psychiatry, University of Oklahoma College of Medicine, Tulsa, Oklahoma, USA
| |
Collapse
|
20
|
Ramadan E, Basselin M, Taha AY, Cheon Y, Chang L, Chen M, Rapoport SI. Chronic valproate treatment blocks D2-like receptor-mediated brain signaling via arachidonic acid in rats. Neuropharmacology 2011; 61:1256-64. [PMID: 21839100 PMCID: PMC3190603 DOI: 10.1016/j.neuropharm.2011.07.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Revised: 07/12/2011] [Accepted: 07/17/2011] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND OBJECTIVE Hyperdopaminergic signaling and an upregulated brain arachidonic acid (AA) cascade may contribute to bipolar disorder (BD). Lithium and carbamazepine, FDA-approved for the treatment of BD, attenuate brain dopaminergic D(2)-like (D(2), D(3), and D(4)) receptor signaling involving AA when given chronically to awake rats. We hypothesized that valproate (VPA), with mood-stabilizing properties, would also reduce D(2)-like-mediated signaling via AA. METHODS An acute dose of quinpirole (1 mg/kg) or saline was administered to unanesthetized rats that had been treated for 30 days with a therapeutically relevant dose of VPA (200 mg/kg/day) or vehicle. Regional brain AA incorporation coefficients, k*, and incorporation rates, J(in), markers of AA signaling and metabolism, were measured by quantitative autoradiography after intravenous [1-(14)C]AA infusion. Whole brain concentrations of prostaglandin (PG)E(2) and thromboxane (TX)B(2) also were measured. RESULTS Quinpirole compared to saline significantly increased k* in 40 of 83 brain regions, and increased brain concentrations of PGE(2) in chronic vehicle-treated rats. VPA treatment by itself reduced concentrations of plasma unesterified AA and whole brain PGE(2) and TXB(2), and blocked the quinpirole-induced increments in k* and PGE(2). CONCLUSION These results further provide evidence that mood stabilizers downregulate brain dopaminergic D(2)-like receptor signaling involving AA.
Collapse
Affiliation(s)
- Epolia Ramadan
- Brain Physiology and Metabolism Section, National Institute on Aging, National Institutes of Health, Bethesda, MD 20892, USA.
| | | | | | | | | | | | | |
Collapse
|