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Tampi RR, Tampi DJ, Farheen SA, Ochije SI, Joshi P. Propranolol for the management of behavioural and psychological symptoms of dementia. Drugs Context 2022; 11:dic-2022-8-3. [PMID: 36544625 PMCID: PMC9753600 DOI: 10.7573/dic.2022-8-3] [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] [Received: 08/25/2022] [Accepted: 10/26/2022] [Indexed: 12/12/2022] Open
Abstract
Propranolol is a β-adrenergic antagonist used in the management of hypertension, cardiac arrhythmia, and angina pectoris. There is some evidence that propranolol may benefit individuals with behavioural and psychological symptoms of dementia (BPSD). A total of three case series, one randomized controlled trial and one case report were identified (from a literature search of three major databases: PubMed, Ovid, and Cochrane collaboration) that assessed the use of propranolol for the management of BPSD. From these studies, it appears that propranolol improves BPSD, including agitation and aggression. Propranolol is also well tolerated with no significant bradycardia or hypotension noted in these studies. Current data on the use of propranolol for the management of BPSD are limited in comparison to other pharmacological agents (atypical antipsychotics, antidepressants, acetylcholinesterase inhibitors, memantine, and cannabinoids) and treatment modalities (repetitive transcranial magnetic stimulation and electroconvulsive therapy). The efficacy and safety of these treatments among individuals with BPSD has been evaluated in multiple controlled studies. In clinical practice, the routine use of propranolol among people with BPSD cannot be recommended at this time given the limited data. However, propranolol can be trialled among individuals with BPSD when symptoms have not responded adequately to other medications. Propranolol may also be used prior to embarking on trials of repetitive transcranial magnetic stimulation and electroconvulsive therapy among people with BPSD given the greater acceptance of this medication in the general population.
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Affiliation(s)
- Rajesh R Tampi
- Department of Psychiatry, Creighton University School of Medicine, Omaha, NE, USA,Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA,Department of Psychiatry & Behavioral Sciences, Cleveland Clinic Akron General, Akron, OH, USA
| | - Deena J Tampi
- Co-Founder and Managing Principal, Behavioral Health Advisory Group, Princeton, NJ, USA
| | - Syeda Arshiya Farheen
- Department of Psychiatry & Behavioral Sciences, Cleveland Clinic Akron General, Akron, OH, USA
| | - Sochima I Ochije
- Department of Psychiatry, Emory University Hospital, Atlanta GA, USA
| | - Pallavi Joshi
- Department of Psychiatry, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA
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Sundarrajan L, Rajeswari JJ, Weber LP, Unniappan S. The sympathetic/beta-adrenergic pathway mediates irisin regulation of cardiac functions in zebrafish. Comp Biochem Physiol A Mol Integr Physiol 2021; 259:111016. [PMID: 34126232 DOI: 10.1016/j.cbpa.2021.111016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 12/15/2022]
Abstract
Irisin is a 23 kDa myokine encoded in its precursor, fibronectin type III domain containing 5 (FNDC5). The exercise-induced increase in the expression of peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC1-α) promotes FNDC5 mRNA, followed by the proteolytic cleavage of FNDC5 to release irisin from the skeletal or cardiac muscle into the blood. Irisin is abundantly expressed in skeletal and cardiac muscle and plays an important role in feeding, modulates appetite regulatory peptides, and regulates cardiovascular functions in zebrafish. In order to determine the potential mechanisms of acute irisin effects, in this research, we explored whether adrenergic or muscarinic pathways mediate the cardiovascular effects of irisin. Propranolol (100 ng/g B·W) alone modulated cardiac functions, and when injected in combination with irisin (0.1 ng/g B·W) attenuated the effects of irisin in regulating cardiovascular functions in zebrafish at 15 min post-injection. Atropine (100 ng/g B·W) modulated cardiovascular physiology in the absence of irisin, while it was ineffective in influencing irisin-induced effects on cardiovascular functions in zebrafish. At 1 h post-injection, irisin downregulated PGC-1 alpha mRNA, myostatin-a and myostatin-b mRNA expression in zebrafish heart and skeletal muscle. Propranolol alone had no effect on the expression of these mRNAs in zebrafish and did not alter the irisin-induced changes in expression. At 1 h post-injection, irisin siRNA downregulated PGC-1 alpha, troponin C and troponin T2D mRNA expression, while upregulating myostatin a and b mRNA expression in zebrafish heart and skeletal muscle. Atropine alone had no effects on mRNA expression, and was unable to alter effects on mRNA expression of siRNA. Overall, this research identified a role for the sympathetic/beta-adrenergic pathway in regulating irisin effects on cardiovascular physiology and cardiac gene expression in zebrafish.
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Affiliation(s)
- Lakshminarasimhan Sundarrajan
- Laboratory of Integrative Neuroendocrinology, Department of Veterinary Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5B4, Canada
| | - Jithine Jayakumar Rajeswari
- Laboratory of Integrative Neuroendocrinology, Department of Veterinary Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5B4, Canada
| | - Lynn P Weber
- Laboratory of Integrative Neuroendocrinology, Department of Veterinary Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5B4, Canada
| | - Suraj Unniappan
- Laboratory of Integrative Neuroendocrinology, Department of Veterinary Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5B4, Canada.
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Llano López LH, Melonari P, Olguin M, Fraile MD, Landa AI, Gargiulo PA. Effects of atenolol injected into the nucleus accumbens septi in rats in the elevated plus-maze test. J Basic Clin Physiol Pharmacol 2020; 31:jbcpp-2020-0003. [PMID: 32598313 DOI: 10.1515/jbcpp-2020-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/07/2020] [Indexed: 11/15/2022]
Abstract
Background In previous studies, we have observed that glutamate antagonists injected within the nucleus accumbens septi (NAS) induced an anxiolytic-like effect in the elevated plus maze (EPM) test in rats. In the present study, the effect of Atenolol, a specific Beta Adreno-receptor antagonist in the EPM was studied in male rats bilaterally cannulated NAS. Methods Rats were divided into five groups that received either 1 μL injections of saline or atenolol in different doses (0.75, 1 or 2 μg/1 μL, n=15-16) 15 min before testing. Results Time Spent in the Open Arm was modified by treatment (F=4.563, p=0.006, df 3). This was increased by the lowest dose of atenolol (p<0.05), by the medium doses (p<0.001) and also by the highest dose (p<0.01). Time per Entry was modified by treatment (F=4.54, p=0.06, df 3). This parameter was increased by the lowest dose of atenolol (p<0.01), but not for the medium and higher doses. Conclusions We conclude that Atenolol beta receptor blockade in the accumbens lead to an anxiolytic-like effect related to an increase in the time spent in the open arm and in the time per entry, showing specific behavioral patterns.
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Affiliation(s)
- Luis H Llano López
- National Council of Scientific and Technological Research (CONICET), Laboratory of Neurosciences and Experimental Psychology, Ciudad Universitaria, Parque General San Martin, Mendoza, Argentina.,National University of Cuyo, Faculty of Medical Sciences, Area of Pharmacology, Department of Pathology, Ciudad Universitaria, Parque General San Martin, Mendoza, Argentina.,Servicio de Terapia Intensiva Infantil, Hospital Pediátrico Dr. Humberto Notti, Mendoza, Argentina
| | - Pablo Melonari
- National University of Cuyo, Faculty of Medical Sciences, Area of Pharmacology, Department of Pathology, Ciudad Universitaria, Parque General San Martin, Mendoza, Argentina
| | - Marisa Olguin
- National Council of Scientific and Technological Research (CONICET), Laboratory of Neurosciences and Experimental Psychology, Ciudad Universitaria, Parque General San Martin, Mendoza, Argentina
| | - Miriam Débora Fraile
- National Council of Scientific and Technological Research (CONICET), Laboratory of Neurosciences and Experimental Psychology, Ciudad Universitaria, Parque General San Martin, Mendoza, Argentina
| | - Adriana I Landa
- National Council of Scientific and Technological Research (CONICET), Laboratory of Neurosciences and Experimental Psychology, Ciudad Universitaria, Parque General San Martin, Mendoza, Argentina.,National University of Cuyo, Faculty of Medical Sciences, Area of Pharmacology, Department of Pathology, Ciudad Universitaria, Parque General San Martin, Mendoza, Argentina
| | - Pascual A Gargiulo
- National Council of Scientific and Technological Research (CONICET), Laboratory of Neurosciences and Experimental Psychology, Ciudad Universitaria, Parque General San Martin, Mendoza, Argentina.,National University of Cuyo, Faculty of Medical Sciences, Area of Pharmacology, Department of Pathology, Ciudad Universitaria, Parque General San Martin, Mendoza, Argentina
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