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Coutens B, Yrondi A, Rampon C, Guiard BP. Psychopharmacological properties and therapeutic profile of the antidepressant venlafaxine. Psychopharmacology (Berl) 2022; 239:2735-2752. [PMID: 35947166 DOI: 10.1007/s00213-022-06203-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 07/26/2022] [Indexed: 10/15/2022]
Abstract
Major depression (MD) is one of the most common psychiatric disorders worldwide. Currently, the first-line treatment for MD targets the serotonin system but these drugs, notably the selective serotonin reuptake inhibitors, usually need 4 to 6 weeks before the benefit is felt and a significant proportion of patients shows an unsatisfactory response. Numerous treatments have been developed to circumvent these issues as venlafaxine, a mixed serotonin-norepinephrine reuptake inhibitor that binds and blocks both the SERT and NET transporters. Despite this pharmacological profile, it is difficult to have a valuable insight into its ability to produce more robust efficacy than single-acting agents. In this review, we provide an in-depth characterization of the pharmacological properties of venlafaxine from in vitro data to preclinical and clinical efficacy in depressed patients and animal models of depression to propose an indirect comparison with the most common antidepressants. Preclinical studies show that the antidepressant effect of venlafaxine is often associated with an enhancement of serotonergic neurotransmission at low doses. High doses of venlafaxine, which elicit a concomitant increase in 5-HT and NE tone, is associated with changes in different forms of plasticity in discrete brain areas. In particular, the hippocampus appears to play a crucial role in venlafaxine-mediated antidepressant effects notably by regulating processes such as adult hippocampal neurogenesis or the excitatory/inhibitory balance. Overall, depending on the dose used, venlafaxine shows a high efficacy on depressive-like symptoms in relevant animal models but to the same extent as common antidepressants. However, these data are counterbalanced by a lower tolerance. In conclusion, venlafaxine appears to be one of the most effective treatments for treatment of major depression. Still, direct comparative studies are warranted to provide definitive conclusions about its superiority.
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Affiliation(s)
- Basile Coutens
- Centre de Recherches sur la Cognition Animale, Centre de Biologie Intégrative, Université de Toulouse, CNRS, 31000, Toulouse, France
| | - Antoine Yrondi
- Département de psychiatrie, CHU Toulouse-Purpan, Toulouse NeuroImaging Center, ToNIC, Université de Toulouse, Inserm, 31059, Toulouse, France
| | - Claire Rampon
- Centre de Recherches sur la Cognition Animale, Centre de Biologie Intégrative, Université de Toulouse, CNRS, 31000, Toulouse, France
| | - Bruno P Guiard
- Centre de Recherches sur la Cognition Animale, Centre de Biologie Intégrative, Université de Toulouse, CNRS, 31000, Toulouse, France.
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Chung W, Wang DS, Khodaei S, Pinguelo A, Orser BA. GABA A Receptors in Astrocytes Are Targets for Commonly Used Intravenous and Inhalational General Anesthetic Drugs. Front Aging Neurosci 2022; 13:802582. [PMID: 35087395 PMCID: PMC8787299 DOI: 10.3389/fnagi.2021.802582] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/20/2021] [Indexed: 12/14/2022] Open
Abstract
Background: Perioperative neurocognitive disorders (PNDs) occur commonly in older patients after anesthesia and surgery. Treating astrocytes with general anesthetic drugs stimulates the release of soluble factors that increase the cell-surface expression and function of GABAA receptors in neurons. Such crosstalk may contribute to PNDs; however, the receptor targets in astrocytes for anesthetic drugs have not been identified. GABAA receptors, which are the major targets of general anesthetic drugs in neurons, are also expressed in astrocytes, raising the possibility that these drugs act on GABAA receptors in astrocytes to trigger the release of soluble factors. To date, no study has directly examined the sensitivity of GABAA receptors in astrocytes to general anesthetic drugs that are frequently used in clinical practice. Thus, the goal of this study was to determine whether the function of GABAA receptors in astrocytes was modulated by the intravenous anesthetic etomidate and the inhaled anesthetic sevoflurane. Methods: Whole-cell voltage-clamp recordings were performed in astrocytes in the stratum radiatum of the CA1 region of hippocampal slices isolated from C57BL/6 male mice. Astrocytes were identified by their morphologic and electrophysiologic properties. Focal puff application of GABA (300 μM) was applied with a Picospritzer system to evoke GABA responses. Currents were studied before and during the application of the non-competitive GABAA receptor antagonist picrotoxin (0.5 mM), or etomidate (100 μM) or sevoflurane (532 μM). Results: GABA consistently evoked inward currents that were inhibited by picrotoxin. Etomidate increased the amplitude of the peak current by 35.0 ± 24.4% and prolonged the decay time by 27.2 ± 24.3% (n = 7, P < 0.05). Sevoflurane prolonged current decay by 28.3 ± 23.1% (n = 7, P < 0.05) but did not alter the peak amplitude. Etomidate and sevoflurane increased charge transfer (area) by 71.2 ± 45.9% and 51.8 ± 48.9% (n = 7, P < 0.05), respectively. Conclusion: The function of astrocytic GABAA receptors in the hippocampus was increased by etomidate and sevoflurane. Future studies will determine whether these general anesthetic drugs act on astrocytic GABAA receptors to stimulate the release of soluble factors that may contribute to PNDs.
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Affiliation(s)
- Woosuk Chung
- Department of Physiology, University of Toronto, Toronto, ON, Canada.,Department of Anesthesiology and Pain Medicine, Chungnam National University, Daejeon, South Korea
| | - Dian-Shi Wang
- Department of Physiology, University of Toronto, Toronto, ON, Canada
| | - Shahin Khodaei
- Department of Physiology, University of Toronto, Toronto, ON, Canada
| | - Arsene Pinguelo
- Department of Physiology, University of Toronto, Toronto, ON, Canada
| | - Beverley A Orser
- Department of Physiology, University of Toronto, Toronto, ON, Canada.,Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada.,Department of Anesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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Liang C, Chen P, Tang Y, Zhang C, Lei N, Luo Y, Duan S, Zhang Y. Venlafaxine as an Adjuvant Therapy for Inflammatory Bowel Disease Patients With Anxious and Depressive Symptoms: A Randomized Controlled Trial. Front Psychiatry 2022; 13:880058. [PMID: 35664492 PMCID: PMC9160994 DOI: 10.3389/fpsyt.2022.880058] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 04/13/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND AIMS The effect of antidepressant therapy on Inflammatory Bowel Disease (IBD) remains controversial. This trial aimed to assess whether adding venlafaxine to standard therapy for IBD improved the quality of life (QoL), mental health, and disease activity of patients with IBD with anxious and depressive symptoms. METHODS A prospective, randomized, double-blind, and placebo-controlled clinical trial was conducted. Participants diagnosed with IBD with symptoms of anxiety or depression were randomly assigned to receive either venlafaxine 150 mg daily or equivalent placebo and followed for 6 months. Inflammatory Bowel Disease Questionnaire (IBDQ), Mayo score, Crohn's disease activity index (CDAI), Hospital Anxiety and Depression Scale (HADS), and blood examination were completed before the enrollment, during, and after the follow-up. Mixed linear models and univariate analyses were used to compare groups. RESULTS Forty-five patients with IBD were included, of whom 25 were randomized to receive venlafaxine. The mean age was 40.00 (SD = 13.12) years old and 25 (55.6%) were male. Venlafaxine showed a significant improvement on QoL (p < 0.001) and disease course (p = 0.035), a greater reduction in HADS (anxiety: p < 0.001, depression: p < 0.001), Mayo scores (p < 0.001), and CDAI (p = 0.006) after 6 months. Venlafaxine had no effect on IL-10 expression, endoscopic scores, relapse rate, and use rate of biologics and corticosteroids, but did reduce serum level of erythrocyte estimation rate (ESR; p = 0.003), C-reactive protein (CRP; p < 0.001) and tumor necrosis factor-α (TNF-α; p = 0.009). CONCLUSIONS Venlafaxine has a significantly beneficial effect on QoL, IBD activity, and mental health in patients with IBD with comorbid anxious or depressive symptoms. (Chinese Clinical Trial Registry, ID: ChiCTR1900021496).
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Affiliation(s)
- Chang Liang
- Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, China
| | - Pingrun Chen
- Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, China
| | - Yu Tang
- Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, China
| | - Chuheng Zhang
- Institute for Interdisciplinary Information Science, Tsinghua University, Beijing, China
| | - Na Lei
- Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, China
| | - Ying Luo
- Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, China
| | - Shihao Duan
- Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, China
| | - Yan Zhang
- Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, China
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Sun Q, Yan H, Chen F, Jiang F, Chen W, Li D, Guo Y. Restoration of Proresolution Pathway with Exogenous Resolvin D1 Prevents Sevoflurane-Induced Cognitive Decline by Attenuating Neuroinflammation in the Hippocampus in Rats with Type 2 Diabetes Mellitus. Front Pharmacol 2021; 12:720249. [PMID: 34366871 PMCID: PMC8343131 DOI: 10.3389/fphar.2021.720249] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/13/2021] [Indexed: 12/31/2022] Open
Abstract
Sevoflurane (SEV), a commonly used volatile anesthetic, has been shown to cause cognitive decline in diabetic rats by aggregating neuroinflammation in the hippocampus, but the underlying mechanisms are unknown. Recent evidence suggests that neuroinflammation could be a consequence of failure to resolve inflammation by specialized pro-resolving lipid mediators including resolvin D1 (RvD1). Here we first examined whether type 2 diabetes mellitus (DM) alters RvD1 proresolution pathway. Diabetic Goto-Kakizaki (GK) rats and non-diabetic Wistar rats received control or 2.6% SEV exposure for 4 h. Seven days after exposure, GK control rats, compared with Wistar control rats, had significantly lower RvD1 levels in plasma and CSF and decreased RvD1 receptor FPR2 expression in the hippocampus. SEV increased RvD1 levels in plasma and CSF and FPR2 expression in the hippocampus in Wistar rats but not in GK rats. We next examined whether RvD1 treatment of GK rats can prevent SEV-induced neuroinflammation and cognitive decline. GK rats received control, SEV or SEV and once-daily treatment with exogenous RvD1 (0.2 ug/kg, ip) for 7 days. RvD1 administration markedly increased RvD1 levels in plasma and CSF and FPR2 expression in the hippocampus in GK rats received SEV. Compared with GK control rats, GK rats received SEV exhibited shorter freezing times in trace fear conditioning task, which was accompanied by increased microglia activity and pro-inflammatory cytokine expression in the hippocampus. RvD1 administration attenuated SEV-induced increases in microglia activity and pro-inflammatory cytokine expression in the hippocampus, preventing cognitive decline in GK rats. Notably, neither SEV nor RvD1 altered metabolic parameters in GK rats. The results suggest that RvD1 proresolution pathway is impaired in the brain of diabetic GK rats. which may enhance the susceptibility to SEV, contributing to neuroinflammation and cognitive decline. Restoration of RvD1 proresolution pathway in diabetic GK rats with exogenous RvD1 can prevent SEV-induced cognitive decline by attenuating neuroinflammation in the hippocampus.
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Affiliation(s)
- Qingmei Sun
- Department of Anesthesiology, Qilu Hospital, Shandong University, Jinan, China
| | - Hongdan Yan
- Department of Anesthesiology, Qilu Hospital, Shandong University, Jinan, China
| | - Falong Chen
- Department of Anesthesiology, Qilu Hospital, Shandong University, Jinan, China
| | - Fen Jiang
- Department of Anesthesiology, Qilu Hospital, Shandong University, Jinan, China
| | - Wenjuan Chen
- Department of Anesthesiology, Qilu Hospital, Shandong University, Jinan, China
| | - Dongliang Li
- Department of Anesthesiology, Qilu Hospital, Shandong University, Jinan, China
| | - Yongmin Guo
- Department of Anesthesiology, Qilu Hospital, Shandong University, Jinan, China
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Mihai DP, Ungurianu A, Ciotu CI, Fischer MJM, Olaru OT, Nitulescu GM, Andrei C, Zbarcea CE, Zanfirescu A, Seremet OC, Chirita C, Negres S. Effects of Venlafaxine, Risperidone and Febuxostat on Cuprizone-Induced Demyelination, Behavioral Deficits and Oxidative Stress. Int J Mol Sci 2021; 22:7183. [PMID: 34281235 PMCID: PMC8268376 DOI: 10.3390/ijms22137183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 12/27/2022] Open
Abstract
Multiple sclerosis (MS) is a demyelinating, autoimmune disease that affects a large number of young adults. Novel therapies for MS are needed considering the efficiency and safety limitations of current treatments. In our study, we investigated the effects of venlafaxine (antidepressant, serotonin-norepinephrine reuptake inhibitor), risperidone (atypical antipsychotic) and febuxostat (gout medication, xanthine oxidase inhibitor) in the cuprizone mouse model of acute demyelination, hypothesizing an antagonistic effect on TRPA1 calcium channels. Cuprizone and drugs were administered to C57BL6/J mice for five weeks and locomotor activity, motor performance and cold sensitivity were assessed. Mice brains were harvested for histological staining and assessment of oxidative stress markers. Febuxostat and metabolites of venlafaxine (desvenlafaxine) and risperidone (paliperidone) were tested for TRPA1 antagonistic activity. Following treatment, venlafaxine and risperidone significantly improved motor performance and sensitivity to a cold stimulus. All administered drugs ameliorated the cuprizone-induced deficit of superoxide dismutase activity. Desvenlafaxine and paliperidone showed no activity on TRPA1, while febuxostat exhibited agonistic activity at high concentrations. Our findings indicated that all three drugs offered some protection against the effects of cuprizone-induced demyelination. The agonistic activity of febuxostat can be of potential use for discovering novel TRPA1 ligands.
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Affiliation(s)
- Dragos Paul Mihai
- Faculty of Pharmacy, “Carol Davila”, University of Medicine and Pharmacy, 020956 Bucharest, Romania; (D.P.M.); (O.T.O.); (G.M.N.); (C.A.); (C.E.Z.); (A.Z.); (O.C.S.); (C.C.); (S.N.)
| | - Anca Ungurianu
- Faculty of Pharmacy, “Carol Davila”, University of Medicine and Pharmacy, 020956 Bucharest, Romania; (D.P.M.); (O.T.O.); (G.M.N.); (C.A.); (C.E.Z.); (A.Z.); (O.C.S.); (C.C.); (S.N.)
| | - Cosmin I. Ciotu
- Center for Physiology and Pharmacology, Institute of Physiology, Medical University of Vienna, 1090 Vienna, Austria; (C.I.C.); (M.J.M.F.)
| | - Michael J. M. Fischer
- Center for Physiology and Pharmacology, Institute of Physiology, Medical University of Vienna, 1090 Vienna, Austria; (C.I.C.); (M.J.M.F.)
| | - Octavian Tudorel Olaru
- Faculty of Pharmacy, “Carol Davila”, University of Medicine and Pharmacy, 020956 Bucharest, Romania; (D.P.M.); (O.T.O.); (G.M.N.); (C.A.); (C.E.Z.); (A.Z.); (O.C.S.); (C.C.); (S.N.)
| | - George Mihai Nitulescu
- Faculty of Pharmacy, “Carol Davila”, University of Medicine and Pharmacy, 020956 Bucharest, Romania; (D.P.M.); (O.T.O.); (G.M.N.); (C.A.); (C.E.Z.); (A.Z.); (O.C.S.); (C.C.); (S.N.)
| | - Corina Andrei
- Faculty of Pharmacy, “Carol Davila”, University of Medicine and Pharmacy, 020956 Bucharest, Romania; (D.P.M.); (O.T.O.); (G.M.N.); (C.A.); (C.E.Z.); (A.Z.); (O.C.S.); (C.C.); (S.N.)
| | - Cristina Elena Zbarcea
- Faculty of Pharmacy, “Carol Davila”, University of Medicine and Pharmacy, 020956 Bucharest, Romania; (D.P.M.); (O.T.O.); (G.M.N.); (C.A.); (C.E.Z.); (A.Z.); (O.C.S.); (C.C.); (S.N.)
| | - Anca Zanfirescu
- Faculty of Pharmacy, “Carol Davila”, University of Medicine and Pharmacy, 020956 Bucharest, Romania; (D.P.M.); (O.T.O.); (G.M.N.); (C.A.); (C.E.Z.); (A.Z.); (O.C.S.); (C.C.); (S.N.)
| | - Oana Cristina Seremet
- Faculty of Pharmacy, “Carol Davila”, University of Medicine and Pharmacy, 020956 Bucharest, Romania; (D.P.M.); (O.T.O.); (G.M.N.); (C.A.); (C.E.Z.); (A.Z.); (O.C.S.); (C.C.); (S.N.)
| | - Cornel Chirita
- Faculty of Pharmacy, “Carol Davila”, University of Medicine and Pharmacy, 020956 Bucharest, Romania; (D.P.M.); (O.T.O.); (G.M.N.); (C.A.); (C.E.Z.); (A.Z.); (O.C.S.); (C.C.); (S.N.)
| | - Simona Negres
- Faculty of Pharmacy, “Carol Davila”, University of Medicine and Pharmacy, 020956 Bucharest, Romania; (D.P.M.); (O.T.O.); (G.M.N.); (C.A.); (C.E.Z.); (A.Z.); (O.C.S.); (C.C.); (S.N.)
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