Dopamine release in human neocortical slices: characterization of inhibitory autoreceptors and of nicotinic acetylcholine receptor-evoked release.

The autoinhibitory control of electrically evoked release of [3H]-dopamine and the properties of that induced by nicotinic receptor (nAChR) stimulation were studied in slices of the human neocortex. In both models [3H]-dopamine release was action potential-induced and exocytotic. The selective dopamine D2 receptor agonist (-)-quinpirole reduced electrically evoked release of [3H]-dopamine, yielding IC50 and I(max) values of 23 nM and 76%, respectively. Also, the effects of several other subtype-selective dopamine receptor ligands confirmed that the terminal dopamine autoreceptor belongs to the D2 subtype. The autoinhibitory feedback control was slightly operative under stimulation conditions of 90 pulses and 3 Hz, with a biophase concentration of endogenous dopamine of 3.6 nM, and was enhanced under blockade of dopamine reuptake. [3H]-dopamine release evoked in an identical manner in mouse neocortical slices was not inhibited by (-)-quinpirole, suggesting the absence of dopamine autoreceptors in this tissue and underlining an important species difference. Also, nAChR stimulation-induced release of [3H]-dopamine revealed a species difference: [3H]-dopamine release was evoked in human, but not in rat neocortical slices. The nAChRs inducing [3H]-dopamine release most probably belong to the alpha3/beta2subtype, according to the potencies and efficacies of subtype-selective nAChR ligands. Part of these receptors may be located on glutamatergic neurons.

Stereospecific immuno-recognition of the tetracyclic anti-depressant oxaprotiline.

Immunization of a rabbit with a racemic mixture of (+/-)-oxaprotiline, conjugated to bovine serum albumin, resulted in two antibody populations with affinity constants 1.5 x 10(9) and 2.5 x 10(6) M-1. Both populations showed a higher affinity for the (-)-isomer than for the (+)-isomer of the drug. Both stereoisomers of the drug were immunogenic in mice, but only the (-)-isomer was recognized with high affinity. Somatic fusion of the spleen of a mouse, immunized with the (-)-isomer yielded 12 hybridomas secreting monoclonal anti-oxaprotiline antibodies. Five of these monoclonal antibodies (MAbs) recognized both isomers, four bound more specifically to the (-)-isomer, one recognized the (+)-isomer and two were specific for the coupling arm. One of the MAbs was further analyzed to gain insight into the structural features of the drug involved in antibody recognition. This analysis suggested that the stereospecific recognition of oxaprotiline could be directly linked to the position of the hydroxyl group on the asymmetric carbon.

A clinical test of noradrenergic involvement in the therapeutic mode of action of an experimental antidepressant.

The noradrenaline (NA) hypothesis of depression is founded primarily on preclinical and clinically indirect evidence. In two three-compartment randomized parallel clinical trials conducted serially, we examined the significance of NA uptake for antidepressant activity. The racemic compound oxaprotiline (hydroxymaprotiline) is a highly specific inhibitor of NA uptake, whereas its R-(-) enantiomer levoprotiline is totally devoid of this property. Oxaprotiline significantly resembled amitriptyline in its antidepressant potential. Conversely, levoprotiline significantly resembled placebo in antidepressant potential. Therefore, NA uptake was necessary for the observed therapeutic effect of this experimental antidepressant.

The beta-adrenoceptor-coupled adenylate cyclase system in rat C6 glioma cells. Deamplification by isoproterenol and oxaprotiline.

The beta-adrenoceptor-coupled adenylate cyclase system in rat C6 glioma cells displays many characteristics observed in brain tissue: using nonlinear regression analysis of agonist competition binding curves, we demonstrated that the bulk of beta-adrenoceptors show high nanomolar affinity for isoproterenol; like in brain tissue, Gpp(NH)p does not shift agonist competition binding curves to the right; and the agonist isoproterenol rapidly downregulates the number of beta-adrenoceptors and deamplifies the norepinephrine signal. However, unlike in brain tissue, where (-)-oxaprotiline fails to decrease the number of beta-adrenoceptors and to desensitize the cyclic adenosine monophosphate generating system, it desensitizes the beta-adrenoceptor-coupled adenylate cyclase system in C6 glioma cells. Determination of the relative steady-state levels of beta-adrenoceptor messenger ribonucleic acid (mRNA) by Northern blot analysis showed a twofold increase in the steady-state levels of the mRNA at 30 minutes following exposure to (-)-isoproterenol or (-)-oxaprotiline. At 48 hours, basal values of mRNA were observed at a time when beta-adrenoceptors were maximally decreased. Further experiments on transcriptional activation, and mRNA stability and translation will be required to unravel the complexity of agonist-dependent and agonist-independent regulation of beta-adrenoceptor density and function.

cAMP binding proteins in the rat cerebral cortex after administration of selective 5-HT and NE reuptake blockers with antidepressant activity.

This study was undertaken to evaluate the cyclic adenosine monophosphate (cAMP) binding proteins in the cerebral cortex of rat after short- and long-term administration with antidepressants. Prolonged treatment with different antidepressants that inhibit serotonin or norepinephrine uptake such as fluoxetine and the (+) enantiomer of oxaprotiline, respectively, was able to induce an increase in the photoactivated incorporation of 8-N3-[32P]cAMP into a protein band with apparent molecular weight of 52,000 in both soluble and crude microtubule fraction. On the contrary, chronic treatment with the (-) enantiomer of oxaprotiline, which does not affect monoamine uptake, failed to produce this effect. Moreover, no changes were observed after acute or in vitro addition of antidepressants, suggesting that modification in the cAMP binding may be related to adaptive changes elicited by prolonged antidepressants treatment. In conclusion, our studies indicate that the cAMP binding protein associated with the crude microtubule fraction could be an intracellular target for the action of antidepressant drugs.

Neuronal sensitivity to substance P is increased after repeated treatment with tranylcypromine, carbamazepine or oxaprotaline, but decreased after repeated electroconvulsive shock.

The responsiveness of neurones in the cingulate cortex of the rat to the excitatory effects of iontophoretically applied substance P (SP) was determined after chronic administration of several drugs known to possess antidepressant actions. The agents tested were tranylcypromine, carbamazepine and oxaprotiline [(+) and (-)isomers]. Twenty-four to 36 hr after the last of 14 consecutive daily treatments there was an increase in neuronal sensitivity to substance P with all three drugs. The two isomers of oxaprotaline were equally active in inducing this change in sensitivity. None of the agents significantly altered responses to substance P after a single acute treatment. Responsiveness to substance P was also tested one day after the last of 14 daily treatments with electroconvulsive shock. In this case there was a marked reduction of the sensitivity of cingulate neurones to substance P with no apparent change in responsiveness to acetylcholine. A single shock treatment did not detectably alter responses to substance P.

Functional supersensitivity to the alpha 1-adrenoceptor agonist after repeated treatment with antidepressant drugs is not conditioned by beta-down-regulation.

The effect of repeated administration of desipramine, and the (+)- and (-)-enantiomers of oxaprotiline (10 mg/kg i.p., twice daily for 14 days) on the binding of beta- and alpha 1-adrenoceptors in the cortex of the rat brain were studied. The functional consequences of such treatment were measured in a behavioural model, involving the exploratory activity of rats in response to administration of the alpha 1-agonist phenylephrine. Desipramine and (+)-oxaprotiline decreased the binding of [3H]dihydroalprenolol ([3H]DHA) to beta-adrenoceptors in the cortex, did not change the binding of [3H]prazosin to alpha 1-adrenoceptors, but enhanced behavioural responses to phenylephrine. A behavioural facilitation was also observed after administration of (-)-oxaprotiline, a substance which does not change the binding of [3H]DHA. These results indicate that a functional supersensitivity to the alpha 1-adrenoceptor agonist, after repeated treatment with antidepressants is not conditioned by beta-down-regulation.

The effect of antidepressant drugs on the locomotor hyperactivity induced by MK-801, a non-competitive NMDA receptor antagonist.

It was found earlier that imipramine, amitriptyline and citalopram enhanced the locomotor hyperactivity induced by MK-801, a non-competitive NMDA receptor antagonist, in rats. Now, three other antidepressants: (+)-oxaprotiline, an inhibitor of the uptake of noradrenaline, (-)-oxaprotiline, an enantiomer devoid of any effect on the uptake of noradrenaline and fluoxetine, an inhibitor of the uptake of 5-hydroxytryptamine, have been examined in male Wistar rats. All those antidepressants, given in a single dose, increased the MK-801-induced locomotor hyperactivity. That increase was completely antagonized by haloperidol and partly by SCH 23390 and (+/-)-sulpiride; prazosin was inactive. Repeated administration of antidepressants produced a similar but more potent (than acute one) enhancement of the action of MK-801. Also, in that case haloperidol and SCH 23390 produced the strongest antagonistic effect; (+/-)-sulpiride and prazosin had a distinctly less potent action. Another effect of MK-801, anticonvulsant activity (electroshock-induced convulsions), was not increased by the antidepressants studied. These results indicate that antidepressants with a different pharmacological profile, increased the MK-801-induced locomotor hyperactivity, this effect being probably indirectly mediated, at least in part, by a dopamine mechanism.

Uptake, release, and modulation of release of noradrenaline in rabbit superior colliculus.

The noradrenaline content, the uptake of [3H]noradrenaline, and the release of previously incorporated [3H]noradrenaline were studied in slices of rabbit superior colliculus. The concentration of endogenous noradrenaline was higher in superficial than in deep layers of the superior colliculus. Upon incubation with [3H]noradrenaline, tritium was accumulated by a mechanism that was strongly inhibited by oxaprotiline but little inhibited by 6-nitroquipazine. Electrical stimulation at 0.2 or 3 Hz increased the outflow of tritium from slices preincubated with [3H]noradrenaline; the increase was almost abolished by tetrodotoxin or a low calcium medium. Clonidine reduced the evoked overflow of tritium, whereas yohimbine increased it and antagonized clonidine. The evoked overflow was also reduced by the dopamine D2-receptor-selective agonists apomorphine and quinpirole, an effect antagonized by sulpiride. The preferential opioid kappa-receptor agonist ethylketocyclazocine produced an inhibition that was counteracted by naloxone. Nicotine accelerated the basal outflow of tritium; part of the acceleration was blocked by hexamethonium. The muscarinic agonist oxotremorine slightly diminished the electrically evoked overflow, and its effect was abolished by atropine. The oxaprotiline-sensitive uptake of [3H]noradrenaline as well as the tetrodotoxin-sensitive and calcium-dependent overflow of tritium upon electrical stimulation (presumably reflecting the release of [3H]noradrenaline) indicate that noradrenaline is a neurotransmitter in the superior colliculus. The release of [3H]noradrenaline is modulated through alpha 2-adrenoceptors as well as dopamine D2-receptors, opioid kappa-receptors and nicotine and muscarine receptors. No clear evidence was found for modulation through beta-adrenoceptors, D1-receptors, serotonin receptors, opioid mu- or delta-receptors or receptors for GABA or glutamate. Only the alpha 2-adrenoceptors receive an endogenous agonist input, at least under the conditions of these experiments. The pattern of presynaptic modulation resembles that found for noradrenaline release in other rabbit brain regions, suggesting that all noradrenergic axons arising in the locus coeruleus possess similar presynaptic receptor systems.

The involvement of the opioidergic system in the antinociceptive mechanism of action of antidepressant compounds.

1. Debate exists as to the nature of antidepressant-induced antinociception. It is unclear whether antidepressants are inherently antinociceptive, are able to potentiate opioid antinociception or both. We have used the acetic acid induced abdominal constriction assay in mice to investigate antidepressant-induced antinociception. 2. All the antidepressants tested (s.c.) produced dose-dependent protection against acetic acid-induced abdominal constriction. Similarly, morphine and aspirin were also effective antinociceptive agents in this nociceptive assay. 3. Opioid antagonists, naloxone (0.5 mg kg(-1), s.c.) and naltrindole (1 mg kg(-1), s.c.), shifted the dose-response relationships to the right for each of the antidepressant agents (dothiepin, amitriptyline, sibutramine, (+)-oxaprotiline and paroxetine). In this context the naloxone dose-ratios were 1.95, 3.90, 2.32, 4.50 and 2.65, with naltrindole dose-ratios of 4.36, 17.00, 4.28, 11.48 and 2.65 were obtained, respectively. Naloxone also shifted the morphine dose-response relationship to the right, by a factor of 2.62, whilst naltrindole had no effect upon morphine antinociception. Aspirin antinociception remained unaffected by both opioid antagonists. 4. The enkephalin catabolism inhibitor acetorphan, by itself, produced no activity in this test at a dose of 10 mg kg(-1) (s.c.). However, at higher doses, acetorphan produced a linear dose-response relationship against acetic acid-induced abdominal constriction. 5. When acetorphan was administered before either the antidepressants or morphine, there was a clear potentiation of the antidepressant- or morphine-induced antinociception. However, acetorphan had no effect on aspirin antinociception. 6. Since neither of the opioid antagonists were able to attenuate, nor was acetorphan able to potentiate, aspirin antinociception, we concluded that the mechanism of antidepressant-induced antinociception is different from that of the non-steroidal anti-inflammatory drugs. 7. These data are consistent with the view that antidepressants may induce endogenous opioid peptide release, as shown by the acetorphan study. In this context, the ability of naltrindole to displace the antidepressant dose-response relationship to the right without affecting morphine antinociception, implicates the delta-opioid receptor and endogenous opioid peptides in antidepressant-induced antinociception.

Clinical studies of the effect of (+) and (-)-oxaprotiline upon noradrenaline uptake.

In six normal male subjects the mydriatic effect of tyramine eye drops was inhibited by 1 day's treatment with desipramine and the (+)- but not the (-)-enantiomer of oxaprotiline. In the same experiment, the secretion of melatonin was increased after treatment with (+)- but not with (-)-oxaprotiline. The effects of (+)-oxaprotiline and of desipramine treatment were similar, as were those of (-)-oxaprotiline and placebo. These findings extend to clinical studies the demonstration in animal experiments of stereo-specificity for the effects of (+)- and (-)-oxaprotiline upon noradrenaline uptake. A comparison of the effects of the two enantiomers should provide an ideal strategy for studying effects of noradrenaline uptake blockade in clinical studies.

Effect of some stereoisomeric tricyclic antidepressants on 45Ca uptake in synaptosomes from rat hippocampus.

The present study has examined the inhibition of synaptosomal 45calcium uptake by trimipramine, oxaprotiline and doxepin, and their stereoisomers, in synaptosomes from the rat hippocampus. No significant difference in potency could be established for inhibition of net depolarization-induced 45calcium uptake for any pair of antipodes, and the IC50 values for calcium channel blockade were in the vicinity of 30 microM for this group of compounds. Trimipramine, doxepin and oxaprotiline also inhibited the 45calcium uptake mediated by Na(+)-Ca2+ exchange, with IC50 values of 71 microM, 110 microM, and 100 microM, respectively. The similar potency of doxepin isomers for inhibition of voltage-dependent calcium channels is in harmony with their reported similar potency in the clinic. A slight difference in potency is reported between the isomers of oxaprotiline in the behavioral despair test in rats, and the dextrorotatory isomer of trimipramine is reported to be a much more potent antidepressant than the levorotatory isomer: these order of potencies do not correspond perfectly with the similar potency of the antipodes against voltage-dependent calcium channels. The present study of stereoisomeric tricyclic antidepressants therefore fails to provide unequivocal support for the hypothesis that calcium channel blockade by tricyclic antidepressants is involved in their therapeutic effect.

Antidepressant-like effects of (+)-oxaprotiline on a behavioral screen.

(+)-Oxaprotiline (1.25-10 mg/kg), a highly selective and stereospecifically acting norepinephrine (NE) uptake inhibiting drug, increased the reinforcement rate, decreased the response rate, and enhanced temporal discrimination in rats performing under a differential-reinforcement-of-low-rate 72-s schedule of reinforcement similar to other antidepressant drugs. (-)-Oxaprotiline did not affect the reinforcement rate, response rate or temporal discrimination. Since the most prominent known difference between the oxaprotiline enantiomers is the greater potency for inhibition of norepinephrine (NE) uptake by the (+) enantiomer, the effects of (+)-oxaprotiline in the present studies is probably due to inhibition of NE or epinephrine uptake. The present work also predicts that the therapeutic effects of oxaprotiline in the treatment of affective disorders is due to the (+) enantiomer.

Cerebral cortex injury: effect of blockers of re-uptake of catecholamines.

In rats, surgical injury of the neocortex enhances the level of procholecystokinin-mRNA in the ipsilateral cortex. This increase in procholecystokinin gene expression was significantly reduced by the blockers of catecholamine re-uptake nomifensine (4 mg/kg), cocaine (5 mg/kg) and (+)-oxaprotiline (1.5 mg/kg) given i.m. 30 min before the injury. The ganglionic blocking agent hexamethonium (3 mg/kg) prevented this effect of (+)-oxaprotiline and nomifensine. Also the alpha 1-adrenoceptor antagonists corynanthine (2 mg/kg) and prazosin (2 mg/kg) blocked this effect of (+/-)-oxaprotiline (1.5 mg/kg). It is concluded that catecholamines acting on alpha 1-adrenoceptors can reduce the increase in procholecystokinin-mRNA caused by cortex injury. The catecholamines may be released from the sympathetic nervous system.

The influence of oxaprotiline enantiomers given repeatedly on the behavioural effects of d-amphetamine and dopamine injected into the nucleus accumbens.

The effects of (+)- and (-)-oxaprotiline, given repeatedly (10 mg/kg p.o., twice daily, 14 days), on the behavioural action of d-amphetamine and dopamine injected bilaterally into the nucleus accumbens were studied in rats. Repeated but not acute treatment with (+)- or (-)-oxaprotiline enhanced the d-amphetamine-induced locomotor hyperactivity. Both enantiomers, given repeatedly but not acutely, attenuated the inhibition of exploration activity induced by dopamine and potentiated the stimulating effect of dopamine as assessed in the open field test. The results indicate that, like other antidepressants studied previously, both oxaprotilines increase the responsiveness of the dopamine mesolimbic system (nucleus accumbens) of the rat.

Antidepressant drugs potentiate the alpha 1-adrenoceptor effect in hippocampal slices.

The effect of prolonged treatment with antidepressant drugs on the phenylephrine- and norepinephrine (NE)-evoked reaction in hippocampal slices was examined by extracellular recording of the spontaneous activity of CA1 layer neurons. The alpha 1-adrenoceptor agonists, phenylephrine and methoxamine, depressed the neuronal discharges of most of the units tested, while NE evoked both excitatory and inhibitory effects which were blocked by propranolol and phentolamine or prazosin, respectively. Imipramine, mianserin, (+)- and (-)-oxaprotiline administered subchronically (10 mg/kg p.o., twice daily for 14 days, withdrawal 48 h), potentiated the inhibitory reaction to phenylephrine. Mianserin was the only drug tested in the acute dose to effectively augment the reaction to alpha 1-adrenoceptor stimulation. Prolonged administration of mianserin and imipramine attenuated the excitatory effect to NE, which probably reflects beta-receptor down-regulation; however, only mianserin, but not imipramine, enhanced the NE-induced inhibition. The observed potentiation of the alpha 1-adrenoceptor-related inhibitory reaction to phenylephrine produced by antidepressant drugs may reflect the development of the alpha 1-adrenergic system supersensitivity in the hippocampus.

Do alpha2-adrenoceptors play an integral role in the antinociceptive mechanism of action of antidepressant compounds?

Antidepressants are analgesic in the absence or presence of depression. The underlying mechanisms probably involve a complex interplay between several neurotransmitter systems and neuroreceptors. Alpha-adrenoceptors play an important role in pain processing and alpha2-adrenoceptor agonists have been used in clinical pain management so we have investigated whether alpha-adrenoceptor sub-types mediate the antinociceptive activity of antidepressants. Thus, the abdominal constriction assay in mice was used to examine the antinociceptive responses of a diverse range of antidepressants following alpha1- or alpha2-adrenoceptor antagonism. The antidepressants or monoamine reuptake inhibitors included the serotonin selective reuptake inhibitor paroxetine, the serotonin-noradrenaline reuptake inhibitor sibutramine, the resolved (+)- and (-)-enantiomers of the noradrenaline reuptake inhibitor oxaprotiline, plus the tricyclics amitriptyline and dothiepin. All these compounds have been previously shown to be antinociceptive in this paradigm. The respective alpha1- and alpha2-adrenoceptor antagonists prazosin and RX821002 ([2-(2-methoxy-1,-4-benzodioxan-2-yl)-2-imidazoline]) did not produce antinociception though at 1.0 mg kg(-1); s.c., RX821002 but not prazosin blocked clonidine antinociception. The antinociceptive activity produced by sub-maximal doses of amitriptyline, dothiepin, sibutramine, paroxetine, (+)- and (-)-oxaprotiline were all blocked by RX821002 but not by prazosin. Additionally, both morphine and aspirin antinociception was resistant to alpha1- and alpha2-adrenoceptor antagonism. Thus, alpha2- rather than alpha1-adrenoceptors may play an integral role in antidepressant antinociception irrespective of the propensity for inhibiting reuptake of not only noradrenaline but also serotonin. It is probable, however, that other differing pharmacological properties of some antidepressants, such as opioid-like activity, may complicate any empirical correlation between monoamine uptake and analgesia.

The noradrenaline uptake inhibitor, (+)-oxaprotiline, but not the inactive enantiomer, (-)-oxaprotiline, inhibits sympathetic nerve activity in the rabbit: involvement of adrenoceptors.

The effect of the enantiomers of oxaprotiline on the sympathetic nervous system was studied in anesthetized rabbits. (+)-Oxaprotile 0.2, 0.6 and 1.8 mg kg-1 dose dependently reduced prostganglionic renal sympathetic nerve activity and the clearance of [3H]noradrenaline from the plasma but increased the plasma noradrenaline concentration. The spillover of noradrenaline into the blood was not changed significantly, nor were blood pressure and heart rate, except transiently. The same doses of (-)-oxaprotiline had no effect on any of the parameters measured. (+)-Oxoprotiline also reduced lumbar preganglionic sympathetic nerve activity. The effect of (+)-oxaprotiline on renal sympathetic nerve activity was only minimally antagonized by yohimbine given alone. (+)-Oxaprotiline also inhibited renal sympathetic nerve activity after treatment with prazosin and propranolol. Subsequent administration of yohimbine restored sympathetic nerve activity to the value seen before the administration of (+)-oxaprotiline. The results show that inhibition of the re-uptake of released noradrenaline is the basis of the sympathoinhibition produced by (+)-oxaprotiline. Noradrenaline probably acts on alpha 2-adrenoceptors in the central nervous system to produce sympathoinhibition.

Long term treatment with oxaprotiline in patients with major depression.

1) Four hundred thirty-seven patients with depressive illness were treated for up to 11 months with oxaprotiline (Ba-49802B) in a continuation study. 2) Results of this study suggest that oxaprotiline continued to be effective in alleviating depressive symptoms. 3) Additionally, evaluation of safety parameters failed to reveal any significant risk to patients who were treated with oxaprotiline over this extended period of time.

Actions of oxaprotiline in the rat hippocampal slice.

1. Recordings were obtained from transverse slices of rat hippocampus, which were placed in a perfusion chamber and superfused with oxygenated artificial cerebrospinal fluid. 2. The effects of 10 microM (+)- or (-)-oxaprotiline applied by the bath were examined on the population spike, postsynaptic excitability in low Ca2+-high Mg2+ medium, the epileptiform discharge in Mg2+-free medium and long-term potentiation (LTP). Only the last paradigm (LTP) was significantly enhanced by (+)-oxaprotiline. 3. In rats chronically injected with (+)-oxaprotiline, neither LTP nor the actions of a variety of neurotransmitters in low Ca2+-high Mg2+ medium were significantly altered. 4. Intracellular recordings showed a small depolarization (3.5 +/- 1.6 mV) in response to 10 microM (+)- or (-)-oxaprotiline. Neither input resistance nor inward rectification, long-lasting afterhyperpolarization or accommodation were significantly altered. 5. Acute application, but not chronic treatment with (+)-oxaprotiline affects long-term potentiation in the hippocampal slice, presumably due to an effect on gabaergic inhibition.