piperidines and cianopramine

Depression has been associated with a disturbance in serotonin function as reflected in platelet uptake of the transmitter as well as in CSF levels of its major metabolite, 5-hydroxyindoleacetic acid (5-HIAA). CSF 5-HIAA levels are subnormal in approximately 30% of melancholia patients. Early studies suggested that patients with a disturbed serotonin metabolism were less responsive to treatment with uptake inhibitors with a preferential action on noradrenaline neurons. Such findings encouraged the search for compounds with a selective effect on serotonin neurons. Although some classical antidepressants are potent inhibitors of serotonin uptake, they are not selective, since their metabolites, which appear to have antidepressant effects, inhibit noradrenaline uptake. The consistent findings of an increased risk for suicide in patients with low CSF 5-HIAA underlines the importance of exploring drugs that act on serotonin transmission. The biochemical effects of some serotonin uptake inhibitors and their clinical and research potential in depression are reviewed.

Topics: 5-Hydroxytryptophan; Alanine; Citalopram; Depressive Disorder; Fluoxetine; Fluvoxamine; Humans; Imipramine; Oximes; Paroxetine; Piperidines; Propylamines; Serotonin; Serotonin Antagonists; Trazodone; Zimeldine

The inhibition of the binding of [3H]cyanoimipramine in the rat brain in vivo, with and without pretreatment with proadifen (SK & F 525 A) to prevent its metabolism, has recently been shown to reflect inhibition of 5-HT uptake. This method has been suggested to be more sensitive than other more indirect methods. We have used this method to study the reversible MAO-A inhibitor, brofaromine, which has been shown previously to inhibit 5-HT uptake into synaptosomal preparations in vitro and ex vivo at doses about 30 times higher than those that inhibited MAO-A, and a number of 5-HT uptake inhibitors. The effects of orally administered clomipramine, imipramine, citalopram, CGP 6085 A, fluoxetine and brofaromine on [3H]cyanoimipramine binding were similar to those obtained in the synaptosome ex vivo model in the absence of proadifen; ifoxetine seemed to be more potent in inhibiting [3H]cyanoimipramine binding. The effects of clomipramine, imipramine, citalopram and ifoxetine were moderately to markedly enhanced by proadifen, indicating a first-pass effect. The effect of brofaromine on [3H]cyanoimipramine binding showed a time course similar to that on MAO-A, and was not altered upon repeated treatment. The inactivity of another MAO-A inhibitor, moclobemide, suggest that the effect of brofaromine was due to true inhibition of 5-HT uptake and not to displacement of [3H]cyanoimipramine by elevated synaptic 5-HT. The possible role of inhibition of 5-HT uptake in the antidepressant effect of brofaromine is discussed.

Topics: Animals; Brain; Imipramine; In Vitro Techniques; Male; Monoamine Oxidase Inhibitors; Piperidines; Proadifen; Rats; Rats, Inbred Strains; Serotonin; Serotonin Antagonists

Reserpine + nialamid administration to the rat induces a strong yellow fluorescence of the neuronal bodies of the raphe, due to serotonin (5-HT) accumulation. Under these conditions, administration of clomipramine (an antidepressant drug acting preferentially on 5-HT-mediated neurons) induces a decrease of intraneuronal fluorescence and its interneuronal diffusion. On this pattern we administered new antidepressant drugs which act on 5-HT neurons in a much more intensive way than clomipramine (fluvoxamine, clovoxamine, LM 5008, citalopram, Ro 11-2465). To varying degrees, we observed in the raphe, in addition to a decrease in intraneuronal fluorescence and interneuronal diffusion, the presence of a yellow fluorescence in capillary walls. It seems that under these antidepressants, 5-HT, which is outside neuronal bodies because of uptake blockade, is partly caught by the capillary walls. In these walls rich in monoamine oxydase, 5-HT would be catabolized, 5HIAA dispersed in the blood and thus, this 'capillary effect' could correspond to a loss of 5-HT in the raphe. Antidepressant drugs preferentially acting upon noradrenaline (NA) neurons do not, in this model, induce analogous phenomena in NA cell bodies of the locus coeruleus. So the 'capillary effect' differentiates antidepressant drugs acting specifically on 5-HT or NA neurons. It may be considered together with other parameters which also indicate asymmetries on the modes of action of antidepressant drugs, such as effects on monoamine turnover (increase for NA and decrease for 5-HT) and on receptor sensitivity (decrease for NA and increase for 5-HT).

Topics: Animals; Antidepressive Agents, Tricyclic; Benzofurans; Brain Stem; Citalopram; Clomipramine; Ethers; Fluvoxamine; Imipramine; Indoles; Locus Coeruleus; Male; Microscopy, Fluorescence; Norepinephrine; Oximes; Piperidines; Propylamines; Raphe Nuclei; Rats; Receptors, Serotonin; Serotonin