Drug interactions on spontaneous locomotor activity in rats. Neuroleptics and amphetamine-induced hyperactivity

Fifty years of experience with loxapine for the rapid non-coercive tranquilization of acute behavioral disturbances in schizophrenia patients, and beyond

INTRODUCTION

Acute behavioral disturbances in psychosis, including agitation, comprise a heterogeneous group of manifestations varying in intensity and duration they last for. They require rapid, non-coercive treatments ranging from verbal de-escalation to the calming effect of pharmacological agents. The treatment goals are reduction of patient suffering and prevention of disease deterioration. Stabilizing rather than sedating is preferred to ensure improved compliance and a stronger therapeutic alliance. Furthermore, animal pharmacology and clinical studies on agitation reveal the robust calming and anxiolytic properties of loxapine.

AREAS COVERED

This review covers the pharmacological and clinical history of loxapine along with research developments. It emphasizes the advantages of its multiple formulations ranging from injectable forms and tablets to orally inhaled forms to attain rapid and fine-tuned tranquilization.

EXPERT OPINION

Rapid tranquillization is achieved within 2-6 hours using liquid orally-consumed loxapine, and within an hour or less with its IM or orally inhaled forms. Loxapine has been adopted in the management of a wide range of acute disturbances, such as agitation in psychosis. In the context of personalized medicine, key cellular and molecular elements of the schizophrenia phenotype were recently shown to be improved with loxapine.

Dopaminergic mechanisms underlying the expression of antipsychotic-induced dopamine supersensitivity in rats

Antipsychotic treatment can produce a dopamine-supersensitive state, potentiating the response to dopamine receptor stimulation. In both schizophrenia patients and rats, this is linked to tolerance to ongoing antipsychotic treatment. In rodents, dopamine supersensitivity is often confirmed by an exaggerated psychomotor response to d-amphetamine after discontinuation of antipsychotic exposure. Here we examined in rats the dopaminergic mechanisms mediating this enhanced behavioural response, as this could uncover pathophysiological processes underlying the expression of antipsychotic-evoked dopamine supersensitivity. Rats received 0.5 mg/kg/day haloperidol via osmotic minipump for 2 weeks, before treatment was discontinued. After cessation of antipsychotic treatment, rats showed a supersensitive psychomotor response to the D2 agonist quinpirole, but not to the D1 partial agonist SKF38393 or the dopamine reuptake blocker GBR12783. Furthermore, acute D1 receptor blockade (using SCH39166) decreased the exaggerated psychomotor response to d-amphetamine in haloperidol-pretreated rats, whereas acute D2 receptor blockade (using sulpiride) enhanced it. Thus, after discontinuation of antipsychotic treatment, D1- and D2-mediated transmission differentially modulate the expression of a supersensitive response to d-amphetamine. This supersensitive behavioural response was accompanied by enhanced GSK3β activity and suppressed ERK1/2 activity in the nucleus accumbens (but not caudate-putamen), suggesting increased mesolimbic D2 transmission. Finally, after discontinuing haloperidol treatment, neither increasing ventral midbrain dopamine impulse flow nor infusing d-amphetamine into the cerebral ventricles triggered the expression of already established dopamine supersensitivity, suggesting that peripheral effects are required. Thus, while dopamine receptor-mediated signalling regulates the expression of antipsychotic-evoked dopamine supersensitivity, a simple increase in central dopamine neurotransmission is insufficient to trigger this supersensitivity.

Evidence that haloperidol impairs learning and motivation scores in a probabilistic task by reducing the reward expectation

Activation of midbrain dopamine neurons in response to positive prediction errors and reward predictive cues is proposed to "energize" reward seeking behaviors and approach responses to places where the reward is expected. In the present study, we tested the effect of the D2-dopamine receptor antagonist haloperidol on response latencies to enter two arms of a Y-maze with different reward probabilities. Adult male Wistar rats were trained to explore the Y-maze with sucrose pellets placed 30% of times at the end of one arm and 70% of times at the opposite arm. Therefore, the reward expectation was different among arms, and was updated in the trials when the reward was omitted. After training, rats received 0.05, 0.10, 0.15 mg/kg haloperidol, or saline 30 min before the test session. In the last, but not in the first trials, haloperidol caused a dose-dependent increase in arm choice latency and response latency. Saline, but not haloperidol, treated rats presented significantly longer response latencies for the 30% compared to the 70% reward probability arm. Haloperidol also caused a dose-dependent decrease in the number of entries in the 70% reward probability arm, increased the number of non-responses, and caused a dose-dependent increase in the number of re-entries in the 30% reward probability arm after non-rewarded trials. Control experiments suggested that haloperidol did not cause motor impairment or satiation, but rather impaired learning and motivation scores by reducing the reward expectation.

5-HT2C Agonists Modulate Schizophrenia-Like Behaviors in Mice

All FDA-approved antipsychotic drugs (APDs) target primarily dopamine D₂ or serotonin (5-HT_2A) receptors, or both; however, these medications are not universally effective, they may produce undesirable side effects, and provide only partial amelioration of negative and cognitive symptoms. The heterogeneity of pharmacological responses in schizophrenic patients suggests that additional drug targets may be effective in improving aspects of this syndrome. Recent evidence suggests that 5-HT_2C receptors may be a promising target for schizophrenia since their activation reduces mesolimbic nigrostriatal dopamine release (which conveys antipsychotic action), they are expressed almost exclusively in CNS, and have weight-loss-promoting capabilities. A difficulty in developing 5-HT_2C agonists is that most ligands also possess 5-HT_2B and/or 5-HT_2A activities. We have developed selective 5-HT_2C ligands and herein describe their preclinical effectiveness for treating schizophrenia-like behaviors. JJ-3-45, JJ-3-42, and JJ-5-34 reduced amphetamine-stimulated hyperlocomotion, restored amphetamine-disrupted prepulse inhibition, improved social behavior, and novel object recognition memory in NMDA receptor hypofunctioning NR1-knockdown mice, and were essentially devoid of catalepsy. However, they decreased motivation in a breakpoint assay and did not promote reversal learning in MK-801-treated mice. Somewhat similar effects were observed with lorcaserin, a 5-HT_2C agonist with potent 5-HT_2B and 5-HT_2A agonist activities, which is approved for treating obesity. Microdialysis studies revealed that both JJ-3-42 and lorcaserin reduced dopamine efflux in the infralimbic cortex, while only JJ-3-42 decreased it in striatum. Collectively, these results provide additional evidence that 5-HT_2C receptors are suitable drug targets with fewer side effects, greater therapeutic selectivity, and enhanced efficacy for treating schizophrenia and related disorders than current APDs.

The role of dopaminergic transmission through D1-like and D2-like receptors in amphetamine-induced rat ultrasonic vocalizations

RATIONALE

Systemic amphetamine (AMPH) administration increases the rate of 50-kHz ultrasonic vocalizations (USVs) in adult rats and preferentially enhances the 'trill' subtype; these effects of AMPH critically depend on noradrenergic transmission, but the possible contributions of dopamine are unclear.

OBJECTIVE

To assess the role of dopamine in 50-kHz USVs emitted drug-free and following systemic AMPH administration.

METHODS

Adult male Long-Evans rats pre-selected for high AMPH-induced calling rates were tested with AMPH (1 mg/kg, intraperitoneal (IP)) and saline following pretreatment with the following dopamine receptor antagonists: SCH 23390 (0.005-0.02 mg/kg, subcutaneous (SC)), SCH 39166 (0.03-0.3 mg/kg, SC), haloperidol (0.1, 0.2 mg/kg, IP), sulpiride (20-80 mg/kg, SC), raclopride (0.1-0.5 mg/kg, SC), clozapine (4 mg/kg, SC), risperidone (0.5 mg/kg, SC), and pimozide (1 mg/kg, IP). The dopamine and noradrenaline reuptake inhibitors (GBR 12909 and nisoxetine, respectively) were also tested, alone and in combination.

RESULTS

SCH 23390, SCH 39166, haloperidol, and raclopride dose-dependently inhibited vocalizations under AMPH and suppressed the proportion of trill calls. Sulpiride, however, had no discernable effect on call rate or profile, even at a high dose that reduced locomotor activity. Single doses of clozapine, risperidone, and pimozide all markedly decreased calling under saline and AMPH. Finally, GBR 12909 and nisoxetine failed to promote 50-kHz USVs detectably or alter the subtype profile, when tested alone or in combination.

CONCLUSIONS

The rate of 50-kHz USVs and the call subtype profile following systemic AMPH administration depends on dopaminergic neurotransmission through D1-like and D2-like receptors. However, inhibiting dopamine and/or noradrenaline reuptake appears insufficient to induce calling.

Pharmacological characterization of social isolation-induced hyperactivity

RATIONALE

Social isolation (SI) of rats directly after weaning is a non-pharmacological, non-lesion animal model based on the neurodevelopmental hypothesis of schizophrenia. The model causes several neurobiological and behavioral alterations consistent with observations in schizophrenia.

OBJECTIVES

In the present study, we evaluated if isolated rats display both a pre-pulse inhibition (PPI) deficit and hyperactivity. Furthermore, the sensitivity of SI hyperactivity to antipsychotic was evaluated.

METHODS

Rats were socially isolated or group-housed for 12 weeks starting on postnatal day 25. In one batch of animals, the PPI and hyperactivity response were repeatedly compared. Furthermore, we investigated the robustness of the SI-induced hyperactivity by testing close to 50 batches of socially isolated or group-housed rats and tested the sensitivity of the assay to first- and second-generation antipsychotics, haloperidol, olanzapine, and risperidone, as well as the group II selective metabotrobic glutamate receptor agonist (LY404039).

RESULTS

Socially isolated rats showed a minor PPI deficit and a robust increase in hyperactivity compared with controls. Furthermore, SI-induced hyperactivity was selectively reversed by all antipsychotics, as well as the potential new antipsychotic, LY404039.

CONCLUSION

SI-induced hyperactivity was more pronounced and robust, as compared with SI-induced PPI deficits. Furthermore, SI-induced hyperactivity might be predictive for antipsychotic efficacy, as current treatment was effective in the model. Finally, using LY404039, a compound in development against schizophrenia, we have shown that the hyperactivity assay is sensitive to potential novel mechanisms of action. Thus, SI-induced hyperactivity might be a robust and novel in vivo screening assay of antipsychotic efficacy.

Clozapine reduces alcohol drinking in Syrian golden hamsters

Alcohol abuse contributes substantially to the overall morbidity of schizophrenia. While typical antipsychotic medications do not limit alcohol use in patients with schizophrenia, emerging data suggest that the atypical antipsychotic clozapine does. To further elucidate the effects of these antipsychotics on alcohol use, we initiated a study in alcohol-preferring rodents. Syrian golden hamsters were given free-choice, unlimited access to alcohol. Nine days of treatment (s.c. injection) with clozapine (2-4 mg/kg/day), but not haloperidol (0.2-0.4 mg/kg/day), reduced alcohol drinking. Clozapine reduced alcohol drinking by 88% (from 11.3+/-1.7 to 1.4+/-0.2 g/kg/day) while increasing both water and food intake. Alcohol drinking gradually (during 24 days) returned toward baseline in the clozapine-treated animals when vehicle was substituted for clozapine. Further increasing the doses of haloperidol (0.6-1.0 mg/kg/day) had no effect on alcohol drinking; moreover, very low doses of haloperidol (0.025-0.1 mg/kg/day) tested in separate groups of hamsters also had no effect on alcohol drinking. This study demonstrates that clozapine, but not haloperidol, can effectively and reversibly decrease alcohol consumption in alcohol-preferring hamsters. The results are compatible with the observations that clozapine, but not haloperidol, limits alcohol use in patients with schizophrenia. These data further suggest that clozapine may serve as a prototype for developing novel treatments for alcohol abuse.

The dopamine D3 receptor mediates locomotor hyperactivity induced by NMDA receptor blockade

N-methyl-D-aspartate (NMDA)/glutamate receptor antagonists, like phencyclidine, generate schizophrenic-like symptoms in humans and behavioural abnormalities in animals, such as hyperactivity. We investigated the role of the dopamine D(3) receptor in locomotor hyperactivity produced in mice by dizocilpine (MK-801), another NMDA receptor antagonist, at a low dose (0.12 mg/kg). BP 897, a highly D(3) receptor-selective partial agonist, or nafadotride, a preferential D(3) receptor antagonist, both at low doses (1 mg/kg and lower), had no effects on spontaneous activity and completely inhibited MK-801-induced hyperactivity. Clozapine, an atypical antipsychotic, produced the same effect as BP 897 and nafadotride. Haloperidol, a typical antipsychotic, reduced both spontaneous activity and MK-801-induced hyperactivity. In D(3) receptor knockout mice, MK-801-induced hyperactivity was weaker than that observed in wild-type mice while BP 897 and nafadotride were inactive. On the contrary, the effects of clozapine and haloperidol, which target multiple receptors in addition to the D(3) receptor, were almost completely preserved in D(3) receptor knockout mice. Our results show that hyperactivity produced by a low dose of MK-801 is dependent upon D(3) receptor stimulation and constitutes the first simple response to assess the in vivo activity of D(3) receptor-selective drugs. In addition, since D(3) receptor antagonists and antipsychotics produced very similar effects, our results add to the growing evidence suggesting that D(3) receptor blockade might produce antipsychotic effects.

Schedule-induced polydipsia and the nucleus accumbens: electrochemical measurements of dopamine efflux and effects of excitotoxic lesions in the core

The efflux of dopamine (DA) in the nucleus accumbens (NAcc) core during the acquisition of schedule-induced polydipsia (drinking in response to intermittent food presentation) was measured using rapid scan voltammetry. DA efflux increased throughout the SIP sessions, always reaching a peak after the session had terminated. There was, however, no relationship between the acquisition of the drinking response to intermittent food presentation and DA efflux. When water was absent from the test chamber, DA efflux still increased and reached a peak after food delivery was terminated, dissociating drinking and increased DA efflux. Taken in conjunction with previously presented data, these results suggest that the presence of DA in the NAcc core might be necessary for the development of SIP but that its efflux does not bear a systematic relationship to the acquisition of adjunctive behaviour. In a second experiment the effects of NMDA-induced lesions of the NAcc core on the acquisition and performance of SIP were examined. Lesioned rats did not differ to controls in terms of water intake, mean drinking bout length, latency to panel press for food or to begin drinking. The number of drinking bouts/min was reduced in lesioned rats, but did not reach statistical significance; the number of panel presses/min was significantly reduced in lesioned rats. These data demonstrate that the NAcc core is not necessary for the development of SIP but that elements of performance are affected. This suggests that the development of SIP can be fractionated and that different neural elements control different aspects of its expression. These data are used to support the hypothesis that the NAcc core is involved in focusing behaviour and regulating switching between response options.

A new motor test sensitive to aging and dopaminergic function

Neurodegenerative disorders which involve motor impairment is characteristic of old age. Although there are a few tests which attempt to assess motor incapacities, many have utilized scales which have either a great deal of subjective evaluations or are subject to learning-performance complexities. This study describes a method able to measure motor impairment of aging rats which is subject to dopaminergic influences and has negligible practice effects. The test is designed so that rats have to traverse 2 meter beams of 15 degrees inclination whose widths 3, 6, 12, 18 and 24 mm are changed on each test session using a table of random numbers. The time ceiling allowed for traversing the 2 m beams was established at 120 sec. 3-month-old rats (n = 20) and aged rats (n = 20) with a mean age of 26.5 +/- 3.8 months ranging from 23 to 34 months were utilized in this study. All young rats traversed the beams, independently of beam width, while virtually none of the old rats traversed the 3 and 6 mm beams. However, as the beam width increased more and more aged rats ascended the beam. Nevertheless, there were always a few old rats who were unable to cross even on the widest beam. When young rats were fitted with a lead belt which increased their body weight by approximately 40%, they still traversed all beam widths. On the other hand, haloperidol (0.1 and 0.2 mg/kg) severely impaired the performance of young rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Specific α2-adrenoreceptor antagonists induce behavioural activation in the rat

The behavioural effects of the specific and selective α(2)-adrenoreceptor antagonists, idazoxan, efaroxan and RX811059, have been investigated in the rat. All three drugs induced periods of behavioural activation characterized by increased locomotion and exploration (rearing and hole dipping). However, these effects were only apparent in animals which were fully habituated to their environments and thus displayed low baseline activity. The behaviour observed lay within the normal range of activity and was not apparent under conditions when exploration was stimulated such as in a novel environment. α( 2)-Adrenoreceptor antagonist- induced activation was a weak response when compared with the intense and prolonged hyperactivity, in both novel and non-novel environments, induced by the amine releaser D- amphetamine. Possible mechanisms involving a direct action of noradrenaline at postsynaptic α( 1)-adrenoreceptors (subsequent to enhanced presynaptic α(2)-receptor feedback blockade) or an indirect action of α(2)-antagonists on dopamine function in mesolimbic pathways are discussed.

The effects of haloperidol and amphetamine on ascorbic acid and uric acid in caudate and nucleus accumbens of rats as measured by voltammetry in vivo

The ability of haloperidol (0.1 mg/kg) to reduce the amphetamine-induced (2 and 5 mg/kg) increase in ascorbic and uric acid in anterior caudate and in nucleus accumbens was tested using voltammetry in vivo. In both areas, haloperidol reduced the amphetamine-induced increase in uric acid. In both areas, haloperidol only marginally affected the amphetamine-induced increase in ascorbic acid. Amphetamine-induced increases in uric acid were more nearly dose-related than changes in ascorbic acid. Of the two compounds, uric acid seems more likely to be associated with dopamine.

Atypical antipsychotic drugs block selective components of amphetamine-induced stereotypy

Individual items of behavior produced by 1.0 or 5.0 mg/kg d-amphetamine were monitored in rats pretreated 15 minutes earlier with vehicle or with behaviorally relevant doses of haloperidol (0.1 or 0.25 mg/kg), clozapine (1.0 or 5.0 mg/kg), or thioridazine (1.0 or 5.0 mg/kg). Unlike haloperidol, the atypical antipsychotics failed to block all components of either the low- or high-dose response to amphetamine. These drugs, however, did block selective items of amphetamine-induced stereotyped behavior. Clozapine significantly attenuated the sniffing produced by 1.0 mg/kg d-amphetamine as well as the oral behavior (licking and/or biting) produced by 5.0 mg/kg d-amphetamine. Thioridazine, at a dose of 5.0 mg/kg, also reduced oral behavior and selectively blocked repetitive head bobbing. Taken together, these results suggest that although atypical antipsychotic drugs exert some common effects on the amphetamine behavioral response, these drugs do not influence all amphetamine-induced behaviors equally.

Opposite actions of CCK-8 on amphetamine-induced hyperlocomotion and stereotypy following intracerebroventricular and intra-accumbens injections in rats

Cholecystokinin-octapeptide (CCK-8) has recently been found to coexist with dopamine (DA) in a subpopulation of midbrain DA neurons. The present study investigated the functional nature of this coexistence by testing the effects of intracerebroventricular (ICV) and intra-nucleus accumbens (NAS) applications of CCK-8 in two behavioral assays of DA function (i.e., stimulant-induced hyperlocomotion and stereotypy). Rats were injected with 1 or 3 mg/kg of d-amphetamine sulfate (AMP) 15 minutes prior to ICV (2 micrograms) or intra-NAS (20 ng, 200 ng, or 2 micrograms) injections of CCK-8 or haloperidol (HAL; 5 micrograms). ICV administered CCK-8 was found to antagonize the locomotor stimulatory effects of the low AMP dose, while the same peptide treatment markedly potentiated the stereotypy produced by the high dose of AMP. Similar results were obtained when CCK-8 was microinjected directly into the NAS, with the strongest effects observed following the smallest (i.e., 20 micrograms) dose. These results suggest that both locomotor-antagonizing and stereotypy-potentiating effects of central CCK application depend on CCK-DA interactions in the nucleus accumbens.

D-1 and D-2 receptor blockade have additive cataleptic effects in mice, but receptor effects may interact in opposite ways

The dopaminergic role of D-1 and D-2 receptors in catalepsy was evaluated using drugs with preferential receptor affinities. The D-1 antagonist, SCH 23390, caused distinct catalepsy in mice at 1, 2, and 10 mg/kg, IP, but not at two lower doses. The selective D-1 blocker, molindone, also caused catalepsy at 5 and 10 mg/kg; and blockade of both receptor types produced additive cataleptogenic effects. Apomorphine (4 mg/kg), which is an agonist for both receptors, potentiated SCH 23390-induced catalepsy much more than it did the catalepsy induced by molindone; the potentiation was produced by higher, not lower, doses of apomorphine. To determine if the apomorphine potentiation was mediated by D-1 or D-2 receptors, we tested selective agonists in mice that were concurrently injected with selective blockers. SCH 23390-induced catalepsy was potentiated by a large dose of the D-2 agonist, bromocriptine. The catalepsy of D-2 blockade with molindone was not potentiated by the D-1 agonist, SKF 38393, which slightly disrupted the catalepsy of D-2 blockade. We conclude that catalepsy is not a simple D-2 blockade phenomenon and that preferential antagonism of either receptor type can cause catalepsy. Catalepsy is most profound when both receptor types are blocked. Dopamine agonists, in large concentrations, are known to promote movements, and thus it is not surprising that they tend to disrupt catalepsy.(ABSTRACT TRUNCATED AT 250 WORDS)

Environmental stimulation promotes recovery from haloperidol-induced extinction of open field behavior in rats

Rats receiving 0.1 mg/kg haloperidol showed a progressive decline in their rate of spontaneous motor activity in an open field environment, suggesting that incentive motivational properties of stimuli in the experimental situation may be blunted by neuroleptic treatment. After removal for a short time-out in the home cage they were re-tested in this, or a novel stimulus environment, for a second observation session. Under novel (but not familiar) stimulus conditions haloperidol-treated rats showed an enhancement of spontaneous activity, similar to that observed in vehicle-treated animals, and exceeded their previous low rates of crossing and rearing responses. As drug conditions were similar for the two haloperidol groups, it is likely that neuroleptic-induced effects on spontaneous motor behavior are sensitive to the stimulus complexity of the environmental situation.

An automatic device for measuring speed of movement and time spent at rest: its application to testing dopaminergic drugs

We describe a device to measure speed of movement and time at rest for use with a commercially available infrared photobeam activity monitor. This system is a reliable substitute for a human observer and provides additional measures of activity that can help in interpreting how psychoactive drugs alter behavior. The effects of graded doses of d-amphetamine, haloperidol and (-)3-(3-hydroxyphenyl)-N-n-propylpiperidine, (-)-3-PPP, were studied with the device, and the results confirmed that these drugs differentially alter speed of movement and time at rest.