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Maldonado-García JL, Pérez-Sánchez G, Becerril-Villanueva E, Alvarez-Herrera S, Pavón L, Sánchez-Torres L, Gutiérrez-Ospina G, Girón-Pérez MI, Damian-Morales G, Maldonado-Tapia JO, López-Santiago R, Moreno-Lafont MC. Imipramine Administration in Brucella abortus 2308-Infected Mice Restores Hippocampal Serotonin Levels, Muscle Strength, and Mood, and Decreases Spleen CFU Count. Pharmaceuticals (Basel) 2023; 16:1525. [PMID: 38004391 PMCID: PMC10674296 DOI: 10.3390/ph16111525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/25/2023] [Accepted: 09/28/2023] [Indexed: 11/26/2023] Open
Abstract
Brucellosis infection causes non-specific symptoms such as fever, chills, sweating, headaches, myalgia, arthralgia, anorexia, fatigue, and mood disorders. In mouse models, it has been associated with increased levels of IL-6, TNF-α, and IFN-γ, a decrease in serotonin and dopamine levels within the hippocampus, induced loss of muscle strength and equilibrium, and increased anxiety and hopelessness. Imipramine (ImiP), a tricyclic antidepressant, is used to alleviate neuropathic pain. This study evaluated the effects of ImiP on Balb/c mice infected with Brucella abortus 2308 (Ba) at 14- and 28-days post-infection. Serum levels of six cytokines (IFN-γ, IL-6, TNF-α, IL-12, MCP-1. and IL-10) were assessed by FACS, while the number of bacteria in the spleen was measured via CFU. Serotonin levels in the hippocampus were analyzed via HPLC, and behavioral tests were conducted to assess strength, equilibrium, and mood. Our results showed that mice infected with Brucella abortus 2308 and treated with ImiP for six days (Im6Ba14) had significantly different outcomes compared to infected mice (Ba14) at day 14 post-infection. The mood was enhanced in the forced swimming test (FST) (p < 0.01), tail suspension test (TST) (p < 0.0001), and open-field test (p < 0.0001). Additionally, there was an increase in serotonin levels in the hippocampus (p < 0.001). Furthermore, there was an improvement in equilibrium (p < 0.0001) and muscle strength (p < 0.01). Lastly, there was a decrease in IL-6 levels (p < 0.05) and CFU count in the spleen (p < 0.0001). At 28 days, infected mice that received ImiP for 20 days (Im20Ba28) showed preservation of positive effects compared to infected mice (Ba28). These effects include the following: (1) improved FST (p < 0.0001) and TST (p < 0.0001); (2) better equilibrium (p < 0.0001) and muscle strength (p < 0.0001); (3) decreased IL-6 levels (p < 0.05); and (4) reduced CFU count in the spleen (p < 0.0001). These findings suggest the potential for ImiP to be used as an adjuvant treatment for the symptoms of brucellosis, which requires future studies.
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Affiliation(s)
- José Luis Maldonado-García
- Laboratorio de Psicoinmunología, Dirección de Investigaciones en Neurociencias del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
- Laboratorio de Inmunología Celular, Departamento de Inmunología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City 07738, Mexico
| | - Gilberto Pérez-Sánchez
- Laboratorio de Psicoinmunología, Dirección de Investigaciones en Neurociencias del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
| | - Enrique Becerril-Villanueva
- Laboratorio de Psicoinmunología, Dirección de Investigaciones en Neurociencias del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
| | - Samantha Alvarez-Herrera
- Laboratorio de Psicoinmunología, Dirección de Investigaciones en Neurociencias del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
| | - Lenin Pavón
- Laboratorio de Psicoinmunología, Dirección de Investigaciones en Neurociencias del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
| | - Luvia Sánchez-Torres
- Laboratorio de Inmunología de los Microorganismos, Departamento de Inmunología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City 07738, Mexico
| | - Gabriel Gutiérrez-Ospina
- Laboratorio de Biología de Sistemas, Departamento de Biología Celular y Fisiología, Instituto de Investigaciones Biomédicas y Coordinación de Psicobiología y Neurociencias, Facultad de Psicología, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | | | - Gabriela Damian-Morales
- Laboratorio de Inmunología Celular, Departamento de Inmunología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City 07738, Mexico
| | - Jesús Octavio Maldonado-Tapia
- Laboratorio de Psicoinmunología, Dirección de Investigaciones en Neurociencias del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
- Laboratorio de Inmunología Celular, Departamento de Inmunología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City 07738, Mexico
| | - Rubén López-Santiago
- Laboratorio de Inmunología Celular, Departamento de Inmunología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City 07738, Mexico
| | - Martha C Moreno-Lafont
- Laboratorio de Inmunología Celular, Departamento de Inmunología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City 07738, Mexico
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Medeiros MAMB, Gama e Silva M, de Menezes Barbosa J, Martins de Lavor É, Ribeiro TF, Macedo CAF, de Souza Duarte-Filho LAM, Feitosa TA, de Jesus Silva J, Fokoue HH, Araújo CRM, de Assis Gonsalves A, Augusto de Araújo Ribeiro L, Almeida JRGDS. Antinociceptive and anti-inflammatory effects of hydrazone derivatives and their possible mechanism of action in mice. PLoS One 2021; 16:e0258094. [PMID: 34818331 PMCID: PMC8612535 DOI: 10.1371/journal.pone.0258094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 09/20/2021] [Indexed: 01/12/2023] Open
Abstract
Pain and inflammation are unpleasant experiences that usually occur as a result of tissue damage. Despite the number of existing analgesic drugs, side effects limit their use, stimulating the search for new therapeutic agents. In this sense, five hydrazone derivatives (H1, H2, H3, H4, and H5), with general structure R1R2C = NNR3R4, were synthesized with molecular modification strategies. In this paper, we describe the ability of hydrazone derivatives to attenuate nociceptive behavior and the inflammatory response in mice. Antinociceptive activity was evaluated through acetic acid-induced writhing and formalin-induced nociception tests. In both experimental models, the hydrazone with the greatest potency (H5) significantly (p < 0.05) reduced nociceptive behavior. Additionally, methods of acute and chronic inflammation induced by different chemicals (carrageenan and histamine) were performed to evaluate the anti-inflammatory effect of H5. Moreover, molecular docking analysis revealed that H5 can block the COX-2 enzyme, reducing arachidonic acid metabolism and consequently decreasing the production of prostaglandins, which are important inflammatory mediators. H5 also changes locomotor activity. In summary, H5 exhibited relevant antinociceptive and anti-inflammatory potential and acted on several targets, making it a candidate for a new multi-target oral anti-inflammatory drug.
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Affiliation(s)
- Maria Alice Miranda Bezerra Medeiros
- Núcleo de Estudos e Pesquisas de Plantas Medicinais (NEPLAME), Universidade Federal do Vale do São Francisco, Petrolina, Pernambuco, Brasil
- Pós-Graduação em Biotecnologia, Universidade Estadual de Feira de Santana, Feira de Santana, Bahia, Brasil
| | - Mariana Gama e Silva
- Núcleo de Estudos e Pesquisas de Plantas Medicinais (NEPLAME), Universidade Federal do Vale do São Francisco, Petrolina, Pernambuco, Brasil
- Pós-Graduação em Biotecnologia—Rede Nordeste de Biotecnologia (RENORBIO), Universidade Federal Rural de Pernambuco, Recife, Pernambuco, Brasil
| | - Jackson de Menezes Barbosa
- Núcleo de Estudos e Pesquisas de Plantas Medicinais (NEPLAME), Universidade Federal do Vale do São Francisco, Petrolina, Pernambuco, Brasil
- Pós-Graduação em Biotecnologia—Rede Nordeste de Biotecnologia (RENORBIO), Universidade Federal Rural de Pernambuco, Recife, Pernambuco, Brasil
| | - Érica Martins de Lavor
- Núcleo de Estudos e Pesquisas de Plantas Medicinais (NEPLAME), Universidade Federal do Vale do São Francisco, Petrolina, Pernambuco, Brasil
- Pós-Graduação em Biotecnologia, Universidade Estadual de Feira de Santana, Feira de Santana, Bahia, Brasil
| | - Tiago Feitosa Ribeiro
- Pós-Graduação em Biotecnologia—Rede Nordeste de Biotecnologia (RENORBIO), Universidade Federal Rural de Pernambuco, Recife, Pernambuco, Brasil
| | | | | | - Thiala Alves Feitosa
- Núcleo de Estudos e Pesquisas de Plantas Medicinais (NEPLAME), Universidade Federal do Vale do São Francisco, Petrolina, Pernambuco, Brasil
- Pós Graduação em Biociências, Universidade Federal do Vale do São Francisco, Petrolina, Pernambuco, Brasil
| | - Jussara de Jesus Silva
- Colegiado de Farmácia, Universidade Federal do Vale do São Francisco, Petrolina, Pernambuco, Brasil
| | - Harold Hilarion Fokoue
- Laboratório de Avaliação e Síntese de Substâncias Bioativas (LASSBio), Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brasil
| | | | - Arlan de Assis Gonsalves
- Colegiado de Farmácia, Universidade Federal do Vale do São Francisco, Petrolina, Pernambuco, Brasil
| | - Luciano Augusto de Araújo Ribeiro
- Pós Graduação em Biociências, Universidade Federal do Vale do São Francisco, Petrolina, Pernambuco, Brasil
- Colegiado de Farmácia, Universidade Federal do Vale do São Francisco, Petrolina, Pernambuco, Brasil
| | - Jackson Roberto Guedes da Silva Almeida
- Núcleo de Estudos e Pesquisas de Plantas Medicinais (NEPLAME), Universidade Federal do Vale do São Francisco, Petrolina, Pernambuco, Brasil
- Pós-Graduação em Biotecnologia, Universidade Estadual de Feira de Santana, Feira de Santana, Bahia, Brasil
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Todorović M, Micov A, Nastić K, Tomić M, Pecikoza U, Vuković M, Stepanović-Petrović R. Vortioxetine as an analgesic in preclinical inflammatory pain models: Mechanism of action. Fundam Clin Pharmacol 2021; 36:237-249. [PMID: 34820899 DOI: 10.1111/fcp.12737] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/02/2021] [Accepted: 11/18/2021] [Indexed: 01/10/2023]
Abstract
Vortioxetine is a novel atypical antidepressant with multimodal activity that has recently demonstrated efficacy against neuropathic pain. There is no published data about its analgesic properties in models characterized by peripheral inflammation and consequent pain pathway sensitization, nor data on its mechanism of antinociceptive action. This study aimed to investigate vortioxetine's antinociceptive/antihyperalgesic effects in trigeminal, visceral, and somatic inflammatory pain models, and provide evidence on its mechanism of action in the modulation of trigeminal nociception. Vortioxetine's effects on the nociceptive behavior in orofacial formalin test (OFT) and acetic acid-writhing test in mice and on mechanical hyperalgesia in carrageenan-induced paw inflammation in rats were examined following peroral single administration. The involvement of serotonergic/adrenergic/cholinergic/cannabinoid/adenosine receptors was evaluated in OFT by intraperitoneally treating mice with an appropriate antagonist immediately after vortioxetine application. We used antagonists of 5-HT1B/1D serotonergic (GR 127935), α1 -adrenergic (prazosin), α2 -adrenergic (yohimbine), β1 -adrenergic (metoprolol), muscarinic (atropine), α7 nicotinic (methyllycaconitine), CB1 /CB2 cannabinoid (AM251 and AM630), and adenosine A1 (DPCPX) receptors. Vortioxetine dose-dependently reduced pain behavior in OFT and acetic acid writhing test, as well as inflammatory hyperalgesia in paw pressure test. All examined antagonists except prazosin dose-dependently inhibited vortioxetine's antinociceptive effects. In conclusion, vortioxetine exerted analgesic efficacy in trigeminal, visceral, and somatic inflammatory pain. The effect is at least in part mediated by 5-HT1B/1D serotonergic, α2 /β1 -adrenergic, muscarinic and nicotinic cholinergic, CB1 /CB2 cannabinoid, and adenosine A1 receptors. These findings contribute to better understanding of the analgesic effect of vortioxetine and suggest its potential usefulness for inflammatory pain treatment.
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Affiliation(s)
- Marija Todorović
- Department of Pharmacology, University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia
| | - Ana Micov
- Department of Pharmacology, University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia
| | - Katarina Nastić
- Department of Pharmacology, University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia
| | - Maja Tomić
- Department of Pharmacology, University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia
| | - Uroš Pecikoza
- Department of Pharmacology, University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia
| | - Milja Vuković
- Department of Pharmacology, University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia
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Li YS, Zhang J, Tian GH, Shang HC, Tang HB. Kirenol, darutoside and hesperidin contribute to the anti-inflammatory and analgesic activities of Siegesbeckia pubescens makino by inhibiting COX-2 expression and inflammatory cell infiltration. JOURNAL OF ETHNOPHARMACOLOGY 2021; 268:113547. [PMID: 33152433 DOI: 10.1016/j.jep.2020.113547] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 10/26/2020] [Accepted: 10/30/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The Chinese traditional medicine of Siegesbeckia pubescens Makino (SM), which has the effect of healing rheumatism and promoting joint health, is often used to treat rheumatoid arthritis and ischemic stroke. AIM OF THE STUDY To clarify the mechanisms underlying the anti-inflammatory and analgesic influence of active components in the ethanol extract of Siegesbeckia pubescens Makino (ESM). MATERIALS AND METHODS The active ingredients in the ESM were identified practicing high-performance liquid chromatography-diode array detection (HPLC-DAD). Four models including xylene-induced ear oedema, complete Freund's adjuvant (CFA)-induced hind paw oedema, acetic acid-induced pain writhing and lipopolysaccharide (LPS)-induced RAW264.7 cell migration, were used to clarify the anti-inflammatory and analgesic mechanisms of the active ingredients in the ESM. RESULTS (1) Three active ingredients of kirenol, darutoside and hesperidin were identified in the ESM, with relative proportion of 0.6%, 0.2% and 0.01%, respectively; hesperidin was reported for the first time in the ESM. (2) Both the ESM and its active ingredients could effectively alleviate the degree of swelling of the auricle and toes, increase the threshold of heat pain, decrease the overexpression of inflammatory protein cyclooxygenase-2 (COX-2) in the skin tissue of the tested parts of the toes, and reduce the number of writhes induced by acetic acid in mice. (3) ESM and its active ingredients also dose-dependently inhibited the migration of RAW264.7 cells. CONCLUSIONS ESM and its active ingredients can effectively attenuate the expression of inflammatory factors induced by chemical inflammation, prevent the infiltration of inflammatory cells, and exert good anti-inflammatory and antinociceptive activities.
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Affiliation(s)
- Yu-Sang Li
- Lab of Hepatopharmacology and Ethnopharmacology, School of Pharmaceutical Sciences, South-Central University for Nationalities, No. 182, Minyuan Road, Wuhan, 430074, China.
| | - Jian Zhang
- Lab of Hepatopharmacology and Ethnopharmacology, School of Pharmaceutical Sciences, South-Central University for Nationalities, No. 182, Minyuan Road, Wuhan, 430074, China.
| | - Gui-Hua Tian
- Key Laboratory of Chinese Internal Medicine of MOE, Beijing Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
| | - Hong-Cai Shang
- Key Laboratory of Chinese Internal Medicine of MOE, Beijing Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
| | - He-Bin Tang
- Lab of Hepatopharmacology and Ethnopharmacology, School of Pharmaceutical Sciences, South-Central University for Nationalities, No. 182, Minyuan Road, Wuhan, 430074, China.
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Karimzadeh K, Ramzanpoor M, Keihankhadiv S. Antinociceptive and Anti-inflammatory Effects of Methanolic Extract of Laurencia caspica. INTERNATIONAL JOURNAL OF BASIC SCIENCE IN MEDICINE 2020. [DOI: 10.34172/ijbsm.2020.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: Seaweeds are valuable resources for the discovery of efficient and safe drugs for pain treatment. In the present investigation, we evaluated the antinociceptive and anti-inflammatory properties of, methanolic extract of Laurencia caspica, a red algae, in mice models. Methods: The analgesic effect of methanolic extract of L. caspica was assessed by hot-plate and acetic acid-induced writhing tests in male Swiss albino mice (weight = 20-25 g). The anti-inflammatory activity of methanolic extract of L. caspica was also evaluated by formalin-induced ear edema and xylene-induced paw edema tests. Results: The total flavonoid content of the extract was estimated as 0.0537 mg quercetin/g extract. Both first and second phases of the nociception were significantly inhibited at a dose of 120 mg/kg of methanolic extract of L. caspica. The observed anti-inflammatory effect was dose-dependent. Acetic acid-induced writhing test and hot plate test showed that the extract significantly reduced pain in all evaluated doses (15, 30, 60, and 120 mg/kg). The antinociceptive activity of the methanolic extract was significantly reduced by naloxone (4 mg/kg). Moreover, the extract significantly reduced paw edema at the dose of 120 mg/kg in all the animals. Conclusion: Methanolic extract of L. caspica exhibited central analgesic effect, as well as anti-inflammatory activity probably due to the presence of constituents like flavonoids and triterpenoids.
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Affiliation(s)
- Katayoon Karimzadeh
- Department of Biology, Lahijan Branch, Islamic Azad University, Lahijan, Iran
| | - Mahdiyeh Ramzanpoor
- Department of Biology, Lahijan Branch, Islamic Azad University, Lahijan, Iran
| | - Shadi Keihankhadiv
- Department of Chemistry, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran
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Green Synthesis of Gold Nanoparticles from Vitex negundo Leaf Extract to Inhibit Lipopolysaccharide-Induced Inflammation Through In Vitro and In Vivo. J CLUST SCI 2019. [DOI: 10.1007/s10876-019-01661-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Belinskaia DA, Belinskaia MA, Barygin OI, Vanchakova NP, Shestakova NN. Psychotropic Drugs for the Management of Chronic Pain and Itch. Pharmaceuticals (Basel) 2019; 12:ph12020099. [PMID: 31238561 PMCID: PMC6631469 DOI: 10.3390/ph12020099] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 06/19/2019] [Accepted: 06/21/2019] [Indexed: 12/11/2022] Open
Abstract
Clinical observations have shown that patients with chronic neuropathic pain or itch exhibit symptoms of increased anxiety, depression and cognitive impairment. Such patients need corrective therapy with antidepressants, antipsychotics or anticonvulsants. It is known that some psychotropic drugs are also effective for the treatment of neuropathic pain and pruritus syndromes due to interaction with the secondary molecular targets. Our own clinical studies have identified antipruritic and/or analgesic efficacy of the following compounds: tianeptine (atypical tricyclic antidepressant), citalopram (selective serotonin reuptake inhibitor), mianserin (tetracyclic antidepressant), carbamazepine (anticonvulsant), trazodone (serotonin antagonist and reuptake inhibitor), and chlorprothixene (antipsychotic). Venlafaxine (serotonin-norepinephrine reuptake inhibitor) is known to have an analgesic effect too. The mechanism of such effect of these drugs is not fully understood. Herein we review and correlate the literature data on analgesic/antipruritic activity with pharmacological profile of these compounds.
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Affiliation(s)
- Daria A Belinskaia
- Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, pr. Torez 44, St. Petersburg 194223, Russia.
| | - Mariia A Belinskaia
- International Centre for Neurotherapeutics, Dublin City University, Glasnevin, Dublin 9, Ireland.
| | - Oleg I Barygin
- Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, pr. Torez 44, St. Petersburg 194223, Russia.
| | - Nina P Vanchakova
- Department of Pedagogy and Psychology, Faculty of Postgraduate Education, First Pavlov State Medical University, L'va Tolstogo str. 6-8, St. Petersburg 197022, Russia.
| | - Natalia N Shestakova
- Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, pr. Torez 44, St. Petersburg 194223, Russia.
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Abstract
Pain is a significant public health problem, and assessment of pain-related impairment of behavior is a key clinical indicator and treatment target. Similar to opioids and NSAIDs, dopamine (DA) transporter inhibitors block pain-related depression of intracranial self-stimulation (ICSS) in rats. The primary goal of the present study was to determine if the effects of monoamine uptake inhibitors on pain-related depression of ICSS in rats extend to an assay of pain-related depression of nesting in mice. We hypothesized that the DA transporter-selective uptake inhibitor bupropion would block depression of nesting behavior produced by intraperitoneal injection of lactic acid, whereas selective serotonin transporter-selective citalopram, norepinephrine transporter-selective nisoxetine, and the mixed action selective serotonin transporter/norepinephrine transporter inhibitor milnacipran would be ineffective. Effects of the NSAID ketoprofen were also obtained to facilitate interpretation of the effects of the monoamine uptake inhibitors. Consistent with previous findings, ketoprofen blocked pain-related depression of nesting. In contrast, none of the monoamine uptake inhibitors blocked pain-related depression of nesting, although they all blocked pain-related stimulation of stretching. Unlike findings from studies of pain-related depression of ICSS, these results do not support consideration of DA uptake inhibitors for treatment of pain-related depression of behavior.
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Silva JC, de Oliveira Júnior RG, Silva MGE, de Lavor ÉM, Soares JMD, de Lima-Saraiva SRG, Diniz TC, Mendes RL, de Alencar Filho EB, Barreiro EJDL, Lima LM, Almeida JRGDS. LASSBio-1586, an N-acylhydrazone derivative, attenuates nociceptive behavior and the inflammatory response in mice. PLoS One 2018; 13:e0199009. [PMID: 30059558 PMCID: PMC6066216 DOI: 10.1371/journal.pone.0199009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 05/24/2018] [Indexed: 12/14/2022] Open
Abstract
Pain and inflammation are complex clinical conditions that are present in a wide variety of disorders. Most drugs used to treat pain and inflammation have potential side effects, which makes it necessary to search for new sources of bioactive molecules. In this paper, we describe the ability of LASSBio-1586, an N-acylhydrazone derivative, to attenuate nociceptive behavior and the inflammatory response in mice. Antinociceptive activity was evaluated through acetic acid-induced writhing and formalin-induced nociception tests. In these experimental models, LASSBio-1586 significantly (p<0.05) reduced nociceptive behavior. Several methods of acute and chronic inflammation induced by different chemical (carrageenan, histamine, croton oil, arachidonic acid) and physical (cotton pellet) agents were used to evaluate the anti-inflammatory effect of LASSBio-1586. LASSBio-1586 exhibited potent anti-inflammatory activity in all tests (p<0.05). Study of the mechanism of action demonstrated the possible involvement of the nitrergic, serotonergic and histamine signaling pathways. In addition, a molecular docking study was performed, indicating that LASSBio-1586 is able to block the COX-2 enzyme, reducing arachidonic acid metabolism and consequently decreasing the production of prostaglandins, which are important inflammatory mediators. In summary, LASSBio-1586 exhibited relevant antinociceptive and anti-inflammatory potential and acted on several targets, making it a candidate for a new multi-target oral anti-inflammatory drug.
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Affiliation(s)
- Juliane Cabral Silva
- Núcleo de Estudos e Pesquisas de Plantas Medicinais (NEPLAME), Universidade Federal do Vale do São Francisco, Petrolina, Brasil
| | | | - Mariana Gama e Silva
- Núcleo de Estudos e Pesquisas de Plantas Medicinais (NEPLAME), Universidade Federal do Vale do São Francisco, Petrolina, Brasil
| | - Érica Martins de Lavor
- Núcleo de Estudos e Pesquisas de Plantas Medicinais (NEPLAME), Universidade Federal do Vale do São Francisco, Petrolina, Brasil
| | - Juliana Mikaelly Dias Soares
- Núcleo de Estudos e Pesquisas de Plantas Medicinais (NEPLAME), Universidade Federal do Vale do São Francisco, Petrolina, Brasil
| | | | - Tâmara Coimbra Diniz
- Núcleo de Estudos e Pesquisas de Plantas Medicinais (NEPLAME), Universidade Federal do Vale do São Francisco, Petrolina, Brasil
| | | | | | - Eliezer Jesus de Lacerda Barreiro
- Instituto Nacional de Ciência e Tecnologia de Fármacos e Medicamentos (INCT-INOFAR), Universidade Federal do Rio de Janeiro, Laboratório de Avaliação e Síntese de Substâncias Bioativas (LASSBio), Rio de Janeiro, Brasil
| | - Lídia Moreira Lima
- Instituto Nacional de Ciência e Tecnologia de Fármacos e Medicamentos (INCT-INOFAR), Universidade Federal do Rio de Janeiro, Laboratório de Avaliação e Síntese de Substâncias Bioativas (LASSBio), Rio de Janeiro, Brasil
| | - Jackson Roberto Guedes da Silva Almeida
- Núcleo de Estudos e Pesquisas de Plantas Medicinais (NEPLAME), Universidade Federal do Vale do São Francisco, Petrolina, Brasil
- Instituto Nacional de Ciência e Tecnologia de Fármacos e Medicamentos (INCT-INOFAR), Universidade Federal do Rio de Janeiro, Laboratório de Avaliação e Síntese de Substâncias Bioativas (LASSBio), Rio de Janeiro, Brasil
- * E-mail:
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10
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Antiepileptic drugs as analgesics/adjuvants in inflammatory pain: current preclinical evidence. Pharmacol Ther 2018; 192:42-64. [PMID: 29909236 DOI: 10.1016/j.pharmthera.2018.06.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 06/04/2018] [Indexed: 12/20/2022]
Abstract
Inflammatory pain is the most common type of pain that is treated clinically. The use of currently available treatments (classic analgesics - NSAIDs, paracetamol and opioids) is limited by insufficient efficacy and/or side effects/tolerance development. Antiepileptic drugs (AEDs) are widely used in neuropathic pain treatment, but there is substantial preclinical evidence on their efficacy against inflammatory pain, too. In this review we focus on gabapentinoids (gabapentin and pregabalin) and dibenzazepine AEDs (carbamazepine, oxcarbazepine, and recently introduced eslicarbazepine acetate) and their potential for relieving inflammatory pain. In models of somatic, visceral and trigeminal inflammatory pain, that have a translational value for inflammatory conditions in locomotor system, viscera and head/face, AEDs have demonstrated analgesic activity. This activity was mostly consistent, dependent on the dose and largely independent on the site of inflammation and method of its induction, nociceptive stimuli, species, specific drug used, its route of administration and dosing schedule. AEDs exerted comparable efficacy with classic analgesics. Effective doses of AEDs are lower than toxic doses in animals and, when expressed as equivalent human doses, they are largely overlapping with AEDs doses already used in humans for treating epilepsy/neuropathic pain. The main mechanism of antinociceptive/antihyperalgesic action of gabapentinoids in inflammatory pain models seems to be α2δ-dependent suppression of voltage-gated calcium channels in primary sensory neurons that leads to reduced release of neurotransmitters in the spinal/medullar dorsal horn. The suppression of NMDA receptors via co-agonist binding site primarily at spinal sites, activation of various types of K+ channels at spinal and peripheral sites, and activation of noradrenergic and serotonergic descending pain modulatory pathways may also contribute. Inhibition of voltage-gated sodium channels along the pain pathway is probably the main mechanism of antinociceptive/antihyperalgesic effects of dibenzazepines. The recruitment of peripheral adrenergic and purinergic mechanisms and central GABAergic mechanisms may also contribute. When co-administered with classic/other alternative analgesics, AEDs exerted synergistic/additive interactions. Reviewed data could serve as a basis for clinical studies on the efficacy/safety of AEDs as analgesics/adjuvants in patients with inflammatory pain, and contribute to the improvement of the treatment of various inflammatory pain states.
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Evaluation of the analgesic effects of ammoxetine, a novel potent serotonin and norepinephrine reuptake inhibitor. Acta Pharmacol Sin 2016; 37:1154-65. [PMID: 27424654 DOI: 10.1038/aps.2016.45] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 04/21/2016] [Indexed: 12/24/2022] Open
Abstract
AIM The selective serotonin (5-HT) and norepinephrine (NE) reuptake inhibitors (SNRIs) are commonly used for the treatment of neuropathic pain and fibromyalgia. Ammoxetine ((±)-3-(benzo[d] [1,3]dioxol-4-yloxy)-N-methyl-3-(thiophen-2-yl)propan-1-amine) has been identified as a novel potent SNRI. In this study, we evaluated the acute analgesic properties of ammoxetine in different animal models of pain, and examined the involvement of monoamines in its analgesic actions. METHODS The analgesic effects of ammoxetine were assayed using models of acetic acid- and formalin-induced pain in mice, neuropathic pain induced by sciatic nerve injury (SNI), chronic constriction injury (CCI) and reserpine-induced fibromyalgia pain in rats. The contents of 5-HT and NE in brain regions of fibromyalgia rats were measured using HPLC-ECD. In all the experiments, duloxetine was used as a positive control drug. RESULTS Oral administration of ammoxetine (0.625-10 mg/kg) or duloxetine (2.5-40 mg/kg) dose-dependently decreased the number of acetic acid-induced writhing and formalin-induced first phase and second phase paw licking time in mice. Oral administration of ammoxetine (2.5-10 mg/kg) or duloxetine (10 mg/kg) alleviated mechanical allodynia in SNI and CCI rats and thermal hyperalgesia in CCI rats. The antiallodynic effect of ammoxetine in CCI rats was abolished by pretreatment with para-chlorophenylalanine methyl ester hydrochloride (PCPA, a 5-HT synthesis inhibitor) or α-methyl-para-tyrosine methylester (AMPT, a catecholamine synthesis inhibitor). Oral administration of ammoxetine (30 mg/kg) or duloxetine (50 mg/kg) significantly attenuated tactile allodynia in rats with reserpine-induced fibromyalgia. In the fibromyalgia rats, administration of ammoxetine (10, 30 mg/kg) or duloxetine (30, 50 mg/kg) dose-dependently increased the levels of 5-HT and NE, and decreased the metabolite ratio of 5-HT (5-HIAA/5-HT) in the spinal cord, hypothalamus, thalamus and prefrontal cortex. CONCLUSION Ammoxetine effectively alleviates inflammatory, continuous, neuropathic and fibromyalgia-related pain in animal models, which can be attributed to enhanced neurotransmission of 5-HT and NE in the descending inhibitory systems.
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Naghizadeh B, Mansouri MT, Ghorbanzadeh B. Ellagic acid enhances the antinociceptive action of carbamazepine in the acetic acid writhing test with mice. PHARMACEUTICAL BIOLOGY 2015; 54:157-61. [PMID: 25898222 DOI: 10.3109/13880209.2015.1025288] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
CONTEXT Ellagic acid (EA) produced antinociceptive and anti-inflammatory effects through the central and peripheral sites of action. OBJECTIVE The objective of the current study was to examine the functional interaction between ellagic acid and carbamazepine (CBZ) on pain. MATERIALS AND METHODS Fourteen groups of mice (8-10 each) were used in this study. Pain was induced by intraperitoneal acetic acid in mice (writhing test) and the functional interaction was analyzed using the isobolographic method. EA at doses 0.3, 1, 3, and 10 mg/kg and carbamazepine at doses 3, 10, 20, and 30 mg/kg, alone and also in combination (1/2, 1/4, and 1/8 of the drug's ED50) were intraperitoneally administered 30 min before acetic acid (0.6% v/v). Then, the abdominal writhes were counted during a 25-min period. RESULTS EA (0.3-10 mg/kg, i.p.) and CBZ (3-30 mg/kg, i.p.) inhibited the writhing response evoked by acetic acid. Fifty percent effective dose (ED50) values against this tonic pain were 1.02 mg/kg and 6.40 mg/kg for EA and CBZ, respectively. The antinociception induced by EA showed higher potency than that of carbamazepine. Co-administration of increasing fractional increments of ED50 values of EA and CBZ produced additive interaction against writhing responses, as revealed by isobolographic analysis. DISCUSSION AND CONCLUSION These results suggest that a combination of carbamazepine and ellagic acid may be a new strategy for the management of neuropathic pain such as what occurs in trigeminal neuralgia, since the use of carbamazepine is often limited by its adverse effects and by reduction of its analgesic effect through microsomal enzyme induction.
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Affiliation(s)
- Bahareh Naghizadeh
- a Department of Pharmacology , Medical School, Pain and Physiology Research Centers, Ahvaz Jundishapur University of Medical Sciences , Ahvaz , Iran
| | - Mohammad Taghi Mansouri
- b Department of Pharmacology , Medical School, Physiology and Atherosclerosis Research Centers, Ahvaz Jundishapur University of Medical Sciences , Ahvaz , Iran , and
| | - Behnam Ghorbanzadeh
- c Department of Pharmacology , Medical School, Ahvaz Jundishapur University of Medical Sciences , Ahvaz , Iran
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Wang C, Ma J, Liu R, Han W, Tang X. A thermoplastic elastomer patch matrix for traditional Chinese medicine: design and evaluation. Drug Dev Ind Pharm 2013; 40:211-21. [PMID: 23327358 DOI: 10.3109/03639045.2012.755191] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To design and evaluate a novel pressure sensitive adhesive (PSA) patch containing traditional Chinese medicine (TCM) using styrene-isoprene-styrene (SIS) copolymer. METHOD A mixture D-optimal design with ternary response surface diagram was employed in the optimization process. The proportions of SIS copolymer, tackifying resin and plasticizer were selected as the independent variables while tack force, peel strength of the patch and skin penetrability of methyl salicylate were selected as the dependent variables. The optimized patch was then evaluated including in vivo absorption, pharmacological activities and skin irritation, by comparing with a commercial patch based on natural rubber. RESULTS The optimized patch, which comprised 30.0% SIS copolymer, 26.6% tackifying resin and 43.4% plasticizer, was superior to commercial patch in skin permeation, pharmacological activities and skin biocompatibility. CONCLUSION SIS copolymer was a suitable substitute to natural rubber in producing patches containing TCM formula.
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Affiliation(s)
- Chengxiao Wang
- School of Pharmacy, East China University of Science and Technology , Shanghai , China
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Effects of monoamine reuptake inhibitors in assays of acute pain-stimulated and pain-depressed behavior in rats. THE JOURNAL OF PAIN 2013; 14:246-59. [PMID: 23332494 DOI: 10.1016/j.jpain.2012.11.006] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 10/12/2012] [Accepted: 11/12/2012] [Indexed: 01/23/2023]
Abstract
UNLABELLED Pain is associated with stimulation of some behaviors (eg, withdrawal reflexes) but depression of many other behaviors (eg, feeding, locomotion, positively reinforced operant behavior). Drugs that block reuptake of serotonin, norepinephrine, and/or dopamine are widely used to treat depression, and they have also emerged as useful drugs for treatment of pain. This study compared effects of selective and mixed-action inhibitors of serotonin, norepinephrine, and/or dopamine reuptake in assays of acute pain-stimulated and pain-depressed behavior. Intraperitoneal injection of dilute acid served as a noxious stimulus to stimulate a writhing response or depress intracranial self-stimulation (ICSS) in Sprague Dawley rats. Selective reuptake inhibitors of serotonin (citalopram, clomipramine) and norepinephrine (nisoxetine, nortriptyline) and a mixed-action reuptake inhibitor of serotonin and norepinephrine (milnacipran) blocked acid-stimulated writhing but failed to block acid-induced depression of ICSS. Selective dopamine reuptake inhibitors (RTI-113 [3ß-(4-chlorophenyl)tropane-2ß-carboxylic acid phenyl ester hydrochloride], bupropion) and a triple reuptake inhibitor of dopamine, serotonin, and norepinephrine (RTI-112 [3ß-(3-methyl-4-chlorophenyl)tropane-2ß-carboxylic acid methyl ester hydrochloride]) blocked both acid-stimulated writhing and acid-induced depression of ICSS, although these drugs also produced an abuse-related facilitation of ICSS in the absence of the noxious stimulus. These results support further consideration of dopamine reuptake inhibitors as candidate analgesics, although abuse liability remains a concern. PERSPECTIVE Monoamine reuptake inhibitors are used to treat depression and some forms of pain. This study examined effects of monoamine reuptake inhibitors in a preclinical assay of pain-related behavioral depression. The results support further consideration of dopamine reuptake inhibitors as candidate analgesics under selected circumstances, although abuse liability remains a concern.
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Depoortère R, Meleine M, Bardin L, Aliaga M, Muller E, Ardid D, Newman-Tancredi A. Milnacipran is active in models of irritable bowel syndrome and abdominal visceral pain in rodents. Eur J Pharmacol 2011; 672:83-7. [DOI: 10.1016/j.ejphar.2011.09.182] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Revised: 09/20/2011] [Accepted: 09/24/2011] [Indexed: 12/28/2022]
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Concomitant use of carbamazepine and olanzapine and the effect on some behavioral functions in rats. Pharmacol Rep 2011; 63:372-80. [DOI: 10.1016/s1734-1140(11)70503-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Revised: 08/17/2010] [Indexed: 11/24/2022]
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Fernández-Dueñas V, Poveda R, Fernández A, Sánchez S, Planas E, Ciruela F. Fentanyl-trazodone-paracetamol triple drug combination: multimodal analgesia in a mouse model of visceral pain. Pharmacol Biochem Behav 2011; 98:331-6. [PMID: 21296105 DOI: 10.1016/j.pbb.2011.01.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Revised: 01/10/2011] [Accepted: 01/30/2011] [Indexed: 10/18/2022]
Abstract
Multimodal or balanced analgesia is commonly used in the management of acute and chronic pain in humans, in order to achieve the best analgesic/safety profile. Here, by using a model of visceral acute tonic pain, the acetic acid-induced writhing test of mice, we show a synergistic interaction between fentanyl, trazodone and paracetamol on the inhibition of nociception. First of all, once assessed that all drugs induced dose-related antinociceptive effects, they were mixed in fixed ratio (1:1) combinations and a synergistic drug-drug interaction was obtained in all circumstances. Thereafter, we assayed the effects of the triple combination of fentanyl-trazodone-paracetamol and it was demonstrated that they displayed a potent synergistic interaction on the inhibition of acetic acid-mediated nociception. Interestingly, drug dosage reduction permitted to reduce the incidence of possible adverse effects, namely exploratory activity and motor coordination, thus it was demonstrated that it improved the benefit/risk profile of such treatment. Afterwards, we attempted to elucidate the mechanism of action of such interaction, by means of the non-selective opioid receptor antagonist naloxone. Interestingly, naloxone completely antagonized the antinociceptive effects of fentanyl, and it also partially reversed paracetamol and trazodone mediated analgesia. Furthermore, when naloxone was co-administered with the triple-drug treatment it blocked the previously observed enhanced antinociceptive effects of the combination. Thus, these results indicated that the endogenous opioid system played a main role in the present drug-drug interaction. Overall, the triple combination of fentanyl-trazodone-paracetamol induced a potent synergistic antinociceptive effect, which could be of interest for optimal multimodal clinical analgesia.
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Affiliation(s)
- Víctor Fernández-Dueñas
- Unitat de Farmacologia, Departament Patologia i Terapèutica Experimental, Facultat de Medicina, Universitat de Barcelona, L'Hospitalet de Llobregat, 08907 Barcelona, Spain.
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Hache G, Coudore F, Gardier AM, Guiard BP. Monoaminergic Antidepressants in the Relief of Pain: Potential Therapeutic Utility of Triple Reuptake Inhibitors (TRIs). Pharmaceuticals (Basel) 2011. [PMCID: PMC4053958 DOI: 10.3390/ph4020285] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Over 75% of depressed patients suffer from painful symptoms predicting a greater severity and a less favorable outcome of depression. Imaging, anatomical and functional studies have demonstrated the existence of common brain structures, neuronal pathways and neurotransmitters in depression and pain. In particular, the ascending serotonergic and noradrenergic pathways originating from the raphe nuclei and the locus coeruleus; respectively, send projections to the limbic system. Such pathways control many of the psychological functions that are disturbed in depression and in the perception of pain. On the other hand, the descending pathways, from monoaminergic nuclei to the spinal cord, are specifically implicated in the inhibition of nociception providing rationale for the use of serotonin (5-HT) and/or norepinephrine (NE) reuptake inhibitors (SSRIs, NRIs, SNRIs), in the relief of pain. Compelling evidence suggests that dopamine (DA) is also involved in the pathophysiology and treatment of depression. Indeed, recent insights have demonstrated a central role for DA in analgesia through an action at both the spinal and suprasinal levels including brain regions such as the periaqueductal grey (PAG), the thalamus, the basal ganglia and the limbic system. In this context, dopaminergic antidepressants (i.e., containing dopaminergic activity), such as bupropion, nomifensine and more recently triple reuptake inhibitors (TRIs), might represent new promising therapeutic tools in the treatment of painful symptoms with depression. Nevertheless, whether the addition of the dopaminergic component produces more robust effects than single- or dual-acting agents, has yet to be demonstrated. This article reviews the main pathways regulating pain transmission in relation with the monoaminergic systems. It then focuses on the current knowledge regarding the in vivo pharmacological properties and mechanism of action of monoaminergic antidepressants including SSRIs, NRIs, SNRIs and TRIs. Finally, a synthesis of the preclinical studies supporting the efficacy of these antidepressants in analgesia is also addressed in order to highlight the relative contribution of 5-HT, NE and DA to nociception.
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Affiliation(s)
- Guillaume Hache
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: 011-331-46-83-53-61
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Kawaura K, Miki R, Urashima Y, Honda S, Shehata AM, Soeda F, Shirasaki T, Takahama K. Tipepidine enhances the antinociceptive-like action of carbamazepine in the acetic acid writhing test. Eur J Pharmacol 2011; 651:106-8. [DOI: 10.1016/j.ejphar.2010.10.086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2010] [Revised: 10/06/2010] [Accepted: 10/29/2010] [Indexed: 10/18/2022]
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Lee KH, Park CE, Min KH, Shin YJ, Chung CM, Kim HH, Yoon HJ, Won-Kim, Ryu EJ, Shin YJ, Nam HS, Cho JW, Lee HY. Synthesis and pharmacological evaluation of 3-aryl-3-azolylpropan-1-amines as selective triple serotonin/norepinephrine/dopamine reuptake inhibitors. Bioorg Med Chem Lett 2010; 20:5567-71. [DOI: 10.1016/j.bmcl.2010.07.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Revised: 06/29/2010] [Accepted: 07/07/2010] [Indexed: 10/19/2022]
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Zhang ZJ, Tan QR, Tong Y, Li Q, Kang WH, Zhen XC, Post RM. The effectiveness of carbamazepine in unipolar depression: a double-blind, randomized, placebo-controlled study. J Affect Disord 2008; 109:91-7. [PMID: 18093662 DOI: 10.1016/j.jad.2007.11.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2007] [Revised: 11/11/2007] [Accepted: 11/12/2007] [Indexed: 10/22/2022]
Abstract
Our previous studies have shown the effectiveness of carbamazepine (CBZ) in the treatment of bipolar depression. This double-blind, randomized, placebo-controlled study was designed to further evaluate the efficacy of CBZ in unipolar depressed subjects who never received antidepressant and other psychotherapeutic treatment. A total of 89 patients who had at least two major depressive episodes, but never experienced mania or hypomania, were randomly assigned to treatment with immediate-release CBZ 300-800 mg/daily (n=51) or placebo (n=38) for 12 weeks. The primary efficacy was measured using the Hamilton Rating Scale for Depression (HAMD), Montgomery-Asberg Depression Rating Scale (MADRS), and Clinical Global Impression-Severity (CGI-S). The mean final CBZ dose of CBZ-treated patients was 461.6 mg/day. CBZ treatment yielded significantly greater improvements on the three efficacy measures at week 8 through endpoint compared to placebo. Patients assigned to CBZ treatment also had a significantly higher clinical response rate than placebo (74% vs. 42%, p<0.001), as defined for > or = 50% reduction in HAMD score. Based on the results of our present and previous studies, we suggest that CBZ might be considered an alternative in the management of certain conditions in major depressive disorder.
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Affiliation(s)
- Zhang-Jin Zhang
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shannxi 710032, China.
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Usefulness of antidepressants for improving the neuropathic pain-like state and pain-induced anxiety through actions at different brain sites. Neuropsychopharmacology 2008; 33:1952-65. [PMID: 17957217 DOI: 10.1038/sj.npp.1301590] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Clinically, it is well known that chronic pain induces depression, anxiety, and a reduced quality of life. There have been many reports on the relationship between pain and emotion. We previously reported that chronic pain induced anxiety with changes in opioidergic function in the central nervous system. In this study, we evaluated the anxiolytic-like effects of several types of antidepressants under a chronic neuropathic pain-like state and searched for the brain site of action where antidepressants show anxiolytic or antinociceptive effects. Sciatic nerve-ligated mice exhibited thermal hyperalgesia and tactile allodynia from days 7 to 28 after nerve ligation. At 4 weeks after ligation, these mice showed a significant anxiety-related behavior in the light-dark test and the elevated plus-maze test. Under these conditions, repeated administration of antidepressants, including the tricyclic antidepressant (TCA) imipramine, the serotonin noradrenaline reuptake inhibitor (SNRI) milnacipran, and the selective serotonin reuptake inhibitor (SSRI) paroxetine, significantly prevented the anxiety-related behaviors induced by chronic neuropathic pain. These antidepressants also produced a significant reduction in thermal hyperalgesia and tactile allodynia. Moreover, the microinjection of paroxetine into the basolateral amygdala or cingulate cortex reduced anxiety-related behavior, and microinjection into the primary somatosensory cortex significantly attenuated thermal hyperalgesia. These findings suggest that serotonergic antidepressants are effective for treating anxiety associated with chronic neuropathic pain and may be useful for treating neuropathic pain with emotional dysfunction such as anxiety. Furthermore, SSRIs show anxiolytic and antinociceptive effects by acting on different brain regions.
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