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Silva-Cardoso GK, Lazarini-Lopes W, Primini EO, Hallak JE, Crippa JA, Zuardi AW, Garcia-Cairasco N, Leite-Panissi CRA. Cannabidiol modulates chronic neuropathic pain aversion behavior by attenuation of neuroinflammation markers and neuronal activity in the corticolimbic circuit in male Wistar rats. Behav Brain Res 2023; 452:114588. [PMID: 37474023 DOI: 10.1016/j.bbr.2023.114588] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/26/2023] [Accepted: 07/16/2023] [Indexed: 07/22/2023]
Abstract
Chronic neuropathic pain (CNP) is a vast world health problem often associated with the somatosensory domain. This conceptualization is problematic because, unlike most other sensations that are usually affectively neutral and may present emotional, affective, and cognitive impairments. Neuronal circuits that modulate pain can increase or decrease painful sensitivity based on several factors, including context and expectation. The objective of this study was to evaluate whether subchronic treatment with Cannabidiol (CBD; 0.3, 3, and 10 mg/kg intraperitoneal route - i.p., once a day for 3 days) could promote pain-conditioned reversal, in the conditioned place preference (CPP) test, in male Wistar rats submitted to chronic constriction injury (CCI) of the sciatic nerve. Then, we evaluated the expression of astrocytes and microglia in animals treated with CBD through the immunofluorescence technique. Our results demonstrated that CBD promoted the reversal of CPP at 3 and 10 mg/kg. In CCI animals, CBD was able to attenuate the increase in neuronal hyperactivity, measured by FosB protein expression, in the regions of the corticolimbic circuit: anterior cingulate cortex (ACC), complex basolateral amygdala (BLA), granular layer of the dentate gyrus (GrDG), and dorsal hippocampus (DH) - adjacent to subiculum (CA1). CBD also prevented the increased expression of GFAP and IBA-1 in CCI animals. We concluded that CBD effects on CNP are linked to the modulation of the aversive component of pain. These effects decrease chronic neuronal activation and inflammatory markers in regions of the corticolimbic circuit.
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Affiliation(s)
- Gleice K Silva-Cardoso
- Department of Psychology, School of Philosophy, Science and Letters of Ribeirão Preto, University of São Paulo, Brazil; National Institute for Translational Medicine (INCT-TM; CNPq), São Paulo, Brazil
| | - Willian Lazarini-Lopes
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, Brazil; Department of Pharmacology, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, SP 14049-900, Brazil
| | - Eduardo Octaviano Primini
- Department of Psychology, School of Philosophy, Science and Letters of Ribeirão Preto, University of São Paulo, Brazil
| | - Jaime E Hallak
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, Brazil; National Institute for Translational Medicine (INCT-TM; CNPq), São Paulo, Brazil
| | - José A Crippa
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, Brazil; National Institute for Translational Medicine (INCT-TM; CNPq), São Paulo, Brazil
| | - Antônio W Zuardi
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, Brazil; National Institute for Translational Medicine (INCT-TM; CNPq), São Paulo, Brazil
| | - Norberto Garcia-Cairasco
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, Brazil; Department of Physiology, Ribeirão Preto School of Medicine, University of São Paulo, Brazil
| | - Christie R A Leite-Panissi
- Department of Psychology, School of Philosophy, Science and Letters of Ribeirão Preto, University of São Paulo, Brazil; National Institute for Translational Medicine (INCT-TM; CNPq), São Paulo, Brazil.
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Macêdo-Souza C, Maisonnette SS, Hallak JE, Crippa JA, Zuardi AW, Landeira-Fernandez J, Leite-Panissi CRA. Systemic Chronic Treatment with Cannabidiol in Carioca High- and Low-Conditioned Freezing Rats in the Neuropathic Pain Model: Evaluation of Pain Sensitivity. Pharmaceuticals (Basel) 2023; 16:1003. [PMID: 37513915 PMCID: PMC10383663 DOI: 10.3390/ph16071003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/06/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Studies have shown high comorbidity of anxiety disorder and chronic pain; generalized anxiety disorder (GAD) and neuropathic pain are among these pathologies. Cannabidiol (CBD) has been considered a promising treatment for these conditions. This study investigated whether chronic systemic treatment with CBD alters pain in high- (CHF) and low-freezing (CLF) Carioca rats (GAD model) and control rats (CTL) submitted to chronic neuropathic pain. The rats were evaluated in the sensory aspects (von Frey, acetone, and hot plate tests) before the chronic constriction injury of the ischiatic nerve (CCI) or not (SHAM) and on days 13 and 23 after surgery. Chronic treatment with CBD (5 mg/kg daily) was used for ten days, starting the 14th day after surgery. The open field test on the 22nd also evaluated locomotion and anxiety-like behavior. CBD treatment had an anti-allodynic effect on the mechanical and thermal threshold in all lineages; however, these effects were lower in the CHF and CLF lineages. Considering emotional evaluation, we observed an anxiolytic effect in CTL+CCI and CHF+CCI after CBD treatment and increased mobility in CLF+SHAM rats. These results suggest that the CBD mechanical anti-allodynic and emotional effects can depend on anxiety level.
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Affiliation(s)
- Carolina Macêdo-Souza
- Department of Psychology, Faculty of Philosophy, Science and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-901, Brazil
- National Institute for Translational Medicine (INCT-TM; CNPq), São Paulo 14049-900, Brazil
| | - Silvia Soares Maisonnette
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro 22451-900, Brazil
| | - Jaime E Hallak
- National Institute for Translational Medicine (INCT-TM; CNPq), São Paulo 14049-900, Brazil
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto 14049-900, Brazil
| | - José A Crippa
- National Institute for Translational Medicine (INCT-TM; CNPq), São Paulo 14049-900, Brazil
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto 14049-900, Brazil
| | - Antônio W Zuardi
- National Institute for Translational Medicine (INCT-TM; CNPq), São Paulo 14049-900, Brazil
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto 14049-900, Brazil
| | - J Landeira-Fernandez
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro 22451-900, Brazil
| | - Christie Ramos Andrade Leite-Panissi
- Department of Psychology, Faculty of Philosophy, Science and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-901, Brazil
- National Institute for Translational Medicine (INCT-TM; CNPq), São Paulo 14049-900, Brazil
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Libânio TC, Eufrásio RA, Niigaki SS, Peres FF, Silva RH, Zuardi AW, Hallak JEC, Crippa JAS, Calzavara MB, Abílio VC. Harmine impairs memory performance of treated rats and nontreated cagemates. Exp Clin Psychopharmacol 2022; 30:751-759. [PMID: 34735205 DOI: 10.1037/pha0000525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The interest in psychedelic substances as potential treatments for psychiatric disorders is increasing. The β-carboline harmine, an Ayahuasca component, presents hallucinogenic and antidepressant effects. Although Ayuahuasca-and consequently harmine-is usually consumed in rituals, the role of social contexts in the behavioral effects of harmine has not been investigated yet. In this sense, affective states may modulate cohabitants' behavior, including learning/memory. This work investigates the effects of harmine on the learning/memory performance of rats evaluated on the contextual and tone fear conditioning (CFC and TFC) and on the plus-maze discriminative avoidance (PMDAT) tasks. The possible influence of a harmine-treated cohabitant was assessed by evaluating rats housed in homogeneous cages-where all the animals were acutely administered with the same treatment (vehicle, 5, 10, or 15 mg/kg harmine), and in heterogeneous cages-where each animal received a different drug treatment. The main results are: (a) harmine impaired CFC (10 mg/kg) and PMDAT discrimination (all doses); and (b) harmine caused a memory deficit in CFC, TFC, and PMDAT of untreated rats kept in heterogeneous cages. Our results show that harmine induces a memory deficit in tasks with emotional contexts. Further, the cohabitation with animals treated with this drug also seems to impair memory performance of untreated animals. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Fabris D, Carvalho MC, Brandão ML, Prado WA, Zuardi AW, Crippa JA, de Oliveira AR, Lovick TA, Genaro K. Sex-dependent differences in the anxiolytic-like effect of cannabidiol in the elevated plus-maze. J Psychopharmacol 2022; 36:1371-1383. [PMID: 36239039 PMCID: PMC9716492 DOI: 10.1177/02698811221125440] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
RATIONALE Cannabidiol (CBD), the major non-psychoactive constituent of cannabis, has therapeutic potential for the treatment of anxiety. Most preclinical studies investigate only acute effects of CBD and only in males, yet the drug is most likely to be used over a sustained period in clinical practice. OBJECTIVES The objectives of this study were to investigate the anxiolytic-like effect of CBD in female rats compared to males and to determine whether the responsiveness of females was influenced by the stage of the estrous cycle. METHODS We carried out experiments to compare the effect of CBD in male and female rats in the elevated plus maze (EPM) in response to acute and short-term (4 days) administration through a complete cycle in females. RESULTS Male and female rats behaved in a similar manner in the EPM, but females in the late diestrus (LD) phase exhibited more anxiety-like behavior than at other stages, the difference reaching statistical significance compared to proestrus stages. CBD produced anxiolytic-like effects in both sexes, but female rats were responsive only in LD and 10-fold lower dose than males. After sub-chronic (4 days) treatment, responsiveness to CBD was maintained in females in LD, but females in proestrus remained unresponsive to CBD treatment. CONCLUSIONS We suggest that there are sex differences in the anxiolytic-like effects of CBD in rats that reflect different underlying mechanisms: based on literature data, gonadal hormone status linked to GABAA receptor expression in females, and 5-HT1A receptor activation in males.
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Affiliation(s)
- Débora Fabris
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil,Institute of Neurosciences and Behavior and Laboratory of Neuropsychopharmacology of Faculty of Philosophy, Sciences and Letters of University of São Paulo, Ribeirao Preto, SP, Brazil,Department of Psychology, Center of Education and Human Sciences, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Milene C Carvalho
- Institute of Neurosciences and Behavior and Laboratory of Neuropsychopharmacology of Faculty of Philosophy, Sciences and Letters of University of São Paulo, Ribeirao Preto, SP, Brazil,Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil
| | - Marcus L Brandão
- Institute of Neurosciences and Behavior and Laboratory of Neuropsychopharmacology of Faculty of Philosophy, Sciences and Letters of University of São Paulo, Ribeirao Preto, SP, Brazil
| | - Wiliam A Prado
- Institute of Neurosciences and Behavior and Laboratory of Neuropsychopharmacology of Faculty of Philosophy, Sciences and Letters of University of São Paulo, Ribeirao Preto, SP, Brazil,Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil
| | - Antônio W Zuardi
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil,National Institute of Science and Technology for Translational Medicine, Conselho Nacional de Desenvolvimento Científico e Tecnológico (INCT-TM, CNPq), Brasília, DF, Brazil
| | - José A Crippa
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil,National Institute of Science and Technology for Translational Medicine, Conselho Nacional de Desenvolvimento Científico e Tecnológico (INCT-TM, CNPq), Brasília, DF, Brazil
| | - Amanda R de Oliveira
- Institute of Neurosciences and Behavior and Laboratory of Neuropsychopharmacology of Faculty of Philosophy, Sciences and Letters of University of São Paulo, Ribeirao Preto, SP, Brazil,Department of Psychology, Center of Education and Human Sciences, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Thelma A Lovick
- Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
| | - Karina Genaro
- Institute of Neurosciences and Behavior and Laboratory of Neuropsychopharmacology of Faculty of Philosophy, Sciences and Letters of University of São Paulo, Ribeirao Preto, SP, Brazil,Department of Anesthesiology, School of Medicine, University of California, Irvine, CA, USA,Karina Genaro, Department of Anesthesiology, School of Medicine, University of California, 837 Health Sci. Rd. Gillespie BLDG., Irvine, CA 92617, USA.
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5
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Pedrazzi JFC, Ferreira FR, Silva-Amaral D, Lima DA, Hallak JEC, Zuardi AW, Del-Bel EA, Guimarães FS, Costa KCM, Campos AC, Crippa ACS, Crippa JAS. Cannabidiol for the treatment of autism spectrum disorder: hope or hype? Psychopharmacology (Berl) 2022; 239:2713-2734. [PMID: 35904579 DOI: 10.1007/s00213-022-06196-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 07/18/2022] [Indexed: 11/30/2022]
Abstract
RATIONALE Autism spectrum disorder (ASD) is defined as a group of neurodevelopmental disorders whose symptoms include impaired communication and social interaction, restricted and repetitive patterns of behavior, and varying levels of intellectual disability. ASD is observed in early childhood and is one of the most severe chronic childhood disorders in prevalence, morbidity, and impact on society. It is usually accompanied by attention deficit hyperactivity disorder, anxiety, depression, sleep disorders, and epilepsy. The treatment of ASD has low efficacy, possibly because it has a heterogeneous nature, and its neurobiological basis is not clearly understood. Drugs such as risperidone and aripiprazole are the only two drugs available that are recognized by the Food and Drug Administration, primarily for treating the behavioral symptoms of this disorder. These drugs have limited efficacy and a high potential for inducing undesirable effects, compromising treatment adherence. Therefore, there is great interest in exploring the endocannabinoid system, which modulates the activity of other neurotransmitters, has actions in social behavior and seems to be altered in patients with ASD. Thus, cannabidiol (CBD) emerges as a possible strategy for treating ASD symptoms since it has relevant pharmacological actions on the endocannabinoid system and shows promising results in studies related to disorders in the central nervous system. OBJECTIVES Review the preclinical and clinical data supporting CBD's potential as a treatment for the symptoms and comorbidities associated with ASD, as well as discuss and provide information with the purpose of not trivializing the use of this drug.
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Affiliation(s)
- João F C Pedrazzi
- Department of Neurosciences and Behavioral Sciences, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | - Frederico R Ferreira
- Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, 21040-900, Brazil
| | - Danyelle Silva-Amaral
- Department of Physiology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Daniel A Lima
- Department of Neurosciences and Behavioral Sciences, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Jaime E C Hallak
- Department of Neurosciences and Behavioral Sciences, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Antônio W Zuardi
- Department of Neurosciences and Behavioral Sciences, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Elaine A Del-Bel
- Department of Neurosciences and Behavioral Sciences, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Morphology, Physiology, and Basic Pathology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Francisco S Guimarães
- Department of Pharmacology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Karla C M Costa
- Department of Pharmacology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Alline C Campos
- Department of Pharmacology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Ana C S Crippa
- Graduate Program in Child and Adolescent Health, Neuropediatric Center of the Hospital of Clinics (CENEP), Federal University of Paraná, Curitiba, Paraná, Brazil
| | - José A S Crippa
- Department of Neurosciences and Behavioral Sciences, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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6
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Rossi GN, Osório FL, Morgan CJA, Crippa JAS, Bouso JC, Rocha JM, Zuardi AW, Hallak JEC, Santos RGD. The effects of Cannabidiol (CBD) and Delta-9-Tetrahydrocannabinol (THC) on the recognition of emotions in facial expressions: A systematic review of randomized controlled trials. Neurosci Biobehav Rev 2020; 118:236-246. [PMID: 32745478 DOI: 10.1016/j.neubiorev.2020.07.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/03/2020] [Accepted: 07/27/2020] [Indexed: 11/25/2022]
Abstract
Tetrahydrocannabinol (THC) and cannabidiol (CBD) are phytocannabinoids being linked with modulation of anxiety and depression. The recognition of emotions in facial expressions (REFE) is impaired in these disorders. Both drugs could modulate anxiety and mood by interfering with REFE. Thus, a systematic review of controlled trials assessing the effects of THC and CBD on REFE was performed. Ten studies describing seven distinct experiments were found (n = 170). THC (7.5-15 mg) did not alter REFE in three experiments, but reduced task performance in other three experiments. CBD did not alter REFE in two experiments, but improved task performance and counteracted the effects of THC in one experiment. THC (≥ 10 mg) and CBD (600 mg) showed opposite effects on brain activation, skin conductance, and anxiety measures with negative/threatening faces. The limited number of studies precludes firm conclusions on the effects of these substances on REFE. Further controlled trials are needed to elucidate the effects of THC and CBD on REFE. The PROSPERO ID for this study is CRD42019135085.
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Affiliation(s)
- Giordano Novak Rossi
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil.
| | - Flávia L Osório
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil; National Institute for Translational Medicine (INCT-TM), CNPq, Brazil.
| | - Celia J A Morgan
- Clinical Psychopharmacology Unit, University College London, London, UK; Psychopharmacology and Addiction Research Centre, University of Exeter, Exeter, UK.
| | - José Alexandre S Crippa
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil; National Institute for Translational Medicine (INCT-TM), CNPq, Brazil.
| | - José Carlos Bouso
- ICEERS Foundation (International Center for Ethnobotanical Education, Research and Services), Barcelona, Spain.
| | - Juliana Mendes Rocha
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil.
| | - Antônio W Zuardi
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil; National Institute for Translational Medicine (INCT-TM), CNPq, Brazil.
| | - Jaime E C Hallak
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil; National Institute for Translational Medicine (INCT-TM), CNPq, Brazil.
| | - Rafael G Dos Santos
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil; National Institute for Translational Medicine (INCT-TM), CNPq, Brazil; ICEERS Foundation (International Center for Ethnobotanical Education, Research and Services), Barcelona, Spain.
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Dos Santos RG, Guimarães FS, Crippa JAS, Hallak JEC, Rossi GN, Rocha JM, Zuardi AW. Serious adverse effects of cannabidiol (CBD): a review of randomized controlled trials. Expert Opin Drug Metab Toxicol 2020; 16:517-526. [PMID: 32271618 DOI: 10.1080/17425255.2020.1754793] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Recent trials using cannabidiol (CBD) have shown that most acute and prolonged adverse effects of CBD are mild to moderate, with rare serious adverse effects (SAEs). This review focused on analyzing SAEs of CBD and their possible relation to drug-drug interactions. AREAS COVERED We systematically analyzed the SAEs reported in randomized controlled trials (RCTs) involving the administration of oral CBD for at least 1 week in both healthy volunteers and clinical samples. EXPERT OPINION SAEs related to CBD in RCT are rare and include mainly elevated transaminases, convulsion, sedation, lethargy, and upper respiratory tract infections. Elevated transaminases are related to concomitant valproate use, while sedation, lethargy, and upper respiratory tract infections are related to concomitant clobazam use. Epileptic patients should be monitored when using CBD concomitantly with these and other antiepileptic drugs for other possible drug-drug interactions.
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Affiliation(s)
- Rafael G Dos Santos
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto, Brazil.,National Institute of Science and Technology - Translational Medicine , Brazil
| | - Francisco S Guimarães
- National Institute of Science and Technology - Translational Medicine , Brazil.,Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto, Brazil
| | - José Alexandre S Crippa
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto, Brazil.,National Institute of Science and Technology - Translational Medicine , Brazil
| | - Jaime E C Hallak
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto, Brazil.,National Institute of Science and Technology - Translational Medicine , Brazil
| | - Giordano Novak Rossi
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto, Brazil
| | - Juliana Mendes Rocha
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto, Brazil
| | - Antônio W Zuardi
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto, Brazil.,National Institute of Science and Technology - Translational Medicine , Brazil
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De Oliveira Sergio T, Frias AT, Vilela-Costa HH, De Oliveira DC, Zuardi AW, Zangrossi H. Serotonin mediates the panicolytic-like effect of oxytocin in the dorsal periaqueductal gray. J Psychopharmacol 2020; 34:383-390. [PMID: 32108540 DOI: 10.1177/0269881120907960] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION AND OBJECTIVES Oxytocin (OT) has been widely linked to positive social interactions, and there is great interest in OT as a therapy for a variety of neuropsychiatric conditions. Recent evidence also suggests that OT can play an important role in the mediation of anxiety-associated defensive responses, including a role for serotonin (5-HT) neurotransmission in this action. However, it is presently unknown whether OT additionally regulates the expression of panic-related behaviors, such as escape, by acting in the dorsal periaqueductal gray (dPAG), a key panic-regulating area. This study aimed to investigate the consequence of OT injection in the dPAG on escape expression and whether facilitation of 5-HT neurotransmission in this midbrain area is implicated in this action. METHODS Male Wistar rats were injected with OT in the dPAG and tested for escape expression in the elevated T-maze (ETM) and dPAG electrical stimulation tests. Using the latter test, OT's effect was also investigated after previous intra-dPAG injection of the OT receptor antagonist atosiban, the preferential antagonists of 5-HT1A and 5-HT2A receptors, WAY-100635 and ketanserin, respectively, or systemic pretreatment with the 5-HT synthesis inhibitor p-CPA. RESULTS OT impaired escape expression in the two tests used, suggesting a panicolytic-like effect. In the ETM, the peptide also facilitated inhibitory avoidance acquisition, indicating an anxiogenic effect. Previous administration of atosiban, WAY-100635, ketanserin, or p-CPA counteracted OT's anti-escape effect. CONCLUSIONS OT and 5-HT in the dPAG interact in the regulation of panic- and anxiety-related defensive responses. These findings open new perspectives for the development of novel therapeutic strategies for the treatment of anxiety disorders.
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Affiliation(s)
- Thatiane De Oliveira Sergio
- Department of Pharmacology, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Alana Tercino Frias
- Department of Pharmacology, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Heloisa Helena Vilela-Costa
- Department of Pharmacology, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Danielle Cg De Oliveira
- Department of Neurosciences and Behavior, Division of Psychiatry, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | - Antônio W Zuardi
- Department of Neurosciences and Behavior, Division of Psychiatry, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | - Hélio Zangrossi
- Department of Pharmacology, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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9
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Crippa JAS, Hallak JEC, Zuardi AW, Guimarães FS, Tumas V, Dos Santos RG. Is cannabidiol the ideal drug to treat non-motor Parkinson's disease symptoms? Eur Arch Psychiatry Clin Neurosci 2019; 269:121-133. [PMID: 30706171 DOI: 10.1007/s00406-019-00982-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 01/03/2019] [Indexed: 12/13/2022]
Abstract
Parkinson's disease (PD) is a chronic neurodegenerative disorder characterized by motor symptoms such as bradykinesia, rest tremor, postural disturbances, and rigidity. PD is also characterized by non-motor symptoms such as sleep disturbances, cognitive deficits, and psychiatric disorders such as psychosis, depression, and anxiety. The pharmacological treatment for these symptoms is limited in efficacy and induce significant adverse reactions, highlighting the need for better treatment options. Cannabidiol (CBD) is a phytocannabinoid devoid of the euphoriant and cognitive effects of tetrahydrocannabinol, and preclinical and preliminary clinical studies suggest that this compound has therapeutic effect in non-motor symptoms of PD. In the present text, we review the clinical studies of cannabinoids in PD and the preclinical and clinical studies specifically on CBD. We found four randomized controlled trials (RCTs) involving the administration of agonists/antagonists of the cannabinoid 1 receptor, showing that these compounds were well tolerated, but only one study found positive results (reductions on levodopa-induced dyskinesia). We found seven preclinical models of PD using CBD, with six studies showing a neuroprotective effect of CBD. We found three trials involving CBD and PD: an open-label study, a case series, and an RCT. CBD was well tolerated, and all three studies reported significant therapeutic effects in non-motor symptoms (psychosis, rapid eye movement sleep behaviour disorder, daily activities, and stigma). However, sample sizes were small and CBD treatment was short (up to 6 weeks). Large-scale RCTs are needed to try to replicate these results and to assess the long-term safety of CBD.
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Affiliation(s)
- José Alexandre S Crippa
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
- National Institute of Science and Technology-Translational Medicine, Ribeirão Preto, Brazil.
- Hospital das Clínicas, Terceiro Andar, Av. Bandeirantes, 3900, Ribeirão Preto, São Paulo, CEP-14049-900, Brazil.
| | - Jaime E C Hallak
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- National Institute of Science and Technology-Translational Medicine, Ribeirão Preto, Brazil
| | - Antônio W Zuardi
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- National Institute of Science and Technology-Translational Medicine, Ribeirão Preto, Brazil
| | - Francisco S Guimarães
- National Institute of Science and Technology-Translational Medicine, Ribeirão Preto, Brazil
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Vitor Tumas
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- National Institute of Science and Technology-Translational Medicine, Ribeirão Preto, Brazil
| | - Rafael G Dos Santos
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- National Institute of Science and Technology-Translational Medicine, Ribeirão Preto, Brazil
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10
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Peres FF, Diana MC, Levin R, Suiama MA, Almeida V, Vendramini AM, Santos CM, Zuardi AW, Hallak JEC, Crippa JA, Abílio VC. Cannabidiol Administered During Peri-Adolescence Prevents Behavioral Abnormalities in an Animal Model of Schizophrenia. Front Pharmacol 2018; 9:901. [PMID: 30186164 PMCID: PMC6113576 DOI: 10.3389/fphar.2018.00901] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 07/23/2018] [Indexed: 01/08/2023] Open
Abstract
Schizophrenia is considered a debilitating neurodevelopmental psychiatric disorder and its pharmacotherapy remains problematic without recent major advances. The development of interventions able to prevent the emergence of schizophrenia would therefore represent an enormous progress. Here, we investigated whether treatment with cannabidiol (CBD - a compound of Cannabis sativa that presents an antipsychotic profile in animals and humans) during peri-adolescence would prevent schizophrenia-like behavioral abnormalities in an animal model of schizophrenia: the spontaneously hypertensive rat (SHR) strain. Wistar rats and SHRs were treated with vehicle or CBD from 30 to 60 post-natal days. In experiment 1, schizophrenia-like behaviors (locomotor activity, social interaction, prepulse inhibition of startle and contextual fear conditioning) were assessed on post-natal day 90. Side effects commonly associated with antipsychotic treatment were also evaluated: body weight gain and catalepsy throughout the treatment, and oral dyskinesia 48 h after treatment interruption and on post-natal day 90. In experiment 2, serum levels of triglycerides and glycemia were assessed on post-natal day 61. In experiment 3, levels of BDNF, monoamines, and their metabolites were evaluated on post-natal days 61 and 90 in the prefrontal cortex and striatum. Treatment with CBD prevented the emergence of SHRs' hyperlocomotor activity (a model for the positive symptoms of schizophrenia) and deficits in prepulse inhibition of startle and contextual fear conditioning (cognitive impairments). CBD did not induce any of the potential motor or metabolic side effects evaluated. Treatment with CBD increased the prefrontal cortex 5-HIAA/serotonin ratio and the levels of 5-HIAA on post-natal days 61 and 90, respectively. Our data provide pre-clinical evidence for a safe and beneficial effect of peripubertal and treatment with CBD on preventing positive and cognitive symptoms of schizophrenia, and suggest the involvement of the serotoninergic system on this effect.
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Affiliation(s)
- Fernanda F Peres
- Department of Pharmacology, Federal University of São Paulo, São Paulo, Brazil.,National Institute for Translational Medicine, National Council for Scientific and Technological Development, Ribeirão Preto, Brazil.,Interdisciplinary Laboratory of Clinical Neurosciences, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Mariana C Diana
- Department of Pharmacology, Federal University of São Paulo, São Paulo, Brazil.,Interdisciplinary Laboratory of Clinical Neurosciences, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Raquel Levin
- Department of Pharmacology, Federal University of São Paulo, São Paulo, Brazil.,Interdisciplinary Laboratory of Clinical Neurosciences, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Mayra A Suiama
- Department of Pharmacology, Federal University of São Paulo, São Paulo, Brazil.,Interdisciplinary Laboratory of Clinical Neurosciences, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Valéria Almeida
- Department of Pharmacology, Federal University of São Paulo, São Paulo, Brazil.,Interdisciplinary Laboratory of Clinical Neurosciences, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Ana M Vendramini
- Department of Pharmacology, Federal University of São Paulo, São Paulo, Brazil.,Interdisciplinary Laboratory of Clinical Neurosciences, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Camila M Santos
- Department of Pharmacology, Federal University of São Paulo, São Paulo, Brazil.,Interdisciplinary Laboratory of Clinical Neurosciences, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Antônio W Zuardi
- National Institute for Translational Medicine, National Council for Scientific and Technological Development, Ribeirão Preto, Brazil.,Department of Neuroscience and Behavior, University of São Paulo, Ribeirão Preto, Brazil
| | - Jaime E C Hallak
- National Institute for Translational Medicine, National Council for Scientific and Technological Development, Ribeirão Preto, Brazil.,Department of Neuroscience and Behavior, University of São Paulo, Ribeirão Preto, Brazil
| | - José A Crippa
- National Institute for Translational Medicine, National Council for Scientific and Technological Development, Ribeirão Preto, Brazil.,Department of Neuroscience and Behavior, University of São Paulo, Ribeirão Preto, Brazil
| | - Vanessa C Abílio
- Department of Pharmacology, Federal University of São Paulo, São Paulo, Brazil.,National Institute for Translational Medicine, National Council for Scientific and Technological Development, Ribeirão Preto, Brazil.,Department of Neuroscience and Behavior, University of São Paulo, Ribeirão Preto, Brazil
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11
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Callejas GH, Figueira RL, Gonçalves FLL, Volpe FAP, Zuardi AW, Crippa JA, Hallak JE, Sbragia L. Maternal administration of cannabidiol promotes an anti-inflammatory effect on the intestinal wall in a gastroschisis rat model. ACTA ACUST UNITED AC 2018; 51:e7132. [PMID: 29561958 PMCID: PMC5875904 DOI: 10.1590/1414-431x20177132] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 12/19/2017] [Indexed: 01/08/2023]
Abstract
Gastroschisis (GS) is an abdominal wall defect that results in histological and morphological changes leading to intestinal motility perturbation and impaired absorption of nutrients. Due to its anti-inflammatory, antioxidant, and neuroprotective effects, cannabidiol (CBD) has been used as a therapeutic agent in many diseases. Our aim was to test the effect of maternal CBD in the intestine of an experimental model of GS. Pregnant rats were treated over 3 days with CBD (30 mg/kg) after the surgical induction of GS (day 18.5 of gestation) and compared to controls. Fetuses were divided into 4 groups: 1) control (C); 2) C+CBD (CCBD); 3) gastroschisis (G), and 4) G+CBD (GCBD). On day 21.5 of gestation, the fetuses were harvested and evaluated for: a) body weight (BW), intestinal weight (IW), and IW/BW ratio; b) histometric analysis of the intestinal wall; c) immunohistochemically analysis of inflammation (iNOS) and nitrite/nitrate level. BW: GCBD was lower than CCBD (P<0.005), IW and IW/BW ratio: GCBD was smaller than G (P<0.005), GCBD presented lower thickness in all parameters compared to G (P<0.005), iNOS and nitrite/nitrate were lower concentration in GCBD than to G (P<0.005). Maternal use of CBD had a beneficial effect on the intestinal loops of GS with decreased nitrite/nitrate and iNOS expression.
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Affiliation(s)
- G H Callejas
- Laboratório de Cirurgia Experimental Fetal e Neonatal "Michael Harrison" Divisão de Cirurgia Pediátrica, Departamento de Cirurgia e Anatomia Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - R L Figueira
- Laboratório de Cirurgia Experimental Fetal e Neonatal "Michael Harrison" Divisão de Cirurgia Pediátrica, Departamento de Cirurgia e Anatomia Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - F L L Gonçalves
- Laboratório de Cirurgia Experimental Fetal e Neonatal "Michael Harrison" Divisão de Cirurgia Pediátrica, Departamento de Cirurgia e Anatomia Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - F A P Volpe
- Laboratório de Cirurgia Experimental Fetal e Neonatal "Michael Harrison" Divisão de Cirurgia Pediátrica, Departamento de Cirurgia e Anatomia Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - A W Zuardi
- Departmento de Neurociências e Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - J A Crippa
- Departmento de Neurociências e Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - J E Hallak
- Departmento de Neurociências e Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - L Sbragia
- Laboratório de Cirurgia Experimental Fetal e Neonatal "Michael Harrison" Divisão de Cirurgia Pediátrica, Departamento de Cirurgia e Anatomia Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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12
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Genaro K, Fabris D, Arantes ALF, Zuardi AW, Crippa JAS, Prado WA. Cannabidiol Is a Potential Therapeutic for the Affective-Motivational Dimension of Incision Pain in Rats. Front Pharmacol 2017; 8:391. [PMID: 28680401 PMCID: PMC5478794 DOI: 10.3389/fphar.2017.00391] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 06/06/2017] [Indexed: 12/11/2022] Open
Abstract
Background: Pain involves different brain regions and is critically determined by emotional processing. Among other areas, the rostral anterior cingulate cortex (rACC) is implicated in the processing of affective pain. Drugs that interfere with the endocannabinoid system are alternatives for the management of clinical pain. Cannabidiol (CBD), a phytocannabinoid found in Cannabis sativa, has been utilized in preclinical and clinical studies for the treatment of pain. Herein, we evaluate the effects of CBD, injected either systemically or locally into the rACC, on mechanical allodynia in a postoperative pain model and on the negative reinforcement produced by relief of spontaneous incision pain. Additionally, we explored whether CBD underlies the reward of pain relief after systemic or rACC injection. Methods and Results: Male Wistar rats were submitted to a model of incision pain. All rats had mechanical allodynia, which was less intense after intraperitoneal CBD (3 and 10 mg/kg). Conditioned place preference (CPP) paradigm was used to assess negative reinforcement. Intraperitoneal CBD (1 and 3 mg/kg) inverted the CPP produced by peripheral nerve block even at doses that do not change mechanical allodynia. CBD (10 to 40 nmol/0.25 μL) injected into the rACC reduced mechanical allodynia in a dose-dependent manner. CBD (5 nmol/0.25 μL) did not change mechanical allodynia, but reduced peripheral nerve block-induced CPP, and the higher doses inverted the CPP. Additionally, CBD injected systemically or into the rACC at doses that did not change the incision pain evoked by mechanical stimulation significantly produced CPP by itself. Therefore, a non-rewarding dose of CBD in sham-incised rats becomes rewarding in incised rats, presumably because of pain relief or reduction of pain aversiveness. Conclusion: The study provides evidence that CBD influences different dimensions of the response of rats to a surgical incision, and the results establish the rACC as a brain area from which CBD evokes antinociceptive effects in a manner similar to the systemic administration of CBD. In addition, the study gives further support to the notion that the sensorial and affective dimensions of pain may be differentially modulated by CBD.
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Affiliation(s)
- Karina Genaro
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São PauloSão Paulo, Brazil.,Department of Psychology and Education, Faculty of Phylosophy, Science and Language Studies of Ribeirão Preto, University of São PauloSão Paulo, Brazil
| | - Débora Fabris
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São PauloSão Paulo, Brazil.,Department of Psychology and Education, Faculty of Phylosophy, Science and Language Studies of Ribeirão Preto, University of São PauloSão Paulo, Brazil
| | - Ana L F Arantes
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São PauloSão Paulo, Brazil.,Department of Psychology and Education, Faculty of Phylosophy, Science and Language Studies of Ribeirão Preto, University of São PauloSão Paulo, Brazil
| | - Antônio W Zuardi
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São PauloSão Paulo, Brazil.,National Institute of Science and Technology for Translational Medicine, Conselho Nacional de Desenvolvimento Cientifico e TecnologicoBrasília, Brazil
| | - José A S Crippa
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São PauloSão Paulo, Brazil.,National Institute of Science and Technology for Translational Medicine, Conselho Nacional de Desenvolvimento Cientifico e TecnologicoBrasília, Brazil
| | - Wiliam A Prado
- Department of Psychology and Education, Faculty of Phylosophy, Science and Language Studies of Ribeirão Preto, University of São PauloSão Paulo, Brazil.,Department of Pharmacology, Ribeirão Preto Medical School, University of São PauloSão Paulo, Brazil
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13
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Affiliation(s)
- Cristiano Chaves
- Department of Neuroscience and Behavior, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Antônio W Zuardi
- Department of Neuroscience and Behavior, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Jaime E C Hallak
- Department of Neuroscience and Behavior, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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14
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Peres FF, Levin R, Suiama MA, Diana MC, Gouvêa DA, Almeida V, Santos CM, Lungato L, Zuardi AW, Hallak JEC, Crippa JA, Vânia D, Silva RH, Abílio VC. Cannabidiol Prevents Motor and Cognitive Impairments Induced by Reserpine in Rats. Front Pharmacol 2016; 7:343. [PMID: 27733830 PMCID: PMC5040118 DOI: 10.3389/fphar.2016.00343] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 09/13/2016] [Indexed: 12/29/2022] Open
Abstract
Cannabidiol (CBD) is a non-psychotomimetic compound from Cannabis sativa that presents antipsychotic, anxiolytic, anti-inflammatory, and neuroprotective effects. In Parkinson's disease patients, CBD is able to attenuate the psychotic symptoms induced by L-DOPA and to improve quality of life. Repeated administration of reserpine in rodents induces motor impairments that are accompanied by cognitive deficits, and has been applied to model both tardive dyskinesia and Parkinson's disease. The present study investigated whether CBD administration would attenuate reserpine-induced motor and cognitive impairments in rats. Male Wistar rats received four injections of CBD (0.5 or 5 mg/kg) or vehicle (days 2-5). On days 3 and 5, animals received also one injection of 1 mg/kg reserpine or vehicle. Locomotor activity, vacuous chewing movements, and catalepsy were assessed from day 1 to day 7. On days 8 and 9, we evaluated animals' performance on the plus-maze discriminative avoidance task, for learning/memory assessment. CBD (0.5 and 5 mg/kg) attenuated the increase in catalepsy behavior and in oral movements - but not the decrease in locomotion - induced by reserpine. CBD (0.5 mg/kg) also ameliorated the reserpine-induced memory deficit in the discriminative avoidance task. Our data show that CBD is able to attenuate motor and cognitive impairments induced by reserpine, suggesting the use of this compound in the pharmacotherapy of Parkinson's disease and tardive dyskinesia.
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Affiliation(s)
- Fernanda F Peres
- Interdisciplinary Laboratory of Clinical Neurosciences, Department of Psychiatry, Federal University of São PauloSão Paulo, Brazil; Department of Pharmacology, Federal University of São PauloSão Paulo, Brazil
| | - Raquel Levin
- Interdisciplinary Laboratory of Clinical Neurosciences, Department of Psychiatry, Federal University of São PauloSão Paulo, Brazil; Department of Pharmacology, Federal University of São PauloSão Paulo, Brazil
| | - Mayra A Suiama
- Interdisciplinary Laboratory of Clinical Neurosciences, Department of Psychiatry, Federal University of São PauloSão Paulo, Brazil; Department of Pharmacology, Federal University of São PauloSão Paulo, Brazil
| | - Mariana C Diana
- Interdisciplinary Laboratory of Clinical Neurosciences, Department of Psychiatry, Federal University of São PauloSão Paulo, Brazil; Department of Pharmacology, Federal University of São PauloSão Paulo, Brazil
| | - Douglas A Gouvêa
- Interdisciplinary Laboratory of Clinical Neurosciences, Department of Psychiatry, Federal University of São PauloSão Paulo, Brazil; Department of Pharmacology, Federal University of São PauloSão Paulo, Brazil
| | - Valéria Almeida
- Interdisciplinary Laboratory of Clinical Neurosciences, Department of Psychiatry, Federal University of São PauloSão Paulo, Brazil; Department of Pharmacology, Federal University of São PauloSão Paulo, Brazil
| | - Camila M Santos
- Interdisciplinary Laboratory of Clinical Neurosciences, Department of Psychiatry, Federal University of São PauloSão Paulo, Brazil; Department of Pharmacology, Federal University of São PauloSão Paulo, Brazil
| | - Lisandro Lungato
- Department of Psychobiology, Federal University of São Paulo São Paulo, Brazil
| | - Antônio W Zuardi
- Department of Neuroscience and Behavior, University of São PauloRibeirão Preto, Brazil; National Institute for Translational Medicine - National Council for Scientific and Technological DevelopmentRibeirão Preto, Brazil
| | - Jaime E C Hallak
- Department of Neuroscience and Behavior, University of São PauloRibeirão Preto, Brazil; National Institute for Translational Medicine - National Council for Scientific and Technological DevelopmentRibeirão Preto, Brazil
| | - José A Crippa
- Department of Neuroscience and Behavior, University of São PauloRibeirão Preto, Brazil; National Institute for Translational Medicine - National Council for Scientific and Technological DevelopmentRibeirão Preto, Brazil
| | - D'Almeida Vânia
- Department of Psychobiology, Federal University of São Paulo São Paulo, Brazil
| | - Regina H Silva
- Department of Pharmacology, Federal University of São Paulo São Paulo, Brazil
| | - Vanessa C Abílio
- Interdisciplinary Laboratory of Clinical Neurosciences, Department of Psychiatry, Federal University of São PauloSão Paulo, Brazil; Department of Pharmacology, Federal University of São PauloSão Paulo, Brazil
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15
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Dos Santos RG, Osório FL, Crippa JAS, Riba J, Zuardi AW, Hallak JEC. Antidepressive, anxiolytic, and antiaddictive effects of ayahuasca, psilocybin and lysergic acid diethylamide (LSD): a systematic review of clinical trials published in the last 25 years. Ther Adv Psychopharmacol 2016; 6:193-213. [PMID: 27354908 PMCID: PMC4910400 DOI: 10.1177/2045125316638008] [Citation(s) in RCA: 155] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
To date, pharmacological treatments for mood and anxiety disorders and for drug dependence show limited efficacy, leaving a large number of patients suffering severe and persistent symptoms. Preliminary studies in animals and humans suggest that ayahuasca, psilocybin and lysergic acid diethylamide (LSD) may have antidepressive, anxiolytic, and antiaddictive properties. Thus, we conducted a systematic review of clinical trials published from 1990 until 2015, assessing these therapeutic properties. Electronic searches were performed using the PubMed, LILACS, and SciELO databases. Only clinical trials published in peer-reviewed journals were included. Of these, 151 studies were identified, of which six met the established criteria. Reviewed studies suggest beneficial effects for treatment-resistant depression, anxiety and depression associated with life-threatening diseases, and tobacco and alcohol dependence. All drugs were well tolerated. In conclusion, ayahuasca, psilocybin and LSD may be useful pharmacological tools for the treatment of drug dependence, and anxiety and mood disorders, especially in treatment-resistant patients. These drugs may also be useful pharmacological tools to understand psychiatric disorders and to develop new therapeutic agents. However, all studies reviewed had small sample sizes, and half of them were open-label, proof-of-concept studies. Randomized, double-blind, placebo-controlled studies with more patients are needed to replicate these preliminary findings.
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Affiliation(s)
- Rafael G Dos Santos
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Hospital das Clínicas, Terceiro Andar, Av. Bandeirantes, 3900, Ribeirão Preto, São Paulo, Brazil
| | - Flávia L Osório
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil National Institute for Translational Medicine (INCT-TM), CNPq, Brazil
| | - José Alexandre S Crippa
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil National Institute for Translational Medicine (INCT-TM), CNPq, Brazil
| | - Jordi Riba
- Centre d'Investigació de Medicaments, Servei de Farmacologia Clínica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Antônio W Zuardi
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil National Institute for Translational Medicine (INCT-TM), CNPq, Brazil
| | - Jaime E C Hallak
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil National Institute for Translational Medicine (INCT-TM), CNPq, Brazil
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16
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Chaves C, Marque CR, Maia-de-Oliveira JP, Wichert-Ana L, Ferrari TB, Santos AC, Araújo D, Machado-de-Sousa JP, Bressan RA, Elkis H, Crippa JA, Guimarães FS, Zuardi AW, Baker GB, Dursun SM, Hallak JEC. Effects of minocycline add-on treatment on brain morphometry and cerebral perfusion in recent-onset schizophrenia. Schizophr Res 2015; 161:439-45. [PMID: 25497439 DOI: 10.1016/j.schres.2014.11.031] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 11/14/2014] [Accepted: 11/20/2014] [Indexed: 10/24/2022]
Abstract
Increasing evidence suggests that the tetracycline antibiotic minocycline has neuroprotective effects and is a potential treatment for schizophrenia. However, the mechanisms of action of minocycline in the CNS remain elusive. The aim of this study was to investigate the effects of minocycline on brain morphology and cerebral perfusion in patients with recent-onset schizophrenia after 12months of a randomized double-blind, placebo-controlled clinical trial of minocycline add-on treatment. This study included 24 outpatients with recent-onset schizophrenia randomized for 12months of adjuvant treatment with minocycline (200mg/d) or placebo. MRI (1.5T) and [(99m)Tc]-ECD SPECT brain scans were performed at the end of the 12-month of trial. Between-condition comparisons of SPECT and MRI brain images were performed using statistical parametric mapping and analyzed by voxel-based morphometry (VBM). Minocycline adjuvant treatment significantly reduced positive and negative symptoms when compared with placebo. The VBM analysis of MRI scans showed that the patients in the placebo group had significant lower gray matter volumes in the midposterior cingulate cortex and in the precentral gyrus in comparison with the patients in the minocycline group. In addition, a decreased ECD uptake in the minocycline condition was observed in fronto-temporal areas. These results suggest that minocycline may protect against gray matter loss and modulate fronto-temporal areas involved in the pathophysiology of schizophrenia. Furthermore, minocycline add-on treatment may be a potential treatment in the early stages of schizophrenia and may ameliorate clinical deterioration and brain alterations observed in this period.
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Affiliation(s)
- Cristiano Chaves
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil.
| | - Cristiane R Marque
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil
| | - João P Maia-de-Oliveira
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil; Department of Clinical Medicine, Federal University of Rio Grande do Norte, Brazil
| | - Lauro Wichert-Ana
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; Department of Internal Medicine, Division of Nuclear Medicine, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - Thiago B Ferrari
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil
| | - Antonio C Santos
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; Department of Internal Medicine, Division of Radiology, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - David Araújo
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Canada
| | - João P Machado-de-Sousa
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil
| | - Rodrigo A Bressan
- Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Department of Psychiatry, Federal University of São Paulo, Brazil
| | - Helio Elkis
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Brazil
| | - José A Crippa
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil
| | - Francisco S Guimarães
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - Antônio W Zuardi
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil
| | - Glen B Baker
- National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil; Neurochemical Research Unit, Department of Psychiatry, University of Alberta, Canada
| | - Serdar M Dursun
- National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil; Neurochemical Research Unit, Department of Psychiatry, University of Alberta, Canada
| | - Jaime E C Hallak
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil
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17
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dos Santos RG, Hallak JEC, Leite JP, Zuardi AW, Crippa JAS. Phytocannabinoids and epilepsy. J Clin Pharm Ther 2014; 40:135-43. [PMID: 25475762 DOI: 10.1111/jcpt.12235] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 11/06/2014] [Indexed: 12/30/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Antiepileptic drugs often produce serious adverse effects, and many patients do not respond to them properly. Phytocannabinoids produce anticonvulsant effects in preclinical and preliminary human studies, and appear to produce fewer adverse effects than available antiepileptic drugs. The present review summarizes studies on the anticonvulsant properties of phytocannabinoids. METHODS Literature search using the PubMed database to identify studies on phytocannabinoids and epilepsy. RESULTS AND DISCUSSION Preclinical studies suggest that phytocannabinoids, especially cannabidiol and cannabidivarin, have potent anticonvulsant effects which are mediated by the endocannabinoid system. Human studies are limited in number and quality, but suggest that cannabidiol has anticonvulsant effects in adult and infantile epilepsy and is well tolerated after prolonged administration. WHAT IS NEW AND CONCLUSION Phytocannabinoids produce anticonvulsant effects through the endocannabinoid system, with few adverse effects. Cannabidiol and cannabidivarin should be tested in randomized, controlled clinical trials, especially in infantile epileptic syndromes.
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Affiliation(s)
- R G dos Santos
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
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18
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Linares IMP, Jackowski AP, Trzesniak CMF, Arrais KC, Chagas MHN, Sato JR, Santos AC, Hallak JEC, Zuardi AW, Nardi AE, Coimbra NC, Crippa JAS. Cortical thinning of the right anterior cingulate cortex in spider phobia: a magnetic resonance imaging and spectroscopy study. Brain Res 2014; 1576:35-42. [PMID: 24892191 DOI: 10.1016/j.brainres.2014.05.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Revised: 05/21/2014] [Accepted: 05/26/2014] [Indexed: 10/25/2022]
Abstract
There a lack of consistent neuroimaging data on specific phobia (SP) and a need to assess volumetric and metabolic differences in structures implicated in this condition. The aim of this study is investigate possible metabolic (via (1)H MRS) and cortical thickness abnormalities in spider-phobic patients compared to healthy volunteers. Participants were recruited via public advertisement and underwent clinical evaluations and MRI scans. The study started in 2010 and the investigators involved were not blind in respect to patient groupings. The study was conducted at the Ribeirão Preto Medical School University Hospital of the University of São Paulo, Brazil. Patients with spider phobia (n=19) were matched to 17 healthy volunteers with respect to age, education and socio-economic status. The spider SP group fulfilled the diagnostic criteria for spider phobia according to the Structured Clinical Interview for DSM-IV. None of the participants had a history of neurological, psychiatric or other relevant organic diseases, use of prescribed psychotropic medication or substance abuse. All imaging and spectroscopy data were collected with a 3 T MRI scanner equipped with 25 mT gradient coils in 30-minute scans. The Freesurfer image analysis package and LC Model software were used to analyze data. The hypothesis being tested was formulated before the data collection (neural correlates of SP would include the amygdala, insula, anterior cingulate gyrus and others). The results indicated the absence of metabolic alterations, but thinning of the right anterior cingulate cortex (ACC) in the SP group when compared to the healthy control group (mean cortical thickness±SD: SP=2.11±0.45 mm; HC=2.16±0.42 mm; t (34)=3.19, p=0.001 [-35.45, 71.00, -23.82]). In spectroscopy, the ratios between N-acetylaspartate and creatine and choline levels were measured. No significant effect or correlation was found between MRS metabolites and scores in the Spider Phobia Questionnaire and Beck Anxiety Inventory (p>0.05). The ACC is known to be related to the cognitive processing of fear and anxiety and to be linked with the conditioning circuit. The MRS findings are preliminary and need more studies. The finding of reduced ACC thickness in SP is in agreement with evidence from previous functional neuroimaging studies and highlights the importance of this brain area in the pathophysiology of SP.
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Affiliation(s)
- I M P Linares
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, National Institute for Translational Medicine (INCT, CNPq), Ribeirão Preto, São Paulo, Brazil.
| | - A P Jackowski
- Laboratory of Interdisciplinary Neurosciences (LINC), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - C M F Trzesniak
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, National Institute for Translational Medicine (INCT, CNPq), Ribeirão Preto, São Paulo, Brazil
| | - K C Arrais
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, National Institute for Translational Medicine (INCT, CNPq), Ribeirão Preto, São Paulo, Brazil
| | - M H N Chagas
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, National Institute for Translational Medicine (INCT, CNPq), Ribeirão Preto, São Paulo, Brazil
| | - J R Sato
- Center of Mathematics, Computation and Cognition, Universidade Federal do ABC, Santo André, Brazil
| | - A C Santos
- Department of Medical Clinic Department, Division of Radiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - J E C Hallak
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, National Institute for Translational Medicine (INCT, CNPq), Ribeirão Preto, São Paulo, Brazil
| | - A W Zuardi
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, National Institute for Translational Medicine (INCT, CNPq), Ribeirão Preto, São Paulo, Brazil
| | - A E Nardi
- Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - N C Coimbra
- Laboratory of Neuroanatomy & Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - J A S Crippa
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, National Institute for Translational Medicine (INCT, CNPq), Ribeirão Preto, São Paulo, Brazil
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Chagas MHN, Eckeli AL, Zuardi AW, Pena-Pereira MA, Sobreira-Neto MA, Sobreira ET, Camilo MR, Bergamaschi MM, Schenck CH, Hallak JEC, Tumas V, Crippa JAS. Cannabidiol can improve complex sleep-related behaviours associated with rapid eye movement sleep behaviour disorder in Parkinson's disease patients: a case series. J Clin Pharm Ther 2014; 39:564-6. [PMID: 24845114 DOI: 10.1111/jcpt.12179] [Citation(s) in RCA: 149] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 04/23/2014] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Cannabidiol (CBD) is the main non-psychotropic component of the Cannabis sativa plant. REM sleep behaviour disorder (RBD) is a parasomnia characterized by the loss of muscle atonia during REM sleep associated with nightmares and active behaviour during dreaming. We have described the effects of CBD in RBD symptoms in patients with Parkinson's disease. CASES SUMMARY Four patients treated with CBD had prompt and substantial reduction in the frequency of RBD-related events without side effects. WHAT IS NEW AND CONCLUSION This case series indicates that CBD is able to control the symptoms of RBD.
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Affiliation(s)
- M H N Chagas
- Department of Neuroscience and Behavior, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil; INCT Translational Medicine (CNPq), São Paulo, Brazil
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20
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Almeida V, Peres FF, Levin R, Suiama MA, Calzavara MB, Zuardi AW, Hallak JE, Crippa JA, Abílio VC. Effects of cannabinoid and vanilloid drugs on positive and negative-like symptoms on an animal model of schizophrenia: the SHR strain. Schizophr Res 2014; 153:150-9. [PMID: 24556469 DOI: 10.1016/j.schres.2014.01.039] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 01/14/2014] [Accepted: 01/16/2014] [Indexed: 02/06/2023]
Abstract
Studies have suggested that the endocannabinoid system is implicated in the pathophysiology of schizophrenia. We have recently reported that Spontaneously Hypertensive Rats (SHRs) present a deficit in social interaction that is ameliorated by atypical antipsychotics. In addition, SHRs display hyperlocomotion - reverted by atypical and typical antipsychotics. These results suggest that this strain could be useful to study negative symptoms (modeled by a decrease in social interaction) and positive symptoms (modeled by hyperlocomotion) of schizophrenia and the effects of potential drugs with an antipsychotic profile. The aim of this study was to investigate the effects of WIN55-212,2 (CB1/CB2 agonist), ACEA (CB1 agonist), rimonabant (CB1 inverse agonist), AM404 (anandamide uptake/metabolism inhibitor), capsaicin (agonist TRPV1) and capsazepine (antagonist TRPV1) on the social interaction and locomotion of control animals (Wistar rats) and SHRs. The treatment with rimonabant was not able to alter either the social interaction or the locomotion presented by Wistar rats (WR) and SHR at any dose tested. The treatment with WIN55-212,2 decreased locomotion (1mg/kg) and social interaction (0.1 and 0.3mg/kg) of WR, while the dose of 1mg/kg increased social interaction of SHR. The treatment with ACEA increased (0.3mg/kg) and decreased (1mg/kg) locomotion of both strain. The administration of AM404 increased social interaction and decreased locomotion of SHR (5mg/kg), and decreased social interaction and increased locomotion in WR (1mg/kg). The treatment with capsaicin (2.5mg/kg) increased social interaction of both strain and decreased locomotion of SHR (2.5mg/kg) and WR (0.5mg/kg and 2.5mg/kg). In addition, capsazepine (5mg/kg) decreased locomotion of both strains and increased (5mg/kg) and decreased (10mg/kg) social interaction of WR. Our results indicate that the schizophrenia-like behaviors displayed by SHR are differently altered by cannabinoid and vanilloid drugs when compared to control animals and suggest the endocannabinoid and the vanilloid systems as a potential target for the treatment of schizophrenia.
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Affiliation(s)
- Valéria Almeida
- Department of Pharmacology, Federal University of São Paulo, UNIFESP/EPM, Brazil; Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Department of Psychiatry, Federal University of São Paulo, UNIFESP/EPM, Brazil
| | - Fernanda F Peres
- Department of Pharmacology, Federal University of São Paulo, UNIFESP/EPM, Brazil; Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Department of Psychiatry, Federal University of São Paulo, UNIFESP/EPM, Brazil
| | - Raquel Levin
- Department of Pharmacology, Federal University of São Paulo, UNIFESP/EPM, Brazil; Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Department of Psychiatry, Federal University of São Paulo, UNIFESP/EPM, Brazil
| | - Mayra A Suiama
- Department of Pharmacology, Federal University of São Paulo, UNIFESP/EPM, Brazil; Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Department of Psychiatry, Federal University of São Paulo, UNIFESP/EPM, Brazil
| | - Mariana B Calzavara
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Department of Psychiatry, Federal University of São Paulo, UNIFESP/EPM, Brazil
| | - Antônio W Zuardi
- Department of Neuroscience and Behavior, University of São Paulo, Ribeirão Preto, Brazil; National Institute for Translational Medicine (INCT-TM, CNPq), Ribeirão Preto, Brazil
| | - Jaime E Hallak
- Department of Neuroscience and Behavior, University of São Paulo, Ribeirão Preto, Brazil; National Institute for Translational Medicine (INCT-TM, CNPq), Ribeirão Preto, Brazil
| | - José A Crippa
- Department of Neuroscience and Behavior, University of São Paulo, Ribeirão Preto, Brazil; National Institute for Translational Medicine (INCT-TM, CNPq), Ribeirão Preto, Brazil
| | - Vanessa C Abílio
- Department of Pharmacology, Federal University of São Paulo, UNIFESP/EPM, Brazil; Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Department of Psychiatry, Federal University of São Paulo, UNIFESP/EPM, Brazil.
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Atakan Z, Bhattacharyya S, Allen P, Martín-Santos R, Crippa JA, Borgwardt SJ, Fusar-Poli P, Seal M, Sallis H, Stahl D, Zuardi AW, Rubia K, McGuire P. Cannabis affects people differently: inter-subject variation in the psychotogenic effects of Δ9-tetrahydrocannabinol: a functional magnetic resonance imaging study with healthy volunteers. Psychol Med 2013; 43:1255-1267. [PMID: 23020923 DOI: 10.1017/s0033291712001924] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Cannabis can induce transient psychotic symptoms, but not all users experience these adverse effects. We compared the neural response to Δ9-tetrahydrocannabinol (THC) in healthy volunteers in whom the drug did or did not induce acute psychotic symptoms. Method In a double-blind, placebo-controlled, pseudorandomized design, 21 healthy men with minimal experience of cannabis were given either 10 mg THC or placebo, orally. Behavioural and functional magnetic resonance imaging measures were then recorded whilst they performed a go/no-go task. RESULTS The sample was subdivided on the basis of the Positive and Negative Syndrome Scale positive score following administration of THC into transiently psychotic (TP; n = 11) and non-psychotic (NP; n = 10) groups. During the THC condition, TP subjects made more frequent inhibition errors than the NP group and showed differential activation relative to the NP group in the left parahippocampal gyrus, the left and right middle temporal gyri and in the right cerebellum. In these regions, THC had opposite effects on activation relative to placebo in the two groups. The TP group also showed less activation than the NP group in the right middle temporal gyrus and cerebellum, independent of the effects of THC. CONCLUSIONS In this first demonstration of inter-subject variability in sensitivity to the psychotogenic effects of THC, we found that the presence of acute psychotic symptoms was associated with a differential effect of THC on activation in the ventral and medial temporal cortex and cerebellum, suggesting that these regions mediate the effects of the drug on psychotic symptoms.
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Affiliation(s)
- Z Atakan
- Section of Neuroimaging, Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK.
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22
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Martin-Santos R, Crippa JA, Batalla A, Bhattacharyya S, Atakan Z, Borgwardt S, Allen P, Seal M, Langohr K, Farré M, Zuardi AW, McGuire PK. Acute effects of a single, oral dose of d9-tetrahydrocannabinol (THC) and cannabidiol (CBD) administration in healthy volunteers. Curr Pharm Des 2013; 18:4966-79. [PMID: 22716148 DOI: 10.2174/138161212802884780] [Citation(s) in RCA: 176] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 04/10/2012] [Indexed: 11/22/2022]
Abstract
RATIONALE Animal and humans studies suggest that the two main constituents of cannabis sativa, delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) have quite different acute effects. However, to date the two compounds have largely been studied separately. OBJECTIVE To evaluate and compare the acute pharmacological effects of both THC and CBD in the same human volunteers. METHODS A randomised, double-blind, cross-over, placebo controlled trial was conducted in 16 healthy male subjects. Oral THC 10 mg or CBD 600 mg or placebo was administered in three consecutive sessions, at one-month interval. Physiological measures and symptom ratings were assessed before, and at 1, 2 and 3 hours post drug administration. The area under the curve (AUC) between baseline and 3 hours, and the maximum absolute change from baseline at 2 hours were analysed by one-way repeated measures analysis of variance, with drug condition (THC or CBD or placebo) as the factor. RESULTS Relative to both placebo and CBD, administration of THC was associated with anxiety, dysphoria, positive psychotic symptoms, physical and mental sedation, subjective intoxication (AUC and effect at 2 hours: p < 0.01), an increase in heart rate (p < 0.05). There were no differences between CBD and placebo on any symptomatic, physiological variable. CONCLUSIONS In healthy volunteers, THC has marked acute behavioural and physiological effects, whereas CBD has proven to be safe and well tolerated.
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Affiliation(s)
- R Martin-Santos
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London, UK.
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23
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Almeida V, Levin R, Peres FF, Niigaki ST, Calzavara MB, Zuardi AW, Hallak JE, Crippa JA, Abílio VC. Cannabidiol exhibits anxiolytic but not antipsychotic property evaluated in the social interaction test. Prog Neuropsychopharmacol Biol Psychiatry 2013; 41:30-5. [PMID: 23127569 DOI: 10.1016/j.pnpbp.2012.10.024] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 10/26/2012] [Accepted: 10/30/2012] [Indexed: 10/27/2022]
Abstract
Cannabidiol (CBD), a non-psychotomimetic compound of the Cannabis sativa, has been reported to have central therapeutic actions, such as antipsychotic and anxiolytic effects. We have recently reported that Spontaneously Hypertensive Rats (SHRs) present a deficit in social interaction that is ameliorated by atypical antipsychotics. In addition, SHRs present a hyperlocomotion that is reverted by typical and atypical antipsychotics, suggesting that this strain could be useful to study negative symptoms (modeled by a decrease in social interaction) and positive symptoms (modeled by hyperlocomotion) of schizophrenia as well as the effects of potential antipsychotics drugs. At the same time, an increase in social interaction in control animals similar to that induced by benzodiazepines is used to screen potential anxiolytic drugs. The aim of this study was to investigate the effects of CBD on social interaction presented by control animals (Wistar) and SHRs. The lowest dose of CBD (1mg/kg) increased passive and total social interaction of Wistar rats. However, the hyperlocomotion and the deficit in social interaction displayed by SHRs were not altered by any dose of CBD. Our results do not support an antipsychotic property of cannabidiol on symptoms-like behaviors in SHRs but reinforce the anxiolytic profile of this compound in control rats.
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Affiliation(s)
- Valéria Almeida
- Departamento de Farmacologia da Universidade Federal de São Paulo, UNIFESP, Brazil
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24
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Chaves C, Trzesniak C, Derenusson GN, Araújo D, Wichert-Ana L, Machado-de-Sousa JP, Carlotti Jr CG, Nardi AE, Zuardi AW, de S. Crippa JA, Hallak JEC. Late-onset social anxiety disorder following traumatic brain injury. Brain Inj 2012; 26:882-6. [DOI: 10.3109/02699052.2012.666373] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ribeiro A, Ferraz-de-Paula V, Pinheiro ML, Vitoretti LB, Mariano-Souza DP, Quinteiro-Filho WM, Akamine AT, Almeida VI, Quevedo J, Dal-Pizzol F, Hallak JE, Zuardi AW, Crippa JA, Palermo-Neto J. Cannabidiol, a non-psychotropic plant-derived cannabinoid, decreases inflammation in a murine model of acute lung injury: role for the adenosine A(2A) receptor. Eur J Pharmacol 2012; 678:78-85. [PMID: 22265864 DOI: 10.1016/j.ejphar.2011.12.043] [Citation(s) in RCA: 126] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Revised: 12/19/2011] [Accepted: 12/28/2011] [Indexed: 12/29/2022]
Abstract
Acute lung injury is an inflammatory condition for which treatment is mainly supportive because effective therapies have not been developed. Cannabidiol, a non-psychotropic cannabinoid component of marijuana (Cannabis sativa), has potent immunosuppressive and anti-inflammatory properties. Therefore, we investigated the possible anti-inflammatory effect of cannabidiol in a murine model of acute lung injury. Analysis of total inflammatory cells and differential in bronchoalveolar lavage fluid was used to characterize leukocyte migration into the lungs; myeloperoxidase activity of lung tissue and albumin concentration in the bronchoalveolar lavage fluid were analyzed by colorimetric assays; cytokine/chemokine production in the bronchoalveolar lavage fluid was also analyzed by Cytometric Bead Arrays and Enzyme-Linked Immunosorbent Assay (ELISA). A single dose of cannabidiol (20mg/kg) administered prior to the induction of LPS (lipopolysaccharide)-induced acute lung injury decreases leukocyte (specifically neutrophil) migration into the lungs, albumin concentration in the bronchoalveolar lavage fluid, myeloperoxidase activity in the lung tissue, and production of pro-inflammatory cytokines (TNF and IL-6) and chemokines (MCP-1 and MIP-2) 1, 2, and 4days after the induction of LPS-induced acute lung injury. Additionally, adenosine A(2A) receptor is involved in the anti-inflammatory effects of cannabidiol on LPS-induced acute lung injury because ZM241385 (4-(2-[7-Amino-2-(2-furyl)[1,2,4]triazolo[2,3-a][1,3,5]triazin-5-ylamino]ethyl)phenol) (a highly selective antagonist of adenosine A(2A) receptor) abrogated all of the anti-inflammatory effects of cannabidiol previously described. Thus, we show that cannabidiol has anti-inflammatory effects in a murine model of acute lung injury and that this effect is most likely associated with an increase in the extracellular adenosine offer and signaling through adenosine A(2A) receptor.
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Affiliation(s)
- Alison Ribeiro
- Neuroimmunomodulation Research Group, Department of Pathology, School of Veterinary Medicine, University of São Paulo, Av. Prof. Orlando Marques de Paiva, 87 - CEP 05508-270, Cidade Universitária, São Paulo, SP, Brazil
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26
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Réus GZ, Stringari RB, Ribeiro KF, Luft T, Abelaira HM, Fries GR, Aguiar BW, Kapczinski F, Hallak JE, Zuardi AW, Crippa JA, Quevedo J. Administration of cannabidiol and imipramine induces antidepressant-like effects in the forced swimming test and increases brain-derived neurotrophic factor levels in the rat amygdala. Acta Neuropsychiatr 2011; 23:241-8. [PMID: 25379896 DOI: 10.1111/j.1601-5215.2011.00579.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Réus GZ, Stringari RB, Ribeiro KF, Luft T, Abelaira HM, Fries GR, Aguiar BW, Kapczinski F, Hallak JE, Zuardi AW, Crippa JA, Quevedo J. Administration of cannabidiol and imipramine induces antidepressant-like effects in the forced swimming test and increases brain-derived neurotrophic factor levels in the rat amygdala.Objective:Cannabidiol is a chemical constituent fromCannabis sativaand it has multiple mechanisms of action, including antidepressant effects. The main objective of the present study was to evaluate behavioural and molecular effects induced by administration of cannabidiol and imipramine in rats.Methods:In the present study, rats were acutely or chronically treated for 14 days once a day with saline, cannabidiol (15, 30 and 60 mg/kg) or imipramine (30 mg/kg) and the animals behaviour was assessed in forced swimming and open-field tests. Afterwards, the prefrontal cortex, hippocampus and amygdala brain-derived neurotrophic factor (BDNF) levels were assessed by enzyme-linked immunosorbent sandwich assay.Results:We observed that both acute and chronic treatments with imipramine at the dose of 30 mg/kg and cannabidiol at the dose of 30 mg/kg reduced immobility time and increased swimming time; climbing time was increased only with imipramine at the dose of 30 mg/kg, without affecting locomotor activity. In addition, chronic treatment with cannabidiol at the dose of 15 mg/kg and imipramine at the dose of 30 mg/kg increased BDNF levels in the rat amygdala.Conclusion:In conclusion, our results indicate that cannabidiol has an antidepressant-like profile and could be a new pharmacological target for the treatment of major depression.
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Affiliation(s)
- Gislaine Z Réus
- Laboratório de Neurociências and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Roberto B Stringari
- Laboratório de Neurociências and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Karine F Ribeiro
- Laboratório de Neurociências and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Tatiana Luft
- Laboratório de Neurociências and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Helena M Abelaira
- Laboratório de Neurociências and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
| | - Gabriel R Fries
- Laboratório de Psiquiatria Molecular and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Centro de Pesquisas, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Bianca W Aguiar
- Laboratório de Psiquiatria Molecular and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Centro de Pesquisas, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Flávio Kapczinski
- Laboratório de Psiquiatria Molecular and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Centro de Pesquisas, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Jaime E Hallak
- Departamento de Neurociências e Ciências do Comportamento and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Antônio W Zuardi
- Departamento de Neurociências e Ciências do Comportamento and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - José A Crippa
- Departamento de Neurociências e Ciências do Comportamento and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - João Quevedo
- Laboratório de Neurociências and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil
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Réus GZ, Stringari RB, de Souza B, Petronilho F, Dal-Pizzol F, Hallak JE, Zuardi AW, Crippa JA, Quevedo J. Harmine and imipramine promote antioxidant activities in prefrontal cortex and hippocampus. Oxid Med Cell Longev 2010; 3:325-31. [PMID: 21150338 PMCID: PMC3154037 DOI: 10.4161/oxim.3.5.13109] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Revised: 07/20/2010] [Accepted: 07/21/2010] [Indexed: 02/07/2023]
Abstract
A growing body of evidence has suggested that reactive oxygen species (ROS) may play an important role in the physiopathology of depression. Evidence has pointed to the β-carboline harmine as a potential therapeutic target for the treatment of depression. The present study we evaluated the effects of acute and chronic administration of harmine (5, 10 and 15 mg/kg) and imipramine (10, 20 and 30 mg/kg) or saline in lipid and protein oxidation levels and superoxide dismutase (SOD) and catalase (CAT) activities in rat prefrontal cortex and hippocampus. Acute and chronic treatments with imipramine and harmine reduced lipid and protein oxidation, compared to control group in prefrontal cortex and hippocampus. The SOD and CAT activities increased with acute and chronic treatments with imipramine and harmine, compared to control group in prefrontal cortex and hippocampus. In conclusion, our results indicate positive effects of imipramine antidepressant and β-carboline harmine of oxidative stress parameters, increasing SOD and CAT activities and decreasing lipid and protein oxidation.
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Affiliation(s)
- Gislaine Z. Réus
- Laboratório de Neurociências, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Roberto B. Stringari
- Laboratório de Neurociências, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Bruna de Souza
- Laboratório de Fisiopatologia Experimental, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, SP, Brazil
| | - Fabrícia Petronilho
- Laboratório de Fisiopatologia Experimental, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, SP, Brazil
| | - Felipe Dal-Pizzol
- Laboratório de Fisiopatologia Experimental, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, SP, Brazil
| | - Jaime E. Hallak
- Departamento de Neurocincias e Ciências do Comportamento, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Antônio W. Zuardi
- Departamento de Neurocincias e Ciências do Comportamento, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - José A. Crippa
- Departamento de Neurocincias e Ciências do Comportamento, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - João Quevedo
- Laboratório de Neurociências, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Fortunato JJ, Réus GZ, Kirsch TR, Stringari RB, Fries GR, Kapczinski F, Hallak JE, Zuardi AW, Crippa JA, Quevedo J. Chronic administration of harmine elicits antidepressant-like effects and increases BDNF levels in rat hippocampus. J Neural Transm (Vienna) 2010; 117:1131-7. [PMID: 20686906 DOI: 10.1007/s00702-010-0451-2] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Accepted: 07/12/2010] [Indexed: 01/18/2023]
Abstract
A growing body of evidence has pointed to the β-carboline harmine as a potential therapeutic target for the treatment of major depression. The present study was aimed to evaluate behavioural and molecular effects of the chronic treatment with harmine and imipramine in rats. To this aim, rats were treated for 14 days once a day with harmine (5, 10 and 15 mg/kg) and imipramine (10, 20 and 30 mg/kg) and then subjected to the forced swimming and open-field tests. Harmine and imipramine, at all doses tested, reduced immobility time of rats compared with the saline group. Imipramine increased the swimming time at 20 and 30 mg/kg and harmine increased swimming time at all doses. The climbing time increased in rats treated with imipramine (10 and 30 mg/kg) and harmine (5 and 10 mg/kg), without affecting spontaneous locomotor activity. Brain-derived neurotrophic factor (BDNF) hippocampal levels were assessed in imipramine and harmine-treated rats by ELISA sandwich assay. Interestingly, chronic administration of harmine at the higher doses (10 and 15 mg/kg), but not imipramine, increased BDNF protein levels in rat hippocampus. Finally, these findings further support the hypothesis that harmine could bring about behavior and molecular effects, similar to antidepressants drugs.
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Affiliation(s)
- Jucélia J Fortunato
- Laboratório de Neurociências and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, SC 88806-000, Brazil
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Chaves C, Marque CR, Trzesniak C, Machado de Sousa JP, Zuardi AW, Crippa JAS, Dursun SM, Hallak JE. Glutamate-N-methyl-D-aspartate receptor modulation and minocycline for the treatment of patients with schizophrenia: an update. Braz J Med Biol Res 2010; 42:1002-14. [PMID: 19855900 DOI: 10.1590/s0100-879x2009001100002] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2009] [Accepted: 09/15/2009] [Indexed: 01/31/2023] Open
Abstract
Growing consistent evidence indicates that hypofunction of N-methyl-D-aspartate (NMDA) transmission plays a pivotal role in the neuropathophysiology of schizophrenia. Hence, drugs which modulate NMDA neurotransmission are promising approaches to the treatment of schizophrenia. The aim of this article is to review clinical trials with novel compounds acting on the NMDA receptor (NMDA-R). This review also includes a discussion and translation of neuroscience into schizophrenia therapeutics. Although the precise mechanism of action of minocycline in the brain remains unclear, there is evidence that it blocks the neurotoxicity of NMDA antagonists and may exert a differential effect on NMDA signaling pathways. We, therefore, hypothesize that the effects of minocycline on the brain may be partially modulated by the NMDA-R or related mechanisms. Thus, we have included a review of minocycline neuroscience. The search was performed in the PubMed, Web of Science, SciELO, and Lilacs databases. The results of glycine and D-cycloserine trials were conflicting regarding effectiveness on the negative and cognitive symptoms of schizophrenia. D-serine and D-alanine showed a potential effect on negative symptoms and on cognitive deficits. Sarcosine data indicated a considerable improvement as adjunctive therapy. Finally, minocycline add-on treatment appears to be effective on a broad range of psychopathology in patients with schizophrenia. The differential modulation of NMDA-R neurosystems, in particular synaptic versus extrasynaptic NMDA-R activation and specific subtypes of NMDA-R, may be the key mediators of neurogenesis and neuroprotection. Thus, psychotropics modulating NMDA-R neurotransmission may represent future monotherapy or add-on treatment strategies in the treatment of schizophrenia.
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Affiliation(s)
- C Chaves
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Chaves C, de Marque CR, Wichert-Ana L, Maia-de-Oliveira JP, Itikawa EN, Crippa JADS, Zuardi AW, Todd KG, Baker GB, Dursun SM, Hallak JEC. Functional neuroimaging of minocycline's effect in a patient with schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2010; 34:550-2. [PMID: 20138948 DOI: 10.1016/j.pnpbp.2010.01.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Revised: 01/29/2010] [Accepted: 01/30/2010] [Indexed: 11/25/2022]
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Filho AS, Hetem LAB, Ferrari MCF, Trzesniak C, Martín-Santos R, Borduqui T, de Lima Osório F, Loureiro SR, Busatto Filho G, Zuardi AW, Crippa JAS. Social anxiety disorder: what are we losing with the current diagnostic criteria? Acta Psychiatr Scand 2010; 121:216-26. [PMID: 19694635 DOI: 10.1111/j.1600-0447.2009.01459.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To assess the rate of comorbidities and the functional impairment associated with the social anxiety disorder (SAD), with an emphasis on the so-called subthreshold clinical signs and symptoms. METHOD Psychiatric comorbidities and psychosocial functioning were evaluated in 355 volunteers (college students) who had been diagnosed as SAD (n = 141), Subthreshold SAD (n = 92) or Controls (n = 122). RESULTS The rate of comorbidities was 71.6% in the SAD group and 50% in subjects with Subthreshold SAD, both significantly greater than Controls (28.7%). Concerning psychosocial functioning, the SAD group had higher impairment than the other two groups in all domains evaluated, and subjects with Subthreshold SAD presented intermediate values. CONCLUSION The rates of psychiatric comorbidities and the impairment of psychosocial functioning increase progressively along the spectrum of social anxiety. The fact that Subthreshold SAD causes considerable disability and suffering in comparison with control subjects justifies a review of the validity of the diagnostic criteria.
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Affiliation(s)
- A S Filho
- Department of Neuroscience and Behavior, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
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Fortunato JJ, Réus GZ, Kirsch TR, Stringari RB, Stertz L, Kapczinski F, Pinto JP, Hallak JE, Zuardi AW, Crippa JA, Quevedo J. Acute harmine administration induces antidepressive-like effects and increases BDNF levels in the rat hippocampus. Prog Neuropsychopharmacol Biol Psychiatry 2009; 33:1425-30. [PMID: 19632287 DOI: 10.1016/j.pnpbp.2009.07.021] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2009] [Revised: 07/17/2009] [Accepted: 07/18/2009] [Indexed: 01/22/2023]
Abstract
Harmine is a beta-carboline alkaloid that inhibits monoamine reuptake systems. Findings point to an antidepressant effect of the compounds that increases the levels of monoamines after monoamine oxidase inhibition. The present study aims to compare the behavioral effects and the BDNF hippocampus levels of acute administration of harmine and imipramine in rats. To this aim, rats were acutely treated with harmine (5, 10 and 15 mg/kg) and imipramine (10, 20 and 30 mg/kg) and animal behavior was assessed in the forced swimming and open-field tests. Afterwards, hippocampal BDNF protein levels were assessed in imipramine- and harmine-treated rats by ELISA-sandwich assay. We observed that harmine at doses of 10 and 15 mg/kg, and imipramine at 20 and 30 mg/kg reduced immobility time, and increased both climbing and swimming time of rats compared to saline group, without affecting locomotor activity. Acute administration of harmine at the higher dose, but not imipramine, increased BDNF protein levels in the rat hippocampus. Finally, these findings further support the hypothesis that harmine could be a new pharmacological target for the treatment of mood disorders.
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Affiliation(s)
- Jucélia J Fortunato
- Laboratório de Neurociências and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, 88806-000, Criciúma, SC, Brazil
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Zuardi AW, Crippa JAS, Hallak JEC, Pinto JP, Chagas MHN, Rodrigues GGR, Dursun SM, Tumas V. Cannabidiol for the treatment of psychosis in Parkinson's disease. J Psychopharmacol 2009; 23:979-83. [PMID: 18801821 DOI: 10.1177/0269881108096519] [Citation(s) in RCA: 207] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The management of psychosis in Parkinson's disease (PD) has been considered a great challenge for clinicians and there is a need for new pharmacological intervention. Previously an antipsychotic and neuroprotective effect of Cannabidiol (CBD) has been suggested. Therefore, the aim of the present study was to directly evaluate for the first time, the efficacy, tolerability and safety of CBD on PD patients with psychotic symptoms. This was an open-label pilot study. Six consecutive outpatients (four men and two women) with the diagnosis of PD and who had psychosis for at least 3 months were selected for the study. All patients received CBD in flexible dose (started with an oral dose of 150 mg/day) for 4 weeks, in addition to their usual therapy. The psychotic symptoms evaluated by the Brief Psychiatric Rating Scale and the Parkinson Psychosis Questionnaire showed a significant decrease under CBD treatment. CBD did not worsen the motor function and decreased the total scores of the Unified Parkinson's Disease Rating Scale. No adverse effect was observed during the treatment. These preliminary data suggest that CBD may be effective, safe and well tolerated for the treatment of the psychosis in PD.
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Affiliation(s)
- A W Zuardi
- Department of Neuropsychiatry and Medical Psychology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
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Fortunato JJ, Réus GZ, Kirsch TR, Stringari RB, Fries GR, Kapczinski F, Hallak JE, Zuardi AW, Crippa JA, Quevedo J. Effects of beta-carboline harmine on behavioral and physiological parameters observed in the chronic mild stress model: further evidence of antidepressant properties. Brain Res Bull 2009; 81:491-6. [PMID: 19772900 DOI: 10.1016/j.brainresbull.2009.09.008] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2009] [Revised: 09/14/2009] [Accepted: 09/15/2009] [Indexed: 11/30/2022]
Abstract
The chronic mild stress (CMS) model has been used as an animal model of depression which induces anhedonic behavior in rodents. The present study was aimed to evaluate the behavioral and physiological effects of administration of beta-carboline harmine in rats exposed to CMS procedure. To this aim, after 40 days of exposure to CMS procedure, rats were treated with harmine (15 mg/kg/day) for 7 days. In this study, sweet food consumption, adrenal gland weight, adrenocorticotrophin hormone (ACTH) levels, and hippocampal brain-derived-neurotrophic factor (BDNF) protein levels were assessed. Our findings demonstrated that chronic stressful situations induced anhedonia, hypertrophy of adrenal gland weight, increase ACTH circulating levels in rats and increase BDNF protein levels. Interestingly, treatment with harmine reversed anhedonia, the increase of adrenal gland weight, normalized ACTH circulating levels and BDNF protein levels. Finally, these findings further support the hypothesis that harmine could be a new pharmacological tool for the treatment of depression.
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Affiliation(s)
- Jucélia J Fortunato
- Laboratório de Neurociências and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Programa de Pós-Graduação em Ciências da Saúde, Unidade Acadêmica de Ciências da Saúde, Universidade do Extremo Sul Catarinense, 88806-000 Criciúma, SC, Brazil
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Piqueira JRC, Fagali GM, de Pinho M, Sanches RF, Del-Ben CM, Zuardi AW. Bits and q-bits in a psychiatric ward. J Theor Biol 2007; 247:182-5. [PMID: 17395210 DOI: 10.1016/j.jtbi.2007.02.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2006] [Revised: 01/08/2007] [Accepted: 02/19/2007] [Indexed: 11/22/2022]
Abstract
The present study is a trial on expressing the whole state of a psychiatric ward as a linear combination of base states in a Hilbert space. Real data were collected by observing the behavior of the patients from the psychiatric ward of the Clinical Hospital from Faculdade de Medicina de Ribeirão Preto for 12 days and, according to standard procedures, 18 behavioral parameters were daily measured for each patient. The whole data set was analyzed and, by taking the standard grades as eigenstates, the state of the ward was daily expressed by a linear combination of them, allowing the estimation of state transition matrices and of the quantum variability measure. Coefficients of the linear combination can be interpreted as square roots of probabilities and informational entropy is associated to each state resulting in the classical variability measure. Temporal evolutions of the classical and quantum variability measures are plotted trying to relate them to the behavioral state of the whole ward.
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Affiliation(s)
- J R C Piqueira
- Departamento de Engenharia de Telecomunicações e Controle, Escola Politécnica da Universidade de São Paulo, Av. Prof. Luciano Gualberto, travessa 3, n. 158, 05508-900 São Paulo, SP, Brazil.
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Abstract
A high dose of delta9-tetrahydrocannabinol, the main Cannabis sativa (cannabis) component, induces anxiety and psychotic-like symptoms in healthy volunteers. These effects of delta9-tetrahydrocannabinol are significantly reduced by cannabidiol (CBD), a cannabis constituent which is devoid of the typical effects of the plant. This observation led us to suspect that CBD could have anxiolytic and/or antipsychotic actions. Studies in animal models and in healthy volunteers clearly suggest an anxiolytic-like effect of CBD. The antipsychotic-like properties of CBD have been investigated in animal models using behavioral and neurochemical techniques which suggested that CBD has a pharmacological profile similar to that of atypical antipsychotic drugs. The results of two studies on healthy volunteers using perception of binocular depth inversion and ketamine-induced psychotic symptoms supported the proposal of the antipsychotic-like properties of CBD. In addition, open case reports of schizophrenic patients treated with CBD and a preliminary report of a controlled clinical trial comparing CBD with an atypical antipsychotic drug have confirmed that this cannabinoid can be a safe and well-tolerated alternative treatment for schizophrenia. Future studies of CBD in other psychotic conditions such as bipolar disorder and comparative studies of its antipsychotic effects with those produced by clozapine in schizophrenic patients are clearly indicated.
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Affiliation(s)
- A W Zuardi
- Departamento de Neurologia, Psiquiatria e Psicologia Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
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Crippa JAS, Uchida R, Busatto GF, Guimarães FS, Del-Ben CM, Zuardi AW, Santos AC, Araújo D, McGuire PK, Graeff FG. The size and prevalence of the cavum septum pellucidum are normal in subjects with panic disorder. Braz J Med Biol Res 2004; 37:371-4. [PMID: 15060705 DOI: 10.1590/s0100-879x2004000300013] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Panic disorder is thought to involve dysfunction in the septohippocampal system, and the presence of a cavum septum pellucidum might indicate the aberrant development of this system. We compared the prevalence and size of cavum septum pellucidum in 21 patients with panic disorder and in 21 healthy controls by magnetic resonance imaging. The length of the cavum septum pellucidum was measured by counting the number of consecutive 1-mm coronal slices in which it appeared. A cavum septum pellucidum of >6 mm in length was rated as large. There was no significant difference in the proportion of patients (16 of 21 or 76.2%) and controls (18 of 21 or 85.7%) with a cavum septum pellucidum (P=0.35, Fisher's exact test, one-tailed), and no members of either group had a large cavum septum pellucidum. The mean cavum septum pellucidum rating in the patient and control groups was 1.81 (SD=1.50) and 2.09 (SD=1.51), respectively. There were also no significant differences between groups when we analyzed cavum septum pellucidum ratings as a continuous variable (U=196.5; P=0.54). Across all subjects there was a trend towards a higher prevalence of cavum septum pellucidum in males (100%, 10 of 10) than females (75%, 24 of 32; P=0.09, Fisher's exact test, one-tailed). Thus, we conclude that, while panic disorder may involve septo-hippocampal dysfunction, it is not associated with an increased prevalence or size of the cavum septum pellucidum.
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Affiliation(s)
- J A S Crippa
- Departamento de Neurologia, Psiquiatria e Psicologia Médica, Facudade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
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Hallak JEC, Crippa JAS, Vansan G, Zuardi AW. Diagnostic profile of inpatients as a determinant of length of stay in a general hospital psychiatric unit. Braz J Med Biol Res 2003; 36:1233-40. [PMID: 12937791 DOI: 10.1590/s0100-879x2003000900014] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to determine if the diagnostic profile of inpatients of a psychiatric unit in a general hospital influences the length of stay. The results of a retrospective survey comprising the first 16 years of operation of the Psychiatric Unit of the Ribeirão Preto General Hospital (PURP) showed that the progressive increase observed in the length of stay correlated with the increase in percentage of schizophrenia diagnosis, after the 8th year of hospital operation, and of affective disorders, after the 12th year. The length of hospitalization kept increasing until the 16th year, even though there was no change in the diagnostic profile of the patients admitted to the unit. In a prospective study encompassing the next six months, 61 inpatients were evaluated with the Structured Clinical Interview for DSM-III-R and the Brief Psychiatric Rating Scale (BPRS). The results showed that 82% of the inpatients fulfilled the diagnostic criteria for the schizophrenic or affective disorder spectrum at admission, with a discharge rate slower than for other diagnoses, although the length of hospitalization did not significantly differ among diagnostic categories. The results further demonstrated that in every diagnostic category more than 50% of the patients stayed in hospital for more than one week after reaching a BPRS score equal to 6, indicative of discharge. Overall, these data suggest that the increase in length of hospitalization may be due to a higher percentage of patients with a diagnosis of schizophrenia and affective disorder admitted to the PURP. In addition, patients with low symptomatic levels remained in hospital longer than they should have.
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Affiliation(s)
- J E C Hallak
- Departamento de Neurologia, Psiquiatria e Psicologia Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Crippa JAS, Sanches RF, Hallak JEC, Loureiro SR, Zuardi AW. Factor structure of Bech's version of the Brief Psychiatric Rating Scale in Brazilian patients. Braz J Med Biol Res 2002; 35:1209-13. [PMID: 12424494 DOI: 10.1590/s0100-879x2002001000014] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The objective of the present study was to evaluate the factor structure of Bech's version of the Brief Psychiatric Rating Scale (BPRS), translated into Portuguese. The BPRS was administered to a heterogeneous group of psychiatric inpatients (N = 98) and outpatients (N = 62) in a University Hospital. Each patient was evaluated from one to eight times. The interval between consecutive interviews was one week for the inpatients and one month for the outpatients. The results were submitted to factorial analysis. The internal consistency of the total scale and of each factor was also estimated. Factorial analysis followed by normalized orthogonal rotation (Varimax) yielded four factors: Withdrawal-Retardation, Thinking Disorder, Anxious-Depression and Activation. Internal consistency measured by Cronbach's alpha coefficient ranged from 0.766 to 0.879. The data show that the factor structure of the present instrument is similar to that of the American version of the BPRS which contains 18 items, except for the absence of the fifth factor of the latter scale, Hostile-Suspiciousness.
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Affiliation(s)
- J A S Crippa
- Departamento de Neurologia, Psiquiatria e Psicologia Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Graeff FG, Silva M, Del Ben CM, Zuardi AW, Hetem LA, Guimarães FS. Comparison between two models of experimental anxiety in healthy volunteers and panic disorder patients. Neurosci Biobehav Rev 2001; 25:753-9. [PMID: 11801299 DOI: 10.1016/s0149-7634(01)00055-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
To further investigate the role of serotonin (5-HT) in anxiety, two tests were used in human subjects. The first was the conditioning of skin conductance response (CSCR) that associates a tone to a loud noise. The second was simulated public speaking (SPS), which is believed to represent unconditioned fear. In healthy volunteers the 5-HT(2A) receptor blocker and 5-HT reuptake inhibitor nefazodone reduced subjective anxiety and the number of spontaneous fluctuations of skin conductance during CSCR, but enhanced anxiety induced by SPS. Opposite effects had been reported with the 5-HT releasing and uptake-inhibiting agent D-fenfluramine. Panic patients behaved like controls in the CSCR. However, they had a higher level of baseline anxiety and were insensitive to SPS. This profile resembles the reported effect of the non-selective 5-HT receptor blocker metergoline in healthy volunteers. Therefore, panic patients seem to process unconditioned fear abnormally, which may be due to lack of 5-HT inhibition in brain structures commanding flight from proximal danger stimuli.
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Affiliation(s)
- F G Graeff
- Department of Neurology, Psychiatry and Medical Psychology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, 14049-900, SP, Ribeirão Preto, Brazil.
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Del-Ben CM, Vilela JA, Hetem LA, Guimarães FS, Graeff FG, Zuardi AW. Do panic patients process unconditioned fear vs. conditioned anxiety differently than normal subjects? Psychiatry Res 2001; 104:227-37. [PMID: 11728612 DOI: 10.1016/s0165-1781(01)00312-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Panic patients were evaluated with two models of experimental anxiety that are believed to generate distinct emotional states: (1) a stimulated public speaking test (SPS), a presumed indicator of unconditioned fear, and (2) conditioning of skin conductance responses (CSCR) to a tone associated with an aversive white noise, an index of conditioned anxiety. Subjective states were evaluated through the visual analogue mood scale (VAMS) and a bodily symptoms scale (BSS). In the SPS test, panic patients showed higher baseline levels of VAMS-measured anxiety than controls. Unlike controls, panic patients failed to show increased anxiety before and during speech. Although baseline levels of arousal were similar in both groups, VAMS mental sedation decreased in controls, but not in panic patients during the SPS. Panic patients showed more discontent than controls throughout the whole experimental session. They also scored higher than controls on several items of the BSS. In the CSCR test, panic patients showed more spontaneous fluctuations of skin conductance than controls. Nevertheless, conditioning of skin conductance responses to the tone was similar in both groups. Therefore, panic patients seemed to process unconditioned fear abnormally.
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Affiliation(s)
- C M Del-Ben
- Department of Neurology, Psychiatry and Medical Psychology, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil.
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Pedrão LJ, Hallak JE, Bernardo SA, Zuardi AW. Reliability and validity of the interactive observation scale for psychiatric inpatients applied by nursing aides in daily ward practice. Braz J Med Biol Res 2001; 34:939-48. [PMID: 11449312 DOI: 10.1590/s0100-879x2001000700013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The main characteristic of the nursing Interactive Observation Scale for Psychiatric Inpatients (IOSPI) is the necessity of interaction between raters and patients during assessment. The aim of this study was to evaluate the reliability and validity of the scale in the "real" world of daily ward practice and to determine whether the IOSPI can increase the interaction time between raters and patients and influence the raters' opinion about mental illness. All inpatients of a general university hospital psychiatric ward were assessed daily over a period of two months by 9 nursing aides during the morning and afternoon shifts, with 273 pairs of daily observations. Once a week the patients were interviewed by a psychiatrist who filled in the Brief Psychiatric Rating Scale (BPRS). The IOSPI total score was found to show significant test-retest reliability (interclass correlation coefficient = 0.83) and significant correlation with the BPRS total score (r = 0.69), meeting the criteria of concurrent validity. The instrument can also discriminate between patients in need of further inpatient treatment from those about to be discharged (negative predictive value for discharge = 0.91). Using this scale, the interaction time between nursing aides and patients increased significantly (t = 2.93, P<0.05) and their opinion about the mental illness changed. The "social restrictiveness" factor of the opinion scale about mental illness showed a significant reduction (t = 4.27, P<0.01) and the "interpersonal etiology" factor tended to increase (t = 1.98, P = 0.08). The IOSPI was confirmed as a reliable and valid scale and as an efficient tool to stimulate the therapeutic attitudes of the nursing staff.
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Affiliation(s)
- L J Pedrão
- Departamento de Enfermagem Psiquiátrica e Ciências Humanas, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Crippa JA, Sanches RF, Hallak JE, Loureiro SR, Zuardi AW. A structured interview guide increases Brief Psychiatric Rating Scale reliability in raters with low clinical experience. Acta Psychiatr Scand 2001; 103:465-70. [PMID: 11401662 DOI: 10.1034/j.1600-0447.2001.00185.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess the beneficial impact of a structured interview on the reliability of BPRS ratings in raters with low clinical experience. METHOD Each patient was rated once a week in two separate interviews, conducted on the same day. The first interview was conducted by a rater with low clinical experience (recruited from a group of five residents in psychiatry and one clinical psychologist in training). All second interviews were conducted by the same highly experienced psychiatrist. RESULTS The number of items with full agreement between observers increased with the use of SIG. The value of intraclass correlation coefficients for individual items and the total score also increased, approaching reported studies with experienced raters. CONCLUSION These results suggest that the use of SIG reduces variability of information gathering in reliability testing of BPRS with less experienced raters.
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Affiliation(s)
- J A Crippa
- Department of Neuropsychiatry and Medical Psychology, Faculty of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Abstract
OBJECTIVES The aim was to carry out a prospective study about the characteristics of the public seen at a psychiatric emergency room and of its service. METHODS The data were acquired though a protocol developed for this study and applied to all the patients seen during two months. RESULTS 600 protocols were filled out, corresponding to 96.5% (487 patients) of the attendance during the study period. Most of the patients seen were males, single, with a low educational level, professionally inactive and living with their families. The most frequent diagnoses were psychoactive substance use disorders (26.3%), schizophrenia (15.5%), manic episode (11.8%), major depression (10.9%) and non-psychotic disorders (10.9%). There were differences between gender in some diagnostic categories. After initial evaluation, 2/3 were medicated, (1/2) stayed under observation, and (1/4) stayed more than 10 hours in the service unit. About 20% of the attendance resulted in hospitalization and 60% in referrals to outpatient services. Discharges due to evasion represented only 2.0% of the total. Returning service users did not differ from those seen only once to what concern marital status, professional situation and household conditions. However, returning users presented a higher frequency of previous hospitalization and psychotic disorders. CONCLUSIONS Individuals with severe psychiatric disorders were seen in an actual emergency situation. The psychiatric emergency service has been expanding its actions and has been an effective part of the mental health service network.
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Affiliation(s)
- M E Santos
- Hospital de Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Monteiro-dos-Santos PC, Graeff FG, dos-Santos JE, Ribeiro RP, Guimarães FS, Zuardi AW. Effects of tryptophan depletion on anxiety induced by simulated public speaking. Braz J Med Biol Res 2000; 33:581-7. [PMID: 10775890 DOI: 10.1590/s0100-879x2000000500013] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Several lines of evidence point to the participation of serotonin (5HT) in anxiety. Its specific role, however, remains obscure. The objective of the present study was to evaluate the effect of reducing 5HT-neurotransmission through an acute tryptophan depletion on anxiety induced by a simulated public speaking (SPS) test. Two groups of 14-15 subjects were submitted to a 24-h diet with a low or normal content of tryptophan and received an amino acid mixture without (TRY-) or with (TRY+) tryptophan under double-blind conditions. Five hours later they were submitted to the SPS test. The state-trait anxiety inventory (STAI) and the visual analogue mood scale (VAMS) were used to measure subjective anxiety. Both scales showed that SPS induced a significant increase in anxiety. Although no overall difference between groups was found, there was a trend (P = 0.078) to an interaction of group x gender x phases of the SPS, and a separate analysis of each gender showed an increase in anxiety measured by the STAI in females of the TRY- group. The results for the female TRY- group also suggested a greater arousing effect of the SPS test. In conclusion, the tryptophan depletion procedure employed in the present study did not induce a significant general change in subjective anxiety, but tended to induce anxiety in females. This suggests a greater sensitivity of the 5HT system to the effects of the procedure in this gender.
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Abstract
OBJECTIVE To verify the modifications observed in a school hospital psychiatric emergency unit in Ribeirão Preto - SP, Brazil (EP-RP), due to alterations in the mental health policies implemented in this region. METHODS Data about attendances was collected from university hospital files of the EP-RP, from 1988 to 1997. The following variables were studied: sex, age, origin and main diagnosis. Data about changes in mental health policies of the region was obtained from documents of the city and state departments of health. RESULTS The yearly increase in the number of attendances followed the progressive involvement of EP-RP with the mental health service network, as the number of patients who looked for the service in 1995 was 2.3 times greater than in 1988. During this period, attendance at the EP-RP gave support to the modifications in the mental health policies in this region, resulting in a reduction of 654 psychiatry beds. In 1996 and 1997, a reduction of about 20% was observed in the total of attendance, as compared to 1995, result from an increase in the attendance capacity and number of the extra-hospital services. Since 1990, the EP-RP started to attend a higher proportion of older, male patients, with drug dependency and psychotic disorders and a lower proportion of non-psychotic patients. CONCLUSIONS The changes observed in the EP-RP are related to modifications in the Ribeirão Preto region mental health policies, like the psychiatric beds control, installed in 1990, the reduction of psychiatric beds after 1993, and the creation and/or amplification of extra-hospital services, in 1995.
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Affiliation(s)
- C M Del-Ben
- Departamento de Neurologia, Psiquiatria e Psicologia Médica da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
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Del-Ben CM, Rodrigues CR, Zuardi AW. Reliability of the Portuguese version of the structured clinical interview for DSM-III-R (SCID) in a Brazilian sample of psychiatric outpatients. Braz J Med Biol Res 1996; 29:1675-82. [PMID: 9222432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The objective of the present study was to determine the reliability of psychiatric diagnoses using a translation and adaptation of Portuguese of the "Structured Clinical Interview for DSM-III-R-patient version" (SCID-P) and the "Structured Clinical Interview for DSM-III-R Personality Disorders" (SCID-II), using the joint interviews methodology. Thirty-nine subjects were evaluated using the SCID-P and 20 of them using the SCID-II. Interrater reliability was analyzed statistically by means of the Kappa Coefficient. Agreement between results obtained with SCID-P was statistically significant for the major diagnostic categories of DSM-III-R and for 10 of the 12 specific diagnostic categories studied (a minimum of 4 subjects per diagnosis). Agreement was not statistically significant for Psychotic Disorder Not Otherwise Specified (NOS) and for Other Bipolar Disorder. The Weighted Kappa for the main diagnoses and the Overall Kappa for the entire set of 25 specific diagnostic categories proposed by the SCID-P were statistically significant. The general agreement for Personality Disorders with SCID-II was statistically significant. The Kappa Coefficient was determined for the Avoidant, Paranoid, Histrionic and Borderline Personality Disorders and for the Conduct Disorder. The remaining Personality Disorders were not analyzed statistically because of their low prevalence in the sample. Agreement was not significant only for the Histrionic Personality Disorder. These data suggest that the translation and adaptation of the SCID-P and SCID-II to Portuguese presents, in general, good reliability indices, and thus its use is recommended.
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Affiliation(s)
- C M Del-Ben
- Departamento de Neurologia, Psiquitaria e Psicologia, Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brasil
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Hetem LA, de Souza CJ, Guimarães ES, Zuardi AW, Graeff FG. Effect of d-fenfluramine on human experimental anxiety. Psychopharmacology (Berl) 1996; 127:276-82. [PMID: 8912406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
To investigate the role of 5-HT in human anxiety, the 5-HT releaser and uptake blocker d-fenfluramine (FEN) was administered to healthy volunteers under two models of experimental anxiety. The first was a simulated public speaking (SPS) test consisting of talking in front of a video camera, anxiety being evaluated mainly by self-rating scales. The second was a conditioned fear test, in which the changes in skin electrical conductance caused by a tone associated once with an aversive white noise were measured. The doses of 15 and 30 mg FEN, PO, decreased anxiety induced by SPS in a dose-dependent way, as indicated by the anxiety factor of Norris Visual Analogue Mood Scale. In the conditioned fear test, however, the amplitude and level of skin conductance responses to the conditioned aversive stimulus were not significantly changed by FEN. The differential effects of FEN in these human experimental models of anxiety, together with similar results reported in rats, support the view that 5-HT exerts a dual action on brain mechanisms regulating anxiety, facilitating conditioned while inhibiting unconditioned fear. The presumed reduction in unconditioned fear caused by FEN may have implications for the treatment of panic disorder.
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Affiliation(s)
- L A Hetem
- Departamento de Neurologia, Psiquiatria e Psicologia Médica, Universidade de São Paulo, Ribeirão Preto, Brazil
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Zuardi AW, Morais SL, Guimarães FS, Mechoulam R. Antipsychotic effect of cannabidiol. J Clin Psychiatry 1995; 56:485-6. [PMID: 7559378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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