ABSTRACT
Brain concussion is a common disturbance caused by external forces or acceleration affecting the head. It may be accompanied by transient loss of consciousness and amnesia. Typical symptoms include headache, nausea and dizziness; these may remain for a week or two. Some patients may experience transient loss of inability to create new memories or other brief impairment of mental functioning. Treatment is symptomatic. Some patients may suffer from prolonged symptoms, the connection of which with brain concession is difficult to show. Almost invariably the prognosis of brain concussion is good.
Subject(s)
Brain Concussion/physiopathology , Brain Concussion/therapy , Dizziness , Headache , Humans , Memory Disorders/physiopathology , Nausea , PrognosisABSTRACT
Selective serotonin reuptake inhibitors (SSRIs) bind directly to various neurotransmitter receptors. The clinical effects of SSRIs appear gradually during weeks of treatment, suggesting a role for adaptive changes in neurotransmitter receptors. Most clinically used antidepressants, e.g. fluoxetine, bind to 5-HT2C receptors. When administered chronically, many antidepressants elicit adaptive regulation of 5-HT2C receptors. The present study was conducted in order to determine the effects of acute and chronic fluoxetine and citalopram treatments on the density and function of 5-HT2C receptors in the rat choroid plexus. Acute and chronic treatments followed by phosphoinositide (PI) hydrolysis assays and quantitative receptor autoradiography were performed. Acute (single-dose) treatment with neither drug significantly affected basal or 5-HT-stimulated PI hydrolysis, but acute citalopram (20 mg/kg) treatment increased both agonist and antagonist binding to 5-HT(2C) receptors. Chronic (14 days) citalopram treatment (20 mg/kg) increased the maximal PI hydrolysis response by 40%, but fluoxetine lacked this effect. The present data suggest that sensitisation of 5-HT2C receptor-mediated intracellular signal transduction may play a role in the effects of citalopram. In contrast, fluoxetine treatment does not functionally sensitise 5-HT2C receptors. Thus, functional 5-HT2C receptor sensitisation is not a common effect of antidepressants, but the differential effects may explain some of the pharmacodynamic differences seen with these drugs, especially upon repeated administration.
Subject(s)
Choroid Plexus/drug effects , Citalopram/pharmacology , Fluoxetine/pharmacology , Phosphatidylinositols/metabolism , Receptor, Serotonin, 5-HT2C/physiology , Selective Serotonin Reuptake Inhibitors/pharmacology , Amphetamines/metabolism , Animals , Choroid Plexus/metabolism , Citalopram/administration & dosage , Dose-Response Relationship, Drug , Ergolines/metabolism , Fluoxetine/administration & dosage , Hydrolysis , Inositol Phosphates/biosynthesis , Male , Rats , Rats, Sprague-Dawley , Second Messenger Systems , Serotonin 5-HT2 Receptor Agonists , Serotonin 5-HT2 Receptor Antagonists , Selective Serotonin Reuptake Inhibitors/administration & dosageABSTRACT
Ex vivo receptor occupancy measurements were performed in order to study the effects of the serotonin reuptake inhibitors fluoxetine and citalopram on serotonin 5-HT(2C) receptors. To determine the degree of 5-HT(2C) receptor occupancy, [(3)H]mesulergine binding in brain sections containing rat choroid plexus was measured at various time-points after drug injection. For comparison, [(3)H]ketanserin binding to frontal cortex 5-HT(2A) receptors was measured. Fluoxetine treatments (10 and 20 mg/kg) resulted in 5-HT(2C) receptor occupancy of up to 25 and 43%, respectively. Fluoxetine (20 mg/kg) caused a persistent effect: at the 24 h time-point, 23% of 5-HT(2C) receptors were still occupied. Citalopram treatment did not result in marked 5-HT(2C) receptor occupancy. Neither drug caused significant 5-HT(2A) receptor occupancy. In conclusion, the results demonstrate pharmacodynamic differences between fluoxetine and citalopram at the level of 5-HT(2C) receptors. These findings provide evidence that direct occupancy of 5-HT(2C) receptors may contribute to the mechanism of action of fluoxetine.
