ABSTRACT
This chapter outlines the clinician' s guide for prescription of benzodiazepine anxiolytics and 5-HT1A receptor agonists. 5-HT1A receptor agonists have entirely different pharmacological mechanism of action from benzodiazepines, and the pattern of their use is quite different from benzodiazepines. In the global trend, there are strict regulations for the prescription of benzodiazepines, because of the risk of low-dose dependence. Benzodiazepines are recommended for the use only when necessary in the short term. In contrast, benzodiazepines have many clinical indications, compared with 5-HT1A receptor agonists. In Japan, there is no strict regulation to prescription of benzodiazepines. However, we now tend to follow international trends in general.
Subject(s)
Anti-Anxiety Agents/administration & dosage , Benzodiazepines/administration & dosage , Selective Serotonin Reuptake Inhibitors/administration & dosage , HumansABSTRACT
Event-related potentials were recorded from human subjects performing a visual detection task to find correlates of detection performance (d' and beta) in accordance with the theory of signal detection. Two spatial frequencies of square waves shifted horizontally with three shifting-step varieties were presented to the subjects who reported whether or not the waves were perceived to shift. Although three components of N1, P2, and P3 were observed for all of four response categories of hit, miss, false alarm, and correct rejection, only the amplitudes of the P3 component at vertex and parietal sites highly correlated to the detection sensitivity of d'. It was also found that coefficients of correlation between the P3 amplitudes at these sites and observed hit and false alarm rates were highly significant and a d'-extrapolation value reproduced by the normalized P3 amplitudes and the usual d' indicated a highly linear trend. Results suggest that generation of the P3 component is associated with "threshold-modulating" mechanisms which determine detection sensitivity of a task for each perceptual event.
Subject(s)
Evoked Potentials, Visual/physiology , Visual Perception/physiology , Adult , Female , Humans , Judgment , Male , Psychophysics , ROC Curve , Reaction TimeSubject(s)
Dysthymic Disorder , Antidepressive Agents, Tricyclic/therapeutic use , Diagnosis, Differential , Diagnostic and Statistical Manual of Mental Disorders , Dysthymic Disorder/diagnosis , Dysthymic Disorder/epidemiology , Dysthymic Disorder/etiology , Dysthymic Disorder/therapy , Genetic Predisposition to Disease , Humans , Psychotherapy , Reference Standards , Selective Serotonin Reuptake Inhibitors/therapeutic useSubject(s)
Cyclothymic Disorder , Age of Onset , Antimanic Agents/therapeutic use , Antipsychotic Agents/therapeutic use , Cyclothymic Disorder/diagnosis , Cyclothymic Disorder/epidemiology , Cyclothymic Disorder/etiology , Cyclothymic Disorder/therapy , Diagnosis, Differential , Genetic Predisposition to Disease , Humans , Psychotherapy , Reference StandardsABSTRACT
Although it is suggested that (+/-)-pindolol, a beta-adrenergic/5-HT1A receptor antagonist, may enhance the efficacy of selective serotonin reuptake inhibitors (SSRI), the results of double-blind studies are contradictory and recent animal studies suggest that (+/-)-pindolol may act as a partial agonist to the 5-HT1A receptor. In this study we have investigated the effect of (+/-)-pindolol on both pre- and postsynaptic 5-HT1A receptors using in vivo microdialysis and hippocampal slice preparations. (+/-)-pindolol and flesinoxan, a 5-HT1A receptor full agonist, significantly decreased the extracellular levels of 5-HT in the raphe and prefrontal cortex. The 5-HT and other 5-HT1A receptor agonists, flesinoxan and 8-hydroxy-2- (di-n-propylamino)tetralon (8-OH-DPAT), significantly decreased the population excitatory postsynaptic potential (EPSP) in the CA3-CA1 excitatory synapse in a dose-dependent manner. The effect of 5-HT and other 5-HT1A receptor agonists accompanied the increase in paired-pulse facilitation (ppf) induced by short-interval two stimuli and were reversed by the coadministration of the 5-HT1A receptor agonist, NAN-190, but not by (+/-)-pindolol. (+/-)-pindolol also suppressed the EPSP, but this effect was not reversed by NAN-190. These results suggest that (+/-)-pindolol acts as a partial agonist to the somatodendritic 5-HT1A receptor in the raphe, whereas it may have no action on the postsynaptic 5-HT1A receptor in the hippocampus.
