Ryan T Terry-Lorenzo, Reuben H Fan, Ni A Khin, Jaskaran B Singh
Hypofunction of the N-methyl-D-aspartate receptor (NMDAR) has been proposed to underlie the pathophysiology of schizophrenia, suggesting that promoting NMDAR activity may alleviate the negative or cognitive symptoms associated with schizophrenia. To circumvent excitotoxicity that may accompany direct agonism of the glutamate binding site on the NMDAR, therapeutic trials have focused on targeting the glycine binding site on the NMDAR. Direct administration of either glycine or D-serine, both of which are endogenous coagonists at the NMDAR glycine site, has yielded mixed outcomes across an array of clinical trials investigating different doses or patient populations. Furthermore, directly administering D-serine and glycine is challenging, and thus attention has turned to alternative, indirect methods that increase endogenous D-serine and glycine levels in the brain, such as D-amino acid oxidase (DAAO) inhibitors and glycine transporter 1 inhibitors, respectively. In this review, we provide an overview of the evidence supporting the potential of NMDAR modulators in general, and DAAO inhibitors in particular, as potential adjunctive treatments for schizophrenia. We also discuss the preclinical and clinical data related to luvadaxistat, an investigational highly selective and potent DAAO inhibitor that was under development for the treatment of the cognitive impairment associated with schizophrenia.
n -甲基- d -天冬氨酸受体(NMDAR)功能低下已被认为是精神分裂症病理生理学的基础,表明促进NMDAR活性可能减轻与精神分裂症相关的阴性或认知症状。为了避免NMDAR上谷氨酸结合位点的直接激动作用可能带来的兴奋性毒性,治疗试验主要针对NMDAR上的甘氨酸结合位点。直接给药甘氨酸或d -丝氨酸都是NMDAR甘氨酸位点的内源性凝血剂,在一系列研究不同剂量或患者群体的临床试验中产生了不同的结果。此外,直接给药d -丝氨酸和甘氨酸是具有挑战性的,因此人们的注意力转向了可增加大脑内源性d -丝氨酸和甘氨酸水平的替代间接方法,如d -氨基酸氧化酶(DAAO)抑制剂和甘氨酸转运蛋白1抑制剂。在这篇综述中,我们概述了支持NMDAR调节剂,特别是DAAO抑制剂作为精神分裂症潜在辅助治疗的潜力的证据。我们还讨论了与luvadaxistat相关的临床前和临床数据,luvadaxistat是一种高选择性和有效的DAAO抑制剂,正在开发用于治疗与精神分裂症相关的认知障碍。
{"title":"Therapeutic potential of D-amino acid oxidase inhibitors for cognitive impairment associated with schizophrenia: learnings from luvadaxistat.","authors":"Ryan T Terry-Lorenzo, Reuben H Fan, Ni A Khin, Jaskaran B Singh","doi":"10.1093/ijnp/pyae066","DOIUrl":"10.1093/ijnp/pyae066","url":null,"abstract":"<p><p>Hypofunction of the N-methyl-D-aspartate receptor (NMDAR) has been proposed to underlie the pathophysiology of schizophrenia, suggesting that promoting NMDAR activity may alleviate the negative or cognitive symptoms associated with schizophrenia. To circumvent excitotoxicity that may accompany direct agonism of the glutamate binding site on the NMDAR, therapeutic trials have focused on targeting the glycine binding site on the NMDAR. Direct administration of either glycine or D-serine, both of which are endogenous coagonists at the NMDAR glycine site, has yielded mixed outcomes across an array of clinical trials investigating different doses or patient populations. Furthermore, directly administering D-serine and glycine is challenging, and thus attention has turned to alternative, indirect methods that increase endogenous D-serine and glycine levels in the brain, such as D-amino acid oxidase (DAAO) inhibitors and glycine transporter 1 inhibitors, respectively. In this review, we provide an overview of the evidence supporting the potential of NMDAR modulators in general, and DAAO inhibitors in particular, as potential adjunctive treatments for schizophrenia. We also discuss the preclinical and clinical data related to luvadaxistat, an investigational highly selective and potent DAAO inhibitor that was under development for the treatment of the cognitive impairment associated with schizophrenia.</p>","PeriodicalId":14134,"journal":{"name":"International Journal of Neuropsychopharmacology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11712274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mary R Lee, Ehsan Shokri Kojori, William Dieckmann, Erick Singley, Julie A Mattison, Peter Herscovitch, Lorenzo Leggio
Background: Oxytocin is being evaluated as a potential treatment for psychostimulant use disorders. It is unknown what effect oxytocin has on dopamine signaling in response to psychostimulants in brain regions such as the striatum where oxytocin and dopamine interact to process natural rewards. We investigated the effect of oxytocin on striatal dopamine release stimulated by methylphenidate whose mechanism of action is analogous to that of cocaine.
Methods: We conducted an [11C] raclopride positron emission tomography study to assess striatal dopamine release in male rhesus macaques treated with oxytocin (80 IU) (administered via the intranasal [N = 5] and intravenous [N = 6] routes) followed by methylphenidate/[11C] raclopride.
Results: Oxytocin delivered by both routes significantly reduced methylphenidate-stimulated dopamine release in the dorsal striatum (caudate/putamen). These effects were, in part, evidenced by a reduction in dorsal striatal [11C] raclopride binding potential (increased dopamine release) following oxytocin administration.
Conclusions: The results provide translational and mechanistic evidence for the potential role of oxytocin as a treatment for psychostimulant use disorders.
{"title":"Oxytocin Reduces Methylphenidate-Induced Dorsal Striatal Dopamine Release in Male Rhesus Macaques.","authors":"Mary R Lee, Ehsan Shokri Kojori, William Dieckmann, Erick Singley, Julie A Mattison, Peter Herscovitch, Lorenzo Leggio","doi":"10.1093/ijnp/pyae056","DOIUrl":"10.1093/ijnp/pyae056","url":null,"abstract":"<p><strong>Background: </strong>Oxytocin is being evaluated as a potential treatment for psychostimulant use disorders. It is unknown what effect oxytocin has on dopamine signaling in response to psychostimulants in brain regions such as the striatum where oxytocin and dopamine interact to process natural rewards. We investigated the effect of oxytocin on striatal dopamine release stimulated by methylphenidate whose mechanism of action is analogous to that of cocaine.</p><p><strong>Methods: </strong>We conducted an [11C] raclopride positron emission tomography study to assess striatal dopamine release in male rhesus macaques treated with oxytocin (80 IU) (administered via the intranasal [N = 5] and intravenous [N = 6] routes) followed by methylphenidate/[11C] raclopride.</p><p><strong>Results: </strong>Oxytocin delivered by both routes significantly reduced methylphenidate-stimulated dopamine release in the dorsal striatum (caudate/putamen). These effects were, in part, evidenced by a reduction in dorsal striatal [11C] raclopride binding potential (increased dopamine release) following oxytocin administration.</p><p><strong>Conclusions: </strong>The results provide translational and mechanistic evidence for the potential role of oxytocin as a treatment for psychostimulant use disorders.</p>","PeriodicalId":14134,"journal":{"name":"International Journal of Neuropsychopharmacology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Depression is a prevalent and disabling disorder that poses serious problems in mental health care, and rapid antidepressants are novel treatments for this disorder. Cannabidiol (CBD), a non-intoxicating phytocannabinoid, is thought to have therapeutic potential due to its important neurological and anti-inflammatory properties. Despite major advances in pharmacotherapy in experimental animals, the exact mechanism of antidepressant-like effects remains to be elucidated.
Methods: In this paper, we review the current state of knowledge on the antidepressant properties of CBD in numerous experimental and clinical studies.
Results: Accumulating evidence suggests that CBD has antidepressant properties in humans and animals with few side effects, suggesting that CBD may be a potential antidepressant. Furthermore, we discuss CBD may therefore provide a potential treatment to exert antidepressant-like effects through various molecular targets, reducing inflammation, and enhancing neurogenesis.
Conclusions: Taken together with the growing popularity of CBD as a medicine, these findings extend the limited knowledge on the antidepressant effects of CBD. This potentially opens up new therapeutic means for the patients with depression.
{"title":"A novel insight into the antidepressant effect of cannabidiol: possible involvement of the 5-HT1A, CB1, GPR55, and PPARγ receptors.","authors":"Yang Miao, Fei Zhao, Wei Guan","doi":"10.1093/ijnp/pyae064","DOIUrl":"https://doi.org/10.1093/ijnp/pyae064","url":null,"abstract":"<p><strong>Background: </strong>Depression is a prevalent and disabling disorder that poses serious problems in mental health care, and rapid antidepressants are novel treatments for this disorder. Cannabidiol (CBD), a non-intoxicating phytocannabinoid, is thought to have therapeutic potential due to its important neurological and anti-inflammatory properties. Despite major advances in pharmacotherapy in experimental animals, the exact mechanism of antidepressant-like effects remains to be elucidated.</p><p><strong>Methods: </strong>In this paper, we review the current state of knowledge on the antidepressant properties of CBD in numerous experimental and clinical studies.</p><p><strong>Results: </strong>Accumulating evidence suggests that CBD has antidepressant properties in humans and animals with few side effects, suggesting that CBD may be a potential antidepressant. Furthermore, we discuss CBD may therefore provide a potential treatment to exert antidepressant-like effects through various molecular targets, reducing inflammation, and enhancing neurogenesis.</p><p><strong>Conclusions: </strong>Taken together with the growing popularity of CBD as a medicine, these findings extend the limited knowledge on the antidepressant effects of CBD. This potentially opens up new therapeutic means for the patients with depression.</p>","PeriodicalId":14134,"journal":{"name":"International Journal of Neuropsychopharmacology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matan Dahan, Joseph Zohar, Doron Todder, Aleksander A Mathé, Hagit Cohen
Background: The regulatory neuropeptide Y (NPY) is implicated in anxiety and post-traumatic stress disorder (PTSD)-related behaviors. NPY exerts its effects through 5 receptor subtypes, with Y1 and Y2 receptors being predominantly expressed in the rat brain. Activation of Y1 by full-length NPY1-36 induces anxiolytic effects, whereas Y2 binds truncated peptides, eliciting region-specific anxiogenic responses. Dipeptidyl peptidase-IV (DPP-IV) cleaves NPY, thereby modulating its functionality. Sitagliptin, a DPP-IV inhibitor (DPP-IV-I), inhibits the degradation of various vasoactive peptides, including cerebral NPY. As such, the therapeutic potential of DPP-IV-I following a traumatic event remains inconclusive. We assessed the effects of a highly selective DPP-IV-I, administered either shortly after the stressor or intermittently over 3 days, on behavioral outcomes using the predator scent stress (PSS) model of PTSD.
Methods: Rats exposed to PSS or sham-PSS received a single dose of sitagliptin (10 or 30 mg/kg) or saline 1 hour post-exposure, or repeated doses over 3 days (20 mg/kg). Behavioral outcomes were evaluated using the elevated plus maze and acoustic startle response at 7 days post-exposure. Additionally, rats exposed to PSS or sham-PSS were treated with sitagliptin (30 mg/kg) or saline, and their brains were prepared for immunofluorescence and enzyme-linked immunosorbent assay (ELISA).
Results: Sitagliptin did not attenuate anxiety-related behaviors or PTSD-related behavior prevalence compared to saline. Notably, the 30 mg/kg dose increased NPY levels in several brain regions without affecting NPY-Y1 levels.
Conclusions: The findings suggest that sitagliptin-induced upregulation of NPY levels shortly after PSS is insufficient to prevent the development of post-traumatic responses. The effectiveness of NPY signaling may be influenced by factors beyond peptide concentration alone, potentially limiting its therapeutic efficacy. Activation of NPY-Y1 receptors, rather than merely increasing NPY levels, appears to be crucial for modulating anti-anxiety and post-traumatic responses.
{"title":"Exploring the Anxiolytic Potential of NPY by a Dipeptidyl Peptidase-IV Inhibitor in an Animal Model of PTSD.","authors":"Matan Dahan, Joseph Zohar, Doron Todder, Aleksander A Mathé, Hagit Cohen","doi":"10.1093/ijnp/pyae062","DOIUrl":"10.1093/ijnp/pyae062","url":null,"abstract":"<p><strong>Background: </strong>The regulatory neuropeptide Y (NPY) is implicated in anxiety and post-traumatic stress disorder (PTSD)-related behaviors. NPY exerts its effects through 5 receptor subtypes, with Y1 and Y2 receptors being predominantly expressed in the rat brain. Activation of Y1 by full-length NPY1-36 induces anxiolytic effects, whereas Y2 binds truncated peptides, eliciting region-specific anxiogenic responses. Dipeptidyl peptidase-IV (DPP-IV) cleaves NPY, thereby modulating its functionality. Sitagliptin, a DPP-IV inhibitor (DPP-IV-I), inhibits the degradation of various vasoactive peptides, including cerebral NPY. As such, the therapeutic potential of DPP-IV-I following a traumatic event remains inconclusive. We assessed the effects of a highly selective DPP-IV-I, administered either shortly after the stressor or intermittently over 3 days, on behavioral outcomes using the predator scent stress (PSS) model of PTSD.</p><p><strong>Methods: </strong>Rats exposed to PSS or sham-PSS received a single dose of sitagliptin (10 or 30 mg/kg) or saline 1 hour post-exposure, or repeated doses over 3 days (20 mg/kg). Behavioral outcomes were evaluated using the elevated plus maze and acoustic startle response at 7 days post-exposure. Additionally, rats exposed to PSS or sham-PSS were treated with sitagliptin (30 mg/kg) or saline, and their brains were prepared for immunofluorescence and enzyme-linked immunosorbent assay (ELISA).</p><p><strong>Results: </strong>Sitagliptin did not attenuate anxiety-related behaviors or PTSD-related behavior prevalence compared to saline. Notably, the 30 mg/kg dose increased NPY levels in several brain regions without affecting NPY-Y1 levels.</p><p><strong>Conclusions: </strong>The findings suggest that sitagliptin-induced upregulation of NPY levels shortly after PSS is insufficient to prevent the development of post-traumatic responses. The effectiveness of NPY signaling may be influenced by factors beyond peptide concentration alone, potentially limiting its therapeutic efficacy. Activation of NPY-Y1 receptors, rather than merely increasing NPY levels, appears to be crucial for modulating anti-anxiety and post-traumatic responses.</p>","PeriodicalId":14134,"journal":{"name":"International Journal of Neuropsychopharmacology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lakshmi Thangavelu, Siddig Ibrahim Abdelwahab, Abdullah Farasani, Suhas Ballal, Pooja Bansal, Deepak Nathiya, Kiranjeet Kaur, M Ravi Kumar, Aashna Sinha, Hayam A Alrasheed, Maha F Al-Subaie, Nawal A Al Kaabi, Ali Al Bshabshe, Mona A Al Fares, Hawra Albayat, Ali A Rabaan, Kumud Pant, Quazi Syed Zahiruddin, Arathi P Rao, Mahalaqua Nazli Khatib, Hassan Ahmad Alfaifi, Syam Mohan, Sanjit Sah, Prakasini Satapathy
Dengue fever, caused by the dengue virus and transmitted through Aedes mosquitoes, is a growing public health concern, particularly in tropical and subtropical regions. Traditionally associated with febrile and hemorrhagic symptoms, recent research suggests a potential link between dengue and cognitive impairments. This systematic review assessed existing research to understand the association between dengue virus infection and cognitive impairments, including dementia, Alzheimer disease, memory loss, and confusion. This systematic review followed preferred reporting items for systematic reviews and meta-analyses guidelines. A comprehensive literature search was conducted in PubMed, EMBASE, and Web of Science up to January 18, 2024. Studies examining the prevalence and association of cognitive impairments in dengue patients were included. Data extraction and quality assessment were performed using Nested Knowledge software and the Newcastle-Ottawa Scale. Of the 1129 articles identified, 5 were included in the review, covering a total of 200 873 participants from Taiwan, Brazil, and France. Evidence from population-based cohort studies indicated short-term cognitive impairments, including confusion and memory loss, in some dengue patients. Additionally, long-term risks of dementia, including Alzheimer disease and vascular dementia, were observed, particularly among older adults. Although the findings suggest there might be an association between dengue infection and cognitive decline, the mechanisms underlying this link remain unclear. This systematic review suggests that dengue virus infection may affect cognitive function in both acute and long-term contexts. However, the current evidence is not strong enough to establish a conclusive link. Further research with larger sample sizes and longitudinal studies is essential to confirm the impact of dengue virus on cognitive health.
{"title":"Risk of cognitive decline among patients with dengue virus infection: a systematic review.","authors":"Lakshmi Thangavelu, Siddig Ibrahim Abdelwahab, Abdullah Farasani, Suhas Ballal, Pooja Bansal, Deepak Nathiya, Kiranjeet Kaur, M Ravi Kumar, Aashna Sinha, Hayam A Alrasheed, Maha F Al-Subaie, Nawal A Al Kaabi, Ali Al Bshabshe, Mona A Al Fares, Hawra Albayat, Ali A Rabaan, Kumud Pant, Quazi Syed Zahiruddin, Arathi P Rao, Mahalaqua Nazli Khatib, Hassan Ahmad Alfaifi, Syam Mohan, Sanjit Sah, Prakasini Satapathy","doi":"10.1093/ijnp/pyae053","DOIUrl":"10.1093/ijnp/pyae053","url":null,"abstract":"<p><p>Dengue fever, caused by the dengue virus and transmitted through Aedes mosquitoes, is a growing public health concern, particularly in tropical and subtropical regions. Traditionally associated with febrile and hemorrhagic symptoms, recent research suggests a potential link between dengue and cognitive impairments. This systematic review assessed existing research to understand the association between dengue virus infection and cognitive impairments, including dementia, Alzheimer disease, memory loss, and confusion. This systematic review followed preferred reporting items for systematic reviews and meta-analyses guidelines. A comprehensive literature search was conducted in PubMed, EMBASE, and Web of Science up to January 18, 2024. Studies examining the prevalence and association of cognitive impairments in dengue patients were included. Data extraction and quality assessment were performed using Nested Knowledge software and the Newcastle-Ottawa Scale. Of the 1129 articles identified, 5 were included in the review, covering a total of 200 873 participants from Taiwan, Brazil, and France. Evidence from population-based cohort studies indicated short-term cognitive impairments, including confusion and memory loss, in some dengue patients. Additionally, long-term risks of dementia, including Alzheimer disease and vascular dementia, were observed, particularly among older adults. Although the findings suggest there might be an association between dengue infection and cognitive decline, the mechanisms underlying this link remain unclear. This systematic review suggests that dengue virus infection may affect cognitive function in both acute and long-term contexts. However, the current evidence is not strong enough to establish a conclusive link. Further research with larger sample sizes and longitudinal studies is essential to confirm the impact of dengue virus on cognitive health.</p>","PeriodicalId":14134,"journal":{"name":"International Journal of Neuropsychopharmacology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Esketamine nasal spray (ESK) is approved, in conjunction with an oral antidepressant, for the treatment of treatment-resistant depression in adults and for the treatment of depressive symptoms in adults with major depressive disorder with acute suicidal ideation or behavior. No adverse events (AEs) of respiratory depression were reported in ESK phase 3 clinical trials; however, postmarketing incidents of respiratory depression associated with ESK use have been observed.
Methods: The Janssen Global Medical Safety (GMS) database was reviewed for cases meeting the criteria for respiratory depression with ESK using 47 months of postapproval data, based on the Standardized Medical Dictionary for Regulatory Activities (MedDRA) Query (SMQ) acute central respiratory depression (broad). FDA Adverse Event Reporting System (FAERS), EudraVigilance, and literature searches were performed to identify reports of respiratory depression related to ESK use.
Results: Fifty cases, representing 50 patients, in the GMS database met the case definition for respiratory depression; 8 of these had a stronger association with ESK use. The MedDRA preferred term (PT) hypopnea met the threshold for disproportionality with ESK in FAERS. The MedDRA PTs asphyxia, oxygen saturation decreased, respiratory depression, and apnea met the threshold for disproportionality with ESK in EudraVigilance.
Conclusion: Despite extensive soliciting of AEs for ESK with the US Risk Evaluation and Mitigation Strategy program, respiratory depression is infrequently observed with ESK treatment in the postmarketing setting (estimated incidence: 1 case per 20 000 treatment sessions). Symptoms are manageable and resolve with minor supportive measures. Monitoring for symptoms of respiratory depression, including pulse oximetry, is recommended within the postdose observation period.
{"title":"Real-World Safety of Esketamine Nasal Spray: A Comprehensive Analysis of Esketamine and Respiratory Depression.","authors":"Craig Chepke, Richard Shelton, Gerard Sanacora, Teodora Doherty, Palina Tsytsik, Nancy Parker","doi":"10.1093/ijnp/pyae058","DOIUrl":"10.1093/ijnp/pyae058","url":null,"abstract":"<p><strong>Background: </strong>Esketamine nasal spray (ESK) is approved, in conjunction with an oral antidepressant, for the treatment of treatment-resistant depression in adults and for the treatment of depressive symptoms in adults with major depressive disorder with acute suicidal ideation or behavior. No adverse events (AEs) of respiratory depression were reported in ESK phase 3 clinical trials; however, postmarketing incidents of respiratory depression associated with ESK use have been observed.</p><p><strong>Methods: </strong>The Janssen Global Medical Safety (GMS) database was reviewed for cases meeting the criteria for respiratory depression with ESK using 47 months of postapproval data, based on the Standardized Medical Dictionary for Regulatory Activities (MedDRA) Query (SMQ) acute central respiratory depression (broad). FDA Adverse Event Reporting System (FAERS), EudraVigilance, and literature searches were performed to identify reports of respiratory depression related to ESK use.</p><p><strong>Results: </strong>Fifty cases, representing 50 patients, in the GMS database met the case definition for respiratory depression; 8 of these had a stronger association with ESK use. The MedDRA preferred term (PT) hypopnea met the threshold for disproportionality with ESK in FAERS. The MedDRA PTs asphyxia, oxygen saturation decreased, respiratory depression, and apnea met the threshold for disproportionality with ESK in EudraVigilance.</p><p><strong>Conclusion: </strong>Despite extensive soliciting of AEs for ESK with the US Risk Evaluation and Mitigation Strategy program, respiratory depression is infrequently observed with ESK treatment in the postmarketing setting (estimated incidence: 1 case per 20 000 treatment sessions). Symptoms are manageable and resolve with minor supportive measures. Monitoring for symptoms of respiratory depression, including pulse oximetry, is recommended within the postdose observation period.</p>","PeriodicalId":14134,"journal":{"name":"International Journal of Neuropsychopharmacology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Gonadal hormones have been reported to be involved in the molecular mechanisms of schizophrenia (SCH). However, only a few studies have examined the gonadal hormone dysfunctions in first-episode schizophrenia (FES) patients, in particular in young patients with SCH. This study was designed to investigate the sex differences in gonadal hormones in young and antipsychotic-naïve FES patients.
Methods: One hundred and sixty-two patients with SCH and 74 healthy controls were recruited, and blood gonadal hormones, including estradiol (E2), follicular-stimulating hormone (FSH), progesterone (PROG), luteinizing hormone (LH), and testosterone (TESTO), were measured in young FES patients and controls.
Results: We found that both male and female young FES patients showed gonadal hormone disturbances at the onset of psychosis. Male patients exhibited a significantly higher rate of abnormal E2 (25.6% vs 3.9%), while female patients had higher rates of abnormal FSH (0% vs 5.3%), PROG (0% vs 21.1%), LH (3.5% vs 17.1%), and TESTO (3.5% vs 13.2%) (all P < .05). Multivariate logistic regression analysis further identified that specific gonadal hormone indices, including E2, LH, and TESTO, were factors associated with sex differences in young FES patients, after controlling for age, smoking status, and body mass index.
Conclusions: Our study reveals an overall gonadal hormone imbalance in young antipsychotic-naïve FES patients, highlighting sex differences at the onset of psychosis. Our study provides a foundation for further research into the role of gonadal hormones in the pathophysiology of SCH and the potential for personalized medicine approaches based on hormonal balance. Future studies were warranted to explore these differences and their implications for clinical practice to improve the treatment outcomes for individuals suffering from SCH.
背景:据报道,性腺激素与精神分裂症(SCH)的分子机制有关。然而,只有少数研究探讨了首发精神分裂症(FES)患者,尤其是年轻精神分裂症患者的性腺激素功能障碍。本研究旨在调查年轻和未服用抗精神病药物的首发精神分裂症患者性腺激素的性别差异:方法:招募 162 名 SCH 患者和 74 名健康对照者,测量年轻 FES 患者和对照者的血液性腺激素,包括雌二醇(E2)、卵泡刺激素(FSH)、孕酮(PROG)、黄体生成素(LH)和 TESTO:结果:我们发现,男女青年 FES 患者在精神病发作时均出现性腺激素紊乱。男性患者的 E2 异常率明显较高(25.6% vs 3.9%),而女性患者的 FSH 异常率较高(0% vs 5.3%)、PROG 异常率较高(0% vs 21.1%)、LH 异常率较高(3.5% vs 17.1%)和 TESO 异常率较高(3.5% vs 13.2%)(均为 p):我们的研究揭示了抗精神病药物无效的年轻 FES 患者总体性腺激素失衡的情况,凸显了精神病发病时的性别差异。我们的研究为进一步研究性腺激素在 SCH 病理生理学中的作用以及基于激素平衡的个性化医疗方法的潜力奠定了基础。未来的研究有必要探索这些差异及其对临床实践的影响,以改善SCH患者的治疗效果。
{"title":"Gonadal hormone abnormalities in young patients with first-episode schizophrenia.","authors":"Qiang Hu, Jindong Wang, Jing Liang, Meihong Xiu, Shuangli Zhang, Fengchun Wu","doi":"10.1093/ijnp/pyae063","DOIUrl":"10.1093/ijnp/pyae063","url":null,"abstract":"<p><strong>Background: </strong>Gonadal hormones have been reported to be involved in the molecular mechanisms of schizophrenia (SCH). However, only a few studies have examined the gonadal hormone dysfunctions in first-episode schizophrenia (FES) patients, in particular in young patients with SCH. This study was designed to investigate the sex differences in gonadal hormones in young and antipsychotic-naïve FES patients.</p><p><strong>Methods: </strong>One hundred and sixty-two patients with SCH and 74 healthy controls were recruited, and blood gonadal hormones, including estradiol (E2), follicular-stimulating hormone (FSH), progesterone (PROG), luteinizing hormone (LH), and testosterone (TESTO), were measured in young FES patients and controls.</p><p><strong>Results: </strong>We found that both male and female young FES patients showed gonadal hormone disturbances at the onset of psychosis. Male patients exhibited a significantly higher rate of abnormal E2 (25.6% vs 3.9%), while female patients had higher rates of abnormal FSH (0% vs 5.3%), PROG (0% vs 21.1%), LH (3.5% vs 17.1%), and TESTO (3.5% vs 13.2%) (all P < .05). Multivariate logistic regression analysis further identified that specific gonadal hormone indices, including E2, LH, and TESTO, were factors associated with sex differences in young FES patients, after controlling for age, smoking status, and body mass index.</p><p><strong>Conclusions: </strong>Our study reveals an overall gonadal hormone imbalance in young antipsychotic-naïve FES patients, highlighting sex differences at the onset of psychosis. Our study provides a foundation for further research into the role of gonadal hormones in the pathophysiology of SCH and the potential for personalized medicine approaches based on hormonal balance. Future studies were warranted to explore these differences and their implications for clinical practice to improve the treatment outcomes for individuals suffering from SCH.</p>","PeriodicalId":14134,"journal":{"name":"International Journal of Neuropsychopharmacology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tatiana V Lipina, Huy Giang, Jonathan S Thacker, William C Wetsel, Marc G Caron, Jean Martin Beaulieu, Ali Salahpour, Amy J Ramsey
Background: Glutamatergic system dysfunction contributes to a full spectrum of schizophrenia-like symptoms, including the cognitive and negative symptoms that are resistant to treatment with antipsychotic drugs (APDs). Aripiprazole, an atypical APD, acts as a dopamine partial agonist, and its combination with haloperidol (a typical APD) has been suggested as a potential strategy to improve schizophrenia. Recently, an analog of aripiprazole, UNC9994, was developed. UNC9994 does not affect dopamine 2 receptor (D2R)-mediated Gi/o protein signaling but acts as a partial agonist for D2R/β-arrestin interactions. Hence, one of our objectives was to probe the behavioral effects of co-administrating haloperidol with UNC9994 in the N-methyl-D-aspartate receptor (NMDAR) mouse models of schizophrenia. The biochemical mechanisms underlying the neurobiological effects of dual haloperidol × UNC9994 action are currently missing. Hence, we aimed to explore D2R- and NMDAR-dependent signaling mechanisms that could underlie the effects of dual drug treatments.
Methods: NMDAR hypofunction was induced pharmacologically by acute injection of MK-801 (NMDAR pore blocker; 0.15 mg/kg) and genetically by knockdown of Grin1 gene expression in mice, which have a 90% reduction in NMDAR levels (Grin1 knockdown [Grin1-KD]). After intraperitoneal injections of vehicle, haloperidol (0.15 mg/kg), UNC9994 (0.25 mg/kg), or their combination, mice were tested in open field, prepulse inhibition (PPI), Y-maze, and Puzzle box. Biochemical effects on the phosphorylation of Akt, glycogen synthase kinase-3 (GSK-3), and CaMKII in the prefrontal cortex (PFC) and striatum of MK-801-treated mice were assessed by western blotting.
Results: Our findings indicate that low dose co-administration of UNC9994 and haloperidol reduces hyperactivity in MK-801-treated animals and in Grin1-KD mice. Furthermore, this dual administration effectively reverses PPI deficits, repetitive/rigid behavior in the Y-maze, and deficient executive function in the Puzzle box in both animal models. Pharmacological inhibition of NMDAR by MK-801 induced the opposite effects in the PFC and striatum on pAkt-S473 and pGSK3β-Ser9. Dual injection of haloperidol with UNC9994 reversed MK-801-induced effects on pAkt-S473 but not on pGSK3β-Ser9 in both brain structures.
Conclusions: The dual administration of haloperidol with UNC9994 at low doses represents a promising approach to ameliorate symptoms of schizophrenia. The combined drug regimen elicits synergistic effects specifically on pAkt-S473, suggesting it as a potential biomarker for antipsychotic actions.
{"title":"Combination of Haloperidol With UNC9994, β-arrestin-Biased Analog of Aripiprazole, Ameliorates Schizophrenia-Related Phenotypes Induced by NMDAR Deficit in Mice.","authors":"Tatiana V Lipina, Huy Giang, Jonathan S Thacker, William C Wetsel, Marc G Caron, Jean Martin Beaulieu, Ali Salahpour, Amy J Ramsey","doi":"10.1093/ijnp/pyae060","DOIUrl":"10.1093/ijnp/pyae060","url":null,"abstract":"<p><strong>Background: </strong>Glutamatergic system dysfunction contributes to a full spectrum of schizophrenia-like symptoms, including the cognitive and negative symptoms that are resistant to treatment with antipsychotic drugs (APDs). Aripiprazole, an atypical APD, acts as a dopamine partial agonist, and its combination with haloperidol (a typical APD) has been suggested as a potential strategy to improve schizophrenia. Recently, an analog of aripiprazole, UNC9994, was developed. UNC9994 does not affect dopamine 2 receptor (D2R)-mediated Gi/o protein signaling but acts as a partial agonist for D2R/β-arrestin interactions. Hence, one of our objectives was to probe the behavioral effects of co-administrating haloperidol with UNC9994 in the N-methyl-D-aspartate receptor (NMDAR) mouse models of schizophrenia. The biochemical mechanisms underlying the neurobiological effects of dual haloperidol × UNC9994 action are currently missing. Hence, we aimed to explore D2R- and NMDAR-dependent signaling mechanisms that could underlie the effects of dual drug treatments.</p><p><strong>Methods: </strong>NMDAR hypofunction was induced pharmacologically by acute injection of MK-801 (NMDAR pore blocker; 0.15 mg/kg) and genetically by knockdown of Grin1 gene expression in mice, which have a 90% reduction in NMDAR levels (Grin1 knockdown [Grin1-KD]). After intraperitoneal injections of vehicle, haloperidol (0.15 mg/kg), UNC9994 (0.25 mg/kg), or their combination, mice were tested in open field, prepulse inhibition (PPI), Y-maze, and Puzzle box. Biochemical effects on the phosphorylation of Akt, glycogen synthase kinase-3 (GSK-3), and CaMKII in the prefrontal cortex (PFC) and striatum of MK-801-treated mice were assessed by western blotting.</p><p><strong>Results: </strong>Our findings indicate that low dose co-administration of UNC9994 and haloperidol reduces hyperactivity in MK-801-treated animals and in Grin1-KD mice. Furthermore, this dual administration effectively reverses PPI deficits, repetitive/rigid behavior in the Y-maze, and deficient executive function in the Puzzle box in both animal models. Pharmacological inhibition of NMDAR by MK-801 induced the opposite effects in the PFC and striatum on pAkt-S473 and pGSK3β-Ser9. Dual injection of haloperidol with UNC9994 reversed MK-801-induced effects on pAkt-S473 but not on pGSK3β-Ser9 in both brain structures.</p><p><strong>Conclusions: </strong>The dual administration of haloperidol with UNC9994 at low doses represents a promising approach to ameliorate symptoms of schizophrenia. The combined drug regimen elicits synergistic effects specifically on pAkt-S473, suggesting it as a potential biomarker for antipsychotic actions.</p>","PeriodicalId":14134,"journal":{"name":"International Journal of Neuropsychopharmacology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ying Zhang, Meinv Liu, Dongdong Yu, Jing Wang, Jianli Li
Background: Postoperative cognitive dysfunction (POCD) is a common neurological complication in older patients and correlated with adverse outcomes. 17β-estradiol treatment was reported to provide neuroprotective protection in various neurologic disorders, but whether it attenuated POCD was unknown. The purpose of this study was to explore the effects of 17β-estradiol treatment on POCD and its mechanisms.
Methods: We generated a POCD model in 15-month-old mice via laparotomy, followed by subcutaneous injection of 17β-estradiol, intraperitoneal injection of EX527 (a Sirtuin 1 [SIRT1] inhibitor), or bilateral hippocampal injection of miR-138-5p-agomir. Morris water maze test and open field test were applied to evaluate the cognitive function. The neuronal apoptosis in the hippocampus was detected using the terminal transferase dUTP nick end labeling assay. Meanwhile, the levels of interleukin-1β (IL-1β) and microglia activation were measured by enzymelinked immunosorbent assay and immunofluorescence, respectively. Western blot was utilized to assess the expression of SIRT1 and high mobility group box 1 (HMGB1) protein, and gene expression of miR-138-5p was determined through quantitative real-time polymerase chain reaction.
Results: Behavioral tests showed that 17β-estradiol treatment improved cognitive function in aged POCD mice. In addition, 17β-estradiol attenuated neuronal apoptosis and microglia activation as well as IL-1β expression in the hippocampus. Nonetheless, injection with EX527 abolished the beneficial impacts of 17β-estradiol against POCD. Furthermore, miR-138-5p was verified to bind with SIRT1, which regulated the expression of HMGB1. After treatment with 17β-estradiol, miR-138-5p expression was reduced in the hippocampus, and the neuroprotective influence of 17β-estradiol on aged POCD mice was reversed after administration of miR-138-5p-agomir.
Conclusions: 17β-estradiol treatment exerted neuroprotection effects on POCD in aged mice, which might be relevant to alleviating neuroinflammation via miR-138-5p/SIRT1/HMGB1 pathway.
{"title":"17β-Estradiol Ameliorates Postoperative Cognitive Dysfunction in Aged Mice via miR-138-5p/SIRT1/HMGB1 Pathway.","authors":"Ying Zhang, Meinv Liu, Dongdong Yu, Jing Wang, Jianli Li","doi":"10.1093/ijnp/pyae054","DOIUrl":"10.1093/ijnp/pyae054","url":null,"abstract":"<p><strong>Background: </strong>Postoperative cognitive dysfunction (POCD) is a common neurological complication in older patients and correlated with adverse outcomes. 17β-estradiol treatment was reported to provide neuroprotective protection in various neurologic disorders, but whether it attenuated POCD was unknown. The purpose of this study was to explore the effects of 17β-estradiol treatment on POCD and its mechanisms.</p><p><strong>Methods: </strong>We generated a POCD model in 15-month-old mice via laparotomy, followed by subcutaneous injection of 17β-estradiol, intraperitoneal injection of EX527 (a Sirtuin 1 [SIRT1] inhibitor), or bilateral hippocampal injection of miR-138-5p-agomir. Morris water maze test and open field test were applied to evaluate the cognitive function. The neuronal apoptosis in the hippocampus was detected using the terminal transferase dUTP nick end labeling assay. Meanwhile, the levels of interleukin-1β (IL-1β) and microglia activation were measured by enzymelinked immunosorbent assay and immunofluorescence, respectively. Western blot was utilized to assess the expression of SIRT1 and high mobility group box 1 (HMGB1) protein, and gene expression of miR-138-5p was determined through quantitative real-time polymerase chain reaction.</p><p><strong>Results: </strong>Behavioral tests showed that 17β-estradiol treatment improved cognitive function in aged POCD mice. In addition, 17β-estradiol attenuated neuronal apoptosis and microglia activation as well as IL-1β expression in the hippocampus. Nonetheless, injection with EX527 abolished the beneficial impacts of 17β-estradiol against POCD. Furthermore, miR-138-5p was verified to bind with SIRT1, which regulated the expression of HMGB1. After treatment with 17β-estradiol, miR-138-5p expression was reduced in the hippocampus, and the neuroprotective influence of 17β-estradiol on aged POCD mice was reversed after administration of miR-138-5p-agomir.</p><p><strong>Conclusions: </strong>17β-estradiol treatment exerted neuroprotection effects on POCD in aged mice, which might be relevant to alleviating neuroinflammation via miR-138-5p/SIRT1/HMGB1 pathway.</p>","PeriodicalId":14134,"journal":{"name":"International Journal of Neuropsychopharmacology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Antonina Luca, Maria Luca, Siegfried Kasper, Basilio Pecorino, Joseph Zohar, Daniel Souery, Stuart Montgomery, Panagiotis Ferentinos, Dan Rujescu, Antonino Messina, Raffaella Zanardi, Raffaele Ferri, Mariangela Tripodi, Bernhard T Baune, Giuseppe Fanelli, Chiara Fabbri, Julien Mendlewicz, Alessandro Serretti
Background: Anhedonic features within major depressive disorder (MDD) have been associated with worse course and outcome and may predict nonresponse to treatment. However, a detailed clinical profile of anhedonia in MDD is still lacking.
Materials and methods: One thousand two hundred ninety-four patients with MDD were selected from the cross-sectional European multicenter Group for the Study of Resistant Depression study. Anhedonia was assessed through the Montgomery-Åsberg Depression Rating Scale anhedonia item "inability to feel." Clinical and demographic features were then analyzed.
Results: The presence of anhedonia related to a distinct demographical (living alone) and clinical profile (thyroid diseases, diabetes, suicide risk, high number of previous depressive episodes, more severe MDD, and more frequent inpatient status). Furthermore, anhedonia was associated with nonresponse to treatment and treatment resistance, even after adjusting for confounding variables.
Conclusions: Our findings support the role of anhedonia as a modulating feature of MDD, being associated with a more severe depression profile. Moreover, anhedonic features are independent predictors of poor treatment response.
{"title":"Anhedonia is associated with a specific depression profile and poor antidepressant response.","authors":"Antonina Luca, Maria Luca, Siegfried Kasper, Basilio Pecorino, Joseph Zohar, Daniel Souery, Stuart Montgomery, Panagiotis Ferentinos, Dan Rujescu, Antonino Messina, Raffaella Zanardi, Raffaele Ferri, Mariangela Tripodi, Bernhard T Baune, Giuseppe Fanelli, Chiara Fabbri, Julien Mendlewicz, Alessandro Serretti","doi":"10.1093/ijnp/pyae055","DOIUrl":"10.1093/ijnp/pyae055","url":null,"abstract":"<p><strong>Background: </strong>Anhedonic features within major depressive disorder (MDD) have been associated with worse course and outcome and may predict nonresponse to treatment. However, a detailed clinical profile of anhedonia in MDD is still lacking.</p><p><strong>Materials and methods: </strong>One thousand two hundred ninety-four patients with MDD were selected from the cross-sectional European multicenter Group for the Study of Resistant Depression study. Anhedonia was assessed through the Montgomery-Åsberg Depression Rating Scale anhedonia item \"inability to feel.\" Clinical and demographic features were then analyzed.</p><p><strong>Results: </strong>The presence of anhedonia related to a distinct demographical (living alone) and clinical profile (thyroid diseases, diabetes, suicide risk, high number of previous depressive episodes, more severe MDD, and more frequent inpatient status). Furthermore, anhedonia was associated with nonresponse to treatment and treatment resistance, even after adjusting for confounding variables.</p><p><strong>Conclusions: </strong>Our findings support the role of anhedonia as a modulating feature of MDD, being associated with a more severe depression profile. Moreover, anhedonic features are independent predictors of poor treatment response.</p>","PeriodicalId":14134,"journal":{"name":"International Journal of Neuropsychopharmacology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}