Donepezil‐ or rivastigmine‐induced acetylcholinesterase inactivation is not modulated by neramexane in rat brain

Abstract

AbstractIn Alzheimer's disease (AD), the involvement of cholinergic deficit and overstimulation of N‐methyl‐D‐aspartate (NMDA) receptors by excessively released glutamate has been proposed. Since no existing drug currently addresses both pathologies, a combination therapy may be used clinically to target both mechanisms. The objective of the current study was to determine whether the NMDA receptor antagonist, neramexane affects the acetylcholinesterase (AChE) inhibition produced by donepezil and rivastigmine, two drugs used in the treatment of AD, or a prototype organophosphate compound diisopropylphosphorofluoridate (DFP) in rat cortex, hippocampus, striatum, and brainstem. Neramexane, at therapeutically relevant or higher doses (3.1, 6.2, or 12.4 mg/kg, ip), did not produce any apparent behavioral toxicity. Donepezil (0.75 mg/kg, ip), rivastigmine (0.35 mg/kg, ip) or DFP (1.5 mg/kg, ip) were administered at doses that produced approximately 50% inhibition of AChE and were well tolerated. Also, neramexane in combination with either of the AChE inhibitors did not produce any behavioral toxicity. This magnitude of AChE inhibition has been shown to increase extracellular acetylcholine (ACh) concentrations to therapeutically relevant levels. Neramexane (12.4 mg/kg) did not inhibit AChE activity in any of the brain regions tested when evaluated over a 24‐h period. Rats receiving neramexane alone or in combination with an AChE inhibitor (donepezil, rivastigmine, or DFP) were sacrificed 60 min after neramexane or DFP, 15 min after donepezil, and 30 min after rivastigmine administration. The times at which drug (donepezil, rivastigmine, or DFP) effects were assessed were based on maximal AChE inhibition established from previously reported time course studies. The current findings indicate that neramexane alone did not affect AChE activity at any dose tested nor did it influence the AChE inhibition produced by donepezil or rivastigmine in any brain region examined. However, a low dose of neramexane (3.1 mg/kg) significantly attenuated the inhibition of AChE produced by DFP in the hippocampus, striatum and brainstem, while higher doses (6.2 or 12.4 mg/kg) attenuated DFP‐induced AChE inhibition in all four of the brain regions evaluated. These results suggest that AChE inhibition produced by donepezil or rivastigmine is not altered by the co‐administration of neramexane. Drug Dev Res 68:253–260, 2007. © 2007 Wiley‐Liss, Inc.