Serotonin Reuptake Inhibitor Clomipramine Research Articles

Evaluating the Role of the Serotoninergic System in the Control of Human Seminal Vesicle Smooth Muscle—An in Vitro Approach

It has been suggested that serotonin re-uptake inhibitors (SRIs) may retard the ejaculatory response by acting directly on the seminal vesicle (SV) and ductus deferens smooth muscle. However, until now, only a very few experimental studies have investigated such potential local (peripheral) effects. To elucidate the effects of serotonin (5-HT) and the SRIs clomipramine, fluoxetine and imipramine on the tension induced by norepinephrine (NE) of isolated human SV smooth muscle, as well as on the production of tissue cyclic AMP and cyclic GMP. To measure the inhibition exerted by serotonin and SRIs clomipramine, fluoxetine, and imipramine on the contractile response of isolated SV tissue. In addition, the effects of the drugs on the turn-over of cyclic nucleotides cAMP and cGMP were also elucidated. The effects of the cumulative addition of serotonin and the SRIs clomipramine, fluoxetine and imipramine (1 nM-10 microM) on the tension induced by the alpha(1)-adrenoceptor agonist NE (10 microM) of SV strip preparations were studied using the organ bath technique. Cyclic AMP and cyclic GMP were measured by means of specific radioimmunoassays. The tension induced by NE was dose-dependently reversed by the drugs tested. The rank order of efficacy was: imipramine > or = fluoxetine > or = clomipramine > serotonin. Mean reversion of tension was measured between 66 +/- 6.6% and 52 +/- 6.6%. These effects were paralleled by a 1.3-fold to 2.7-fold increase in tissue cAMP in response to exposure to the drugs. In contrast, no significant enhancement in cGMP was noted. The findings, for the first time, present evidence that SRIs may antagonize the sympathetic contraction of SV smooth muscle via stimulation of tissue cyclic AMP.

Abnormal neuroendocrine response to clomipramine in hereditary affective psychosis

Blunting of prolactin response after serotonergic stimulation during a major depressive episode has been described by several investigators. In this study, the neuroendocrine responses to clomipramine were assessed in remitted patients suffering from hereditary depression. Twenty remitted patients from 11 large families with multigenerational, multiple cases of major affective disorder (bipolar disorder n=15, recurrent depression n=5, according DSM-IV) and 12 healthy relatives were investigated. After intravenous application of 12.5 mg of the serotonin re-uptake inhibitor clomipramine, serum prolactin and cortisol levels were analysed. Patients and comparison group did not differ significantly with respect to age, baseline prolactin and cortisol concentrations. A gender effect was found in an exploratory analysis for prolactin but not for cortisol and therefore the data for prolactin were analysed separately. After clomipramine infusion, the increase of cortisol was significantly lower in patients than in the comparison group (P=.046). For prolactin, this effect could be found in the male (P=.012) as well as in the female (P=.007) subsample. These results suggest that blunted prolactin and cortisol responses to serotonergic stimulation are characteristic for remitted depressive patients with previous episodes of major affective disorders.

Influence of synaptic serotonin level on [ 18F]altanserin binding to 5HT 2 receptors in man

The feasibility of in vivo serotonin 5HT 2 receptor binding measurement using [ 18F]altanserin as a radioligand has been well established. In this study, the postsynaptic receptor binding potential of this ligand was examined as a possible indicator of synaptic serotonin content after pharmacological challenge. Studies were performed in 11 subjects with a history of recurrent major depression. Six of them received serotonergic antidepressive treatment at the time of the experiment, the other five patients were untreated. Two PET measurements were carried out in each subject within 2 or 3 days. Before one of the measurements, 25 mg of the serotonin re-uptake inhibitor clomipramine were given intravenously, the other measurement was done without pharmacological challenge. The data were analyzed using non-linear least-square regression and Logan's graphical method. In the whole group of subjects, binding potential and distribution volume of altanserin decreased following clomipramine challenge. The decrease was between 14 ( P=0.03) and 23% ( P=0.004). This effect was mainly seen in subjects not on antidepressive medication. Clomipramine challenge probably increased the synaptic serotonin level, which competed with altanserin leading to the lowered binding potential. The paradigm might, thus, be useful to estimate serotonin release in vivo. Pretreatment with serotonergic antidepressants reduces the effect of clomipramine.

Correlations between serotonin level and single-cell firing in the rat's nucleus raphe magnus

The relation between serotonin release and electrical activity was examined in the nucleus raphe magnus of rats anesthetized with pentobarbital. Serotonin levels were monitored through a carbon-fiber microelectrode by fast cyclic voltammetry (usually at 1 Hz). Single-cell firing was recorded through the same microelectrode, except during the voltammetry waveform and associated electrical artifact (totaling about 30 ms). Multi-barrel micropipettes incorporating the voltammetry electrode were used for iontophoresis of drugs. Cells were inhibited, excited or unaffected by noxious mechanical skin stimulation. These were respectively designated as off(M) cells, on(M) cells and neutral(M) cells, M denoting mechanical. During 3 min of pinching, serotonin slowly rose near seven of 14 on(M) cells and 26 of 46 off(M) cells; it fell near two off(M) cells; it was unchanged near all other cells, including six neutral(M) cells. On a finer spatiotemporal scale, near four of seven on(M) cells, 10 of 14 off(M) cells and 0 of four neutral(M) cells, average serotonin levels fell significantly within ±100 ms of spontaneous spikes. Lower serotonin may have caused the higher spike probability; the converse is theoretically unlikely, since delays between release and detection are estimated to exceed 100 ms. Increased serotonin and decreased firing were always seen following iontophoresis or intravenous injection (1 mg/kg) of the serotonin re-uptake inhibitor clomipramine ( n=7). Iontophoresis of ±propranolol, whose serotonergic actions include antagonism and partial agonism at 5-HT1 receptors, also increased serotonin and decreased firing ( n=4). Methiothepin (intravenous, 1 mg/kg), whose serotonergic actions include 5-HT1 and 5-HT2 antagonism, typically raised serotonin levels (four of five cells) and always blocked inhibition by clomipramine ( n=3). Iontophoresis of glutamate always lowered serotonin and increased firing ( n=4). Since serotonin levels and firing were usually inversely correlated, except near on(M) cells during pinch, we propose that serotonin is released from terminals of incoming nociceptive afferents. Prior neuroanatomical knowledge favors a midbrain origin for these afferents, while some of the drug findings suggest that their terminals possess inhibitory serotonergic autoreceptors, possibly of 5-HT1b subtype. The released serotonin could contribute to the inhibition of off(M) cells and excitation of on(M) cells by noxious stimulation, since inhibitory 5-HT1a receptors and excitatory 5-HT2 receptors, respectively, have previously been shown to dominate their serotonergic responses.

Treatment of depersonalization disorder with clomipramine

Background: Although there is a dire paucity of data on the pharmacologic treatment of depersonalization disorder, there have been a few reports in the literature suggesting that selective serotonin reuptake inhibitors may be of therapeutic benefit. In this study, we undertook to evaluate the efficacy of the potent serotonin reuptake inhibitor clomipramine in treating depersonalization. Methods: Eight subjects with DSM-III-R depersonalization disorder were entered into a double-blind crossover trial consisting of 8 weeks desipramine and 8 weeks clomipramine. Due to the very small size of the trial findings are presented descriptively. Results: Of 7 subjects who entered the clomipramine trial, two showed significant improvement in depersonalization. Three subjects dropped out early, unable to tolerate adverse effects. Of 6 subjects who entered the desipramine trial, 1 showed significant improvement in depersonalization. One clomipramine responder was subsequently followed in open maintenance treatment with clomipramine for 4 years, and her depersonalization symptoms remained in almost complete remission, with relapses upon each attempt to taper off or switch medication. Conclusions: Clomipramine may be a promising pharmacologic treatment for primary depersonalization disorder and warrants further investigation.

Long-term effects on serotonin transporter mRNA expression of chronic neonatal exposure to a serotonin reuptake inhibitor

Chronic administration of clomipramine or other serotonin (5-hydroxytryptamine, 5-HT) reuptake inhibitors to neonatal rats produces behaviours that resemble a depressive state in the adult animal, and this model is therefore regarded as a putative animal model of depression. Alterations in the activity of the central 5-HT system are important in understanding the pathophysiology of depression, and therefore, we examined whether this model was associated with changes in the expression of 5-HT 1A receptor, 5-HT 1B receptor, and 5-HT transporter mRNA in the dorsal raphe nucleus and the hippocampus. Wistar rats were injected twice daily with the serotonin reuptake inhibitors clomipramine and 5-chloro-1-[3-(dimethylamino)propyl]-1-(4-fluoro-phenyl)-1,3-dihydroiso-benzofurane, hydrochloride (code Lu 10-134-C) at doses of 15 mg kg −1 or vehicle i.p. from postnatal day 8 for 14 days. Groups of rats ( n=10) were either killed the day after the last injection or left undisturbed for 69 days before they were killed. The expression of 5-HT transporter, 5-HT 1A receptor, and 5-HT 1B receptor mRNA was examined in the dorsal raphe nucleus and in the CA1 of the hippocampus by means of quantitative in situ hybridisation histochemistry. Both compounds resulted in an increase in 5-HT transporter mRNA expression (40% more than vehicle) in the dorsal raphe nucleus the day after the last injection (postnatal day 22). A small but significant increase in 5-HT 1B receptor mRNA expression in the CA1 was seen after clomipramine, but not after Lu 10-134-C, probably reflecting clomipramine's affinity for both the 5-HT and noradrenaline transporters as well as for a number of monoamine receptor sites. Levels of 5-HT 1A receptor mRNA were unchanged. In contrast, 5-HT transporter mRNA expression in the dorsal raphe nucleus was significantly decreased in the adult after neonatal treatment with either of the two drugs compared to vehicle. No changes in 5-HT 1A receptor and 5-HT 1B receptor mRNA expression were observed in any of the regions examined in these animals. The results show that the persistent depressive behaviour previously shown in this model is also associated with changes in the expression of 5-HT transporter mRNA. This long-term alteration in gene expression may result from disturbances in 5-HT neurotransmission in the brain of the neonatal animals.

Effects of tricyclic antidepressants on mechanosensitive pelvic nerve afferent fibers innervating the rat colon

The aim of this study was to examine the effects of tricyclic antidepressants on responses of mechanosensitive afferent fibers innervating the rat colon. A total of 53 fibers in the decentralized S1 dorsal root were studied. The effects of the non-specific monoamine reuptake inhibitor imipramine (IMI), the noradrenaline reuptake inhibitor desipramine (DES), and the serotonin reuptake inhibitor clomipramine (CLO) were tested on responses of 22 mechanosensitive afferent fibers to noxious colorectal distension (CRD; 80 mmHg). Cumulative doses of 16 mg/kg of IMI, DES and of CLO reduced responses to noxious CRD to a mean 20%, 22% and 46% of control, respectively. The mean inhibitory doses of the three antidepressants did not differ significantly. Inhibitory effects were independent of potential effects on neurotransmitter reuptake: the effects of IMI and DES were not blocked by the adrenoreceptor antagonist phentolamine, and the effects of IMI and CLO were not affected by the serotonin receptor antagonist metergoline. Attenuation of afferent nerve activity was not mimicked by the anticholinergic glycopyrrolate; the cholinesterase inhibitor neostigmine did not attenuate the effect of IMI on responses to noxious CRD. Interestingly, the opioid receptor antagonist naloxone partially reversed the effects of IMI, and the NMDA receptor channel blocker MK-801 enhanced the inhibitory effects of DES and CLO. These results document that responses of mechanosensitive pelvic nerve afferent fibers to noxious CRD are significantly attenuated by tricyclic antidepressants, a peripheral action that may contribute to the beneficial effects of tricyclic antidepressants in treatment of irritable bowel syndrome.

The effects of age, gender, and season on serotonergic function in healthy subjects

1. 1. Several factors, including age, gender, and season of the year, have been reported to affect physiologic indices of central serotonergic function, although some of these findings have not been consistent across groups of subjects and types of serotonergic measures. 2. 2. The authors investigated the role that each of these variables might play in the neuroendocrine response to acute intravenous challenge with the serotonin reuptake inhibitor clomipramine (CMI) in healthy volunteers. 3. 3. Thirty seven healthy subjects (17 women and 20 men), with an age range of 19 to 50 years, received 12.5 mg of CMI intravenously under standardized conditions. 4. 4. The maximum change from baseline in plasma prolactin concentrations (“delta-max”) was significantly related to age, after controlling for gender and season. 5. 5. In contrast, neither gender nor season was significantly related to prolactin delta-max, after controlling for the other two variables. 6. 6. Although the age range and sample size are relatively limited, the results from this study suggest that age, but not gender or season, may influence serotonergic function, as measured by the prolactin response to CMI challenge.

The serotonin reuptake inhibitor clomipramine markedly reduces premenstrual irritability and dysphoria in women suffering from premenstrual syndrome

The serotonin reuptake inhibitor clomipramine markedly reduces premenstrual irritability and dysphoria in women suffering from premenstrual syndrome