Differential occupancy of somatodendritic and postsynaptic 5HT(1A) receptors by pindolol: a dose-occupancy study with [11C]WAY 100635 and positron emission tomography in humans

Neuropsychopharmacology. 2001 Mar;24(3):209-29. doi: 10.1016/S0893-133X(00)00187-1.

Abstract

Augmentation of selective serotonin reuptake inhibitors (SSRIs) therapy by the 5-HT(1A) receptor agent pindolol may reduce the delay between initiation of antidepressant treatment and clinical response. This hypothesis is based on the ability of pindolol to block 5-HT(1A) autoreceptors in the dorsal raphe nuclei (DRN) and to potentiate the increase in 5-HT transmission induced by SSRIs. However, placebo-controlled clinical studies of pindolol augmentation of antidepressant therapy have reported inconsistent results. Here, we evaluated the occupancy of 5-HT(1A) receptors during treatment with pindolol controlled release (CR) in nine healthy volunteers with Positron Emission Tomography and [11C]WAY 100635. Subjects were studied four times: at baseline, following one week of pindolol CR 7.5 mg/day (4 and 10 hrs post dose), and following one dose of pindolol CR 30 mg(4 hrs post dose). Occupancy of the DRN was 40 +/- 29% on scan 2, 38 +/- 26% on scan 3, and 64 +/- 15% on scan 4. The average occupancy in all other regions was significantly lower at each doses (18 +/- 5% on scan 2, 12 +/- 3% on scan 3, and 42 +/- 4% on scan 4). These results suggest that the blockade in the DRN reached in clinical studies (7.5 mg/day) might be too low and variable to consistently augment the therapeutic effect of SSRIs. However, these data indicate that pindolol exhibits in vivo selectivity for the DRN 5-HT(1A) autoreceptors. As DRN selectivity is desirable for potentiation of 5-HT function, this observation represents an important proof of concept for the development of 5-HT(1A) agents in this application.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Antidepressive Agents / therapeutic use
  • Brain / drug effects
  • Humans
  • Kinetics
  • Magnetic Resonance Imaging
  • Male
  • Mood Disorders / drug therapy*
  • Pindolol / administration & dosage
  • Pindolol / blood
  • Pindolol / pharmacology*
  • Pindolol / therapeutic use
  • Piperazines / blood
  • Piperazines / pharmacokinetics
  • Piperazines / therapeutic use*
  • Pyridines / blood
  • Pyridines / pharmacokinetics
  • Pyridines / therapeutic use*
  • Raphe Nuclei / metabolism*
  • Receptors, Neurotransmitter / physiology
  • Receptors, Serotonin / drug effects*
  • Receptors, Serotonin, 5-HT1
  • Selective Serotonin Reuptake Inhibitors / pharmacology*
  • Selective Serotonin Reuptake Inhibitors / therapeutic use
  • Synaptic Transmission / physiology
  • Tomography, Emission-Computed

Substances

  • Antidepressive Agents
  • Piperazines
  • Pyridines
  • Receptors, Neurotransmitter
  • Receptors, Serotonin
  • Receptors, Serotonin, 5-HT1
  • Serotonin Uptake Inhibitors
  • N-(2-(4-(2-methoxyphenyl)-1-piperazinyl)ethyl)-N-(2-pyridinyl)cyclohexanecarboxamide
  • Pindolol