Positive GABAA modulators and other sedatives, anxiolytics, and anticonvulsants were used to evaluate mechanisms underlying the discriminative stimulus effects of midazolam in untreated monkeys and of flumazenil in monkeys treated with diazepam (5.6 mg/kg/day). Positive GABAA modulators at benzodiazepine (e.g., flunitrazepam and abecarnil) and neuroactive steroid sites (e.g., androsterone) substituted for midazolam in all monkeys; the neuroactive steroids dihydroandrosterone and epipregnanolone substituted for midazolam in two of three monkeys. All positive GABAA modulators attenuated flumazenil in diazepam-treated monkeys; doses of flunitrazepam and abecarnil larger than doses substituting for midazolam were required to attenuate flumazenil, whereas doses of neuroactive steroids smaller than doses substituting for midazolam attenuated flumazenil. Drugs with mechanisms that do not predominantly involve allosteric modulation of GABA (e.g., buspirone, ketamine, valproic acid, and diphenhydramine) did not substitute for midazolam or flumazenil. However, valproic acid enhanced the midazolam discriminative stimulus and attenuated the flumazenil discriminative stimulus; diphenhydramine attenuated the midazolam discriminative stimulus. These results suggest that drugs not sharing a mechanism of action with benzodiazepines can modulate the behavioral effects of benzodiazepines. In addition, this study demonstrates that endogenous ligands, presumably by acting at neuroactive steroid sites on the GABAA receptor complex, share discriminative stimulus effects with benzodiazepines. This study also suggests that positive GABAA-modulating neuroactive steroids are especially potent in attenuating behavioral effects that are related to diazepam withdrawal.

译文

使用阳性GABAA调节剂和其他镇静剂,抗焦虑药和抗惊厥药来评估未治疗的猴子中的咪达唑仑和用地西epa (5.6 mg/kg/天) 治疗的猴子中的氟马西尼的鉴别性刺激作用的潜在机制。在所有猴子中,苯二氮卓 (例如氟硝西泮和阿贝卡尼尔) 和神经活性类固醇位点 (例如雄酮) 的GABAA调节剂阳性取代了咪达唑仑; 在三只猴子中的两只猴子中,神经活性类固醇二氢雄酮和表pregnanolone取代了咪达唑仑。在地西epa治疗的猴子中,所有阳性的GABAA调节剂均减弱了氟马西尼; 氟硝西泮和阿贝卡尼的剂量大于替代咪达唑仑的剂量,以减弱氟马西尼,而神经活性类固醇的剂量小于替代咪达唑仑的剂量则减弱了氟马西尼。具有主要不涉及GABA变构调节机制的药物 (例如丁螺环酮,氯胺酮,丙戊酸和苯海拉明) 不能替代咪达唑仑或氟马西尼。但是,丙戊酸增强了咪达唑仑的判别性刺激并减弱了氟马西尼判别性刺激; 苯海拉明减弱了咪达唑仑判别性刺激。这些结果表明,与苯二氮卓类药物不具有作用机制的药物可以调节苯二氮卓类药物的行为作用。此外,这项研究表明,内源性配体可能通过在GABAA受体复合物上的神经活性类固醇位点起作用,与苯二氮卓类药物具有歧视性刺激作用。这项研究还表明,积极的GABAA调节神经活性类固醇在减轻与地西epa戒断相关的行为作用方面尤其有效。

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