Tolerance in the anxiolytic profile following repeated administration of diazepam but not buspirone is associated with a decrease in the responsiveness of postsynaptic 5-HT-1A receptors

To understand the role of serotonin (5-hydroxytryptamine; 5-HT)-1A receptors in the treatment of anxiety and the development of tolerance to benzodiazepines the present study was designed to monitor the responsiveness of postsynaptic 5-HT-1A receptors following repeated administration of diazepam and buspirone. Results show that tolerance in the anxiolytic profile is produced following repeated administration (2 weeks) of diazepam (2 mg/kg) but not buspirone (0.5 mg/kg). The behavioral effects of 8-OH-DPAT at a dose of 0.25 mg/kg were monitored 3 days after repeated administration of saline or buspirone or diazepam. The results show that 8-OH-DPAT elicited forepaw treading was smaller in repeated diazepam but not repeated buspirone injected rats, while hyperlocomotive effects of 8-OH-DPAT were smaller in both repeated buspirone and repeated diazepam injected rats. The results suggest that postsynaptic 5-HT-1A receptor-dependent responses were attenuated following long-term administration of diazepam but not buspirone. Role of 5-HT-1A receptors in the development of tolerance to the anxiolytic effects of diazepam but not buspirone is discussed.     

Relations between anxiolytic effects of diazepam and changes in the EEG spectral power

The influence of diazepam (1; 5; 10 mg/kg, i. p.), chlorpromazine (1 mg/kg) and amphetamine (1; 5 mg/kg) on the Fourier's spectral EEG power of sensomotor cortex and dorsal hippocampus and conflict behavior freely moving albino and cotton (Sigmondon hispidus) rats was studied. Effects of diazepam (5 mg/kg) in cotton rats were similar, but influence on the theta-activity was more expressed. Correlation between slowing of theta-activity and extent of anxiolytic effect in conflict situation was showed. On the basis of the results obtained the authors discuss possible mutual relations between the influence of diazepam on EEG and anxiolytic effect of benzodiazepines.     

The phenomenon of one-trial tolerance to the anxiolytic effect of chlordiazepoxide in the elevated plus-maze test is abolished by previous administration of chlordiazepoxide or buspirone

It has been repeatedly reported that the anxiolytic action of benzodiazepines in the elevated plus-maze test is abolished in rats that have received a single prior experience of the test apparatus (one-trial tolerance effect). To analyze whether the one-trial tolerance effect of chlordiazepoxide can be influenced by administration of chlordiazepoxide or buspirone on trial 1, male Wistar rats received an IP injection of vehicle, chlordiazepoxide (8 mg/kg) or buspirone (2.5 mg/kg) 30 min. before testing for 5 min. in the plus-maze (trial 1). Seventy-two hours later, the rats received vehicle or chlordiazepoxide 30 min. before the re-exposure to the plus-maze for 5 min. (trial 2). Groups injected with chlordiazepoxide or buspirone on trial 1 and with chlordiazepoxide on trial 2 showed an anxiolytic effect of chlordiazepoxide on trial 2, as opposed to rats injected with vehicle on trial 1 and with chlordiazepoxide on trial 2. As opposed to previous studies, the present results suggest that the influence of prior experience with the plus-maze on the anxiolytic action of chlordiazepoxide during re-exposure seems to depend critically on the drug state in which trial 1 is experienced. These results are discussed with respect to the hypothesis proposed to explain the phenomenon of one-trial tolerance.     

Effect of withdrawal of diazepam or morphine treatment on gastric motility (charcoal meal test) in mice: possible role of different central and peripheral receptors

Increased gastrointestinal motility in mice as one of the withdrawal symptoms of commonly abused drugs like diazepam or morphine and its possible mechanism of action was studied. Male Laka mice (20-25 g) were made addict to either diazepam (20 mg/kg, ip for 7 days) or morphine (10 mg/kg, sc for 9 days). Withdrawal symptoms were noted 24 hr after the last injection of diazepam or morphine. The animals were injected with Ro 15-1788 (flumazenil) (1 mg/kg, ip) or naloxone (2 mg/kg, ip) in the respective group to precipitate the withdrawal symptoms. Gastrointestinal motility was assessed by charcoal-meal test. Animals developed tolerance to acute sedative effect of diazepam, and similarly to the acute nociceptive action of morphine. On abrupt cessation of these drugs after chronic treatment the animals showed hyperlocomotion and hyperreactivity in diazepam withdrawal group and hyperalgesia on hot plate in morphine withdrawal groups, respectively. Increase in gastrointestinal motility was observed in all the drug withdrawal groups. Treatment with respective antagonists, Ro 15-1788 (flumazenil) and naloxone precipitated the withdrawal symptoms. The results suggest the involvement of both central and peripheral receptors of benzodiazepines and opioid (mu) receptors in the withdrawal symptoms of the benzodiazepines and morphine, respectively.     

6-Methyl-3'-bromoflavone, a high-affinity ligand for the benzodiazepine binding site of the GABA(A) receptor with some antagonistic properties.

6-Methyl-3'-bromoflavone inhibited [(3)H]flunitrazepam binding to the benzodiazepine binding site of the GABA(A) receptor (BDZ-bs) with Ki values between 10 and 50 nM in different brain regions.The GABA ratio of 1.03 for [(3)H]flunitrazepam binding to cerebral cortex, 0.76 for cerebellum, 0.7 for hippocampus, 0.7 for striatum, and 0.8 for spinal cord indicated an antagonistic or weak inverse agonistic profile of 6-methyl-3'-bromoflavone on BDZ-bs. Unlike classical benzodiazepines, it had no anticonvulsant, anxiolytic, myorelaxant, sedative, amnestic or motor incoordination effects. However, it antagonized the muscle relaxant, the sedative effect, and the changes in locomotor activity induced by diazepam. Taken together, these findings suggest that 6-methyl-3'-bromoflavone has an antagonistic profile on the BDZ-bs.     

GABA(A) Receptor α Subunits Differentially Contribute to Diazepam Tolerance after Chronic Treatment

Background

Within the GABA_A-receptor field, two important questions are what molecular mechanisms underlie benzodiazepine tolerance, and whether tolerance can be ascribed to certain GABA_A-receptor subtypes.

Methods

We investigated tolerance to acute anxiolytic, hypothermic and sedative effects of diazepam in mice exposed for 28-days to non-selective/selective GABA_A-receptor positive allosteric modulators: diazepam (non-selective), bretazenil (partial non-selective), zolpidem (α₁ selective) and TPA023 (α_2/3 selective). In-vivo binding studies with [³H]flumazenil confirmed compounds occupied CNS GABA_A receptors.

Results

Chronic diazepam treatment resulted in tolerance to diazepam''s acute anxiolytic, hypothermic and sedative effects. In mice treated chronically with bretazenil, tolerance to diazepam''s anxiolytic and hypothermic, but not sedative, effects was seen. Chronic zolpidem treatment resulted in tolerance to diazepam''s hypothermic effect, but partial anxiolytic tolerance and no sedative tolerance. Chronic TPA023 treatment did not result in tolerance to diazepam''s hypothermic, anxiolytic or sedative effects.

Conclusions

Our data indicate that: (i) GABA_A-α₂/α₃ subtype selective drugs might not induce tolerance; (ii) in rodents quantitative and temporal variations in tolerance development occur dependent on the endpoint assessed, consistent with clinical experience with benzodiazepines (e.g., differential tolerance to antiepileptic and anxiolytic actions); (iii) tolerance to diazepam''s sedative actions needs concomitant activation of GABA_A-α₁/GABA_A-α₅ receptors. Regarding mechanism, in-situ hybridization studies indicated no gross changes in expression levels of GABA_A α₁, α₂ or α₅ subunit mRNA in hippocampus or cortex. Since selective chronic activation of either GABA_A α₂, or α₃ receptors does not engender tolerance development, subtype-selective GABA_A drugs might constitute a promising class of novel drugs.     

RO 15-1788 selectively reverses antagonism of pentylenetetrazol-induced discriminative stimuli by benzodiazepines but not by barbiturates

The specificity of ethyl 8-fluro-5,6-dihydro-5-methyl-6-oxo-4H-imidazo (1,5-a) (1,4) benzodiazepine-3-carboxylate (RO 15-1788) in reversing the effectiveness of diazepam and des-methylclobazam, but not of pentobarbital, in antagonizing discriminative stimuli produced by pentylenetetrazol is described. Male hooded rats were trained to discriminate pentylenetetrazol-induced interoceptive discriminative-stimuli (IDS) in a two-lever choice paradigm on an FR10 schedule of food reinforcement. These IDS pharmacologically model verbal report of anxiogenic activity in humans. Diazepam (1,4 benzodiazepine), des-methylclobazam (1,5 benzo-diazepine), and pentobarbital antagonized pentylenetetrazol-IDS. RO 15-1788 neither generalized to nor antagonized pentylenetetrazol-IDS. It also did not cause convulsions in pentylenetetrazol sensitized rats at doses up to 40 mg/kg. It did, however, antagonize the action of diazepam (10 mg/kg) as well as that of des-methylclobazam (160 mg/kg) but not that of pentobarbital. These data suggest that RO 15-1788 is not an anxiomimetic, anxiolytic or a convulsant drug, but it is a specific and effective antagonist of anxiolytic action of benzodiazepines.     

Cortexolone as a modulator of diazepam activity

The influence of ACTH (200 micrograms/kg), corticosterone (20 mg/kg) and cortexolone (20 mg/kg) on the anxiolytic activity of diazepam was studied. ACTH partly and corticosterone completely blocked the action of diazepam. Cortexolone injection 30 min before the administration of diazepam induced a 100% anxiolytic effect of diazepam in the range of doses from 0.1 to 0.3 mg/kg (ED50 of anxiolytic diazepam effect is 0.2 mg/kg). The role of stress hormones in the regulation of psychotropic drug activity is discussed.     

Inhibition of rat brain adenylate cyclase activity by benzodiazepine through the effects on Gi and catalytic proteins

The effect of benzodiazepines on adenylate cyclase system was examined in rat brain. Micromolar concentrations of diazepam inhibited the enzyme activity in synaptic membranes in dose- and time-dependent manners. The inhibitory effect of diazepam was more evident on the enzyme activity in the presence of guanylyl-5'-imidodiphosphate (GppNHp) or NaF-AlCl3 than on that in the basal state. In the pertussis toxin-treated membranes, the effect of diazepam in the presence of GppNHp or NaF-AlCl3 was markedly suppressed. In addition, other benzodiazepines, such as medazepam, flurazepam, flunitrazepam, and clonazepam, had similar effects to those of diazepam, whereas Ro15-1788, an antagonist of a high affinity receptor in the central nervous system, had no effect on adenylate cyclase activity and did not antagonize the effect of diazepam. These findings indicate that benzodiazepines inhibit rat brain adenylate cyclase activity through the effects on both a low affinity benzodiazepine receptor coupled with the inhibitory GTP-binding regulatory protein (Gi) and catalytic protein.     

Mechanism of the tranquilizing action of electron structural analogs of nicotinamide

The interaction of nicotinamide and its electron structural analogs (NMF and AzN compounds) with central benzodiazepine receptor antagonist Ro 15-1788 and GABA-ergic system antagonist bicuculline were studied in a conflicting situation test. NMF and AzN behaved as the agonists of GABA-benzodiazepine receptor complex. Like in diazepam, the anxiolytic effects of benzodiazepines and nicotinamide was prevented by bicuculline and Ro 15-1788. The given compounds were shown to be more active, than nicotinamide.     

Stereoselective stimulus effects of 3-methylflunitrazepam and pentobarbital

Rats trained to discriminate 3.0 mg/kg of diazepam from saline in a two-lever operant choice task were challenged with the racemic mixture and optical isomers of 3- methylflunitrazepam or pentobarbital. Generalization of the diazepam stimulus was found to occur to (+/-)- and S(+)-3- methylflunitrazepam , with the S(+)-isomer being twice as active as the racemate. Diazepam stimulus generalization also occurred to (+/-)-, S(-)-, and R(+)-pentobarbital, with the S(-)-isomer being approximately twice as active as (+/-)- or R(+)-pentobarbital. In addition, the administration of the imidazobenzodiazepine Ro 15-1788, a selective benzodiazepine receptor antagonist, prior to benzodiazepine or barbiturate administration competitively antagonized the discriminative stimulus properties of the benzodiazepines but was completely ineffective in attenuating the discriminative stimulus effect of the barbiturates. The results of this study suggest that benzodiazepines exert their stimulus effects by a stereoselective interaction at a benzodiazepine receptor and that stereochemical factors are important in evaluating the stimulus properties of benzodiazepines or barbiturates.     

The effect of a novel pentadecapeptide BPC 157 on development of tolerance and physical dependence following repeated administration of diazepam

A novel gastric pentadecapeptide BPC 157 with different beneficial activities and anticonvulsant effect interacting with GABAergic system could improve diazepam efficacy coadministered (10 microg/kg, 10 ng/kg i.p.) with diazepam (5.0 mg/kg i.p.) twice daily for 10 days, since diazepam chronic medication would otherwise predispose for diazepam- tolerance/withdrawal development (shorter latency to convulsion after convulsant). In diazepam chronically treated mice, it attenuated diazepam tolerance (provoked by later acute administration of diazepam together with convulsant) and postponed physical dependence/withdrawal effects (provoked by later administration of isoniazid). In tolerance assay, at 42 h after the end of conditioning regimen, shorter preconvulsive latencies than in healthy (non-diazepam conditioned) mice following isoniazid (800 mg/kg i.p.) (as hallmark of tolerance) were observed if diazepam (5.0 mg/kg i.p.) was again given acutely to mice previously conditioned with diazepam alone (use of picrotoxin 3.0 mg/kg i.p., as convulsant, with acute application of diazepam in previously diazepam conditioned mice did not lead to tolerance hallmark). This was completely avoided in diazepam+BPC 157 10 microg or diazepam+BPC 157 10 ng chronically treated animals. In physical dependence assay (isoniazid challenge assessed at 6, 14, 42 and 72 h after conditioning medication), when compared to diazepam non-conditioned healthy mice, in diazepam conditioned mice residual anticonvulsive activity was not present already at the earliest post-conditioning interval (i.e., not different latency to isoniazid-convulsions), whereas shorter preconvulsive latencies (as physical dependence/withdrawal hallmark) were noted in diazepam conditioned mice following isoniazid challenge at 42 h and at 72 h after end of conditioning treatment. In diazepam+BPC 157 10 microg- conditioned mice, a residual anticonvulsive activity (i.e., longer latency to isoniazid convulsion) was noted at 6 h post-conditioning, whereas shorter preconvulsive latencies appeared only at 72 h-post-conditioning period. In conclusion, taken together these data (lack of tolerance development (tolerance studies), prolonged residual anticonvulsive activity, and postponed physical dependence/withdrawal hallmark in diazepam+BPC 157 chronically treated mice) with common benzodiazepines tolerance/withdrawal knowledge, it could be speculated that BPC 157 acts favoring the natural homeostasis of the GABA receptor complex as well as enhancing the GABAergic transmission, and having a mechanism at least partly different from those involved in diazepam tolerance/withdrawal, it may be likely used in further therapy of diazepam tolerance and withdrawal.     

Benzodiazepines attenuate single unit activity in the locus coeruleus

Several classes of anxiolytic compounds have the common effect of decreasing the firing of noradrenergic neurons or attenuating the post- synaptic effects of noradrenergic activity. In order to determine whether the benzodiazepines, the most widely used anxiolytics, also decrease noradrenergic activity, the effect of acute intravenous injections of diazepam (0.1–2.0 mg/kg) and chlordiazepoxide (0.5–4.0 mg/kg) were administered to anesthetized rats while spontaneous activity of single neurons in the principal noradrenergic nucleus, the locus coeruleus, was recorded. Diazepam and chlordiazepoxide decreased spontaneous single unit activity in the locus coeruleus at relatively low doses. This net effect on noradrenergic systems is consistent with the actions of several classes of nonbenzodiazepine anxiolytics, and with the involvement of noradrenergic systems in the neural mechanisms of anxiety.     

A change in the alarm level entails a change in behavioural strategy of mice in stress and a change in analgesia induced by it

The effects of anxiogenic (pentylentetrazole) and anxiolytic (diazepam) agents on and cold swim stress-induced analgesia were investigated in SHR and NMRI male mice. It was shown that behavioral response to acute stress was associated with a change in the pain tolerance threshold. Diazepam increased immobility time and attenuated stress-induced analgesia (SIA). NMRI mice were more responsive to anxiolytic than the SHR mice, but the lattes manifested more dramatic changes when anxiety was pharmacologically enhanced (immobility time was significantly reduced and the SIA exaggerated). Our findings suggest that the main parameters change in reciprocal manner following a pharmacologically altered anxiety, and reveal that differences between two strains of mice are determined by differences in their sensitivity to stress.     

Anxiolytic effects of Equisetum arvense Linn. extracts in mice

The petroleum ether (PE), chloroform (CH), ethanol (ETH) and water extracts of E. arvense stems were evaluated for anti-anxiety activity in mice using elevated plus maze model. Ketamine induced hypnosis and actophotometer was used to evaluate sedative effect with various extracts in mice. The results were compared with standard drug diazepam. The ethanolic extract of E. arvense (50 and 100 mg/kg) significantly increased the time-spent and the percentage of the open arm entries in the elevated plus-maze model which was comparable to diazepam. Ethanolic extract (100 mg/kg) prolonged the ketamine-induced total sleeping time and decreased the locomotor activity in mice. The results suggest that the ethanolic extract of E. arvense seems to possess anxiolytic effect with lower sedative activity than that of diazepam. The results could be attributed to the flavonoid content of the ethanolic extract.     

Increases in plasma corticosterone and stretched-attend postures in rats naive and previously exposed to the elevated plus-maze are sensitive to the anxiolytic-like effects of midazolam

A single exposure to the elevated plus-maze test (EPM) reduces or abolishes the anxiolytic efficacy of benzodiazepines on a second trial. This phenomenon known as one-trial tolerance (OTT) is considered to be due to a shift in the emotional state of the animals across the test/retest sessions. Activation of the hypothalamic-pituitary-adrenocortical (HPA) axis has been considered to be an adaptive response to stressful or challenging situations such as height and openness of the EPM. This work looks at the phenomenon of OTT to the benzodiazepine compound midazolam through the conjoint examination of the novel ethological measures of the EPM and adrenocortical response of rats exposed to single and repeated sessions of the EPM. The results obtained confirmed that the approach/avoidance conflict on the first trial of the EPM is very sensitive to the anxiolytic effects of benzodiazepines. Moreover, stressful stimuli present upon initial exposure to the EPM render the standard measures of the EPM resistant to the anxiolytic effects of benzodiazepines on retest. However, the increases in plasma corticosterone and in risk assessment behavior observed in rats submitted to single or repeated sessions in the EPM were reversed by pretreatment with midazolam. The administration of metyrapone, a glucocorticoid synthesis blocker, decreased risk assessment but did not affect locomotion and anxiety-like behaviors. It is suggested that the detection of the dangerous environment through the stretched-attend postures in the second trial leads to the known low level of exploration and the consequent OTT upon retest. Moreover, in view of the similarity between the risk assessment and plasma corticosterone patterns in both naive and experienced rats, this hormone-behavior profile may be crucial for the expression of OTT to benzodiazepines in rodents exposed to the EPM.     

Effect of honokiol on activity of GAD65 and GAD67 in the cortex and hippocampus of mice

Honokiol, an active agent extracted from magnolia bark, has been reported that induces anxiolytic action in a mouse elevated plus-maze test. However, the mechanism of anxiolytic action induced by honokiol remains unclear. This study was to investigate the change in two forms of glutamic acid decarboxylase (GABA synthesized enzymes) GAD₆₅ and GAD₆₇ in the cortex and hippocampus areas while the anxiolytic actions induced by chronic administration of honokiol in mice. Mice treated with 7 daily injection of honokiol (1 mg/kg, p.o.) caused anxiolytic action which was similar to that was induced by 7 daily injection of diazepam (2 mg/kg, p.o.) in the elevated plus-maze test. In addition, the activity of hippocampal GAD₆₅ of honokiol treated mice was significantly increased than that of the vehicle or diazepam treated groups. These data suggest that honokiol causes diazepam-like anxiolytic action, which may be mediated by altering the synthesis of GABA in the brain of mice.     

Anticonflict properties of the dipeptide Litoralon and of diazepam in rats

The anticonflict properties of the anxiolytic diazepam and of the dipeptide Litoralon gamma-L-glutamyl-taurine and two of its analogues SZJ 3388, gamma-aminobutyryl-ethanolamine phosphate, and SZJ 3361, D-1-aminoisobutyrylethanolamine phosphate have been investigated in a "time-to-emerge" conflict paradigm in non-deprived rats. Diazepam, Litoralon and compound SZJ 3388 significantly decreased the "time-to-emerge" latency (TTE latency) in a dose-dependent manner versus saline- or vehicle-treated controls in doses between 0.05 and 0.50 mg/kg intraperitoneally. The analogue SZJ 3361 was inactive as regards the TTE latency, while the anti-histaminic promethazine lengthened the TTE latency in a dose-dependent manner. The number of irresolute responses was significantly decreased following administration of diazepam, SZJ 3388 and Litoralon and was positively correlated with the TEE latency-decreasing activity of these compounds. The data are discussed in terms of the benzodiazepine-like anxiolytic or anti-conflict properties of these dipeptides.     

Gabamimetic properties of anxiolytic drugs

Diazepam (5 mg/kg, ip) and tracazolate (40 mg/kg, ip), a nonbenzodiazepine anxiolytic, blocked electrically-induced head-turning without producing sedation. Bicuculline and picrotoxin, GABA antagonists, at doses not affecting head-turning (2 mg/kg, ip) antagonized the effects of diazepam and tracazolate on head-turning. However, at the same dose, bicuculline was more effective as an antagonist of diazepam whereas picrotoxin was more effective as an antagonist of tracazolate. These results suggest that benzodiazepine as well as nonbenzodiazepine anxiolytics possess GABAmimetic activity. The difference in potency between bicuculline and picrotoxin as antagonists of diazepam and tracazolate may be related to their reported differences as GABA antagonists (e.g., site of receptor interaction).     

Increase of natural benzodiazepines in wheat and potato during germination

Aqueous acid extracts of wheat grains and potato exhibit after HPLC separation a series of compounds that are able to inhibit the binding of benzodiazepines to benzodiazepine receptors of rat brain membranes. In wheat one of the inhibiting compounds was shown to be identical to diazepam by means of HPLC characterization and gas chromatography combined with mass spectrometry. In potato one of the most prominent components in terms of binding inhibiting activity was identified as lormetazepam. In wheat and potato germination increases total inhibiting activity of the whole plant extracts as well as the content of the benzodiazepines approximately by factor five. Because uptake of benzodiazepines from the surrounding was excluded these findings indicate the biosynthesis of the benzodiazepines diazepam and lormetazepam by the plants investigated.