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Use-dependent inhibition of synaptic transmission by the secretion of intravesicularly accumulated antipsychotic drugs
Authors:Tischbirek Carsten H  Wenzel Eva M  Zheng Fang  Huth Tobias  Amato Davide  Trapp Stefan  Denker Annette  Welzel Oliver  Lueke Katharina  Svetlitchny Alexei  Rauh Manfred  Deusser Janina  Schwab Annemarie  Rizzoli Silvio O  Henkel Andreas W  Müller Christian P  Alzheimer Christian  Kornhuber Johannes  Groemer Teja W
Institution:Department of Psychiatry and Psychotherapy, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany.
Abstract:Antipsychotic drugs are effective for the treatment of schizophrenia. However, the functional consequences and subcellular sites of their accumulation in nervous tissue have remained elusive. Here, we investigated the role of the weak-base antipsychotics haloperidol, chlorpromazine, clozapine, and risperidone in synaptic vesicle recycling. Using multiple live-cell microscopic approaches and electron microscopy of rat hippocampal neurons as well as in vivo microdialysis experiments in chronically treated rats, we demonstrate the accumulation of the antipsychotic drugs in synaptic vesicles and their release upon neuronal activity, leading to a significant increase in extracellular drug concentrations. The secreted drugs exerted an autoinhibitory effect on vesicular exocytosis, which was promoted by the inhibition of voltage-gated sodium channels and depended on the stimulation intensity. Taken together, these results indicate that accumulated antipsychotic drugs recycle with synaptic vesicles and have a use-dependent, autoinhibitory effect on synaptic transmission.
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