Effect of citalopram on brain serotonin release in experimental hepatic encephalopathy: implications for thymoleptic drug safety in liver insufficiency

Clin Neuropharmacol. 1997 Dec;20(6):511-22. doi: 10.1097/00002826-199712000-00003.

Abstract

In the present study, effects of citalopram (CIT) on brain 5-hydroxytryptamine (5-HT) release in experimental chronic hepatic encephalopathy (HE) were investigated. Neocortical administration of CIT (1.0 microM) increased the brain 5-HT output to a similar extent in portacaval shunted (PCS) rats and sham-operated controls, indicating that a previous described mismatch between increased 5-HT turnover and unchanged release in PCS rats is not explained by an accelerated brain 5-HT reuptake. Subsequent systemic administration of CIT (5 mg/kg subcutaneously) resulted in a more pronounced attenuation of the brain 5-HT release in PCS rats than in sham-operated controls, possibly indicating a higher susceptibility to indirect mid-brain 5-HT1A autoreceptor activation in experimental portal-systemic encephalopathy (PSE). A KCl (60 mM) challenge in the presence of locally administered CIT (1 microM) induced a more marked neocortical 5-HT response in PCS rats than in sham-operated controls, confirming previous results of a higher than normal amount of 5-HT available for depolarization-induced release in PCS rats. Although the pharmacodynamic parameters in this study was investigated for CIT, the likelihood of a parallel pharmacokinetic alteration existing for this drug in the PCS condition also was indicated. It is thus suggested that otherwise generally safe central nervous system 5-HT-active drugs may represent a potential hazard in patients with liver failure with or without PSE.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antidepressive Agents / pharmacology*
  • Biotransformation
  • Brain Chemistry / drug effects*
  • Citalopram / adverse effects
  • Citalopram / pharmacokinetics
  • Citalopram / pharmacology*
  • Extracellular Space / drug effects
  • Extracellular Space / metabolism
  • Hepatic Encephalopathy / metabolism*
  • Hydroxyindoleacetic Acid / metabolism
  • Injections
  • Injections, Subcutaneous
  • Male
  • Microdialysis
  • Neocortex / drug effects
  • Neocortex / metabolism
  • Potassium Chloride / pharmacology
  • Rats
  • Rats, Sprague-Dawley
  • Selective Serotonin Reuptake Inhibitors / adverse effects
  • Selective Serotonin Reuptake Inhibitors / pharmacokinetics
  • Selective Serotonin Reuptake Inhibitors / pharmacology*
  • Serotonin / metabolism*

Substances

  • Antidepressive Agents
  • Serotonin Uptake Inhibitors
  • Citalopram
  • Serotonin
  • Hydroxyindoleacetic Acid
  • Potassium Chloride