Combined 5-HT1A and 5-HT1B receptor agonists for the treatment of L-DOPA-induced dyskinesia

Brain. 2008 Dec;131(Pt 12):3380-94. doi: 10.1093/brain/awn235. Epub 2008 Oct 24.

Abstract

Appearance of dyskinesia is a common problem of long-term l-DOPA treatment in Parkinson's disease patients and represents a major limitation for the pharmacological management of the motor symptoms in advanced disease stages. We have recently demonstrated that dopamine released from serotonin neurons is responsible for l-DOPA-induced dyskinesia in 6-hydroxydopamine (6-OHDA)-lesioned rats, raising the possibility that blockade of serotonin neuron activity by combination of 5-HT(1A) and 5-HT(1B) agonists could reduce l-DOPA-induced dyskinesia. In the present study, we have investigated the efficacy of 5-HT(1A) and 5-HT(1B) agonists to counteract l-DOPA-induced dyskinesia in 1-methyl-4-phenyl 1,2,3,6-tetrahydropyridine (MPTP)-treated macaques, the gold standard model of Parkinson's disease. In addition, we have studied the ability of this treatment to prevent development of l-DOPA-induced dyskinesia in 6-OHDA-lesioned rats. The results demonstrate the existence of a potent synergistic effect between 5-HT(1A) and 5-HT(1B) agonists in their ability to dampen l-DOPA-induced dyskinesia in the MPTP-treated macaques. Sub-threshold doses of the drugs, which individually produced no effect, were able to reduce the abnormal involuntary movements by up to 80% when administered in combination, without affecting the anti-parkinsonian properties of l-DOPA. Furthermore, chronic administration of low doses of the 5-HT(1) agonists in combination was able to prevent development of dyskinesia, and reduce the up-regulation of FosB after daily treatment with l-DOPA in the rat 6-OHDA model. Our results support the importance of a clinical investigation of the effect of 5-HT(1A) and 5-HT(1B) agonists, particularly in combination, in dyskinetic l-DOPA-treated Parkinson's disease patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine
  • 8-Hydroxy-2-(di-n-propylamino)tetralin / administration & dosage
  • 8-Hydroxy-2-(di-n-propylamino)tetralin / therapeutic use
  • Animals
  • Antiparkinson Agents / adverse effects*
  • Antiparkinson Agents / therapeutic use
  • Corpus Striatum / metabolism
  • Disease Models, Animal
  • Drug Administration Schedule
  • Drug Evaluation, Preclinical / methods
  • Drug Therapy, Combination
  • Dyskinesia, Drug-Induced / etiology
  • Dyskinesia, Drug-Induced / prevention & control*
  • Female
  • Levodopa / adverse effects*
  • Levodopa / therapeutic use
  • Macaca fascicularis
  • Motor Activity / drug effects
  • Parkinson Disease / drug therapy
  • Parkinson Disease / metabolism
  • Parkinsonian Disorders / chemically induced
  • Parkinsonian Disorders / drug therapy
  • Proto-Oncogene Proteins c-fos / metabolism
  • Pyridines / administration & dosage
  • Pyridines / therapeutic use
  • Receptors, N-Methyl-D-Aspartate / metabolism
  • Serotonin 5-HT1 Receptor Agonists*
  • Serotonin Receptor Agonists / administration & dosage
  • Serotonin Receptor Agonists / therapeutic use*
  • Treatment Outcome

Substances

  • Antiparkinson Agents
  • CP 94253
  • Proto-Oncogene Proteins c-fos
  • Pyridines
  • Receptors, N-Methyl-D-Aspartate
  • Serotonin 5-HT1 Receptor Agonists
  • Serotonin Receptor Agonists
  • Levodopa
  • 8-Hydroxy-2-(di-n-propylamino)tetralin
  • 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine