title: Effect of halving the dose of venlafaxine to adjust for putative pharmacokinetic and pharmacodynamic changes in an animal model of chronic hepatic encephalopathy.
abstract: Patients with chronic hepatic encephalopathy display monoaminergic perturbations together with affective symptoms. Thus, these patients belong to a group with a probability of receiving antidepressant drug treatment. The liver impairment may result in pharmacokinetic alterations of the antidepressant drug, which in turn may affect the already perturbed monoaminergic function. Venlafaxine (VEN) was administered as a single subcutaneous challenge to portacaval shunted (experimental hepatic encephalopathy model) rats (5 mg/kg) and sham-operated rats (5 and 10 mg/kg). The aims were to investigate whether a reduced dose in portacaval shunted rats resulted in higher concentrations of VEN and serotonin as compared to control rats, which had been demonstrated earlier when the rats received the same dose (10 mg/kg). A 50% reduction of the dose of VEN administered to portacaval shunted rats resulted in elevated levels of VEN in serum, brain parenchyma, and brain dialysate about 300 minutes after the injection. The VEN challenge increased the serotonin and noradrenaline concentrations in dialysate in portacaval shunted rats and both sham groups, but the three VEN groups did not differ in any major way in serotonin and noradrenaline output. Therefore, when the dose of VEN administered to experimental hepatic encephalopathy was reduced 50% as compared to control rats, mainly pharmacokinetic, and possibly also monoaminergic, alterations were observed.
authors.affiliation: Department of Clinical Pharmacology, Lund University Hospital, S-221 85 Lund, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Wikell
authors.forename: F C
authors.initials: FC
authors.lastname: Kugelberg
authors.forename: S
authors.initials: S
authors.lastname: Hjorth
authors.forename: G
authors.initials: G
authors.lastname: Apelqvist
authors.forename: F
authors.initials: F
authors.lastname: Bengtsson
mesh_terms: D000818:Animals; D001711:Biotransformation; D001923:Brain Chemistry / Q000187:drug effects; D002908:Chronic Disease; D003511:Cyclohexanols / Q000008:administration & dosage* / Q000493:pharmacokinetics* / Q000627:therapeutic use; D004195:Disease Models, Animal; D004298:Dopamine / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D006207:Half-Life; D006501:Hepatic Encephalopathy / Q000188:drug therapy / Q000378:metabolism*; D008297:Male; D017551:Microdialysis; D009638:Norepinephrine / Q000378:metabolism; D051381:Rats; D017207:Rats, Sprague-Dawley; D012701:Serotonin / Q000378:metabolism; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage* / Q000493:pharmacokinetics* / Q000627:therapeutic use; D000069470:Venlafaxine Hydrochloride
chemical_list: D003511:Cyclohexanols; D004298:Dopamine; D009638:Norepinephrine; D012701:Serotonin; D017367:Selective Serotonin Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride