Dopaminergic

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The chemical structure of the neurotransmitter dopamine Dopamine2.svg
The chemical structure of the neurotransmitter dopamine

Dopaminergic means "related to dopamine" (literally, "working on dopamine"), a common neurotransmitter. [1] Dopaminergic substances or actions increase dopamine-related activity in the brain.

Contents

Dopaminergic brain pathways facilitate dopamine-related activity. For example, certain proteins such as the dopamine transporter (DAT), vesicular monoamine transporter 2 (VMAT2), and dopamine receptors can be classified as dopaminergic, and neurons that synthesize or contain dopamine and synapses with dopamine receptors in them may also be labeled as dopaminergic. Enzymes that regulate the biosynthesis or metabolism of dopamine such as aromatic L-amino acid decarboxylase or DOPA decarboxylase, monoamine oxidase (MAO), and catechol O-methyl transferase (COMT) may be referred to as dopaminergic as well.

Also, any endogenous or exogenous chemical substance that acts to affect dopamine receptors or dopamine release through indirect actions (for example, on neurons that synapse onto neurons that release dopamine or express dopamine receptors) can also be said to have dopaminergic effects, two prominent examples being opioids, which enhance dopamine release indirectly in the reward pathways, and some substituted amphetamines, which enhance dopamine release directly by binding to and inhibiting VMAT2.

Dopaminergic agents

Dopamine precursors

Dopamine precursors including L-phenylalanine and L-tyrosine are used as dietary supplements. L-DOPA (Levodopa), another precursor, is used in the treatment of Parkinson's disease. Prodrugs of levodopa, including melevodopa, etilevodopa, foslevodopa, and XP-21279 also exist. They are inactive themselves but are converted into dopamine and hence act as non-selective dopamine receptor agonists.

Dopamine receptor ligands

Dopamine receptor agonists

Dopamine receptor agonists can be divided into non-selective dopamine receptor agonists, D1-like receptor agonists, and D2-like receptor agonists.

Non-selective dopamine receptor agonists include dopamine, deoxyepinephrine (epinine), dinoxyline, and dopexamine. They are mostly peripherally selective drugs, are often also adrenergic receptor agonists, and are used to treat certain cardiovascular conditions.

D2-like receptor agonists include the ergolines bromocriptine, cabergoline, dihydroergocryptine, ergoloid, lisuride, metergoline, pergolide, quinagolide, and terguride; the morphine analogue apomorphine; and the structurally distinct agents piribedil, pramipexole, ropinirole, rotigotine, and talipexole. Some of these agents also have weak affinity for the D1-like receptors. They are used to treat Parkinson's disease, restless legs syndrome, hyperprolactinemia, prolactinomas, acromegaly, erectile dysfunction, and for lactation suppression. They are also being studied in the treatment of depression and are sometimes used in the treatment of disorders of diminished motivation like apathy, abulia, and akinetic mutism.

D1-like receptor agonists include 6-Br-APB, A-68930, A-77636, A-86929, adrogolide, dihydrexidine, dinapsoline, doxanthrine, fenoldopam, razpipadon, SKF-81,297, SKF-82,958, SKF-89,145, tavapadon, and trepipam. They have been researched for and are under development for the treatment of Parkinson's disease and dementia-related apathy. Peripherally selective D1-like receptor agonists like fenoldopam are used to treat hypertensive crisis.

Dopamine receptor positive allosteric modulators

Positive allosteric modulators of the dopamine D1 receptor like mevidalen and glovadalen are under development for the treatment of Lewy body disease and Parkinson's disease.

Dopamine receptor antagonists

Dopamine receptor antagonists including typical antipsychotics such as chlorpromazine (Thorazine), fluphenazine, haloperidol (Haldol), loxapine, molindone, perphenazine, pimozide, thioridazine, thiothixene, and trifluoperazine, the atypical antipsychotics such as amisulpride, clozapine, olanzapine, quetiapine (Seroquel), risperidone (Risperdal), sulpiride, and ziprasidone, and antiemetics like domperidone, metoclopramide, and prochlorperazine, among others, which are used in the treatment of schizophrenia and bipolar disorder as antipsychotics, and nausea and vomiting.

Dopamine receptor antagonists can be divided into D1-like receptor antagonists and D2-like receptor antagonists. Ecopipam is an example of a D1-like receptor antagonist.

At low doses, dopamine D2 and D3 receptor antagonists can preferentially block presynaptic dopamine D2 and D3 autoreceptors and thereby increase dopamine levels and enhance dopaminergic neurotransmission. [2] [3] [4] Examples of dopamine D2 and D3 receptor antagonists which have been used in this way include amisulpride, [3] [5] [6] sulpiride, [7] [8] [9] [10] and ENX-104. [11] [12]

Dopamine receptor negative allosteric modulators

Negative allosteric modulators of the dopamine receptors, such as SB269652, have been identified and are being researched. [13] [14] [15] [16]

Dopamine reuptake inhibitors

Dopamine reuptake inhibitors (DRIs) or dopamine transporter (DAT) inhibitors such as methylphenidate (Ritalin), amineptine, nomifensine, cocaine, bupropion, modafinil, armodafinil, phenylpiracetam, mesocarb, and vanoxerine, among others. They are used in the treatment of attention-deficit hyperactivity disorder (ADHD) as psychostimulants, narcolepsy as wakefulness-promoting agents, obesity and binge eating disorder as appetite suppressants, depression as antidepressants, and fatigue as pro-motivational agents. They are also used as illicit street and recreational drugs due to their euphoriant and psychostimulant effects.

Dopamine releasing agents

Dopamine releasing agents (DRAs) such as phenethylamine, amphetamine, lisdexamfetamine (Vyvanse), methamphetamine, methylenedioxymethamphetamine (MDMA), phenmetrazine, pemoline, 4-methylaminorex (4-MAR), phentermine, and benzylpiperazine, among many others, which, like DRIs, are used in the treatment of attention-deficit hyperactivity disorder (ADHD) and narcolepsy as psychostimulants, obesity as anorectics, depression and anxiety as antidepressants and anxiolytics respectively, drug addiction as anticraving agents, and sexual dysfunction as aphrodisiacs. Many of these compounds are also illicit street or recreational drugs.

Dopaminergic activity enhancers

Dopaminergic activity enhancers such as the prescription drug selegiline (deprenyl) and the research chemicals BPAP and PPAP enhance the action potential-mediated release of dopamine. [17] This is in contrast to dopamine releasing agents like amphetamine, which induce the uncontrolled release of dopamine regardless of electrical stimulation. [17] The effects of the activity enhancers may be mediated by intracellular TAAR1 agonism coupled with uptake into monoaminergic neurons by monoamine transporters. [18] [19] Dopaminergic activity enhancers are of interest in the potential treatment of a number of medical disorders, such as depression and Parkinson's disease. To date, only phenylethylamine, tryptamine, and tyramine have been identified as endogenous activity enhancers. [17]

Dopamine depleting agents

Vesicular monoamine transporter 2 (VMAT2) inhibitors such as reserpine, tetrabenazine, valbenazine, and deutetrabenazine act as dopamine depleting agents and are used as sympatholytics or antihypertensives, to treat tardive dyskinesia, and in the past as antipsychotics. They have been associated with side effects including depression, apathy, fatigue, amotivation, and suicidality.

Dopamine metabolism modulators

Monoamine oxidase inhibitors

Monoamine oxidase (MAO) inhibitors (MAOIs) including non-selective agents such as phenelzine, tranylcypromine, isocarboxazid, and pargyline, MAOA selective agents like moclobemide and clorgyline, and MAOB selective agents such as selegiline and rasagiline, as well as the harmala alkaloids like harmine, harmaline, tetrahydroharmine, harmalol, harman, and norharman, which are found to varying degrees in Nicotiana tabacum (tobacco), Banisteriopsis caapi (ayahuasca, yage), Peganum harmala (Harmal, Syrian Rue), Passiflora incarnata (Passion Flower), and Tribulus terrestris , among others, which are used in the treatment of depression and anxiety as antidepressants and anxiolytics, respectively, in the treatment of Parkinson's disease and dementia, and for the recreational purpose of boosting the effects of certain drugs like phenethylamine (PEA) and psychedelics like dimethyltryptamine (DMT) via inhibiting their metabolism.

Catechol O-methyltransferase inhibitors

Catechol O-methyl transferase (COMT) inhibitors such as entacapone, opicapone, and tolcapone, which are used in the treatment of Parkinson's disease. Entacapone and opicapone are peripherally selective, but tolcapone significantly crosses the blood–brain barrier. Tolcapone is under study for potential treatment of certain psychiatric disorders such as obsessive–compulsive disorder and schizophrenia. [20] [21] [22]

Aromatic L-amino acid decarboxylase inhibitors

Aromatic L-amino acid decarboxylase (AAAD) or DOPA decarboxylase inhibitors including benserazide, carbidopa, and methyldopa, which are used in the treatment of Parkinson's disease in augmentation of L-DOPA to block the peripheral conversion of dopamine, thereby inhibiting undesirable side-effects, and as sympatholytic or antihypertensive agents.

Dopamine β-hydroxylase inhibitors

Dopamine β-hydroxylase inhibitors like disulfiram (Antabuse), which can be used in the treatment of addiction to cocaine and similar dopaminergic drugs as a deterrent drug. The excess dopamine resulting from inhibition of the dopamine β-hydroxylase enzyme increases unpleasant symptoms such as anxiety, higher blood pressure, and restlessness. Disulfiram is not an anticraving agent, because it does not decrease craving for drugs. Instead, positive punishment from its unpleasant effects deters drug consumption. [23] Other dopamine β-hydroxylase inhibitors include the centrally active nepicastat and the peripherally selective etamicastat and zamicastat.

Other enzyme inhibitors

Phenylalanine hydroxylase inhibitors like 3,4-dihydroxystyrene), which is currently only a research chemical with no suitable therapeutic indications, likely because such drugs would induce the potentially highly dangerous hyperphenylalaninemia or phenylketonuria.

Tyrosine hydroxylase inhibitors like metirosine, which is used in the treatment of pheochromocytoma as a sympatholytic or antihypertensive agent.

Dopaminergic neurotoxins

Dopaminergic neurotoxins like 6-hydroxydopamine (6-OHDA) and MPTP are used in scientific research to lesion the dopamine system and study the biological role of dopamine.

Miscellaneous agents

Adamantane derivatives

Amantadine has dopaminergic effects through uncertain mechanisms of action. [24] [25] It is structurally related to other adamantanes like bromantane and rimantadine, which also have dopaminergic actions. [26] Bromantane can upregulate tyrosine hydroxylase (TH) and thereby increase dopamine production and this might be involved in its dopaminergic effects. [27] [28] Amantadine can upregulate TH simiarly, but as with bromantane, it is unclear whether this is involved in or responsible for its dopaminergic actions. [24] Amantadine is used in the treatment of Parkinson's disease, levodopa-induced dyskinesia, and fatigue in multiple sclerosis. It has also been used in the treatment of disorders of consciousness, disorders of diminished motivation, and brain injuries. The drug is being studied in the treatment of depression and attention deficit hyperactivity disorder (ADHD) as well.

Diphenylpiperidines

4,4-Diphenylpiperidines including budipine and prodipine are effective in the treatment of Parkinson's disease. [29] [30] [31] Their mechanism of action is unknown but they act as indirect dopaminergic agents. [30] [29] [31] They have distinct effects from other antiparkinsonian agents and dopaminergic drugs. [30] [29] [31]

Other miscellaneous agents

Aspirin upregulates tyrosine hydroxylase and increases dopamine production. [32]

Others such as hyperforin and adhyperforin (both found in Hypericum perforatum St. John's Wort), L-theanine (found in Camellia sinensis , the tea plant), and S-adenosyl-L-methionine (SAMe).

See also

Related Research Articles

<span class="mw-page-title-main">Dopamine receptor</span> Class of G protein-coupled receptors

Dopamine receptors are a class of G protein-coupled receptors that are prominent in the vertebrate central nervous system (CNS). Dopamine receptors activate different effectors through not only G-protein coupling, but also signaling through different protein interactions. The neurotransmitter dopamine is the primary endogenous ligand for dopamine receptors.

<span class="mw-page-title-main">Dopamine antagonist</span> Drug which blocks dopamine receptors

A dopamine antagonist, also known as an anti-dopaminergic and a dopamine receptor antagonist (DRA), is a type of drug which blocks dopamine receptors by receptor antagonism. Most antipsychotics are dopamine antagonists, and as such they have found use in treating schizophrenia, bipolar disorder, and stimulant psychosis. Several other dopamine antagonists are antiemetics used in the treatment of nausea and vomiting.

<span class="mw-page-title-main">Amisulpride</span> Atypical antipsychotic and antiemetic medication

Amisulpride, sold under the brand names Solian and Barhemsys, is a medication used in the treatment of schizophrenia, acute psychotic episodes, depression, and nausea and vomiting. It is specifically used at lower doses intravenously to prevent and treat postoperative nausea and vomiting; at low doses by mouth to treat depression; and at higher doses by mouth to treat psychosis.

<span class="mw-page-title-main">Sulpiride</span> Atypical antipsychotic

Sulpiride, sold under the brand name Dogmatil among others, is an atypical antipsychotic medication of the benzamide class which is used mainly in the treatment of psychosis associated with schizophrenia and major depressive disorder, and is sometimes used in low dosage to treat anxiety and mild depression.

<span class="mw-page-title-main">Pramipexole</span> Dopamine agonist medication

Pramipexole, sold under the brand Mirapex among others, is a medication used to treat Parkinson's disease (PD) and restless legs syndrome (RLS). In Parkinson's disease it may be used alone or together with levodopa. It is taken by mouth. Pramipexole is a dopamine agonist of the non-ergoline class.

<span class="mw-page-title-main">Dopamine agonist</span> Compound that activates dopamine receptors

A dopamine agonist is a compound that activates dopamine receptors. There are two families of dopamine receptors, D1-like and D2-like. They are all G protein-coupled receptors. D1- and D5-receptors belong to the D1-like family and the D2-like family includes D2, D3 and D4 receptors. Dopamine agonists are primarily used in the treatment of the motor symptoms of Parkinson's disease, and to a lesser extent, in hyperprolactinemia and restless legs syndrome. They are also used off-label in the treatment of clinical depression. Impulse control disorders are associated with the use of dopamine agonists for whatever condition.

Extrapyramidal symptoms (EPS) are symptoms that are archetypically associated with the extrapyramidal system of the brain's cerebral cortex. When such symptoms are caused by medications or other drugs, they are also known as extrapyramidal side effects (EPSE). The symptoms can be acute (short-term) or chronic (long-term). They include movement dysfunction such as dystonia, akathisia, parkinsonism characteristic symptoms such as rigidity, bradykinesia, tremor, and tardive dyskinesia. Extrapyramidal symptoms are a reason why subjects drop out of clinical trials of antipsychotics; of the 213 (14.6%) subjects that dropped out of one of the largest clinical trials of antipsychotics, 58 (27.2%) of those discontinuations were due to EPS.

Dopamine receptor D<sub>2</sub> Main receptor for most antipsychotic drugs

Dopamine receptor D2, also known as D2R, is a protein that, in humans, is encoded by the DRD2 gene. After work from Paul Greengard's lab had suggested that dopamine receptors were the site of action of antipsychotic drugs, several groups, including those of Solomon H. Snyder and Philip Seeman used a radiolabeled antipsychotic drug to identify what is now known as the dopamine D2 receptor. The dopamine D2 receptor is the main receptor for most antipsychotic drugs. The structure of DRD2 in complex with the atypical antipsychotic risperidone has been determined.

Dopamine receptor D<sub>1</sub> Protein-coding gene in humans

Dopamine receptor D1, also known as DRD1. It is one of the two types of D1-like receptor family — receptors D1 and D5. It is a protein that in humans is encoded by the DRD1 gene.

Dopamine receptor D<sub>3</sub> Subtype of Dopamine Receptor

Dopamine receptor D3 is a protein that in humans is encoded by the DRD3 gene.

<span class="mw-page-title-main">Nemonapride</span> Antipsychotic medication

Nemonapride, also previously known as emonapride and sold under the brand name Emilace, is an atypical antipsychotic which is used in the treatment of schizophrenia. It is taken by mouth.

<span class="mw-page-title-main">Tiapride</span> Antipsychotic medication

Tiapride is a drug that selectively blocks D2 and D3 dopamine receptors in the brain. It is used to treat a variety of neurological and psychiatric disorders including dyskinesia, alcohol withdrawal syndrome, negative symptoms of psychosis, and agitation and aggression in the elderly. A derivative of benzamide, tiapride is chemically and functionally similar to other benzamide antipsychotics such as sulpiride and amisulpride known for their dopamine antagonist effects.

<span class="mw-page-title-main">Sultopride</span> Antipsychotic medication

Sultopride (trade names Barnetil, Barnotil, Topral) is an atypical antipsychotic of the benzamide chemical class used in Europe, Japan, and Hong Kong for the treatment of schizophrenia. It was launched by Sanofi-Aventis in 1976. Sultopride acts as a selective D2 and D3 receptor antagonist. It has also been shown to have clinically relevant affinity for the GHB receptor as well, a property it shares in common with amisulpride and sulpiride.

<span class="mw-page-title-main">Pimavanserin</span> Atypical antipsychotic medication

Pimavanserin, sold under the brand name Nuplazid, is an atypical antipsychotic which is approved for the treatment of Parkinson's disease psychosis. Unlike other antipsychotics, pimavanserin is not a dopamine receptor antagonist, but rather is a selective inverse agonist of the serotonin 5-HT2A receptor.

<span class="mw-page-title-main">Levosulpiride</span> Dopamine antagonist medication

Levosulpiride, sold under the brand names Dislep and Sulpepta among others, is a dopamine antagonist medication which is used in the treatment of psychotic disorders like schizophrenia, major depressive disorder, nausea and vomiting, and gastroparesis. It is taken by mouth.

<span class="mw-page-title-main">Roxindole</span> Dopaminergic & serotonergic drug developed for schizophrenia treatment

Roxindole (EMD-49,980) is a dopaminergic and serotonergic drug which was originally developed by Merck KGaA for the treatment of schizophrenia. In clinical trials its antipsychotic efficacy was only modest but it was unexpectedly found to produce potent and rapid antidepressant and anxiolytic effects. As a result, roxindole was further researched for the treatment of depression instead. It has also been investigated as a therapy for Parkinson's disease and prolactinoma.

<span class="mw-page-title-main">Cariprazine</span> Atypical antipsychotic medicine

Cariprazine, sold under the brand name Vraylar among others, is an atypical antipsychotic developed by Gedeon Richter, which is used in the treatment of schizophrenia, bipolar mania, bipolar depression, and major depressive disorder. It acts primarily as a D3 and D2 receptor partial agonist, with a preference for the D3 receptor. Cariprazine is also a partial agonist at the serotonin 5-HT1A receptor and acts as an antagonist at 5-HT2B and 5-HT2A receptors, with high selectivity for the D3 receptor. It is taken by mouth.

Peripherally selective drugs have their primary mechanism of action outside of the central nervous system (CNS), usually because they are excluded from the CNS by the blood–brain barrier. By being excluded from the CNS, drugs may act on the rest of the body without producing side-effects related to their effects on the brain or spinal cord. For example, most opioids cause sedation when given at a sufficiently high dose, but peripherally selective opioids can act on the rest of the body without entering the brain and are less likely to cause sedation. These peripherally selective opioids can be used as antidiarrheals, for instance loperamide (Imodium).

<span class="mw-page-title-main">Motivation-enhancing drug</span> Drug increasing motivation in humans

A motivation-enhancing drug, also known as a pro-motivational drug, is a drug which increases motivation. Drugs enhancing motivation can be used in the treatment of motivational deficits, for instance in depression, schizophrenia, and attention deficit hyperactivity disorder (ADHD). They can also be used in the treatment of disorders of diminished motivation (DDMs), including apathy, abulia, and akinetic mutism, disorders that can be caused by conditions like stroke, traumatic brain injury (TBI), and neurodegenerative diseases. Motivation-enhancing drugs are used non-medically by healthy people to increase motivation and productivity as well, for instance in educational contexts.

The conditioned avoidance response (CAR) test, also known as the active avoidance test, is an animal test used to identify drugs with antipsychotic-like effects. It is most commonly employed as a two-way active avoidance test with rodents. The test assesses the conditioned ability of an animal to avoid an unpleasant stimulus. Drugs that selectively suppress conditioned avoidance responses without affecting escape behavior are considered to have antipsychotic-like activity. Variations of the test, like testing for enhancement of avoidance and escape responses, have also been used to assess other drug effects, like pro-motivational and antidepressant-like effects.

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