Effects of antidepressant drug combinations on cortical 5-HT₂ receptors and wet-dog shakes in rats

Rats pretreated with the monoamine oxidase inhibitor, phenelzine 18 h (46.8 mg/kg) and 90 min (11.7 mg/kg) previously or only 90 min (46.8 mg/kg) previously developed a 5-HT dependent syndrome (including wet-dog shakes, WDS) when given the 5-HT uptake inhibitor, paroxetine (11.6 mg/kg). After 2 h, but only in rats pretreated with 2 injections of phenelzine, there was a gradual reduction in the number of cortical 5-HT₂ receptors, determined in vitro with [³H]ketanserin, and this was temporally related to a reduction in the frequency of WDS. Both effects (down-regulation and WDS) were prevented by the 5-HT₂ receptor antagonist, pirenperone. A second injection of paroxetine at 3 h evoked additional WDS in rats pretreated with 1 injection of phenelzine but not in rats pretreated with 2 injections, suggesting that spinal 5-HT₂ receptors might also have been down-regulated at the same time. Similar results were obtained when rats were pretreated instead with the selective MAO A inhibitor, clorgyline or when given either citalopram or fenfluramine instead of paroxetine. 5-HTP also evoked WDS in phenelzine-treated rats and markedly increased brain 5-HT concentration but only slowly down-regulated 5-HT₂ receptors; in carbidopa-treated animals, 5-HTP was without effect on receptor numbers despite production of frequent WDS. It thus appears that drugs which increase synaptic 5-HT (as indicated by production of WDS) by interference with the release or reuptake of 5-HT more readily down-regulate 5-HT₂ receptors than 5-HTP which does not directly affect these mechanisms.