Antidepressants are widely used in the treatment of depressive illnesses associated with neurodegenerative disorders such as Alzheimer’s disease, Parkinson’s disease and Huntington’s disease. Neuroprotection in such disorders is of vital importance in order to delay the progression of the primary disorder. The pathology of neurodegeneration is not fully understood. It is however widely accepted that oxidative stress and excitotoxicity play a major role. Brain tissue is rich in phospholipids, which are especially prone to oxidation due to the high level of oxygen utilization in the brain. In addition, the brain lacks defence mechanisms to protect it against the wrath of free radicals. Presently, there is a wide variety of antidepressant drugs available. These range from the original tricyclic antidepressants to the newer selective serotonin reuptake inhibitors. It is not known whether antidepressant drugs, old or new, offer neuroprotection or how the existing state and/or the progression of neurodegeneration, is influenced by these agents. The present study was undertaken to determine how nortriptyline, trimipramine and fluoxetine affect neurodegeneration. Initial in vitro and in vivo studies show that all three of the antidepressants (0-1mM) studied provide neuroprotection from quinolinic acid induced lipid peroxidation. A histological investigation supported these findings by showing that a marginal degree of neuroprotection is apparent when treating animals with antidepressants (10mg/kg) before and following quinolinic acid intrastriatal injection. Further studies were undertaken in an attempt to determine the mode of neuroprotective action of the agents studied. An in vitro study of superoxide anion induced lipid peroxidation indicates that these agents do not act as antioxidants. The influence of the antidepressants on tryptophan 2,3-dioxygenase activity was assessed, based on the understanding that inhibition of this enzyme results in increased levels of the known antioxidant indoleamine, melatonin. Nortriptyline hydrochloride is seen to inhibit tryptophan 2,3-dioxygenase activity and as such it is possible that this antidepressant can indirectly provide neuroprotection by increasing available melatonin. Electrochemical and UV/visible studies show that trimipramine maleate interacts with free iron (II) and iron (III) ions. Free metal ions can catalyse the formation of damaging free radicals. Through interaction with trimipramine maleate, these ions will be unavailable to the system and thus cannot contribute to oxidative stress. The findings of this study indicate that antidepressants may be able to provide neuroprotection to neuronal cells. The mode of such neuroprotective actions need to be further examined so that patients suffering from depression coexisting with neurodegenerative diseases can be safely and effectively treated.

The rat pineal gland provides a convenient model for investigating nor adrenergic receptor neurotransmission and the effects of various drugs on these processes in health and disease. The effect of a variety of antidepressant drugs on rat pineal gland function following acute and chronic administration is described. Antidepressants from several different classes increase melatonin synthesis in rat pineal gland cultures when administered acutely. This effect appears to be mediated by noradrenaline acting on postsynaptic β-adrenoceptors. Activation of these receptors, in turn, activates the enzyme serotonin N-acetyltransferase via a cyclic adenosine monophosphate (cAMP) second messenger system. Serotonin N-acetyltransferase catalyses the rate-limiting conversion of serotonin to melatonin. Blockade of postsynaptic β-adrenoceptors prevents the antidepressant-induced increase in melatonin synthesis. The possibility that atypical antidepressants as well as those that selectively inhibit serotonin reuptake may increase melatonin synthesis via a β-adrenoceptor mechanism is discussed. In contrast, however, antidepressants from different classes have variable effects on rat pineal gland function when administered repeatedly. Chronic treatment with antidepressants that selectively inhibit noradrenaline reuptake appear to down-regulate the β-adrenoceptor system while, simultaneously, increasing melatonin output. Atypical antidepressants and those that selectively inhibit serotonin reuptake appear to be without these effects when administered repeatedly. The pineal gland of normal rats may therefore not represent a suitable model for evaluating the biochemical effects of chronic antidepressant treatment. In an attempt to investigatc pineal gland function in rats with "model depression" , antidepressants were administered to chronically reserpinized rats. Treatment with reserpine produced an increase in the density of pineal β-adrenoceptors. In addition, pineal cyclic AMP accumulation and N-acetyltransferase activity were increased in reserpinized rats following exogenous catecholamine stimulation. Reserpine, by depleting intraneuronal catecholamine stores, prevented the nocturnal induction of N-acetyltransferase activity and reduced the synthesis of melatonin in pineal gland cultures. A variety of antidepressants, irrespective of their acute pharmacological actions, reversed these effects when administered chronically to resepinized rats. Acute antidepressant administration was not associated with a reversal of the reserpine-induced effects. These findings provide additional evidence against the hypothesis that antidepressant drugs act by reducing noradrenergic neurotransmission and casts doubt on the importance of β-adrenoceptor down-regulation in the mechanism of antidepressant action. The possibility that the pineal gland of the reserpinized rat may represent an alternative model for evaluating antidepressant therapies is discussed.