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      Atomoxetine reduces hyperactive/impulsive behaviours in neurokinin-1 receptor ‘knockout’ mice

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          Abstract

          Background

          Mice with functional ablation of the neurokinin-1 receptor gene (NK1R −/−) display behavioural abnormalities which resemble the hyperactivity, inattention and impulsivity seen in Attention Deficit Hyperactivity Disorder (ADHD). Here, we investigated whether the established ADHD treatment, atomoxetine, alleviates these abnormalities when tested in the light/dark exploration box (LDEB) and 5-Choice Serial Reaction-Time Task (5-CSRTT).

          Methods

          Separate cohorts of mice were tested in the 5-CSRTT and LDEB after treatment with no injection, vehicle or atomoxetine (5-CSRTT: 0.3, 3 or 10 mg/kg; LDEB: 1, 3 or 10 mg/kg).

          Results

          Atomoxetine reduced the hyperactivity displayed by NK1R −/− mice in the LDEB at a dose (3 mg/kg) which did not affect the locomotor activity of wildtypes. Atomoxetine (10 mg/kg) also reduced impulsivity in NK1R −/− mice, but not wildtypes, in the 5-CSRTT. No dose of drug affected attention in either genotype.

          Conclusions

          This evidence that atomoxetine reduces hyperactive/impulsive behaviours in NK1R −/− mice consolidates the validity of using NK1R −/− mice in research of the aetiology and treatment of ADHD.

          Highlights

          • We compared the behavioural response to atomoxetine in NK1R −/− and wildtype mice.

          • Atomoxetine reduced hyperactivity and impulsivity in NK1R −/− mice but not wildtypes.

          • This was not explained by changes in animals' emotional status or motor motivation.

          • NK1R −/− mice are more sensitive to atomoxetine (an ADHD treatment) than wildtypes.

          • These findings consolidate the NK1R −/− mouse model of ADHD.

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          Most cited references31

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          Altered nociception, analgesia and aggression in mice lacking the receptor for substance P.

          The peptide neurotransmitter substance P modulates sensitivity to pain by activating the neurokinin-1 (NK-1) receptor, which is expressed by discrete populations of neurons throughout the central nervous system. Substance P is synthesized by small-diameter sensory 'pain' fibres, and release of the peptide into the dorsal horn of the spinal cord following intense peripheral stimulation promotes central hyperexcitability and increased sensitivity to pain. However, despite the availability of specific NK-1 antagonists, the function of substance P in the perception of pain remains unclear. Here we investigate the effect of disrupting the gene encoding the NK-1 receptor in mice. We found that the mutant mice were healthy and fertile, but the characteristic amplification ('wind up') and intensity coding of nociceptive reflexes was absent. Although substance P did not mediate the signalling of acute pain or hyperalgesia, it was essential for the full development of stress-induced analgesia and for an aggressive response to territorial challenge, demonstrating that the peptide plays an unexpected role in the adaptive response to stress.
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            A comparison of the efficacy of medications for adult attention-deficit/hyperactivity disorder using meta-analysis of effect sizes.

            Medications used to treat attention-deficit/hyperactivity disorder (ADHD) in adults have been well researched, but comparisons among drugs are hindered by the absence of direct comparative trials. Our objectives were to (1) estimate the effect size of the medications used to treat adult ADHD, (2) determine if differences in the designs of studies confound comparisons of medication efficacy, (3) quantify the evidence for differences in effect sizes among medications, and (4) see if features of study design influence estimates of efficacy. The following search engines were used: PubMed, Ovid, ERIC, CINAHL, MEDLINE, PREMEDLINE, the Cochrane database, e-psyche, and Social Sciences Abstracts. Presentations from the American Psychiatric Association and American Academy of Child and Adolescent Psychiatry meetings were reviewed. A literature search was conducted to identify double-blind, placebo-controlled studies of ADHD in adults published in English after 1979. Only trials that used DSM-III, -III-R, or -IV ADHD criteria and followed subjects for > or = 2 weeks were selected. Meta-analysis regression assessed the influence of medication type and study design features on medication effects. Nineteen trials met criteria and were included in this meta-analysis. These trials studied 13 drugs using 18 different outcome measures of hyperactive, inattentive, or impulsive behavior. After trials were stratified on the class of drug studied (short-acting stimulant vs long-acting stimulant vs nonstimulant), significant differences in effect size were observed between stimulant and nonstimulant medications (P = .006 and P = .0001, respectively, for short- and long-acting stimulants vs nonstimulants), but the effect for short-acting stimulants was not significant after correcting for study design features. The effect sizes for each drug class were similar in magnitude to what we previously reported for medication treatment studies of children with ADHD. We found significant heterogeneity of effect sizes for short-acting stimulants (P < .001) but not for other medication groups. Although both stimulant and nonstimulant medications are effective for treating ADHD in adults, stimulant medications show greater efficacy for the short durations of treatment characteristic of placebo-controlled studies. We found no significant differences between short- and long-acting stimulant medications. Study design features vary widely among studies and can confound indirect comparisons unless addressed statistically as we have done in this study. 2010 Physicians Postgraduate Press, Inc.
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              Similar effects of the selective noradrenaline reuptake inhibitor atomoxetine on three distinct forms of impulsivity in the rat.

              Atomoxetine is a noradrenaline-specific reuptake inhibitor used clinically for the treatment of childhood and adult attention deficit hyperactivity disorder (ADHD). Studies in human volunteers and patient groups have shown that atomoxetine improves stop-signal reaction time (SSRT) performance, an effect consistent with a reduction in motor impulsivity. However, ADHD is a heterogeneous disorder and it is of interest to determine whether atomoxetine is similarly effective against other forms of impulsivity, as well as the attentional impairment present in certain subtypes of ADHD. The present study examined the effects of atomoxetine on impulsivity using an analogous SSRT task in rats and two additional tests of impulsivity; delay discounting of reward and the five-choice serial reaction time task (5CSRTT), the latter providing an added assessment of sustained visual attention. Atomoxetine produced a significant dose-dependent speeding of SSRT. In addition, atomoxetine produced a selective, dose-dependent decrease in premature responding on the 5CSRTT. Finally, on the delay-discounting task, atomoxetine significantly decreased impulsivity by increasing preference for the large-value reward across increasing delay. These findings conclusively demonstrate that atomoxetine decreases several distinct forms of impulsivity in rats. The apparent contrast of these effects with stimulant drugs such as amphetamine and methylphenidate, which generally act to increase impulsivity on the 5CSRTT, may provide new insights into the mechanisms of action of stimulant and nonstimulant drugs in ADHD.
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                Author and article information

                Contributors
                Journal
                Pharmacol Biochem Behav
                Pharmacol. Biochem. Behav
                Pharmacology, Biochemistry, and Behavior
                Elsevier
                0091-3057
                1873-5177
                1 December 2014
                December 2014
                : 127
                : 56-61
                Affiliations
                [a ]Department of Neuroscience, Physiology and Pharmacology, University College London, Gower St, London WC1E 6BT, UK
                [b ]RenaSci Ltd, BioCity, Pennyfoot Street, Nottingham, NG1 1GF, UK
                Author notes
                [* ]Corresponding author. Tel.: + 44 20 7679 3731. c.stanford@ 123456ucl.ac.uk
                Article
                S0091-3057(14)00282-2
                10.1016/j.pbb.2014.10.008
                4258612
                25450119
                8a75a34a-6c1d-4d0a-9282-1b79ef6d20a4
                © 2014 The Authors. Published by Elsevier Inc.
                History
                : 26 August 2014
                : 9 October 2014
                : 19 October 2014
                Categories
                Article

                Pharmacology & Pharmaceutical medicine
                adhd, attention deficit hyperactivity disorder,5-csrtt, 5-choice serial reaction-time task,ldeb, light/dark exploration box,nk1r, neurokinin-1 receptor,viti, variable inter-trial interval,atomoxetine,attention deficit hyperactivity disorder,5-choice serial reaction-time task,hyperactivity,impulsivity,nk1r−/− ‘knockout’ mouse

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