Neurotransmitter




Structure of a typical chemical synapse


An illustrated chemical synapse
Postsynaptic
density

Voltage-
gated Ca++
channel

Synaptic
vesicle

Neurotransmitter
transporter

Receptor

Neurotransmitter

Axon terminal

Synaptic cleft

Dendrite


Neurotransmitters are endogenous chemicals that enable neurotransmission. It is a type of chemical messenger which transmits signals across a chemical synapse, such as a neuromuscular junction, from one neuron (nerve cell) to another "target" neuron, muscle cell, or gland cell.[1] Neurotransmitters are released from synaptic vesicles in synapses into the synaptic cleft, where they are received by neurotransmitter receptors on the target cells. Many neurotransmitters are synthesized from simple and plentiful precursors such as amino acids, which are readily available from the diet and only require a small number of biosynthetic steps for conversion. Neurotransmitters play a major role in shaping everyday life and functions. Their exact numbers are unknown, but more than 200 chemical messengers have been uniquely identified.[2][3][4]




Contents





  • 1 Mechanism


  • 2 Discovery


  • 3 Identification


  • 4 Types

    • 4.1 List of neurotransmitters, peptides, and gaseous signaling molecules



  • 5 Actions

    • 5.1 Excitatory and inhibitory


    • 5.2 Examples of important neurotransmitter actions



  • 6 Brain neurotransmitter systems


  • 7 Drug effects

    • 7.1 Agonists


    • 7.2 Antagonists

      • 7.2.1 Drug antagonists



    • 7.3 Precursors

      • 7.3.1 Catecholamine and trace amine precursors


      • 7.3.2 Serotonin precursors




  • 8 Diseases and disorders


  • 9 Neurotransmitter imbalance


  • 10 Elimination of neurotransmitters


  • 11 See also


  • 12 Notes


  • 13 References


  • 14 External links




Mechanism




Synaptic vesicles containing neurotransmitters


Neurotransmitters are stored in synaptic vesicles, clustered close to the cell membrane at the axon terminal of the presynaptic neuron. Neurotransmitters are released into and diffuse across the synaptic cleft, where they bind to specific receptors on the membrane of the postsynaptic neuron.[5]


Most neurotransmitters are about the size of a single amino acid, however, some neurotransmitters may be the size of larger proteins or peptides. A released neurotransmitter is typically available in the synaptic cleft for a short time before it is metabolized by enzymes, pulled back into the presynaptic neuron through reuptake, or bound to a postsynaptic receptor. Nevertheless, short-term exposure of the receptor to a neurotransmitter is typically sufficient for causing a postsynaptic response by way of synaptic transmission.


In response to a threshold action potential or graded electrical potential, a neurotransmitter is released at the presynaptic terminal. Low level "baseline" release also occurs without electrical stimulation. The released neurotransmitter may then move across the synapse to be detected by and bind with receptors in the postsynaptic neuron. Binding of neurotransmitters may influence the postsynaptic neuron in either an inhibitory or excitatory way. This neuron may be connected to many more neurons, and if the total of excitatory influences are greater than those of inhibitory influences, the neuron will also "fire". Ultimately it will create a new action potential at its axon hillock to release neurotransmitters and pass on the information to yet another neighboring neuron.[6]



Discovery



Until the early 20th century, scientists assumed that the majority of synaptic communication in the brain was electrical. However, through the careful histological examinations by Ramón y Cajal (1852–1934), a 20 to 40 nm gap between neurons, known today as the synaptic cleft, was discovered. The presence of such a gap suggested communication via chemical messengers traversing the synaptic cleft, and in 1921 German pharmacologist Otto Loewi (1873–1961) confirmed that neurons can communicate by releasing chemicals. Through a series of experiments involving the vagus nerves of frogs, Loewi was able to manually slow the heart rate of frogs by controlling the amount of saline solution present around the vagus nerve. Upon completion of this experiment, Loewi asserted that sympathetic regulation of cardiac function can be mediated through changes in chemical concentrations. Furthermore, Otto Loewi is credited with discovering acetylcholine (ACh)—the first known neurotransmitter.[7] Some neurons do, however, communicate via electrical synapses through the use of gap junctions, which allow specific ions to pass directly from one cell to another.[8]



Identification


There are four main criteria for identifying neurotransmitters:


  1. The chemical must be synthesized in the neuron or otherwise be present in it.

  2. When the neuron is active, the chemical must be released and produce a response in some target.

  3. The same response must be obtained when the chemical is experimentally placed on the target.

  4. A mechanism must exist for removing the chemical from its site of activation after its work is done.

However, given advances in pharmacology, genetics, and chemical neuroanatomy, the term "neurotransmitter" can be applied to chemicals that:


  • Carry messages between neurons via influence on the postsynaptic membrane.

  • Have little or no effect on membrane voltage, but have a common carrying function such as changing the structure of the synapse.

  • Communicate by sending reverse-direction messages that affect the release or reuptake of transmitters.

The anatomical localization of neurotransmitters is typically determined using immunocytochemical techniques, which identify the location of either the transmitter substances themselves, or of the enzymes that are involved in their synthesis. Immunocytochemical techniques have also revealed that many transmitters, particularly the neuropeptides, are co-localized, that is, one neuron may release more than one transmitter from its synaptic terminal.[9] Various techniques and experiments such as staining, stimulating, and collecting can be used to identify neurotransmitters throughout the central nervous system.[10]



Types


There are many different ways to classify neurotransmitters. Dividing them into amino acids, peptides, and monoamines is sufficient for some classification purposes.


Major neurotransmitters:



  • Amino acids: glutamate,[6]aspartate, D-serine, γ-aminobutyric acid (GABA), glycine


  • Gasotransmitters: nitric oxide (NO), carbon monoxide (CO), hydrogen sulfide (H2S)


  • Monoamines: dopamine (DA), norepinephrine (noradrenaline; NE, NA), epinephrine (adrenaline), histamine, serotonin (SER, 5-HT)


  • Trace amines: phenethylamine, N-methylphenethylamine, tyramine, 3-iodothyronamine, octopamine, tryptamine, etc.


  • Peptides: oxytocin, somatostatin, substance P, cocaine and amphetamine regulated transcript, opioid peptides[11]


  • Purines: adenosine triphosphate (ATP), adenosine

  • Others: acetylcholine (ACh), anandamide, etc.

In addition, over 50 neuroactive peptides have been found, and new ones are discovered regularly. Many of these are "co-released" along with a small-molecule transmitter. Nevertheless, in some cases a peptide is the primary transmitter at a synapse. β-endorphin is a relatively well-known example of a peptide neurotransmitter because it engages in highly specific interactions with opioid receptors in the central nervous system.


Single ions (such as synaptically released zinc) are also considered neurotransmitters by some,[12] as well as some gaseous molecules such as nitric oxide (NO), carbon monoxide (CO), and hydrogen sulfide (H2S).[13] The gases are produced in the neural cytoplasm and are immediately diffused through the cell membrane into the extracellular fluid and into nearby cells to stimulate production of second messengers. Soluble gas neurotransmitters are difficult to study, as they act rapidly and are immediately broken down, existing for only a few seconds.


The most prevalent transmitter is glutamate, which is excitatory at well over 90% of the synapses in the human brain.[6] The next most prevalent is Gamma-Aminobutyric Acid, or GABA, which is inhibitory at more than 90% of the synapses that do not use glutamate. Although other transmitters are used in fewer synapses, they may be very important functionally: the great majority of psychoactive drugs exert their effects by altering the actions of some neurotransmitter systems, often acting through transmitters other than glutamate or GABA. Addictive drugs such as cocaine and amphetamines exert their effects primarily on the dopamine system. The addictive opiate drugs exert their effects primarily as functional analogs of opioid peptides, which, in turn, regulate dopamine levels.



List of neurotransmitters, peptides, and gaseous signaling molecules
























































































































































































































































































































































































































Category

Name

Abbreviation

Metabotropic

Ionotropic

Small: Amino acids (Arg)
Arginine
α2-Adrenergic receptors, imidazoline receptors

NMDA receptors
Small: Amino acidsAspartateAsp
NMDA receptors
Small: Amino acidsGlutamateGluMetabotropic glutamate receptors
NMDA receptors, kainate receptors, AMPARs
Small: Amino acidsGamma-aminobutyric acidGABAGABAB receptors
GABAA receptors, GABAA-ρ receptors
Small: Amino acidsGlycineGly
NMDA receptors, glycine receptors
Small: Amino acids
D-serine
Ser
NMDA receptors
Small: AcetylcholineAcetylcholineAchMuscarinic acetylcholine receptors
Nicotinic acetylcholine receptors
Small: Monoamine (Phe/Tyr)DopamineDA
Dopamine receptors, trace amine-associated receptor 1[14][15]

Small: Monoamine (Phe/Tyr)
Norepinephrine (noradrenaline)
NE, NAdAdrenergic receptors
Small: Monoamine (Phe/Tyr)
Epinephrine (adrenaline)
Epi, AdAdrenergic receptors
Small: Monoamine (Trp)
Serotonin (5-hydroxytryptamine)
5-HT
Serotonin receptors (all except 5-HT3)

5-HT3
Small: Monoamine (His)HistamineHHistamine receptors
Small: Trace amine (Phe)PhenethylaminePEAHuman trace amine-associated receptors: hTAAR1, hTAAR2

Small: Trace amine (Phe)
N-methylphenethylamine
NMPEAhTAAR1
Small: Trace amine (Phe/Tyr)TyramineTYR
hTAAR1, hTAAR2

Small: Trace amine (Phe/Tyr)OctopamineOcthTAAR1
Small: Trace amine (Phe/Tyr)SynephrineSynhTAAR1
Small: Trace amine (Trp)Tryptamine
hTAAR1, various serotonin receptors

Small: Trace amine (Trp)
N-methyltryptamine
NMT
hTAAR1, various serotonin receptors

Lipid
AnandamideAEACannabinoid receptors
Lipid
2-Arachidonoylglycerol2-AGCannabinoid receptors
Lipid
2-Arachidonyl glyceryl ether2-AGECannabinoid receptors
Lipid

N-Arachidonoyl dopamine
NADACannabinoid receptors
TRPV1
Lipid
VirodhamineCannabinoid receptors
Small: Purine
AdenosineAdoAdenosine receptors
Small: PurineAdenosine triphosphateATPP2Y receptors
P2X receptors

PP: Bradykinins
Bradykinin
B1, B2

PP: Corticotropin-releasing factors
Corticotropin-releasing hormoneCRHCRHR1
PP: Corticotropin-releasing factorsUrocortinCRHR1
PP: GalaninsGalanin
GALR1, GALR2, GALR3

PP: GalaninsGalanin-like peptide
GALR1, GALR2, GALR3

PP: GastrinsGastrinCholecystokinin B receptor
PP: GastrinsCholecystokininCCKCholecystokinin receptors
PP: Melanocortins
Adrenocorticotropic hormoneACTHACTH receptor
PP: MelanocortinsProopiomelanocortinPOMCMelanocortin 4 receptor
PP: MelanocortinsMelanocyte-stimulating hormonesMSHMelanocortin receptors
PP: Neurohypophyseals
VasopressinAVPVasopressin receptors
PP: NeurohypophysealsOxytocinOTOxytocin receptor
PP: NeurohypophysealsNeurophysin I
PP: NeurohypophysealsNeurophysin II
PP: NeuromedinsNeuromedin UNmU
NmUR1, NmUR2

PP: Neuropeptide B/WNeuropeptide BNPB
NPBW1, NPBW2

PP: Neuropeptide B/WNeuropeptide SNPSNeuropeptide S receptors
PP: Neuropeptide YNeuropeptide YNYNeuropeptide Y receptors
PP: Neuropeptide YPancreatic polypeptidePP
PP: Neuropeptide YPeptide YYPYY
PP: Opioids
Enkephalinδ-Opioid receptor
PP: OpioidsDynorphinκ-Opioid receptor
PP: OpioidsEndorphinμ-Opioid receptors
PP: OpioidsEndomorphinμ-Opioid receptors
PP: OpioidsNociceptin/orphanin FQN/OFQNociceptin receptors
PP: Orexins
Orexin AOX-AOrexin receptors
PP: OrexinsOrexin BOX-BOrexin receptors
PP: RFamides
KisspeptinKiSSGPR54
PP: RFamidesNeuropeptide FFNPFFNPFF1, NPFF2
PP: RFamidesProlactin-releasing peptidePrRPPrRPR
PP: RFamidesPyroglutamylated RFamide peptideQRFPGPR103
PP: Secretins
SecretinSecretin receptor
PP: SecretinsMotilinMotilin receptor
PP: SecretinsGlucagonGlucagon receptor
PP: SecretinsGlucagon-like peptide-1GLP-1Glucagon-like peptide 1 receptor
PP: SecretinsGlucagon-like peptide-2GLP-2Glucagon-like peptide 2 receptor
PP: SecretinsVasoactive intestinal peptideVIPVasoactive intestinal peptide receptors
PP: SecretinsGrowth hormone–releasing hormoneGHRHGrowth hormone–releasing hormone receptor
PP: SecretinsPituitary adenylate cyclase-activating peptidePACAPADCYAP1R1
PP: SomatostatinsSomatostatinSomatostatin receptors
PP: Tachykinins
Neurokinin A
PP: TachykininsNeurokinin B
PP: TachykininsSubstance P
PP: TachykininsNeuropeptide K
PP: OtherAgouti-related peptideAgRP
Melanocortin receptor –
PP: Other
N-Acetylaspartylglutamate
NAAG
Metabotropic glutamate receptor 3 (mGluR3)

PP: OtherCocaine- and amphetamine-regulated transcriptCARTUnknown Gi/Go-coupled receptor[16]
PP: OtherBombesin
PP: OtherGastrin releasing peptideGRP
PP: OtherGonadotropin-releasing hormoneGnRHGnRHR
PP: OtherMelanin-concentrating hormoneMCH
MCHR 1,2

Gaseous signaling moleculeNitric oxideNOSoluble guanylyl cyclase

Gaseous signaling moleculeCarbon monoxideCO
Heme bound to potassium channels
Gaseous signaling moleculeHydrogen sulfideH2S


Actions


Neurons form elaborate networks through which nerve impulses—action potentials—travel. Each neuron has as many as 15,000 connections with neighboring neurons.


Neurons do not touch each other (except in the case of an electrical synapse through a gap junction); instead, neurons interact at contact points called synapses: a junction within two nerve cells, consisting of a miniature gap within which impulses are carried by a neurotransmitter. A neuron transports its information by way of a nerve impulse called an action potential. When an action potential arrives at the synapse's presynaptic terminal button, it may stimulate the release of neurotransmitters. These neurotransmitters are released into the synaptic cleft to bind onto the receptors of the postsynaptic membrane and influence another cell, either in an inhibitory or excitatory way. The next neuron may be connected to many more neurons, and if the total of excitatory influences minus inhibitory influences is great enough, it will also "fire". That is to say, it will create a new action potential at its axon hillock, releasing neurotransmitters and passing on the information to yet another neighboring neuron.



Excitatory and inhibitory


A neurotransmitter can influence the function of a neuron through a remarkable number of mechanisms. In its direct actions in influencing a neuron's electrical excitability, however, a neurotransmitter acts in only one of two ways: excitatory or inhibitory. A neurotransmitter influences trans-membrane ion flow either to increase (excitatory) or to decrease (inhibitory) the probability that the cell with which it comes in contact will produce an action potential. Thus, despite the wide variety of synapses, they all convey messages of only these two types, and they are labeled as such. Type I synapses are excitatory in their actions, whereas type II synapses are inhibitory. Each type has a different appearance and is located on different parts of the neurons under its influence. Each neuron receives thousands of excitatory and inhibitory signals every second.[citation needed]


Type I (excitatory) synapses are typically located on the shafts or the spines of dendrites, whereas type II (inhibitory) synapses are typically located on a cell body. In addition, Type I synapses have round synaptic vesicles, whereas the vesicles of type II synapses are flattened. The material on the presynaptic and post-synaptic membranes is denser in a Type I synapse than it is in a type II, and the type I synaptic cleft is wider. Finally, the active zone on a Type I synapse is larger than that on a Type II synapse.


The different locations of type I and type II synapses divide a neuron into two zones: an excitatory dendritic tree and an inhibitory cell body. From an inhibitory perspective, excitation comes in over the dendrites and spreads to the axon hillock to trigger an action potential. If the message is to be stopped, it is best stopped by applying inhibition on the cell body, close to the axon hillock where the action potential originates. Another way to conceptualize excitatory–inhibitory interaction is to picture excitation overcoming inhibition. If the cell body is normally in an inhibited state, the only way to generate an action potential at the axon hillock is to reduce the cell body's inhibition. In this "open the gates" strategy, the excitatory message is like a racehorse ready to run down the track, but first the inhibitory starting gate must be removed.[17]



Examples of important neurotransmitter actions


As explained above, the only direct action of a neurotransmitter is to activate a receptor. Therefore, the effects of a neurotransmitter system depend on the connections of the neurons that use the transmitter, and the chemical properties of the receptors that the transmitter binds to.


Here are a few examples of important neurotransmitter actions:



  • Glutamate is used at the great majority of fast excitatory synapses in the brain and spinal cord. It is also used at most synapses that are "modifiable", i.e. capable of increasing or decreasing in strength. Modifiable synapses are thought to be the main memory-storage elements in the brain. Excessive glutamate release can overstimulate the brain and lead to excitotoxicity causing cell death resulting in seizures or strokes.[18] Excitotoxicity has been implicated in certain chronic diseases including ischemic stroke, epilepsy, amyotrophic lateral sclerosis, Alzheimer's disease, Huntington disease, and Parkinson's disease.[19]


  • GABA is used at the great majority of fast inhibitory synapses in virtually every part of the brain. Many sedative/tranquilizing drugs act by enhancing the effects of GABA.[20] Correspondingly, glycine is the inhibitory transmitter in the spinal cord.


  • Acetylcholine was the first neurotransmitter discovered in the peripheral and central nervous systems. It activates skeletal muscles in the somatic nervous system and may either excite or inhibit internal organs in the autonomic system.[10] It is distinguished as the transmitter at the neuromuscular junction connecting motor nerves to muscles. The paralytic arrow-poison curare acts by blocking transmission at these synapses. Acetylcholine also operates in many regions of the brain, but using different types of receptors, including nicotinic and muscarinic receptors.[21]


  • Dopamine has a number of important functions in the brain; this includes regulation of motor behavior, pleasures related to motivation and also emotional arousal. It plays a critical role in the reward system; Parkinson's disease has been linked to low levels of dopamine and schizophrenia has been linked to high levels of dopamine.[22]


  • Serotonin is a monoamine neurotransmitter. Most is produced by and found in the intestine (approximately 90%), and the remainder in central nervous system neurons. It functions to regulate appetite, sleep, memory and learning, temperature, mood, behaviour, muscle contraction, and function of the cardiovascular system and endocrine system. It is speculated to have a role in depression, as some depressed patients are seen to have lower concentrations of metabolites of serotonin in their cerebrospinal fluid and brain tissue.[23]


  • Norepinephrine which is synthesized in the central nervous system and sympathetic nerves, modulates the responses of the autonomic nervous system, the sleep patterns, focus and alertness. It is synthesized from tyrosine.


  • Epinephrine which is also synthesized from tyrosine is released in the adrenal glands and the brainstem. It plays a role in sleep, with ones ability to become and stay alert, and the fight-or-flight response.


  • Histamine works with the central nervous system (CNS), specifically the hypothalamus (tuberomammillary nucleus) and CNS mast cells.


Brain neurotransmitter systems


Neurons expressing certain types of neurotransmitters sometimes form distinct systems, where activation of the system affects large volumes of the brain, called volume transmission. Major neurotransmitter systems include the noradrenaline (norepinephrine) system, the dopamine system, the serotonin system, and the cholinergic system, among others. Trace amines have a modulatory effect on neurotransmission in monoamine pathways (i.e., dopamine, norepinephrine, and serotonin pathways) throughout the brain via signaling through trace amine-associated receptor 1.[24][25] A brief comparison of these systems follows:





















Neurotransmitter systems in the brain
SystemPathway origin and projectionsRegulated cognitive processes and behaviors
Noradrenaline system
[26][27][28][29][30][31]

Noradrenergic pathways:

  • Locus coeruleus (LC) projections
  • LC → Amygdala and Hippocampus

  • LC → Brain stem and Spinal cord

  • LC → Cerebellum

  • LC → Cerebral cortex

  • LC → Hypothalamus

  • LC → Tectum

  • LC → Thalamus

  • LC → Ventral tegmental area


  • Lateral tegmental field (LTF) projections
  • LTF → Brain stem and Spinal cord

  • LTF → Olfactory bulb


  • anxiety


  • arousal (wakefulness)

  • circadian rhythm


  • cognitive control and working memory (co-regulated by dopamine)

  • feeding and energy homeostasis

  • medullary control of respiration

  • negative emotional memory


  • nociception (perception of pain)


  • reward (minor role)

Dopamine system
[28][29][30][32][33][34]

Dopaminergic pathways:

  • Ventral tegmental area (VTA) projections
  • VTA → Amygdala

  • VTA → Cingulate cortex

  • VTA → Hippocampus

  • VTA → Ventral striatum (Mesolimbic pathway)

  • VTA → Olfactory bulb

  • VTA → Prefrontal cortex (Mesocortical pathway)

  • Nigrostriatal pathway

  • Substantia nigra pars compacta → Dorsal striatum
  • Tuberoinfundibular pathway

  • Arcuate nucleus → Median eminence


  • arousal (wakefulness)

  • aversion


  • cognitive control and working memory (co-regulated by norepinephrine)

  • emotion and mood

  • motivation (motivational salience)

  • motor function

  • positive reinforcement


  • reward (primary mediator)


  • sexual arousal, orgasm, and refractory period (via neuroendocrine regulation)

Histamine system
[29][30][35]

Histaminergic pathways:

  • Tuberomammillary nucleus (TMN) projections
  • TMN → Cerebral cortex

  • TMN → Hippocampus

  • TMN → Neostriatum

  • TMN → Nucleus accumbens

  • TMN → Amygdala

  • TMN → Hypothalamus



  • arousal (wakefulness)

  • feeding and energy homeostasis

  • learning

  • memory

Serotonin system
[26][28][29][30][36][37][38]

Serotonergic pathways:

Caudal nuclei (CN):
Raphe magnus, raphe pallidus, and raphe obscurus


  • Caudal projections
  • CN → Cerebral cortex

  • CN → Thalamus

  • CN → Caudate-putamen and nucleus accumbens

  • CN → Substantia nigra and ventral tegmental area

Rostral nuclei (RN):
Nucleus linearis, dorsal raphe, medial raphe, and raphe pontis


  • Rostral projections
  • RN → Amygdala

  • RN → Cingulate cortex

  • RN → Hippocampus

  • RN → Hypothalamus

  • RN → Neocortex

  • RN → Septum

  • RN → Thalamus

  • RN → Ventral tegmental area



  • arousal (wakefulness)


  • body temperature regulation

  • emotion and mood, potentially including aggression

  • feeding and energy homeostasis


  • reward (minor role)

  • sensory perception

Acetylcholine system
[26][28][29][30][39]

Cholinergic pathways:

Forebrain cholinergic nuclei (FCN):
Nucleus basalis of Meynert, medial septal nucleus, and diagonal band


  • Forebrain nuclei projections
  • FCN → Hippocampus

  • FCN → Cerebral cortex

  • FCN → Limbic cortex and sensory cortex

Brainstem cholinergic nuclei (BCN):
Pedunculopontine nucleus, laterodorsal tegmentum, medial habenula, and
parabigeminal nucleus


  • Brainstem nuclei projections
  • BCN → Ventral tegmental area

  • BCN → Thalamus



  • arousal (wakefulness)

  • emotion and mood

  • learning

  • motor function

  • motivation (motivational salience)

  • short-term memory


  • reward (minor role)


Drug effects



Understanding the effects of drugs on neurotransmitters comprises a significant portion of research initiatives in the field of neuroscience. Most neuroscientists involved in this field of research believe that such efforts may further advance our understanding of the circuits responsible for various neurological diseases and disorders, as well as ways to effectively treat and someday possibly prevent or cure such illnesses.[40]


Drugs can influence behavior by altering neurotransmitter activity. For instance, drugs can decrease the rate of synthesis of neurotransmitters by affecting the synthetic enzyme(s) for that neurotransmitter. When neurotransmitter syntheses are blocked, the amount of neurotransmitters available for release becomes substantially lower, resulting in a decrease in neurotransmitter activity. Some drugs block or stimulate the release of specific neurotransmitters. Alternatively, drugs can prevent neurotransmitter storage in synaptic vesicles by causing the synaptic vesicle membranes to leak. Drugs that prevent a neurotransmitter from binding to its receptor are called receptor antagonists. For example, drugs used to treat patients with schizophrenia such as haloperidol, chlorpromazine, and clozapine are antagonists at receptors in the brain for dopamine. Other drugs act by binding to a receptor and mimicking the normal neurotransmitter. Such drugs are called receptor agonists. An example of a receptor agonist is morphine, an opiate that mimics effects of the endogenous neurotransmitter β-endorphin to relieve pain. Other drugs interfere with the deactivation of a neurotransmitter after it has been released, thereby prolonging the action of a neurotransmitter. This can be accomplished by blocking re-uptake or inhibiting degradative enzymes. Lastly, drugs can also prevent an action potential from occurring, blocking neuronal activity throughout the central and peripheral nervous system. Drugs such as tetrodotoxin that block neural activity are typically lethal.


Drugs targeting the neurotransmitter of major systems affect the whole system, which can explain the complexity of action of some drugs. Cocaine, for example, blocks the re-uptake of dopamine back into the presynaptic neuron, leaving the neurotransmitter molecules in the synaptic gap for an extended period of time. Since the dopamine remains in the synapse longer, the neurotransmitter continues to bind to the receptors on the postsynaptic neuron, eliciting a pleasurable emotional response. Physical addiction to cocaine may result from prolonged exposure to excess dopamine in the synapses, which leads to the downregulation of some post-synaptic receptors. After the effects of the drug wear off, an individual can become depressed due to decreased probability of the neurotransmitter binding to a receptor. Fluoxetine is a selective serotonin re-uptake inhibitor (SSRI), which blocks re-uptake of serotonin by the presynaptic cell which increases the amount of serotonin present at the synapse and furthermore allows it to remain there longer, providing potential for the effect of naturally released serotonin.[41]AMPT prevents the conversion of tyrosine to L-DOPA, the precursor to dopamine; reserpine prevents dopamine storage within vesicles; and deprenyl inhibits monoamine oxidase (MAO)-B and thus increases dopamine levels.












































































































































































































































































Drug-Neurotransmitter Interactions[42]
Drug
Interacts with:
Receptor Interaction:
Type
Effects

Botulinum Toxin (Botox)
Acetylcholine

Antagonist
Blocks acetylcholine release in PNS

Prevents muscle contractions


Black Widow Spider Venom
Acetylcholine

Agonist
Promotes acetylcholine release in PNS

Stimulates muscle contractions


Neostigmine
Acetylcholine


Interferes with acetylcholinerase activity

Increases effects of ACh at receptors


Used to treat myasthenia gravis



Nicotine
Acetylcholine

Nicotinic (skeletal muscle)
Agonist
Increases ACh activity

Increases attention


Reinforcing effects


d-tubocurarine
Acetylcholine

Nicotinic (skeletal muscle)
Antagonist
Decreases activity at receptor site
Curare
Acetylcholine

Nicotinic (skeletal muscle)
Antagonist
Decreases ACh activity

Prevents muscle contractions



Muscarine
Acetylcholine

Muscarinic (heart and smooth muscle)
Agonist
Increases ACh activity

Toxic



Atropine
Acetylcholine

Muscarinic (heart and smooth muscle)
Antagonist
Blocks pupil constriction

Blocks saliva production


Scopolamine (Hyoscine)
Acetylcholine

Muscarinic (heart and smooth muscle)
Antagonist
Treats motion sickness and postoperative nausea and vomiting
AMPT
Dopamine/norepinephrine


Inactivates tyrosine hydroxylase and inhibits dopamine production

Reserpine
Dopamine


Prevents storage of dopamine and other monoamines in synaptic vesicles

Causes sedation and depression



Apomorphine
Dopamine

D2 Receptor (presynaptic autoreceptors/postsynaptic receptors)
Antagonist (low dose)/Direct agonist (high dose)
Low dose: blocks autoreceptors

High dose: stimulates postsynaptic receptors



Amphetamine
Dopamine/norepinephrine

Indirect agonist
Releases dopamine, noradrenaline, and serotonin

Blocks reuptake[24][25]



Methamphetamine
Dopamine/norepinephrine


Releases dopamine and noradrenaline

Blocks reuptake



Methylphenidate
Dopamine


Blocks reuptake

Enhances attention and impulse control in ADHD



Cocaine
Dopamine

Indirect Agonist
Blocks reuptake into presynapse

Blocks voltage-dependent sodium channels


Can be used as a topical anesthetic (eye drops)


Deprenyl
Dopamine

Agonist
Inhibits MAO-B

Prevents destruction of dopamine



Chlorpromazine
Dopamine

D2 Receptors
Antagonist
Blocks D2 receptors

Alleviates hallucinations



MPTP
Dopamine


Results in Parkinson like symptoms
PCPA
Serotonin (5-HT)

Antagonist
Disrupts serotonin synthesis by blocking the activity of tryptophan hydroxylase
Ondanestron
Serotonin (5-HT)

5-HT3 receptors
Antagonist
Reduces side effects of chemotherapy and radiation

Reduces nausea and vomiting



Buspirone
Serotonin (5-HT)

5-HT1A receptors
Partial Agonist
Treats symptoms of anxiety and depression

Fluoxetine
Serotonin (5-HT)

SSRI
Inhibits reuptake of serotonin

Treats depression, some anxiety disorders, and OCD[41]



Fenfluramine
Serotonin (5-HT)


Causes release of serotonin

Inhibits reuptake of serotonin


Used as an appetite suppressant



Lysergic acid diethylamide
Serotonin (5-HT)
Post-synaptic 5-HT2A receptors
Direct Agonist
Produces visual perception distortions

Stimulates 5-HT2A receptors in forebrain


Methylenedioxymethamphetamine (MDMA)
Serotonin (5-HT)/ norepinphrine


Stimulates release of serotonin and norepinephrine and inhibits the reuptake

Causes excitatory and hallucinogenic effects



Strychnine
Glycine

Antagonist
Causes severe muscle spasms[43]
Diphenyldramine
Histamine


Crosses blood brain barrier to cause drowsiness

Tetrahydrocannabinol (THC)
Endocannabinoids
Cannabinoid (CB) receptors
Agonist
Produces analgesia and sedation

Increases appetite


Cognitive effects


Rimonabant
Endocannabinoids
Cannabinoid (CB) receptors
Antagonist
Suppresses appetite

Used in smoking cessation


MAFP
Endocannabinoids


Inhibits FAAH

Used in research to increase cannabinoid system activity


AM1172
Endocannabinoids


Blocks cannabinoid reuptake

Used in research to increase cannabinoid system activity


Anandamide (endogenous)

Cannabinoid (CB) receptors; 5-HT3 receptors

Reduce nausea and vomiting

Caffeine
Adenosine
Adenosine receptors
Antagonist
Blocks adenosine receptors

Increases wakefullness



PCP
Glutamate

NMDA receptor
Indirect Antagonist
Blocks PCP binding site

Prevents calcium ions from entering neurons


Impairs learning



AP5
Glutamate

NMDA receptor
Antagonist
Blocks glutamate binding site on NMDA receptor

Impairs synaptic plasticity and certain forms of learning



NMDA
Glutamate

NMDA receptor
Agonist
Used in research to study NMDA receptor

AMPA
Glutamate

AMPA receptor
Agonist
Used in research to study AMPA receptor

Ketamine
Glutamate

Kainate receptor
Antagonist
Used in research to study Kainate receptor
Allyglycine
GABA


Inhibits GABA synthesis

Causes seizures



Muscimol
GABA

GABA receptor
Agonist
Causes sedation

Bicuculine
GABA
GABA receptor
Antagonist
Causes Seizures

Benzodiazepines
GABA

GABAA receptor
Indirect agonists
Anxiolytic, sedation, memory impairment, muscle relaxation

Barbiturates
GABA

GABAA receptor
Indirect agonists
Sedation, memory impairment, muscle relaxation

Alcohol
GABA

GABA receptor
Indirect agonist
Sedation, memory impairment, muscle relaxation

Picrotoxin
GABA

GABAA receptor
Indirect antagonist
High doses cause seizures

Tiagabine
GABA

Antagonist
GABA transporter antagonist

Increase availability of GABA


Reduces the likelihood of seizures



Moclobemide
Norepinephrine

Agonist
Blocks MAO-A to treat depression

Idazoxan
Norepinephrine
alpha-2 adrenergic autoreceptors
Agonist
Blocks alpha-2 autoreceptors

Used to study norepinephrine system


Fusaric acid
Norepinephrine


Inhibits activity of dopamine beta-hydroxylase which blocks the production of norepinephrine

Used to study norepinephrine system without affecting dopamine system


Opiates (Opium, morphine, heroin,and oxycodone)
Opioids
Opioid receptor[44]Agonists
Analgesia, sedation, and reinforcing effects

Naloxone
Opioids

Antagonist
Reverses opiate intoxication or overdo


Agonists



An agonist is a chemical capable of binding to a receptor, such as a neurotransmitter receptor, and initiating the same reaction typically produced by the binding of the endogenous substance.[45] An agonist of a neurotransmitter will thus initiate the same receptor response as the transmitter. In neurons, an agonist drug may activate neurotransmitter receptors either directly or indirectly. Direct-binding agonists can be further characterized as full agonists, partial agonists, inverse agonists.[citation needed]


Direct agonists act similar to a neurotransmitter by binding directly to its associated receptor site(s), which may be located on the presynaptic neuron or postsynaptic neuron, or both.[46] Typically, neurotransmitter receptors are located on the postsynaptic neuron, while neurotransmitter autoreceptors are located on the presynaptic neuron, as is the case for monoamine neurotransmitters;[24] in some cases, a neurotransmitter utilizes retrograde neurotransmission, a type of feedback signaling in neurons where the neurotransmitter is released postsynaptically and binds to target receptors located on the presynaptic neuron.[47][note 1]Nicotine, a compound found in tobacco, is a direct agonist of most nicotinic acetylcholine receptors, mainly located in cholinergic neurons.[44]Opiates, such as morphine, heroin, hydrocodone, oxycodone, codeine, and methadone, are μ-opioid receptor agonists; this action mediates their euphoriant and pain relieving properties.[44]


Indirect agonists increase the binding of neurotransmitters at their target receptors by stimulating the release or preventing the reuptake of neurotransmitters.[46] Some indirect agonists trigger neurotransmitter release and prevent neurotransmitter reuptake. Amphetamine, for example, is an indirect agonist of postsynaptic dopamine, norepinephrine, and serotonin receptors in each their respective neurons;[24][25] it produces both neurotransmitter release into the presynaptic neuron and subsequently the synaptic cleft and prevents their reuptake from the synaptic cleft by activating TAAR1, a presynaptic G protein-coupled receptor, and binding to a site on VMAT2, a type of monoamine transporter located on synaptic vesicles within monoamine neurons.[24][25]



Antagonists



An antagonist is a chemical that acts within the body to reduce the physiological activity of another chemical substance (as an opiate); especially one that opposes the action on the nervous system of a drug or a substance occurring naturally in the body by combining with and blocking its nervous receptor.[48]


There are two main types of antagonist: direct-acting Antagonist and indirect-acting Antagonists:


  1. Direct-acting antagonist- which takes up space present on receptors which are otherwise taken up by neurotransmitters themselves. This results in neurotransmitters being blocked from binding to the receptors. The most common is called Atropine.

  2. Indirect-acting antagonist- drugs that inhibit the release/production of neurotransmitters (e.g., Reserpine).


Drug antagonists


An antagonist drug is one that attaches (or binds) to a site called a receptor without activating that receptor to produce a biological response. It is therefore said to have no intrinsic activity. An antagonist may also be called a receptor "blocker" because they block the effect of an agonist at the site. The pharmacological effects of an antagonist therefore result in preventing the corresponding receptor site's agonists (e.g., drugs, hormones, neurotransmitters) from binding to and activating it. Antagonists may be "competitive" or "irreversible".


A competitive antagonist competes with an agonist for binding to the receptor. As the concentration of antagonist increases, the binding of the agonist is progressively inhibited, resulting in a decrease in the physiological response. High concentration of an antagonist can completely inhibit the response. This inhibition can be reversed, however, by an increase of the concentration of the agonist, since the agonist and antagonist compete for binding to the receptor. Competitive antagonists, therefore, can be characterized as shifting the dose-response relationship for the agonist to the right. In the presence of a competitive antagonist, it takes an increased concentration of the agonist to produce the same response observed in the absence of the antagonist.


An irreversible antagonist binds so strongly to the receptor as to render the receptor unavailable for binding to the agonist. Irreversible antagonists may even form covalent chemical bonds with the receptor. In either case, if the concentration of the irreversible antagonist is high enough, the number of unbound receptors remaining for agonist binding may be so low that even high concentrations of the agonist do not produce the maximum biological response.[49]



Precursors





Biosynthetic pathways for catecholamines and trace amines in the human brain[50][51][52]


Graphic of catecholamine and trace amine biosynthesis



L-Phenylalanine

L-Tyrosine

L-DOPA

Epinephrine

Phenethylamine

p-Tyramine

Dopamine

Norepinephrine

N-Methylphenethylamine

N-Methyltyramine

p-Octopamine

Synephrine

3-Methoxytyramine

AADC

AADC

AADC

primary
pathway

PNMT

PNMT

PNMT

PNMT

AAAH

AAAH

brain
CYP2D6

minor
pathway

COMT

DBH

DBH





The image above contains clickable links
In humans, catecholamines and phenethylaminergic trace amines are derived from the amino acid L-phenylalanine.



While intake of neurotransmitter precursors does increase neurotransmitter synthesis, evidence is mixed as to whether neurotransmitter release and postsynaptic receptor firing is increased. Even with increased neurotransmitter release, it is unclear whether this will result in a long-term increase in neurotransmitter signal strength, since the nervous system can adapt to changes such as increased neurotransmitter synthesis and may therefore maintain constant firing.[53][unreliable medical source?] Some neurotransmitters may have a role in depression and there is some evidence to suggest that intake of precursors of these neurotransmitters may be useful in the treatment of mild and moderate depression.[53][unreliable medical source?][54]



Catecholamine and trace amine precursors


L-DOPA, a precursor of dopamine that crosses the blood–brain barrier, is used in the treatment of Parkinson's disease. For depressed patients where low activity of the neurotransmitter norepinephrine is implicated, there is only little evidence for benefit of neurotransmitter precursor administration. L-phenylalanine and L-tyrosine are both precursors for dopamine, norepinephrine, and epinephrine. These conversions require vitamin B6, vitamin C, and S-adenosylmethionine. A few studies suggest potential antidepressant effects of L-phenylalanine and L-tyrosine, but there is much room for further research in this area.[53][unreliable medical source?]



Serotonin precursors


Administration of L-tryptophan, a precursor for serotonin, is seen to double the production of serotonin in the brain. It is significantly more effective than a placebo in the treatment of mild and moderate depression.[53][unreliable medical source?] This conversion requires vitamin C.[23]5-hydroxytryptophan (5-HTP), also a precursor for serotonin, is more effective than a placebo.[53][unreliable medical source?]



Diseases and disorders


Diseases and disorders may also affect specific neurotransmitter systems. For example, problems in producing dopamine can result in Parkinson's disease, a disorder that affects a person's ability to move as they want to, resulting in stiffness, tremors or shaking, and other symptoms. Some studies suggest that having too little or too much dopamine or problems using dopamine in the thinking and feeling regions of the brain may play a role in disorders like schizophrenia or attention deficit hyperactivity disorder (ADHD). Similarly, after some research suggested that drugs that block the recycling, or reuptake, of serotonin seemed to help some people diagnosed with depression, it was theorized that people with depression might have lower-than-normal serotonin levels. Though widely popularized, this theory was not borne out in subsequent research.[55] Furthermore, problems with producing or using glutamate have been suggestively and tentatively linked to many mental disorders, including autism, obsessive compulsive disorder (OCD), schizophrenia, and depression.[56]




CAPON Binds Nitric Oxide Synthase, Regulating NMDA Receptor–Mediated Glutamate Neurotransmission



Neurotransmitter imbalance


Generally, there are no scientifically established "norms" for appropriate levels or "balances" of different neurotransmitters. It is in most cases pragmatically impossible to even measure levels of neurotransmitters in a brain or body at any distinct moments in time. Neurotransmitters regulate each other's release, and weak consistent imbalances in this mutual regulation were linked to temperament in healthy people
.[57][58][59][60][61] Strong imbalances or disruptions to neurotransmitter systems have been associated with many diseases and mental disorders. These include Parkinson's, depression, insomnia, Attention Deficit Hyperactivity Disorder (ADHD), anxiety, memory loss, dramatic changes in weight and addictions. Chronic physical or emotional stress can be a contributor to neurotransmitter system changes. Genetics also plays a role in neurotransmitter activities. Apart from recreational use, medications that directly and indirectly interact one or more transmitter or its receptor are commonly prescribed for psychiatric and psychological issues. Notably, drugs interacting with serotonin and norepinephrine are prescribed to patients with problems such as depression and anxiety—though the notion that there is much solid medical evidence to support such interventions has been widely criticized.[62]



Elimination of neurotransmitters


A neurotransmitter must be broken down once it reaches the post-synaptic cell to prevent further excitatory or inhibitory signal transduction. This allows new signals to be produced from the adjacent nerve cells. When the neurotransmitter has been secreted into the synaptic cleft, it binds to specific receptors on the postsynaptic cell, thereby generating a postsynaptic electrical signal. The transmitter must then be removed rapidly to enable the postsynaptic cell to engage in another cycle of neurotransmitter release, binding, and signal generation. Neurotransmitters are terminated in three different ways:


  1. Diffusion – the neurotransmitter detaches from receptor, drifting out of the synaptic cleft, here it becomes absorbed by glial cells.

  2. Enzyme degradation – special chemicals called enzymes break it down.

  3. Reuptake – re-absorption of a neurotransmitter into the neuron. Transporters, or membrane transport proteins, pump neurotransmitters from the synaptic cleft back into axon terminals (the presynaptic neuron) where they are stored.[63]

For example, choline is taken up and recycled by the pre-synaptic neuron to synthesize more ACh. Other neurotransmitters such as dopamine are able to diffuse away from their targeted synaptic junctions and are eliminated from the body via the kidneys, or destroyed in the liver. Each neurotransmitter has very specific degradation pathways at regulatory points, which may be targeted by the body's regulatory system or by recreational drugs.



See also




  • Kiss-and-run fusion

  • Natural neuroactive substance

  • Neuroendocrine

  • Neuroendocrinology

  • Neuropsychopharmacology

  • Neurotransmitter release



Notes




  1. ^ In the central nervous system, anandamide other endocannabinoids utilize retrograde neurotransmission, since their release is postsynaptic, while their target receptor, cannabinoid receptor 1 (CB1), is presynaptic.[47] The cannabis plant contains Δ9-tetrahydrocannabinol, which is a direct agonist at CB1.[47]




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    Figure 3: The ventral striatum and self-administration of amphetamine



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External links






  • Molecular Cell Biology. 4th edition. Section 21.4: Neurotransmitters, Synapses, and Impulse Transmission

  • Molecular Expressions Photo Gallery: The Neurotransmitter Collection

  • Brain Neurotransmitters

  • Endogenous Neuroactive Extracellular Signal Transducers


  • Neurotransmitter at the US National Library of Medicine Medical Subject Headings (MeSH)

  • neuroscience for kids website

  • brain explorer website












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