The effects of desipramine and iprindole on levels of enantiomers of fluoxetine in rat brain and urine

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Abstract
The antidepressant fluoxetine (FLU) and its N‐demethylated metabolite, norfluoxetine (NFLU), each contains a chiral center. The combination of FLU and desipramine (DMI), another antidepressant, has been reported to be useful in treatment of depression, to dramatically increase plasma levels of DMI and also to produce more rapid β‐adrenergic receptor down‐regulation in brain than caused by DMI alone. We have now begun studies on the effects of this drug combination on the levels of FLU and NFLU enantiomers in the rat. In addition, the combination of FLU and iprindole (IPR) was also investigated. Male Sprague–Dawley rats were treated intraperitoneally with either normal saline vehicle, DMI (5 mg/kg/day), (R,S)‐FLU (10 mg/kg/day) or DMI (5 mg/kg/day) + (R,S)‐FLU (10 mg/kg/day) for 4 days. Following the last treatment, 24 h urine samples were collected. Rats were sacrificed and brains were removed. For the IPR study, rats were pretreated with either saline or IPR‐HCl (11.2 mg/kg) and then treated 1 h later with (R,S)‐FLU. After 5 h, the rats were sacrificed and brains were removed. Brain and urine samples were analyzed by gas chromatography with electron‐capture detection for free (R)‐ and (S)‐FLU and (R)‐ and (S)‐NFLU after extraction and reaction with (−)‐(S)‐N‐(trifluoroacetyl)prolyl chloride. The results from the brains of the rats treated with DMI/FLU indicate that levels of the enantiomers of both FLU and NFLU were significantly increased over those seen in the animals receiving (R,S)‐FLU alone. In the IPR/FLU treated rats, an increase in the brain levels of both (R)‐ and (S)‐FLU was noted when compared with rats receiving (R,S)‐FLU alone; however, there appeared to be no increase in the brain levels of NFLU enantiomers.