Antidepressants modulate the in vitro inhibitory effects of propofol and ketamine on norepinephrine and serotonin transporter function.

Norepinephrine transporter (NET) and serotonin transporter (SERT) proteins regulate norepinephrine (NE) and serotonin via their reuptake function and are targets of antidepressants action. Several intravenous (IV) anesthetics have been shown to inhibit NET and SERT. The interactions between antidepressants and anesthetics on transporter function, however, are not well studied. We examined the effect of different IV anesthetics on NET and SERT function, with and without chronic antidepressant pretreatment, by measuring NE or 5-hydroxytryptamine (5-HT) uptake and determined NET and SERT protein expression via immunoblotting. Both ketamine and propofol inhibited NET dose-dependently (propofol 10(-4)M -22%+/-5.6%, and propofol 10(-3)M -35%+/-5.7%; ketamine 10(-4)M -23%+/-4.1% and ketamine 10(-3)M -73%+/-2.9%); and SERT (propofol 10(-4)M -11%+/-4.3% and propofol 10(-3)M -23%+/-3.8%; ketamine 10(-4)M -29%+/-5.2% and ketamine 10(-3)M -63%+/-6.4%). Etomidate and thiopental had no effect on either NET or SERT function. Desipramine and fluoxetine, specific inhibitors of NET and SERT, respectively, both enhanced the inhibitory effects of propofol but reduced the inhibitory effects of ketamine on NET and SERT functions. IV anesthetics treatment did not change transporter protein expression in the presence of its respective inhibitor. Our results demonstrate that both ketamine and propofol inhibited SERT and NET function, but the inhibition was differentially modulated by antidepressants. Therefore, in the clinical context, this would suggest that patients receiving antidepressant treatments might have altered response to IV anesthetics in an agent-specific manner.