Effects of antiepileptic drugs on glutamate release from rat and human neocortical synaptosomes.

Aim of this study was to learn whether the antiepileptic drugs (AEDs) carbamazepine, lamotrigine, phenytoin, gabapentin, pregabalin, levetiracetam, and valproate (all at 100 μM) presynaptically influence the neurotransmission of the excitatory transmitter glutamate. The effects of these frequently used AEDs were examined on ³H-glutamate release from superfused synaptosomes of both rat and human neocortex. Release was evoked by elevation of buffer [K(+)] from 3 to 15 mM or by the Na(+) channel activator veratridine (1, 3.2, and 10 μM). Buffer [K(+)] elevation induced ³H-glutamate exocytosis, which was Ca(²+)-, but not Na(+)-, dependent and which was accompanied only in human tissue by release through transporter reversal. In rat tissue, release was diminished by the Na(+) channel inhibitors carbamazepine, lamotrigine, and phenytoin, which therefore may also affect presynaptic Ca(²+) channels. Interestingly, levetiracetam increased ³H-glutamate release. In contrast, the tested AEDs did not affect K(+)-evoked ³H-glutamate release in human tissue, neither when the transporters were operative nor when exocytosis was isolated by transporter blockade. Veratridine-evoked ³H-glutamate release was a Na(+)-dependent transmitter efflux through reversed transporters in both species which in human synaptosomes was accompanied by exocytosis. The latter depended on external Ca(²+). Carbamazepine, lamotrigine, and phenytoin reduced this release from both rat and human tissue. There is an obvious species difference in the effects of carbamazepine, lamotrigine, and phenytoin on K(+)-evoked ³H-glutamate release while their inhibitory effects on veratridine-evoked release were similar. Thus, the depression of ³H-glutamate release by carbamazepine, lamotrigine, and phenytoin may be due to inhibited synaptosomal Na(+) or Ca(²+) influx.