Harmala alkaloids and related beta-carbolines: a myoclonic model and antimyoclonic drugs.

The neuropharmacologic profile of intraperitoneally injected harmala alkaloids and related beta-carbolines was evaluated in the rat. All drugs induced central effects (convulsions, catalepsy, or altered startle), but only harmaline and harmine were tremorogenic at low doses. Methoxylation of the carboline 7 position was requisite for this effect. Coadministration of harmaline (but not harmine) and 5-hydroxytryptophan (tryptamine or m-chlorophenyl-piperazine) induced a lethal convulsive myoclonic syndrome which could not be evoked by either drug separately. Compared with the myoclonic-serotonergic syndrome evoked by 5-hydroxytryptophan in rats with 5.7-dihydroxytryptamine lesions, harmaline+5-hydroxytryptophan-treated rats displayed more continuous and greater axial myoclonic jerks and some postural differences. Clorgyline or tranylcypromine but not pargyline could be substituted for harmaline. The harmaline syndrome was blocked by the benzodiazepine agonists, physostigmine and verapamil. The harmaline+5-hydroxytryptophan syndrome was blocked by drugs acting at benzodiazepine receptors (CL 218,872 greater than ethyl-beta-carboline-3-carboxylate, clonazepam, diazepam, Ro 15-1788, pentobarbital), and baclofen. Naloxone, benztropine, quipazine, and apomorphine had partial effects, and calcium channel blockers prevented death but did not prevent convulsions. 5-Hydroxytryptamine antagonists were poor blockers, although cyproheptadine and ketanserin significantly reduced mortality. Phenobarbital was more effective than other anticonvulsants. Lesion studies suggested a role for monoaminergic neurons and the inferior olive in the expression of the harmaline+5-hydroxytryptophan syndrome. These data describe a complex convulsive myoclonic syndrome that is behaviorally related to but pharmacologically distinct from the serotonin syndrome, which may be useful in studying serotonergic-benzodiazepine interactions in the pathophysiology of myoclonus.