Pharmacokinetic-pharmacodynamic modeling of stimulatory and sedative effects of alprazolam: timing performance deficits.

Alprazolam decreased the reinforcement rate and increased the shorter-response rate of contingency-controlled timing behavior under a differential reinforcement of low-rate schedule (DRL 45-s) in rats. An integrated pharmacokinetic-pharmacodynamic (PK-PD) model was developed to describe and characterize the effects of i.v. and s. c. administration of alprazolam. The onset, peak and disappearance of alprazolam effects were evaluated during a 3-hr session. After s. c. alprazolam administration, two peak increases in shorter-response rate occurred at moderate alprazolam serum levels, first in the ascending and then in the descending limb of the concentration-time profile. We used a stimulation-sedation PD model incorporating two opposing effect-link sigmoidal Emax functions to model the two peaks after s.c. alprazolam administration. The model suggested that alprazolam possesses both stimulatory and sedative effects in a continuous but sequential fashion, which corresponded to low- and high-concentration effects as indicated by the EC50 values of 0.09 and 0.18 microg/ml, respectively. Owing to the rapid onset of i.v. administration, the first peak (a transition phase before the onset of the sedative effect) was absent, with the presence of the second peak again coinciding with the offset of the sedative effect. The reinforcement rate (IC50 = 0.02 microg/ml) characterized by the indirect response model to account for the initial hysteresis is an index for evaluating the deficit in timing performance. Although the effects of alprazolam can be described in behavioral terms, simultaneous PK-PD optimization numerically defines the performance and hypothesizes the coexistence of stimulation and sedation components for alprazolam. The stimulation-sedation model may help in delineating the possible mechanisms for adverse rebound side effects and of tolerance in humans.