Long-Term Benefits of Chronic 5-HT2A Antagonist and 5-HT1A Agonist Treatment on ADHD Behavior in Juvenile...

Norepinephrine and Dopamine (DA) are critical brain amines in Attention Deficit Hyperactivity Disorder (ADHD), with treatments targeting their neuroreceptors often causing adverse effects, particularly in the motor system through DA receptors. Our earlier study suggested that chronic treatment with a 5-HT1A receptor agonist or a 5-HT2A receptor antagonist in juvenile spontaneously hypertensive rats (SHRs) may improve ADHD-like symptoms by potentially modulating DA receptors. This study investigated the long-term impacts of these serotonergic receptor manipulations on ADHD behavior.

Male SHRs (15 days old) received either ipsapirone (a 5-HT1A agonist) or MDL100907 (a 5-HT2A antagonist) from postnatal day (PND) 15 to 42, in parallel with similarly aged Wistar Kyoto rats (WKY). After eight weeks of undisturbed observation, we assessed hyperlocomotor activity, anxiety, and impulsivity. On PND 122, rats were sacrificed, and the striatum and prefrontal cortex (PFC) were analyzed for DA-D1, DA-D2, 5-HT1A, and 5-HT2A receptor proteins and DA levels.

The results showed that both treatments had lasting positive effects on ADHD behaviors, linked to increased 5-HT1A and 5-HT2A receptors in the PFC and striatum. Ipsapirone (5-HT1A agonist) did not alter DA receptor expression but reduced DA levels, while the 5-HT2A antagonist reduced DA-D2 and increased DA-D1 expression, with enhanced DA content levels. In the striatum, both treatments increased DA-D2 and reduced DA-D1 receptors, but the 5-HT1A agonist lowered DA content.

Striatal DA-D2 dysregulation appears to contribute to hyperlocomotor activity, while attentional impairments are associated with enhanced striatal DA-D2 receptor expression. Enhancing 5-HT activity either through 5-HT2A antagonists or 5-HT1A agonists effectively alleviates core ADHD symptoms in SHRs, likely by indirectly modulating DA signaling. These serotonergic agents may influence DA pathway activity via cortical mechanisms, providing therapeutic benefits without the long-term adverse effects typically associated with direct DA receptor blockade.

These findings suggest that dysregulation of 5-HT1A and DA-D2 receptors may contribute to ADHD, and monotherapy with either a 5-HT1A receptor stimulator or a 5-HT2A receptor inhibitor can effectively alleviate core ADHD symptoms long-term, likely through indirect DA system modulation.