Although carbamazepine (CBZ) is used therapeutically in the treatment of va
rious neurological and psychiatric conditions, its mechanism of action rema
ins largely unknown. CBZ has now been shown to inhibit the binding of [H-3]
PK 11195 to peripheral benzodiazepine receptors (PBRs) in rat brain and ova
ry membranes in vitro with a potency (IC50, similar to 60 mu M) much lower
than that of unlabeled PK 11195 (IC50, similar to 2.0 nM). Administration o
f CBZ to rats induced dose (25 to 100 mg/kg, i.p.) and time (15 to 60 min)
dependent increases in the concentrations of pregnenolone, progesterone, al
lopregnanolone, and allotetrahydrodeoxycorticosterone in both the cerebral
cortex and plasma. CBZ also induced steroidogenesis in the brain of adrenal
ectomized-orchiectomized rats, suggesting that this effect is mediated in a
manner independent of peripheral PBRs. The increase in brain concentration
s of neuroactive steroids induced by a single injection of CBZ was associat
ed with a marked protective effect against isoniazid-induced convulsions. I
n contrast, long-term administration of CBZ (50 mg/kg, twice a day for 30 d
ays) induced tolerance to the anticonvulsant action of the drug. This same
treatment, however, did not prevent the ability of a challenge dose of CBZ
to stimulate steroidogenesis. These results indicate that CBZ-induced stero
idogenesis might not be responsible for the anticonvulsant activity of this
drug, (C) 2000 Elsevier Science Ltd. All rights reserved.