Differential effects of the translocator protein 18 kDa (TSPO) ligand etifoxine and the benzodiazepine alprazolam on startle response to predictable threat in a NPU-threat task after acute and short-term treatment

Psychopharmacology (Berl). 2022 Jul;239(7):2233-2244. doi: 10.1007/s00213-022-06111-x. Epub 2022 Mar 12.

Abstract

Rationale: Benzodiazepines have been extensively investigated in experimental settings especially after single administration, which mostly revealed effects on unpredictable threat (U-threat) rather than predictable threat (P-threat). Given the need for pharmacological alternatives with a preferable side-effect profile and to better represent clinical conditions, research should cover also other anxiolytics and longer application times.

Objectives: The present study compared the acute and short-term effects of the translocator protein 18 kDa (TSPO) ligand etifoxine and the benzodiazepine alprazolam on P-threat and U-threat while controlling for sedation.

Methods: Sixty healthy male volunteers, aged between 18 and 55 years, were randomly assigned to receive a daily dose of either 150 mg etifoxine, 1.5 mg alprazolam, or placebo for 5 days. On days 1 and 5 of intake, they performed a NPU-threat task including neutral (N), predictable (P), and unpredictable (U) conditions, while startle responsivity and self-reports were studied. Sedative effects were assessed using a continuous performance test.

Results: Neither alprazolam nor etifoxine affected startle responsivity to U-threat on any of the testing days. While etifoxine reduced the startle response to P-threat on day 1 of treatment for transformed data, a contrary effect of alprazolam was found for raw values. No effects on self-reports and no evidence of sedation could be observed for either drug.

Conclusions: None of the anxiolytic substances had an impact on startle potentiation to U-threat even after several days of intake. The effects of the anxiolytics on startle responsivity to P-threat as well as implications for future studies are discussed.

Keywords: Alprazolam; Etifoxine; GABAA receptor; NPU-threat task; Predictable threat; Translocator protein 18 kDa (TSPO); Unpredictable threat.

MeSH terms

  • Adolescent
  • Adult
  • Alprazolam* / pharmacology
  • Anti-Anxiety Agents* / pharmacology
  • Benzodiazepines / pharmacology
  • Humans
  • Ligands
  • Male
  • Middle Aged
  • Oxazines
  • Receptors, GABA
  • Reflex, Startle
  • Young Adult

Substances

  • Anti-Anxiety Agents
  • Ligands
  • Oxazines
  • Receptors, GABA
  • TSPO protein, human
  • Benzodiazepines
  • etifoxine
  • Alprazolam