Release of non-neuronal acetylcholine from the isolated human placenta is affected by antidepressants

Non-neuronal acetylcholine (ACh) is released from the human placenta into the extracellular space via organic cation transporters (OCTs). The present experiments investigated whether ACh release from epithelial cells is affected by drugs which are substrates of OCTs. The antidepressant drugs amitriptyline and doxepine were tested as both substances are not approved for pregnant women but frequently used. Release of ACh was measured in 10 min intervals over a period of 100 min. Test substances were added from t = 50 min of incubation onwards. The effect was calculated by comparing the ACh release of the last three samples (t = 70–100 min; B2) with that immediately before the application of the test substances (t = 20–50 min; B1). The baseline ACh release amounted to 2.07 ± 0.17 nmol/10 min (n = 29; villus). Under control conditions a B2/B1 ratio of 0.78 ± 0.02 was obtained. The following B2/B1 ratios were found, when therapeutic drugs were added: 0.54 ± 0.04 (n = 7; P < 0.05) in the presence of 10 μM amitriptyline; 0.44 ± 0.04 (10; P < 0.01) in the presence of 10 μM doxepin; 0.73 ± 0.04 (13) in the presence of 10 μM metformin; 0.76 ± 0.06 (7) in the presence of 10 μM minoxidil; 0.63 ± 0.03 (10) in the presence of 1 μM theophylline. The results demonstrate that antidepressants reduce the release of non-neuronal ACh at least in the human placenta, most likely by intracellular substrate competition at the polyspecific organic cation transporters (OCTs) but only at concentrations roughly 30-fold above the therapeutic range. Theophylline may also interfere with the release of non-neuronal ACh.