Recent in vitro and in vivo experiments have suggested that
excitatory amino acid antagonists, particularly those active at the
N-methyl-D-aspartate receptor subtype, are effective in ameliorating ischemic injury due to their antiexcitotoxic activity. However, these drugs are also potent and effective in vivo
anticonvulsants. The present experiments compared the noncompetitive
N-methyl-D-aspartate antagonists
phencyclidine and
MK-801 with the
anticonvulsant phenytoin in a model of focal
brain ischemia. Fisher F-344 rats were subjected to tandem occlusion of the middle cerebral and ipsilateral common carotid arteries under
halothane anesthesia. Compounds were administered intravenously 30 minutes and 24 hours after
arterial occlusion;
infarct size was assessed at 48 hours after occlusion.
Phencyclidine had no effect on
infarct volume at 1 mg/kg, significantly reduced (by 36%)
infarct volume at 3 mg/kg, and produced a nonsignificant 26% decrease
at 10 mg/kg. The more potent and selective noncompetitive antagonist
MK-801 reduced (by 32%)
infarct volume significantly at 0.1 mg/kg, produced a nonsignificant 23% decrease at 0.3 mg/kg, and had no effect at 0.5 mg/kg.
Phenytoin, which is not a
glutamate antagonist, reduced the
infarct volume by 45% at 28 mg/kg. A single dose of
phenytoin (28 mg/kg) administered 30 minutes after occlusion was neuroprotective, but delaying
drug administration for more than 2 hours was ineffective. These data suggest that blockade of the
N-methyl-D-aspartate receptor is effective in reducing the
infarct size after focal
cerebral ischemia. The neuroprotective activity of
phenytoin suggests that this may be related to the common
anticonvulsant action.