Summary:Purpose: Carbamazepine is one of several antiepileptic drugs (AEDs) that release the inhibitory neurotransmitter serotonin as part of their pharmacodynamic action on brain neurons. We undertook this study to investigate the cellular processes by which carbamazepine (CBZ) releases serotonin from brain tissue.Methods: Tissue slices were prepared from hippocampi of Sprague-Dawley rats. These hippocampal slices were preincubated in vitro in a buffer so that neurons within the slice would take up tritium-labeled serotonin. Subsequently the slices were superfused with buffer containing CBZ or other chemicals (or both) that increase the overflow of serotonin radioactivity.Results: Carbamazepine produced a concentration-dependent (50, 125, 250, or 500 pM) increase in basal overflow of serotonin radioactivity from superfused rat hippocampal slices in vitro. In contrast, these concentrations did not alter potassiumstimulated release, suggesting that the CBZ-induced release does not depend on depolarization or exocytosis. Blockade of the neuronal membrane serotonin transporter by fluoxetine (I FM) or citaloprarn (2 pM) did not alter overflow of serotonin radioactivity produced by 250 pM CBZ. p-chloramphetamine (10 pM) produced a substantial increase in overflow of serotonin radioactivity, and this effect appears to be antagonized by 250 FM CBZ. Uptake of ['HI-labeled serotonin into hippocampal synaptosomes was inhibited by CBZ with a median inhibitory concentration of 51 1 ? 33 pM and a Hill coefficient of 0.87 f 0.1 1, suggesting competitive inhibition of uptake by CBZ.Conclusions: We conclude that CBZ (a) releases serotonin from hippocampal slices independent of exocytosis and by a mechanism not involving the neuronal membrane serotonin transporter, and (b) at high enough concentration, blocks the neuronal serotonin transporter. Key Words: CarbamazepineSerotonin-Hippocampal slice-Anticonvulsant-Neurons.A number of antiepileptic drugs (AEDs) have been shown to increase the release or extracellular concentration of the inhibitory neurotransmitter serotonin as part of their pharmacodynamic action on neuronal tissue. This effect was demonstrated for valproate (VPA; l), zonisamide (ZNS; 2), loreclezole (LCZ), which was formerly in clinical trial in Europe (3), antiepilepsirine, a product used clinically in China (4), lamotrigine (LTG; 5), and carbamazepine (CBZ; 2,4,6,7). Unlike the aforementioned drugs, phenytoin (PHT) does not release serotonin as part of its pharmacodynamic action (7).Systemic administration of anticonvulsant doses of CBZ increases brain extracellular serotonin release, as measured by microdialysis, in intact nonepileptic rats (2,8) and in genetically epilepsy-prone rats (GEPRs; 4,6,7). The increases in extracellular serotonin are dose related (6,8), and several lines of evidence indicate that the serotonin release is integral to the mechanism by which CBZ produces its anticonvulsant effects (4,7). The CBZ-induced release can be produced by systemic (4,6, 8) as well as by focal CBZ administratio...