Neurotransmitter receptor binding agents

CNS agents of the 1,4 benzodiazepine class presumably exert their effects by binding at stereo specific receptors at several sites within the central nervous system (CNS). Alprazolam like other benzodiazepines exerts its anxiolytic action by potentiating GABA activity. GABA is a neurotransmitter which inhibits the CNS activity. Alprazolam acts preferentially in midbrain, ascending reticular formation (which maintains wakefulness) and on limbic system (thought and mental functions). 

FIGURE 10—24. Five modulatory sites on the N-methyW-aspartate (NMDA) receptor. The NMDA glutamate—calcium channel complex has multiple receptors in and around it, which act in concert as allosteric modulators. Three of these modulatory sites are located around the NMDA receptor. One of these modulatory sites is for the neurotransmitter glycine, another is for polyamines, and yet another is for zinc. Two of the modulatory sites are located inside or near the ion channel itself. The magnesium ion can block the calcium channel at one of these modulatory site, which is presumably inside the ion channel or close to it. The other inhibitory modulatory site, located inside the ion channel, is sometimes called the PCP site, since the psychotomimic agent phencylclidine (PCP) binds to this site. 

The benzodiazepine derivatives class of antianxiety agents shares the property of binding to a benzodiazepine receptor, part of the GABA receptor-chloride channel complex whose function it modulates allosterically. Not only the anxiolytic effects of the benzodiazepines, but also the anticonvulsant, sedative, or muscle relaxant effects seem to be mediated by the GABA-related mechanism. Besides the direct involvement of the GABA system, in parallel or more downstream to this, several other neurotransmitters such as serotonin have been suggested to participate in different aspects of benzodiazepine action. 

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