VMAT2 is believed to possess at least two distinct binding sites, which are characterized by
tetrabenazine (TBZ) and
reserpine binding to the transporter. VMAT2 inhibitors like tetrabenazine and reserpine reduce the concentration of monoamine neurotransmitters in the synaptic cleft by inhibiting uptake through VMAT2; the inhibition of SLC18A2 uptake by these drugs prevents the storage of neurotransmitters in synaptic vesicles and reduces the quantity of neurotransmitters that are released through
exocytosis. Although many
substituted amphetamines induce the release of neurotransmitters from vesicles through VMAT2 while inhibiting uptake through VMAT2, they may facilitate the release of
monoamine neurotransmitters into the synaptic cleft by simultaneously
reversing the direction of transport through the primary plasma
membrane transport proteins for monoamines (i.e., the
dopamine transporter,
norepinephrine transporter, and
serotonin transporter) in monoamine neurons. Other VMAT2 inhibitors such as
GZ-793A inhibit the reinforcing effects of methamphetamine, but without producing stimulant or reinforcing effects themselves. Researchers have found that inhibiting the dopamine transporter (but not VMAT2) will block the effects of
amphetamine and
cocaine; while, in another experiment, observing that disabling VMAT2 (but not the dopamine transporter) prevents any notable action in test animals after amphetamine administration yet not cocaine administration. This suggests that amphetamine may be an atypical substrate with little to no ability to prevent dopamine reuptake via binding to the dopamine transporter but, instead, uses it to enter a neuron where it then interacts with VMAT2 to induce efflux of dopamine from their vesicles into the cytoplasm whereupon dopamine transporters with amphetamine substrates attached move this recently liberated dopamine into the synaptic cleft. Although most amphetamines and other
monoamine releasing agents (MRA) act on VMAT2, several MRAs, including
phentermine,
phenmetrazine, and
benzylpiperazine (BZP), are inactive at VMAT2. Others, including
cathinones like
mephedrone,
methcathinone, and
methylone, also show only weak VMAT2 activity (e.g., ~10-fold weaker than the corresponding amphetamines). MRAs acting on VMAT2 additionally continue to induce monoamine release in
in-vitro systems in which VMAT2 is absent or inhibited.
List of VMAT2 Inhibitors •
Lobelane •
Quinlobelane •
UKCP-110 • CT-005404 •
GZ-11608 • 4-Benzyl-1-(3,4-dimethoxyphenethyl)piperidine [15565-25-0] • PC118857804 •
Valbenazine •
JPC-141 (PC155541952) • arylpiperidinylquinazolines (APQs) ==Inhibition==