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1.
Neuropsychopharmacology ; 49(6): 905-914, 2024 May.
Article En | MEDLINE | ID: mdl-38177696

The NMDA receptor (NMDAR) antagonist ketamine has shown great potential as a rapid-acting antidepressant; however, its use is limited by poor oral bioavailability and a side effect profile that necessitates in-clinic dosing. GM-1020 is a novel NMDAR antagonist that was developed to address these limitations of ketamine as a treatment for depression. Here, we present the preclinical characterization of GM-1020 alongside ketamine, for comparison. In vitro, we profiled GM-1020 for binding to NMDAR and functional inhibition using patch-clamp electrophysiology. In vivo, GM-1020 was assessed for antidepressant-like efficacy using the Forced Swim Test (FST) and Chronic Mild Stress (CMS), while motor side effects were assessed in spontaneous locomotor activity and on the rotarod. The pharmacokinetic properties of GM-1020 were profiled across multiple preclinical species. Electroencephalography (EEG) was performed to determine indirect target engagement and provide a potentially translational biomarker. These results demonstrate that GM-1020 is an orally bioavailable NMDAR antagonist with antidepressant-like efficacy at exposures that do not produce unwanted motor effects.


Antidepressive Agents , Receptors, N-Methyl-D-Aspartate , Animals , Antidepressive Agents/administration & dosage , Antidepressive Agents/pharmacology , Antidepressive Agents/pharmacokinetics , Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors , Male , Rats , Mice , Administration, Oral , Rats, Sprague-Dawley , Biological Availability , Ketamine/administration & dosage , Ketamine/pharmacology , Depression/drug therapy , Motor Activity/drug effects , Dose-Response Relationship, Drug , Mice, Inbred C57BL , Excitatory Amino Acid Antagonists/administration & dosage , Excitatory Amino Acid Antagonists/pharmacology , Excitatory Amino Acid Antagonists/pharmacokinetics , Humans
2.
Eur J Pharmacol ; 910: 174455, 2021 Nov 05.
Article En | MEDLINE | ID: mdl-34461125

Memantine is a non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist that was initially indicated for the treatment of moderate to severe Alzheimer's disease. It is now also considered for a variety of other pathologies in which activation of NMDA receptors apparently contributes to the pathogenesis and progression of disease. In addition to the central nervous system (CNS), NMDA receptors can be found in non-neuronal cells and tissues that recently have become an interesting research focus. Some studies have shown that glutamate signaling plays a role in cell transformation and cancer progression. In addition, these receptors may play a role in cardiovascular disorders. In this review, we focus on the most recent findings for memantine with respect to its pharmacological effects in a range of diseases, including inflammatory disorders, cardiovascular diseases, cancer, neuropathy, as well as retinopathy.


Cardiovascular Diseases/drug therapy , Excitatory Amino Acid Antagonists/pharmacology , Memantine/pharmacology , Neoplasms/drug therapy , Nervous System Diseases/drug therapy , Animals , Cardiovascular Diseases/metabolism , Excitatory Amino Acid Antagonists/pharmacokinetics , Excitatory Amino Acid Antagonists/therapeutic use , Humans , Inflammation/drug therapy , Inflammation/metabolism , Memantine/pharmacokinetics , Memantine/therapeutic use , Neoplasms/metabolism , Nervous System Diseases/metabolism , Oxidative Stress/drug effects , Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors , Receptors, N-Methyl-D-Aspartate/metabolism , Retinal Diseases/drug therapy , Retinal Diseases/metabolism
3.
Eur Arch Psychiatry Clin Neurosci ; 271(3): 417-429, 2021 Apr.
Article En | MEDLINE | ID: mdl-31745646

The motive of this article is to review the pharmacological and clinical aspects of esketamine (ESK), an NMDA-receptor antagonist approved recently by the FDA for treatment-resistant depression (TRD). PubMed/Medline database was searched using keywords 'esketamine' and 'depression', 'S-ketamine' and 'depression', and 'NMDA antagonist' and 'depression'. Individual trials were searched from ClinicalTrials.gov. We included English-language articles evaluating pharmacokinetics and pharmacodynamics of intranasal (IN) esketamine, along with clinical trial data related to its efficacy and safety in patients diagnosed with TRD. Compared to placebo, IN esketamine causes significant and rapid improvement in depression. Dizziness, vertigo, headache, increase in blood pressure are some of its common adverse effects. With the growing number of patients of TRD, additional effective and safe treatment is the need of the hour. Esketamine appears to be an effective therapy when combined with oral antidepressants in patients with TRD. It is of special value due to the rapid onset of its action. Long-term clinical studies are, however, needed to ascertain its safety profile.


Antidepressive Agents/pharmacology , Clinical Trials, Phase III as Topic , Depressive Disorder, Treatment-Resistant/drug therapy , Excitatory Amino Acid Antagonists/pharmacology , Ketamine/pharmacology , Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors , Drug Therapy, Combination , Excitatory Amino Acid Antagonists/adverse effects , Excitatory Amino Acid Antagonists/pharmacokinetics , Humans , Ketamine/adverse effects , Ketamine/pharmacokinetics
4.
Pain ; 161(1): 135-146, 2020 01.
Article En | MEDLINE | ID: mdl-31568235

Metabotropic glutamate receptor 5 (mGlu5) has been shown to modulate nociception in animals, but no mGlu5 antagonists have been developed commercially as analgesics. The mGlu5 antagonist fenobam [N-(3-chlorophenyl)-N'-(4,5-dihydro-1-methyl-4-oxo-1H-imidazole-2-yl)urea] was originally evaluated for development as a nonbenzodiazepine anxiolytic. Fenobam is analgesic in numerous mouse pain models, acting exclusively through mGlu5 blockade. Furthermore, fenobam showed no signs of analgesic tolerance with up to 2 weeks of daily dosing in mice. Analgesic effects of fenobam in humans have not been reported. The purpose of this investigation was to evaluate fenobam pharmacokinetics and analgesic effects in humans. We first evaluated single-dose oral fenobam disposition in a parallel-group dose-escalation study in healthy volunteers. A second investigation tested the analgesic effects of fenobam in an established experimental human pain model of cutaneous sensitization using capsaicin cream and heat, in a double-blind placebo-controlled study. The primary outcome measure was the area of hyperalgesia and allodynia around the area applied with heat/capsaicin. Secondary outcome measures included nociception, measured as pain rating on a visual analog scale, heat pain detection threshold, and effects on cognition and mood. Fenobam plasma exposures showed considerable interindividual variability and were not linear with dose. Fenobam reduced sensitization vs placebo at a single timepoint (peak plasma concentration); we found no other difference between fenobam and placebo. Our results suggest highly variable fenobam disposition and minimal analgesic effects at the dose tested. We suggest that future studies testing analgesic effects of mGlu5 blockade are warranted, but such studies should use molecules with improved pharmacokinetic profiles.


Analgesics/pharmacology , Excitatory Amino Acid Antagonists/pharmacology , Hyperalgesia/drug therapy , Imidazoles/pharmacology , Pain/drug therapy , Receptor, Metabotropic Glutamate 5/antagonists & inhibitors , Adult , Analgesics/pharmacokinetics , Analgesics/therapeutic use , Double-Blind Method , Excitatory Amino Acid Antagonists/pharmacokinetics , Excitatory Amino Acid Antagonists/therapeutic use , Female , Healthy Volunteers , Humans , Imidazoles/pharmacokinetics , Imidazoles/therapeutic use , Male , Middle Aged , Pain Measurement , Treatment Outcome , Young Adult
5.
Behav Brain Res ; 378: 112312, 2020 01 27.
Article En | MEDLINE | ID: mdl-31629003

Chemical inhibition and nitrergic stimulation of the left and right medial prefrontal cortex (L and RmPFC), respectively, provoke anxiety in mice. Moreover, LmPFC inhibition immediately followed by a single social defeat stress (SDS) led to anxiogenesis in mice exposed to the elevated plus maze (EPM) 24 h later. Given that glutamate NMDA (N-methyl-D-aspartate) receptors are densely present in the mPFC, we investigated (i) the time course of LmPFC inhibition + SDS-induced anxiogenesis and (ii) the effects of intra-RmPFC injection of AP-7 (a NMDA receptor antagonist) on this long-lasting anxiety. Male Swiss mice received intra-LmPFC injection of CoCl2 (1 mM) and 10 min later were subjected to a single SDS episode and then (i) exposed to the EPM 2, 5, or 10 days later or (ii) 2 days later, received intra-RmPFC injection of AP-7 (0.05 nmol) and were exposed to the EPM to observe the percentage of open arm entries and time (%OE; %OT) and frequency of closed arm entries (CE). Dorsal but not ventral LmPFC inhibition + SDS reduced open arm exploration 2, 5, and 10 days later relative to that of saline-treated or non-defeated mice. Moreover, this effect is not due to locomotor impairment as assessed using the general activity. Intra-RmPFC AP-7 injection 2 days after LmPFC inhibition + SDS prevented this type of anxiogenesis. These results suggest that the integrity of the LmPFC is important for mice to properly cope with SDS, and that NMDA receptor blockade in the RmPFC facilitates resilience to SDS-induced anxiogenesis in mice.


Anxiety , Behavior, Animal , Excitatory Amino Acid Antagonists/pharmacology , Maze Learning , Prefrontal Cortex/drug effects , Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors , Social Defeat , Stress, Psychological/complications , 2-Amino-5-phosphonovalerate/analogs & derivatives , 2-Amino-5-phosphonovalerate/pharmacokinetics , Adaptation, Psychological/drug effects , Adaptation, Psychological/physiology , Animals , Anxiety/etiology , Anxiety/physiopathology , Anxiety/prevention & control , Behavior, Animal/drug effects , Behavior, Animal/physiology , Excitatory Amino Acid Antagonists/pharmacokinetics , Functional Laterality/physiology , Male , Maze Learning/drug effects , Maze Learning/physiology , Mice
6.
Expert Opin Drug Metab Toxicol ; 15(12): 1033-1041, 2019 Dec.
Article En | MEDLINE | ID: mdl-31693437

Introduction: Chronic neuropathic pain (NP) is an incapacitating illness caused by a lesion of the somatosensory nervous system and is associated with several diseases or syndromes. Since current treatment options lack adequate efficacy in the majority of patients, ketamine is often administered to treat refractory NP.Areas covered: This review gives an overview of new ketamine pharmacokinetic data including data on intranasal and inhaled ketamine. The outcome of seven systematic reviews and meta-analyses, published since 2012, on ketamine efficacy in NP is discussed. The reader will additionally get an understanding of ketamine's complex metabolism with emphasis on the metabolite hydroxynorketamine.Expert opinion: Proof of sustained, large effects of ketamine in the treatment of NP from randomized controlled clinical trials is lacking, although we cannot exclude selective ketamine efficacy in patients with central sensitization, opioid-induced hyperalgesia or opioid tolerance. Interestingly, data from observational trials and case series do suggest the efficacy of ketamine in producing effective pain relief in NP with positive patient-related outcome measures. Additional randomized trials in often ill-defined groups of chronic pain patients are not useful and we suggest to conduct future studies in NP patients with central sensitization and/or with opioid refractory severe NP.


Excitatory Amino Acid Antagonists/administration & dosage , Ketamine/administration & dosage , Neuralgia/drug therapy , Analgesics/administration & dosage , Analgesics/pharmacokinetics , Analgesics/pharmacology , Animals , Chronic Pain/drug therapy , Chronic Pain/physiopathology , Excitatory Amino Acid Antagonists/pharmacokinetics , Excitatory Amino Acid Antagonists/pharmacology , Humans , Ketamine/pharmacokinetics , Ketamine/pharmacology , Neuralgia/physiopathology
7.
J Control Release ; 303: 34-41, 2019 06 10.
Article En | MEDLINE | ID: mdl-30928488

Adherence to medication regimens is a major barrier to effective treatment in many disease areas, notably in dementia which causes cognitive impairment that reduces patients' awareness of non-adherence and their ability to manage medication. The development of oral dosage forms that can be infrequently dosed, and therefore improve adherence rate and facilitate direct observed therapy, has been a goal for decades. We describe the first demonstration of an oral formulation that achieves >7-day gastric retention and sustained pharmacokinetics in the challenging dog model. Gastric retention requires physical resistance of the dosage form to gastric emptying forces, which are known to be stronger in dogs than in humans, making successful gastric retention in dogs a stringent test for predicting human translatability. This formulation of memantine hydrochloride is the first oral dosage form that achieves multi-day drug release with near zero-order kinetics and efficient delivery. In the dog model, relative memantine bioavailability approaches 100% with sustained plasma levels of memantine over seven days and profiles that can be tuned by varying components of the formulation. A single gastric resident dosage form achieves an AUC equivalent to 7 daily treatments with the marketed daily capsule, with a Cmax that is no higher than the daily product. PK modeling predicts that the gastroretentive formulation will maintain therapeutic blood levels in humans when administered once weekly. The formulation methodology presented here is applicable to many water soluble drugs and may enable the development of long-acting oral therapies for a wide variety of conditions.


Alzheimer Disease/drug therapy , Excitatory Amino Acid Antagonists/administration & dosage , Memantine/administration & dosage , Administration, Oral , Animals , Biological Availability , Delayed-Action Preparations/administration & dosage , Delayed-Action Preparations/pharmacokinetics , Dogs , Drug Administration Schedule , Excitatory Amino Acid Antagonists/blood , Excitatory Amino Acid Antagonists/pharmacokinetics , Food-Drug Interactions , Humans , Male , Medication Adherence , Memantine/blood , Memantine/pharmacokinetics , Models, Biological , Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors
8.
Eur Neuropsychopharmacol ; 29(6): 740-755, 2019 06.
Article En | MEDLINE | ID: mdl-30981586

Although ketamine has long been known to increase locomotor activity, only recently was it realized that this behavioral effect varies according to both sex and age. The purpose of the present study was threefold: first, to measure the locomotor activating effects of ketamine in male and female rats across early ontogeny and into adulthood; second, to assess ketamine and norketamine pharmacokinetics in the dorsal striatum and hippocampus of the same age groups; and, third, to use curvilinear regression to determine the relationship between locomotor activity and dorsal striatal concentrations of ketamine and norketamine. A high dose of ketamine (80 mg/kg, i.p.) was administered in order to examine the complete cycle of locomotor responsiveness across a 280-min testing session. In separate groups of rats, the dorsal striata and hippocampi were removed at 10 time points (0-360 min) after ketamine administration and samples were assayed for ketamine, norketamine, and dopamine using HPLC. In female rats, ketamine produced high levels of locomotor activity that varied only slightly among age groups. Male preweanling rats responded like females, but adolescent and adult male rats exhibited lesser amounts of ketamine-induced locomotor activity. Ketamine and norketamine pharmacokinetics, especially peak values and area under the curve, generally mirrored age- and sex-dependent differences in locomotor activity. Among male rats and younger female rats, dorsal striatal ketamine and norketamine levels accounted for a large proportion of the variance in locomotor activity. In adult female rats, however, an additional factor, perhaps involving other ketamine and norketamine metabolites, was influencing locomotor activity.


Excitatory Amino Acid Antagonists/pharmacology , Excitatory Amino Acid Antagonists/pharmacokinetics , Ketamine/pharmacology , Ketamine/pharmacokinetics , Locomotion/drug effects , Aging/metabolism , Aging/psychology , Animals , Animals, Newborn , Dopamine/metabolism , Female , Hippocampus/metabolism , Humans , Ketamine/analogs & derivatives , Ketamine/metabolism , Male , Neostriatum/metabolism , Rats , Rats, Sprague-Dawley , Sex Characteristics
9.
Neurosurg Focus ; 46(3): E6, 2019 03 01.
Article En | MEDLINE | ID: mdl-30835675

OBJECTIVERiluzole is a glutamatergic modulator that has recently shown potential for neuroprotection after spinal cord injury (SCI). While the effects of riluzole are extensively documented in animal models of SCI, there remains heterogeneity in findings. Moreover, there is a paucity of data on the pharmacology of riluzole and its effects in humans. For the present study, the authors systematically reviewed the literature to provide a comprehensive understanding of the effects of riluzole in SCI.METHODSThe PubMed database was queried from 1996 to September 2018 to identify animal studies and clinical trials involving riluzole administration for SCI. Once articles were identified, they were processed for year of publication, study design, subject type, injury model, number of subjects in experimental and control groups, dose, timing/route of administration, and outcomes.RESULTSA total of 37 studies were included in this study. Three placebo-controlled clinical trials were included with a total of 73 patients with a mean age of 39.1 years (range 18-70 years). For the clinical trials included within this study, the American Spinal Injury Association Impairment Scale distributions for SCI were 42.6% grade A, 25% grade B, 26.6% grade C, and 6.2% grade D. Key findings from studies in humans included decreased nociception, improved motor function, and attenuated spastic reflexes. Twenty-six animal studies (24 in vivo, 1 in vitro, and 1 including both in vivo and in vitro) were included. A total of 520 animals/in vitro specimens were exposed to riluzole and 515 animals/in vitro specimens underwent other treatment for comparison. The average dose of riluzole for intraperitoneal, in vivo studies was 6.5 mg/kg (range 1-10 mg/kg). Key findings from animal studies included behavioral improvement, histopathological tissue sparing, and modified electrophysiology after SCI. Eight studies examined the pharmacology of riluzole in SCI. Key findings from pharmacological studies included riluzole dose-dependent effects on glutamate uptake and its modified bioavailability after SCI in both animal and clinical models.CONCLUSIONSSCI has many negative sequelae requiring neuroprotective intervention. While still relatively new in its applications for SCI, both animal and human studies demonstrate riluzole to be a promising pharmacological intervention to attenuate the devastating effects of this condition.


Neuroprotective Agents/therapeutic use , Riluzole/therapeutic use , Spinal Cord Injuries/drug therapy , Adolescent , Adult , Aged , Animals , Biological Availability , Clinical Trials as Topic , Drug Evaluation , Drug Evaluation, Preclinical , Excitatory Amino Acid Antagonists/pharmacokinetics , Excitatory Amino Acid Antagonists/therapeutic use , Glutamic Acid/metabolism , Humans , Middle Aged , Neuroprotective Agents/pharmacokinetics , Rabbits , Rats , Recovery of Function , Riluzole/pharmacokinetics , Spinal Cord Injuries/complications , Trauma Severity Indices , Treatment Outcome , Young Adult
10.
Expert Opin Drug Metab Toxicol ; 15(3): 189-198, 2019 Mar.
Article En | MEDLINE | ID: mdl-30714429

INTRODUCTION: Recommended medications for the acute treatment of migraine encompass triptans, nonsteroidal anti-inflammatory drugs (NSAIDs), and analgesics. While it is true that triptans have been the first successful mechanism-driven treatment in the field, recently, new targets involved in migraine pathogenesis have emerged and new drug classes have been studied for migraine attack therapy. Areas covered: Pharmacodynamics and pharmacokinetics of the new acute treatments of migraine (i.e. ditans, gepants, and glutamate receptor antagonists), considering also marketed drugs in new formulations and administration routes. Expert opinion: Research on the administration routes of marketed drugs was performed in order to improve, in accordance with basic pharmacokinetics parameters, the speed of action of these medications. Similar to the triptans, the new acute treatments are migraine-specific medications, acting on the trigeminovascular system, albeit with different mechanisms. Although available data do not conclusively indicate the superiority of a class over the others, the pharmacodynamics explains the peculiar tolerability and safety profile of different drug classes emerging from clinical trials. Further studies are needed to investigate the possibility of combining different drug classes to optimize the clinical response and the potential role of the novel drugs in medication-overuse headache.


Calcitonin Gene-Related Peptide Receptor Antagonists/administration & dosage , Excitatory Amino Acid Antagonists/administration & dosage , Migraine Disorders/drug therapy , Serotonin Receptor Agonists/administration & dosage , Analgesics/therapeutic use , Animals , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Calcitonin Gene-Related Peptide Receptor Antagonists/pharmacokinetics , Calcitonin Gene-Related Peptide Receptor Antagonists/pharmacology , Drug Development/methods , Excitatory Amino Acid Antagonists/pharmacokinetics , Excitatory Amino Acid Antagonists/pharmacology , Headache Disorders, Secondary/etiology , Humans , Migraine Disorders/physiopathology , Serotonin Receptor Agonists/pharmacokinetics , Serotonin Receptor Agonists/pharmacology , Tryptamines/therapeutic use
11.
Neuropharmacology ; 143: 122-129, 2018 12.
Article En | MEDLINE | ID: mdl-30227149

NMDA receptors (NMDARs) are essential components in glutamatergic synaptic signaling. The NMDAR antagonist MK-801 has been a valuable pharmacological tool in evaluating NMDAR function because it binds with high affinity to the NMDAR ion channel pore and is non-competitive with ligand binding. MK-801 has also been used to selectively inhibit NMDAR current in only the cell being recorded by including the drug in the intracellular recording solution. Here, we report that intracellular MK-801 (iMK-801) only partially inhibits synaptic NMDAR currents at +40 mV at both cortical layer 4 to layer 2/3 and hippocampal Schaffer collateral to CA1 synapses. Furthermore, iMK-801 incompletely inhibits heterologously expressed NMDAR currents at -60 mV, consistent with a model of iMK-801 having a very slow binding rate and consequently ∼30,000 times lower affinity than MK-801 applied to the extracellular side of the receptor. While iMK-801 can be used as a qualitative tool to study reduced postsynaptic NMDAR function, it cannot be assumed to completely block NMDARs at concentrations typically used in experiments.


Dizocilpine Maleate/pharmacology , Excitatory Amino Acid Antagonists/pharmacology , Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors , Synaptic Transmission/drug effects , Animals , Binding Sites , Cerebral Cortex/drug effects , Cerebral Cortex/metabolism , Dizocilpine Maleate/pharmacokinetics , Excitatory Amino Acid Antagonists/pharmacokinetics , Extracellular Space/drug effects , Extracellular Space/metabolism , HEK293 Cells , Hippocampus/drug effects , Hippocampus/metabolism , Humans , Mice, Inbred C57BL , Models, Molecular , Protein Binding , Rats, Sprague-Dawley , Receptors, N-Methyl-D-Aspartate/metabolism , Recombinant Proteins/metabolism , Synapses/drug effects , Synapses/metabolism , Synaptic Transmission/physiology , Tissue Culture Techniques
12.
Eur J Pharm Sci ; 125: 1-10, 2018 Dec 01.
Article En | MEDLINE | ID: mdl-30201516

Enterally administered riluzole is currently being investigated in a Phase II/III clinical trial for the treatment of acute spinal cord injury (SCI). Many SCI patients suffer from severe motor dysfunction and exhibit swallowing difficulties and cannot swallow riluzole tablets. The purpose of the present study was to develop a liquid solution formulation of riluzole, which can be administered more easily to this patient population with the capability to adjust the dose if needed. Riluzole was solubilized using water miscible organic solvents, namely, polyethylene glycol 400, propylene glycol and glycerin. A Central Composite Design (CCD) approach was used to develop an optimum co-solvent composition that can solubilize the entire 50 mg dose of riluzole in 5 ml. A three-factor five-level design was employed to investigate the effects of composition of co-solvents on riluzole solubility. The selected optimum formulation consists of 15% v/v PEG 400, 20% v/v propylene glycol and 10% v/v glycerin, with riluzole concentration of 10 mg/ml. The optimum composition was assessed for stability at different temperatures. Satisfactory stability was obtained at room temperature and 4 °C (t90 of 17 and 35 months, respectively). The optimum formulation of riluzole was suitable for both oral and intravenous administrations. Single dose pharmacokinetic studies of the optimum formulation by oral and IV routes were evaluated in rats, using commercially available Rilutek® tablets as a reference. The co-solvent formulation was well tolerated both orally and intravenously. In comparison to the commercial tablet, the co-solvent formulation had a faster rate of absorption and more sustained plasma levels with a significantly longer elimination half-life. Higher concentrations of riluzole in brain and spinal cord were achieved from co-solvent formulation as compared to tablet. The riluzole solution formulation is stable and offers advantages of ease of administration, consistent dosing, rapid onset and longer duration of action, better availability at site of action which can be extremely beneficial for the therapy in SCI patients.


Excitatory Amino Acid Antagonists , Riluzole , Sodium Channel Blockers , Administration, Intravenous , Administration, Oral , Animals , Brain/metabolism , Drug Design , Excitatory Amino Acid Antagonists/administration & dosage , Excitatory Amino Acid Antagonists/chemistry , Excitatory Amino Acid Antagonists/pharmacokinetics , Glycerol/administration & dosage , Glycerol/chemistry , Glycerol/pharmacokinetics , Male , Polyethylene Glycols/administration & dosage , Polyethylene Glycols/chemistry , Polyethylene Glycols/pharmacokinetics , Propylene Glycol/administration & dosage , Propylene Glycol/chemistry , Propylene Glycol/pharmacokinetics , Rats, Sprague-Dawley , Riluzole/administration & dosage , Riluzole/chemistry , Riluzole/pharmacokinetics , Sodium Channel Blockers/administration & dosage , Sodium Channel Blockers/chemistry , Sodium Channel Blockers/pharmacokinetics , Solvents/administration & dosage , Solvents/chemistry , Solvents/pharmacokinetics , Spinal Cord/metabolism
13.
Synapse ; 72(9): e22041, 2018 09.
Article En | MEDLINE | ID: mdl-29935121

[11 C]ABP688 is a positron emission tomography (PET) radioligand that binds selectively to metabotropic glutamate type 5 receptors (mGluR5). The use of this tracer has identified receptor binding changes in clinical populations, and has been informative in drug occupancy studies. However, previous studies have found significant increases in [11 C]ABP688 binding in the later scan of same-day comparisons, and estimates of test-retest reliability under consistent scanning conditions are not available. The objective of this study was to assess the variability of [11 C]ABP688 binding in healthy people in scans performed at the same time of day. Two [11 C]ABP688 scans were acquired in eight healthy volunteers (6 women, 2 men) using a high-resolution research tomograph (HRRT). Scans were acquired 3 weeks apart with start times between 10:00am and 1:30pm. Mean mGluR5 binding potential (BPND ) values were calculated across cortical, striatal and limbic brain regions. Participants reported on subjective mood state after each scan and blood samples were drawn for cortisol analysis. No significant change in BPND between scans was observed. Variability in BPND values of 11-21% was observed across regions, with the greatest change in the hippocampus and amygdala. Reliability was low to moderate. BPND was not statistically related to scan start time, subjective anxiety, serum cortisol levels, or menstrual phase in women. Overall, [11 C]ABP688 BPND estimates show moderate variability in healthy people. Reliability is fair in cortical and striatal regions, and lower in limbic regions. Future research using this ligand should account for this in study design and analysis.


Brain/diagnostic imaging , Excitatory Amino Acid Antagonists/pharmacokinetics , Oximes/pharmacokinetics , Pyridines/pharmacokinetics , Receptor, Metabotropic Glutamate 5/metabolism , Adult , Analysis of Variance , Brain/drug effects , Brain Mapping , Carbon Radioisotopes/pharmacokinetics , Female , Healthy Volunteers , Humans , Male , Positron-Emission Tomography , Protein Binding/drug effects , Reproducibility of Results , Young Adult
14.
Clin Pharmacol Ther ; 104(6): 1136-1145, 2018 12.
Article En | MEDLINE | ID: mdl-29672831

Increased excitability of motor neurons in patients with amyotrophic lateral sclerosis (ALS) may be a relevant factor leading to motor neuron damage. This randomized, double-blind, three-way crossover, placebo-controlled study evaluated peripheral motor nerve excitability testing as a biomarker of hyperexcitability and assessed the effects of riluzole and retigabine in 18 patients with ALS. We performed excitability testing at baseline, and twice after participants had received a single dose of either 100 mg riluzole, 300 mg retigabine, or placebo. Between- and within-day repeatability was at least acceptable for 14 out of 18 recorded excitability variables. No effects of riluzole on excitability testing were observed, but retigabine significantly decreased strength-duration time-constant (9.2%) and refractoriness at 2 ms (10.2) compared to placebo. Excitability testing was shown to be a reliable biomarker in patients with ALS, and the acute reversal of previously abnormal variables by retigabine justifies long-term studies evaluating the impact on disease progression and survival.


Amyotrophic Lateral Sclerosis/drug therapy , Axons/drug effects , Carbamates/administration & dosage , Evoked Potentials, Motor/drug effects , Excitatory Amino Acid Antagonists/administration & dosage , Motor Neurons/drug effects , Neuroprotective Agents/administration & dosage , Phenylenediamines/administration & dosage , Riluzole/administration & dosage , Adult , Aged , Amyotrophic Lateral Sclerosis/pathology , Amyotrophic Lateral Sclerosis/physiopathology , Axons/pathology , Carbamates/adverse effects , Carbamates/pharmacokinetics , Cross-Over Studies , Double-Blind Method , Electromyography , Excitatory Amino Acid Antagonists/adverse effects , Excitatory Amino Acid Antagonists/pharmacokinetics , Female , Humans , Male , Middle Aged , Motor Neurons/pathology , Netherlands , Neuroprotective Agents/adverse effects , Neuroprotective Agents/pharmacokinetics , Phenylenediamines/adverse effects , Phenylenediamines/pharmacokinetics , Refractory Period, Electrophysiological/drug effects , Riluzole/adverse effects , Riluzole/pharmacokinetics , Time Factors , Treatment Outcome
15.
Clin Pharmacol Ther ; 103(2): 193-195, 2018 02.
Article En | MEDLINE | ID: mdl-29076553

The probability of achieving marketing approval of a novel therapeutic for psychiatric indications is extremely low due largely to the inability to demonstrate durable and reproducible efficacy in phase II trials and beyond. These failures are often attributed to the lack of translation of the underlying neuropharmacology from animal model(s) to the disease population. However, how assured is such a conclusion considering the clinical efficacy path rarely meticulously parallels the preclinical experiment(s) that underwrote it?


Central Nervous System Agents/pharmacology , Drug Development/methods , Drug Discovery/methods , Evidence-Based Medicine/methods , Excitatory Amino Acid Antagonists/pharmacology , Ketamine/pharmacology , Translational Research, Biomedical/methods , Animals , Central Nervous System/drug effects , Central Nervous System/metabolism , Central Nervous System/physiopathology , Central Nervous System Agents/pharmacokinetics , Central Nervous System Agents/toxicity , Data Mining , Databases, Factual , Excitatory Amino Acid Antagonists/pharmacokinetics , Excitatory Amino Acid Antagonists/toxicity , Humans , Ketamine/pharmacokinetics , Ketamine/toxicity , Learning , Models, Animal , Models, Theoretical , Patient Safety , Receptors, Glutamate/drug effects , Receptors, Glutamate/metabolism , Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors , Receptors, N-Methyl-D-Aspartate/metabolism , Risk Assessment , Sulfonamides/pharmacology , Thiophenes/pharmacology
16.
Zh Nevrol Psikhiatr Im S S Korsakova ; 117(10): 136-143, 2017.
Article Ru | MEDLINE | ID: mdl-29171502

Memantine is the first clinically available glutamate antagonist, with an antagonist action at the N-methyl-D-aspartate receptors in the brain, for correction of cognitive and behavioral functions in neurodegenerative disorders. Glutamate mediated excitotoxic neuronal damage has been implicated in Alzheimer's disease (AD) and other parkinsonism-related dementias and, therefore, memantine represents a novel mode of action to counteract the glutamate-mediated excitotoxicity. In moderate to severe AD, 20 mg of memantine shows a positive effect on cognition, mood, behavior and the ability to perform activities of daily living. Long-term studies show good tolerability of memantine with an acceptable side-effect profile. In recent years, there have been a proliferation of a number of companies producing generic memantine with different trade names. In Russia, the first memantine generic drug noojerone was approved in 2010 and its use has since been supported by a growing evidence base of efficacy in real-life clinical practice. Postmarketing studies show that noojerone provides long-term and effective therapy in patients with moderate and severe Alzheimer's dementia. This observation is supported by the clinically significant therapeutic effect of noojerone on cognitive and daily functioning, behavioral and psychotic symptoms of dementia and a reduction of the burden on caregivers. This generic version of memantine is affordable and, therefore, reduces financial burden on patients and improves compliance with treatment.


Alzheimer Disease/drug therapy , Antiparkinson Agents/therapeutic use , Drugs, Generic/therapeutic use , Excitatory Amino Acid Antagonists/therapeutic use , Glutamic Acid/metabolism , Memantine/therapeutic use , Activities of Daily Living , Alzheimer Disease/physiopathology , Alzheimer Disease/psychology , Antiparkinson Agents/adverse effects , Antiparkinson Agents/pharmacokinetics , Antiparkinson Agents/pharmacology , Brain/drug effects , Brain/metabolism , Drugs, Generic/adverse effects , Drugs, Generic/pharmacokinetics , Drugs, Generic/pharmacology , Excitatory Amino Acid Antagonists/adverse effects , Excitatory Amino Acid Antagonists/pharmacokinetics , Excitatory Amino Acid Antagonists/pharmacology , Humans , Memantine/adverse effects , Memantine/pharmacokinetics , Memantine/pharmacology , Neurons/drug effects , Neurons/metabolism , Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors , Russia
17.
Rev. neurol. (Ed. impr.) ; 65(10): 433-438, 16 nov., 2017. ilus, tab
Article Es | IBECS | ID: ibc-169066

Introducción. El tratamiento de complicaciones motoras en la enfermedad de Parkinson (EP) sigue siendo limitado. La safinamida, un nuevo fármaco con actividad inhibidora de la monoaminooxidasa-B y antiglutamatérgica al inhibir canales de sodio, ha mostrado eficacia en dosis de 50-100 mg/día para las fluctuaciones en la EP. Pacientes y métodos. Desde la práctica clínica diaria, se ha descrito la eficacia y la tolerabilidad de la safinamida a los tres meses en pacientes con EP y complicaciones motoras. Se evaluó la eficacia mediante la escala global de impresión de cambio y el cambio en el número de horas en off al día, y se registraron todos los efectos secundarios comunicados por los pacientes. Resultados. En una muestra de 50 pacientes, el 57,4% refirió estar mucho mejor o moderadamente mejor a los tres meses, y presentaba mejoría de las fluctuaciones motoras y no motoras. El tiempo off diario disminuyó significativamente (0,9 ± 0,6 h). En 13 pacientes (27,6%) se redujo la dosis equivalente de levodopa en 132 mg/día. En pacientes con discinesias, la dosis de 100 mg/día consiguió un mejor control de las complicaciones motoras. El 19% de los pacientes presentó efectos secundarios leves. Siete pacientes abandonaron el tratamiento por síndrome confusional. Conclusiones. El mecanismo de acción dopaminérgico y no dopaminérgico de la safinamida permite un buen control de las fluctuaciones en la EP. La presencia de discinesias aconseja usar la safinamida en dosis de 100 mg/día. La safinamida presenta buena tolerabilidad global, pero debe administrarse con cautela en pacientes mayores de 75 años o estadios más avanzados de la enfermedad (AU)


Introduction. The management of motor complications in Parkinson’s disease (PD) is still limited. Safinamide, a new drug that has MAO-B inhibition and antiglutamatergic effects through inhibition of sodium channels, has shown efficacy for the treatment of fluctuations at doses of 50-100 mg/day. Patients and methods. From daily clinical practice, we describe the efficacy and tolerability of safinamide at three months in PD patients with motor complications. Efficacy was assessed by the Clinical Global Impression of Change scale and change in ‘off’ time during the daytime. All reported adverse events were recorded. Results. Fifty patients were recruited. 57.4% reported to be much better or moderately better at three months, improving both motor and non-motor fluctuations. Significant decrease of 0.9 ± 0.6 h/day was achieved at three months. In 13 patients (27.6%), levodopa equivalent daily dose was reduced in 132 mg/day. In patients with dyskinesias, safinamide 100 mg/day was better for controlling fluctuations and dyskinesias. 19% of patients had mild adverse events. Seven patients stopped treatment after development of confusional syndrome. Conclusions. The dopaminergic and non-dopaminergic action of safinamide exerts a good control of motor fluctuations. In patients with fluctuations and dyskinesias the dose of 100 mg/day of safinamide is preferred. Tolerability was good, except for patients older than 75 years or in advanced stages of the disease (AU)


Humans , Parkinson Disease/drug therapy , Monoamine Oxidase Inhibitors/pharmacokinetics , Excitatory Amino Acid Antagonists/pharmacokinetics , Antiparkinson Agents/pharmacokinetics , Dopamine Agents/therapeutic use , Dyskinesias/drug therapy , 50293 , Drug Tolerance , Prospective Studies
18.
ACS Chem Neurosci ; 8(9): 1823-1829, 2017 09 20.
Article En | MEDLINE | ID: mdl-28737885

Memantine was the first breakthrough medication for the treatment of moderate to severe Alzheimer's disease (AD) patients and represents a fundamentally new mechanism of action (moderate-affinity, uncompetitive, voltage-dependent, N-methyl-d-aspartate (NMDA) receptor antagonist that exhibits fast on/off kinetics) to modulate glutamatergic dysfunction. Since its approval by the FDA in 2003, memantine, alone and in combination with donepezil, has improved patient outcomes in terms of cognition, behavioral disturbances, daily functioning, and delaying time to institutionalization. In this review, we will highlight the historical significance of memantine to AD (and other neuropsychiatric disorders) as well as provide an overview of the synthesis, pharmacology, and drug metabolism of this unique NMDA uncompetitive antagonist that clearly secures its place among the Classics in Chemical Neuroscience.


Excitatory Amino Acid Antagonists/pharmacology , Memantine/pharmacology , Nootropic Agents/pharmacology , Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors , Alzheimer Disease/drug therapy , Alzheimer Disease/metabolism , Animals , Excitatory Amino Acid Antagonists/chemical synthesis , Excitatory Amino Acid Antagonists/pharmacokinetics , Excitatory Amino Acid Antagonists/therapeutic use , Humans , Memantine/chemical synthesis , Memantine/pharmacokinetics , Memantine/therapeutic use , Molecular Structure , Nootropic Agents/chemical synthesis , Nootropic Agents/pharmacokinetics , Nootropic Agents/therapeutic use , Receptors, N-Methyl-D-Aspartate/metabolism
19.
Basic Clin Pharmacol Toxicol ; 121(5): 382-389, 2017 Nov.
Article En | MEDLINE | ID: mdl-28557265

Memantine is a drug approved for the treatment of moderate-to-severe Alzheimer's disease (AD), and there is ongoing research on the potential expansion of its clinical applicability. Published data on the pharmacokinetics of memantine in the mouse are still incomplete, particularly for chronic administration regimens and mouse models of specific genetic disorders. Down's syndrome (DS) is a genetic disorder known to affect multiple organs and systems, with the potential to alter significantly drug pharmacokinetics. Here, we describe a simple, efficient and sensitive GC/MS-based procedure for the determination of memantine concentrations in murine blood and tissue samples. We analysed pharmacokinetic properties of memantine, particularly its distribution in blood, brain and liver in the Ts65Dn mouse model of DS and euploid F1 hybrid mice after single intraperitoneal administrations of increasing doses of this drug. We also determined steady-state memantine concentrations in plasma, brain and liver after chronic oral administration of this drug in adult male Ts65Dn mice, euploid littermate controls and nursing or pregnant Ts65Dn mice. Our results revalidated the acute dose of memantine used in previously published work, determined the appropriate amount of memantine to be mixed into mouse chow to achieve steady and pharmacologically relevant plasma and tissue levels of this drug and demonstrated that memantine can be transferred from mother to offspring via maternal milk and placenta. Most of these findings are potentially applicable not only to the study of DS but also to other neurodevelopmental and neurodegenerative disorders.


Down Syndrome/metabolism , Excitatory Amino Acid Antagonists/administration & dosage , Gas Chromatography-Mass Spectrometry/methods , Memantine/administration & dosage , Administration, Oral , Animals , Brain/metabolism , Disease Models, Animal , Excitatory Amino Acid Antagonists/pharmacokinetics , Female , Injections, Intraperitoneal , Liver/metabolism , Male , Memantine/pharmacokinetics , Mice , Mice, Inbred C3H , Mice, Inbred C57BL , Tissue Distribution
20.
Neuropharmacology ; 115: 100-114, 2017 03 15.
Article En | MEDLINE | ID: mdl-26748052

Metabotropic glutamate 2/3 (mGlu2/3) receptors are of considerable interest owing to their role in modulating glutamate transmission via presynaptic, postsynaptic and glial mechanisms. As part of our ongoing efforts to identify novel ligands for these receptors, we have discovered (1S,2R,3S,4S,5R,6R)-2-amino-3-[(3,4-difluorophenyl)sulfanylmethyl]-4-hydroxy-bicyclo[3.1.0]hexane-2,6-dicarboxylic acid; (LY3020371), a potent and selective orthosteric mGlu2/3 receptor antagonist. In this account, we characterize the effects of LY3020371 in membranes and cells expressing human recombinant mGlu receptor subtypes as well as in native rodent and human brain tissue preparations, providing important translational information for this molecule. In membranes from cells expressing recombinant human mGlu2 and mGlu3 receptor subtypes, LY3020371.HCl competitively displaced binding of the mGlu2/3 agonist ligand [3H]-459477 with high affinity (hmGlu2 Ki = 5.26 nM; hmGlu3 Ki = 2.50 nM). In cells expressing hmGlu2 receptors, LY3020371.HCl potently blocked mGlu2/3 agonist (DCG-IV)-inhibited, forskolin-stimulated cAMP formation (IC50 = 16.2 nM), an effect that was similarly observed in hmGlu3-expressing cells (IC50 = 6.21 nM). Evaluation of LY3020371 in cells expressing the other human mGlu receptor subtypes revealed high mGlu2/3 receptor selectivity. In rat native tissue assays, LY3020371 demonstrated effective displacement of [3H]-459477 from frontal cortical membranes (Ki = 33 nM), and functional antagonist activity in cortical synaptosomes measuring both the reversal of agonist-suppressed second messenger production (IC50 = 29 nM) and agonist-inhibited, K+-evoked glutamate release (IC50 = 86 nM). Antagonism was fully recapitulated in both primary cultured cortical neurons where LY3020371 blocked agonist-suppressed spontaneous Ca2+ oscillations (IC50 = 34 nM) and in an intact hippocampal slice preparation (IC50 = 46 nM). Functional antagonist activity was similarly demonstrated in synaptosomes prepared from epileptic human cortical or hippocampal tissues, suggesting a translation of the mGlu2/3 antagonist pharmacology from rat to human. Intravenous dosing of LY3020371 in rats led to cerebrospinal fluid drug levels that are expected to effectively block mGlu2/3 receptors in vivo. Taken together, these results establish LY3020371 as an important new pharmacological tool for studying mGlu2/3 receptors in vitro and in vivo. This article is part of the Special Issue entitled 'Metabotropic Glutamate Receptors, 5 years on'.


Cyclohexanes/pharmacokinetics , Excitatory Amino Acid Antagonists/pharmacokinetics , Receptors, Metabotropic Glutamate/antagonists & inhibitors , Receptors, Metabotropic Glutamate/metabolism , Animals , Cell Line , Cerebral Cortex/drug effects , Cerebral Cortex/metabolism , Cyclohexanes/chemistry , Dose-Response Relationship, Drug , Excitatory Amino Acid Antagonists/chemistry , Humans , Male , Rats , Rats, Sprague-Dawley
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