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Mishra MK, Kukal S, Paul PR, Bora S, Singh A, Kukreti S, Saso L, Muthusamy K, Hasija Y, Kukreti R. Insights into Structural Modifications of Valproic Acid and Their Pharmacological Profile. MOLECULES (BASEL, SWITZERLAND) 2021; 27:molecules27010104. [PMID: 35011339 PMCID: PMC8746633 DOI: 10.3390/molecules27010104] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 11/16/2022]
Abstract
Valproic acid (VPA) is a well-established anticonvulsant drug discovered serendipitously and marketed for the treatment of epilepsy, migraine, bipolar disorder and neuropathic pain. Apart from this, VPA has potential therapeutic applications in other central nervous system (CNS) disorders and in various cancer types. Since the discovery of its anticonvulsant activity, substantial efforts have been made to develop structural analogues and derivatives in an attempt to increase potency and decrease adverse side effects, the most significant being teratogenicity and hepatotoxicity. Most of these compounds have shown reduced toxicity with improved potency. The simple structure of VPA offers a great advantage to its modification. This review briefly discusses the pharmacology and molecular targets of VPA. The article then elaborates on the structural modifications in VPA including amide-derivatives, acid and cyclic analogues, urea derivatives and pro-drugs, and compares their pharmacological profile with that of the parent molecule. The current challenges for the clinical use of these derivatives are also discussed. The review is expected to provide necessary knowledgebase for the further development of VPA-derived compounds.
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Affiliation(s)
- Manish Kumar Mishra
- Genomics and Molecular Medicine Unit, Institute of Genomics and Integrative Biology (IGIB), Council of Scientific and Industrial Research (CSIR), Mall Road, Delhi 110007, India; (M.K.M.); (S.K.); (P.R.P.); (S.B.)
- Department of Biotechnology, Delhi Technological University, Shahbad Daulatpur, Main Bawana Road, Delhi 110042, India;
| | - Samiksha Kukal
- Genomics and Molecular Medicine Unit, Institute of Genomics and Integrative Biology (IGIB), Council of Scientific and Industrial Research (CSIR), Mall Road, Delhi 110007, India; (M.K.M.); (S.K.); (P.R.P.); (S.B.)
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Priyanka Rani Paul
- Genomics and Molecular Medicine Unit, Institute of Genomics and Integrative Biology (IGIB), Council of Scientific and Industrial Research (CSIR), Mall Road, Delhi 110007, India; (M.K.M.); (S.K.); (P.R.P.); (S.B.)
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Shivangi Bora
- Genomics and Molecular Medicine Unit, Institute of Genomics and Integrative Biology (IGIB), Council of Scientific and Industrial Research (CSIR), Mall Road, Delhi 110007, India; (M.K.M.); (S.K.); (P.R.P.); (S.B.)
- Department of Biotechnology, Delhi Technological University, Shahbad Daulatpur, Main Bawana Road, Delhi 110042, India;
| | - Anju Singh
- Nucleic Acids Research Lab, Department of Chemistry, University of Delhi (North Campus), Delhi 110007, India; (A.S.); (S.K.)
- Department of Chemistry, Ramjas College, University of Delhi (North Campus), Delhi 110007, India
| | - Shrikant Kukreti
- Nucleic Acids Research Lab, Department of Chemistry, University of Delhi (North Campus), Delhi 110007, India; (A.S.); (S.K.)
| | - Luciano Saso
- Department of Physiology and Pharmacology “Vittorio Erspamer”, Sapienza University of Rome, P. le Aldo Moro 5, 00185 Rome, Italy;
| | - Karthikeyan Muthusamy
- Department of Bioinformatics, Alagappa University, Karaikudi 630004, Tamil Nadu, India;
| | - Yasha Hasija
- Department of Biotechnology, Delhi Technological University, Shahbad Daulatpur, Main Bawana Road, Delhi 110042, India;
| | - Ritushree Kukreti
- Genomics and Molecular Medicine Unit, Institute of Genomics and Integrative Biology (IGIB), Council of Scientific and Industrial Research (CSIR), Mall Road, Delhi 110007, India; (M.K.M.); (S.K.); (P.R.P.); (S.B.)
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
- Correspondence: or ; Tel.: +91-11-27662202; Fax: +91-11-27667471
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Krivoshein AV. α-Substituted Lactams and Acetamides: Ion Channel Modulators that Show Promise in Treating Drug-resistant Epilepsy. Cent Nerv Syst Agents Med Chem 2020; 20:79-87. [PMID: 32386500 DOI: 10.2174/1871524920666200510005458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/15/2020] [Accepted: 04/20/2020] [Indexed: 11/22/2022]
Abstract
The two main problems in the pharmacotherapy of epilepsy are resistance to currently available first-line medications (which occurs in about one third of patients) and the high incidence of side effects. To address these two challenges, extensive efforts are being undertaken to design new, structurally distinct antiepileptic drugs with a broad spectrum of anticonvulsant activity. Tests in animal models of epilepsy indicate that α-substituted lactams and acetamides show a broad spectrum of anticonvulsant activity (including very promising activity in drug-resistant models) as well as an excellent safety profile. Limited clinical results confirm these preclinical findings. In the first part of this review, pharmacology and toxicology of α-substituted lactams and acetamides and their putative protein targets in the brain have been discussed. This is followed by a discussion of structure-activity relationships among α-alkyl-, α-aryl-, and α-aryl-α-alkyl-substituted derivatives. The most promising structures seem to be those related to 3-ethyl-3-phenylpyrrolidin-2-one, 2-phenylbutyramide, and 2- sec-butylvaleramide. The information presented in this review is expected to facilitate rational drug design and development efforts for α-substituted lactams and acetamides.
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Affiliation(s)
- Arcadius V Krivoshein
- Chemistry Program, University of Houston-Clear Lake, Houston, TX 77058, United States
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sec-Butylpropylacetamide (SPD), a new amide derivative of valproic acid for the treatment of neuropathic and inflammatory pain. Pharmacol Res 2016; 117:129-139. [PMID: 27890817 DOI: 10.1016/j.phrs.2016.11.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 10/20/2016] [Accepted: 11/22/2016] [Indexed: 01/12/2023]
Abstract
Chronic pain is a multifactorial disease comprised of both inflammatory and neuropathic components that affect ∼20% of the world's population. sec-Butylpropylacetamide (SPD) is a novel amide analogue of valproic acid (VPA) previously shown to possess a broad spectrum of anticonvulsant activity. In this study, we defined the pharmacokinetic parameters of SPD in rat and mouse, and then evaluated its antinociceptive potential in neuropathic and acute inflammatory pain models. In the sciatic nerve ligation (SNL) model of neuropathic pain, SPD was equipotent to gabapentin and more potent than its parent compound VPA. SPD also showed either higher or equal potency to VPA in the formalin, carrageenan, and writhing tests of inflammatory pain. SPD showed no effects on compound action potential properties in a sciatic nerve preparation, suggesting that its mechanism of action is distinct from local anesthetics and membrane stabilizing drugs. SPD's activity in both neuropathic and inflammatory pain warrants its development as a potential broad-spectrum anti-nociceptive drug.
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Pirapakaran K, Aggarwal A. The use of low-dose sodium valproate in the management of neuropathic pain: illustrative case series. Intern Med J 2016; 46:849-52. [DOI: 10.1111/imj.13125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 12/09/2015] [Accepted: 12/09/2015] [Indexed: 11/28/2022]
Affiliation(s)
- K. Pirapakaran
- Department of Anaesthetics; Royal Prince Alfred Hospital; Sydney New South Wales Australia
| | - A. Aggarwal
- Pain Management Centre; Royal Prince Alfred Hospital; Sydney New South Wales Australia
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Wang W, Cui SS, Lu R, Zhang H. Is there any therapeutic value for the use of histone deacetylase inhibitors for chronic pain? Brain Res Bull 2016; 125:44-52. [PMID: 27090944 DOI: 10.1016/j.brainresbull.2016.04.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 03/16/2016] [Accepted: 04/14/2016] [Indexed: 12/16/2022]
Abstract
Chronic pain is a complex clinical condition that reduces the quality of life for billions of people. In recent years, the role of epigenetic modulation in the control of long-term neuronal plasticity has attracted the attention of pain researchers. The epigenetic mechanisms include covalent modifications of DNA and/or histone proteins. Mounting evidence suggests that the activity of histone deacetylases (HDACs) and levels of histone acetylation are dynamic and that these enzymes modulate pain-related synaptic plasticity. Therefore, HDACs play essential roles in chronic pain development and maintenance. In this mini review, we will discuss the role of HDACs in the pathogenesis of chronic pain and will consider the therapeutic value of HDAC inhibitors in treating chronic pain.
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Affiliation(s)
- Wei Wang
- State Key Laboratory of Military Stomatology, Department of Anesthesiology, School of Stomatology, the Fourth Military Medical University, Xi'an 710032, China.
| | - Shan-Shan Cui
- Department of Anesthesiology, Zhongnan Hospital, Wuhan University, East Lake Road, Wuhan 430071, China.
| | - Rui Lu
- State Key Laboratory of Military Stomatology, Department of Anesthesiology, School of Stomatology, the Fourth Military Medical University, Xi'an 710032, China.
| | - Hui Zhang
- State Key Laboratory of Military Stomatology, Department of Anesthesiology, School of Stomatology, the Fourth Military Medical University, Xi'an 710032, China.
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Shekh-Ahmad T, Bialer M, Yavin E. Synthesis and anticonvulsant evaluation of dimethylethanolamine analogues of valproic acid and its tetramethylcyclopropyl analogue. Epilepsy Res 2012; 98:238-46. [DOI: 10.1016/j.eplepsyres.2011.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 10/02/2011] [Accepted: 10/06/2011] [Indexed: 01/16/2023]
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Pessah N, Kaufmann D, Yagen B, Hen N, Wlodarczyk B, Finnell RH, Bialer M. Comparative pharmacodynamic and pharmacokinetic analysis of two anticonvulsant halo derivatives of 2,2,3,3-tetramethylcyclopropanecarboxamide, an amide of a cyclic analog of valproic acid. Epilepsia 2010; 51:1944-53. [PMID: 20738383 DOI: 10.1111/j.1528-1167.2010.02684.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE α-Fluoro-2,2,3,3-tetramethylcyclopropanecarboxamide (α-F-TMCD) and α-Cl-TMCD, are α-halo derivatives of TMCD, the corresponding amide of a cyclopropane analog of valproic acid (VPA). This study aimed to comparatively evaluate the pharmacodynamics and pharmacokinetics of α-F-TMCD and α-Cl-TMCD in rodent models of epilepsy and for antiepileptic drug (AED)-induced teratogenicity. The potential of α-F-TMCD as an antiallodynic and antinociceptive compound was also evaluated. METHODS α-F-TMCD and α-Cl-TMCD were synthesized. α-Cl-TMCD anticonvulsant activity was evaluated in comparison to VPA in the mouse maximal-electroshock-seizure (MES), Metrazol (scMet), and 6-Hz psychomotor-seizure tests. Neurotoxicity was assessed by the Rotorod-ataxia test. Induction of neural tube defects (NTDs) by α-Cl-TMCD and α-F-TMCD was evaluated after intraperitoneal administration to a mouse strain highly susceptible to VPA-induced teratogenicity. The ability of α-F-TMCD to reduce pain was evaluated in the rat spinal nerve ligation (SNL) model for neuropathic pain and in the formalin test. α-F-TMCD and α-Cl-TMCD pharmacokinetics was evaluated following intraperitoneal (40 mg/kg) and oral (60 mg/kg) administration to rats. RESULTS α-F-TMCD and α-Cl-TMCD had similar potencies in the 6-Hz test and were more potent than VPA in this model and in the scMet test. Neither induced NTDs, and both exhibited wide safety margins. α-F-TMCD was active in the two pain models, and was found to be equipotent to gabapentin in the SNL model (ED(50) = 37 and 32 mg/kg, respectively). Comparative pharmacokinetic analysis showed that α-Cl-TMCD is less susceptible to liver first-pass effect than α-F-TMCD because of lower total (metabolic) clearance and liver extraction ratio. CONCLUSIONS Based on their potent anticonvulsant activity and lack of teratogenicity, α-F-TMCD and α-Cl-TMCD have the potential for development as new antiepileptics and central nervous system (CNS) drugs.
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Affiliation(s)
- Neta Pessah
- Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
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Kaufmann D, Yagen B, Minert A, Wlodarczyk B, Finnell RH, Schurig V, Devor M, Bialer M. Evaluation of the antiallodynic, teratogenic and pharmacokinetic profile of stereoisomers of valnoctamide, an amide derivative of a chiral isomer of valproic acid. Neuropharmacology 2010; 58:1228-36. [DOI: 10.1016/j.neuropharm.2010.03.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2010] [Revised: 03/07/2010] [Accepted: 03/08/2010] [Indexed: 11/24/2022]
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Bialer M, White HS. Key factors in the discovery and development of new antiepileptic drugs. Nat Rev Drug Discov 2010; 9:68-82. [PMID: 20043029 DOI: 10.1038/nrd2997] [Citation(s) in RCA: 374] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Since the early 1990s, many new antiepileptic drugs (AEDs) that offer appreciable advantages in terms of their favourable pharmacokinetics, improved tolerability and lower potential for drug-drug interactions have entered the market. However, despite the therapeutic arsenal of old and new AEDs, approximately 30% of patients with epilepsy still suffer from seizures. Thus, there remains a substantial need for the development of more efficacious AEDs for patients with refractory seizures. Here, we briefly review the emerging knowledge on the pathological basis of epilepsy and how it might best be used in the design of new therapeutics. We also discuss the current approach to AED discovery and highlight some of the unique features of newer models of pharmacoresistance and epileptogenesis that have emerged in recent years.
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Affiliation(s)
- Meir Bialer
- Institute of Drug Research, School of Pharmacy, Faculty of Medicine, and the David R. Bloom Centre for Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel.
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Kaufmann D, Bialer M, Shimshoni JA, Devor M, Yagen B. Synthesis and Evaluation of Antiallodynic and Anticonvulsant Activity of Novel Amide and Urea Derivatives of Valproic Acid Analogues. J Med Chem 2009; 52:7236-48. [DOI: 10.1021/jm901229s] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Dan Kaufmann
- Department of Pharmaceutics, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Israel
| | - Meir Bialer
- Department of Pharmaceutics, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Israel
- David R. Bloom Center for Pharmacy, The Hebrew University of Jerusalem, Israel
| | - Jakob Avi Shimshoni
- Department of Pharmaceutics, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Israel
| | - Marshall Devor
- Department of Cell and Developmental Biology, Institute of Life Sciences, Faculty of Natural Sciences and Center for Research on Pain, The Hebrew University of Jerusalem, Israel
| | - Boris Yagen
- David R. Bloom Center for Pharmacy, The Hebrew University of Jerusalem, Israel
- Department of Medicinal Chemistry and Natural Products, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Israel
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Wang HL, Jiang WF, Li ZQ. Facile synthesis of amide and amine derivatives of 2,2,3,3-tetramethylcyclopropanecarboxylic acid. JOURNAL OF CHEMICAL RESEARCH 2009. [DOI: 10.3184/030823409x12474221035208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
An efficient one-pot procedure for the synthesis of amide derivatives of 2,2,3,3-tetramethylpropanecarboxylic acid (TMCA) that involves the treating of TMCA in N,N-dimethylacetamide (DMAC) with thionyl chloride and stoichiometric amounts of reactant amines has been developed. The combined reagent TiCl4/NaBH4 was found to be effective for the reduction of the amide derivatives of TMCA to the corresponding amines.
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Affiliation(s)
- Hui-Long Wang
- Department of Chemistry, Dalian University of Technology, Dalian 116023, P.R. China
| | - Wen-Feng Jiang
- Department of Chemistry, Dalian University of Technology, Dalian 116023, P.R. China
| | - Zhe-Qi Li
- Environmental Science and Engineering Institute, Dalian Jiaotong University, Dalian 116023, P.R. China
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Pessah N, Bialer M, Wlodarczyk B, Finnell RH, Yagen B. α-Fluoro-2,2,3,3-Tetramethylcyclopropanecarboxamide, a Novel Potent Anticonvulsant Derivative of a Cyclic Analogue of Valproic Acid. J Med Chem 2009; 52:2233-42. [PMID: 19296679 DOI: 10.1021/jm900017f] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Neta Pessah
- Department of Pharmaceutics and Department of Natural Products and Medicinal Chemistry, School of Pharmacy, Faculty of Medicine, and The David R. Bloom Centre for Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel, and Center for Environmental and Genetic Medicine, Institute of Biosciences and Technology, Texas A & M Health Science Center, Texas A & M University, Houston, Texas
| | - Meir Bialer
- Department of Pharmaceutics and Department of Natural Products and Medicinal Chemistry, School of Pharmacy, Faculty of Medicine, and The David R. Bloom Centre for Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel, and Center for Environmental and Genetic Medicine, Institute of Biosciences and Technology, Texas A & M Health Science Center, Texas A & M University, Houston, Texas
| | - Bogdan Wlodarczyk
- Department of Pharmaceutics and Department of Natural Products and Medicinal Chemistry, School of Pharmacy, Faculty of Medicine, and The David R. Bloom Centre for Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel, and Center for Environmental and Genetic Medicine, Institute of Biosciences and Technology, Texas A & M Health Science Center, Texas A & M University, Houston, Texas
| | - Richard H. Finnell
- Department of Pharmaceutics and Department of Natural Products and Medicinal Chemistry, School of Pharmacy, Faculty of Medicine, and The David R. Bloom Centre for Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel, and Center for Environmental and Genetic Medicine, Institute of Biosciences and Technology, Texas A & M Health Science Center, Texas A & M University, Houston, Texas
| | - Boris Yagen
- Department of Pharmaceutics and Department of Natural Products and Medicinal Chemistry, School of Pharmacy, Faculty of Medicine, and The David R. Bloom Centre for Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel, and Center for Environmental and Genetic Medicine, Institute of Biosciences and Technology, Texas A & M Health Science Center, Texas A & M University, Houston, Texas
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Okada A, Onishi Y, Yagen B, Shimshoni JA, Kaufmann D, Bialer M, Fujiwara M. Tetramethylcyclopropyl analogue of the leading antiepileptic drug, valproic acid: evaluation of the teratogenic effects of its amide derivatives in NMRI mice. BIRTH DEFECTS RESEARCH. PART A, CLINICAL AND MOLECULAR TERATOLOGY 2008; 82:610-21. [PMID: 18671279 DOI: 10.1002/bdra.20490] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Although valproic acid (VPA) is used extensively for treating various kinds of epilepsy, it causes hepatotoxicity and teratogenicity. In an attempt to develop a more potent and safer second generation to VPA drug, the amide derivatives of the tetramethylcyclopropyl VPA analogue, 2,2,3,3-tetramethylcyclopropanecarboxamide (TMCD), N-methyl-TMCD (MTMCD), 4-(2,2,3,3-tetramethylcyclopropanecarboxamide)-benzenesulfonamide (TMCD-benzenesulfonamide), and 5-(TMCD)-1,3,4-thiadiazole-2-sulfonamide (TMCD-thiadiazolesulfonamide) were synthesized and shown to have more potent anticonvulsant activity than VPA. Teratogenic effects of these CNS-active compounds were evaluated in Naval Medical Research Institute (NMRI) mice susceptible to VPA-induced teratogenicity by comparing them to those of VPA. METHODS Pregnant NMRI mice were given a single sc injection of either VPA or TMC-amide derivatives on gestation day 8.5, and then the live fetuses were examined to detect any external malformations on gestation day 18. After double-staining for bone and cartilage, their skeletons were examined. RESULTS In contrast to VPA, which induced NTDs in a high number of fetuses at 2.4-4.8 mmol/kg, TMCD, TMCD-benzenesulfonamide, and TMCD-thiadiazolesulfonamide at 4.8 mmol/kg and MTMCD at 3.6 mmol/kg did not induce a significant number of NTDs. TMCD-thiadiazolesulfonamide exhibited a potential to induce limb defects in fetuses. Skeletal examination also revealed that fetuses exposed to all four of the tetramethylcyclopropanecarboxamide derivatives developed vertebral and rib abnormalities less frequently than those exposed to VPA. Our results established that TMCD, MTMCD, and TMCD-benzenesulfonamide are distinctly less teratogenic than VPA in NMRI mice. CONCLUSIONS The CNS-active amides containing a tetramethylcyclopropanecarbonyl moiety demonstrated better anticonvulsant potency compared to VPA and a lack of teratogenicity, which makes these compounds good second-generation VPA antiepileptic drug candidates.
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Affiliation(s)
- Akinobu Okada
- Drug Safety Research Laboratories, Astellas Pharma Inc., Osaka, Japan
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Khongsombat O, Watanabe H, Tantisira B, Patarapanich C, Tantisira M. Acute effects of N-(2-propylpentanoyl)urea on hippocampal amino acid neurotransmitters in pilocarpine-induced seizure in rats. Epilepsy Res 2008; 79:151-7. [DOI: 10.1016/j.eplepsyres.2008.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2007] [Revised: 01/22/2008] [Accepted: 01/28/2008] [Indexed: 11/16/2022]
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Johannessen Landmark C. Antiepileptic drugs in non-epilepsy disorders: relations between mechanisms of action and clinical efficacy. CNS Drugs 2008; 22:27-47. [PMID: 18072813 DOI: 10.2165/00023210-200822010-00003] [Citation(s) in RCA: 211] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Antiepileptic drugs (AEDs) are used extensively to treat multiple non-epilepsy disorders, both in neurology and psychiatry. This article provides a review of the clinical efficacy of AEDs in non-epilepsy disorders based on recently published preclinical and clinical studies, and attempts to relate this efficacy to the mechanism of action of AEDs and pathophysiological processes associated with the disorders. Some newer indications for AEDs have been established, while others are under investigation. The disorders where AEDs have been demonstrated to be of clinical importance include neurological disorders, such as essential tremor, neuropathic pain and migraine, and psychiatric disorders, including anxiety, schizophrenia and bipolar disorder. Many of the AEDs have various targets of action in the synapse and have several proposed relevant mechanisms of action in epilepsy and in other disorders. Pathophysiological processes disturb neuronal excitability by modulating ion channels, receptors and intracellular signalling pathways, and these are targets for the pharmacological action of various AEDs. Attention is focused on the glutamatergic and GABAergic synapses. In psychiatric conditions such as schizophrenia and bipolar disorder, AEDs such as valproate, carbamazepine and lamotrigine appear to have clear roles based on their effect on intracellular pathways. On the other hand, some AEDs, e.g. topiramate, have efficacy for nonpsychiatric disorders including migraine, possibly by enhancing GABAergic and reducing glutamatergic neurotransmission. AEDs that seem to enhance GABAergic neurotransmission, e.g. tiagabine, valproate, gabapentin and possibly levetiracetam, may have a role in treating neurological disorders such as essential tremor, or anxiety disorders. AEDs with effects on voltage-gated sodium or calcium channels may be advantageous in treating neuropathic pain, e.g. gabapentin, pregabalin, carbamazepine, oxcarbazepine, lamotrigine and valproate. Co-morbid conditions associated with epilepsy, such as mood disorders and migraine, may often respond to treatment with AEDs. Other possible disorders where AEDs may be of clinical importance include cancer, HIV infection, drug and alcohol abuse, and also in neuroprotection. A future challenge is to evaluate the second-generation AEDs in non-epilepsy disorders and to design clinical trials to study their effects in such disorders in paediatric patients. Differentiation between the main mechanisms of action of the AEDs needs more consideration in drug selection for tailored treatment of the various non-epilepsy disorders.
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Landmark CJ, Johannessen SI. Modifications of Antiepileptic Drugs for Improved Tolerability and Efficacy. PERSPECTIVES IN MEDICINAL CHEMISTRY 2008. [DOI: 10.1177/1177391x0800200001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction A large number of antiepileptic drugs (AEDs) are available today, but they may not be satisfactory regarding clinical efficacy, tolerance, toxicity or pharmacokinetic properties. The purpose of this review is to focus upon the rationale behind the chemical modifications of several recently marketed AEDs or drugs in development and to categorize them according to the main purposes for the improvements: better efficacy or tolerability accompanied by improved pharmacokinetic properties. Material and Method AEDs that have been chemically modified to new derivatives during the last years are reviewed based on recent publications and PubMed-searches. Results and Discussion Improvement in pharmacokinetic parameters may affect both tolerability and efficacy. Modifications to improve tolerability include various valproate analogues, divided into aliphatic amides, cyclic derivatives or amino acid conjugates. Furthermore, there are the carbamazepine analogues oxcarbazepine and eslicarbazepine, the felbamate analogues fluorofelbamate and carisbamate (RWJ 33369), and the lamotrigine analogue JZP-4. The levetiracetam analogues brivaracetam and seletracetam and the derivatives of gabapentin, pregabalin and XP13512, have improved selectivity compared to their parent compounds. Other new drugs have new mechanisms of action related to GABA and glutamate receptors; the glutamate antagonists like topiramate (talampanel and NS-1209), and GABAA receptor agonists, benzodiazepine or progesterone analogues (ELB-139 and ganaxolone). Conclusion Further challenges for development of new AEDs include investigations of target molecules affected by pathophysiological processes and detailed structure-activity relationships with focus on stereoselectivity. These potential drugs may become of importance in future drug therapy in epilepsy and other CNS disorders.
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Affiliation(s)
| | - Svein I. Johannessen
- National Center for Epilepsy, Sandvika, Division of Clinical Neuroscience, Rikshospitalet University Hospital, Oslo, Norway
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Morphine and ABT-594 (a Nicotinic Acetylcholine Agonist) Exert Centrally Mediated Antinociception in the Rat Cyclophosphamide Cystitis Model of Visceral Pain. THE JOURNAL OF PAIN 2008; 9:146-56. [DOI: 10.1016/j.jpain.2007.09.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2007] [Revised: 09/19/2007] [Accepted: 09/27/2007] [Indexed: 12/29/2022]
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18
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Kaufmann D, Yagen B, Minert A, Tal M, Devor M, Bialer M. Evaluation of the enantioselective antiallodynic and pharmacokinetic profile of propylisopropylacetamide, a chiral isomer of valproic acid amide. Neuropharmacology 2007; 54:699-707. [PMID: 18201732 DOI: 10.1016/j.neuropharm.2007.11.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2007] [Revised: 11/25/2007] [Accepted: 11/28/2007] [Indexed: 11/17/2022]
Abstract
Propylisopropylacetamide (PID) is a chiral CNS-active constitutional isomer of valpromide, the amide derivative of the major antiepileptic drug valproic acid (VPA). The purpose of this work was: a) To evaluate enantiospecific activity of PID on tactile allodynia in the Chung (spinal nerve ligation, SNL) model of neuropathic pain in rats; b) To evaluate possible sedation at effective antiallodynic doses, using the rotorod ataxia test; c) To investigate enantioselectivity in the pharmacokinetics of (R)- and (S)-PID in comparison to (R,S)-PID; and d) To determine electrophysiologically whether PID has the potential to affect tactile allodynia by suppressing ectopic afferent discharge in the peripheral nervous system (PNS). (R)-, (S)- and (R,S)-PID produced dose-related reversal of tactile allodynia with ED(50) values of 46, 48, 42 mg/kg, respectively. The individual PID enantiomers were not enantioselective in their antiallodynic activity. No sedative side-effects were observed at these doses. Following i.p. administration of the individual enantiomers, (S)-PID had lower clearance (CL) and volume of distribution (V) and a shorter half-life (t(1/2)) than (R)-PID. However following administration of (R,S)-PID, both enantiomers had similar CL and V, but (R)-PID had a longer t(1/2). Systemic administration of (R,S)-PID at antiallodynic doses did not suppress spontaneous ectopic afferent discharge generated in the injured peripheral nerve, suggesting that its antiallodynic action is exerted in the CNS rather than the PNS. Both of PID's enantiomers, and the racemate, are more potent antiallodynic agents than VPA and have similar potency to gabapentin. Consequently, they have the potential to become new drugs for treating neuropathic pain.
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Affiliation(s)
- Dan Kaufmann
- Department of Pharmaceutics, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
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19
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Shimshoni JA, Bialer M, Wlodarczyk B, Finnell RH, Yagen B. Potent Anticonvulsant Urea Derivatives of Constitutional Isomers of Valproic Acid. J Med Chem 2007; 50:6419-27. [DOI: 10.1021/jm7009233] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jakob Avi Shimshoni
- Department of Pharmaceutics and Department of Medicinal Chemistry and Natural Products, School of Pharmacy, Faculty of Medicine, and the David R. Bloom Centre for Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel, and Center for Environmental and Genetic Medicine, Institute of Biosciences and Technology, Texas A & M Health Science Center, Texas A & M University, Houston, Texas
| | - Meir Bialer
- Department of Pharmaceutics and Department of Medicinal Chemistry and Natural Products, School of Pharmacy, Faculty of Medicine, and the David R. Bloom Centre for Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel, and Center for Environmental and Genetic Medicine, Institute of Biosciences and Technology, Texas A & M Health Science Center, Texas A & M University, Houston, Texas
| | - Bogdan Wlodarczyk
- Department of Pharmaceutics and Department of Medicinal Chemistry and Natural Products, School of Pharmacy, Faculty of Medicine, and the David R. Bloom Centre for Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel, and Center for Environmental and Genetic Medicine, Institute of Biosciences and Technology, Texas A & M Health Science Center, Texas A & M University, Houston, Texas
| | - Richard H. Finnell
- Department of Pharmaceutics and Department of Medicinal Chemistry and Natural Products, School of Pharmacy, Faculty of Medicine, and the David R. Bloom Centre for Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel, and Center for Environmental and Genetic Medicine, Institute of Biosciences and Technology, Texas A & M Health Science Center, Texas A & M University, Houston, Texas
| | - Boris Yagen
- Department of Pharmaceutics and Department of Medicinal Chemistry and Natural Products, School of Pharmacy, Faculty of Medicine, and the David R. Bloom Centre for Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel, and Center for Environmental and Genetic Medicine, Institute of Biosciences and Technology, Texas A & M Health Science Center, Texas A & M University, Houston, Texas
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20
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Yogeeswari P, Ragavendran JV, Sriram D. Neuropathic pain: strategies in drug discovery and treatment. Expert Opin Drug Discov 2007; 2:169-84. [DOI: 10.1517/17460441.2.2.169] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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21
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Abstract
The manuscript focuses on structure-activity relationship studies of CNS-active compounds derived from valproic acid (VPA) that have the potential to become second-generation VPA drugs. Valproic acid is one of the four most widely prescribed antiepileptic drugs (AEDs) and is effective (and regularly approved) in migraine prophylaxis and in the treatment of bipolar disorders. Valproic acid is also currently undergoing clinical trials in cancer patients. Valproic acid is the least potent of the established AEDs and its use is limited by two rare but potentially life-threatening side effects, teratogenicity and hepatotoxicity. Because AEDs treat the symptoms (seizure) and not the cause of epilepsy, epileptic patients need to take AEDs for a long period of time. Consequently, there is a substantial need to develop better and safer AEDs. To become a successful second-generation VPA, the new drug should possess the following characteristics: broad-spectrum antiepileptic activity, better potency than VPA, lack of teratogenicity and hepatotoxicity, and a favorable pharmacokinetic profile compared with VPA including a low potential for drug interactions.
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Affiliation(s)
- Meir Bialer
- Department of Pharmaceutics, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.
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22
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Shimshoni JA, Dalton EC, Jenkins A, Eyal S, Ewan K, Williams RSB, Pessah N, Yagen B, Harwood AJ, Bialer M. The effects of central nervous system-active valproic acid constitutional isomers, cyclopropyl analogs, and amide derivatives on neuronal growth cone behavior. Mol Pharmacol 2006; 71:884-92. [PMID: 17167030 DOI: 10.1124/mol.106.030601] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Valproic acid (VPA) is an effective antiepileptic drug with an additional activity for the treatment of bipolar disorder. It has been assumed that both activities arise from a common target. At the molecular level, VPA targets a number of distinct proteins that are involved in signal transduction. VPA inhibition of inositol synthase reduces the cellular concentration of myo-inositol, an effect common to the mood stabilizers lithium and carbamazepine. VPA inhibition of histone deacetylases activates Wnt signaling via elevated beta-catenin expression and causes teratogenicity. Given the VPA chemical structure, it may be possible to design VPA derivatives and analogs that modulate specific protein targets but leave the others unaffected. Indeed, it has been shown that some nonteratogenic VPA derivatives retain antiepileptic and inositol signaling effects. In this study, we describe a further set of VPA analogs and derivatives that separate anticonvulsant activity from effects on neuronal growth cone morphology. Lithium, carbamazepine, and VPA induce inositol-dependent spread of neuronal growth cones, providing a cell-based assay that correlates with mood-stabilizing activity. We find that two constitutional isomers of VPA, propylisopropylacetic acid and diisopropylacetic acid, but not their corresponding amides, and N-methyl-2,2,3,3-tetramethyl-cyclopropanecarboaxamide are more effective than VPA in increasing growth cone spreading. We show that these effects are associated with inositol depletion, and not changes in beta-catenin-mediated Wnt signaling. These results suggest a route to a new generation of central nervous system-active VPA analogs that specifically target bipolar disorder.
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Affiliation(s)
- J A Shimshoni
- Department of Pharmaceutics, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Ein Karem, P.O. Box 12065, Jerusalem 91120, Israel
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23
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Sobol E, Yagen B, Lamb JG, White HS, Wlodarczyk BJ, Finnell RH, Bialer M. Anticonvulsant activity, neural tube defect induction, mutagenicity and pharmacokinetics of a new potent antiepileptic drug, N-methoxy-2,2,3,3-tetramethylcyclopropane carboxamide. Epilepsy Res 2006; 73:75-84. [PMID: 16997532 DOI: 10.1016/j.eplepsyres.2006.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2006] [Revised: 08/22/2006] [Accepted: 08/22/2006] [Indexed: 01/16/2023]
Abstract
N-methoxy-2,2,3,3-tetramethylcyclopropane carboxamide (OM-TMCD) is a methoxyamide derivative of a cyclopropyl analogue of valproic acid (VPA). The structural considerations used in the design of OM-TMCD were aimed to enhance OM-TMCD anticonvulsant potency (compared to VPA) and to prevent VPA's two life-threatening side effects, i.e., induction of neural tube defects (NTDs) and hepatotoxicity. Following i.p. administration to rats OM-TMCD demonstrated a broad spectrum of anticonvulsant activity and showed better potency than VPA in the maximal electroshock seizure and subcutaneous pentylenetetrazole tests as well as in the hippocampal kindling model. OM-TMCD was inactive in the mouse 6-Hz test at 100 mg/kg dose. Teratogenicity studies performed in a SWV/Fnn-mouse model for VPA-induced-exencephaly showed that on the equimolar basis OM-TMCD possesses the same fetal toxicity and ability to induce NTDs as VPA, but since OM-TMCD is a much more potent anticonvulsant its activity/exencephaly formation ratio appears to be much more beneficial than that of VPA. OM-TMCD was found to be non-mutagenic and non-pro-mutagenic in the Ames test. It showed a beneficial pharmacokinetic profile in rats, having a high oral bioavailability of 75% and satisfactory values of clearance and volume of distribution. These results support further studies to fully characterize the therapeutic potential of OM-TMCD.
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Affiliation(s)
- Eyal Sobol
- Department of Pharmaceutics, School of Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel
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Joshi SK, Hernandez G, Mikusa JP, Zhu CZ, Zhong C, Salyers A, Wismer CT, Chandran P, Decker MW, Honore P. Comparison of antinociceptive actions of standard analgesics in attenuating capsaicin and nerve-injury-induced mechanical hypersensitivity. Neuroscience 2006; 143:587-96. [PMID: 16962719 DOI: 10.1016/j.neuroscience.2006.08.005] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2006] [Revised: 07/06/2006] [Accepted: 08/01/2006] [Indexed: 11/23/2022]
Abstract
Intradermal capsaicin injection produces immediate spontaneous pain behaviors, and a secondary mechanical hypersensitivity (SMH) that is employed in the clinic as a model potentially predictive of human neuropathic pain. Presently, we have characterized capsaicin-induced SMH in rats, and compared pharmacological actions of standard analgesics in this and two nerve injury models, the L5/L6 spinal nerve ligation (SNL) and sciatic nerve chronic constriction injury (CCI) models. Intraplantar capsaicin produced dose-related SMH (enhanced paw withdrawal response to von Frey monofilament stimulation at an area away from injection site) that lasted for over 4 h. While pretreatment with a potent selective transient receptor potential vanilloid receptor-1 (TRPV1) antagonist A-425619 (1-isoquinolin-5-yl-3-(4-trifluoromethyl-benzyl)-urea) prevented development of acute nocifensive (flinching) behavior immediately following capsaicin injection (ED(50)=4.9 mg/kg), the compound failed to attenuate the SMH when administered 2 h following capsaicin (10 microg/10 microl). Additional standard analgesics were also tested 3 h following intraplantar capsaicin in the SMH model. Comparison of their potencies in attenuating mechanical hypersensitivity in capsaicin, SNL and CCI models revealed similar ED(50)s for morphine (2.3 mg/kg, 1.6 mg/kg and 3.2 mg/kg, respectively), gabapentin (33.1 mg/kg, 33.9 mg/kg and 26.3 mg/kg, respectively) and lamotrigine (9.1 mg/kg, 8.9 mg/kg and 15.5 mg/kg, respectively). Duloxetine produced 50-65% effect at the highest tested dose (50 mg/kg), whereas the highest tested doses of morphine (10 mg/kg), gabapentin (85.5 mg/kg) and lamotrigine (30 mg/kg) all produced >70% efficacy in capsaicin SMH, SNL and CCI models. In contrast, celecoxib and ibuprofen showed weak effects in all three models. All standard analgesics generally had weak efficacy in attenuating capsaicin-induced immediate acute flinching behavior when administered before capsaicin. These results provide further support to the suggestions that distinct pharmacological mechanisms underlie capsaicin-induced acute nocifensive and SMH behaviors, and certain neuronal mechanisms underlying neuropathic pain states are also contributory to capsaicin-induced SMH.
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Affiliation(s)
- S K Joshi
- Abbott Laboratories, Neuroscience Research, GPRD R4N5 100 Abbott Park Road, Abbott Park, IL 60064, USA.
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25
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Bialer M. New antiepileptic drugs that are second generation to existing antiepileptic drugs. Expert Opin Investig Drugs 2006; 15:637-47. [PMID: 16732716 DOI: 10.1517/13543784.15.6.637] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In the last decade, 10 new antiepileptic drugs (AEDs) have been introduced that offer appreciable advantages in terms of their favourable pharmacokinetics, improved tolerability and lower potential for drug interactions. However, despite the large therapeutic range of old and new AEDs, approximately 30% of the patients with epilepsy are still not seizure free and, consequently, there is a substantial need to develop new AEDs. The new AEDs currently in development can be divided into two categories: drugs with completely new chemical structures such as lacosamide (formally harkoseride), retigabine, rufinamide and talampanel; and drugs that are derivatives or analogues of existing AEDs that can be regarded as second-generation or follow-up compounds of established AEDs. This article focuses on the second category and thus critically reviews the following second-generation compounds: eslicarbazepine acetate or BIA-2-093 and 10-hydroxy carbazepine (carbamazepine derivatives); valrocemide and NPS 1776 (isovaleramide; valproic acid derivatives); pregabalin and XP13512 (gabapentin derivatives); brivaracetam (ucb 34714) and seletracetam (ucb 44212; levetiracetam derivatives); and fluorofelbamate (a felbamate derivative). In addition, a series of valproic acid derivatives that are currently in preclinical stage has also been evaluated because some lead compounds of this series have a promising potential to become new antiepileptics and CNS drugs. For any of these follow-up compounds to become a successful second generation to an existing AED, it has to be more potent, safer and possess favourable pharmacokinetics, including low potential for pharmacokinetic and pharmacodynamic drug interactions.
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Affiliation(s)
- Meir Bialer
- The Hebrew University of Jerusalem, Department of Pharmaceutics, School of Pharmacy, Faculty of Medicine, P.O. Box 12065, Ein Karem, Jerusalem 91120, Israel.
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