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Fava M, Stahl S, Pani L, De Martin S, Pappagallo M, Guidetti C, Alimonti A, Bettini E, Mangano RM, Wessel T, de Somer M, Caron J, Vitolo OV, DiGuglielmo GR, Gilbert A, Mehta H, Kearney M, Mattarei A, Gentilucci M, Folli F, Traversa S, Inturrisi CE, Manfredi PL. REL-1017 (Esmethadone) as Adjunctive Treatment in Patients With Major Depressive Disorder: A Phase 2a Randomized Double-Blind Trial. Am J Psychiatry 2022; 179:122-131. [PMID: 34933568 DOI: 10.1176/appi.ajp.2021.21020197] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objective: The purpose of this study was to examine the effects of REL-1017 (esmethadone), a novel N-methyl-d-aspartate receptor (NMDAR) channel blocker, in patients with major depressive disorder who failed to benefit from one to three standard antidepressant treatments in their current major depressive episode. Methods: A 7-day phase 2 multicenter randomized double-blind placebo-controlled trial, comprising three arms, was conducted to assess the safety, tolerability, pharmacokinetics, and efficacy of two dosages of REL-1017 (25 mg or 50 mg orally once a day). Patients were randomly assigned in a 1:1:1 ratio to placebo (N=22), REL-1017 25 mg/day (N=19), or REL-1017 50 mg/day (N=21). Safety scales included the 4-item Positive Symptom Rating Scale for psychotomimetic symptoms, the Clinician-Administered Dissociative States Scale for dissociative symptoms, the Clinical Opiate Withdrawal Scale for withdrawal signs and symptoms, and the Columbia-Suicide Severity Rating Scale for suicidality. The primary efficacy endpoint was the Montgomery-Åsberg Depression Scale (MADRS) score. All 62 randomly assigned patients were included in the full analysis set population analysis. Results: Patients experienced mild or moderate transient adverse events and no evidence of dissociative or psychotomimetic effects, opioid effects, or withdrawal signs and symptoms. The improvement in MADRS score shown on day 4 in both of the REL-1017 dosage groups was sustained through day 7 (last dose) and day 14 (7 days after the last dose), with effect sizes from 0.7 to 1.0. Conclusions: This trial showed favorable safety, tolerability, and pharmacokinetic profiles and suggests that REL-1017 may have rapid and sustained antidepressant effects compared with placebo in patients with inadequate responses to antidepressant treatments. These results will need confirmation in larger and longer trials.
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Affiliation(s)
- Maurizio Fava
- Department of Psychiatry, Massachusetts General Hospital, Boston (Fava, Vitolo); Neuroscience Education Institute, University of California, San Diego (Stahl); Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami (Pani); Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy (Martin, Mattarei); Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, N.Y. (Pappagallo); University of Genoa, Genoa, Italy (Guidetti); Catholic University of the Sacred Heart, Rome (Guidetti); Department of Neuroscience, Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome (Guidetti); Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland (Alimonti); Institute of Oncology Research, Southern Switzerland, Bellinzona (Alimonti); Università della Svizzera Italiana, Bellinzona (Alimonti); Veneto Institute of Molecular Medicine, Padua, Italy (Alimonti); Department of Medicine, Zurich University, Zurich (Alimonti); University of Padua, Padua, Italy (Alimonti); In Vitro Pharmacology Department, Aptuit an Evotec Company, Verona, Italy (Bettini); Drexel University College of Medicine, Philadelphia (Mangano); Relmada Therapeutics, New York (Pappagallo, Wessel, de Somer, Caron, DiGuglielmo, Traversa, Inturrisi, Manfredi); Department of Cardiology, Syneos Health, Morrisville, N.C. (Gilbert, Mehta, Kearney); Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y. (Gentilucci); and Department of Health Science, University of Milan, Milan, Italy (Folli)
| | - Stephen Stahl
- Department of Psychiatry, Massachusetts General Hospital, Boston (Fava, Vitolo); Neuroscience Education Institute, University of California, San Diego (Stahl); Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami (Pani); Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy (Martin, Mattarei); Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, N.Y. (Pappagallo); University of Genoa, Genoa, Italy (Guidetti); Catholic University of the Sacred Heart, Rome (Guidetti); Department of Neuroscience, Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome (Guidetti); Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland (Alimonti); Institute of Oncology Research, Southern Switzerland, Bellinzona (Alimonti); Università della Svizzera Italiana, Bellinzona (Alimonti); Veneto Institute of Molecular Medicine, Padua, Italy (Alimonti); Department of Medicine, Zurich University, Zurich (Alimonti); University of Padua, Padua, Italy (Alimonti); In Vitro Pharmacology Department, Aptuit an Evotec Company, Verona, Italy (Bettini); Drexel University College of Medicine, Philadelphia (Mangano); Relmada Therapeutics, New York (Pappagallo, Wessel, de Somer, Caron, DiGuglielmo, Traversa, Inturrisi, Manfredi); Department of Cardiology, Syneos Health, Morrisville, N.C. (Gilbert, Mehta, Kearney); Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y. (Gentilucci); and Department of Health Science, University of Milan, Milan, Italy (Folli)
| | - Luca Pani
- Department of Psychiatry, Massachusetts General Hospital, Boston (Fava, Vitolo); Neuroscience Education Institute, University of California, San Diego (Stahl); Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami (Pani); Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy (Martin, Mattarei); Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, N.Y. (Pappagallo); University of Genoa, Genoa, Italy (Guidetti); Catholic University of the Sacred Heart, Rome (Guidetti); Department of Neuroscience, Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome (Guidetti); Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland (Alimonti); Institute of Oncology Research, Southern Switzerland, Bellinzona (Alimonti); Università della Svizzera Italiana, Bellinzona (Alimonti); Veneto Institute of Molecular Medicine, Padua, Italy (Alimonti); Department of Medicine, Zurich University, Zurich (Alimonti); University of Padua, Padua, Italy (Alimonti); In Vitro Pharmacology Department, Aptuit an Evotec Company, Verona, Italy (Bettini); Drexel University College of Medicine, Philadelphia (Mangano); Relmada Therapeutics, New York (Pappagallo, Wessel, de Somer, Caron, DiGuglielmo, Traversa, Inturrisi, Manfredi); Department of Cardiology, Syneos Health, Morrisville, N.C. (Gilbert, Mehta, Kearney); Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y. (Gentilucci); and Department of Health Science, University of Milan, Milan, Italy (Folli)
| | - Sara De Martin
- Department of Psychiatry, Massachusetts General Hospital, Boston (Fava, Vitolo); Neuroscience Education Institute, University of California, San Diego (Stahl); Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami (Pani); Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy (Martin, Mattarei); Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, N.Y. (Pappagallo); University of Genoa, Genoa, Italy (Guidetti); Catholic University of the Sacred Heart, Rome (Guidetti); Department of Neuroscience, Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome (Guidetti); Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland (Alimonti); Institute of Oncology Research, Southern Switzerland, Bellinzona (Alimonti); Università della Svizzera Italiana, Bellinzona (Alimonti); Veneto Institute of Molecular Medicine, Padua, Italy (Alimonti); Department of Medicine, Zurich University, Zurich (Alimonti); University of Padua, Padua, Italy (Alimonti); In Vitro Pharmacology Department, Aptuit an Evotec Company, Verona, Italy (Bettini); Drexel University College of Medicine, Philadelphia (Mangano); Relmada Therapeutics, New York (Pappagallo, Wessel, de Somer, Caron, DiGuglielmo, Traversa, Inturrisi, Manfredi); Department of Cardiology, Syneos Health, Morrisville, N.C. (Gilbert, Mehta, Kearney); Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y. (Gentilucci); and Department of Health Science, University of Milan, Milan, Italy (Folli)
| | - Marco Pappagallo
- Department of Psychiatry, Massachusetts General Hospital, Boston (Fava, Vitolo); Neuroscience Education Institute, University of California, San Diego (Stahl); Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami (Pani); Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy (Martin, Mattarei); Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, N.Y. (Pappagallo); University of Genoa, Genoa, Italy (Guidetti); Catholic University of the Sacred Heart, Rome (Guidetti); Department of Neuroscience, Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome (Guidetti); Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland (Alimonti); Institute of Oncology Research, Southern Switzerland, Bellinzona (Alimonti); Università della Svizzera Italiana, Bellinzona (Alimonti); Veneto Institute of Molecular Medicine, Padua, Italy (Alimonti); Department of Medicine, Zurich University, Zurich (Alimonti); University of Padua, Padua, Italy (Alimonti); In Vitro Pharmacology Department, Aptuit an Evotec Company, Verona, Italy (Bettini); Drexel University College of Medicine, Philadelphia (Mangano); Relmada Therapeutics, New York (Pappagallo, Wessel, de Somer, Caron, DiGuglielmo, Traversa, Inturrisi, Manfredi); Department of Cardiology, Syneos Health, Morrisville, N.C. (Gilbert, Mehta, Kearney); Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y. (Gentilucci); and Department of Health Science, University of Milan, Milan, Italy (Folli)
| | - Clotilde Guidetti
- Department of Psychiatry, Massachusetts General Hospital, Boston (Fava, Vitolo); Neuroscience Education Institute, University of California, San Diego (Stahl); Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami (Pani); Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy (Martin, Mattarei); Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, N.Y. (Pappagallo); University of Genoa, Genoa, Italy (Guidetti); Catholic University of the Sacred Heart, Rome (Guidetti); Department of Neuroscience, Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome (Guidetti); Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland (Alimonti); Institute of Oncology Research, Southern Switzerland, Bellinzona (Alimonti); Università della Svizzera Italiana, Bellinzona (Alimonti); Veneto Institute of Molecular Medicine, Padua, Italy (Alimonti); Department of Medicine, Zurich University, Zurich (Alimonti); University of Padua, Padua, Italy (Alimonti); In Vitro Pharmacology Department, Aptuit an Evotec Company, Verona, Italy (Bettini); Drexel University College of Medicine, Philadelphia (Mangano); Relmada Therapeutics, New York (Pappagallo, Wessel, de Somer, Caron, DiGuglielmo, Traversa, Inturrisi, Manfredi); Department of Cardiology, Syneos Health, Morrisville, N.C. (Gilbert, Mehta, Kearney); Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y. (Gentilucci); and Department of Health Science, University of Milan, Milan, Italy (Folli)
| | - Andrea Alimonti
- Department of Psychiatry, Massachusetts General Hospital, Boston (Fava, Vitolo); Neuroscience Education Institute, University of California, San Diego (Stahl); Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami (Pani); Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy (Martin, Mattarei); Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, N.Y. (Pappagallo); University of Genoa, Genoa, Italy (Guidetti); Catholic University of the Sacred Heart, Rome (Guidetti); Department of Neuroscience, Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome (Guidetti); Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland (Alimonti); Institute of Oncology Research, Southern Switzerland, Bellinzona (Alimonti); Università della Svizzera Italiana, Bellinzona (Alimonti); Veneto Institute of Molecular Medicine, Padua, Italy (Alimonti); Department of Medicine, Zurich University, Zurich (Alimonti); University of Padua, Padua, Italy (Alimonti); In Vitro Pharmacology Department, Aptuit an Evotec Company, Verona, Italy (Bettini); Drexel University College of Medicine, Philadelphia (Mangano); Relmada Therapeutics, New York (Pappagallo, Wessel, de Somer, Caron, DiGuglielmo, Traversa, Inturrisi, Manfredi); Department of Cardiology, Syneos Health, Morrisville, N.C. (Gilbert, Mehta, Kearney); Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y. (Gentilucci); and Department of Health Science, University of Milan, Milan, Italy (Folli)
| | - Ezio Bettini
- Department of Psychiatry, Massachusetts General Hospital, Boston (Fava, Vitolo); Neuroscience Education Institute, University of California, San Diego (Stahl); Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami (Pani); Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy (Martin, Mattarei); Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, N.Y. (Pappagallo); University of Genoa, Genoa, Italy (Guidetti); Catholic University of the Sacred Heart, Rome (Guidetti); Department of Neuroscience, Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome (Guidetti); Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland (Alimonti); Institute of Oncology Research, Southern Switzerland, Bellinzona (Alimonti); Università della Svizzera Italiana, Bellinzona (Alimonti); Veneto Institute of Molecular Medicine, Padua, Italy (Alimonti); Department of Medicine, Zurich University, Zurich (Alimonti); University of Padua, Padua, Italy (Alimonti); In Vitro Pharmacology Department, Aptuit an Evotec Company, Verona, Italy (Bettini); Drexel University College of Medicine, Philadelphia (Mangano); Relmada Therapeutics, New York (Pappagallo, Wessel, de Somer, Caron, DiGuglielmo, Traversa, Inturrisi, Manfredi); Department of Cardiology, Syneos Health, Morrisville, N.C. (Gilbert, Mehta, Kearney); Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y. (Gentilucci); and Department of Health Science, University of Milan, Milan, Italy (Folli)
| | - Richard M Mangano
- Department of Psychiatry, Massachusetts General Hospital, Boston (Fava, Vitolo); Neuroscience Education Institute, University of California, San Diego (Stahl); Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami (Pani); Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy (Martin, Mattarei); Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, N.Y. (Pappagallo); University of Genoa, Genoa, Italy (Guidetti); Catholic University of the Sacred Heart, Rome (Guidetti); Department of Neuroscience, Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome (Guidetti); Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland (Alimonti); Institute of Oncology Research, Southern Switzerland, Bellinzona (Alimonti); Università della Svizzera Italiana, Bellinzona (Alimonti); Veneto Institute of Molecular Medicine, Padua, Italy (Alimonti); Department of Medicine, Zurich University, Zurich (Alimonti); University of Padua, Padua, Italy (Alimonti); In Vitro Pharmacology Department, Aptuit an Evotec Company, Verona, Italy (Bettini); Drexel University College of Medicine, Philadelphia (Mangano); Relmada Therapeutics, New York (Pappagallo, Wessel, de Somer, Caron, DiGuglielmo, Traversa, Inturrisi, Manfredi); Department of Cardiology, Syneos Health, Morrisville, N.C. (Gilbert, Mehta, Kearney); Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y. (Gentilucci); and Department of Health Science, University of Milan, Milan, Italy (Folli)
| | - Thomas Wessel
- Department of Psychiatry, Massachusetts General Hospital, Boston (Fava, Vitolo); Neuroscience Education Institute, University of California, San Diego (Stahl); Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami (Pani); Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy (Martin, Mattarei); Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, N.Y. (Pappagallo); University of Genoa, Genoa, Italy (Guidetti); Catholic University of the Sacred Heart, Rome (Guidetti); Department of Neuroscience, Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome (Guidetti); Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland (Alimonti); Institute of Oncology Research, Southern Switzerland, Bellinzona (Alimonti); Università della Svizzera Italiana, Bellinzona (Alimonti); Veneto Institute of Molecular Medicine, Padua, Italy (Alimonti); Department of Medicine, Zurich University, Zurich (Alimonti); University of Padua, Padua, Italy (Alimonti); In Vitro Pharmacology Department, Aptuit an Evotec Company, Verona, Italy (Bettini); Drexel University College of Medicine, Philadelphia (Mangano); Relmada Therapeutics, New York (Pappagallo, Wessel, de Somer, Caron, DiGuglielmo, Traversa, Inturrisi, Manfredi); Department of Cardiology, Syneos Health, Morrisville, N.C. (Gilbert, Mehta, Kearney); Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y. (Gentilucci); and Department of Health Science, University of Milan, Milan, Italy (Folli)
| | - Marc de Somer
- Department of Psychiatry, Massachusetts General Hospital, Boston (Fava, Vitolo); Neuroscience Education Institute, University of California, San Diego (Stahl); Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami (Pani); Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy (Martin, Mattarei); Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, N.Y. (Pappagallo); University of Genoa, Genoa, Italy (Guidetti); Catholic University of the Sacred Heart, Rome (Guidetti); Department of Neuroscience, Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome (Guidetti); Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland (Alimonti); Institute of Oncology Research, Southern Switzerland, Bellinzona (Alimonti); Università della Svizzera Italiana, Bellinzona (Alimonti); Veneto Institute of Molecular Medicine, Padua, Italy (Alimonti); Department of Medicine, Zurich University, Zurich (Alimonti); University of Padua, Padua, Italy (Alimonti); In Vitro Pharmacology Department, Aptuit an Evotec Company, Verona, Italy (Bettini); Drexel University College of Medicine, Philadelphia (Mangano); Relmada Therapeutics, New York (Pappagallo, Wessel, de Somer, Caron, DiGuglielmo, Traversa, Inturrisi, Manfredi); Department of Cardiology, Syneos Health, Morrisville, N.C. (Gilbert, Mehta, Kearney); Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y. (Gentilucci); and Department of Health Science, University of Milan, Milan, Italy (Folli)
| | - Judy Caron
- Department of Psychiatry, Massachusetts General Hospital, Boston (Fava, Vitolo); Neuroscience Education Institute, University of California, San Diego (Stahl); Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami (Pani); Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy (Martin, Mattarei); Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, N.Y. (Pappagallo); University of Genoa, Genoa, Italy (Guidetti); Catholic University of the Sacred Heart, Rome (Guidetti); Department of Neuroscience, Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome (Guidetti); Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland (Alimonti); Institute of Oncology Research, Southern Switzerland, Bellinzona (Alimonti); Università della Svizzera Italiana, Bellinzona (Alimonti); Veneto Institute of Molecular Medicine, Padua, Italy (Alimonti); Department of Medicine, Zurich University, Zurich (Alimonti); University of Padua, Padua, Italy (Alimonti); In Vitro Pharmacology Department, Aptuit an Evotec Company, Verona, Italy (Bettini); Drexel University College of Medicine, Philadelphia (Mangano); Relmada Therapeutics, New York (Pappagallo, Wessel, de Somer, Caron, DiGuglielmo, Traversa, Inturrisi, Manfredi); Department of Cardiology, Syneos Health, Morrisville, N.C. (Gilbert, Mehta, Kearney); Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y. (Gentilucci); and Department of Health Science, University of Milan, Milan, Italy (Folli)
| | - Ottavio V Vitolo
- Department of Psychiatry, Massachusetts General Hospital, Boston (Fava, Vitolo); Neuroscience Education Institute, University of California, San Diego (Stahl); Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami (Pani); Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy (Martin, Mattarei); Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, N.Y. (Pappagallo); University of Genoa, Genoa, Italy (Guidetti); Catholic University of the Sacred Heart, Rome (Guidetti); Department of Neuroscience, Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome (Guidetti); Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland (Alimonti); Institute of Oncology Research, Southern Switzerland, Bellinzona (Alimonti); Università della Svizzera Italiana, Bellinzona (Alimonti); Veneto Institute of Molecular Medicine, Padua, Italy (Alimonti); Department of Medicine, Zurich University, Zurich (Alimonti); University of Padua, Padua, Italy (Alimonti); In Vitro Pharmacology Department, Aptuit an Evotec Company, Verona, Italy (Bettini); Drexel University College of Medicine, Philadelphia (Mangano); Relmada Therapeutics, New York (Pappagallo, Wessel, de Somer, Caron, DiGuglielmo, Traversa, Inturrisi, Manfredi); Department of Cardiology, Syneos Health, Morrisville, N.C. (Gilbert, Mehta, Kearney); Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y. (Gentilucci); and Department of Health Science, University of Milan, Milan, Italy (Folli)
| | - Gina R DiGuglielmo
- Department of Psychiatry, Massachusetts General Hospital, Boston (Fava, Vitolo); Neuroscience Education Institute, University of California, San Diego (Stahl); Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami (Pani); Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy (Martin, Mattarei); Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, N.Y. (Pappagallo); University of Genoa, Genoa, Italy (Guidetti); Catholic University of the Sacred Heart, Rome (Guidetti); Department of Neuroscience, Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome (Guidetti); Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland (Alimonti); Institute of Oncology Research, Southern Switzerland, Bellinzona (Alimonti); Università della Svizzera Italiana, Bellinzona (Alimonti); Veneto Institute of Molecular Medicine, Padua, Italy (Alimonti); Department of Medicine, Zurich University, Zurich (Alimonti); University of Padua, Padua, Italy (Alimonti); In Vitro Pharmacology Department, Aptuit an Evotec Company, Verona, Italy (Bettini); Drexel University College of Medicine, Philadelphia (Mangano); Relmada Therapeutics, New York (Pappagallo, Wessel, de Somer, Caron, DiGuglielmo, Traversa, Inturrisi, Manfredi); Department of Cardiology, Syneos Health, Morrisville, N.C. (Gilbert, Mehta, Kearney); Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y. (Gentilucci); and Department of Health Science, University of Milan, Milan, Italy (Folli)
| | - Adam Gilbert
- Department of Psychiatry, Massachusetts General Hospital, Boston (Fava, Vitolo); Neuroscience Education Institute, University of California, San Diego (Stahl); Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami (Pani); Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy (Martin, Mattarei); Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, N.Y. (Pappagallo); University of Genoa, Genoa, Italy (Guidetti); Catholic University of the Sacred Heart, Rome (Guidetti); Department of Neuroscience, Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome (Guidetti); Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland (Alimonti); Institute of Oncology Research, Southern Switzerland, Bellinzona (Alimonti); Università della Svizzera Italiana, Bellinzona (Alimonti); Veneto Institute of Molecular Medicine, Padua, Italy (Alimonti); Department of Medicine, Zurich University, Zurich (Alimonti); University of Padua, Padua, Italy (Alimonti); In Vitro Pharmacology Department, Aptuit an Evotec Company, Verona, Italy (Bettini); Drexel University College of Medicine, Philadelphia (Mangano); Relmada Therapeutics, New York (Pappagallo, Wessel, de Somer, Caron, DiGuglielmo, Traversa, Inturrisi, Manfredi); Department of Cardiology, Syneos Health, Morrisville, N.C. (Gilbert, Mehta, Kearney); Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y. (Gentilucci); and Department of Health Science, University of Milan, Milan, Italy (Folli)
| | - Hiren Mehta
- Department of Psychiatry, Massachusetts General Hospital, Boston (Fava, Vitolo); Neuroscience Education Institute, University of California, San Diego (Stahl); Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami (Pani); Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy (Martin, Mattarei); Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, N.Y. (Pappagallo); University of Genoa, Genoa, Italy (Guidetti); Catholic University of the Sacred Heart, Rome (Guidetti); Department of Neuroscience, Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome (Guidetti); Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland (Alimonti); Institute of Oncology Research, Southern Switzerland, Bellinzona (Alimonti); Università della Svizzera Italiana, Bellinzona (Alimonti); Veneto Institute of Molecular Medicine, Padua, Italy (Alimonti); Department of Medicine, Zurich University, Zurich (Alimonti); University of Padua, Padua, Italy (Alimonti); In Vitro Pharmacology Department, Aptuit an Evotec Company, Verona, Italy (Bettini); Drexel University College of Medicine, Philadelphia (Mangano); Relmada Therapeutics, New York (Pappagallo, Wessel, de Somer, Caron, DiGuglielmo, Traversa, Inturrisi, Manfredi); Department of Cardiology, Syneos Health, Morrisville, N.C. (Gilbert, Mehta, Kearney); Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y. (Gentilucci); and Department of Health Science, University of Milan, Milan, Italy (Folli)
| | - Morgan Kearney
- Department of Psychiatry, Massachusetts General Hospital, Boston (Fava, Vitolo); Neuroscience Education Institute, University of California, San Diego (Stahl); Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami (Pani); Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy (Martin, Mattarei); Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, N.Y. (Pappagallo); University of Genoa, Genoa, Italy (Guidetti); Catholic University of the Sacred Heart, Rome (Guidetti); Department of Neuroscience, Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome (Guidetti); Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland (Alimonti); Institute of Oncology Research, Southern Switzerland, Bellinzona (Alimonti); Università della Svizzera Italiana, Bellinzona (Alimonti); Veneto Institute of Molecular Medicine, Padua, Italy (Alimonti); Department of Medicine, Zurich University, Zurich (Alimonti); University of Padua, Padua, Italy (Alimonti); In Vitro Pharmacology Department, Aptuit an Evotec Company, Verona, Italy (Bettini); Drexel University College of Medicine, Philadelphia (Mangano); Relmada Therapeutics, New York (Pappagallo, Wessel, de Somer, Caron, DiGuglielmo, Traversa, Inturrisi, Manfredi); Department of Cardiology, Syneos Health, Morrisville, N.C. (Gilbert, Mehta, Kearney); Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y. (Gentilucci); and Department of Health Science, University of Milan, Milan, Italy (Folli)
| | - Andrea Mattarei
- Department of Psychiatry, Massachusetts General Hospital, Boston (Fava, Vitolo); Neuroscience Education Institute, University of California, San Diego (Stahl); Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami (Pani); Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy (Martin, Mattarei); Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, N.Y. (Pappagallo); University of Genoa, Genoa, Italy (Guidetti); Catholic University of the Sacred Heart, Rome (Guidetti); Department of Neuroscience, Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome (Guidetti); Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland (Alimonti); Institute of Oncology Research, Southern Switzerland, Bellinzona (Alimonti); Università della Svizzera Italiana, Bellinzona (Alimonti); Veneto Institute of Molecular Medicine, Padua, Italy (Alimonti); Department of Medicine, Zurich University, Zurich (Alimonti); University of Padua, Padua, Italy (Alimonti); In Vitro Pharmacology Department, Aptuit an Evotec Company, Verona, Italy (Bettini); Drexel University College of Medicine, Philadelphia (Mangano); Relmada Therapeutics, New York (Pappagallo, Wessel, de Somer, Caron, DiGuglielmo, Traversa, Inturrisi, Manfredi); Department of Cardiology, Syneos Health, Morrisville, N.C. (Gilbert, Mehta, Kearney); Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y. (Gentilucci); and Department of Health Science, University of Milan, Milan, Italy (Folli)
| | - Marco Gentilucci
- Department of Psychiatry, Massachusetts General Hospital, Boston (Fava, Vitolo); Neuroscience Education Institute, University of California, San Diego (Stahl); Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami (Pani); Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy (Martin, Mattarei); Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, N.Y. (Pappagallo); University of Genoa, Genoa, Italy (Guidetti); Catholic University of the Sacred Heart, Rome (Guidetti); Department of Neuroscience, Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome (Guidetti); Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland (Alimonti); Institute of Oncology Research, Southern Switzerland, Bellinzona (Alimonti); Università della Svizzera Italiana, Bellinzona (Alimonti); Veneto Institute of Molecular Medicine, Padua, Italy (Alimonti); Department of Medicine, Zurich University, Zurich (Alimonti); University of Padua, Padua, Italy (Alimonti); In Vitro Pharmacology Department, Aptuit an Evotec Company, Verona, Italy (Bettini); Drexel University College of Medicine, Philadelphia (Mangano); Relmada Therapeutics, New York (Pappagallo, Wessel, de Somer, Caron, DiGuglielmo, Traversa, Inturrisi, Manfredi); Department of Cardiology, Syneos Health, Morrisville, N.C. (Gilbert, Mehta, Kearney); Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y. (Gentilucci); and Department of Health Science, University of Milan, Milan, Italy (Folli)
| | - Franco Folli
- Department of Psychiatry, Massachusetts General Hospital, Boston (Fava, Vitolo); Neuroscience Education Institute, University of California, San Diego (Stahl); Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami (Pani); Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy (Martin, Mattarei); Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, N.Y. (Pappagallo); University of Genoa, Genoa, Italy (Guidetti); Catholic University of the Sacred Heart, Rome (Guidetti); Department of Neuroscience, Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome (Guidetti); Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland (Alimonti); Institute of Oncology Research, Southern Switzerland, Bellinzona (Alimonti); Università della Svizzera Italiana, Bellinzona (Alimonti); Veneto Institute of Molecular Medicine, Padua, Italy (Alimonti); Department of Medicine, Zurich University, Zurich (Alimonti); University of Padua, Padua, Italy (Alimonti); In Vitro Pharmacology Department, Aptuit an Evotec Company, Verona, Italy (Bettini); Drexel University College of Medicine, Philadelphia (Mangano); Relmada Therapeutics, New York (Pappagallo, Wessel, de Somer, Caron, DiGuglielmo, Traversa, Inturrisi, Manfredi); Department of Cardiology, Syneos Health, Morrisville, N.C. (Gilbert, Mehta, Kearney); Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y. (Gentilucci); and Department of Health Science, University of Milan, Milan, Italy (Folli)
| | - Sergio Traversa
- Department of Psychiatry, Massachusetts General Hospital, Boston (Fava, Vitolo); Neuroscience Education Institute, University of California, San Diego (Stahl); Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami (Pani); Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy (Martin, Mattarei); Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, N.Y. (Pappagallo); University of Genoa, Genoa, Italy (Guidetti); Catholic University of the Sacred Heart, Rome (Guidetti); Department of Neuroscience, Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome (Guidetti); Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland (Alimonti); Institute of Oncology Research, Southern Switzerland, Bellinzona (Alimonti); Università della Svizzera Italiana, Bellinzona (Alimonti); Veneto Institute of Molecular Medicine, Padua, Italy (Alimonti); Department of Medicine, Zurich University, Zurich (Alimonti); University of Padua, Padua, Italy (Alimonti); In Vitro Pharmacology Department, Aptuit an Evotec Company, Verona, Italy (Bettini); Drexel University College of Medicine, Philadelphia (Mangano); Relmada Therapeutics, New York (Pappagallo, Wessel, de Somer, Caron, DiGuglielmo, Traversa, Inturrisi, Manfredi); Department of Cardiology, Syneos Health, Morrisville, N.C. (Gilbert, Mehta, Kearney); Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y. (Gentilucci); and Department of Health Science, University of Milan, Milan, Italy (Folli)
| | - Charles E Inturrisi
- Department of Psychiatry, Massachusetts General Hospital, Boston (Fava, Vitolo); Neuroscience Education Institute, University of California, San Diego (Stahl); Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami (Pani); Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy (Martin, Mattarei); Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, N.Y. (Pappagallo); University of Genoa, Genoa, Italy (Guidetti); Catholic University of the Sacred Heart, Rome (Guidetti); Department of Neuroscience, Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome (Guidetti); Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland (Alimonti); Institute of Oncology Research, Southern Switzerland, Bellinzona (Alimonti); Università della Svizzera Italiana, Bellinzona (Alimonti); Veneto Institute of Molecular Medicine, Padua, Italy (Alimonti); Department of Medicine, Zurich University, Zurich (Alimonti); University of Padua, Padua, Italy (Alimonti); In Vitro Pharmacology Department, Aptuit an Evotec Company, Verona, Italy (Bettini); Drexel University College of Medicine, Philadelphia (Mangano); Relmada Therapeutics, New York (Pappagallo, Wessel, de Somer, Caron, DiGuglielmo, Traversa, Inturrisi, Manfredi); Department of Cardiology, Syneos Health, Morrisville, N.C. (Gilbert, Mehta, Kearney); Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y. (Gentilucci); and Department of Health Science, University of Milan, Milan, Italy (Folli)
| | - Paolo L Manfredi
- Department of Psychiatry, Massachusetts General Hospital, Boston (Fava, Vitolo); Neuroscience Education Institute, University of California, San Diego (Stahl); Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami (Pani); Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy (Martin, Mattarei); Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, N.Y. (Pappagallo); University of Genoa, Genoa, Italy (Guidetti); Catholic University of the Sacred Heart, Rome (Guidetti); Department of Neuroscience, Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome (Guidetti); Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland (Alimonti); Institute of Oncology Research, Southern Switzerland, Bellinzona (Alimonti); Università della Svizzera Italiana, Bellinzona (Alimonti); Veneto Institute of Molecular Medicine, Padua, Italy (Alimonti); Department of Medicine, Zurich University, Zurich (Alimonti); University of Padua, Padua, Italy (Alimonti); In Vitro Pharmacology Department, Aptuit an Evotec Company, Verona, Italy (Bettini); Drexel University College of Medicine, Philadelphia (Mangano); Relmada Therapeutics, New York (Pappagallo, Wessel, de Somer, Caron, DiGuglielmo, Traversa, Inturrisi, Manfredi); Department of Cardiology, Syneos Health, Morrisville, N.C. (Gilbert, Mehta, Kearney); Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y. (Gentilucci); and Department of Health Science, University of Milan, Milan, Italy (Folli)
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