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Jaiswal S, Ayyannan SR. Lead optimization study on indoline-2,3-dione derivatives as potential fatty acid amide hydrolase inhibitors. J Biomol Struct Dyn 2023; 41:9632-9650. [PMID: 36379672 DOI: 10.1080/07391102.2022.2145372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 11/02/2022] [Indexed: 11/17/2022]
Abstract
Based on the known isatin-based fatty acid amide hydrolase (FAAH) inhibitor BSS-7, we designed and synthesized two small sets (6-13 and 17-20) of N-1 and C-3 substituted isatin derivatives and evaluated them for their in vitro FAAH inhibition properties. The lead simplification by modification of bulky aryl moiety at N-1 with a flexible allyl group produced a nanomolar (IC50 = 6.7 nM, Ki = 5 nM) inhibitor 11 (Z)-3-((1H-benzo[d]imidazol-2-yl)imino)-1-allylindolin-2-one which exhibited a reversible and competitive FAAH inhibition with 1500 times more potency to BSS-7 (1.49 ± 0.03 µM). The lead compound 11 also showed a high blood-brain permeability and a significant antioxidant profile with no neurotoxicity. Docking results suggested that the inhibitor molecules occupied the active site of FAAH and offered optimal binding interactions. A molecular dynamics simulation study ascertained the stability of the lead inhibitor 11-FAAH complex. In silico ADMET profiling studies unveiled that compound 11 possesses good drug-like properties and merits further evaluation.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Shivani Jaiswal
- Pharmaceutical Chemistry Research Laboratory II, Department of Pharmaceutical Engineering & Technology, Indian Institute of Technology (Banaras Hindu University), Varanasi, Uttar Pradesh, India
| | - Senthil Raja Ayyannan
- Pharmaceutical Chemistry Research Laboratory II, Department of Pharmaceutical Engineering & Technology, Indian Institute of Technology (Banaras Hindu University), Varanasi, Uttar Pradesh, India
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Jaiswal S, Akhilesh, Tiwari V, Ayyannan SR. Anti-nociceptive potential of an isatin-derived dual fatty acid amide hydrolase-monoacylglycerol lipase inhibitor. Pharmacol Rep 2023; 75:737-745. [PMID: 36913176 DOI: 10.1007/s43440-023-00468-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Recently, we have reported an isatin-derived carbohydrazone, 5-chloro-N'-(6-chloro-2-oxoindolin-3-ylidene)-2-hydroxybenzohydrazide (SIH 3) as dual nanomolar FAAH (fatty acid amide hydrolase)-MAGL (monoacylglycerol lipase) inhibitor with good CNS penetration and neuroprotective activity profile. In this study, we further investigated the pharmacological profile of compound SIH 3 in the neuropathic pain model along with acute toxicity and ex vivo studies. METHODS Chronic constrictive injury (CCI) was used to induce neuropathic pain in male Sprague-Dawley rats and the anti-nociceptive activity of the compound SIH 3 was investigated at 25, 50, and 100 mg/kg ip. Subsequently, locomotor activity was measured by rotarod and actophotometer experiments. The acute oral toxicity of the compound was assessed as per the OECD guidelines 423. RESULTS Compound SIH 3 showed significant anti-nociceptive activity in the CCI-induced neuropathic pain model without altering the locomotor activity. Furthermore, compound SIH 3 showed an excellent safety profile (up to 2000 mg/kg, po) in the acute oral toxicity study and was also non-hepatotoxic. Further, ex vivo studies revealed that the compound SIH 3 produces a significant antioxidant effect in oxidative stress induced by CCI. CONCLUSION Our findings suggest that the investigated compound SIH 3 has the potential to be developed as an anti-nociceptive agent.
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Affiliation(s)
- Shivani Jaiswal
- Pharmaceutical Chemistry Research Laboratory II, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi, UP, 221005, India
- Institute of Pharmaceutical Research, GLA University, Mathura, UP, 281406, India
| | - Akhilesh
- Neuroscience and Pain Research Laboratory, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi, UP, 221005, India
| | - Vinod Tiwari
- Neuroscience and Pain Research Laboratory, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi, UP, 221005, India
| | - Senthil Raja Ayyannan
- Pharmaceutical Chemistry Research Laboratory II, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi, UP, 221005, India.
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Jaiswal S, Gupta G, Ayyannan SR. Synthesis and evaluation of carbamate derivatives as fatty acid amide hydrolase and monoacylglycerol lipase inhibitors. Arch Pharm (Weinheim) 2022; 355:e2200081. [PMID: 35924298 DOI: 10.1002/ardp.202200081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/24/2022] [Accepted: 07/11/2022] [Indexed: 11/06/2022]
Abstract
Fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MAGL) are the primary catabolic enzymes for endocannabinoids, anandamide (AEA), and 2-arachidonoyl glycerol. Numerous studies have shown that FAAH and MAGL play an important role in modulating various central nervous system activities; hence, the development of small molecule FAAH/MAGL inhibitors is an active area of research. Several small molecules possessing the carbamate scaffold are documented as potential FAAH/MAGL inhibitors. Here, we designed and synthesized a series of open chain and cyclic carbamates and evaluated their dual FAAH-MAGL inhibition properties. Phenyl [4-(piperidin-1-ylmethyl)phenyl]carbamate (2e) emerged as the most potent MAGL inhibitor (IC50 = 19 nM), benzyl (1H-benzo[d]imidazol-2-yl)carbamate (3h) was the most potent FAAH inhibitor (IC50 = 55 nM), and phenyl (6-fluorobenzo[d]thiazol-2-yl)carbamate (2i) egressed as a nonselective dual FAAH-MAGL inhibitor (FAAH: 82 nM, MAGL: 72 nM). The enzyme kinetics experiments revealed that the compounds inhibit FAAH/MAGL in a covalent-reversible manner, with a mixed binding mode of action. Moreover, the lead compounds were found suitable for blood-brain permeation in the parallel artificial membrane permeation assay. Furthermore, docking simulation experiments suggested that the potency of the lead compounds was governed by hydrogen bonds and hydrophobic interactions with the enzyme active sites. In silico drug-likeness and ADMETox prediction studies provided useful information on the compounds' oral absorption, metabolism, and toxicity profiles. In summary, this study afforded potent multifunctional carbamates with appreciable pharmacokinetic profiles meriting further investigation.
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Affiliation(s)
- Shivani Jaiswal
- Pharmaceutical Chemistry Research Laboratory II, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (Banaras Hindu University), Varanasi, Uttar Pradesh, India
| | - Garima Gupta
- Pharmaceutical Chemistry Research Laboratory II, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (Banaras Hindu University), Varanasi, Uttar Pradesh, India
| | - Senthil R Ayyannan
- Pharmaceutical Chemistry Research Laboratory II, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (Banaras Hindu University), Varanasi, Uttar Pradesh, India
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Wooldridge LM, Ji L, Liu Y, Nikas SP, Makriyannis A, Bergman J, Kangas BD. Antiemetic Effects of Cannabinoid Agonists in Nonhuman Primates. J Pharmacol Exp Ther 2020; 374:462-468. [PMID: 32561684 DOI: 10.1124/jpet.120.265710] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 06/18/2020] [Indexed: 02/06/2023] Open
Abstract
Attenuating emesis elicited by both disease and medical treatments of disease remains a critical public health challenge. Although cannabinergic medications have been used in certain treatment-resistant populations, Food and Drug Administration-approved cannabinoid antiemetics are associated with undesirable side effects, including cognitive disruption, that limit their prescription. Previous studies have shown that a metabolically stable analog of the endocannabinoid anandamide, methanandamide (mAEA), may produce lesser cognitive disruption than that associated with the primary psychoactive constituent in cannabis, Δ9-tetrahydrocannabinol (Δ9-THC), raising the possibility that endocannabinoids may offer a therapeutic advantage over currently used medications. The present studies were conducted to evaluate this possibility by comparing the antiemetic effects of Δ9-THC (0.032-0.1 mg/kg) and mAEA (3.2-10.0 mg/kg) against nicotine- and lithium chloride (LiCl)-induced emesis and prodromal hypersalivation in squirrel monkeys. Pretreatment with 0.1 mg/kg Δ9-THC blocked nicotine-induced emesis and reduced hypersalivation in all subjects and blocked LiCl-induced emesis and reduced hypersalivation in three of four subjects. Pretreatment with 10 mg/kg mAEA blocked nicotine-induced emesis in three of four subjects and LiCl-induced emesis in one of four subjects and reduced both nicotine- and LiCl-induced hypersalivation. Antiemetic effects of Δ9-THC and mAEA were reversed by rimonabant pretreatment, providing verification of cannabinoid receptor type 1 mediation. These studies systematically demonstrate for the first time the antiemetic effects of cannabinoid agonists in nonhuman primates. Importantly, although Δ9-THC produced superior antiemetic effects, the milder cognitive effects of mAEA demonstrated in previous studies suggest that it may provide a favorable treatment option under clinical circumstances in which antiemetic efficacy must be balanced against side effect liability. SIGNIFICANCE STATEMENT: Emesis has significant evolutionary value as a defense mechanism against ingested toxins; however, it is also one of the most common adverse symptoms associated with both disease and medical treatments of disease. The development of improved antiemetic pharmacotherapies has been impeded by a paucity of animal models. The present studies systematically demonstrate for the first time the antiemetic effects of the phytocannabinoid Δ9-tetrahydrocannabinol and endocannabinoid analog methanandamide in nonhuman primates.
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Affiliation(s)
- Lisa M Wooldridge
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts (J.B., B.D.K.); Behavioral Biology Program, McLean Hospital, Belmont, Massachusetts (L.M.W., J.B., B.D.K.); and Center for Drug Discovery, Northeastern University, Boston, Massachusetts (L.J., Y.L., S.P.N., A.M.)
| | - Lipin Ji
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts (J.B., B.D.K.); Behavioral Biology Program, McLean Hospital, Belmont, Massachusetts (L.M.W., J.B., B.D.K.); and Center for Drug Discovery, Northeastern University, Boston, Massachusetts (L.J., Y.L., S.P.N., A.M.)
| | - Yingpeng Liu
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts (J.B., B.D.K.); Behavioral Biology Program, McLean Hospital, Belmont, Massachusetts (L.M.W., J.B., B.D.K.); and Center for Drug Discovery, Northeastern University, Boston, Massachusetts (L.J., Y.L., S.P.N., A.M.)
| | - Spyros P Nikas
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts (J.B., B.D.K.); Behavioral Biology Program, McLean Hospital, Belmont, Massachusetts (L.M.W., J.B., B.D.K.); and Center for Drug Discovery, Northeastern University, Boston, Massachusetts (L.J., Y.L., S.P.N., A.M.)
| | - Alexandros Makriyannis
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts (J.B., B.D.K.); Behavioral Biology Program, McLean Hospital, Belmont, Massachusetts (L.M.W., J.B., B.D.K.); and Center for Drug Discovery, Northeastern University, Boston, Massachusetts (L.J., Y.L., S.P.N., A.M.)
| | - Jack Bergman
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts (J.B., B.D.K.); Behavioral Biology Program, McLean Hospital, Belmont, Massachusetts (L.M.W., J.B., B.D.K.); and Center for Drug Discovery, Northeastern University, Boston, Massachusetts (L.J., Y.L., S.P.N., A.M.)
| | - Brian D Kangas
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts (J.B., B.D.K.); Behavioral Biology Program, McLean Hospital, Belmont, Massachusetts (L.M.W., J.B., B.D.K.); and Center for Drug Discovery, Northeastern University, Boston, Massachusetts (L.J., Y.L., S.P.N., A.M.)
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Dong B, Shilpa BM, Shah R, Goyal A, Xie S, Bakalian MJ, Suckow RF, Cooper TB, Mann JJ, Arango V, Vinod KY. Dual pharmacological inhibitor of endocannabinoid degrading enzymes reduces depressive-like behavior in female rats. J Psychiatr Res 2020; 120:103-112. [PMID: 31654971 PMCID: PMC6916267 DOI: 10.1016/j.jpsychires.2019.10.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 09/18/2019] [Accepted: 10/10/2019] [Indexed: 11/16/2022]
Abstract
Major depressive disorder (MDD) is common, often under-treated and a leading cause of disability and mortality worldwide. The causes of MDD remain unclear, including the role of the endocannabinoid system. Intriguingly, the prevalence of depression is significantly greater in women than men. In this study we examined the role of endocannabinoids in depressive behavior. The levels of endocannabinoids, N-arachidonoyl ethanolamide (AEA) and 2-arachidonoyl glycerol (2-AG) were measured along with brain derived neurotrophic factor (BDNF) in postmortem ventral striata of female patients with MDD and non-psychiatric controls, and in Wistar Kyoto (WKY) rat, a selectively inbred strain of rat widely used for testing the depressive behavior. The effect of pharmacological elevation of endocannabinoids through inhibition of their catabolizing enzymes (fatty acid amide hydrolase [FAAH] and monoacyl glycerol lipase [MAGL]) on depressive-like phenotype was also assessed in WKY rat. The findings showed lower levels of endocannabinoids and BDNF in the ventral striata of MDD patients and WKY rats. A dual inhibitor of FAAH and MAGL, JZL195, elevated the endocannabinoids and BDNF levels in ventral striatum, and reduced the depressive-like phenotype in female WKY rats. Collectively, our study suggests a blunted ventral striatal endocannabinoid and BDNF signaling in depressive behavior and concludes that endocannabinoid enhancing agents may have an antidepressant effect.
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Affiliation(s)
- Bin Dong
- Division of Analytical Psychopharmacology, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Borehalli M Shilpa
- Division of Analytical Psychopharmacology, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA; School of Basic and Applied Sciences, Dayananda Sagar University, Bangalore, India
| | - Relish Shah
- Division of Analytical Psychopharmacology, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Arjun Goyal
- Division of Analytical Psychopharmacology, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Shan Xie
- Division of Analytical Psychopharmacology, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | | | - Raymond F Suckow
- Division of Analytical Psychopharmacology, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA; New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Thomas B Cooper
- Division of Analytical Psychopharmacology, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA; New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - J John Mann
- New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Victoria Arango
- New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - K Yaragudri Vinod
- Division of Analytical Psychopharmacology, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Emotional Brain Institute, Orangeburg, NY, USA; Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY, USA.
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Kangas BD, Zakarian AS, Vemuri K, Alapafuja SO, Jiang S, Nikas SP, Makriyannis A, Bergman J. Cannabinoid Antagonist Drug Discrimination in Nonhuman Primates. J Pharmacol Exp Ther 2019; 372:119-127. [PMID: 31641018 DOI: 10.1124/jpet.119.261818] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 10/21/2019] [Indexed: 11/22/2022] Open
Abstract
Despite a growing acceptance that withdrawal symptoms can emerge following discontinuation of cannabis products, especially in high-intake chronic users, there are no Food and Drug Administration (FDA)-approved treatment options. Drug development has been hampered by difficulties studying cannabis withdrawal in laboratory animals. One preclinical approach that has been effective in studying withdrawal from drugs in several pharmacological classes is antagonist drug discrimination. The present studies were designed to examine this paradigm in squirrel monkeys treated daily with the long-acting CB1 agonist AM2389 (0.01 mg/kg) and trained to discriminate the CB1 inverse agonist/antagonist rimonabant (0.3 mg/kg) from saline. The discriminative-stimulus effects of rimonabant were both dose and time dependent and, importantly, could be reproduced by discontinuation of agonist treatment. Antagonist substitution tests with the CB1 neutral antagonists AM4113 (0.03-0.3 mg/kg), AM6527 (0.03-1.0 mg/kg), and AM6545 (0.03-1.0 mg/kg) confirmed that the rimonabant discriminative stimulus also could be reproduced by CB1 antagonists lacking inverse agonist action. Agonist substitution tests with the phytocannabinoid ∆9-tetrahydrocannabinol (0.1-1.0 mg/kg), synthetic CB1 agonists nabilone (0.01-0.1 mg/kg), AM4054 (0.01-0.03 mg/kg), K2/Spice compound JWH-018 (0.03-0.3 mg/kg), FAAH-selective inhibitors AM3506 (0.3-5.6 mg/kg), URB597 (3.0-5.6 mg/kg), and nonselective FAAH/MGL inhibitor AM4302 (3.0-10.0 mg/kg) revealed that only agonists with CB1 affinity were able to reduce the rimonabant-like discriminative stimulus effects of withholding daily agonist treatment. Although the present studies did not document physiologic disturbances associated with withdrawal, the results are consistent with the view that the cannabinoid antagonist drug discrimination paradigm provides a useful screening procedure for examining the ability of candidate medications to attenuate the interoceptive stimuli provoked by cannabis discontinuation. SIGNIFICANCE STATEMENT: Despite a growing acceptance that withdrawal symptoms can emerge following the discontinuation of cannabis products, especially in high-intake chronic users, there are no FDA-approved pharmacotherapies to assist those seeking treatment. The present studies systematically examined cannabinoid antagonist drug discrimination, a preclinical animal model that is designed to appraise the ability of candidate medications to attenuate the interoceptive effects that accompany abrupt cannabis abstinence.
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Affiliation(s)
- Brian D Kangas
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts (B.D.K., J.B.); Behavioral Biology Program, McLean Hospital, Belmont, Massachusetts (B.D.K., A.S.Z., J.B.); and Center for Drug Discovery, Northeastern University, Boston, Massachusetts (K.V., S.O.A., S.J., S.P.N., A.M.)
| | - Ani S Zakarian
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts (B.D.K., J.B.); Behavioral Biology Program, McLean Hospital, Belmont, Massachusetts (B.D.K., A.S.Z., J.B.); and Center for Drug Discovery, Northeastern University, Boston, Massachusetts (K.V., S.O.A., S.J., S.P.N., A.M.)
| | - Kiran Vemuri
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts (B.D.K., J.B.); Behavioral Biology Program, McLean Hospital, Belmont, Massachusetts (B.D.K., A.S.Z., J.B.); and Center for Drug Discovery, Northeastern University, Boston, Massachusetts (K.V., S.O.A., S.J., S.P.N., A.M.)
| | - Shakiru O Alapafuja
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts (B.D.K., J.B.); Behavioral Biology Program, McLean Hospital, Belmont, Massachusetts (B.D.K., A.S.Z., J.B.); and Center for Drug Discovery, Northeastern University, Boston, Massachusetts (K.V., S.O.A., S.J., S.P.N., A.M.)
| | - Shan Jiang
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts (B.D.K., J.B.); Behavioral Biology Program, McLean Hospital, Belmont, Massachusetts (B.D.K., A.S.Z., J.B.); and Center for Drug Discovery, Northeastern University, Boston, Massachusetts (K.V., S.O.A., S.J., S.P.N., A.M.)
| | - Spyros P Nikas
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts (B.D.K., J.B.); Behavioral Biology Program, McLean Hospital, Belmont, Massachusetts (B.D.K., A.S.Z., J.B.); and Center for Drug Discovery, Northeastern University, Boston, Massachusetts (K.V., S.O.A., S.J., S.P.N., A.M.)
| | - Alexandros Makriyannis
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts (B.D.K., J.B.); Behavioral Biology Program, McLean Hospital, Belmont, Massachusetts (B.D.K., A.S.Z., J.B.); and Center for Drug Discovery, Northeastern University, Boston, Massachusetts (K.V., S.O.A., S.J., S.P.N., A.M.)
| | - Jack Bergman
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts (B.D.K., J.B.); Behavioral Biology Program, McLean Hospital, Belmont, Massachusetts (B.D.K., A.S.Z., J.B.); and Center for Drug Discovery, Northeastern University, Boston, Massachusetts (K.V., S.O.A., S.J., S.P.N., A.M.)
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Smalheiser NR. A Neglected Link Between the Psychoactive Effects of Dietary Ingredients and Consciousness-Altering Drugs. Front Psychiatry 2019; 10:591. [PMID: 31474892 PMCID: PMC6706955 DOI: 10.3389/fpsyt.2019.00591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 07/25/2019] [Indexed: 01/24/2023] Open
Affiliation(s)
- Neil R Smalheiser
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, United States
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