Anxiolytics structure

In 2000, Simig et al. began to conduct structure activity relationships on 25 by employing the Pictet-Gams reaction. Compound 25 had been identified as an anxiolytic agent that does not show sedative side-effects. ... 

Neuropeptide S (NPS) is a recently discovered bioactive peptide that has emerged as a new signaling molecule in the complex circuitry that modulates sleep-wakefulness and anxiety-like behavior. The peptide precursor is expressed most prominently in a novel nucleus located in the perilocus coeruleus, a brain structure with well-defined functions in arousal, stress, and anxiety. NPS was also found to induce anxiolytic-like behavior in a battery of four different tests of innate responses to stress. Infusion of NPS potently increases wakefulness and suppresses non-REM (NREM) and REM sleep (Xu et al, 2004). NPS binds to a G-protein-coupled receptor, the NPS receptor, with nanomolar affinity activation of the receptor mobilizes intracellular calcium. The NPS receptor is expressed throughout the brain, particularly in regions relevant to the modulation of sleep and waking, in the tuberomammillary region, lateral hypothalamus, and medial thalamic nuclei. 

Thus, the evidence that stress, and the stress hormone corticosterone, may cause changes in hippocampal structure, hippocampal connections, and changes in gene and protein expression, suggest that viable targets of anxiolytic agents are cellular signaling pathways involved in neuroplasticity and the maintenance of cellular resilience. 

Another SNRI, bicifadine (20), formerly under clinical development for chronic low back pain, is now being developed for neuropathic pain [65,66]. Flufenoxine, also known as F-98214-TA (21), was reported to display greater potency than several reference antidepressants in animal models predictive of antidepressant and anxiolytic activities [67]. SEP-227162 (structure undisclosed) is another SNRI reportedly undergoing clinical development [68]. 

From the examination of structure-activity relationships, it has been concluded that a phenyl moiety at C-6 as well as a 4-hydroxypiperidine side-chain attached to C-3 of the pyridazine system is essential for anticonvulsant activity in this class of compounds [184], Compounds (54) and (55) have been found to have similar anticonvulsant profiles in animals (mice, rats and baboons) [165, and literature cited therein] and to represent potent broad-spectrum antiepileptic drugs. Their potency with regard to antagonizing seizures (induced by electro-shock or various chemicals) has been compared with standard anticonvulsants like carbamazepine and phenobarbitone [185, 186], A quantitative electroencephalographic analysis of (55) has been published [187]. From in vitro studies it has been concluded that the anticonvulsant activities of these compounds are not mediated by an enhancement of GABAergic transmission or by an interaction with benzodiazepine receptor sites [ 165,186,187], On the other hand, in vivo experiments showed that (54), at anticonvulsant doses, increases the affinity of flunitrazepam for its central receptor site [ 186], Investigations of (54) and (55) in a behavioural test predictive of antianxiety activity revealed a marked difference in the pharmacological profiles of these structurally closely related compounds the dichloro compound SR 41378 (55) has also been found to possess anxiolytic (anticonflict) properties [165],... 

Morphine has anxiolytic effects in humans. Users typically experience a sense of contentment and complacency. This effect is most likely mediated by opioid receptors in limbic structures such as the amygdala (File and Rodgers 1979). 

Catania MA, Firenzuoli F, Crupi A, Mannucd C, Caputi AP, Calapai G (2003) Hypericum perforatum attenuates nicotine withdrawal signs in mice. Psychopharmacology 169 186-189 Cheeta S, Irvine EE, Kenny PJ, File SE (2001) The dorsal raphd nucleus is a crucial structure mediating nicotine s anxiolytic effects and the development of tolerance and withdrawal responses. Psychopharmacology 155 78-85... 

Although the chemical structure of the benzodiazepines was first described by Sternbach in the 1930s, the clinical efficacy of these anxiolytics was only fully realized following a clinical trial of chlordiazepoxide by Harris in the USA in 1960. 

Related hypnotics that also act at benzodiazepine receptors are the newer agents zolpidem, a imida-zopyridine, zaleplon a pyrazolopyrimidine and the cyclopyrrolone zopiclone. Zopiclone might have a role for the treatment of benzodiazepine addiction. In patients in whom zopiclone was substituted for a benzodiazepine for 1 month and then itself abmptly terminated, improved sleep was reported during the zopiclone treatment, and withdrawal effects were absent on discontinuation of zopiclone. A series of non-sedating anxiolytic drugs derived from the same structural families as the above mentioned nonbenzodiazepines, have been developed, such as alpi-dem and pagoclone. 

Buspirone (BuSpar) is the first example of a class of anxiolytic agents that can relieve some symptoms of anxiety in doses that do not cause sedation. Buspirone is structurally unrelated to existing psychotropic drugs. 

Zolpidem is an imidazopyridine, with a chemical structure of N,N,6-trimethyl-2-(4-methylphenyl)-imidazo [ 1,2-alpha] -pyridine-3-acetamine hemitartrate (Salva and Costa, 1995). This nonbenzodiazepine sedative hypnotic was first released in Europe, and then introduced in the United States in 1993 (Hobbs et ah, 1996). Zolpidem has a strong sedative effect that seems to preclude its use as an anxiolytic. It has only weak anticonvulsant effects (Salva and Costa, 1995 Hobbs et ah, 1996). 

It is 1,5 benzodiazepine with a chemical structure slightly different from that of diazepam and clonazepam. This change in structure results in less sedative and psychomotor retardation. Though introduced as an anxiolytic it has been found to be useful in treatment of patients with refractory epilepsy. 

Several drugs with novel chemical structures have been introduced more recently for use in sleep disorders. Zolpidem, an imidazopyridine, zaleplon, a pyrazolopyrimidine, and eszopiclone, a cyclopyrrolone (Figure 22-4), although structurally unrelated to benzodiazepines, share a similar mechanism of action, as described below. Eszopiclone is the (S) enantiomer of zopiclone, a hypnotic drug that has been available outside the United States since 1989. Ramelteon, a melatonin receptor agonist, is a new hypnotic drug (see Ramelteon). Buspirone is a slow-onset anxiolytic agent whose actions are quite different from those of conventional sedative-hypnotics (see Buspirone). 

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