CN101405287A - 新颖的色烯-2-酮衍生物和它们作为单胺神经递质再摄取抑制剂的用途 - Google Patents
新颖的色烯-2-酮衍生物和它们作为单胺神经递质再摄取抑制剂的用途 Download PDFInfo
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- 229920002554 vinyl polymer Polymers 0.000 description 1
- 239000011345 viscous material Substances 0.000 description 1
- 150000003751 zinc Chemical class 0.000 description 1
- 239000011701 zinc Substances 0.000 description 1
- 229910052725 zinc Inorganic materials 0.000 description 1
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Abstract
本发明涉及可用作单胺神经递质再摄取抑制剂的新颖的式(I)色烯-2-酮衍生物。在其它方面中,本发明涉及这些化合物在治疗方法中的用途以及包含本发明化合物的药物组合物。在式(I)中,其中Q表示色烯-2-酮基团;该色烯-2-酮基团任选被一个或多个独立地选自下列的取代基取代:卤素,三氟甲基,三氟甲氧基,氰基,羟基,氨基,硝基,烷氧基,环烷氧基,烷基,环烷基,环烷基烷基,链烯基和炔基;且R1表示氢或烷基;该烷基任选被一个或多个独立地选自下列的取代基取代:卤素,三氟甲基,三氟甲氧基,氰基,羟基,氨基,硝基,烷氧基,环烷氧基,烷基,环烷基,环烷基烷基,链烯基和炔基;且R2和R3一起形成-(CH2)-(CH2)-或-(CH)=(CH)-。
Description
技术领域
本发明涉及可用作单胺神经递质再摄取抑制剂的新颖的色烯-2-酮衍生物。
在其它方面中,本发明涉及这些化合物在治疗方法中的用途以及包含本发明化合物的药物组合物。
背景技术
5-羟色胺选择性再摄取抑制剂(SSRI)目前在几种CNS障碍、包括抑郁症和恐慌症的治疗中提供效力。SSRI通常被精神病医师和初级保健医师认为有效、耐受良好且易于给药。然而,它们与许多不期望的特性有关。
因此,对于就针对单胺神经递质5-羟色胺、多巴胺和去甲肾上腺素的再摄取活性、例如5-羟色胺再摄取与去甲肾上腺素和多巴胺再摄取活性的比而言,具有最佳药理学特征的化合物仍然有着强烈需求。
发明内容
在其第一个方面中,本发明提供了式I化合物:
其任何异构体或其异构体的任何混合物,或其药学上可接受的盐,
其中R1,R2,R3和Q如下定义。
在其第二个方面中,本发明提供了药物组合物,其包含治疗有效量的本发明化合物,其任何异构体或其异构体的任何混合物,或其药学上可接受的盐,以及至少一种药学上可接受的载体、赋形剂或稀释剂。
在进一步的一个方面中,本发明提供了本发明化合物、其任何异构体或其异构体的任何混合物、或其药学上可接受的盐用于制备治疗、预防或减轻哺乳动物、包括人类的疾病或障碍或病症的药物组合物的用途,所述疾病、障碍或病症对于中枢神经系统中单胺神经递质再摄取的抑制有应答。
在更进一步的一个方面中,本发明涉及用于治疗、预防或减轻包括人的活的动物体的疾病、障碍或病症的方法,所述障碍、疾病或病症对于中枢神经系统中单胺神经递质再摄取的抑制有应答,该方法包括给予有此需要的该活的动物体治疗有效量的本发明化合物、其任何异构体或其异构体的任何混合物、或其药学上可接受的盐。
从下面的详细描述及实施例,本发明的其它目的对于本领域技术人员来说将显而易见。
本发明的详细公开
色烯-2-酮衍生物
在其第一个方面中,本发明提供了式I化合物:
其任何异构体或其异构体的任何混合物,
或其药学上可接受的盐,
其中
Q表示色烯-2-酮基团;
该色烯-2-酮基团任选被一个或多个独立地选自下列的取代基取代:
卤素,三氟甲基,三氟甲氧基,氰基,羟基,氨基,硝基,烷氧基,环烷氧基,烷基,环烷基,环烷基烷基,链烯基和炔基;且
R1表示氢或烷基;
该烷基任选被一个或多个独立地选自下列的取代基取代:
卤素,三氟甲基,三氟甲氧基,氰基,羟基,氨基,硝基,烷氧基,环烷氧基,烷基,环烷基,环烷基烷基,链烯基和炔基;且
R2和R3一起形成-(CH2)-(CH2)-或-(CH)=(CH)-。
在式I化合物的一个实施方案中,R2和R3一起形成-(CH2)-(CH2)-;且R1如上所定义。在一个具体实施方案中,R1表示烷基,链烯基或烷氧基烷基。在另一个实施方案中,R1表示C2-6-烷基,链烯基或烷氧基烷基。在另一个实施方案中,R1表示C2-6-烷基,例如乙基或丙基,尤其异丙基。在另一个实施方案中,R1表示链烯基,例如烯丙基。在另一个实施方案中,R1表示烷氧基烷基,例如烷氧基乙基,尤其甲氧基乙基。在另一个实施方案中,R1表示氢。在另一个实施方案中,R1表示烷基,例如甲基。
在式I化合物的另一个实施方案中,R2和R3一起形成-(CH)=(CH)-;且R1如在权利要求1中所定义。在一个具体实施方案中,R1表示氢或烷基。在另一个实施方案中,R1表示氢。在另一个实施方案中,R1表示烷基,例如甲基。
在式I化合物的另一个实施方案中,Q表示色烯-2-酮-基。在式I化合物的一个具体实施方案中,Q表示色烯-2-酮-7-基。在式I化合物的一个具体实施方案中,Q表示色烯-2-酮-6-基。
在式I化合物的另一个实施方案中,Q表示取代的色烯-2-酮-基,例如卤素、氰基或烷基取代的色烯-2-酮-基。在式I化合物的一个具体实施方案中,Q表示取代的色烯-2-酮-7-基,例如卤素、氰基或烷基取代的色烯-2-酮-7-基。在式I化合物的一个具体实施方案中,Q表示取代的色烯-2-酮-6-基,例如卤素、氰基或烷基取代的色烯-2-酮-6-基。
在另一个实施方案中,Q表示色烯-2-酮-基;该色烯-2-酮-基在3-位被选自下列的取代基取代:卤素,三氟甲基,三氟甲氧基,氰基,羟基,氨基,硝基,烷氧基,环烷氧基,烷基,环烷基,环烷基烷基,链烯基和炔基。
在另一个具体的实施方案中,Q表示3-卤代-色烯-2-酮-基,例如3-卤代-色烯-2-酮-6-基或3-卤代-色烯-2-酮-7-基,在一个具体实施方案中,Q表示3-溴-色烯-2-酮-6-基,3-溴-色烯-2-酮-7-基,3-氯-色烯-2-酮-6-基或3-氯-色烯-2-酮-7-基。
在另一个具体的实施方案中,Q表示3-氰基-色烯-2-酮-基,例如3-氰基-色烯-2-酮-6-基或3-氰基-色烯-2-酮-7-基。
在另一个具体的实施方案中,Q表示烷基-氰基-色烯-2-酮-基,例如甲基-氰基-色烯-2-酮-基,例如4-甲基-3-氰基-色烯-2-酮-基。在一个具体的实施方案中,Q表示4-甲基-3-氰基-色烯-2-酮-6-基或4-甲基-3-氰基-色烯-2-酮-7-基。
在一个具体的实施方案中,本发明的化合物是
外-3-溴代-7-(8-甲基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮;
外-7-(8-氮杂-双环[3.2.1]辛-3-基氧基)-2-氧代-2H-色烯-3-腈;
外-6-(8-氮杂-双环[3.2.1]辛-3-基氧基)-3-溴-色烯-2-酮;
外-7-(8-氮杂-双环[3.2.1]辛-3-基氧基)-3-氯-色烯-2-酮;
外-7-(8-氮杂-双环[3.2.1]辛-3-基氧基)-4-甲基-2-氧代-2H-色烯-3-腈;
外-7-(8-乙基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮;
外-7-(8-异丙基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮;
外-7-[8-(2-甲氧基-乙基)-8-氮杂-双环[3.2.1]辛-3-基氧基]-色烯-2-酮;
外-7-(8-烯丙基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮;
外-7-(8-氮杂-双环[3.2.1]辛-6-烯-3-基)氧基)-色烯-2-酮;
外-7-(8-甲基-8-氮杂-双环[3.2.1]辛-6-烯-3-基氧基)-色烯-2-酮;
外-3-溴代-7-(8-甲基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮;
外-3-氯代-7-(8-甲基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮;
或其药学上可接受的盐。
二或更多个上述实施方案的任意组合被视为在本发明的范围之内。
取代基定义
在本发明上下文中,卤素表示氟,氯,溴或碘。
在本发明上下文中,烷基表示单价饱和的、直链或支链的烃链。该烃链优选含有一至六个碳原子(C1-6-烷基),包括戊基,异戊基,新戊基,叔戊基,己基和异己基。在一个优选的实施方案中,烷基表示C1-4-烷基,包括丁基,异丁基,仲丁基和叔丁基。在本发明另一个优选的实施方案中,烷基表示C1-3-烷基,其可特别地为甲基,乙基,丙基或异丙基。
在本发明上下文中,链烯基表示含有一或多个双键的碳链,包括二-烯,三-烯和多-烯。在一个优选的实施方案中,本发明的链烯基含有二至六个碳原子(C2-6-链烯基),其包括至少一个双键。在一个最优选的实施方案中,本发明的链烯基为乙烯基;1-丙烯基或2-丙烯基;1-丁烯基、2-丁烯基或3-丁烯基,或1,3-丁二烯基:1-己烯基、2-己烯基、3-己烯基、4-己烯基或5-己烯基,或1,3-己二烯基,或1,3,5-己三烯基。
在本发明上下文中,炔基表示含有一或多个三键的碳链,包括二-炔,三-炔和多-炔。在一个优选实施方案中,本发明的炔基含有二至六个碳原子(C2-6-炔基),包括至少一个三键。在其最优选的实施方案中,本发明的炔基为乙炔基;1-丙炔基或2-丙炔基:1-丁炔基、2-丁炔基或3-丁炔基,或1,3-丁二炔基;1-戊炔基、2-戊炔基、3-戊炔基、4-戊炔基,或1,3-戊二炔基;1-己炔基、2-己炔基、3-己炔基、4-己炔基或5-己炔基,或1,3-己二炔基,或1,3,5-己三炔基。
在本发明上下文中,环烷基表示环烷基,优选含有三至七个碳原子(C3-7-环烷基),包括环丙基,环丁基,环戊基,环己基和环庚基。
烷氧基为O-烷基,其中的烷基如上所定义。
环烷氧基为O-环烷基,其中的环烷基如上所定义。
环烷基烷基意指如上所述的环烷基和如上所述的烷基,意指例如环丙基甲基。
氨基是NH2或NH-烷基或N-(烷基)2,其中烷基如上所定义。
药学上可接受的盐
本发明化合物可以任何适合打算给药的形式提供。适合的形式包括本发明化合物的药学(即生理学)上可接受的盐类以及前药(predrug)或药物前体(prodrug)形式。
药学上可接受的加成盐类的例子包括但不限于:非毒性无机和有机酸加成盐类,例如盐酸盐、氢溴酸盐、硝酸盐、高氯酸盐、磷酸盐、硫酸盐、甲酸盐、乙酸盐、阿康酸盐、抗坏血酸盐、苯磺酸盐、苯甲酸盐、肉桂酸盐、柠檬酸盐、双羟萘酸盐、庚酸盐、富马酸盐、谷氨酸盐、羟乙酸盐、乳酸盐、马来酸盐、丙二酸盐、扁桃酸盐、甲磺酸盐、萘-2-磺酸盐衍生物、酞酸盐、水杨酸盐、山梨酸盐、硬脂酸盐、琥珀酸盐、酒石酸盐、对-甲苯磺酸盐等。这样的盐类可通过本领域中熟知和描述的方法形成。
其它酸类例如草酸,其可能不被视为是药学上可接受的,但可用于盐类的制备中,所述盐类在获得本发明化合物及其药学上可接受的酸加成盐中可作为中间产物。
本发明化合物的药学上可接受的阳离子盐类的例子包括但不限于:含有阴离子基团的本发明化合物的钠盐,钾盐,钙盐,镁盐,锌盐,铝盐,锂盐,胆碱盐,赖氨酸盐和铵盐等。这样的阳离子盐类可通过本领域中熟知和描述的方法形成。
在本发明上下文中,含氮化合物的“鎓盐”也被认为是药学上可接受的盐。优选的“鎓盐”包括烷基-鎓盐、环烷基-鎓盐和环烷基烷基-鎓盐。
本发明化合物的前药或药物前体形式的实例包括本发明物质适宜的药物前体的实例,包括在母体化合物的一个或多个反应或衍生基团上被修饰的化合物。特别令人感兴趣的化合物是在羧基、羟基或氨基上被修饰的化合物。适宜的衍生物实例为酯或酰胺。
本发明化合物可以可溶或不溶形式与药学上可接受的溶剂如水、乙醇等一起提供。可溶形式还可以包括水合形式,例如一水合物、二水合物、半水合物、三水合物、四水合物等。一般地,就本发明目的而言,认为可溶形式等同于不溶形式。
立体异构体
本领域技术人员将认识到,本发明化合物可以不同的立体异构形式存在,包括对映异构体、非对映异构体和顺式-反式异构体。
例如,式I的基团-O-Q可以具体地是相对于氮杂双环的外或内构型。
本发明包括所有这些异构体及其任何混合物,包括外消旋混合物。
外消旋形式可以用已知的方法和技术拆分成光学对映体。一种分离异构盐的方法是使用光学活性酸,并通过用碱处理来释放光学活性的胺化合物。另一种将外消旋化合物拆分成光学对映体的方法是基于光学活性基质上的色谱。因此,例如可以通过分步结晶D-或L-(酒石酸盐、扁桃酸盐或樟脑磺酸盐)盐而将本发明的外消旋化合物拆分成它们的光学对映体。
本发明化合物还可以通过以下方法拆分:使本发明化合物与光学活性活化的羧酸,诸如由(+)或(-)苯基丙氨酸、(+)或(-)苯基甘氨酸、(+)或(-)樟脑酸衍生的羧酸反应形成非对映的酰胺,或者使本发明的化合物与光学活性的氯甲酸酯或类似物反应形成非对映的氨基甲酸酯。
用于拆分光学异构体的其它方法在本领域中是已知的。这样的方法包括Jaques J,ColletA,& Wilen S在″Enantiomers.Racemates, and Resolutions ″,John Wiley and Sons,New York(1981)中所描述的那些方法。
光学活性化合物还可以由光学活性原料或中间体制备。
标记化合物
本发明化合物可以其标记或未标记的形式使用。在本发明上下文中,该标记化合物具有一或多个原子,所述原子被具有不同于在自然界中通常发现的原子质量或质量数的原子质量或质量数的原子所置换。所述标记可使该化合物容易定量检测。
本发明的标记化合物可以用作各种诊断方法中的诊断工具、放射示踪剂或监测剂,并可用于体内受体成像。
本发明的标记异构体优选包含至少一种放射性核素作为标记。发射正电子的放射性核素均为使用候选物。在本发明上下文中,放射性核素优选选自2H(氘)、3H(氚)、13C、14C、131I、125I、123I和18F。
用于检测本发明标记异构体的物理方法可以选自正电子发射断层成像术(PET)、单光子成像计算机断层成像术(SPECT)、磁共振光谱法(MRS)、磁共振成像(MRI)和计算机辅助轴向X射线断层成像术(CAT)或者它们的组合。
制备方法
本发明的化合物可以通过用于化学合成的常规方法,例如在实施例中所述的方法制备。用于本申请所述方法的原料是已知的,或者可以容易地通过常规方法由商购可得到的化学品制备。
还可以用常规方法将本发明的一种化合物转化成本发明的另一种化合物。
本文所述反应的终产物可以通过常规技术,例如通过萃取、结晶、蒸馏、色谱等进行分离。
生物活性
可以测试本发明化合物抑制突触体中单胺多巴胺、去甲肾上腺素和5-羟色胺再摄取的能力,如在WO 97/30997(NeuroSearch A/S)中所述。基于这些测试中观察到的平衡活性,考虑将本发明化合物用于治疗、预防或减轻哺乳动物、包括人的疾病或障碍或病症,所述疾病、障碍或病症对中枢神经系统中的单胺神经递质再摄取的抑制有应答。
在一个具体的实施方案中,考虑将本发明的化合物用于治疗、预防或减轻:情感障碍、抑郁、非典型抑郁、继发于疼痛的抑郁、重度抑郁症、心境恶劣障碍、双相性精神障碍、I型双相性精神障碍、II型双相性精神障碍、循环情感性障碍、由一般医学病症导致的情感障碍、物质诱导的情感障碍、假性痴呆、甘塞氏综合征、强迫观念与行为障碍、恐慌症、无广场恐怖症的恐慌症、有广场恐怖症的恐慌症、无恐慌症病史的广场恐怖症、惊恐发作、记忆缺陷、记忆丧失、注意涣散多动症、肥胖、焦虑、泛化性焦虑症、进食障碍、帕金森氏病、帕金森氏综合征、痴呆、衰老性痴呆、老年性痴呆、阿尔茨海默氏病、获得性免疫缺陷综合征痴呆复征、老化性记忆机能障碍、特定恐惧症、社交焦虑障碍、创伤后应激障碍、急性应激障碍、药物成瘾、药物滥用、可卡因滥用、烟碱滥用、烟草滥用、酒精成瘾、酒精中毒、偷窃狂、疼痛、慢性疼痛、炎性疼痛、神经病性疼痛、偏头痛、紧张型头痛、慢性紧张型头痛、与抑郁有关的疼痛、纤维肌痛、关节炎、骨关节炎、类风湿性关节炎、背部疼痛、癌痛、肠易激性疼痛、肠易激综合征、术后疼痛、乳房切除术后疼痛综合征(PMPS)、中风后疼痛、药物诱导的神经病、糖尿病性神经病、交感神经维持性疼痛、三叉神经痛、牙痛、肌筋膜疼痛、幻肢痛、贪食症、月经前期综合征、月经前焦虑障碍、晚黄体期综合征、创伤后综合征、慢性疲劳综合征、尿失禁、压力性失禁、紧迫性失禁、夜间失禁、性功能障碍、早泄、勃起困难、勃起功能障碍、过早的女性性高潮、多动腿综合征、周期性肢体运动障碍、进食障碍、神经性厌食、睡眠障碍、全身性发育迟缓、孤独症、阿斯波哥尔障碍、雷特障碍、童年瓦解性障碍、学习能力丧失、运动技能障碍、缄默症、拔毛发癖、发作性睡病、中风后抑郁、中风诱导的脑损伤、中风诱导的神经元损伤,吉勒德拉图雷病,耳鸣、抽动障碍、躯体变形性精神障碍、对立违抗性障碍或中风后残疾。在一个优选的实施方案中,考虑将所述化合物用于治疗、预防或减轻抑郁。
目前预期活性药物成分(API)的适宜剂量范围为大约0.1至大约1000mg API/天,更优选大约10至大约500mg API/天,最优选大约30至大约100mg API/天,但取决于确切的给药方式、其给药形式、考虑的适应症、患者和特别是所涉及的患者的体重,以及进一步地,主治医师或兽医的偏好和经验。
优选的本发明化合物表现出亚微摩尔和微摩尔范围的生物活性,即小于1至大约100μM。
药物组合物
在另一个方面中,本发明提供新颖的药物组合物,其包括治疗有效量的本发明化合物。
尽管用于治疗的本发明化合物可以原料化合物的形式给药,但优选将活性成分、任选地以生理上可接受的盐的形式,与一种或多种辅剂、赋形剂、载体、缓冲剂、稀释剂和/或其它常规的药物辅料一起引入成为药物组合物。
在优选的实施方案中,本发明提供了药物组合物,其包含本发明化合物或其药学上可接受的盐或衍生物以及一种或多种药学上可接受的载体、和任选地与其它本领域已知和使用的治疗性和/或预防性成分混合。该载体必须是″可接受的″,即与制剂中的其它成分相容且不会对其接受者有害。
本发明的药物组合物可以是那些适合于口服、直肠、支气管、鼻、肺、局部(包括颊内和舌下)、透皮、阴道或肠胃外(包括皮肤、皮下、肌内、腹腔内、静脉内、动脉内、脑内、眼内注射或输注)给药的药物组合物,或那些适合于通过吸入或吹入给药的形式,包括粉末和液体气雾剂给药、或通过缓释系统给药的药物组合物。合适的缓释系统的例子包括含有本发明化合物的固体疏水性聚合物的半渗透基质,该基质可以是成形的制品形式,例如薄膜或微囊。
因此可将本发明的化合物与常规的辅剂、载体或稀释剂一起制成药物组合物及其单位剂量的形式。这样的形式包括固体,并尤其是片剂、填充胶囊、粉末和丸剂的形式、以及液体,尤其是水溶液或非水溶液、混悬液、乳剂、酏剂和填充上述形式的胶囊,所有这些形式均用于口服、用于直肠给药的栓剂、以及用于肠胃外的无菌可注射溶液。这样的药物组合物及其单位剂量形式可包括常规比例的常规成分、含有或不含另外的活性化合物或成分,并且这样的单位剂量形式可含有与预期每日应用剂量范围相当的任何合适的有效量的活性成分。
本发明化合物可以各种口服和胃肠外剂型给药。对本领域技术人员来说,显而易见的是下述剂型可包含作为活性成分的本发明化合物或本发明化合物药学上可接受的盐。
为从本发明化合物制备药物组合物,药学上可接受的载体可以是固体或者液体。固体形式的制剂包括粉末、片剂、丸剂、胶囊、扁囊剂、栓剂以及可分散的颗粒剂。固体载体可以是一种或多种还能用作稀释剂、调味剂、增溶剂、润滑剂、悬浮剂、粘合剂、防腐剂、片剂崩解剂或包囊材料的物质。
在粉末剂中,载体为细粒固体,它与细分的活性组分混合。
在片剂中,活性成分与具有必要的结合容量的载体以适当的比例混合并压缩成所需的形状和大小。
粉末剂和片剂优选含5%或10%至约70%的活性化合物。合适的载体为碳酸镁、硬脂酸镁、滑石粉、糖、乳糖、果胶、糊精、淀粉、明胶、黄蓍胶、甲基纤维素、羧甲基纤维素钠、低熔点蜡、可可脂等。术语″制剂″欲包括活性化合物与作为载体的包囊材料的剂型,所述包囊材料提供胶囊,其中含或不含载体的活性成分被载体包围,载体由此与活性化合物结合在一起。类似地,还包括扁囊剂和锭剂。片剂、粉末剂、胶囊、丸剂、扁囊剂和锭剂可以用作适合于口服给药的固体形式。
为了制备栓剂,首先将低熔点的蜡、如脂肪酸甘油酯或可可脂的混合物熔化,并通过搅拌将活性成分均匀地分散在其中。然后将该熔化的均匀混合物倾入适当大小模具中,使其冷却并由此固化。
适合于阴道给药的组合物可以阴道栓剂、棉塞、乳膏剂、凝胶剂、糊剂、泡沫或喷雾剂的形式存在,除含活性成分外还含有本领域已知的合适的载体。
液体制剂包括溶液、混悬液和乳剂,例如,水溶液或水-丙二醇溶液。例如,肠胃外注射液体制剂可以配制成含水聚乙二醇的溶液。
因此,本发明化合物可配制成用于肠胃外给药(例如注射,如推注或连续输注)的制剂,并可以与添加的防腐剂一起以安瓿、预填充注射器、小体积输注液的单位剂量形式或以多剂量容器提供。该组合物可采取油性或水性载体的混悬液、溶液或乳剂的形式,并可含有制剂成分,如悬浮剂、稳定剂和/或分散剂。另外,活性成分可以是粉末形式,通过无菌固体的无菌分离或通过溶液冻干获得,用于在使用前与合适的载体如无菌的、无热原的水进行配制。
适合于口服使用的水溶液可通过将活性组分溶解在水中并根据需要加入合适的着色剂、调味剂、稳定剂和增稠剂来制备。
适合于口服使用的水悬浮液可通过将细分活性组分分散在含粘性物质、如天然或合成的树胶、树脂、甲基纤维素、羧甲基纤维素钠、或其它公知的悬浮剂的水中而制备。
还包括欲在临用之前转化为用于口服给药的液体形式制剂的固体形式制剂。这样的液体形式包括溶液、混悬液和乳剂。除活性组分之外,这样的制剂可包含着色剂、调味剂、稳定剂、缓冲剂、人造和天然的甜味剂、分散剂、增稠剂、增溶剂等。
为了局部施用到表皮,可将本发明化合物配制成软膏剂、霜剂,或洗剂,或透皮贴剂。例如,软膏剂和霜剂可用水性或油性基质外加合适的增稠剂和/或胶凝剂配制而成。洗剂可用水性或油性基质配制而成,且通常还含一种或多种乳化剂、稳定剂、分散剂、悬浮剂、增稠剂或着色剂。
适合于在口腔中局部给药的组合物包括在调味基质、通常为蔗糖和金合欢胶或黄蓍胶中包含活性成分的锭剂;在惰性基质、如明胶和甘油或蔗糖和金合欢胶中包含活性成分的软锭剂(pastilles);以及在合适的液体载体中包含活性成分的漱口剂。
可将溶液或混悬液用常规方法例如用滴管、吸管或喷雾器直接施用到鼻腔。该组合物可以单剂量或多剂量的形式提供。
呼吸道给药也可以借助气雾剂实现,其中活性成分与合适的推进剂一起在加压包装中提供,合适的推进剂包括含氯氟烃(CFC)例如二氯二氟甲烷、三氯氟甲烷或二氯四氟乙烷,二氧化碳或其它合适的气体。气雾剂还可适当地含有表面活性剂如卵磷脂。药物的剂量可通过配备计量阀控制。
或者,活性成分可以干粉形式提供,例如化合物在合适的粉末基质如乳糖、淀粉、淀粉衍生物如羟丙基甲基纤维素和聚乙烯吡咯烷酮(PVP)中的粉末混合物。适宜地,粉末载体将在鼻腔内形成凝胶。粉末组合物可以单位剂量形式呈现,例如以胶囊或药筒(如明胶的胶囊或药筒)形式,或以粉末可借助吸入器从中给药的泡罩包装形式。
在欲用于呼吸道给药的组合物包括鼻内用组合物中,通常化合物具有小的粒径,例如为5微米或更小的数量级。这样的粒径可以借助本领域已知的方法、例如通过微粉化获得。
需要时,可以应用适合提供活性成分缓释的组合物。
药物制剂优选为单位剂量形式。这类形式中,制剂被细分为含有适量活性组分的单位剂量。单位剂量形式可以是包装的制剂,该包装含有个别量的制剂,如包装的片剂、胶囊,以及小瓶或安瓿中的粉末。此外,单位剂量形式可以是胶囊、片剂、扁囊剂或锭剂本身,或可以是适合数量的任何这些剂型的包装形式。
用于口服给药的片剂或胶囊和用于静脉给药的液体以及连续输注液是优选的组合物。
关于制剂和给药技术的更详细的资料可以在最新版的Reminaton′s Pharmaceutical Sciences(Maack PublishingCo.Easton,PA)上找到。
治疗有效剂量指的是活性成分的量,其可改善症状或病状。治疗效力及毒性、例如ED50及LD50可在细胞培养物或实验动物内通过标准药理学程序予以测定。治疗效果与毒性作用之间的剂量比为治疗指数并可通过比例LD50/ED50表示。优选显现出大的治疗指数的药物组合物。
给予的剂量当然必须针对所治疗的个体的年龄、体重和病症,以及给药途径、剂量形式及给药方案,以及期望的结果而小心地调整,且确切的剂量当然应该由医师决定。
实际的剂量取决于所治疗疾病的性质及严重程度,且在医师的判断范围之内,可以根据本发明具体情况对剂量的反应而改变,以产生所需的治疗效果。然而,目前预期含有从约0.1至约500mg、优选从约1至约100mg、更优选从约1至约10mg的活性成分/单个剂量的药物组合物对于治疗性治疗是合适的。
活性成分可以每日一或数剂给予。在某些情况中,以低至0.1μg/公斤(静脉内)及1μg/公斤(口服)的剂量可以获得令人满意的结果。目前认为剂量范围的上限是约10mg/公斤(静脉内)及100mg/公斤(口服)。优选范围为从约0.1μg/公斤至约10mg/公斤/日(静脉内),且从约1μg/公斤至约100mg/公斤/日(口服)。
治疗方法
在另一个方面中,本发明提供了治疗、预防或减轻活的动物体包括人的疾病,障碍或病症的方法,其中该疾病,障碍或病症对于中枢神经系统中单胺神经递质再摄取的抑制有应答,且该方法包括给予有此需要的活的动物体、包括人类有效量的本发明化合物。
目前预期,适当的剂量范围是每日0.1至1000mg,每日10至500mg,及特别是每日30-100mg,通常取决于确切的给药方式,给药形式,给药所针对的适应症,所涉及的患者及所涉及患者的体重,及进一步地,医师或兽医的偏好及经验。
实施例
参照下列实施例进一步说明本发明,但是这些实施例无意以任何方式限制所要求的本发明范围。
制备实施例
在氮气下和在无水溶剂中,进行涉及空气敏感的试剂或中间体的所有反应。将硫酸镁用作后处理操作的干燥剂,并在减压下蒸发溶剂。
内-苯甲酸8-甲基-8-氮杂-双环[3.2.1]辛-3-基酯
在<30℃下,在30min中将苯甲酰氯(84.3g,600mmol)加入莨菪碱(70.6g,500mmol)、叔丁醇钾(67.3g,600mmol)和THF(500ml)的混合物。在室温搅拌混合物2h。加入水(1L),随后用二乙醚(2x500ml)萃取。用水(2x200ml)洗涤有机相2次,随后用饱和氯化钠水溶液(200ml)洗涤。干燥醚相,加入在乙醇(170ml,3M)中的盐酸。过滤沉淀的盐酸化物,用二乙醚洗涤。通过加入过量的氨水,得到游离碱,随后用乙酸乙酯和二乙醚的混合物萃取。产量66.8g(54%)。
内-苯甲酸8-氮杂-双环[3.2.1]辛-3-基酯
将2,2,2-三氯乙基氯甲酸酯(75.0ml,544mmol)逐滴加入内-苯甲酸8-甲基-8-氮杂-双环[3.2.1]辛-3-基酯(66.8g,272mmol)和干燥的甲苯(500ml)的混合物中。将混合物在室温搅拌1h,随后在100℃搅拌15h。加入水(250ml),随后搅拌1h。分离相,用水(2x200ml)洗涤有机相2次。干燥中间体3-苯甲酰氧基-8-氮杂-双环[3.2.1]辛烷-8-甲酸三氯甲基酯的混合物,并蒸发。加入乙酸(350m l),随后经3小时时间段加入锌(53.4g,817mmol)。加入水(100ml),通过加入冰冷却,通过加入浓氨水(大约400ml)碱化,用二氯甲烷(2X300ml)萃取混合物。产量44.5g(61%)。
内-3-苯甲酰氧基-8-氮杂-双环[3.2.1]辛烷-8-甲酸叔丁基酯
在室温下,经0.5h将溶于THF(100ml)中的二叔丁基-二碳酸酯(39.9g,183mmol)加入搅拌的内-苯甲酸8-氮杂-双环[3.2.1]辛-3-基酯(44.5g,166.4mmol)、三乙胺(67.4g,666mmol)和THF(250ml)的混合物中,然后搅拌1h。加入水(1L),用二乙醚(2x300ml)萃取混合物。用水(2x200ml)洗涤收集的醚相2次,干燥并蒸发。产量60.1g(100%)。
内-3-羟基-8-氮杂-双环[3.2.1]辛烷-8-甲酸叔丁基酯
在室温下搅拌内-3-苯甲酰氧基-8-氮杂-双环[3.2.1]辛烷-8-甲酸叔丁基酯(55.0g,166mmol)、氢氧化钾(11.2g 199mmol)和乙醇(99%,400ml)的混合物3天。通过过滤分离苯甲酸钾,蒸发滤液。加入二乙醚(200ml),过滤分离剩余的苯甲酸钾,蒸发滤液。用石油醚研磨产物。产量30.0g(80%)。熔点139.5-140.8℃。
方法1
外-7-(8-叔丁氧羰基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯
-2-酮
将三苯基膦(7.5g,28.6mmol)溶于二噁烷(70ml),冷却至8℃。将二乙基氮杂二甲酸酯(5.0g,28.6mmol)加入在15℃以下的混合物,随后搅拌15分钟。将内-3-羟基-8-氮杂-双环[3.2.1]辛烷-8-甲酸叔丁基酯(5.0g,22.0mmol)和7-羟基香豆素(4.3g,26.4mmol)加入混合物。由于放热反应,温度升高。在室温搅拌混合物15h。加入水(200ml),随后用二乙醚(2x100ml)萃取。干燥混合物并蒸发。在硅胶上进行色谱,使用二氯甲烷和5%甲醇作为溶剂。将粗产物溶于二乙醚(200ml),用氢氧化钠水溶液(3x200ml,1M)洗涤。干燥产物并蒸发。产量5.32g(65%)。
外-3-(3-氰基-2-氧代-2H-色烯-7-基氧基)-8-氮杂-双环[3.2.1]
辛烷-8-甲酸叔丁基酯(中间体)
根据方法1,从7-羟基-2-氧代-2H-色烯-3-腈和内-3-羟基-8-氮杂-双环[3.2.1]辛烷-8-甲酸叔丁基酯制备。
方法2A
外-7-(8-H-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮盐酸盐
将外-7-(8-叔丁氧基羰基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮(0.60g,1.6mmol)和盐酸(10ml,1M)在乙酸(10ml)中的混合物搅拌1h。加入二乙醚(50ml),过滤沉淀,用二乙醚(10ml)洗涤。产量0.28g(57%)。熔点>300℃。
方法2B
外-3-溴代-7-(8-甲基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯
-2-酮盐酸盐
在室温下将外-7-[(8-叔丁氧羰基-8-氮杂-双环[3.2.1]辛-3-基)氧基]-3-溴-色烯-2-酮(30g,65.3mmol)和氢氯酸在乙酸(500ml,1M)中的混合物搅拌3h。加入二乙醚(50ml),搅拌沉淀,过滤分离。产量25g(99%)。[M+H]+的LC-ESI-HRMS显示350.0405Da。计算值350.039182Da,dev.3.8ppm。
外-7-(8-氮杂-双环[3.2.1]辛-3-基氧基)-2-氧代-2H-色烯-3-
腈盐酸盐
根据方法2B,从外-3-(3-氰基-2-氧代-2H-色烯-7-基氧基)-8-氮杂-双环[3.2.1]辛烷-8-甲酸叔丁基酯制备。[M+H]+的LC-ESI-HRMS显示297.1238Da。计算值297.123918Da,dev.-0.4ppm。
外-6-(8-氮杂-双环[3.2.1]辛-3-基氧基)-3-溴-色烯-2-酮盐酸
盐
根据方法2B,从外-3-(3-溴-2-氧代-2H-色烯-6-基氧基)-8-氮杂-双环[3.2.1]辛烷-8-甲酸叔丁基酯制备。[M+H]+的LC-ESI-HRMS显示350.0379Da。计算值350.039182Da,dev.-3.7ppm。
外-7-(8-氮杂-双环[3.2.1]辛-3-基氧基)-3-氯-色烯-2-酮盐酸
盐
根据方法2B,从外-3-(3-氯-2-氧代-2H-色烯-7-基氧基)-8-氮杂-双环[3.2.1]辛烷-8-甲酸叔丁基酯制备。[M+H]+的LC-ESI-HRMS显示306.0894Da。计算值306.089697Da,dev.-1ppm。
外-7-(8-氮杂-双环[3.2.1]辛-3-基氧基)-4-甲基-2-氧代-2H-
色烯-3-腈盐酸盐
根据方法2B,从外-3-(3-氰基-4-甲基-2-氧代-2H-色烯-7-基氧基)-8-氮杂-双环[3.2.1]辛烷-8-甲酸叔丁基酯制备。[M+H]+的LC-ESI-HRMS显示311.1401Da。计算值311.139568Da,dev.1.7ppm。
方法3
外-7-(8-乙基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮盐
酸盐
在60℃下搅拌外-7-(8-H-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮(3.1g,10.1mmol)、氢化钠、60%矿物油(0.29g 12.1mmol)、碘乙烷(2.46g,15.8mmol)和四氢呋喃(75ml)的混合物3h。通过加入乙醇(75ml)和浓盐酸(1ml)沉淀盐酸化物。从乙醇(100ml,96%)重结晶结晶性产物。产量1.71g(51%)。[M+H]+的LC-ESI-HRMS显示300.1596Da。计算值300.159969Da,dev.-1.2ppm。
外-7-(8-异丙基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮
盐酸盐
根据方法1A,从外-7-(8-H-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮制备。[M+H]+的LC-ESI-HRMS显示314.1746Da。计算值314.175619Da,dev.-3.2ppm。
外-7-[8-(2-甲氧基-乙基)-8-氮杂-双环[3.2.1]辛-3-基氧基]-
色烯-2-酮盐酸盐
根据方法1A,从外-7-(8-H-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮制备。[M+H]+的LC-ESI-HRMS显示330.1691Da。计算值330.170534Da,dev.-4.3ppm。
外-7-(8-烯丙基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮
盐酸盐
根据方法1A,从外-7-(8-H-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮制备。[M+H]+的LC-ESI-HRMS显示312.1584Da。计算值312.159969Da,dev.-5ppm。
方法4A
外-7-(8-氮杂-双环[3.2.1]辛-6-烯-3-基)氧基)-色烯-2-酮盐酸
盐
将2,2,2-三氯乙基氯甲酸酯(3.7g,17.6mmol)加入外-7-(8-甲基-8-氮杂-双环[3.2.1]辛-6-烯-3-基氧基)-色烯-2-酮(1.0g,3.5mmol)和甲苯(20ml)的混合物。在室温搅拌混合物30min,随后在100℃搅拌15h。加入水(10ml),分离有机相,用水(2x25ml)洗涤。将蒸发得到的粗混合物溶于乙酸(10ml)和水(10ml)。将锌粉(2.3g,35.3mmol)分份加入混合物,随后搅拌5h。加入冰-水(20ml),随后加入浓氨水(20ml)。用二氯甲烷(2x20ml)萃取混合物。通过将溶于乙醇中的盐酸加入溶于二乙醚的游离碱沉淀盐酸盐。产量70mg(5%)。熔点>280℃(dec.)。[M+H]+的LC-ESI-HRMS显示270.1117Da。计算值270.113019Da,dev.-4.9ppm。
方法4B
外-7-(8-甲基-8-氮杂-双环[3.2.1]辛-6-烯-3-基氧基)-色烯
-2-酮盐酸盐
在室温下将二乙基氮杂二甲酸酯(10.5g,60.3mmol)于二噁烷(100ml)中的混合物加入溶于二噁烷(80ml)的三苯基膦(15.8g,60.3mmol)。将混合物搅拌15min。将溶于二噁烷(30ml)中的内-8-甲基-8-氮杂-双环[3.2.1]辛-6-烯-3-醇(7.0g,50.3mmol)加入在15℃的混合物,随后加入7-羟基香豆素(9.0g,55.3mmol)。由于放热反应,温度升至30℃。在室温搅拌混合物过夜,随后回流4h。加入水(200ml)和盐酸水溶液(15ml,4M),用二乙醚(3x50ml)洗涤。通过加入氢氧化钠(50ml,4M)碱化水相,随后用二乙醚(3x100ml)萃取。产量1.2g(8%)。通过加入溶于乙醇中的盐酸混合物,制备盐酸盐。熔点>275℃。[M+H]+的LC-ESI-HRMS显示284.1275Da。计算值284.128669Da,dev.-4.1ppm。
方法4C
内-8-甲基-8-氮杂-双环[3.2.1]辛-6-烯-3-醇(中间体)
将锌粉(10g)和盐酸(10ml,1M)的混合物搅拌1分钟,用盐酸(3x10ml,1M)和水(5x10ml)洗涤,随后用硫酸铜水溶液(25ml,2%)、水(5x10ml)、乙醇(10ml,96%)和二乙醚(10ml)洗涤,然后干燥。从氢溴酸东莨菪碱三水合物和锌粉制备标题化合物,随后根据Tetrahedron Letters 42(2001),p 1975,通过用氢氧化钠水溶液处理进行水解。
方法5
外-7-[(8-叔丁氧羰基-8-氮杂-双环[3.2.1]辛-3-基)氧基]-3-溴
-色烯-2-酮(中间体)
将溴(1.38ml,27.0mmol)加入外-7-(8-叔丁氧羰基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮(7.8g,21.0mmol)、乙酸(150ml)和乙酸钠(5.2g,63.0mmol)的混合物。在室温搅拌混合物90min。加入水(100ml)。过滤沉淀,用水(10ml)、甲醇(5ml)和二乙醚(20ml)洗涤。产量7.5g(79%)。
外-3-(3-氯代-2-氧代-2H-色烯-7-基氧基)-8-氮杂-双环[3.2.1]
辛烷-8-甲酸叔丁基(中间体)
根据方法5,从溶于乙酸中的外-7-(8-叔丁氧羰基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮和氯(替代溴)制备。
外-3-(3-溴代-2-氧代-2H-色烯-6-基氧基)-8-氮杂-双环[3.2.1]
辛烷-8-甲酸叔丁基酯(中间体)
根据方法5,从3-(2-氧代-2H-色烯-6-基氧基)-8-氮杂-双环[3.2.1]辛烷-8-甲酸叔丁基酯制备。
外-3-溴代-7-(8-甲基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯
-2-酮游离碱
根据方法5,从外-7-(8-甲基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮制备。[M+H]+的LC-ESI-HRMS显示364.0547Da。计算值364.054832Da,dev.-0.4ppm。
外-3-氯代-7-(8-甲基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯
-2-酮盐酸盐
根据方法5,从溶于乙酸中的外-7-(8-甲基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮和氯(替代溴)制备。[M+H]+的LC-ESI-HRMS显示320.1068Da。计算值320.105347Da,dev.4.5ppm。
实验实施例
体外抑制活性
如WO 97/16451所述,测试了许多化合物的抑制突触小体中单胺神经递质多巴胺(DA)、去甲肾上腺素(NA)和5-羟色胺(5-HT)的再摄取的能力。
将实验值以IC50(将3H-DA,3H-NA,或3H-5-HT的特异性结合抑制50%的实验物质的浓度(μM))给出。
从下表可见通过测试选择的本发明化合物得到的实验结果:
表1
受试化合物 | DA-摄取IC50(μM) | NA-摄取IC50(μM) | 5-HT-摄取IC50(μM) |
方法2B的第一个化合物:外-3-溴代-7-(8-甲基-8-氮杂-双环-[3.2.1]辛-3-基氧基)-色烯-2-酮 | 0.044 | 0.017 | 0.0012 |
方法2B的倒数第二个化合物:外-7-(8-氮杂-双环[3.2.1]辛-3-基氧基)-3-氯-色烯-2-酮 | 0.054 | 0.014 | 0.00059 |
方法4B的第一个化合物:外-7-(8-甲基-8-氮杂-双环[3.2.1]辛-6-烯-3-基氧基)-色烯-2-酮 | 0.70 | 0.72 | 0.036 |
Claims (12)
2.权利要求1的化合物,其中
R2和R3一起形成-(CH2)-(CH2)-;且
R1如在权利要求1中所定义。
3.权利要求2的化合物,其中
R1表示烷基,链烯基或烷氧基烷基。
4.权利要求1的化合物,其中
R2和R3一起形成-(CH)=(CH)-;且
R1如在权利要求1中所定义。
5.权利要求4的化合物,其中
R1表示氢或烷基。
6.权利要求1-5中任一项的化合物,其中
Q表示色烯-2-酮-基;该色烯-2-酮-基在3-位被选自下列的取代基取代:
卤素,三氟甲基,三氟甲氧基,氰基,羟基,氨基,硝基,烷氧基,环烷氧基,烷基,环烷基,环烷基烷基,链烯基和炔基。
7.权利要求1的化合物,它是
外-3-溴代-7-(8-甲基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮;
外-7-(8-氮杂-双环[3.2.1]辛-3-基氧基)-2-氧代-2H-色烯-3-腈;
外-6-(8-氮杂-双环[3.2.1]辛-3-基氧基)-3-溴-色烯-2-酮;
外-7-(8-氮杂-双环[3.2.1]辛-3-基氧基)-3-氯-色烯-2-酮;
外-7-(8-氮杂-双环[3.2.1]辛-3-基氧基)-4-甲基-2-氧代-2H-色烯-3-腈;
外-7-(8-乙基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮;
外-7-(8-异丙基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮;
外-7-[8-(2-甲氧基-乙基)-8-氮杂-双环[3.2.1]辛-3-基氧基]-色烯-2-酮;
外-7-(8-烯丙基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮;
外-7-(8-氮杂-双环[3.2.1]辛-6-烯-3-基)氧基)-色烯-2-酮;
外-7-(8-甲基-8-氮杂-双环[3.2.1]辛-6-烯-3-基氧基)-色烯-2-酮;
外-3-溴代-7-(8-甲基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮;
外-3-氯代-7-(8-甲基-8-氮杂-双环[3.2.1]辛-3-基氧基)-色烯-2-酮;
或其药学上可接受的盐。
8.药物组合物,其包含治疗有效量的权利要求1-7任一项所述的化合物,其任何异构体或其异构体的任何混合物,或其药学上可接受的盐,以及至少一种药学上可接受的载体、赋形剂或稀释剂。
9.权利要求1-7任一项所述的化合物,其任何异构体或其异构体的任何混合物,或其药学上可接受的盐用于制备药物的用途。
10.权利要求9的用途,用于制备治疗、预防或减轻哺乳动物、包括人类的疾病或障碍或病症的药物组合物,所述疾病、障碍或病症对于中枢神经系统中单胺神经递质再摄取的抑制有应答。
11.权利要求10的用途,其中所述的疾病、障碍或病症为情感障碍、抑郁、非典型抑郁、继发于疼痛的抑郁、重度抑郁症、心境恶劣障碍、双相性精神障碍、I型双相性精神障碍、II型双相性精神障碍、循环情感性障碍、由一般医学病症导致的情感障碍、物质诱导的情感障碍、假性痴呆、甘塞氏综合征、强迫观念与行为障碍、恐慌症、无广场恐怖症的恐慌症、有广场恐怖症的恐慌症、无恐慌症病史的广场恐怖症、惊恐发作、记忆缺陷、记忆丧失、注意涣散多动症、肥胖、焦虑、泛化性焦虑症、进食障碍、帕金森氏病、帕金森氏综合征、痴呆、衰老性痴呆、老年性痴呆、阿尔茨海默氏病、获得性免疫缺陷综合征痴呆复征、老化性记忆机能障碍、特定恐惧症、社交焦虑障碍、创伤后应激障碍、急性应激障碍、药物成瘾、药物滥用、可卡因滥用、烟碱滥用、烟草滥用、酒精成瘾、酒精中毒、偷窃狂、疼痛、慢性疼痛、炎性疼痛、神经病性疼痛、偏头痛、紧张型头痛、慢性紧张型头痛、与抑郁有关的疼痛、纤维肌痛、关节炎、骨关节炎、类风湿性关节炎、背部疼痛、癌痛、肠易激性疼痛、肠易激综合征、术后疼痛、乳房切除术后疼痛综合征(PMPS)、中风后疼痛、药物诱导的神经病、糖尿病性神经病、交感神经维持性疼痛、三叉神经痛、牙痛、肌筋膜疼痛、幻肢痛、贪食症、月经前期综合征、月经前焦虑障碍、晚黄体期综合征、创伤后综合征、慢性疲劳综合征、尿失禁、压力性失禁、紧迫性失禁、夜间失禁、性功能障碍、早泄、勃起困难、勃起功能障碍、过早的女性性高潮、多动腿综合征、周期性肢体运动障碍、进食障碍、神经性厌食、睡眠障碍、全身性发育迟缓、孤独症、阿斯波哥尔障碍、雷特障碍、童年瓦解性障碍、学习能力丧失、运动技能障碍、缄默症、拔毛发癖、发作性睡病、中风后抑郁、中风诱导的脑损伤、中风诱导的神经元损伤,吉勒德拉图雷病,耳鸣、抽动障碍、躯体变形性精神障碍、对立违抗性障碍或中风后残疾。
12.治疗、预防或减轻包括人的活的动物体的疾病、障碍或病症的方法,所述疾病、障碍或病症对于中枢神经系统中单胺神经递质再摄取的抑制有应答,该方法包括给予有此需要的该活的动物体治疗有效量的根据权利要求1-7任一项所述的化合物、或其任何异构体或其异构体的任何混合物、或其药学上可接受的盐的步骤。
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