EP1121131A2 - Atypical antipsychotic in combination with acetylcholinesterase inhibitor for improving cognition - Google Patents

Atypical antipsychotic in combination with acetylcholinesterase inhibitor for improving cognition

Info

Publication number
EP1121131A2
EP1121131A2 EP99952580A EP99952580A EP1121131A2 EP 1121131 A2 EP1121131 A2 EP 1121131A2 EP 99952580 A EP99952580 A EP 99952580A EP 99952580 A EP99952580 A EP 99952580A EP 1121131 A2 EP1121131 A2 EP 1121131A2
Authority
EP
European Patent Office
Prior art keywords
atypical antipsychotic
acetylcholinesterase inhibitor
patients suffering
alzheimer
disease
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP99952580A
Other languages
German (de)
French (fr)
Inventor
Paul Leonce Irma De Nijs
Wim Louis Julien Parys
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Janssen Pharmaceutica NV
Original Assignee
Janssen Pharmaceutica NV
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Janssen Pharmaceutica NV filed Critical Janssen Pharmaceutica NV
Priority to EP99952580A priority Critical patent/EP1121131A2/en
Publication of EP1121131A2 publication Critical patent/EP1121131A2/en
Withdrawn legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/55Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00Drugs for disorders of the nervous system
    • A61P25/18Antipsychotics, i.e. neuroleptics; Drugs for mania or schizophrenia
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00Drugs for disorders of the nervous system
    • A61P25/28Drugs for disorders of the nervous system for treating neurodegenerative disorders of the central nervous system, e.g. nootropic agents, cognition enhancers, drugs for treating Alzheimer's disease or other forms of dementia
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

Definitions

  • the present invention is concerned with pharmaceutical compositions comprising a carrier and as first active ingredient an atypical antipsychotic agent (I) and as second active ingredient an acetylcholinesterase inhibitor (H), each in an amount producing a therapeutically beneficial effect in patients suffering from psychosis, or Alzheimer's disease or related dementias.
  • Said therapeutically beneficial effect can be a synergistic effect on the cognitive functioning of patients suffering from Alzheimer's disease or related dementias, or the prevention of the further deterioration of cognition in said patients, or the reduction of adverse effects associated with the one of the active ingredients by the other of the active ingredients.
  • an atypical antipsychotic agent (I) for the preparation of a medicament for reducing adverse effects associated with acetylcholinesterase inhibitors (LI) in patients suffering from Alzheimer's disease or related dementias, such as nausea, vomiting, sweating, restlessness and insomnia.
  • an atypical antipsychotic agent (I) for the preparation of a medicament for improving sleep in patients suffering from Alzheimer's disease or related dementias while being treated with acetylcholinesterase inhibitors (II).
  • the present invention is concerned with a pharmaceutical composition
  • a pharmaceutical composition comprising a carrier and as first active ingredient an atypical antipsychotic agent (I) and as second active ingredient an acetylcholinesterase inhibitor (II), each in an amount producing a therapeutically beneficial effect in patients suffering from psychosis, or Alzheimer's disease or related dementias.
  • Said therapeutically beneficial effect can be a synergistic effect on the cognitive functioning of patients suffering from Alzheimer's disease or related dementias, or the prevention of the further deterioration of cognition in said patients, or the reduction of adverse effects associated with the one of the active ingredients by the other of the active ingredients.
  • the atypical antipsychotic (I) is selected from risperidone, 9-hydroxyrisperidone or a o- 20 alkanoic acid ester thereof, olanzapine, quetiapine, iloperidone or ziprasidone, and the acetylcholinesterase inhibitor (II) is selected from galantamine, rivastigmine or donepezil, or therapeutically active acid addition salt form of any of the foregoing.
  • Said salts comprise salt forms which the active ingredients (I) and (H) are able to form with appropriate acids, such as, for example, inorganic acids such as hydrohalic acids, e.g.
  • hydrochloric or hydrobromic acid sulfuric; nitric; phosphoric and the like acids; or organic acids such as, for example, acetic, propanoic, hydroxyacetic, lactic, pyruvic, oxalic, malonic, succinic, maleic, fumaric, malic, tartaric, citric, methanesulfonic, ethanesulfonic, benzenesulfonic, -toluenesulfonic, cyclamic, salicylic, p-amino- salicylic, pamoic and the like acids.
  • galantamine may conveniently be used as the ( 1 : 1 ) hydrobromide salt.
  • a lkanoic acids are selected from the group consisting of decanoic (capric), undecanoic, dodecanoic (lauric), tridecanoic, tetradecanoic (myristic), pentadecanoic, hexadecanoic (palmitic), heptadecanoic, octadecanoic (stearic), nonadecanoic and eicosanoic acid. Due to their limited aqueous solubility, it was generally believed that the esters had to be suspended into oils.
  • the ester having a C15 (pentadecyl) chain and the active ingredient corresponding thereto being the 9-hydroxyrisperidone palmitate ester was found to be the superior ester from a pharmacokinetic, as well as from a tolerance point of view.
  • the amount of each of the active ingredients is equal to or less than that which is approved in monotherapy with said active ingredient.
  • compositions wherein the atypical antipsychotic (I) is risperidone and the acetylcholinesterase inhibitor (II) is galantamine, in particular as galantamine hydrobromide are particularly preferred.
  • the amount of risperidone is 0.5, 1, 2, 4, or 6 mg and that of galantamine (as base) is 8, 16, 24 or 32 mg per dosage form.
  • the present invention also relates to products containing as first active ingredient an atypical antipsychotic agent (I) and as second active ingredient an acetylcholinesterase inhibitor (II), as combined preparations for simultaneous, separate or sequential use in the treatment of patients suffering from psychosis, Alzheimer's disease or related dementias.
  • an atypical antipsychotic agent I
  • an acetylcholinesterase inhibitor II
  • the present invention also concerns the use of an acetylcholinesterase inhibitor (II) for the preparation of a medicament for enhancing the effect of an atypical antipsychotic agent (I) on cognition in patients suffering from psychosis.
  • II acetylcholinesterase inhibitor
  • the present invention also concerns the use of an atypical antipsychotic agent (I) for the preparation of a medicament for enhancing the effect of an acetylcholinesterase inhibitor (II) on cognition in patients suffering from Alzheimer's disease or related dementias. Additionally, the present invention concerns the use of an atypical antipsychotic agent
  • acetylcholinesterase inhibitors H
  • Said adverse effect can be nausea, vomiting, sweating, restlessness or insomnia.
  • an atypical antipsychotic agent (I) for the preparation of a medicament for improving sleep in patients suffering from Alzheimer's disease or related dementias while being treated with acetylcholinesterase inhibitors (II).
  • the present invention also concerns the use of an acetylcholinesterase inhibitor
  • the atypical antipsychotic (I) is preferably risperidone and the acetylcholinesterase inhibitor (II) is preferably galantamine, in particular the (1:1) hydrobromide.

Landscapes

  • Health & Medical Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Chemical & Material Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Medicinal Chemistry (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Public Health (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Neurology (AREA)
  • Neurosurgery (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • General Chemical & Material Sciences (AREA)
  • Organic Chemistry (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Epidemiology (AREA)
  • Psychiatry (AREA)
  • Hospice & Palliative Care (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
  • Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
  • Medicines Containing Plant Substances (AREA)

Abstract

The present invention is concerned with pharmaceutical compositions comprising a carrier and as first active ingredient an atypical antipsychotic agent (I) and as second active ingredient an acetylcholinesterase inhibitor (II), each in an amount producing a therapeutically beneficial effect in patients suffering from psychosis, or Alzheimer's disease or related dementias. Said therapeutically beneficial effect can be a synergistic effect on the cognitive functioning of patients suffering from Alzheimer's disease or related dementias or the prevention of the further deterioration of cognition in said patients, or the reduction of adverse effects associated with the one of the active ingredients by the other of the active ingredients.

Description

THERAPY FOR IMPROVING COGNITION
The present invention is concerned with pharmaceutical compositions comprising a carrier and as first active ingredient an atypical antipsychotic agent (I) and as second active ingredient an acetylcholinesterase inhibitor (H), each in an amount producing a therapeutically beneficial effect in patients suffering from psychosis, or Alzheimer's disease or related dementias. Said therapeutically beneficial effect can be a synergistic effect on the cognitive functioning of patients suffering from Alzheimer's disease or related dementias, or the prevention of the further deterioration of cognition in said patients, or the reduction of adverse effects associated with the one of the active ingredients by the other of the active ingredients.
Of particular interest is the use of an atypical antipsychotic agent (I) for the preparation of a medicament for reducing adverse effects associated with acetylcholinesterase inhibitors (LI) in patients suffering from Alzheimer's disease or related dementias, such as nausea, vomiting, sweating, restlessness and insomnia. Especially interesting is the use of an atypical antipsychotic agent (I) for the preparation of a medicament for improving sleep in patients suffering from Alzheimer's disease or related dementias while being treated with acetylcholinesterase inhibitors (II).
The present invention is concerned with a pharmaceutical composition comprising a carrier and as first active ingredient an atypical antipsychotic agent (I) and as second active ingredient an acetylcholinesterase inhibitor (II), each in an amount producing a therapeutically beneficial effect in patients suffering from psychosis, or Alzheimer's disease or related dementias. Said therapeutically beneficial effect can be a synergistic effect on the cognitive functioning of patients suffering from Alzheimer's disease or related dementias, or the prevention of the further deterioration of cognition in said patients, or the reduction of adverse effects associated with the one of the active ingredients by the other of the active ingredients.
The atypical antipsychotic (I) is selected from risperidone, 9-hydroxyrisperidone or a o-20 alkanoic acid ester thereof, olanzapine, quetiapine, iloperidone or ziprasidone, and the acetylcholinesterase inhibitor (II) is selected from galantamine, rivastigmine or donepezil, or therapeutically active acid addition salt form of any of the foregoing. Said salts comprise salt forms which the active ingredients (I) and (H) are able to form with appropriate acids, such as, for example, inorganic acids such as hydrohalic acids, e.g. hydrochloric or hydrobromic acid; sulfuric; nitric; phosphoric and the like acids; or organic acids such as, for example, acetic, propanoic, hydroxyacetic, lactic, pyruvic, oxalic, malonic, succinic, maleic, fumaric, malic, tartaric, citric, methanesulfonic, ethanesulfonic, benzenesulfonic, -toluenesulfonic, cyclamic, salicylic, p-amino- salicylic, pamoic and the like acids. For example, galantamine may conveniently be used as the ( 1 : 1 ) hydrobromide salt.
Cl0-20alkanoic acids are selected from the group consisting of decanoic (capric), undecanoic, dodecanoic (lauric), tridecanoic, tetradecanoic (myristic), pentadecanoic, hexadecanoic (palmitic), heptadecanoic, octadecanoic (stearic), nonadecanoic and eicosanoic acid. Due to their limited aqueous solubility, it was generally believed that the esters had to be suspended into oils. The ester having a C15 (pentadecyl) chain and the active ingredient corresponding thereto being the 9-hydroxyrisperidone palmitate ester was found to be the superior ester from a pharmacokinetic, as well as from a tolerance point of view.
Preferably, the amount of each of the active ingredients is equal to or less than that which is approved in monotherapy with said active ingredient.
Most preferred are compositions wherein the atypical antipsychotic (I) is risperidone and the acetylcholinesterase inhibitor (II) is galantamine, in particular as galantamine hydrobromide. In said compositions, the amount of risperidone is 0.5, 1, 2, 4, or 6 mg and that of galantamine (as base) is 8, 16, 24 or 32 mg per dosage form.
The present invention also relates to products containing as first active ingredient an atypical antipsychotic agent (I) and as second active ingredient an acetylcholinesterase inhibitor (II), as combined preparations for simultaneous, separate or sequential use in the treatment of patients suffering from psychosis, Alzheimer's disease or related dementias.
The present invention also concerns the use of an acetylcholinesterase inhibitor (II) for the preparation of a medicament for enhancing the effect of an atypical antipsychotic agent (I) on cognition in patients suffering from psychosis.
Conversely, the present invention also concerns the use of an atypical antipsychotic agent (I) for the preparation of a medicament for enhancing the effect of an acetylcholinesterase inhibitor (II) on cognition in patients suffering from Alzheimer's disease or related dementias. Additionally, the present invention concerns the use of an atypical antipsychotic agent
(I) for the preparation of a medicament for reducing adverse effects associated with acetylcholinesterase inhibitors (H) in patients suffering from Alzheimer's disease or related dementias. Said adverse effect can be nausea, vomiting, sweating, restlessness or insomnia. Especially interesting is the use of an atypical antipsychotic agent (I) for the preparation of a medicament for improving sleep in patients suffering from Alzheimer's disease or related dementias while being treated with acetylcholinesterase inhibitors (II).
Finally, the present invention also concerns the use of an acetylcholinesterase inhibitor
(II) for the preparation of a medicament for reducing adverse effects associated with atypical antipsychotic agents (I) in patients suffering from psychoses. Said the adverse effect can be extrapyramidal syndrome or tardive dyskinesia.
In all the preceding uses the atypical antipsychotic (I) is preferably risperidone and the acetylcholinesterase inhibitor (II) is preferably galantamine, in particular the (1:1) hydrobromide.

Claims

Claims
1. A pharmaceutical composition comprising a carrier and as first active ingredient an atypical antipsychotic agent (I) and as second active ingredient an acetylcholinesterase inhibitor (II), each in an amount producing a therapeutically beneficial effect in patients suffering from psychosis, Alzheimer's disease or related dementias.
2. A composition according to claim 1 wherein said therapeutically beneficial effect is a synergistic effect on the cognitive functioning of patients suffering from
Alzheimer's disease or related dementias, or the prevention of the further deterioration of cognition in said patients, or the reduction of adverse effects associated with the one of the active ingredients by the other of the active ingredients.
3. A composition according to claim 1 wherein the atypical antipsychotic (I) is selected from risperidone, 9-hydroxyrisperidone or a C10-2o alkanoic acid ester thereof, olanzapine, quetiapine, iloperidone or ziprasidone, and the acetylcholinesterase inhibitor (II) is selected from galantamine, rivastigmine or donepezil.
4. A composition according to claim 3 wherein the amount of each of the active ingredients is equal to or less than that which is approved in monotherapy with said active ingredient.
5. A composition according to claim 3 wherein the atypical antipsychotic (I) is risperidone and the acetylcholinesterase inhibitor (II) is galantamine.
6. A composition according to claim 5 wherein the amount of risperidone is 0.5, 1, 2, 4, or 6 mg and that of galantamine (as base) is 8, 16, 24 or 32 mg per dosage form.
7. A product containing as first active ingredient an atypical antipsychotic agent (I) and as second active ingredient an acetylcholinesterase inhibitor (II), as a combined preparation for simultaneous, separate or sequential use in the treatment of patients suffering from psychosis, Alzheimer's disease or related dementias.
8. The use of an acetylcholinesterase inhibitor (II) for the preparation of a medicament for enhancing the effect of an atypical antipsychotic agent (I) on cognition in patients suffering from psychosis.
9. The use of an atypical antipsychotic agent (I) for the preparation of a medicament for enhancing the effect of an acetylcholinesterase inhibitor (LI) on cognition in patients suffering from Alzheimer's disease or related dementias.
10. The use of an atypical antipsychotic agent (I) for the preparation of a medicament for reducing adverse effects associated with acetylcholinesterase inhibitors (II) in patients suffering from Alzheimer's disease or related dementias.
11. Use according to claim 10 wherein the adverse effect is nausea, vomiting, sweating, restlessness or insomnia.
12. The use of an acetylcholinesterase inhibitor (II) for the preparation of a medicament for reducing adverse effects associated with atypical antipsychotic agents (I) in patients suffering from psychoses.
13. Use according to claim 12 wherein the adverse effect is extrapyramidal syndrome or tardive dyskinesia.
14. Use according to any one of claims 8 to 13 wherein the atypical antipsychotic (I) is risperidone and the acetylcholinesterase inhibitor (LI) is galantamine.
EP99952580A 1998-10-16 1999-10-12 Atypical antipsychotic in combination with acetylcholinesterase inhibitor for improving cognition Withdrawn EP1121131A2 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP99952580A EP1121131A2 (en) 1998-10-16 1999-10-12 Atypical antipsychotic in combination with acetylcholinesterase inhibitor for improving cognition

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
EP98203454 1998-10-16
EP98203454 1998-10-16
PCT/EP1999/007804 WO2000023057A2 (en) 1998-10-16 1999-10-12 Atypical antiphsychotic in combination with acetylcholinesterase inhibitor for improving cognition
EP99952580A EP1121131A2 (en) 1998-10-16 1999-10-12 Atypical antipsychotic in combination with acetylcholinesterase inhibitor for improving cognition

Publications (1)

Publication Number Publication Date
EP1121131A2 true EP1121131A2 (en) 2001-08-08

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ID=8234219

Family Applications (1)

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EP99952580A Withdrawn EP1121131A2 (en) 1998-10-16 1999-10-12 Atypical antipsychotic in combination with acetylcholinesterase inhibitor for improving cognition

Country Status (20)

Country Link
EP (1) EP1121131A2 (en)
JP (1) JP2002527469A (en)
KR (1) KR20010072878A (en)
CN (1) CN1367697A (en)
AU (1) AU6472799A (en)
BG (1) BG105302A (en)
BR (1) BR9914419A (en)
CA (1) CA2345767A1 (en)
EE (1) EE200100136A (en)
HK (1) HK1039745A1 (en)
HR (1) HRP20010262A2 (en)
HU (1) HUP0103781A3 (en)
ID (1) ID28441A (en)
IL (1) IL142588A0 (en)
NO (1) NO20011403L (en)
PL (1) PL348107A1 (en)
SK (1) SK4592001A3 (en)
TR (1) TR200101082T2 (en)
WO (1) WO2000023057A2 (en)
ZA (1) ZA200103081B (en)

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GB0102841D0 (en) * 2001-02-05 2001-03-21 Novartis Ag Organic compounds
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GB0216416D0 (en) 2002-07-15 2002-08-21 Novartis Ag Organic compounds
WO2004084905A2 (en) * 2003-03-24 2004-10-07 University Of Florida Use of 5-ht2c receptor activity affecting compounds for treating idiopathic hyperhidrosis and associated conditions
TW200501962A (en) * 2003-04-01 2005-01-16 Novartis Ag Use of carbamazepine derivatives for the treatment of agitation in dementia patients
CA2552221A1 (en) * 2003-12-31 2005-07-21 Actavis Group Hf Donepezil formulations
AU2004325725A1 (en) * 2004-12-10 2006-06-22 Abbott Laboratories Fused bicycloheterocycle substituted quinuclidine derivatives
WO2008055945A1 (en) 2006-11-09 2008-05-15 Probiodrug Ag 3-hydr0xy-1,5-dihydr0-pyrr0l-2-one derivatives as inhibitors of glutaminyl cyclase for the treatment of ulcer, cancer and other diseases
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EP2481408A3 (en) 2007-03-01 2013-01-09 Probiodrug AG New use of glutaminyl cyclase inhibitors
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US20110212928A1 (en) 2010-02-09 2011-09-01 The Johns Hopkins University Methods and compositions for improving cognitive function
ES2586231T3 (en) 2010-03-03 2016-10-13 Probiodrug Ag Glutaminyl cyclase inhibitors
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Also Published As

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HUP0103781A2 (en) 2002-03-28
ZA200103081B (en) 2002-07-12
WO2000023057A2 (en) 2000-04-27
ID28441A (en) 2001-05-24
PL348107A1 (en) 2002-05-06
KR20010072878A (en) 2001-07-31
CN1367697A (en) 2002-09-04
AU6472799A (en) 2000-05-08
IL142588A0 (en) 2002-03-10
NO20011403D0 (en) 2001-03-20
SK4592001A3 (en) 2001-12-03
JP2002527469A (en) 2002-08-27
BR9914419A (en) 2001-06-26
CA2345767A1 (en) 2000-04-27
WO2000023057A3 (en) 2000-07-27
NO20011403L (en) 2001-03-20
HRP20010262A2 (en) 2002-06-30
HK1039745A1 (en) 2002-05-10
BG105302A (en) 2001-11-30
TR200101082T2 (en) 2001-09-21
HUP0103781A3 (en) 2003-09-29
EE200100136A (en) 2002-06-17

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