EP4333979A1 - Procédé de titrage de doses d'agents psychédéliques - Google Patents

Procédé de titrage de doses d'agents psychédéliques

Info

Publication number
EP4333979A1
EP4333979A1 EP22799340.9A EP22799340A EP4333979A1 EP 4333979 A1 EP4333979 A1 EP 4333979A1 EP 22799340 A EP22799340 A EP 22799340A EP 4333979 A1 EP4333979 A1 EP 4333979A1
Authority
EP
European Patent Office
Prior art keywords
dose
administering
psychedelic
individual
time
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.)
Pending
Application number
EP22799340.9A
Other languages
German (de)
English (en)
Inventor
Robert Barrow
Daniel R. Karlin
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.)
Mind Medicine Inc
Original Assignee
Mind Medicine Inc
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 Mind Medicine Inc filed Critical Mind Medicine Inc
Publication of EP4333979A1 publication Critical patent/EP4333979A1/fr
Pending legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/13—Amines
    • A61K31/135—Amines having aromatic rings, e.g. ketamine, nortriptyline
    • A61K31/137—Arylalkylamines, e.g. amphetamine, epinephrine, salbutamol, ephedrine or methadone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
    • A61K31/403—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil condensed with carbocyclic rings, e.g. carbazole
    • A61K31/404—Indoles, e.g. pindolol
    • A61K31/4045—Indole-alkylamines; Amides thereof, e.g. serotonin, melatonin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/47—Quinolines; Isoquinolines
    • A61K31/48—Ergoline derivatives, e.g. lysergic acid, ergotamine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/66—Phosphorus compounds
    • A61K31/675—Phosphorus compounds having nitrogen as a ring hetero atom, e.g. pyridoxal phosphate

Definitions

  • the present invention relates to compositions and methods for dosing psychedelics.
  • Psychedelics including lysergic acid diethylamide are substances capable of inducing unique subjective effects including alterations of consciousness, positive emotions, enhanced introspection, changes in the perception of the environment, the body, and the self as well as synesthesia, mystical-type experiences, and experiences of ego dissolution (Carhart-Harris et al., 2016b; Dolder et al., 2016; Holze et al., 2021 ; Liechti, 2017; Passie et al., 2008; Schmid et al., 2015).
  • All serotonergic psychedelics including LSD, psilocybin, DMT, and mescaline are nonspecific serotonin agonists including agonist activity at the serotonin 5-HT2A receptor (Rickli et al., 2016) and may therefore produce overall largely similar effects. Additionally, psychedelic substances produce their acute effects in humans via activation of the serotonin 5- HT2A receptor as specifically shown in clinical studies for LSD (Holze et al., 2021 ; Preller et al., 2017). LSD and other hallucinogens are partial agonists of the serotonin 5-HT2A receptor (Lopez-Gimenez, et al.
  • Acute effects of psychedelics that may contribute to their therapeutic benefits include enhancing the therapeutic relationship by increased openness, trust, feelings of connectedness or emulsion with people, insight in psychological problems and stimulation of neuroregenerative processes as described in detail elsewhere (Vollenweider & Preller, 2020).
  • Psychedelic administration especially at doses believed to be therapeutic, has a side effect of hallucinations or perceptual disturbances (Ungerleider, J. THOMAS. "The acute side effects from LSD.” The problems and prospects of LSD (1968): 61 -68), (Nichols, Psychedelics, Pharmacol Rev 68:264-355).
  • titration is a method that limits potential side effects by taking time to see how one’s body reacts to a drug, wherein medication is started at a low dose and then the dose is raised every couple of weeks until the maximum effective dose (target dose) has been achieved or side effects occur.
  • Caffrey, et al. (Ther Adv Drug Saf. 2021 Jan 19; 11 : 2042098620958910) describes that titration is commonly used for drugs with a narrow therapeutic index to provide treatment at the lowest dose possible while minimizing medication use and side effects. It is a patient-centered approach to provide individualized therapy. Titration has been used for antibiotics, anticoagulants, anticonvulsants, antidepressants, antidiabetics, antipsychotics, opioids, and stimulants.
  • the present invention provides for a method of dosing a psychedelic that avoids the side effects of hallucinations and perceptual disturbances by administering the psychedelic to an individual in a titrating dosing regimen and reducing side effects of hallucinations and perceptual disturbances.
  • the present invention provides for a kit for administering a titrating dosing regimen of a psychedelic, including a pharmaceutically effective amount of the psychedelic in dosage forms separated in packaging according to dose and time of administration in a titrating dosing regimen, and instructions for use.
  • the present invention also provides for a method of treating an individual with psychedelics, by administering the psychedelic to the individual having a condition or disease in a titrating dosing regimen and reducing side effects of hallucinations and perceptual disturbances during treatment.
  • FIGURE 1 is a graph of dose versus time.
  • the present invention provides for a method of dosing a psychedelic that avoids the side effects of hallucinations and perceptual disturbances by administering the psychedelic to an individual in a titrating dosing regimen and reducing side effects of hallucinations, perceptual disturbances, and other immediately detectable effects of the psychedelic while preserving desired therapeutic benefits.
  • the titrating dosing regimen can include administering a starting dose to the individual, and at a set amount of time, increasing the dose a set amount and administering the increased dose to the individual, and repeating these steps over a period of time that the individual is being treated and until a maximum desired dose is reached.
  • the starting dose can be a sub-perceptual dose (e.g., 10 pg) and taper up over time in a regimen that would never have the hallucinatory side effect but would achieve an effective dose that would be perceptual/hallucinogenic if administered in the absence of the titration regimen (e.g., 30, 50, 100 or 200 pg as the target therapeutic dose).
  • the starting dose can be 10 pg, which is increased by 10 pg every (2, 3, 4, 5, 6 or 7 days).
  • Other starting doses can be within the ranges described below. Other examples of dosing can be found in Buchborn (2016).
  • the time period can be hours, days, weeks, months, or years, or intervals of dose titration with intervals of non-dosing, where each dose titration period can lead to the ability to avoid hallucinations, perceptual, and other detectable effects of the psychedelic, while preserving or enhancing desired therapeutic effects.
  • the starting dose and increased dose levels can be administered once per day, twice per day or three times per day, and can be administered by a care giver, healthcare provider, or self administered by the patient with or without supervision.
  • the dose increase can be any small amount such as 10, 20, 30 or 50 pg, and can be effected and determined by drug and formulation variation, and patient specific factors such as weight, height, body surface area, biochemical assays, metabolic assays, or genomic assays.
  • the dosage form used can be any suitable dosage form such as tablets, capsules, lozenges, transdermal patches, implanted devices, solutions, gels, emulsions, or any solid or liquid form, or some combination of forms, as well as those further described below.
  • the starting dose can also be a larger loading dose administered under medical supervision followed by repeat sub-perceptual doses to maintain the treatment benefit while limiting side effects to only the first dose.
  • the psychedelics in the present invention can be, but are not limited to, lysergic acid diethylamide (LSD), psilocybin, mescaline, 5-methoxy-N,N-dimethyltryptamine (5-MeO- DMT), dimethyltryptamine (DMT), 2,5-dimethoxy-4-iodoamphetamine (DOI), 2,5-dimethoxy-4- bromoamphetamie (DOB), salts thereof, tartrates thereof, analogs thereof, or homologues thereof.
  • the dose of the psychedelic is one that provides a meaningful effect.
  • a dose of 0.01-1 mg (10-1000 pg) can be used of LSD.
  • Psilocybin can be dosed at 5-50 mg
  • mescaline can be dosed at 50-800 mg
  • 5-MeO-DMT can be dosed at 1 -20 mg
  • DMT can be dosed at 20-100 mg
  • DOI can be dosed at 0.1-5 mg
  • DOB can be dosed at 0.1-5 mg.
  • Effects of the psychedelic drug can last 1 -12 hours after administration, and the individual can be supervised by medical personnel such as a psychiatrist during this time. If lower doses are given, medical supervision can be unnecessary.
  • the present invention can carry out its clinical effect by down-regulating (or reducing the expression of) the serotonin 5-HT2A receptor or by another mechanism of action that reduces the hallucinogenic effects of a psychedelic drug over time.
  • the compounds of the present invention are administered and dosed in accordance with good medical practice, considering the clinical condition of the individual patient, the site and method of administration, scheduling of administration, patient age, sex, body weight and other factors known to medical practitioners.
  • the pharmaceutically "effective amount" for purposes herein is thus determined by such considerations as are known in the art. The amount must be effective to achieve improvement including but not limited to improved survival rate or more rapid recovery, or improvement or elimination of symptoms and other indicators as are selected as appropriate measures by those skilled in the art.
  • the compounds of the present invention can be administered in various ways. It should be noted that they can be administered as the compound and can be administered alone or as an active ingredient in combination with pharmaceutically acceptable carriers, diluents, adjuvants, and vehicles.
  • the compounds can be administered orally, transcutaneously, subcutaneously or parenterally including intravenous, intramuscular, and intranasal administration.
  • the patient being treated is a warm blooded animal and, in particular, mammals including man.
  • the pharmaceutically acceptable carriers, diluents, adjuvants, and vehicles as well as implant carriers generally refer to inert, non-toxic solid or liquid fillers, diluents or encapsulating material not reacting with the active ingredients of the invention.
  • the doses can be single doses or multiple doses or a continuous dose over a period of several hours, days, weeks, or months.
  • the compound of the present invention When administering the compound of the present invention parenterally, it will generally be formulated in a sublingual or buccal dissolving tablet, dissolving film, intranasal powder, intranasal solution, inhaled powder, inhaled solution, transdermal patch, transdermal patch (with microneedles or other permeation enhancers) or as a unit dosage injectable form (solution, suspension, emulsion).
  • the pharmaceutical formulations suitable for injection include sterile aqueous solutions or dispersions and sterile powders for reconstitution into sterile injectable solutions or dispersions.
  • the carrier can be a solvent or dispersing medium containing, for example, water, ethanol, polyol (for example, glycerol, propylene glycol, liquid polyethylene glycol, and the like), suitable mixtures thereof, and vegetable oils.
  • Proper fluidity can be maintained, for example, by the use of a coating such as lecithin, by the maintenance of the required particle size in the case of dispersion and by the use of surfactants.
  • Nonaqueous vehicles such as cottonseed oil, sesame oil, olive oil, soybean oil, corn oil, sunflower oil, or peanut oil and esters, such as isopropyl myristate, may also be used as solvent systems for compound compositions.
  • various additives which enhance the stability, sterility, and isotonicity of the compositions including antimicrobial preservatives, antioxidants, chelating agents, and buffers, can be added.
  • antibacterial and antifungal agents for example, parabens, chlorobutanol, phenol, sorbic acid, and the like.
  • isotonic agents for example, sugars, sodium chloride, and the like.
  • Prolonged absorption of the injectable pharmaceutical form can be brought about by the use of agents delaying absorption, for example, aluminum monostearate and gelatin. According to the present invention, however, any vehicle, diluent, or additive used would have to be compatible with the compounds.
  • Sterile injectable solutions can be prepared by incorporating the compounds utilized in practicing the present invention in the required amount of the appropriate solvent with various of the other ingredients, as desired.
  • a pharmacological formulation of the present invention can be administered to the patient in an injectable formulation containing any compatible carrier, such as various vehicle, adjuvants, additives, and diluents; or the compounds utilized in the present invention can be administered parenterally to the patient in the form of slow-release subcutaneous implants or targeted delivery systems such as monoclonal antibodies, vectored delivery, iontophoretic, polymer matrices, liposomes, and microspheres.
  • any compatible carrier such as various vehicle, adjuvants, additives, and diluents
  • the compounds utilized in the present invention can be administered parenterally to the patient in the form of slow-release subcutaneous implants or targeted delivery systems such as monoclonal antibodies, vectored delivery, iontophoretic, polymer matrices, liposomes, and microspheres.
  • the present invention provides for a kit for administering a titrating dosing regimen of a psychedelic, including a pharmaceutically effective amount of the psychedelic in dosage forms separated in packaging according to dose and time of administration in a titrating dosing regimen, and instructions for use.
  • the starting dose and each additional increased dose can be in different colors and/or sizes for an individual to easily distinguish them.
  • the increased dose can be a single dosage form or multiple separate dosage forms (i.e., one dosage form (i.e., tablet, patch, etc.) for each dose increase).
  • the packaging can indicate which time period each dose should be taken in, such as in hours, days, weeks, months, or years.
  • the packaging can be in a bubble/blister pack form, which allows the individual to pop out the exact dose needed for each administration.
  • the present invention also provides for a method of treating an individual with psychedelics, by administering the psychedelic to the individual having a condition or disease in a titrating dosing regimen and reducing side effects of hallucinations and perceptual disturbances during treatment.
  • the condition or disease being treated with the methods of the present invention can include, but is not limited to, anxiety disorders (including anxiety in advanced stage illness e.g. cancer, as well as generalized anxiety disorder), depression (including post partum depression, major depressive disorder and treatment-resistant depression), headache disorder (including cluster headaches and migraine headache), obsessive compulsive disorder (OCD), personality disorders (including conduct disorder), stress disorders (including adjustment disorders and post-traumatic stress disorder), drug disorders (including alcohol dependence, nicotine dependence, opioid dependence, cocaine dependence, methamphetamine dependence), other addictions (including gambling disorder, eating disorder, and body dysmorphic disorder), pain, neurodegenerative disorders (such as dementia, Alzheimer’s Disease, Parkinson’s Disease), movement disorders (such as essential tremor, tardive dyskinesia), autism spectrum disorder, eating disorders, or neurological disorders (such as stroke or traumatic brain injury).
  • anxiety disorders including anxiety in advanced stage illness e.g. cancer, as well as generalized anxiety disorder
  • depression including post partum depression, major depressive disorder and treatment-resistant depression
  • TABLE 1 shows oral administration over different days and for different times of daily administration.
  • the dose levels can translate into 1) a PK threshold and 2) a 5-HT2A expression threshold that can be tailored via other dosing regiments and formulations so that the dosing is done in a way that patients never get PK levels that match the (increasing) threshold for perceptual effects.
  • FIGURE 1 shows how the dose increases over time to a threshold for perceptual effects. Similar effects would be present for PK levels.
  • TABLE 2 shows dosing with an extended release formulation.
  • Precise packaging configurations can be used, such as a dosing kit of multiple patches that can be applied at regular intervals either at home or in a clinic.
  • the kit design i.e., specific way the patches are sized, any differences in their properties, and the actual packaging design
  • the kit design can ensure adherence and so that patients do not inadvertently expose themselves to a hallucinogenic dose.

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  • Health & Medical Sciences (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Public Health (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Chemical & Material Sciences (AREA)
  • Veterinary Medicine (AREA)
  • General Health & Medical Sciences (AREA)
  • Medicinal Chemistry (AREA)
  • Epidemiology (AREA)
  • Neurosurgery (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • General Chemical & Material Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Organic Chemistry (AREA)
  • Neurology (AREA)
  • Emergency Medicine (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Nitrogen And Oxygen Or Sulfur-Condensed Heterocyclic Ring Systems (AREA)
  • Dental Preparations (AREA)
  • Measurement Of Radiation (AREA)
  • Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)

Abstract

Un procédé de dosage d'un agent psychédélique qui évite les effets secondaires des hallucinations et des perturbations perceptives par administration de l'agent psychédélique à un sujet dans le cadre d'un régime posologique par titrage et par réduction des effets secondaires des hallucinations et des perturbations perceptives. Un kit d'administration d'un régime posologique par titrage d'un agent psychédélique comprend une quantité pharmaceutiquement efficace de l'agent psychédélique dans des formes posologiques séparées dans l'emballage selon la dose et l'heure d'administration dans le cadre d'un régime posologique par titrage et des instructions d'utilisation. Un procédé de traitement d'un sujet par agents psychédéliques, par administration de l'agent psychédélique au sujet ayant un état ou une maladie dans le cadre d'un régime posologique par titrage et par réduction des effets secondaires des hallucinations et des perturbations perceptives pendant le traitement.
EP22799340.9A 2021-05-03 2022-05-01 Procédé de titrage de doses d'agents psychédéliques Pending EP4333979A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US202163183579P 2021-05-03 2021-05-03
PCT/US2022/027179 WO2022235529A1 (fr) 2021-05-03 2022-05-01 Procédé de titrage de doses d'agents psychédéliques

Publications (1)

Publication Number Publication Date
EP4333979A1 true EP4333979A1 (fr) 2024-03-13

Family

ID=83932279

Family Applications (1)

Application Number Title Priority Date Filing Date
EP22799340.9A Pending EP4333979A1 (fr) 2021-05-03 2022-05-01 Procédé de titrage de doses d'agents psychédéliques

Country Status (7)

Country Link
EP (1) EP4333979A1 (fr)
JP (1) JP2024517194A (fr)
AU (1) AU2022268891A1 (fr)
CA (1) CA3216939A1 (fr)
IL (1) IL308068A (fr)
TW (1) TW202245767A (fr)
WO (1) WO2022235529A1 (fr)

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2019081764A1 (fr) * 2017-10-26 2019-05-02 Consejo Superior De Investigaciones Científicas (Csic) Produit d'association pour le traitement de troubles neurologiques et/ou psychiatriques
US20220304980A1 (en) * 2019-07-04 2022-09-29 SW Holdings, Inc Metered dosing compositions and methods of use of psychedelic compounds

Also Published As

Publication number Publication date
CA3216939A1 (fr) 2022-11-10
JP2024517194A (ja) 2024-04-19
AU2022268891A1 (en) 2023-11-09
WO2022235529A1 (fr) 2022-11-10
TW202245767A (zh) 2022-12-01
IL308068A (en) 2023-12-01

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