TW201002325A - Pharmaceutical compositions for treating schizophrenia - Google Patents
Pharmaceutical compositions for treating schizophrenia Download PDFInfo
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- TW201002325A TW201002325A TW097125709A TW97125709A TW201002325A TW 201002325 A TW201002325 A TW 201002325A TW 097125709 A TW097125709 A TW 097125709A TW 97125709 A TW97125709 A TW 97125709A TW 201002325 A TW201002325 A TW 201002325A
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Description
201002325 九、發明說明 【發明所屬之技術領域】 本發明關於(硫代)-胺甲醯基一環己烷衍生物(尤其是 反式- 4-{2-[4-(2,3-二氯苯基)-六氫吡哄-1-基]-乙基}-N,N-二甲基胺甲醯基-環己胺)及其藥學上可接受之鹽類於製 造用於治療精神分裂症之藥品上的用途。再者,本發明關 於透過投服(硫代)-胺甲醯基-環己烷衍生物(尤其是反式-4-{2-[4-(2,3-二氯苯基)-六氫吡哄-1-基]-乙基}-丨:^-二甲 基胺甲醯基-環己胺)及其藥學上可接受之鹽類來治療精 神分裂症。 【先前技術】 精神分裂症爲一種終生失能之精神病症,全世界報告 之盛行率爲約1 %,包括3 20萬美國人(見,如:National Institute of Mental Health,Schizophrenia, http://www.nimh.nih.gov/healthinformation/schizophrenia menu.cfm 2006;Mueser and McGurk,Lancet 2 0 0 4 ; 3 6 3 : 2063-72,2004)。此病症通常在青少年期或青年時期即顯 露;主要症狀分爲三種區塊-陽性症狀(諸如妄想及幻 覺)、陰性症狀(諸如缺乏幹勁及社交退縮)和認知症狀(諸 如注意力及記憶之問題)。這些造成社交及職業機能障 礙’其對家庭及受影響之個人在廣大社會中的地位必然有 #遠之影響。除了精神症狀外,罹患精神分裂症之患者在 既有疾病方面的風險亦較一般人爲高。 201002325 在急性及殘留症狀期間,以多巴胺拮抗劑進行之藥物 治療爲精神分裂症處理的基礎。目前之指導原則建議以非 典型抗精神病劑(包括:利培酮(riSperid〇ne)、奧氮平 (olanzapine)、喹硫平(quetiapine)、齊拉西酮(ziprasidone) 及阿立哌唑(aripiprazole))作爲精神分裂症之第—線治 療。這些藥物之一致持徵爲其雙重作用模式:除了拮抗多 巴胺D2外’其亦爲血清素5-HT2A受體之強抑制劑。 雖然較傳統之抗精神分裂症藥改善,非典型之抗精神 病劑在有效管理該疾病中仍有缺點。尤其是,這些藥物在 高劑量下與副作用之高發生率有關(如高劑量時之錐體外 徑症狀[EPS s]、鎭靜、心血管作用,諸如QTc延長 '血液 學上之改變、對性功能之影響、體重增加、代謝異常)。 再者,治療抗性仍存在,有1 〇%至30%患者對目前可用之 抗精神病藥物僅有很小或無反應,另有至多之3 0 %患者僅 有部分治療反應(見,如Lehman " Pac/z/air少, 1 61(2 Suppl),l-56,2004)。此造成在一般臨床上實驗性使 用高劑量之非典型、抗精神病多重用藥並以其他治療精神 病之藥物加強效果(見,如:ZhA: " β/.,五 1 9 : 56-58,2004 ; Stahl and Grady ,Curr .Med. Chem ., 11,313-27,2004)。 根據用於治療精神分裂症之美國精神病協會指導原 則,無維持治療時,60%至之患者在1年內復發且幾 乎9 0%在2年內復發(見,如:Lehman w. J. 户5·少c/z/air},161(2 Suppl),1-56,2004)。 201002325 總括而言,治療精神分裂症仍存在明顯未被滿足的醫 療需求且在鑑定及硏發改良之抗精神病劑上有許多努力仍 在進行。 在此硏究中,D3多巴胺受體顯露出爲抗精神病藥物 治療之可能標的。此策略係植基於D3受體(其在精神病病 理學之核心區域的腹側紋狀體中具最高密度)在腦中之分 佈及建議之角色(見,如Gurevich and Joyce, iVeMropsyc/zop^armaco/o gj/,20,60-80,1999)。多巴月安 D 3 受 體顯示出參與調節運動活性(見,如 Shafer and Levant,P5_yc/zo/?/zi2r77iaco/og_y(Berl) ,135,1-1,1998)及言忍矢口功 能(見,如 Ukai e t al.,Eur.J.Pharmacol.,324,147-5 1,1 9 9 7 ; Smith et a\.,Pharmacol.Biochem.Behav.,63,201-1 1,1 999)。在齧齒動物模型中,受體之選擇性拮抗劑調整 或甚至徹底破壞由D2拮抗劑誘導之運動擾亂(全身僵硬症 (catalepsy))(見,如 Millan ei α/·,五Mr.J.P/zarwaco/·, 3 2 1 , R 7 - 9,1 9 9 7 ; Gy e r t y an et al.,[abstract] .Int. J. iVewro/? 5· _yc/zo/?/?ar»2aco/.,5 Suppl.1,174,2002)且當單獨投藥 時不會造成運動副作用或增加乳泌素之量(見,如Reavill et al.,A.J.Pharmacol.Exp.Ther.,294,1154-65,2000 ; Millan et α 厂,J. 293,1063-73,2000)。此暗示 大爲降低錐體外徑副作用之傾向。D3拮抗劑顯示出改良 齧齒動物(見,如 Sigala e,a/.Jwr.J.P/iarwaco/.JSGJOy-il’lQQ? ; Laszy e t a ί.,P s y c h 0 p h ar m a c o 10 gy (B eri), 179,567-75,2005)及靈長動物中由不同作用劑引起之認知 201002325 不良’此_示一種治療精神分裂症中之認知障礙的可能方 法。多巴胺D 3受體拮抗劑增加動物在習慣環境中的運動 活性(見’如 Waters e/ 〇/.,</· 98,39-55,1 994 ; Sautel et a l., J. P h a r m a c o 1. E xp. T h e r . ,21 5 , 1 239-46,1 995 ; Gyertyan and Saghy, .Pharmacol., 1 5,25 3 -62,20 04)。此活化作用可證明對該疾病之陰性症狀 有益。 然而’目前爲止’用來評估(人類)抗精神病作用之多 種不同動物模型中選擇性D3捨抗劑作用之欠缺暗示單獨 之 純 D3洁抗劑可能無足夠強大之抗精神病效果來辯 明臨床發展。其顯示出爲了在臨床中取得抗精神病作用, 多巴胺D2受體之佔有率必須達約60%至80%(見,如: Nyberg et a l. , B r. J. P s y c h i a t r y. S upp l, ,(2 9) - 4 ay 1996; 。後種現象提供 D2拮抗性對抗精神病作用而言爲必要之觀點的基礎。因 此,在D 2拮抗性中加入D 3拮抗性被認爲可在精神分裂症 之治療中提供超越現存之抗精神病劑的明確益處,亦即, 無EPSs、認知增強潛力及對陰性症狀的強化作用。 美國專利公開第2006/022 92 97號中揭示作爲d3及D2 多巴胺受體亞型較佳配體之具有式⑴的(硫代)-胺甲醯基 -環己烷衍生物:
201002325 其中R2、X和η如其中之定義。 匈牙利專利申請案第Ρ07003 3 9號中揭示反式_4_{2_ [4-(2,3-二氯苯基)-六氫吡哄-1-基]-乙基卜Ν,Ν-二甲基胺甲 酸基- is己fl女之鹽類。其中揭不之一·種特殊化合物爲反 式- 4- {2-[4-(2,3-一氯苯基)-六氫π比哄-i_基]-乙基卜N,N_: 甲基胺甲醯基-環己胺氫氯酸鹽’其亦稱爲反式_;! {4_[2_ [4-(2,3 -二氯苯基)·六氫吡畊-1-基]-乙基]-環己基}_3,3_二 甲基-脲氫氯酸鹽,其結構式顯示於下:
這些(硫代)-胺甲醯基-環己烷衍生物爲口服活性及 非常強之多巴胺D“D2受體拮抗劑,其以明顯較與D2受 體結合力高出很多之效力與D 3結合。該D 3受體掊抗性較 D2受體拮抗性的強度約高一數量級’據信其可抗衡一些 由D2受體掊抗劑產生之錐體外徑副作用。如:反式-4· {2-[4-(2,3-二氯苯基)-六氫吡哄-1-基]-乙基}-N,N-二甲基 胺甲醯基-環己胺氫氯酸鹽除了對D3之親和力較D2增加 外,其在其他受體位置(諸如5-HT2。、組織胺H!及腎上腺 受體位置)處的效力亦低,此暗示發生副作用(諸如E P S s 及增加體重)的可能性較低。 201002325 因此’對於可有效治療精神分裂症之症狀及與精神分 裂症相關之認知作用,且無一些與傳統治療相關之副作用 的治療持續存在著需求。 【發明內容】 本發明關於式(I)之(硫代)-胺甲醯基一環己烷衍生物 (尤其是反式-4-{2-[4-(2,3-二氯苯基)-六氫吡畊-1-基]-乙 基丨-Ν,Ν-二甲基胺甲醯基一環己胺)及其藥學上可接受之 鹽類於製造用於治療精神分裂症之藥品上的用途。再者’ 本發明關於透過投服式(I)之(硫代)-胺甲醯基-環己院衍 生物(尤其是反式-4-{2-[4-(2,3-二氯苯基)-六氫吡哄-1-基]-乙基}-N,N-二甲基胺甲醯基-環己胺)及其藥學上可接 受之鹽類來治療精神分裂症。 本發明之詳細描述 本發明關於式(I)之(硫代)-胺甲醯基一環己烷衍生物 及/或其幾何異構物及/或立體異構物及/或非對映異構物及 /或鹽類及/或水合物及/或溶劑化物及/或多形物於製造用 於治療精神分裂症之藥品上的用途,
其中 -10 - 201002325 和R2各自獨立地爲氫、烷基、烯基、芳基、環烷 基、芳醯基’或者1^和112與該相鄰之氮原子—起形成雜 j·™ · 壞, X爲〇或s ; η爲1或2。 於某些較佳體系中,當Ri及/或R2代表烷基時,該 院基部分爲經取代或未經取代之飽和的烴基,其可爲直鏈 型或支鏈型’含有約1至約6個碳原子(尤其是1至4個 碳原子)’且隨意地經一或多個Cl-6烷氧羰基、芳基(如: 苯基)或(C , ·6烷氧羰基)_ C i _ 6烷基或其組合所取代。 於其他較佳體系中,Ri和與該相鄰之氮原子一起 形成雜環’此雜環可爲飽和或不飽和,經隨意取代之單環 或雙環(其可含有選自0、N或S之其他雜原子)。例如·_ 該雜環可爲吡咯烷、六氫吡哄、六氫吡啶或嗎啉。 於其他較佳體系中,當Rl及/或R2代表烯基時,該 烯基部分可具有2至7個碳原子及1至3個雙鍵。 於其他較佳體系中’當1^及/或R2代表芳基時,該 芳基部分可選自經隨意取代之單環、二環或三環芳基,諸 如’但不限於苯基、萘基、荛基或蒽醌基團(如:苯基或 萘基)。該芳基部分可被一或多個CU烷氧基 '三氟_Ci_6 烷氧基、Cu烷氧羰基、Cl_6烷醯基、芳基' 烷硫 基、鹵素、氰基或其組合所取代。 代表環烷基時, 一環或二環形環 於其他較佳體系中,當Rl及/或R2 該環烷基部分可選自經隨意取代之單環、 -11 - 201002325 烷基,諸如環己基或金剛基。 於其他較佳體系中’當R!及/或R2代表芳醯基時, 其中該芳基部分之定義如上(如苯基)。 藥學上可接受之鹽類包括那些經由將作爲鹼之主要化 合物與無機或有機酸反應所取得之鹽,例如:氫氯酸、硫 酸、磷酸、甲磺酸、樟腦磺酸、草酸、順丁烯二酸、琥珀 酸、檸檬酸、甲酸、氫溴酸、苯甲酸、酒石酸、反丁烯二 酸、水楊酸、扁桃酸及碳酸之鹽類。藥學上可接受之鹽類 亦包括那些其中該作爲酸之主要化合物與合適之鹼反應所 形成之鹽,如:鈉、鉀、鈣、鎂、銨及膽鹽。那些熟習本 技藝之人士將進一步察知該所主張專利之化合物的酸加成 鹽可藉由多種已知方法中之任一種,將化合物與合適之無 機或有機酸反應來製備。或者,可將本發明之化合物與合 適之鹼藉由多種已知方法反應來製備鹼及鹼土金屬鹽類。 下列爲可經由以無機或有機酸反應來製備之酸性鹽的 其他實例:醋酸鹽、己二酸鹽、藻酸鹽、檸檬酸鹽、天門 冬胺酸鹽、苯甲酸鹽、苯磺酸鹽、亞硫酸鹽、丁酸鹽、樟 腦酸鹽、二葡萄糖酸鹽、環戊烷丙酸鹽、十二烷基硫酸 鹽、乙磺酸鹽、葡糖庚酸鹽、甘油磷酸鹽、半硫酸鹽、庚 酸鹽、己酸鹽、反丁烯二酸鹽、氫溴酸鹽、氫碘酸鹽、2_ 羥基-乙磺酸鹽、乳酸鹽、順丁烯二酸鹽、甲磺酸鹽、菸 鹼酸鹽、2 -萘磺酸鹽、草酸鹽、棕櫚酸鹽、果膠酸鹽、過 硫酸鹽、3 -苯基丙酸鹽、苦味酸鹽、三甲基乙酸鹽、丙酸 鹽、琥珀酸鹽、酒石酸鹽、硫代氰酸鹽、甲苯磺酸鹽、甲 -12- 201002325 磺酸鹽及十一院酸鹽。 於一較佳體系中,該藥學上可接受之鹽爲氫氯酸鹽。 可用於本發明之一些化合物可以不同之多形型存在。 如本技藝所知,多形性爲化合物以超過一種不同之結晶型 結晶化或爲“多形”物種之能力。多形物爲一種化合物之 固態結晶相,該化合物分子在固態時具有至少二種不同之 排列或多形型。任何指定之化合物的多形型的定義爲相同 之化學式或組成物而在化學結構上之區別則如同二種不同 化學化合物之結晶型結構。這類多形物之用途係在本發明 之範圍內。 可用於本發明之一些化合物可以不同之溶劑化物型存 在。在結晶化過程中,當溶劑分子被倂入化合物分子之晶 格構造時亦可形成本發明化合物之溶劑化物。例如:合適 之溶劑化物包括水合物,如一水合物、二水合物、倍半水 合物及半水合物。這類溶劑化物之用途係在本發明之範圍 內。 再者’本發明特別關於反式-4-{2-[4-(2,3-二氯苯基)-六氫吡哄-1-基]-乙基}-Ν,Ν·二甲基胺甲醯基-環己胺及其 藥學上可接受之鹽類之用途,更特別的是關於反式-4-{2-[4-(2,3- _•氯苯基)-六氯U比哄-1-基]-乙基}-N,N - 一甲基胺甲 醯基-環己胺氫氯酸鹽於製造用於治療精神分裂症之藥品 上的用途。 再者,本發明關於經由給予有此需要之患者治療上有 效量之作爲活性成分之式(I)化合物及/或其幾何異構物及/ -13- 201002325 或立體異構物及/或非對映異構物及/或鹽類及/或水合物及 /或溶劑化物及/或多形物來治療精神分裂症的方法。再 者,本發明特別關於經由給予有此需要之患者治療上有效 量之作爲活性成分之反式-4-{2-[4-(2,3 -二氯苯基)_六氫口比 哄-1-基]-乙基}-N,N-二甲基胺甲醯基-環己胺或其藥學上 可接受之鹽(更特別的是治療上有效量之反式-4-{2-[4-(2,3- _•氣苯基)-六氨卩比哄-1-基]•乙基}·Ν,Ν-二甲基胺甲醯 基-環己胺氫氯酸鹽)來治療精神分裂症的方法。 於某些較佳體系中,該活性成分之投服量爲約〇 . 1毫 克、約〇·2毫克、約0.3毫克、約0.4毫克、約0.5毫 克、約1毫克、約1 .5毫克、約2毫克、約2 · 5毫克、約 3毫克、約3.5毫克、約4毫克、約4.5毫克、約5毫 克、約5 ·5毫克、約6毫克、約6 · 5毫克、約7毫克、約 7.5毫克、約8毫克、約8.5毫克、約9毫克、約9.5毫 克、約1 〇毫克、約10 · 5毫克、約1 1毫克、約1 1 .5毫克 或約1 2毫克。而於其他較佳體系中,該活性成分之投服 量係介於這些劑量中之任何二個劑量間的範圍內。例如: 於一較佳體系中,該活性成分之投服量爲約1 . 5毫克至約 4.5毫克。於另一較佳體系中,該活性成分之投服量爲約 6毫克至約12毫克。再於另一較佳體系中’該活性成分 之投服量爲約0.5毫克至約12毫克。 於示範之較佳體系中,該活性成分之投服量爲約〇. 5 毫克、約1 . 〇毫克、約1 .5毫克、約3毫克、約4.5毫 克、約6毫克、約9毫克或約12毫克’例如:該投服量 -14- 201002325 爲約1_5毫克、約3毫克、約4.5毫克、約6毫克、約9 毫克或約1 2毫克。 所需之劑量可在一天中,以一或多個每日之次劑量, 於合適之時間間隔內投服,或者,可以,例如:供早上或 晚上投服之單次劑量投服。例如:該每日劑量可分割成 一、二、三或四個分割之日劑量。 治療期可爲數十年、數年、數月、數週或數日,只要 其效益持續。 於一較佳體系中’本發明關於經由給予有此需要之患 者約0·5毫克之反式_4·{2-[4-(2,3 -二氯苯基)-六氫吡哄-1-基]-乙基}-Ν,Ν-二甲基胺甲醯基一環己胺或其藥學上可接 受之鹽來治療精神分裂症的方法。 於一較佳體系中’本發明關於經由給予有此需要之患 者約1.0鼋克之反式- 4_{2-[4-(2,3 -二氯苯基)-六氫吡哄-1-基]-乙基}-Ν,Ν-二甲基胺甲醯基-環己胺或其藥學上可接 受之鹽來治療精神分裂症的方法。 於一較佳體系中’本發明關於經由給予有此需要之患 者約1.5毫克之反式·4-{2·[4-(2,3-二氯苯基)-六氫吡哄-ΐ_ 基]-乙基}-Ν,Ν-二甲基胺甲醯基—環己胺或其藥學上可接 受之鹽來治療精神分裂症的方法。 於另一較佳體系中,本發明關於經由給予有此需要之 患者約3毫克之反式_4_{ 2-[4-(2,3-二氯苯基)-六氫吡哄-h 基]-乙基}-N,N-二甲基胺甲醯基—環己胺或其藥學上可接 受之鹽來治療精神分裂症的方法。 -15- 201002325 於另一較佳體系中’本發明關於經由給予有此需要之 患者約4.5毫克之反式-4-{2-[4-(2,3 -二氯苯基)-六氫吡啡-1-基]-乙基}-N,N-二甲基胺甲醯基-環己胺或其藥學上可 接受之鹽來治療精神分裂症的方法。 再於另一較佳體系中,本發明關於經由給予有此需要 之患者約6毫克之反式-4-{2-[4-(2,3 -二氯苯基)-六氫吡 哄-1-基]-乙基卜N,N_二甲基胺甲醯基-環己胺或其藥學上 可接受之鹽來治療精神分裂症的方法。 於另一較佳體系中,本發明關於經由給予有此需要之 患者約9毫克之反式- 4-{2-[4-(2,3-二氯苯基)-六氫吡哄-1-基]-乙基}-N,N-二甲基胺甲醯基-環己胺或其藥學上可接 受之鹽來治療精神分裂症的方法。 再於另一較佳體系中,本發明關於經由給予有此需要 之患者約12毫克之反式-4-{2-[4-(2,3 -二氯苯基)-六氫吡 哄-1-基]-乙基}·Ν,Ν-二甲基胺甲醯基—環己胺或其藥學上 可接受之鹽來治療精神分裂症的方法。 於其他較佳體系中,投服之活性成分爲反式-4-{2-[4-(2,3-二氯苯基)-六氫吡哄-1-基]-乙基}-叱\-二甲基胺甲醯 基-環己胺氫氯酸鹽。 於一較佳體系中,該活性成分係以一或二個分割之曰 劑量投服。 於一較佳體系中,投服活性成分可於治療精神分裂症 之認知症狀時提供療效。於另一較佳體系中’投服活性成 分可於治療精神分裂症之陽性症狀時提供療效。再於另一 -16- 201002325 較佳體系中,投服活性成分可於治療精神分裂症之陰性症 狀時提供療效。 於其他較佳體系中,投藥可於治療精神分裂症之情感 性症狀、精神分裂症之殘留症狀或類精神分裂性疾患 (schizophreniform disorder)時提供療效。 式(I)之化合物可單獨投服或以醫藥組成物之活性成 分形式來投服。 用於製備適合投服本發明化合物之不同配方的程序之 描述可在多種標準參考資料中取得。例如:在 Handbook of Pharmaceutical Excipients, American Pharmaceutical Association (目前版本);Pharmaceutical Dosage Forms : Tablets(Lieberman,Lachman and Schwartz,編者)目前版本 由 Marcel Dekker,Inc_ 出版,以及 Remington’s Pharmaceutical Sciences(Arthur Osol,編者),1553-1593 (目前版本)中包含可能之配方及製備方法的實例。 投服模式及劑型與所需之化合物或組成物的治療量及 其在指定之治療應用上之效力密切相關。 合適之劑型包括,但不限於用於經由口、直腸、舌 下、黏膜、鼻、眼、皮下、肌肉內、靜脈內、透皮、脊 椎、鞘內、關節內、動脈內、蜘蛛網膜下腔、支氣管、淋 巴及子宮內投服之劑型,以及其他用於系統性遞送活性成 分之劑型。宜爲適合用於口服之配方。 該活性成分係根據習知之藥學化合技術與藥學載體充 分混合以製備這類藥學劑型。該載體可根據投藥所需之製 -17- 201002325 劑形式而有多種形式。 製備口服劑型之組成物時可使用任何常用之藥學介 質。因此’在液態口服製劑(諸如懸浮液、弛劑及溶液)方 面,合適之載體及添加劑包括水、甘醇、油、醇、調味 劑、防腐劑、染色劑’等。在固態口服製劑(諸如粉末、 膠囊及錠劑)方面,合適之載體及添加劑包括澱粉、糖、 稀釋劑、粒化劑、潤滑劑、結合劑、崩散劑,等。錠劑及 膠囊因易於投服’所以代表最有利之口服劑量單位形式。 若需要時可藉由標準技術以糖塗覆或以腸衣包覆錠劑。 在經由腸胃道外途徑投服之配方方面,該載體通常包 括無菌水’但亦可包括其他成分,例如協助溶解或用於保 存之成分。亦可製備其中可使用適當之助溶劑的注射溶 液。 在某些應用中,使用“向量化”形式(vectorized form) 之活性劑可能有所助益,諸如將活性劑包囊在微脂粒或其 他密封劑介質中或將活性劑藉由,如共價鍵結、螯合作用 或聯合配位固定在合適之生物分子(諸如選自蛋白質、脂 蛋白、糖蛋白及多醣者)上。 利用適合口服之配方的本發明治療法可以不連續單位 (諸如膠囊、小藥囊、錠劑或喉糖)呈現,其中各含有預定 量之爲粉末或顆粒狀的活性成分。可選擇性地使用在水性 液體或非水性液體中之懸浮液,諸如弛劑、乳劑或飲用 液。 錠劑可藉由緊壓或鑄型或濕性粒化,並隨意地加上一 -18- 201002325 或多種附加成分來製造。緊壓之錠劑可經由將爲自由流動 形式之活性化合物(諸如粉末或顆粒)在合適之機器中緊壓 來製備,其中該活性化合物係隨意地與,例如結合劑、崩 散劑、潤滑劑、惰性稀釋劑、界面活性劑或釋出劑 (discharging agent)混合。包含粉狀活性化合物與合適載 體之混合物的模型錠劑可經由在合適之機器中鑄型來製 造。 糖漿可經由將活性化合物加入糖(例如蔗糖)之濃縮水 性溶液中來製造,該溶液中亦可加入任何附加成分。這類 附加成分可包括調味劑、合適之防腐劑、阻止糖結晶化之 作用劑、增加任何其他成分之溶解度的作用劑,諸如聚羥 基醇(例如:甘油或山梨糖醇)。 適合經由腸胃道外途徑投服之配方通常包含活性化合 物之無菌水性製劑,此製劑宜與接受者之血液等張(如: 生理食鹽水溶液)。這類配方可包含懸浮劑及增濃劑和微 脂粒或其他被設計成將該化合物瞄準血液成分或一或多種 器官的微粒系統。該配方可以單一劑量或複數劑量形式呈 現。 經由腸胃道外途徑投藥可包含任何合適之系統遞送形 式或可直接遞送至C N S。例如:可經由靜脈內、動脈內、 鞘內、肌肉內、皮下、肌肉內、腹部內(如:腹膜內)’等 途徑投藥且可藉注入唧筒(外用或植入的)或任何其他適合 所需之投藥模式的合適工具來使其作用。 鼻及其他黏膜噴霧配方(如:吸入形式)可包含具有防 -19- 201002325 腐劑及等張劑之純化的活性化合物水溶液。這類配方宜調 整爲與鼻或其他黏膜相容之pH及等張狀態。或者,其可 爲懸浮於氣體載體中之精細分割的固態粉末形式。這類配 方可藉任何合適之工具或方法(如:藉由噴霧器、霧化 器、計量之劑量吸入器,等)遞送。 用於直腸投藥之配方可以具合適之載體(諸如可可 脂、氫化之脂肪或氫化之脂肪羧酸)的栓劑形式呈現。 透皮配方可經由將活性成分倂入流動減黏或膠化之載 體(諸如纖維素介質,如甲基纖維素或羥乙基纖維素)中來 製備,然後,可將所產生之配方包裝在適合確保與使用者 之皮膚作皮膚接觸的透皮裝置中。 除了上述成分外,本發明之配方可進一步包含一或多 種選自下列之附加成分:稀釋劑、緩衝劑、調味劑、結合 劑、崩散劑、界面活性劑、增濃劑、潤滑劑、防腐劑(包 括抗氧化劑),等。 本發明之配方可具有熟習本技術之人士所已知之立即 釋出、持續釋出、延遲開始釋出或任何其他釋出變化形 廓。 於本發明之一·較佳體系中係投服反式-4- {2-[4-(2,3-— 氯苯基)-六氫吡畊-1-基]-乙基}-N,N-二甲基胺甲醯基一環 己胺或其藥學上可接受之鹽作爲一或多種附加治療劑 (如:抗精神病劑、抗抑鬱劑)的輔助治療。於另一較佳體 系中可將反式- 4-{2-[4-(2,3-二氯苯基)-六氫吡哄-1·基]-乙 基丨-Ν,Ν -二甲基胺甲醯基-環己胺或其藥學上可接受之鹽 -20 - 201002325 與一或多種附加治療劑(如:抗精神病劑、抗抑鬱劑)共同 投藥來作爲組合治療。 抗精神病劑可爲非典型或典型之抗精神病劑,宜爲非 典型之抗精神病劑。非典型之抗精神病劑的實例包括,但 不限於:奧氮平(olanzapine)、氯氮平(clozapine)'利培 酮(risperidone)、舍卩引噪(sertindole)、嗤硫平 (quetiapine)、阿立峨哩(aripiprazole)、齊拉西酮 (ziprasidone)及曲米帕明(surmontil)。典型之抗精神病劑 的實例包括,但不限於:乙醯丙哄(acepromazine)、苯嚒 利多(benperidol)、溴西泮(bromazepam)、溴脈利多 (bromperidol)、氯丙哄(chlorpromazine)、氯普噻噸 (chlorprothixene )' 氯 噻平(clotiapine)、 腈 異 丁 哄 (cyamemazine) > 二氮 平 (diazepam) 、 地 西 拉 哄 (dixyr azine) 、 氟 哌利 多(droperidol)、 氟 哌 噻 噸 (flupentixo 1)、 氟 奮乃 靜(fluphenazine)、 氟 斯 必 噻 (fluspirilene) 、 氟 哌 陡醇(haloperidol) > 庚 胺 醇 (heptaminol) ' 異丙碗胺(isopropamide iodide)、左美丙哄 (levomepromazine)、左舒必利(levosulpiride)、洛沙平 (loxapine)、美哌隆(melperone)、美索達哄 (mesoridazine) 嗎節酮(molindone)、奧苷哌汀 (oxypertine)、奧普西平(oxyprothepine)、五氣利多 (penfluridol)、丙拉哄(perazine)、哌氰哄(periciazine)、 奮乃靜(perphenazine)、匹莫齊特(pimozide)、匹泮哌隆 (pipamperone)、峨泊噻哄(pipotiazine)、丙氯拉哄 -21 - 201002325 (prochlorperazine) 丙哄 (promazine)、異丙哄 (promethazine)、丙硫噴地(Pr〇thipendyl)、啦咳 S? (pyridoxine)、舒必利(sulpiride)、舒托必利(sultopride)、 丁 苯那哄(tetrabenazine)、硫丙拉哄(thioproperazine)、硫 利達哄(thioridazine)、硫必利(tiapride)、替沃噻噸 (tiotixene)、三氟拉哄(trifluoperazine)、三氟丙哄 (triflupromazine)、苯海索(trihexyphenidyl)及氯脈嚷囉 (zuclopenthixol)。 定義 “藥學上可接受” 一詞意指在動物或人類體內使用時 爲生物學或藥學上相容,且宜指由聯邦或州政府之管理機 構核准或列於美國藥典或其他一般認可之用於動物(尤其 是人類)的藥典中者。 “精神分裂症”一詞欲包括其特徵爲思考及感知瓦解 的一群心理障礙,包括精神分裂症(及所有其子類別;偏 執型、僵直型、欠組織、殘留、未分類型)及其他精神疾 患(如:Diagnostic and Statistical Manual for Mental Disorders,Fourth Edition,Washington,D.C(1 994):
American Psychiatric Association,or The ICD-10 Classification of Mental and Behavioural Disorders :
Clinical Descriptions and Diagnostic Guidelines,Geneva (1992):World Health Organization),諸如類精神分裂性疾 患及分裂情感性疾患、暫時性精神病,等。 •22- 201002325 在臨床評估中,精神分裂症通常以“陽性症狀”’諸 如幻覺(尤其是常以爲是聲音之聽覺上的幻覺)、欠組織之 思考過程和妄想症),以及“陰性症狀”(其包括情感表現 平板、貧語症、無動機及性快感缺乏)爲特徵。 “精神分裂症之陰性症狀”一詞係指一類精神分裂症 之症狀,其可被視爲反應官能上、指導思想或活性上之 “損失”。精神分裂症之陰性症狀爲本技藝所熟知且包括 情感表現平板(其特徵爲,例如:固定及/或無反應之臉部 表情、少有眼睛接觸及減少之身體語言)、貧語症(言詞貧 乏或簡短、簡明及/或空洞之回應)、無動機(其特徵爲減少 或無能力開始及進行目的性行爲)、性快感缺乏(喪失興趣 或樂趣)、社會孤立(減少社交驅動力及互動)、冷淡及其 他熟習本技藝之人士已知的陰性症狀。精神分裂症之陰性 症狀可利用任何本技藝已知之方法評估,包括’但不限 於:簡明精神分級量表(Brief Psychiatric Rating Scale)(BPRS)及陽性和陰性症狀量表(PANSS)。BPRS及 PANSS具有可用來測量陰性症狀之分量表或因子。其他 已設計用來具體發表陰性症狀之量表爲’例如’評估陰性
症狀之量表(the Scale for the Assessment of Negative Symptoms) (SANS)、陰性症狀評估法(the Negative Symptoms Assessment)(NSA)及缺陷型精神分裂症診斷量 表(the Schedule for the Deficit Syndrome) (SDS)。BPRS 及P AN S S之分量表亦可用來評估陽性症狀’雖然亦可使 用用於具體評估陽性症狀的方法(如:評估陽性症狀之量 -23- 201002325 表(t h e S c a 1 e f 〇 r t h e A s s e s s m e n t 〇 f P 〇 s i t i v e S y m p t 〇 m s 或 SAPS))。 ‘‘與精神分裂症相關之認知障礙”一詞係指精神分裂 症患者中之認知障礙。精神分裂症中之認知損壞爲該疾病 之核心特性(即,非治療結果或臨床症狀)。認知障礙包 括’但不限於··注意力/警覺性、工作記憶、語言學習及 記憶、視覺空間記憶、推理/解決問題和社會認知。用於 測量精神分裂症中之認知障礙的神經精神學試驗有多種, 諸如威斯康辛卡片分類試驗(Wisconsin Card Sorting Test)(WCST)。 “治療 ”(“treat” 、 “treatment” 、 “treating”)一詞 係指下列之一或多項: (a) 減輕或緩和個體內至少一種病症之症狀,包括, 如過敏性及發炎性病症,諸如氣喘及COPD ; (b) 減輕或緩和個體所經歷之病症表現的強度及/或 期間’包括,但不限於那些回應所指定之刺激(如:壓 力、組織傷害、低溫,等)者; (c) 遏制、延遲病症開始(即,病症臨床表現前之期間) 及/或降低病症發展或變壞之風險。 “有效量”一詞係指活性成份之量,當將其給予患者 (如:哺乳動物)以用於治療疾病時(βρ,精神分裂症)可足 夠使這類對疾病之治療生效的量,或係指足夠調整多巴胺 受體(如:多巴胺D2及/或多巴胺D3受體)以達到本發明目 的的量。“有效量”將根據該化合物、該疾病和其嚴重性 -24- 201002325 以及欲治療之患者的年齢、重量、反應性,等而有變化。 投服該對於疾病或病症而言爲有效之治療性攝生法的 治療性化合物的個體或患者宜爲人類,但亦可爲任何動 物,包括在試驗或篩選或活性實驗中的實驗室動物。医I 此,本技藝之一般技術人士可輕易地察知本發明之方法、 化合物及組成物特別適合給予任何動物,尤其是哺乳動物 且包括’但不限於:人類、家畜(諸如貓科或犬科個體)、 農場動物(諸如’但不限於:牛、馬、山羊、綿羊及豬類 之個體)、野生動物(不論是在野外園地或動物園中)、硏 究動物(諸如小鼠、大鼠、兔子、山羊、綿羊、豬、狗、 貓’等)、禽類(諸如雞、火雞、鳴鳥,等),即,用於獸 醫學用途之動物。 ‘‘約”或“近似” 一詞係指在由本技藝之一般技術人 士所測定之特定數値之可接受的誤差範圍內,此將部分取 決於該數値是如何測量或測定,即,該測量系統之限制。 例如:本技藝每次操作時,“約”可指在1個標準差之內 或超過1個標準差。或者,與該組成物相關之“約”可指 加或減至多2 0 %,宜爲至多1 〇 %,更宜爲至多5 %。或 者’尤其是與生物系統或過程相關時,該詞可指在數値之 一數量級範圍內’宜爲在5倍以內,更宜爲在2倍以內。 在申請案及申請專利範圍中所記述之特殊値中,除非另外 指明’該“約’’ 一詞係指在該特定數値之可接受的誤差範 圍內。 -25- 201002325 【實施方式】 下列實例僅用於說明本發明而不應被理解爲在任何方 面限制本發明,熟習此技術之人士在閱讀本揭示內容時可 清楚明白本發明所包含之多種不同的變化及其均等物。 實例1 本臨床硏究將以多中心、隨機化、雙盲、安慰劑對 照、平行試驗、彈性劑量硏究之形式進行。利用包含如下 述之患者的標準選出共約3 7 5位住院患者:(i)目前符合或 過去符合 the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition,Text Revision (DSM-IV-TR) 對精神分裂症之標準的患者,此標準係根據“ Structured Clinical Interview for DSM-IV(SCID)” 定義精神分裂症 (295.30偏執型、295.10錯亂型、295.20僵直型或295.90 未分類型),(ii)在第1及2次訪視中,PANSS總積分270 及S 120之患者,(iii)在第1及2次訪視中,PANS S之 P 1 (妄想)或P 3 (幻覺行爲)項目中積分2 4 (中度)之患者, 及(iv)在第1及2次訪視中,PANSS之P2(思考欠組織)或 P6(懷疑/困擾)項目中積分2 4(中度)之患者。 本硏究期間將爲10週;6週之雙盲治療及4週之安 全性追踪。在隨機選擇前先進行至多7天之無藥物沖洗 期。篩檢執行期間患者需住院。在隨機選擇及開始雙盲藥 物治療後患者將持續住院至少2 1天。評估時間表顯示於 表1中。 -26- 201002325 担 安全性追踪 第10次 訪視 〇 〇 第9次 訪視 〇〇 雙盲階段 第8次 訪視2 第7次 訪視1 in CO 第6次 訪視1 寸 00 <N 第5次 訪視1 m 第4次 訪視 rs) 寸 雙肓階段 第3次 訪視 卜 基線 第2次 訪視 〇 〇 師;® 第1次 訪視 r 1 i 至多7天 硏究週 終點 天數 -27 201002325 第1次訪視時符合所有合格標準之患者將參加至多7 天之無藥物沖洗期。在藥物沖洗期後,第2次訪視時符合 所有合格標準之患者將被隨機分配一個編號並分配對應於 雙盲硏究之銘范包裝藥物,進行第1週之雙盲治療。 將符合所有合格標準之患者隨機(1 : i :分至三組 治療組中之一: (I) 安慰劑 (II) 1.5-4.5 毫克之反式-4-{2-[4-(2,3-二氯苯基)-六 氫吡哄-1-基]-乙基}-N,N-二甲基胺甲醯基一環己胺氫氯酸 鹽,或 (III) 6-12毫克之反式-4-{2-[4-(2,3 -二氯苯基)-六氫吡 哄-1-基]-乙基}-N,N-二甲基胺甲醯基-環己胺氫氯酸鹽。 患者將被供應外表一致之含有1 . 5毫克、3.0毫克或 6.0毫克之反式_4-{2-[4-(2,3 -二氯苯基)-六氫吡畊-1-基]_ 乙基卜Ν,Ν -二甲基胺甲醯基—環己胺氫氯酸鹽或安慰劑的 膠囊。 所有硏究藥物將被分裝在鋁箔包裝中,每週一份。各 卡將含有3 0個以1 〇行、3排方式排列之膠囊,適用於一 週7天再多加3天。鋁箔包裝之配製提供於表2中。所有 硏究藥物將以單次每日劑量形式在睡前投服。若有耐受性 問題,給藥可改在早晨;然而,任何改變均需容許二個連 續劑量間至少相隔24小時。 -28- 201002325 班酿 E 伽 H< »—Η 1〇 τ—^ (η ι—Η fK wo Ό cn m H< 〇 〇 〇 5 5 H< 寸 Η CTs ί〇 Τ·Ή ΙΟ Ϊ-Η ΙΟ ί—^ IK 寸 rfs Ό cn m 寸 ok 〇 〇 〇 搬 搬 搬 IK QO ι〇 •ΤΊ H< 00 cn m fK 00 〇 〇 〇 濉 搬 濉 ίΚ 卜 ΙΟ tn ΙΟ H< 卜 cn m m H< 〇 〇 〇 搬 搬 搬 fK Ό ΙΟ *〇 ιη H< m o m H< 〇 〇 〇 搬 _ 紙 搬 fK l〇 l〇 ιη (Ν Τ~Ή H< 1〇 O m 驗 ik/ IK 〇 〇 〇 搬 (Ν 搬 濉 CI^ W\ Η< 寸 ν〇 ο 糜 FK 寸 m o o cn H< 寸 〇 〇 〇 搬 搬 連 搬 Η< cn ο Η< m m o o fK m 〇 〇 〇 濉 濉 濉 ίΚ (Ν ο ο H< (Ν o o ίΚ (Ν 〇 〇 〇 搬 濉 濉 Η< ι—Η ο ο Η< ι—Η o o 〇 〇 〇 濉 搬 濉 •111 •川 Λ1\ TO jjj_ TO .1U- JJX. M.L· JJJ_ A2A- 搬 濉 搬 減 濉 濉 城 搬 搬 -29- 201002325 在第1天和第2天,給予所有患者一個來自銘箱包裝 之第1排的膠囊。第3天時可將劑量增加至2個膠囊(第 i和2排),若反應不夠則無耐受性之問題。根據反應及 耐受性,自第5天開始’可經由增加一個膠囊至最多3個 膠囊(第I、2及3排)來增加劑量。在隨機分配至第Π組 (1.5-4.5毫克之反式-4-{2-[4-(2,3-二氧苯基)-六氫卩比哄-1-基]-乙基卜N,N-二甲基胺甲醯基-環己胺氫氯酸鹽)之患者 方面,第5天前可達到4.5毫克之最高劑量,然而,在隨 機分配至第瓜組(6_12毫克之反式_4_{2-[4-(2,3-二氯苯 基)-六氫吡畊-1·基]-乙基卜N,N-二甲基胺甲醯基一環己胺 氫氯酸鹽)之患者方面’第9天前可達到12毫克之最高劑 量。任何劑量之增加將以增加一個膠囊的方式完成。 利用已確立之分級方法進行的評估,包括: -30- 201002325 訪視 天 評估 1 至多7天 SCI-PANS S 2 0 SCI-PANSS,CGI-S,CDSS 3 7 SCI-PANSS,CGI-S,CGU-I 4 14 SCI-P ANSS,CGI-S, CGU-I 5 2 1 SCI-PANSS,CGI-S, CGU-I,CDSS 6 28 SCI-PANSS,CGI-S, CGU-I 7 35 SCI-P ANS S,CGI-S, CGU-I 8 42 SCI-PANSS,CGI-S, CGU-I,CDSS PANSS 總積分(見,如:Kay et al_,Schizophr_Bull., 13,261-76,1987) C G I - S :臨床總體印象—嚴重性(見,如:G u y E C D E U Assessment Manual for P s y c h o p h a r m a c o 1 ogy.Rockville,
Md : US Department of Health,Education, and W el fare , 2 1 8 - 22, Publication ADM 76-338, 1976) CG卜I :臨床總體印象—改善(見,如:Guy ECDEU Assessment Manual for Psychopharmacology. Rockville, M d : U S Department of Health,Education,and Welfare,218-22,Publication ADM 76-3 3 8,1 976) CDS S :用於精神分裂症之 Calgary抑鬱量表(見, 如:Addington et al.,Schizophr.Res.,19,205-12,1996 ) 在第 14、21、28、35、42、56及 70天收集血液樣 本。 與以安慰劑治療之患者相較下,以反式-4-{2-[4-(2,3-二氯苯基)-六氫吡哄-1-基]-乙基卜Ν,Ν-二甲基胺甲醯基— 環己胺氫氯酸鹽進行上述治療攝生法來治療精神分裂症時 預料將顯示出顯著效力。 本發明並不侷限於由此處所描述之特殊較佳體系的範 圍。確實,熟習此技術之人士從先前之描述及附圖即可察 -31 - 201002325 知除了此處所描述者外之多種不同的本發明之修改體m 類修改係意欲涵蓋於後附之申請專利範圍內。且需了解’ 所有數値皆爲近似値且僅供用於描述。 前文及下文中所列舉之所有申請案、專利及刊物之全 部揭示內容均倂爲此文之參考資料。 -32-
Claims (1)
- 201002325 十、申請專利範圍 1. 一種治療精神分裂症之醫藥組成物,其包含治療 上有效量之式(I)的(硫代)-胺甲醯基-環己烷衍生物及/或 其幾何異構物及/或立體異構物及/或非對映異構物及/或鹽 類及/或水合物及/或溶劑化物及/或多形物,其中 1^和R2各自獨立地爲氫、烷基、烯基、芳基、環烷 基、芳醯基,或者1和R2與該相鄰之氮原子一起形成雜 X爲0或S ; η爲1或2。 2.如申請專利範圍第1項之醫藥組成物,其中該式 (I)之化合物爲反式-4-{2-[4-(2,3-二氯苯基)-六氫吡哄-1- 基]•乙基}-Ν,Ν-二甲基胺甲醯基-環己胺及/或其鹽類及/或 水合物及/或溶劑化物及/或多形物。 3 _如申請專利範圍第1項之醫藥組成物,其中該式 (I)之化合物爲反式- 4- {2-[4-(2,3-二氯苯基)-六氫吡哄-卜 基]-乙基}-Ν,Ν-二甲基胺甲醯基一環己胺氫氯酸鹽及/或其 水合物及/或溶劑化物及/或多形物。 4.如申請專利範圍第4項之醫藥組成物,其中該式 -33- 201002325 (I)化合物之治療上有效量爲約〇」至12毫克。 5 .如申請專利範圍第4項之醫藥組成物,其中該式 (I)化合物之治療上有效量爲約0.5毫克。 6 .如申請專利範圍第4項之醫藥組成物,其中該式 (I)化合物之治療上有效量爲約1 . 0毫克。 7. 如申請專利範圍第4項之醫藥組成物,其中該式 (I)化合物之治療上有效量爲約1 . 5毫克。 8. 如申請專利範圍第4項之醫藥組成物,其中該式 (I )化合物之治療上有效量爲約3毫克。 9. 如申請專利範圍第4項之醫藥組成物,其中該式 (I)化合物之治療上有效量爲約4.5毫克。 1 0.如申請專利範圍第4項之醫藥組成物,其中該式 (I)化合物之治療上有效量爲約6毫克。 11. 如申請專利範圍第4項之醫藥組成物,其中該式 (I)化合物之治療上有效量爲約9毫克。 12. 如申請專利範圍第4項之醫藥組成物,其中該式 (I)化合物之治療上有效量爲約12毫克。 1 3 ·如申請專利範圍第4 -1 2項中任一項之醫藥組成 物,其中該式(I)之化合物係以一、二、三或四個分割之 每曰劑量投眼。 i 4 .如申請專利範圍第4-1 2項中任一項之醫藥組成 物,其中該式(I)之化合物提供精神分裂症之認知症狀的 治療療效。 1 5 _如申請專利範圍第4_1 2項中任一項之醫藥組成 -34- 201002325 物,其中該式(I)之化合物提供精神分裂症之陰性症狀的 治療療效。 1 6 .如申請專利範圍第4-1 2項中任一項之醫藥組成 物,其中該式(I)之化合物提供精神分裂症之陽性症狀的 治療療效。 17.如申請專利範圍第4-12項中任一項之醫藥組成 物,其中該式(I)之化合物提供精神分裂症之情感性及殘 留症狀的治療療效。 1 8 .如申請專利範圍第4-1 2項中任一項之醫藥組成 物,其中該式(I)之化合物提供精神分裂症之繼發性社會 及職業機能障礙的治療療效。 1 9 .如申請專利範圍第4-1 2項中任一項之醫藥組成 物,其中該式(I)之化合物提供類精神分裂性疾患 (schizophreniform disorder)及分裂情感性疾患 (schizoaffective disorder)的治療療效。 2 0 .如申請專利範圍第4 -1 2項中任一項之醫藥組成 物,其中投服之式(I)化合物係作爲一或多種附加治療劑 的輔助治療。 2 i .如申請專利範圍第4-1 2項中任一項之醫藥組成 物,其中係將式(I)之化合物與一或多種附加治療劑共同 投服來作爲組合療法。 2 2. —種治療上有效量之式(I)的(硫代)-胺甲醯基一 環己烷衍生物及/或其幾何異構物及/或立體異構物及/或非 對映異構物及/或鹽類及/或水合物及/或溶劑化物及/或多 -35- 201002325 形物於製造用於治療精神分裂症之藥品上的用途,、瓌烷 R】和R2各自獨立地爲氫、烷基、烯基、芳基 基、芳醯基’或者1和r2與該相鄰之氮原子形成雜環 X爲0或S ; η爲1或2。物及/或溶劑化物及/或多形物。 24.如申請專利範圍第22項之用途,其中該式(I)之 化合物爲反式-4-{2-[4-(2,3-二氯苯基)-六氫吡哄-1-基]-乙 基}-Ν,Ν-二甲基胺甲醯基一環己胺氫氯酸鹽及/或其水合 物及/或溶劑化物及/或多形物。 2 5 ·如申請專利範圍第2 2 - 2 4項中任一項之用途,其 中該式(I)化合物之治療上有效量爲約0.:1至12毫克。 26_如申請專利範圍第25項之用途,其中該式(1)化 合物之治療上有效量爲約〇 . 5毫克。 27.如申請專利範圍第25項之用途,其中該式(1)化 合物之治療上有效量爲約〗.〇毫克。 28·如申請專利範圍第25項之用途,其中該式(1)化 201002325 合物之治療上有效量爲約1.5毫克。 2 9 .如申請專利範圍第2 5項之用途,其中該式(I)化 合物之治療上有效量爲約3.0毫克。 30. 如申請專利範圍第25項之用途,其中該式(I)化 合物之治療上有效量爲約4 · 5毫克。 31. 如申請專利範圍第25項之用途,其中該式(I)化 合物之治療上有效量爲約6毫克。 32. 如申請專利範圍第25項之用途,其中該式(I)化 合物之治療上有效量爲約9毫克。 33. 如申請專利範圍第25項之用途,其中該式(I)化 合物之治療上有效量爲約1 2毫克。 3 4 _如申請專利範圍第2 2 - 2 4項中任一項之用途,其 中該式(I)化合物之治療上有效量係分割成一、二、三或 四個曰劑量。 3 5 .如申請專利範圍第2 2 - 2 4項中任一項之用途,其 係用於治療精神分裂症之認知症狀。 3 6.如申請專利範圍第22-24項中任一項之用途,其 係用於治療精神分裂症之陰性症狀。 3 7 .如申請專利範圍第2 2 -2 4項中任一項之用途,其 係用於治療精神分裂症之陽性症狀。 3 8 如申請專利範圍第22-24項中任一項之用途,其 係用於治療精神分裂症之認知症狀。 3 9.如申請專利範圍第22 _24項中任—項之用途,其 係用於治療精神分裂症之情感性及殘留症狀。 -37- 201002325 4 0.如申請專利範圍第22-24項中任一項之用途,其 係用於治療精神分裂症之繼發性社會及職業機能障礙。 4 1.如申請專利範圍第22-24項中任一項之用途,其 係用於治療類精神分裂性疾患及分裂情感性疾患。 -38- 201002325 七、指定代表圖: (一) 、本案指定代表圖為:無 (二) 、本代表圖之元件代表符號簡單說明:無 八、本案若有化學式時,請揭示最能顯示發明特徵的化學 式:式(I)-4-
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US7875610B2 (en) * | 2007-12-03 | 2011-01-25 | Richter Gedeon Nyrt. | Pyrimidinyl-piperazines useful as D3/D2 receptor ligands |
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HU230067B1 (hu) | 2008-12-17 | 2015-06-29 | Richter Gedeon Nyrt | Új piperazin só és eljárás előállítására |
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HU231227B1 (hu) | 2012-11-29 | 2022-03-28 | Richter Gedeon Nyrt. | Transz-4-{2-[4-(2,3-diklórfenil)-piperazin-1-il]-etil}N,N-dimetilkarbamoil-ciklohexilamin skizofrénia negatív tüneteinek kezelésére |
US11274087B2 (en) | 2016-07-08 | 2022-03-15 | Richter Gedeon Nyrt. | Industrial process for the preparation of cariprazine |
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