US20140303125A1 - Spirocyclic Cyclohexane Compounds Useful To Treat Substance Dependency - Google Patents

Spirocyclic Cyclohexane Compounds Useful To Treat Substance Dependency Download PDF

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US20140303125A1
US20140303125A1 US14/310,690 US201414310690A US2014303125A1 US 20140303125 A1 US20140303125 A1 US 20140303125A1 US 201414310690 A US201414310690 A US 201414310690A US 2014303125 A1 US2014303125 A1 US 2014303125A1
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dimethylamino
tetrahydro
diazafluorene
pentamethylene
phenylpentamethylene
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Elmar Friderichs
Babette-Yvonne Koegel
Klaus Linz
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Gruenenthal GmbH
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    • A—HUMAN NECESSITIES
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    • A61K31/00—Medicinal preparations containing organic active ingredients
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    • 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
    • A61K31/407—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 other heterocyclic ring systems, e.g. ketorolac, physostigmine
    • 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
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    • A61K31/135—Amines having aromatic rings, e.g. ketamine, nortriptyline
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    • 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
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    • A61K31/47—Quinolines; Isoquinolines
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    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
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    • A61P25/30—Drugs for disorders of the nervous system for treating abuse or dependence
    • A61P25/36—Opioid-abuse

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Abstract

Spirocyclic cyclohexane compounds useful in pharmaceutical compositions for use in the treatment of substance dependency.

Description

    CROSS REFERENCE TO RELATED APPLICATIONS
  • This application is continuation of U.S. application Ser. No. 11/870,051, filed Oct. 10, 2007, which claims priority from international patent application no. PCT/EP2006/003176, filed Apr. 7, 2006, designating the United States of America, and published in German on Oct. 19, 2006 as WO 2006/108565, the entire disclosure of which is incorporated herein by reference. Priority is claimed based on Federal Republic of Germany Patent Application No. DE 10 2005 016 460.9, filed Apr. 11, 2005.
    • BACKGROUND OF THE INVENTION
  • Opiate dependency is a major medical and social problem, which requires intensive medical care. A standard treatment is opiate substitution by a specially suitable μ-opioid. Clinically established substances for the substitution therapy of opiate dependency are:
      • methadone (racemate, in rare cases levomethadone)
      • LAAM (α-acetylmethadol)
      • buprenorphine
        All three substances are used to achieve the same objectives:
      • satisfaction of the opiate craving but without any “kick” and with a significantly reduced euphoria
      • avoidance of bodily withdrawal symptoms
      • re-socialisation of the patient (controlled rehabilitation, ability to work, withdrawal from the drug-related environment)
      • long-term reduction in the opiate dosage until complete abstinence is achieved.
        In order that these effects can be achieved, the substitution therapeutic agents must have the following properties:
      • oral (possibly also cutaneous) effect availability
      • long effective duration (1-3 days, possibly even longer)
      • high potency
      • low euphorisation
      • low “kick”
      • low withdrawal symptoms
      • good long-term compatibility (only slight constipation, good cardiovascular compatibility)
        The standard therapeutic agents used up to now exhibit only some of these properties, with the result that their therapeutic use is to some extent unsatisfactory. The basic problems with the current standard therapeutic agents are the following: methadone has a high potential for misuse. On account of the only moderate action duration a daily administration is necessary. In addition constipation is a side effect. LAAM has the disadvantage of a high cardiotoxicity and can trigger Torsade de Pointes arrhythmia. Buprenorphine has a high toxicity when combined with benzodiazepines.
  • US 2006/004034 A1 (=WO 04/43967) and US 2005/192333 A1 (=WO 2005/066183) describe compounds that are particularly suitable for the treatment of pain, but also inter alia for the treatment of withdrawal symptoms as well as for reducing the potential for opioid addiction. It has now been found that that selected compounds from these patent applications are particularly suitable for use as substitution therapeutic agents in treatment of substance dependence.
    • SUMMARY OF THE INVENTION
  • The object of the present invention was to provide a new method of treating substance dependence with substitution therapeutic agents.
  • Another object of the invention is to provide a method of treating opioid dependency which has advantages compared to the standard therapies.
  • These and other objects have been achieved in accordance with the present invention by providing spirocyclic cyclohexane compounds corresponding to formula I
  • Figure US20140303125A1-20141009-C00001
  • wherein
    • R1 and R2 independently of one another denote H or CH3 or together denote (CH2)4 or (CH2)5 and form a ring with the nitrogen to which they are bound, wherein R1 and R2 do not simultaneously denote H;
    • R3 denotes phenyl, benzyl or heteroaryl in each case unsubstituted or singly or multiply substituted with F, Cl, OH, CN or OCH3;
    • W denotes NR4, O or S, where
      • R4 denotes H; C1-5-alkyl, phenyl; phenyl, COR12 bound via a C1-3-alkyl group;
        • SO2R12, where
        • R12 denotes H; C1-7-alkyl, branched or unbranched, saturated or unsaturated, unsubstituted or singly or multiply substituted with OH, F or COOC1-4-alkyl; C4-6-cycloalkyl; aryl or heteroaryl, unsubstituted or singly or multiply substituted with F, Cl, Br, CF3, OCH3, C1-4-alkyl, branched or unbranched, substituted; or phenyl or heteroaryl bound via saturated or unsaturated C1-3 alkyl, unsubstituted or singly or multiply substituted with F, Cl, Br, CF3, OCH3, C1-4-alkyl, branched or unbranched, substituted; or C5-6-cycloalkyl bound via saturated or unsaturated C1-3-alkyl; OR13; NR14R15;
    • R5 denotes H; COOR13, CONR13, OR13; C1-5-alkyl, saturated or unsaturated, branched or unbranched, unsubstituted or singly or multiply substituted with OH, F, CF3 or CN;
    • R6 denotes H; or
    • R5 and R6 together denote (CH2)n where n=2, 3, 4, 5 or 6, wherein individual hydrogen atoms may also be replaced by F, Cl, NO2, CF3, OR13, CN or C1-5-alkyl;
    • R7, R8, R9 and R10 independently of one another denote H, F, Cl, Br, NO2, CF3, OH, OCH3, CN, COOR13, NR14R15; C1-5-alkyl, heteroaryl, unsubstituted or singly or multiply substituted with benzyl, CH3, Cl, F, OCH3 or OH; where
      • R13 denotes H or C1-5-alkyl; and
      • R14 and R15 independently of one another denote H or C1-5-alkyl;
    • X denotes 0, S, SO, SO2 or NR17; where
      • R17 denotes H; C1-5-alkyl, saturated or unsaturated, branched or unbranched; COR12 or SO2R12,
        in the form of their pure diastereomers, their racemates, their pure enantiomers, or in the form of mixtures of the stereoisomers in an arbitrary mixture ratio; as bases or in the form of their salts, in particular of the physiologically compatible salts or salts of physiological compatible acids or cations; or in the form of their solvates,
        wherein the ratio of the ORL1 receptor affinity to the μ-opioid receptor affinity is 0.3 or greater, for the treatment of substance dependency.
  • As used herein, the term salt is understood to denote any form of the active constituent according to the invention in which this adopts an ionic form or is charged, and is coupled to a counter-ion (a cation or anion) and/or is present in solution. The term is also understood to include complexes of the active constituent with other molecules and ions, in particular complexes which are complexed via ionic interactions. In particular the term is understood to include (and this is also a preferred embodiment of the present invention) physiologically compatible salts, in particular physiologically compatible salts with cations or bases and physiologically compatible salts with anions or acids or also a salt formed with a physiologically compatible acid or with a physiologically compatible cation.
  • The term salt formed with a physiologically compatible acid is understood within the context of the present invention to denote salts of the respective active constituent with inorganic or organic acids, which are physiologically compatible—especially when used in humans and/or mammals. The hydrochloride and citrate are particularly preferred. Examples of physiologically compatible acids are: hydrochloric acid, hydrobromic acid, sulphuric acid, methanesulfonic acid, formic acid, acetic acid, oxalic acid, succinic acid, tartaric acid, mandelic acid, fumaric acid, lactic acid, citric acid, glutanic acid, 1,1-dioxo-1,2-dihydro1λ6-benzo[d]isothiazol-3-one (saccharinic acid), monomethylsebacic acid, 5-oxoproline, hexane-1-sulfonic acid, nicotinic acid, 2-, 3- or 4-aminobenzoic acid, 2,4,6-trimethylbenzoic acid, α-lipoic acid, acetylglycine, hippuric acid and/or aspartic acid.
  • In the context of the present invention, the expressions “C1-3-alkyl” “C1-5-alkyl”, “C1-7-alkyl” and “C1-4-alkyl” include acyclic saturated or unsaturated hydrocarbon radicals, which may be branched or straight-chain, with respectively 1, 2 or 3 C atoms, 1, 2, 3, 4 or 5 C atoms, 1, 2, 3, 4, 5, 6 or 7 C atoms or 1, 2, 3 or 4 C atoms. Unsaturated compounds have at least one C—C double bond or at least one C—C triple bond. From the above group alkyl is advantageously selected, which includes methyl, ethyl, n-propyl, 2-propyl, n-butyl, iso-butyl, sec.-butyl, tert.-butyl, n-pentyl, iso-pentyl, neo-pentyl, n-hexyl, 2-hexyl; ethylenyl (vinyl), ethinyl, propenyl (—CH2CH═CH2, —CH═CH—CH3, —C(═CH2)—CH3), propinyl (—CH—C≡CH, —C≡C—CH3), 1,1-dimethylethyl, 1,1-dimethylpropyl, butenyl, butinyl, pentenyl and pentinyl.
  • For the purposes of the present invention, the expression “C5-6-cycloalkyl” denotes cyclic hydrocarbons with 5 or 6 Carbon atoms, wherein the hydrocarbons may be saturated or unsaturated (but not aromatic). From the above group C5-6-cycloalkyl is advantageously selected, which includes cyclopentyl and cyclohexyl.
  • The expression “heteroaryl” denotes a 5-, 6- or 7-membered cyclic aromatic radical, which contains at least 1, but possibly also 2, 3, 4 or 5 heteroatoms, wherein the heteroatoms are identical or different and the heterocycle may be unsubstituted or singly or multiply substituted; in the case of substitution in the heterocycle, the substituents may be identical or different and in any arbitrary and possible position of the heteroaryl. Preferred heteroatoms are nitrogen, oxygen and sulphur. It is preferred to select the heteroaryl radical from the group comprising pyrrolyl, furyl (furanyl), benzofuranyl, thienyl, pyrazolyl, imidazolyl, thiazolyl, oxazolyl, isoxazolyl, pyridinyl, or carbazolyl, wherein the bonding to the compounds of the general structure I can be effected by any arbitrary and possible ring member of the heteroaryl radical. Pyridyl and thienyl are particularly preferred. Pyrazolyl and furyl are also particularly preferred.
  • Animal experiment investigations with substances from US 2006/004034 A1 and US 2005/192333 A1 have surprisingly shown that the substances with a particularly high ORL1 affinity, which is not more than one order of magnitude less than the μ-opioid receptor affinity, are particularly suitable for an opiate substitution and thus have the potential for a significant improvement in the substitution therapy.
  • Among the spiro compounds described in US 2006/004034 A1 and US 2005/066183 A1 are compounds with higher and lower ORL1 components. In naloxone-induced withdrawal symptoms in mice it was shown that spirocyclic compounds with an ORL1 component which is not weaker by a factor of more than 10 than the μ-component, can suppress withdrawal symptoms. Compounds with a weaker ORL1 component on the other hand trigger withdrawal symptoms. In the “withdrawal jumping” test mice are repeatedly treated over a defined period with the test substance. In the case of a μ-opioid a systemic dependency is induced within this period. At the end of the treatment the effect of the opioid is cancelled immediately by administering naloxone, a μ-antagonist. When the mice become systemically dependent they exhibit characteristic withdrawal symptoms, which are manifested in the form of jumping movements (Saelens J K, Arch Int Pharmacodyn 190: 213-218, 1971).
  • The compounds according to the invention have on account of the ORL1 active component additional properties which the standard substances such as methadone, LAAM or buprenorphine do not possess and which improve the treatment. In withdrawal jumping in mice it was shown that in the case of mice that had been treated with combined μ-/ORL1 agonists, as in Example 1, Example 3 or Example 4, no, or only a minimal, withdrawal behaviour is triggered by naloxone. This confirms that the withdrawal symptoms are suppressed by the ORL1 component. This results in a significant advantage if these substances are used in the treatment of withdrawal symptoms, since the occurrence of withdrawal symptoms is one of the most important side effects of this treatment and often leads to non-compliance. The ORL1/μ-affinity should be 0.3 or greater. It is preferred if the ORL1/μ-affinity ratio is ≧1, particularly preferably ≧1.7.
  • The result that the compounds according to the invention with a stronger ORL1 component suppress the withdrawal jumping that should be triggered by the μ-component, demonstrates the efficacy of these compounds for use in substitution therapy. It is therefore preferred if the substance dependency is opiate dependency, for example dependency on alfentanil, buprenorphine, butorphanol, codeine, dextromoramide, dextropropoxyphene, dezocin, dihydrocodeine, diphenoxylate, ethylmorphine, hydrocodone, hydromorphone, ketobemidone, LAAM, levorphanol, meptazinol, oxycodon, oxymorphone, fentanyl, morphine, heroin, pethidine, sufentanil or tilidin, preferably morphine, methadone or heroin.
  • The spirocyclic cyclohexane derivatives according to the invention can also be used in combination with an opioid receptor antagonist, preferably with naloxone.
  • In the synthesis of the compounds according to the invention, as described in US 2006/004034 A1 and US 2005/066183 A1, two or more diastereomers can occur. In most cases the non-polar diastereomers have compared to the polar diastereomers a higher affinity for the two investigated opiate receptors. It is therefore preferred if the substances according to the invention are present in the form of the non-polar diastereomer.
  • Spirocyclic cyclohexane derivatives in which R3 denotes heteroaryl are preferred in the context of the present invention. Also preferred in the context of the present invention are spirocyclic cyclohexane derivatives in which R3 denotes phenyl, unsubstituted or singly or multiply substituted with F, OH, Cl or OCH3, or denotes benzyl.
  • Also preferred are spirocyclic cyclohexane derivatives in which R1 and R2 denote CH3 or H, in which case R1 and R2 do not simultaneously denote H.
  • It is preferred to use spirocyclic cyclohexane derivatives selected from the group:
    • 1 1,1-(3-dimethylamino-3-phenylpentamethylene)-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 2 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(2-nitrobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 3 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-fluoro-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 4 1,1-(3-dimethylamino-3-(2-thienyl)pentamethylene)-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 5 1,1-(3-dimethylamino-3-phenylpentamethylene)-3-methyl-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 6 1,1-(3-dimethylamino-3-phenylpentamethylene)-3,6-dimethyl-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 7 1,1-(3-dimethylamino-3-(4-fluorophenyl)pentamethylene)-1,3,4,9-tetrahydro-pyrano[3,4-b]indole;
    • 8 1,1-(3-dimethylamino-3-phenylpentamethylene)-3-hydroxymethyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 9 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2,3,4,5,6-pentafluoro-benzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 10 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(methoxycarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 11 1,1-(3-dimethylamino-3-phenylpentamethylene)-7-fluoro-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 12 1,1-(3-dimethylamino-3-phenylpentamethylene)-1,3,4,9-tetrahydro-2-aza-9-oxafluorene;
    • 13 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 14 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-acetyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 15 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 16 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-chloro-3-methyl-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 17 1,1-(3-dimethylamino-3-(2-pyridyl)pentamethylene)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 18 1,1-(3-dimethylamino-3-(3-thienyl)pentamethylene)-6-fluoro-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 19 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-acetyl-7-fluoro-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 20 1,1-(3-dimethylamino-3-phenylpentamethylene)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 21 1,1-(3-dimethylamino-3-phenylpentamethylene)-3-methyl-1,3,4,9-tetra-hydropyrano[3,4-b]indole;
    • 22 1,1-(3-dimethylamino-3-phenylpentamethylene)-1,3,4,9-tetrahydro-2-thia-9-azafluorene;
    • 23 1,1-(3-dimethylamino-3-phenylpentamethylene)-3-methyl-6-nitro-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 24 1,1-(3-dimethylamino-3-(3-thienyl)pentamethylene)-1,3,4,9-tetrahydro-pyrano[3,4-b]indole;
    • 25 1,1-(3-dimethylamino-3-(4-fluorophenyl)pentamethylene)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 26 1,1-(3-dimethylamino-3-phenylpentamethylene)-3-methyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 27 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-oxo-1,3,4,9-tetrahydro-2-thia-9-azafluorene;
    • 28 1,1-(3-dimethylamino-3-phenylpentamethylene)-1,3,4,9-tetrahydro-2-thia-9-azafluorene;
    • 29 1,1-(3-dimethylamino-3-(2-thienyl)pentamethylene)-6-fluoro-1,3,4,9-tetrahydro-pyrano[3,4-b]indole;
    • 30 1,1-(3-dimethylamino-3-phenylpentamethylene)-3-methyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 31 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-fluoro-3-methyl-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 32 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-hydroxy-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 33 1,1-(3-dimethylamino-3-(3-hydroxyphenyl)pentamethylene)-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 34 1,1-(3-dimethylamino-3-phenylpentamethylene)-1,3,4,9-tetrahydro-2-thia-9-azafluorene;
    • 35 6,6-(3-dimethylamino-3-phenylpentamethylene)-1,2,3,4,4a,6,7,11c-octahydro-5-oxa-7-aza-benzo[c]fluorine;
    • 36 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-methyl-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 37 1,1-(3-dimethylamino-3-(4-fluorophenyl)pentamethylene)-2-acetyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 38 1,1-(3-dimethylamino-3-benzylpentamethylene)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 39 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-fluoro-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 40 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-methyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 41 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-bromo-3-methyl-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 42 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-fluoro-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 43 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-bromo-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 44 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-methoxy-1,3,4,9-tetra-hydropyrano[3,4-b]indole;
    • 45 1,1-(3-(1-Pyrrolidyl)-3-phenylpentamethylene)-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 46 1,1-(3-dimethylamino-3-phenylpentamethylene)-7,8-dichloro-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 47 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-(1-benzyl-pyrazol-4-yl)-1,3,4,9-tetrahydro-pyrano[3,4-b]indole;
    • 48 1,1-(3-Methylamino-3-(2-thienyl)pentamethylene)-1,3,4,9-tetrahydro-pyrano[3,4-b]indole;
    • 49 1,1-(3-methylamino-3-(2-thienyl)pentamethylene)-6-fluoro-1,3,4,9-tetrahydro-pyrano[3,4-b]indole;
    • 50 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-cinnamoyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 51 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3,3-dimethylbutanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 52 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(cyclopentylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 53 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3,3-dimethylbutanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 54 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(pentanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 55 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2-furylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 56 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-furylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 57 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(4-fluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 58 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2-methoxybenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 59 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-methylbutanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 60 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(cyclohexylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 61 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-benzoyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 62 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(cyclohexylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 63 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(phenylacetyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 64 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(4-methoxybenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 65 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(4-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 66 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(thien-2-ylacetyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 67 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(phenylacetyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 68 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-butanoyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 69 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(4-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 70 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(3-fluoro-5-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 71 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2,3-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 72 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(4-methylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 73 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-phenylpropanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 74 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3,4-dichlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 75 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-cinnamoyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 76 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(2,6-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 77 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-methoxycarbonylpropanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 78 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3-chlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 79 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-fluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 80 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2,6-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 81 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3,4-dichlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 82 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(2,3,4,5,6-pentafluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 83 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-cyclohexylcarbonyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 84 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-cyclopentylpropanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 85 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(4-fluoro-3-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 86 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(4-methylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 87 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3,4,5-trimethoxybenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 88 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-cyclobutylcarbonyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 89 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(2,6-dichlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 90 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3-methoxybenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 91 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-thienylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 92 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-propanoyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 93 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2,4-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 94 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3,5-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 95 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(4-tert.butylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 96 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(3-methoxycarbonylpropanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 97 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3,4-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 98 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-ethylhexanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 99 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2-methylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 100 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-phenylpropanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 101 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3-fluoro-5-trifluoro
      Figure US20140303125A1-20141009-P00001
      methylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 102 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(4-fluoro-3-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 103 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(4-nitrobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 104 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3,5-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 105 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(2-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 106 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3,4-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 107 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(4-chlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 108 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3-methylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 109 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2,3,4,5-tetrafluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 110 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2,6-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 111 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-furylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 112 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2,4-dichlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 113 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3-methoxycarbonylpropanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 114 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3-chlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 115 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2-fluoro-5-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 116 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2-fluoro-4-trifluoro
      Figure US20140303125A1-20141009-P00001
      methylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 117 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(2-thienylacetyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 118 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(2,6-dichlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 119 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3,4-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 120 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(3-methylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 121 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-methoxycarbonyl
      Figure US20140303125A1-20141009-P00001
      propanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 122 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2-fluoro-6-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 123 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-methylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 124 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3,5-dichlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 125 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(2-furylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 126 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(pentanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 127 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(6-fluoro-2-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 128 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3-methoxybenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 129 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(4-tert.butylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 130 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(phenylacetyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 131 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3,5-dichlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 132 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(2,3,4,5,6-pentafluoro-benzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 133 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(3-nitrobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 134 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-nitrobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 135 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(2,3,4,5-tetrafluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 136 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-thienylacetyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 137 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-fluoro-4-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 138 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-fluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 139 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(cyclobutylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 140 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-methoxybenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 141 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2,5-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 142 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2-bromobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 143 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-fluoro-5-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 144 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-fluoro-5-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 145 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2,3-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene, and
      physiologically compatible salts thereof
  • It has been found that spirocyclic cyclohexane derivatives in which W denotes NR4 and X denotes NR17 are particularly advantageous. Accordingly it is preferred to use compounds in which R denotes NR4 and X denotes NR17. It is particularly preferred to use compounds selected from the group consisting of:
    • 2 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(2-nitrobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 8 1,1-(3-dimethylamino-3-phenylpentamethylene)-3-hydroxymethyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 9 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2,3,4,5,6-pentafluoro-benzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 10 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(methoxycarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 11 1,1-(3-dimethylamino-3-phenylpentamethylene)-7-fluoro-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 13 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 14 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-acetyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 17 1,1-(3-dimethylamino-3-(2-pyridyl)pentamethylene)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 19 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-acetyl-7-fluoro-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 20 1,1-(3-dimethylamino-3-phenylpentamethylene)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 25 1,1-(3-dimethylamino-3-(4-fluorophenyl)pentamethylene)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 26 1,1-(3-dimethylamino-3-phenylpentamethylene)-3-methyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 30 1,1-(3-dimethylamino-3-phenylpentamethylene)-3-methyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 37 1,1-(3-dimethylamino-3-(4-fluorophenyl)pentamethylene)-2-acetyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 38 1,1-(3-dimethylamino-3-benzylpentamethylene)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 39 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-fluoro-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 40 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-methyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 50 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-cinnamoyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 51 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3,3-dimethylbutanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 52 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(cyclopentylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 53 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3,3-dimethylbutanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 54 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(pentanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 55 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2-furylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 56 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-furylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 57 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(4-fluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 58 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2-methoxybenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 59 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-methylbutanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 60 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(cyclohexylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 61 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-benzoyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 62 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(cyclohexylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 63 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(phenylacetyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 64 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(4-methoxybenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 65 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(4-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 66 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(thien-2-ylacetyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 67 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(phenylacetyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 68 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-butanoyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 69 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(4-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 70 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(3-fluoro-5-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 71 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2,3-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 72 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(4-methylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 73 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-phenylpropanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 74 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3,4-dichlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 75 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-cinnamoyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 76 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(2,6-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 77 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-methoxycarbonylpropanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 78 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3-chlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 79 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-fluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 80 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2,6-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 81 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3,4-dichlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 82 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(2,3,4,5,6-pentafluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 83 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-cyclohexylcarbonyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 84 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-cyclopentylpropanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 85 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(4-fluoro-3-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 86 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(4-methylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 87 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3,4,5-trimethoxybenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 88 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-cyclobutylcarbonyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 89 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(2,6-dichlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 90 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3-methoxybenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 91 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-thienylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 92 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-propanoyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 93 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2,4-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 94 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3,5-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 95 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(4-tert.butylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 96 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(3-methoxycarbonylpropanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 97 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3,4-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 98 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-ethylhexanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 99 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2-methylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 100 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-phenylpropanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 101 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3-fluoro-5-trifluoro
      Figure US20140303125A1-20141009-P00001
      methylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 102 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(4-fluoro-3-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 103 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(4-nitrobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 104 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3,5-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 105 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(2-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 106 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3,4-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 107 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(4-chlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 108 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3-methylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 109 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2,3,4,5-tetrafluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 110 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2,6-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 111 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-furylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 112 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2,4-dichlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 113 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3-methoxycarbonylpropanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 114 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3-chlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 115 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2-fluoro-5-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 116 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2-fluoro-4-trifluoro
      Figure US20140303125A1-20141009-P00001
      methylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 117 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(2-thienylacetyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 118 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(2,6-dichlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 119 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3,4-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 120 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(3-methylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 121 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-methoxycarbonyl
      Figure US20140303125A1-20141009-P00001
      propanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 122 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2-fluoro-6-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 123 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-methylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 124 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3,5-dichlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 125 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(2-furylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 126 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(pentanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 127 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(6-fluoro-2-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 128 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3-methoxybenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 129 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(4-tert.butylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 130 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(phenylacetyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 131 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3,5-dichlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 132 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(2,3,4,5,6-pentafluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 133 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(3-nitrobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 134 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-nitrobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 135 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(2,3,4,5-tetrafluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 136 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-thienylacetyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 137 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-fluoro-4-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 138 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-fluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 139 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(cyclobutylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 140 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-methoxybenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 141 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2,5-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 142 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2-bromobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 143 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-fluoro-5-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 144 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-fluoro-5-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 145 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2,3-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene, and
      physiologically compatible salts thereof.
  • Particularly preferred compounds are selected from the group consisting of:
    • 8 1,1-(3-dimethylamino-3-phenylpentamethylene)-3-hydroxymethyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 10 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(methoxycarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 11 1,1-(3-dimethylamino-3-phenylpentamethylene)-7-fluoro-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 13 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 14 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-acetyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 17 1,1-(3-dimethylamino-3-(2-pyridyl)pentamethylene)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 19 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-acetyl-7-fluoro-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 20 1,1-(3-dimethylamino-3-phenylpentamethylene)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 25 1,1-(3-dimethylamino-3-(4-fluorophenyl)pentamethylene)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 50 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-cinnamoyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 51 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3,3-dimethylbutanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 52 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(cyclopentylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 53 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3,3-dimethylbutanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 54 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(pentanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 55 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2-furylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 56 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-furylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 57 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(4-fluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 58 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2-methoxybenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 59 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-methylbutanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 60 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(cyclohexylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 61 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-benzoyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 62 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(cyclohexylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 63 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(phenylacetyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 64 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(4-methoxybenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 65 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(4-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 66 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(thien-2-ylacetyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 67 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(phenylacetyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 68 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-butanoyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 69 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(4-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 70 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(3-fluoro-5-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 71 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2,3-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 72 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(4-methylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 73 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-phenylpropanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 74 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3,4-dichlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 75 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-cinnamoyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 76 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(2,6-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 77 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-methoxycarbonylpropanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 78 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3-chlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 79 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-fluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 80 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2,6-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 81 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3,4-dichlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 82 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(2,3,4,5,6-pentafluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 83 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-cyclohexylcarbonyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 84 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-cyclopentylpropanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 85 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(4-fluoro-3-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 86 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(4-methylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 87 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3,4,5-trimethoxybenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 88 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-cyclobutylcarbonyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 89 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(2,6-dichlorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 90 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3-methoxybenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 91 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-thienylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 92 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-propanoyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 93 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2,4-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 94 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3,5-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 95 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(4-tert.butylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 96 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(3-methoxycarbonylpropanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 97 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3,4-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 98 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-ethylhexanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 99 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2-methylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 100 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-phenylpropanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 101 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3-fluoro-5-trifluoro
      Figure US20140303125A1-20141009-P00001
      methylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 102 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(4-fluoro-3-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene; and
      physiologically compatible salts thereof.
  • Particularly preferred are compounds selected from the group consisting of:
    • 8 1,1-(3-dimethylamino-3-phenylpentamethylene)-3-hydroxymethyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 10 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(methoxycarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 11 1,1-(3-dimethylamino-3-phenylpentamethylene)-7-fluoro-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 13 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 14 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-acetyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 17 1,1-(3-dimethylamino-3-(2-pyridyl)pentamethylene)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 50 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-cinnamoyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 51 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(3,3-dimethylbutanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 52 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(cyclopentylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 53 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3,3-dimethylbutanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 54 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(pentanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 55 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2-furylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 56 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(2-furylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 57 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(4-fluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 58 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2-methoxybenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 59 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(3-methylbutanoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 60 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(cyclohexylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 61 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-benzoyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 62 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(cyclohexylcarbonyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 63 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(phenylacetyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 64 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(4-methoxybenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 65 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-(4-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 66 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(thien-2-ylacetyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 67 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(phenylacetyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 68 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-butanoyl-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 69 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(4-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 70 1,1-(3-dimethylamino-3-benzylpentamethylene)-2-(3-fluoro-5-trifluoromethylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 71 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(2,3-difluorobenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene;
    • 72 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-2-(4-methylbenzoyl)-1,3,4,9-tetrahydro-2,9-diazafluorene, and
      physiologically acceptable salts thereof
  • Furthermore, is has been shown that spirocyclic cyclohexane derivatives in which W denotes NR4 and X denotes O are likewise particularly preferred. Accordingly, in the context of the present invention spirocyclic cyclohexane derivatives in which W denotes NR4 and X denotes O are preferred. It is particularly preferred to use compounds selected from the group consisting of:
    • 1 1,1-(3-dimethylamino-3-phenylpentamethylene)-1,3,4,9-tetrahydro-pyrano[3,4-b]indole;
    • 3 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-fluoro-1,3,4,9-tetrahydro-pyrano[3,4-b]indole;
    • 4 1,1-(3-dimethylamino-3-(2-thienyl)pentamethylene)-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 5 1,1-(3-dimethylamino-3-phenylpentamethylene)-3-methyl-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 6 1,1-(3-dimethylamino-3-phenylpentamethylene)-3,6-dimethyl-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 7 1,1-(3-dimethylamino-3-(4-fluorophenyl)pentamethylene)-1,3,4,9-tetrahydro-pyrano[3,4-b]indole;
    • 12 1,1-(3-dimethylamino-3-phenylpentamethylene)-1,3,4,9-tetrahydro-2-aza-9-oxafluorene;
    • 15 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 16 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-chloro-3-methyl-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 18 1,1-(3-dimethylamino-3-(3-thienyl)pentamethylene)-6-fluoro-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 21 1,1-(3-dimethylamino-3-phenylpentamethylene)-3-methyl-1,3,4,9-tetra-hydropyrano[3,4-b]indole;
    • 23 1,1-(3-dimethylamino-3-phenylpentamethylene)-3-methyl-6-nitro-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 24 1,1-(3-dimethylamino-3-(3-thienyl)pentamethylene)-1,3,4,9-tetrahydro-pyrano[3,4-b]indole;
    • 29 1,1-(3-dimethylamino-3-(2-thienyl)pentamethylene)-6-fluoro-1,3,4,9-tetrahydro-pyrano[3,4-b]indole;
    • 31 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-fluoro-3-methyl-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 32 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-hydroxy-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 33 1,1-(3-dimethylamino-3-(3-hydroxyphenyl)pentamethylene)-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 35 6,6-(3-dimethylamino-3-phenylpentamethylene)-1,2,3,4,4a,6,7,11c-octahydro-5-oxa-7-aza-benzo[c]fluorine;
    • 36 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-methyl-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 41 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-bromo-3-methyl-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 42 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-fluoro-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 43 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-bromo-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 44 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-methoxy-1,3,4,9-tetra-hydropyrano[3,4-b]indole;
    • 45 1,1-(3-(1-Pyrrolidyl)-3-phenylpentamethylene)-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 46 1,1-(3-dimethylamino-3-phenylpentamethylene)-7,8-dichloro-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 47 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-(1-benzyl-pyrazol-4-yl)-1,3,4,9-tetrahydro-pyrano[3,4-b]indole;
    • 48 1,1-(3-Methylamino-3-(2-thienyl)pentamethylene)-1,3,4,9-tetrahydro-pyrano[3,4-b]indole;
    • 49 1,1-(3-Methylamino-3-(2-thienyl)pentamethylene)-6-fluoro-1,3,4,9-tetrahydro-pyrano[3,4-b]indole, and
      physiologically acceptable salts thereof.
  • In particular, it is preferred to use compounds selected from the group consisting of:
    • 1 1,1-(3-dimethylamino-3-phenylpentamethylene)-1,3,4,9-tetrahydro-pyrano[3,4-b]indole
    • 3 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-fluoro-1,3,4,9-tetrahydro-pyrano[3,4-b]indole
    • 4 1,1-(3-dimethylamino-3-(2-thienyl)pentamethylene)-1,3,4,9-tetrahydropyrano[3,4-b]indole
    • 5 1,1-(3-dimethylamino-3-phenylpentamethylene)-3-methyl-1,3,4,9-tetrahydropyrano[3,4-b]indole
    • 6 1,1-(3-dimethylamino-3-phenylpentamethylene)-3,6-dimethyl-1,3,4,9-tetrahydropyrano[3,4-b]indole
    • 7 1,1-(3-dimethylamino-3-(4-fluorophenyl)pentamethylene)-1,3,4,9-tetrahydro-pyrano[3,4-b]indole
    • 12 1,1-(3-dimethylamino-3-phenylpentamethylene)-1,3,4,9-tetrahydro-2-aza-9-oxafluorene
    • 15 1,1-(3-dimethylamino-3-(3-fluorophenyl)pentamethylene)-1,3,4,9-tetrahydropyrano[3,4-b]indole
    • 16 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-chloro-3-methyl-1,3,4,9-tetrahydropyrano[3,4-b]indole
    • 18 1,1-(3-dimethylamino-3-(3-thienyl)pentamethylene)-6-fluoro-1,3,4,9-tetrahydropyrano[3,4-b]indole
    • 21 1,1-(3-dimethylamino-3-phenylpentamethylene)-3-methyl-1,3,4,9-tetra-hydropyrano[3,4-b]indole
    • 23 1,1-(3-dimethylamino-3-phenylpentamethylene)-3-methyl-6-nitro-1,3,4,9-tetrahydropyrano[3,4-b]indole
    • 24 1,1-(3-dimethylamino-3-(3-thienyl)pentamethylene)-1,3,4,9-tetrahydro-pyrano[3,4-b]indole
    • 47 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-(1-benzyl-pyrazol-4-yl)-1,3,4,9-tetrahydro-pyrano[3,4-b]indole
    • 48 1,1-(3-Methylamino-3-(2-thienyl)pentamethylene)-1,3,4,9-tetrahydro-pyrano[3,4-b]indole, and
      physiologically acceptable salts thereof.
  • It is most particularly preferred to use compounds selected from the group:
    • 1 1,1-(3-dimethylamino-3-phenylpentamethylene)-1,3,4,9-tetrahydro-pyrano[3,4-b]indole;
    • 3 1,1-(3-dimethylamino-3-phenylpentamethylene)-6-fluoro-1,3,4,9-tetrahydropyrano[3,4-b]indole;
    • 4 1,1-(3-dimethylamino-3-(2-thienyl)pentamethylene)-1,3,4,9-tetrahydro-pyrano[3,4-b]indole, and
      physiologically acceptable salts thereof
  • Also preferred are compounds selected from the group consisting of:
    • 22 1,1-(3-dimethylamino-3-phenylpentamethylene)-1,3,4,9-tetrahydro-2-thia-9-azafluorene;
    • 27 1,1-(3-dimethylamino-3-phenylpentamethylene)-2-oxo-1,3,4,9-tetrahydro-2-thia-9-azafluorene;
    • 28 1,1-(3-dimethylamino-3-phenylpentamethylene)-1,3,4,9-tetrahydro-2-thia-9-azafluorene;
    • 34 1,1-(3-dimethylamino-3-phenylpentamethylene)-1,3,4,9-tetrahydro-2-thia-9-azafluorene, and
      physiologically acceptable salts thereof.
  • The synthesis of the compounds is described in US 2006/004034 A1 and US 2005/066183 A1. The isolation of the compounds according to the invention by column chromatography with silica gel as stationary phase leads to a separation of the different polar diastereomers. These were characterised on the basis of their running time as “non-polar” diastereomer (shorter running time) and “polar” diastereomer (longer running time). Silica gel 60 (0.040-0.063 mm) from E. Merck, Darmstadt, was used. The thin-layer chromatography investigations were carried out with HPTLC precoated plates from E. Merck, Darmstadt. As solvent, for example methanol/ethyl acetate was used in a ratio of 1:1, 2:1, 3:1 or 4:1, preferably 3:1, or methanol/conc. ammonia solution 99.5:0.5 or methanol/ethyl acetate/conc. ammonia solution in a ratio of 66:33:0.5.
  • The pharmaceutical compositions of the invention optionally contain, besides at least one compound according to the invention, suitable additives and/or auxiliary substances, including carrier materials, fillers, solvents, diluents, coloring agents and/or binders, and may be administered as liquid medicament forms in the form of injection solutions, drops or ointments, as semi-solid medicament forms in the form of granules, tablets, pellets, patches, capsules, plasters/spray plasters or aerosols. The choice of the auxiliary substances etc. as well as the amounts thereof to be used depend on whether the medicament is to be administered orally, perorally, parenterally, intravenously, intraperitoneally, intradermally, intramuscularly, intranasally, buccaly, rectally or topically for example to the skin, mucus membranes or to the eyes. For oral application suitable preparations are in the form of tablets, coated tablets, capsules, granules, drops, ointments and syrups, while for parenteral, topical and inhalative application suitable forms are solutions, suspensions, readily reconstitutable dry preparations, as well as sprays. Spirocyclic cyclohexane derivatives according to the invention in depot form, in dissolved form or in a plaster form, optionally with the addition of agents promoting penetration of the skin, are suitable percutaneous application preparations. Orally or percutaneously usable preparation forms can provide for the delayed release of the compounds according to the invention. The compounds according to the invention can also be employed in parenteral long-term depot forms, such as for example implants or implanted pumps. In principle other active constituents known to the person skilled in the art can be added to the medicaments according to the invention.
  • The amount of active constituent to be administered to the patient varies depending on the patient's weight, form of application, medical implications and the severity of the illness. Normally 0.00005 to 1 mg/kg, preferably 0.0001 to 0.05 mg/kg of at least one spirocyclic cyclohexane derivative according to the invention is applied.
  • All the aforementioned forms of the medicaments according to the invention also may contain, in addition to at least one compound according to the invention, a further active constituent, in particular an opioid antagonist, preferably naloxone.
    • Comparative Investigations
  • For comparison purposes the standard medication levomethadone, which has no significant ORL1 component, was tested in the withdrawal jumping test. Levomethadone, which is one of the standard therapeutic agents used in substitution therapy, likewise induced withdrawal jumping. Among the compounds described in US 2006/004034 A1 and US 2005/066183 A1 are a number of substances with a slight ORL1 component. Two typical members with a slight ORL1 component (compounds m and n) were likewise tested in the withdrawal jumping test and induced withdrawal jumping. This shows the importance of the ORL1 component as regards the suitability of a substance for substitution therapy within the group of compounds described in US 2006/004034 A1 and US 2005/066183 A1.
  • The properties that are desired in the standard therapeutic agents and which are to some extent manifested include:
      • 1. High opioid potency
      • 2. Full intrinsic activity
      • 3. Long action duration (active metabolites such as for example in the case of LAAM are even desirable in this indication)
      • 4. Slower action on set, especially with oral administration (less “kick”)
      • 5. Lower cardio toxicity
        Whereas with the known standard substances some of these properties are missing or are insufficiently manifested, with the compounds according to the invention all the required properties were present.
  • The compounds according to the invention show significantly reduced cardiovascular side effects compared to methadone and LAAM. The cardiovascular side effects are attributed to a delayed cardiac repolarisation (manifested as a QTc extension in the outside ECG), which is caused by the blockade of a special potassium channel (HERG) (Kornick et al. Pain 2003, 105, 499-506). Both methadone and LAAM exhibit interactions with the HERG channel (Jiesheng et al., Eur. J. Pharmacol. 2003, 458, 25-29; Katchman et al., J. Pharmacol. Exp. Ther. 2002, 303, 688-694). In connection with the order issued by Orlaam (LAAM) the FDA gave a warning in 2001 about the cardiovascular effects (JAMA 2001, 285, 2705). In the case of the compounds according to the invention it was shown for example that the cardiovascular side effects are significantly less compared to methadone and LAAM.
    • EXAMPLES
  • Within the group of spiro compounds described in US 2006/004034 A1 and US 2005/192333 A1 there are compounds with a higher and lower ORL1 component.
    • Measurement of the ORL1 Binding
  • The cyclohexane derivatives of the general formula I were investigated in a receptor binding assay with 3H-nociceptin/orphanin FQ with membranes of recombinant CHO-ORL1 cells. This test system was implemented according to the method proposed by Ardati et al. (Mol. Pharmacol., 51, 1997, pp. 816-824). The concentration of 3H-nociceptin/orphanin FQ in these tests was 0.5 nM. The binding assays were carried out with 20 μg of membrane protein per 200 μl of batch in 50 mM Hepes, pH 7.4, 10 mM MgCl2 and 1 mM EDTA. The binding to the ORL1 receptor was determined using in each case 1 mg WGA-SPA beads (Amersham-Pharmacia, Freiburg), by incubating the batch for one hour at room temperature followed by measurement in a Trilux scintillation counter (Wallac, Finland). The affinity is given in Table 1 as nanomolar Kij value in or % inhibition at c=1 μM.
    • Measurement of the μ-Binding
  • The receptor affinity for the human μ-opiate receptor was determined in a homogeneous batch in mikrotiter plates. For this purpose dilution series of the respective substituted cyclohexyl-1,4-diamine derivatives to be tested were incubated with a receptor membrane preparation (15-40 μg protein per 250 μl incubation batch) of CHO—K1 cells which express the human μ-opiate receptor (RB-HOM receptor membrane preparation obtained from the NEN company, Zaventem, Belgium) in the presence of 1 nmol/1 of the radioactive ligand [3H]-naloxone (NET719, NEN company, Zaventem, Belgium) as well as of 1 mg WGA-SPA beads (wheat germ agglutinin SPA Beads from Amersham/Pharmacia, Freiburg, Germany) in a total volume of 250 μl for 90 minutes at room temperature. 50 mmol/l tris-HCl supplemented by 0.05 wt. % of sodium azide and 0.06 wt. % of bovine serum albumin were used as incubation buffer. In order to determine the non-specific binding, 25 μmol/l of naloxone were additionally added. After the end of the 9-minute incubation period the microtiter plates were centrifuged for 20 minutes at 1000 G and the radioactivity was measured in a β-counter (Microbeta-Trilux, PerkinElmer Wallac Company, Freiburg, Germany). The percentage displacement of the radioactive ligand from its binding to the human μ-opiate receptor at a concentration of the test substances of 1 μmol/l was determined and given as the percentage inhibition (% inhibition) of the specific binding. In some cases IC50 inhibition concentrations which effect a 50% displacement of the radioactive ligand were calculated on the basis of the percentage displacement by different concentration of the compounds of the general formula I to be tested. Ki values for the test substances were obtained by conversion using the Cheng-Prusoff relationship.
  • The following table lists by way of example some compounds which, although they bind very well to the μ-opiate receptor, nevertheless have a relatively low ORL1 component:
  • ORL1/μ ratio
    calculated as ORL-1 μ-opiate-
    Ki(μ)/Ki(ORL1) [1 μM], receptor
    (only for measured % [1 μM],
    Compound Structure Ki values) inhibition % inhibition
    a
    Figure US20140303125A1-20141009-C00002
         		1 83
    b
    Figure US20140303125A1-20141009-C00003
       Citrate     		5 89
    c
    Figure US20140303125A1-20141009-C00004
       Citrate     		11 74
    d
    Figure US20140303125A1-20141009-C00005
         		13 83
    e
    Figure US20140303125A1-20141009-C00006
       Citrate    		 15 75
    f
    Figure US20140303125A1-20141009-C00007
       Citrate    		 27 92
    g
    Figure US20140303125A1-20141009-C00008
         		31 91
    h
    Figure US20140303125A1-20141009-C00009
         		32 97
    I
    Figure US20140303125A1-20141009-C00010
         		32 99
    j
    Figure US20140303125A1-20141009-C00011
       Citrate    		 33 78
    k
    Figure US20140303125A1-20141009-C00012
         		41 82
    l
    Figure US20140303125A1-20141009-C00013
       Citrate    		 43 100
    m
    Figure US20140303125A1-20141009-C00014
       Citrate    		 0.03   69 nM (Ki) 2.4 nM (Ki)
    n
    Figure US20140303125A1-20141009-C00015
       Hemicitrate    		 0.1 14.3 nM (Ki) 1.8 nM (Ki)
  • As shown by way of example in the compounds m and n, these compounds do not suppress withdrawal jumping.
  • Compared to the above, the following compounds have an almost balanced ORL1/μ ratio. Ideally, they have a more strongly pronounced ORL1 component. The ORL1:μ ratio is however at least 1:3:
  •
    ORL1/μ
    Ratio ORL1
    calculated human μ
    as Ki(μ)/ Ki Ki
    No. Compound Name Remarks Ki(ORL1) [μM] [μM]
     1
    Figure US20140303125A1-20141009-C00016
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-1,3,4,9- tetrahydropyrano[3,4- b]indole Hemicitrate Non-polar diastereomer 2 0.0034 0.0058
     2
    Figure US20140303125A1-20141009-C00017
         		1,1-(3-dimethylamino- 3-benzylpentamethyl- ene)-2-(2-nitro- benzoyl)-1,3,4,9- tetrahydro-2,9- diazafluorene 0.32 0.0038 0.0012
     3
    Figure US20140303125A1-20141009-C00018
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-6-fluoro-1,3,4,9- tetrahydropyrano[3,4- b]indole Hemicitrate Non-polar diastereomer 2.45 0.0026 0.006
     4
    Figure US20140303125A1-20141009-C00019
         		1,1-(3-dimethylamino- 3-(2-thienyl)penta- methylene)-1,3,4,9- tetrahydropyrano[3,4- b]indole Hemicitrate Non-polar diastereomer 2.07 0.0003 0.0006
     5
    Figure US20140303125A1-20141009-C00020
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-3-methyl-1,3,4,9- tetrahydropyrano[3,4- b]indole Hemicitrate Non-polar diastereomer 3.82 0.0012 0.0047
     6
    Figure US20140303125A1-20141009-C00021
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-3,6-dimethyl- 1,3,4,9-tetrahydro- pyrano[3,4-b]indole Hemicitrate One of two diastereomers 3.18 0.0044 0.014
     7
    Figure US20140303125A1-20141009-C00022
         		1,1-(3-dimethylamino- 3-(4-fluorophenyl)- pentamethylene)- 1,3,4,9-tetrahydro- pyrano[3,4-b]indole Hemicitrate One of two diastereomers 3.00 0.0032 0.010
     8
    Figure US20140303125A1-20141009-C00023
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-3-hydroxymethyl- 1,3,4,9-tetrahydro-2,9- diazafluorene Dicitrate Diastereomer mixture 2.70 0.0010 0.0027
     9
    Figure US20140303125A1-20141009-C00024
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-2-(2,3,4,5,6- pentafluorobenzoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 0.32 0.13 0.041
     10
    Figure US20140303125A1-20141009-C00025
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-2-(methoxy- carbonyl)-1,3,4,9- tetrahydro-2,9- diazafluorene Citrate Diastereomer Mixture 2.67 0.0009 0.0023
     11
    Figure US20140303125A1-20141009-C00026
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-7-fluoro-1,3,4,9- tetrahydro-2,9- diazafluorene Citrate Polar Diastereomer 2.46 0.007 0.02
     12
    Figure US20140303125A1-20141009-C00027
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-1,3,4,9- tetrahydro-2-aza-9- oxafluorene Citrate Diastereomer mixture 2.39 0.07 0.17
     13
    Figure US20140303125A1-20141009-C00028
         		1,1-(3-dimethylamino- 3-(3-fluorophenyl)- pentamethylene)- 1,3,4,9-tetrahydro-2,9- diazafluorene Diastereomer mixture 2.22 0.0036 0.008
     14
    Figure US20140303125A1-20141009-C00029
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-2-acetyl-1,3,4,9- tetrahydro-2,9- diazafluorene hydrochloride Non-polar diastereomer 1.98 0.0029 0.006
     15
    Figure US20140303125A1-20141009-C00030
         		1,1-(3-dimethylamino- 3-(3-fluorophenyl)- pentamethylene)- 1,3,4,9-tetrahydro- pyrano[3,4-b]indole Hemicitrate One of two diastereomers 1.79 0.0012 0.0022
     16
    Figure US20140303125A1-20141009-C00031
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-6-chloro-3- methyl-1,3,4,9- tetrahydropyrano- [3,4-b]indole Citrate Non-polar diastereomer 1.77 0.06 0.11
     17
    Figure US20140303125A1-20141009-C00032
         		1,1-(3-dimethylamino- 3-(2-pyridyl)penta- methylene)-1,3,4,9- tetrahydro-2,9- diazafluorene Diastereomer mixture 1.75 0.0016 0.0028
     18
    Figure US20140303125A1-20141009-C00033
         		1,1-(3-dimethylamino- 3-(3-thienyl)penta- methylene)-6-fluoro- 1,3,4,9-tetrahydro- pyrano[3,4-b]indole Hemicitrate Non-polar Diastereomer 1.62 0.0003 0.0006
     19
    Figure US20140303125A1-20141009-C00034
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-2-acetyl-7-fluoro- 1,3,4,9-tetrahydro-2,9- diazafluorene Citrate Diastereomer mixture 1.41 0.0011 0.0016
     20
    Figure US20140303125A1-20141009-C00035
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- en)-1,3,4,9-tetrahydro- 2,9-diazafluorene Di- hydrochloride Diastereomer mixture 1.38 0.0003 0.0004
     21
    Figure US20140303125A1-20141009-C00036
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-3-methyl-1,3,4,9- tetrahydropyrano[3,4- b]indole Citrate Diastereomer mixture 1.38 0.04 0.06
     22
    Figure US20140303125A1-20141009-C00037
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- en)-1,3,4,9-tetrahydro- 2-thia-9-azafluorene Citrate Diastereomer mixture 1.33 0.02 0.02
     23
    Figure US20140303125A1-20141009-C00038
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-3-methyl-6-nitro- 1,3,4,9-tetrahydro- pyrano[3,4-b]indole Citrate Polar diastereomer 1.29 0.03 0.04
     24
    Figure US20140303125A1-20141009-C00039
         		1,1-(3-dimethylamino- 3-(3-thienyl)penta- methylene)-1,3,4,9- tetrahydropyrano- [3,4-b]indole Hemicitrate Non-polar diastereomer 1.19 0.0006 0.0007
     25
    Figure US20140303125A1-20141009-C00040
         		1,1-(3-dimethylamino- 3-(4-fluorophenyl)- pentamethylene)- 1,3,4,9-tetrahydro-2,9- diazafluorene Diastereomer mixture 1.12 0.0026 0.0029
     26
    Figure US20140303125A1-20141009-C00041
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-3-methyl-1,3,4,9- tetrahydro-2,9- iazafluorene Citrate One of two diastereomers 0.94 0.0005 0.0005
     27
    Figure US20140303125A1-20141009-C00042
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-2-oxo-1,3,4,9- tetrahydro-2-thia-9- azafluorene Citrate 0.94 0.06 0.06
     28
    Figure US20140303125A1-20141009-C00043
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- en)-1,3,4,9-tetrahydro- 2-thia-9-azafluorene Hemicitrate Non-polar diastereomer 0.84 0.0037 0.0031
     29
    Figure US20140303125A1-20141009-C00044
         		1,1-(3-dimethylamino- 3-(2-thienyl)penta- methylene)-6-fluoro- 1,3,4,9-tetrahydro- pyrano[3,4-b]indole Hemicitrate Non-polar diastereomer 0.82 0.0007 0.0006
     30
    Figure US20140303125A1-20141009-C00045
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-3-methyl-1,3,4,9- tetrahydro-2,9- diazafluorene Dihydro- chloride Diastereomer mixture 0.78 0.0006 0.0005
     31
    Figure US20140303125A1-20141009-C00046
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-6-fluoro-3- methyl-1,3,4,9- tetrahydropyrano- [3,4-b]indole Hemicitrate One of two diastereomers 0.73 0.08 0.06
     32
    Figure US20140303125A1-20141009-C00047
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-6-hydroxy- 1,3,4,9-tetrahydro- pyrano[3,4-b]indole Citrate One of two diastereomers 0.7 0.0016 0.0011
     33
    Figure US20140303125A1-20141009-C00048
         		1,1-(3-dimethylamino- 3-(3-hydroxyphenyl)- pentamethylene)- 1,3,4,9-tetrahydro- pyrano[3,4-b]indole Methyl- sulfonate One of two diastereomers 0.66 0.014 0.009
     34
    Figure US20140303125A1-20141009-C00049
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- en)-1,3,4,9-tetrahydro- 2-thia-9-azafluorene Citrate Polar diastereomer 0.62 0.13 0.08
     35
    Figure US20140303125A1-20141009-C00050
         		6,6-(3-dimethylamino- 3-phenylpentamethyl- en)-1,2,3,4,4a,6,7,11c- octahydro-5-oxa-7-aza- benzo[c]fluorine Citrate Diastereomer mixture 0.62 0.11 0.07
     36
    Figure US20140303125A1-20141009-C00051
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-6-methyl-1,3,4,9- tetrahydropyrano- [3,4-b]indole Hemicitrate One of two diastereomers 0.60 0.0045 0.0027
     37
    Figure US20140303125A1-20141009-C00052
         		1,1-(3-dimethylamino- 3-(4-fluorophenyl)- pentamethylene)-2- acetyl-1,3,4,9- tetrahydro-2,9- diazafluorene Citrate Diastereomer mixture 0.55 0.006 0.0033
     38
    Figure US20140303125A1-20141009-C00053
         		1,1-(3-dimethylamino- 3-benzylpentamethyl- en)-1,3,4,9-tetrahydro- 2,9-diazafluorene One of two diastereomers 0.54 0.0011 0.0006
     39
    Figure US20140303125A1-20141009-C00054
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-6-fluoro-1,3,4,9- tetrahydro-2,9- diazafluorene Dihydro- chloride One of two diastereomers 0.51 0.0014 0.0007
     40
    Figure US20140303125A1-20141009-C00055
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-6-methyl-1,3,4,9- tetrahydro-2,9- diazafluorene Citrate Polar diastereomer 0.47 0.03 0.02
     41
    Figure US20140303125A1-20141009-C00056
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-6-bromo-3- methyl-1,3,4,9- tetrahydropyrano- [3,4-b]indole Hemicitrate One of two diastereomers 0.45 0.02 0.010
     42
    Figure US20140303125A1-20141009-C00057
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-6-fluoro-1,3,4,9- tetrahydropyrano- [3,4-b]indole Citrate Polar diastereomer 0.42 0.02 0.009
     43
    Figure US20140303125A1-20141009-C00058
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-6-bromo-1,3,4,9- tetrahydropyrano- [3,4-b]indole Hemicitrate One of two diastereomers 0.37 0.05 0.02
     44
    Figure US20140303125A1-20141009-C00059
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-6-methoxy- 1,3,4,9-tetrahydro- pyrano[3,4-b]indole hydrochloride Non-polar diastereomer 0.34 0.006 0.0020
     45
    Figure US20140303125A1-20141009-C00060
         		1,1-(3-(1-Pyrrolidyl)- 3-phenylpentamethyl- en)-1,3,4,9-tetrahydro- pyrano[3,4-b]indole Hemicitrate Non-polar diastereomer 0.31 0.0035 0.0011
     46
    Figure US20140303125A1-20141009-C00061
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-7,8-dichloro- 1,3,4,9-tetrahydro- pyrano[3,4-b]indole Methane sulfonate One of two diastereomers 0.31 0.0045 0.0014
     47
    Figure US20140303125A1-20141009-C00062
         		1,1-(3-dimethylamino- 3-phenylpentamethyl- ene)-6-(1-benzyl- pyrazol-4-yl)-1,3,4,9- tetrahydropyrano- [3,4-b]indole hydrochloride Non-polar diastereomer 2.73 0.0044 0.012
     48
    Figure US20140303125A1-20141009-C00063
         		1,1-(3-Methylamino-3- (2-thienyl)pentameth- ylene)-1,3,4,9-tetra- hydropyrano[3,4-b]- indole One of two diastereomers 6.56 0.00032 0.0021
     49
    Figure US20140303125A1-20141009-C00064
         		1,1-(3-Methylamino-3- (2-thienyl)pentameth- ylene)-6-fluoro- 1,3,4,9-tetrahydro- pyrano[3,4-b]indole Citrate One of two diastereomers 0.7 0.0042 0.0028
    ORL1,
    ORL1/μ Ki μ, Ki
    No. Compound Name ratio [μM] [μM]
     50
    Figure US20140303125A1-20141009-C00065
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-cinnamoyl-1,3,4,9- tetrahydro-2,9-diazafluorene 21.43 0.0014 0.030000
     51
    Figure US20140303125A1-20141009-C00066
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(3,3-dimethylbutanoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 5.00 0.0026 0.013000
     52
    Figure US20140303125A1-20141009-C00067
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(cyclopentylcarbonyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 4.78 0.0067 0.032
     53
    Figure US20140303125A1-20141009-C00068
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(3,3- dimethylbutanoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 3.54 0.0048 0.017
     54
    Figure US20140303125A1-20141009-C00069
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(pentanoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 3.42 0.0038 0.013
     55
    Figure US20140303125A1-20141009-C00070
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(2-furylcarbonyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 3.14 0.022 0.069
     56
    Figure US20140303125A1-20141009-C00071
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(2- furylcarbonyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 2.90 0.01 0.029
     57
    Figure US20140303125A1-20141009-C00072
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(4-fluorobenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 2.83 0.0046 0.013
     58
    Figure US20140303125A1-20141009-C00073
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(2-methoxybenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 2.78 0.00097 0.0027
     59
    Figure US20140303125A1-20141009-C00074
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(3- methylbutanoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 2.68 0.0041 0.011
     60
    Figure US20140303125A1-20141009-C00075
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(cyclohexylcarbonyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 2.60 0.025 0.065
     61
    Figure US20140303125A1-20141009-C00076
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-benzoyl-1,3,4,9-tetrahydro- 2,9-diazafluorene 2.50 0.0034 0.0085
     62
    Figure US20140303125A1-20141009-C00077
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2- (cyclohexylcarbonyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 2.40 0.002 0.0048
     63
    Figure US20140303125A1-20141009-C00078
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(phenylacetyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 2.35 0.002 0.0047
     64
    Figure US20140303125A1-20141009-C00079
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(4-methoxybenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 2.29 0.038 0.087
     65
    Figure US20140303125A1-20141009-C00080
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(4- trifluoromethylbenzoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 2.18 0.0078 0.017
     66
    Figure US20140303125A1-20141009-C00081
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(thien-2-ylacetyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 2.12 0.017 0.036
     67
    Figure US20140303125A1-20141009-C00082
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(phenylacetyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 2.07 0.0014 0.0029
     68
    Figure US20140303125A1-20141009-C00083
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-butanoyl-1,3,4,9-tetrahydro- 2,9-diazafluorene 2.00 0.0014 0.0028
     69
    Figure US20140303125A1-20141009-C00084
         		1,1-(3-dimethylamino-3- benzylpentamethylene)-2-(4- trifluoromethylbenzoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 1.91 0.011 0.021
     70
    Figure US20140303125A1-20141009-C00085
         		1,1-(3-dimethylamino-3- benzylpentamethylene)-2-(3- fluoro-5-trifluoromethyl- benzoyl)-1,3,4,9-tetrahydro- 2,9-diazafluorene 1.82 0.0077 0.014
     71
    Figure US20140303125A1-20141009-C00086
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(2,3-difluorobenzoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 1.79 0.0014 0.0025
     72
    Figure US20140303125A1-20141009-C00087
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(4-methylbenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 1.77 0.026 0.046
     73
    Figure US20140303125A1-20141009-C00088
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(3- phenylpropanoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 1.64 0.028 0.046
     74
    Figure US20140303125A1-20141009-C00089
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(3,4- dichlorobenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 1.64 0.014 0.023
     75
    Figure US20140303125A1-20141009-C00090
         		1,1-(3-dimethylamino-3- benzylpentamethylene)-2- cinnamoyl-1,3,4,9-tetrahydro- 2,9-diazafluorene 1.54 0.024 0.037
     76
    Figure US20140303125A1-20141009-C00091
         		1,1-(3-dimethylamino-3- benzylpentamethylene)-2-(2,6- difluorobenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 1.54 0.054 0.083
     77
    Figure US20140303125A1-20141009-C00092
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(3- methoxycarbonylpropanoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 1.50 0.01 0.015
     78
    Figure US20140303125A1-20141009-C00093
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(3-chlorobenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 1.50 0.018 0.027
     79
    Figure US20140303125A1-20141009-C00094
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(3- fluorobenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 1.50 0.0028 0.0042
     80
    Figure US20140303125A1-20141009-C00095
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(2,6- difluorobenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 1.50 0.01 0.015
     81
    Figure US20140303125A1-20141009-C00096
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(3,4-dichlorobenzoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 1.37 0.019 0.026
     82
    Figure US20140303125A1-20141009-C00097
         		1,1-(3-dimethylamino-3- benzylpentamethylene)-2- (2,3,4,5,6-pentafluoro- benzoyl)-1,3,4,9-tetrahydro- 2,9-diazafluorene 1.35 0.06 0.081
     83
    Figure US20140303125A1-20141009-C00098
         		1,1-(3-dimethylamino-3- benzylpentamethylene)-2- cyclohexylcarbonyl-1,3,4,9- tetrahydro-2,9-diazafluorene 1.31 0.013 0.017
     84
    Figure US20140303125A1-20141009-C00099
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(3- cyclopentylpropanoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 1.29 0.0093 0.012
     85
    Figure US20140303125A1-20141009-C00100
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(4-fluoro-3-trifluoromethyl- benzoyl)-1,3,4,9-tetrahydro- 2,9-diazafluorene 1.28 0.0071 0.0091
     86
    Figure US20140303125A1-20141009-C00101
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(4-methylbenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 1.24 0.0055 0.0068
     87
    Figure US20140303125A1-20141009-C00102
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(3,4,5-trimethoxybenzoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 1.21 0.019 0.023
     88
    Figure US20140303125A1-20141009-C00103
         		1,1-(3-dimethylamino-3- benzylpentamethylene)-2- cyclobutylcarbonyl-1,3,4,9- tetrahydro-2,9-diazafluorene 1.17 0.041 0.048
     89
    Figure US20140303125A1-20141009-C00104
         		1,1-(3-dimethylamino-3- benzylpentamethylene)-2-(2,6- dichlorobenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 1.14 0.029 0.033
     90
    Figure US20140303125A1-20141009-C00105
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(3-methoxybenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 1.12 0.098 0.11
     91
    Figure US20140303125A1-20141009-C00106
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(2- thienylcarbonyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 1.09 0.032 0.035
     92
    Figure US20140303125A1-20141009-C00107
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-propanoyl-1,3,4,9- tetrahydro-2,9-diazafluorene 1.07 0.057 0.061
     93
    Figure US20140303125A1-20141009-C00108
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(2,4-difluorobenzoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 1.06 0.016 0.017
     94
    Figure US20140303125A1-20141009-C00109
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(3,5-difluorobenzoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 1.06 0.0035 0.0037
     95
    Figure US20140303125A1-20141009-C00110
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(4-tert.butylbenzoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 1.06 0.0090 0.0095
     96
    Figure US20140303125A1-20141009-C00111
         		1,1-(3-dimethylamino-3- benzylpentamethylene)-2-(3- methoxycarbonylpropanoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 1.05 0.066 0.069
     97
    Figure US20140303125A1-20141009-C00112
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(3,4-difluorobenzoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 1.04 0.0023 0.0024
     98
    Figure US20140303125A1-20141009-C00113
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(2- ethylhexanoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 1.04 0.047 0.049
     99
    Figure US20140303125A1-20141009-C00114
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(2-methylbenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 1.02 0.0092 0.0094
    100
    Figure US20140303125A1-20141009-C00115
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(3- phenylpropanoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 1.00 0.04 0.04
    101
    Figure US20140303125A1-20141009-C00116
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(3-fluoro-5-trifluoro- methylbenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 1.00 0.0033 0.0033
    102
    Figure US20140303125A1-20141009-C00117
         		1,1-(3-dimethylamino-3- phenyl-pentamethylene)-2-(4- fluoro-3- trifluoromethylbenzoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 1.00 0.036 0.036
    103
    Figure US20140303125A1-20141009-C00118
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(4-nitrobenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.97 0.0064 0.0062
    104
    Figure US20140303125A1-20141009-C00119
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(3,5- difluorobenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.95 0.002 0.0019
    105
    Figure US20140303125A1-20141009-C00120
         		1,1-(3-dimethylamino-3- benzylpentamethylene)-2-(2- trifluoromethylbenzoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 0.95 0.019 0.018
    106
    Figure US20140303125A1-20141009-C00121
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(3,4-difluorobenzoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 0.94 0.0035 0.0033
    107
    Figure US20140303125A1-20141009-C00122
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(4- chlorobenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.91 0.011 0.010
    108
    Figure US20140303125A1-20141009-C00123
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(3-methylbenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.91 0.011 0.010
    109
    Figure US20140303125A1-20141009-C00124
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(2,3,4,5-tetrafluorobenzoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 0.90 0.002 0.0018
    110
    Figure US20140303125A1-20141009-C00125
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(2,6-difluorobenzoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 0.88 0.0089 0.0078
    111
    Figure US20140303125A1-20141009-C00126
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(2- furylcarbonyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.87 0.039 0.034
    112
    Figure US20140303125A1-20141009-C00127
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(2,4-dichlorobenzoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 0.86 0.022 0.019
    113
    Figure US20140303125A1-20141009-C00128
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(3-methoxycarbonyl- propanoyl)-1,3,4,9-tetrahydro- 2,9-diazafluorene 0.86 0.029 0.025
    114
    Figure US20140303125A1-20141009-C00129
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(3-chlorobenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.83 0.0075 0.0062
    115
    Figure US20140303125A1-20141009-C00130
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(2-fluoro-5-trifluoromethyl- benzoyl)-1,3,4,9-tetrahydro- 2,9-diazafluorene 0.80 0.11 0.088
    116
    Figure US20140303125A1-20141009-C00131
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(2-fluoro-4-trifluoro- methylbenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.80 0.0044 0.0035
    117
    Figure US20140303125A1-20141009-C00132
         		1,1-(3-dimethylamino-3- benzylpentamethylene)-2-(2- thienylacetyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.79 0.014 0.011
    118
    Figure US20140303125A1-20141009-C00133
         		1,1-(3-dimethylamino-3- benzylpentamethylene)-2-(2,6- dichlorobenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.78 0.093 0.073
    119
    Figure US20140303125A1-20141009-C00134
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(3,4- difluorobenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.76 0.0025 0.0019
    120
    Figure US20140303125A1-20141009-C00135
         		1,1-(3-dimethylamino-3- benzylpentamethylene)-2-(3- methylbenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.75 0.016 0.012
    121
    Figure US20140303125A1-20141009-C00136
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(3- methoxycarbonylpropanoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 0.71 0.021 0.015
    122
    Figure US20140303125A1-20141009-C00137
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(2-fluoro-6-trifluoromethyl- benzoyl)-1,3,4,9-tetrahydro- 2,9-diazafluorene 0.67 0.0054 0.0036
    123
    Figure US20140303125A1-20141009-C00138
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(2- methylbenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.65 0.031 0.020
    124
    Figure US20140303125A1-20141009-C00139
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(3,5- dichlorobenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.64 0.0550 0.035
    125
    Figure US20140303125A1-20141009-C00140
         		1,1-(3-dimethylamino-3- benzylpentamethylene)-2-(2- furylcarbonyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.63 0.0054 0.0034
    126
    Figure US20140303125A1-20141009-C00141
         		1,1-(3-dimethylamino-3- benzylpentamethylene)-2- (pentanoyl)-1,3,4,9-tetrahydro- 2,9-diazafluorene 0.63 0.0043 0.0027
    127
    Figure US20140303125A1-20141009-C00142
         		1,1-(3-dimethylamino-3- benzylpentamethylene)-2-(6- fluoro-2-trifluoromethyl- benzoyl)-1,3,4,9-tetrahydro- 2,9-diazafluorene 0.62 0.055 0.034
    128
    Figure US20140303125A1-20141009-C00143
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(3-methoxybenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.57 0.028 0.016
    129
    Figure US20140303125A1-20141009-C00144
         		1,1-(3-dimethylamino-3- benzylpentamethylene)-2-(4- tert.butylbenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.54 0.11 0.059
    130
    Figure US20140303125A1-20141009-C00145
         		1,1-(3-dimethylamino-3- benzylpentamethylene)-2- (phenylacetyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.54 0.0099 0.0053
    131
    Figure US20140303125A1-20141009-C00146
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(3,5-dichlorobenzoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 0.53 0.030 0.016
    132
    Figure US20140303125A1-20141009-C00147
         		1,1-(3-dimethylamino-3- benzylpentamethylene)-2- (2,3,4,5,6-pentafluorobenzoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 0.52 0.075 0.039
    133
    Figure US20140303125A1-20141009-C00148
         		1,1-(3-dimethylamino-3- benzylpentamethylene)-2-(3- nitrobenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.52 0.017 0.0088
    134
    Figure US20140303125A1-20141009-C00149
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(3- nitrobenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.51 0.069 0.035
    135
    Figure US20140303125A1-20141009-C00150
         		1,1-(3-dimethylamino-3- benzylpentamethylene)-2- (2,3,4,5-tetrafluorobenzoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 0.50 0.030 0.015
    136
    Figure US20140303125A1-20141009-C00151
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(2- thienylacetyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.48 0.0069 0.0033
    137
    Figure US20140303125A1-20141009-C00152
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(2- fluoro-4-trifluoromethylbenzoyl)- 1,3,4,9-tetrahydro-2,9- diazafluorene 0.48 0.065 0.031
    138
    Figure US20140303125A1-20141009-C00153
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(2- fluorobenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.47 0.018 0.0084
    139
    Figure US20140303125A1-20141009-C00154
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2- (cyclobutylcarbonyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.45 0.075 0.034
    140
    Figure US20140303125A1-20141009-C00155
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(2- methoxybenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.43 0.046 0.020
    141
    Figure US20140303125A1-20141009-C00156
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(2,5- difluorobenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.42 0.0045 0.0019
    142
    Figure US20140303125A1-20141009-C00157
         		1,1-(3-dimethylamino-3-(3- fluorophenyl)pentamethylene)- 2-(2-bromobenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.41 0.046 0.019
    143
    Figure US20140303125A1-20141009-C00158
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(3- fluoro-5-trifluoromethyl- benzoyl)-1,3,4,9-tetrahydro- 2,9-diazafluorene 0.41 0.037 0.015
    144
    Figure US20140303125A1-20141009-C00159
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(2- fluoro-5-trifluoromethyl- benzoyl)-1,3,4,9-tetrahydro- 2,9-diazafluorene 0.39 0.049 0.019
    145
    Figure US20140303125A1-20141009-C00160
         		1,1-(3-dimethylamino-3- phenylpentamethylene)-2-(2,3- difluorobenzoyl)-1,3,4,9- tetrahydro-2,9-diazafluorene 0.33 0.029 0.0096
    Figure US20140303125A1-20141009-C00161
    • Jumping Test in Mice: Experiment to Determine the Systemic Dependency (Saelens J K, Arch Int Pharmacodyn 190: 213-218, 1971)
  • The test substances were applied intraperitoneally a total of seven times over two days. Five applications were made on the first day at 9:00, 10:00, 11:00, 13:00 and 15:00 hours, and on the second day at 9:00 and 11:00 hours. The first three applications were made in increasing dosages (dosage scheme), the further applications being at the dosage of the third application. The withdrawal symptoms were triggered with 30 mg/kg naloxone (i.p.) two hours after the last substance application. Immediately following this the animals were placed individually in transparent observation cages (height 40 cm, diameter 15 cm) and the jumping reactions were counted over 15 minutes in 5-minute periods in each case. Morphine was administered in a dosage as comparison/standard. The withdrawal symptoms were quantified by counting the number of jumps over 0 to 10 minutes after application of naloxone. The number of animals per group exhibiting more than 10 jumps/10 minutes was determined and recorded as “% positive animals”. The average jumping frequency in the group was also calculated. Twelve animals were used per group.
    • BRIEF DESCRIPTION OF THE DRAWINGS
  • Results of the jumping tests are shown in the accompanying Figures in which:
  • FIG. 1 is a graph of the mice jumping test results for levomethadone;
  • FIG. 2 is a graph of the jumping test results for compound m;
  • FIG. 3 is a graph of the jumping test results for compound n;
  • FIG. 4 is a graph of the jumping test results according to Example 1;
  • FIG. 5 is a graph of the jumping test results according to Example 3, and
  • FIG. 6 is a graph of the jumping test results according to Example 4.
    • INVESTIGATIONS OF CARDIOVASCULAR EFFECTS ECG Method Description, Conscious Dogs:
  • Effects of the substances on the heart rate and electrocardiograph parameters were investigated on conscious Beagle dogs. The electrocardiogram measurement was carried out as a bipolar limb lead according to Einthoven (lead II). For this purpose the Beagle dogs were placed in a special hammock-like holder (Animal sling, Havard Instruments, ZAK, Marktheidenfeld, Germany) and loosely secured. A measurement electrode was applied to each of the left and right front limbs, and a reference electrode was also applied to the rear limb. All electrodes were plate electrodes, which were fixed to the shaved skin by rubber collars. The plate electrodes were connected to a ECG pre-amplifier and the signals were continuously digitised by means of a computer-controlled data receiving and archiving system (PO-NE-MAH, Gould-Instrument Systems, USA) (digitising frequency: 2 kHz). The mean values of the following parameters were determined from 10 successive ECG intervals per measurement time: RR interval, PR interval, QRS interval and QT interval. The frequency correction of the QT interval was made according to the correction formula of Van de Water et al. (1989).
  • Each of the test substances was administered as an i.v. short infusion (15 minutes) via the V. cephalica antibrachii. To quantify effects of substances, the changes in the ECG parameters over a period of 60 minutes after administration of the substance were recorded relative to the base value before administration of the substance. The statistical evaluation was carried out by means of variance analysis (ANOVA) compared to synchronous vehicle control measurements. (Van de Water A, Verheyen J, Xhonneux R, Reneman R S. An improved method to correct the QT interval of the electrocardiogram for changes in heart rate. J Pharmacol Methods. 1989 November; 22(3):207-17).
  • Patch-Clamp, hERG Current
  • Method description in: Bischoff U, Schmidt C, Netzer R, Pongs O. Effects of fluoroquinolones on HERG currents. Eur J Pharmacol. 2000; 406(3):341-3.
    • Blood Pressure, Conscious Rats
  • Method description in: Weeks J R, Compton L D. The cardiovascular pharmacology of prostacyclin (PGI2) in the rat. Prostaglandins 1979; 17(4):501-13.
  • TABLE A
    Summary of the cardiovascular effects of Example 1:
    Model Dose Observation
    Patch clamp, IC50 >> 10 μM (10 μM: 29 ± 7%
    hERG current inhibition)
    Blood pressure, Up to 14.7 μg/kg No effect
    heart rate, i.v.**
    conscious rat
    ECG, 10 μg/kg i.v. Significant Bradycardia (heart rate:
    conscious dog −40%)
    Non-significant extension of the QTc
    [van der Water]
    Slight (<10%) significant increase in
    the QRS time
    No effect on the PRinterval
    **Tail flick, rat: EC50 = 1.44 μg/kg i.v.
  • For comparison: the IC50 value for LAAM is 2 μm (interactions of LAAM/HERG channel, see Jiesheng et al., Eur. J. Pharmacol. 2003, 458, 25-29), the IC50 value for methadone is 9.8 μM (see Katchman et al., J. Pharmacol. Exp. Ther. 2002, 303, 688-694).
  • In conscious rats, no cardiovascular effects are observed with an administration of up to 1 order of magnitude greater than the EC50 value in the tail flick test in rats of Example 1.
  • The foregoing description and examples have been set forth merely to illustrate the invention and are not intended to be limiting. Since modifications of the described embodiments incorporating the spirit and substance of the invention may occur to persons skilled in the art, the invention should be construed broadly to include all variations within the scope of the appended claims and equivalents thereof.

Claims (11)

1-22. (canceled)
23. A method of treating opioid dependency in a patient, said method comprising administering to said patient an effective amount of 1,1-(3-dimethylamino-3-phenylpenta-methylene)-6-fluoro-1,3,4,9-tetrahydropyrano[3,4-b]indole in the form of a pure stereoisomer or a mixture of stereoisomers in any mixing ratio, or a physiologically acceptable salt thereof.
24. The method according to claim 23, wherein 1,1-(3-dimethylamino-3-phenylpenta-methylene)-6-fluoro-1,3,4,9-tetrahydropyrano[3,4-b]indole or the physiologically acceptable salt thereof is in the form of a pure enantiomer or diastereomer.
25. The method according to claim 23, wherein the 1,1-(3-dimethylamino-3-phenylpenta-methylene)-6-fluoro-1,3,4,9-tetrahydropyrano[3,4-b]indole or the physiologically acceptable salt thereof is in the form of a racemate.
26. The method according to claim 23, wherein the opioid dependency is heroin, morphine or methadone dependency.
27. The method according to claim 23, wherein 1,1-(3-dimethylamino-3-phenylpenta-methylene)-6-fluoro-1,3,4,9-tetrahydropyrano[3,4-b]indole is used in combination with naloxone.
28. The method according to claim 23, wherein the 1,1-(3-dimethylamino-3-phenylpenta-methylene)-6-fluoro-1,3,4,9-tetrahydropyrano[3,4-b]indole is present in the form of its hydrochloride, citrate, methane sulfonate or hemicitrate.
29. The method according to claim 23, wherein 1,1-(3-dimethylamino-3-phenylpenta-methylene)-6-fluoro-1,3,4,9-tetrahydropyrano[3,4-b]indole is used in the form of the free base.
30. The method according to claim 23, wherein 1,1-(3-dimethylamino-3-phenylpenta-methylene)-6-fluoro-1,3,4,9-tetrahydropyrano[3,4-b]indole is present in the form of the non-polar diastereomer.
31. The method according to claim 23, wherein 1,1-(3-dimethylamino-3-phenylpenta-methylene)-6-fluoro-1,3,4,9-tetrahydropyrano[3,4-b]indole is present in the form of the non-polar diastereomer of the free base.
32. The method according to claim 23, wherein 1,1-(3-dimethylamino-3-phenylpenta-methylene)-6-fluoro-1,3,4,9-tetrahydropyrano[3,4-b]indole is present in the form of the non-polar diastereomer of the free base and the opioid dependency is heroin, morphine or methadone dependency.
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US20160271107A1 (en) 2016-09-22
WO2006108565A1 (en) 2006-10-19
ES2390468T3 (en) 2012-11-13
DE102005016460A1 (en) 2006-10-19
SI1868600T1 (en) 2012-08-31
PL1868600T3 (en) 2012-11-30
EP1868600A1 (en) 2007-12-26
US20080221141A1 (en) 2008-09-11
US20110053970A1 (en) 2011-03-03
CY1113024T1 (en) 2016-04-13
PT1868600E (en) 2012-08-28
EP1868600B1 (en) 2012-06-27

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