Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
  • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
  • A61K31/403—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil condensed with carbocyclic rings, e.g. carbazole
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
  • A61K31/415—1,2-Diazoles
  • A61K31/4155—1,2-Diazoles non condensed and containing further heterocyclic rings
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
  • A61K31/4164—1,3-Diazoles
  • A61K31/4178—1,3-Diazoles not condensed 1,3-diazoles and containing further heterocyclic rings, e.g. pilocarpine, nitrofurantoin
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
  • A61K31/44—Non condensed pyridines; Hydrogenated derivatives thereof
  • A61K31/445—Non condensed piperidines, e.g. piperocaine
  • A61K31/4523—Non condensed piperidines, e.g. piperocaine containing further heterocyclic ring systems
  • A61K31/454—Non condensed piperidines, e.g. piperocaine containing further heterocyclic ring systems containing a five-membered ring with nitrogen as a ring hetero atom, e.g. pimozide, domperidone
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
  • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
  • A61K31/519—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim ortho- or peri-condensed with heterocyclic rings
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
  • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
  • A61K31/519—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim ortho- or peri-condensed with heterocyclic rings
  • A61K31/52—Purines, e.g. adenine
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/53—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with three nitrogens as the only ring hetero atoms, e.g. chlorazanil, melamine
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/535—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one oxygen as the ring hetero atoms, e.g. 1,2-oxazines
  • A61K31/5355—Non-condensed oxazines and containing further heterocyclic rings
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/30—Drugs for disorders of the nervous system for treating abuse or dependence
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/30—Drugs for disorders of the nervous system for treating abuse or dependence
  • A61P25/32—Alcohol-abuse
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/30—Drugs for disorders of the nervous system for treating abuse or dependence
  • A61P25/34—Tobacco-abuse
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/30—Drugs for disorders of the nervous system for treating abuse or dependence
  • A61P25/36—Opioid-abuse
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

Definitions

• the present invention relates to pharmaceutical compositions for the treatment of alcohol, cocaine or tobacco dependence or addiction in a mammal (e.g. human) comprising an opioid receptor antagonist and a CB-1 receptor antagonist.
• a mammal e.g. human
• CB-1 antagonist refers to both full antagonists and partial antagonists, as well as inverse agonists of the G-protein coupled type 1 cannabinoid receptor.
• the present invention may be used to treat mammals (e.g. humans) for alcohol dependence or addiction and nicotine dependence or addiction; to palliate the effects of alcohol or cocaine withdrawal, to enhance the outcomes of other alcohol cessation therapies and to treat substance abuse and behavioral dependencies, including gambling.
• mammals e.g. humans
• nicotine dependence or addiction e.g. nicotine dependence or addiction
• palliate the effects of alcohol or cocaine withdrawal e.g. nicotine dependence or addiction
• substance abuse and behavioral dependencies e.g. mu, kappa and delta opioid receptors
• Compounds that bind to such receptors are likely to be useful in the treatment of diseases modulated by opioid receptors, for example irritable bowel syndrome; constipation; nausea; vomiting; and pruritic dermatoses, such as allergic dermatitis and atopy in animals and humans.
• Compounds that bind to opioid receptors have also been indicated in the treatment of eating disorders, opioid overdoses, depression, anxiety, schizophrenia, alcohol addiction, including alcohol abuse and dependency, sexual dysfunction, shock, stroke, spinal damage and head trauma.
• the invention also relates to CB-1 receptor antagonists which include: (1 ) purine compounds such as those described in U.S. Provisional Application No.
• 60/432911 filed on December 12, 2002 and incorporated herein by reference
• 2-(1 ,5-diaryl-1 H-pyrazol-3-yl)morpholine compounds such as those described in U.S. Provisional Application No. 60/432911 , filed on December 12, 2002 and incorporated herein by reference
• 1-(1 ,2-diaryl-1 H-imidazol-4-yl)-2- (substituted amino)-ethanone compounds such as those described in U.S. Provisional Application No. 60/432911, filed on December 12, 2002 and incorporated herein by reference.
• opioid receptor ligands listed above which can be employed in the methods and pharmaceutical compositions of this invention, can be made by processes known in the chemical arts, for example by the methods described in WO 03/035,622 published May 1 , 2003 which is U.S. Serial No. 10/278,142 and 60/462,651 filed April 14, 2003 and 60/462,629 filed April. 14, 2003 and 60/462,605 filed April 14, 2003 which are incorporated by reference their entireties.
• Approximately 13.5 million individuals in the US suffer from alcohol abuse and dependence (AAD). Untreated alcoholics are among the highest users of US health care, consuming 15% of each health care dollar.
• AAD alcohol abuse and dependence
• Untreated alcoholics are among the highest users of US health care, consuming 15% of each health care dollar.
• the indirect costs associated with productivity loss, property damage, and premature death are estimated at $100 billion per year.
• the present invention relates to a pharmaceutical composition for treating alcohol or cocaine dependence or addiction, tobacco dependence or addiction, reducing alcohol withdrawal symptoms or aiding in the cessation or lessening of alcohol use or substance abuse or behavioral dependencies including gambling, comprising: (a) an opioid receptor antagonist or a pharmaceutically acceptable salt thereof; (b) a CB-1 receptor antagonist or pharmaceutically acceptable salt thereof; and (c) a pharmaceutically acceptable carrier; wherein the active agents "a" and "b” above are present in amounts that render the composition effective in treating alcohol or cocaine dependence or addiction, tobacco dependence or addiction, reducing alcohol withdrawal symptoms or aiding in the cessation or lessening of alcohol use or substance abuse or behavioral dependencies.
• the therapeutically effective pharmaceutical combination is comprised of an opioid receptor antagonist and a CB- 1 receptor antagonist and a pharmaceutically acceptable carrier.
• CB-1 receptor antagonists purine compounds which are selected from: 1-[9-(4-chloro-phenyl)-8-(2-chlorophenyl)-9H- purin-6-yl]-3-ethylamino-azetidine-3-carboxylic acid amide; 1-[9-(4-chlorophenyl)-8-(2- chlorophenyl)-9H-purin-6-yl]-3-isopropylaminoazetidine-3-carboxylic acid amide; 1- ⁇ 1-[9-(4- chlorophenyl)-8-(2-chlorophenyl)-9H-purin-6-yl]-4-phenylpiperidin-4-yl ⁇ -ethanone; ⁇ 3-[9-(4- chlorophenyl)-8-(2,4-dich
• CB-1 receptor antagonist 1 ,4- and 2,4-disubstituted imidazoles selected from: 5-(4-chloro-phenyl)-3-(5-cydohexyl-1 H- imidazol-2-yl)-1 -(2,4-dichloro-phenyl)-4-methyl-1 H-pyrazole; 5-(4-chloro-phenyl)-3-(2- cyclohexyl-3H-imidazol-4-yl)-1 -(2,4-dichloro-phenyl)-4-methyl-1 H-pyrazole; 5-(4-chloro- phenyl)-1-(2,4-dichloro-phenyl)-4-methyl-3-[1-(1-methyl-1-phenyl-ethyl)-1 H-imidazol-4-yl]-1 H- pyrazole; 5-(4-chloro-phenyl)-1 -(2-chloro-phenyl)-1 -(2-ch
• CB-1 receptor antagonist 1- (1 ,5-diaryl-1 H-pyrazol-3-yl)-2-(substituted amino)-ethanol compounds selected from: 2- (benzyl-isopropyl-amino)-l -[1 -(2-chloro-phenyl)-5-(4-chloro-phenyl)-4-methyl-1 H-pyrazol-3- yl]-ethanol; 1 -[5-(4-chloro-phenyl)-1 -(2-chloro-phenyl)-4-methyl-1 H-pyrazol-3-yl]-2-(3,5- dimethyl-piperidin-1-yl)-ethanol; 1- ⁇ 2-[1-(2-chloro-phenyl)-5-(4-chloro-phenyl)-4-methyl-1 H- pyrazol-3-yl]-2-hydroxy-ethyl ⁇ -4-isopropylamino-piperidine-4-car
• CB-1 receptor antagonist 1- (1 ,2-diaryl-1 H-imidazol-4-yl)-2-(substituted amino)-ethanone compounds selected from: 1-[1- (4-chloro-phenyl)-2-(2,4-dichloro-phenyl)-5-methyl-1 H-imidazol-4-yl]-2-piperidin-1 -yl-ethanone and 1-[1-(4-chloro-phenyl)-2-(2,4-dichloro-phenyl)-5-methyl-1 H-imidazol-4-yl]-2-morpholin-4- yl-ethanone; and a pharmaceutically acceptable salt thereof, or a solvate or hydrate of the compound or the salt.
• the opioid receptor antagonist is selected from: 2-methoxy-ethanesulfonic acid ⁇ 3-[6-ethyl-3-(2-hydroxy-1 ,2,3,4-tetrahydro- naphthalen-2-ylmethyl)-3-aza-bicyclo[3.1.0]hex-6-yl]-phenyl ⁇ -amide; ⁇ /-[3-(6-ethyl-3-indan-2-ylmethyl-3-aza-bicyclo[3.1.0]hex-6-yl)-phenyl]- methanesulfonamide; 2-methoxy-ethanesulfonic acid [3-(6-ethyl-3-indan-2-ylmethyl-3-aza-bicyclo[3.1.0]hex- 6-yl)-phenyl]-amide; ⁇ /- ⁇ 3-[6-ethyl-3-(2-hydroxy-indan-2-ylmethyl)-3-aza-bicyclo[3.1.0]hex-6-yl
• the opioid receptor antagonist is selected from: 2-methoxy-ethanesulfonic acid ⁇ 3-[6-ethyl-3-(2-hydroxy-1 ,2,3,4-tetrahydro- naphthalen-2-ylmethyl)-3-aza-bicyclo[3.1.0]hex-6-yl]-phenyl ⁇ -amide; ⁇ /-[3-(6-ethyl-3-indan-2-ylmethyl-3-aza-bicyclo[3.1.0]hex-6-yl)-phenyl]- methanesulfonamide; 2-methoxy-ethanesulfonic acid [3-(6-ethyl-3-indan-2-ylmethyl-3-aza-bicyclo[3.1.0]hex- 6-yl)-phenyl]-amide; ⁇ /- ⁇ 3-[6-ethyl-3-(2-hydroxy-indan-2-ylmethyl)-3-aza-bicyclo[3.1.0]hex-6-yl]-phenyl
• the opioid receptor antagonist is selected from: 2-methoxy-ethanesulfonic acid ⁇ 3-[6-ethyl-3-(2-hydroxy-1 ,2,3,4-tetrahydro- naphthalen-2-ylmethyl)-3-aza-bicyclo[3.1.0]hex-6-yI]-phenyl ⁇ -amide; ⁇ /-[3-(6-ethyl-3-indan-2-ylmethyl-3-aza-bicyclo[3.1.0]hex-6-yl)-phenyl]- methanesulfonamide; 2-methoxy-ethanesulfonic acid [3-(6-ethyl-3-indan-2-ylmethyl-3-aza-bicyclo[3.1.0]hex-
• 6-yl)-phenyl]-amide ⁇ /- ⁇ 3-[6-ethyl-3-(2-hydroxy-indan-2-ylmethyl)-3-aza-bicyclo[3.1.0]hex-6-yl]-phenyl ⁇ - methanesulfonamide; /V- ⁇ 3-[6-ethyl-3-(2-hydroxy-1 ,2,3,4-tetrahydro-naphthalen-2-ylmethyl)-3-aza- bicyclo[3.1.0]hex-6-yl]-phenyl ⁇ -methanesulfonamide; ⁇ /-(3- ⁇ 6-ethyl-3-[3-(1-hydroxy-cyclohexyl)-propyl]-3-aza-bicyclo[3.1.0]hex-6-yl ⁇ - phenyl)-methanesulfonamide; 3- ⁇ 3-[3-(1-hydroxy-cyclohexyl)-propyl]-8-methoxy-3-aza-bicyclo[
• the present invention also relates to a method of treating alcohol or cocaine dependence or addiction, tobacco dependence or addiction, reducing alcohol withdrawal symptoms or aiding in the cessation or lessening of alcohol use or substance abuse or behavioral dependencies, including gambling, comprising: (a) an opioid receptor antagonist or a pharmaceutically acceptable salt thereof; and (b) a CB-1 receptor antagonist or pharmaceutically acceptable salt thereof; and (c) a pharmaceutically acceptable carrier, wherein the active agents (a) and (b) above are present in amounts that render the composition effective in treating alcohol or cocaine dependence or addiction, tobacco dependence or addiction, reducing alcohol withdrawal symptoms or aiding in the cessation or lessening of alcohol use or substance abuse or behavioral dependencies.
• the CB-1 receptor antagonist and the opioid receptor antagonist present in amounts that render the composition effective in the treatment of alcohol, cocaine or nicotine addiction, alcohol withdrawal symptoms, substance abuse or other behavioral dependencies.
• the CB-1 receptor antagonists are listed herein above.
• the opioid receptor antagonist is selected from: 2-methoxy-ethanesulfonic acid ⁇ 3-[6-ethyl-3-(2-hydroxy-1 ,2,3,4-tetrahydro- naphthalen-2-ylmethyl)-3-aza-bicyclo[3.1.0]hex-6-yl]-phenyl ⁇ -amide; ⁇ /-[3-(6-ethyl-3-indan-2-ylmethyl-3-aza-bicyclo[3.1.0]hex-6-yl)-phenyl]- methanesulfonamide; 2-methoxy-ethanesulfonic acid [3-(6-ethyl-3-indan-2-ylmethyl-3-aza-bicyclo[3.1.OJhex- 6-yl)-phenyl]-amide; /V- ⁇ 3-[6-ethyl-3-(2-hydroxy-indan-2-ylmethyl)-3-aza-bicyclo[3.1.0]hex-6-yI
• the opioid receptor antagonist is selected from: 2-methoxy-ethanesulfonic acid ⁇ 3-[6-ethyl-3-(2-hydroxy-1 ,2,3,4-tetrahydro- naphthalen-2-ylmethyl)-3-aza-bicyclo[3.1.0]hex-6-yl]-phenyl ⁇ -amide; ⁇ /-[3-(6-ethyl-3-indan-2-ylmethyl-3-aza-bicyclo[3.1.0]hex-6-yl)-phenyl]- methanesulfonamide; 2-methoxy-ethanesulfonic acid [3-(6-ethyl-3-indan-2-ylmethyl-3-aza-bicyclo[3.1.0]hex- 6-yl)-phenyl]-amide; N- ⁇ 3-[6-ethyl-3-(2-hydroxy-indan-2-ylmethyl)-3-aza-bicyclo[3.1.0]hex-6-yl]-phenyl ⁇ -amide;
• treating refers to reversing, alleviating, inhibiting or slowing the progress of, or preventing the disorder or condition to which such term applies, or one or more symptoms of such disorder or condition.
• treatment refers to the act of treating, as “treating” is defined immediately above.
• subject abuse refers to a maladaptive use of a substance, which may be either with physiological dependence or without.
• subject abuse thus includes both substance abuse (e.g.
• the maladaptive pattern of substance use may manifest itself in recurrent and significant adverse consequences related to the repeated use of the substance.
• the recurrent substance use may result in a failure to fulfill major role obligations at work, school, or home.
• the maladaptive use of a substance may involve continued use of the substance despite persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse, physical fights).
• the maladaptive pattern of substance use may involve clinically significant impairment or distress, for example manifested by tolerance for the substance, withdrawal symptoms, unsuccessful efforts to cut down or control the substance use, and/or taking larger amounts of the substance and/or taking amounts of the substance over a longer period than was intended.
• Substances to which an addiction may be formed include, but are not limited to, the drugs recited above (including nicotine, alcohol), as well as others, for example benzodiazepines such as Valium®.
• Behavioral dependencies as used here means enduring or persistent patterns of behavior which deviates markedly from the expectations of an individual's culture, is pervasive and inflexible, is stable over time, and leads to distress or impairment, and can include either Axis I or Axis II diagnoses (1994; DSM-IV, American Psychiatric Association). Such diagnoses may include, but are not limited to, substance abuse (nicotine, alcohol, narcotics, inhalants), gambling, eating disorders, and impulse control disorders.
• substance abuse nicotine, alcohol, narcotics, inhalants
• gambling eating disorders
• impulse control disorders The chemist of ordinary skill will recognize that certain compounds of this invention will contain one or more atoms which may be in a particular stereochemical or geometric configuration, giving rise to stereoisomers and configurational isomers. All such isomers and mixture thereof are included in this invention.
• the invention includes a CB-1 receptor antagonist and a pharmaceutically acceptable salt thereof.
• the particular opioid receptor ligands listed above, which can be employed in the methods and pharmaceutical compositions of this invention, can be made by processes known in the chemical arts, for example by the methods described in WO 03/035,622 published May 1 , 2003 which is U.S. Serial No.
• Some of the compounds used herein are related to, or are derived from compounds found in nature and accordingly many such compounds are commercially available or are reported in the literature or are easily prepared from other commonly available substances by methods which are reported in the literature.
• Some of the opioid receptor antagonist compounds employed in this invention are ionizable at physiological conditions.
• some of the compounds of this invention are acidic and they form a salt with a pharmaceutically acceptable cation. All such salts are within the scope of this invention and they can be prepared by cpnventional methods. For example, they can be prepared simply by contacting the acidic and basic entities, usually in a stoichiometric ratio, in either an aqueous, non-aqueous or partially aqueous medium, as appropriate.
• the salts are recovered either by filtration, by precipitation with a non-solvent followed by filtration, by evaporation of the solvent, or, in the case of aqueous solutions, by lyophilization, as appropriate.
• some of the opioid receptor antagonist employed in this invention are basic, and they form a salt with a pharmaceutically acceptable anion. All such salts are within the scope of this invention and they can be prepared by conventional methods. For example, they can be prepared simply by contacting the acidic and basic entities, usually in a stoichiometric ratio, in either an aqueous, non-aqueous or partially aqueous medium, as appropriate.
• the salts are recovered either by filtration, by precipitation with a non-solvent followed by filtration, by evaporation of the solvent, or, in the case of aqueous solutions, by lyophilization, as appropriate.
• the opioid receptor antagonists employed in this invention form hydrates or solvates they are also within the scope of the invention.
• Some of the compounds of this invention are chiral, and as such are subject to preparation via chiral synthetic routes, or separable by conventional resolution or chromatographic means. All optical forms of the compounds of this invention are within the scope of the invention.
• the utility of the opioid receptor antagonists employed in the present invention as medicinal agents in the treatment of alcohol dependence (such as substance dependence or addiction) in mammals e.g.
• Biological Activity Compounds of the subject invention have been found to display activity in opioid receptor binding assays selective for the mu, kappa and delta opioid receptors.
• Assays for mu, kappa and delta opioid receptor binding can be performed according to the following procedure: Affinity of a compound for the delta opioid receptor can be assessed using binding of the delta opioid receptor ligand to NG108-15 neuroblastoma-glioma cells according to modification of the protocol described in Law et al. (Law, P.Y., Koehler, J.E.
• the mu receptor ligand [ 3 H]- DAMGO Perkin Elmer Life Sciences, Boston, Mass.; specific activity 55Ci/mmol, 1.5nM
• the binding is initiated with the addition of a crude membrane preparation of rat forebrain tissue to 96-well polypropylene plates containing the radioligand [ 3 H]-DAMGO and test compound, and are incubated for about 90 minutes at about 25 °C.
• Ki ICso / 1 + [ 3 ligand] / K D
• 1C 50 is the concentration at which 50% of the 3 H ligand is displaced by the test compound
• K D is the dissociation constant for the 3 H ligand at the receptor site.
• a protein assay was performed and 200 ⁇ l of tissue totaling 20 ⁇ g was added to the assay.
• the test compounds were diluted in drug buffer (0.5% BSA, 10% DMSO and TME) and then 25 ⁇ l were added to a deep well polypropylene plate.
• [ 3 H] SR141716A was diluted in a ligand buffer (0.5% BSA plus TME) and 25 ⁇ l were added to the plate.
• a BCA protein assay was used to determine the appropriate tissue concentration and then 200 ⁇ l of rat brain tissue at the appropriate concentration was added to the plate.
• the plates were covered and placed in an incubator at 20 °C for 60 minutes. At the end of the incubation period 250 ⁇ l of stop buffer (5% BSA plus TME) was added to the reaction plate.
• test compounds were diluted in drug buffer (0.5% BSA, 10% DMSO and TME) and then 25 ⁇ l were added to a deep well polypropylene plate.
• [3HJSR141716A was diluted in a ligand buffer (0.5% BSA plus TME) and 25 ⁇ l were added to the plate.
• the plates were covered and placed in an incubator at 30 °C for 60 minutes. At the end of the incubation period 250 ⁇ l of stop buffer (5% BSA plus TME) was added to the reaction plate.
• the plates were then harvested by Skatron onto GF/B filtermats presoaked in BSA (5 mg/ml) plus TME. Each filter was washed twice. The filters were dried overnight.
• a protein assay was performed and 200 ⁇ l of tissue totaling 10 ⁇ g was added to the assay.
• the test compounds were diluted in drug buffer (0.5% BSA, 10% DMSO, and 80.5% TME) and then 25 ⁇ l were added to the deep well polypropylene plate.
• [3H] CP-55940 was diluted a ligand buffer (0.5% BSA and 99.5% TME) and then 25 ⁇ l were added to each well at a concentration of 1 nM.
• a BCA protein assay was used to determine the appropriate tissue concentration and 200 ⁇ l of the tissue at the appropriate concentration was added to the plate.
• the plates were covered and placed in an incubator at 30 °C for 60 minutes. At the end of the incubation period 250 ⁇ l of stop buffer (5% BSA plus TME) was added to the reaction plate.
• the plates were then harvested by Skatron format onto GF/B filtermats presoaked in BSA (5 mg/ml) plus TME. Each filter was washed twice. The filters were dried overnight. The filters were then counted on the Wallac BetaplateTM counter.
• CB-1 GTP ⁇ r 35 Sl Binding Assay Membranes were prepared from CHO-K1 cells stably transfected with the human CB- 1 receptor cDNA.
• Membranes were prepared from cells as described by Bass et al, in "Identification and characterization of novel somatostatin antagonists," Molecular Pharmacology. 50, 709-715 (1996).
• GTP ⁇ [ 35 S] binding assays were performed in a 96 well FlashPlate TM format in duplicate using 100 pM GTP ⁇ [ 35 S] and 10 ⁇ g membrane per well in assay buffer composed of 50 mM Tris HCI, pH 7.4, 3 mM MgCI 2 , pH 7.4, 10 mM MgCI 2 , 20 mM EGTA, 100 mM NaCI, 30 ⁇ M GDP, 0.1 % bovine serum albumin and the following protease inhibitors: 100 ⁇ g/ml bacitracin, 100 ⁇ g/ml benzamidine, 5 ⁇ g/ml aprotinin, 5 ⁇ g/ml leupeptin.
• Serum free medium containing 1 mM IBMX was added to each well followed by 10 ⁇ l of test compound (1 :10 stock solution (25 mM compound in DMSO) into 50% DMSO/PBS) diluted 10X in PBS with 0.1% BSA. After incubating for 20 minutes at 37 °C, 2 ⁇ M of Forskolin was added and then incubated for an additional 20 minutes at 37 °C. The media was removed, 100 ⁇ l of 0.01 N HCI was added and then incubated for 20 minutes at room temperature. Cell lysate (75 ⁇ l) along with 25 ⁇ l of assay buffer (supplied in FlashPlateTM cAMP assay kit available from NEN Life Science Products Boston, MA) into a Flashplate.
• test compound 1 :10 stock solution (25 mM compound in DMSO) into 50% DMSO/PBS) diluted 10X in PBS with 0.1% BSA. After incubating for 20 minutes at 37 °C, 2 ⁇ M of Forskolin was added and
• cAMP standards and cAMP tracer were added following the kit's protocol.
• the flashplate was then incubated for 18 hours at 4 °C.
• the content of the wells were aspirated and counted in a Scintillation counter.
• Cannabinoid agoinists such as ⁇ 9 -tetrahydrocannabinol ( ⁇ 9 -THC) and CP-55940 have been shown to affect four characteristic behaviors in mice, collectively known as the Tetrad. For a description of these behaviors see: Smith, P.B., et al. in "The pharmacological activity of anandamide, a putative endogenous cannabinoid, in mice.” J. Pharmacol. Exp.
• compositions of this invention can be via any method which delivers a compound of this invention systemically and/or locally. These methods include oral routes and transdermal routes, etc.
• the compounds of this invention are administered orally, but parenteral administration may be utilized (e.g., intravenous, intramuscular, subcutaneous or intramedullary).
• parenteral administration may be utilized (e.g., intravenous, intramuscular, subcutaneous or intramedullary).
• the two different compounds of this invention can be co-administered simultaneously or sequentially in any order, or a single pharmaceutical composition comprising an opioid receptor as described above and a CB-1 receptor antagonist as described above in a pharmaceutically acceptable carrier can be administered.
• the amount and timing of compounds administered will, of course, be based on the judgement of the prescribing physician.
• the dosages given below are a guideline and the physician may titrate doses of the agent to achieve the activity that the physician considers appropriate for the individual patient.
• the physician must balance a variety of factors such as cognitive function, age of the patient, presence of preexisting disease, as well as presence of other diseases (e.g., cardiovascular).
• the following paragraphs provide preferred dosage ranges for the various components of this invention (based on average human weight of 70 kg).
• an effective dosage for the opioid receptor compound or a pharmaceutically acceptable salt thereof can be administered orally, transdermally (e.g., through the use of a patch), parenterally (e.g. intravenously), rectally, topically, or by inhalation.
• the daily dosage for treating a disorder or condition as described herein will be about from about 0.01 to about 100 mg per kg, preferably from about 0.1 to about 10 mg per kg, of the body weight of the animal to be treated.
• a compound or a pharmaceutically acceptable salt thereof can be administered for treatment to an adult human of average weight (about 70 kg) in a dose ranging from about 0.1 mg up to about 10 g per day, preferably from about 1 mg to about 1 g per day, in single or divided (i.e., multiple) portions. Variations based on the aforementioned dosage ranges may be made by a physician of ordinary skill taking into account known considerations such as the weight, age, and condition of the animal being treated, the severity of the affliction, and the particular route of administration chosen.
• an effective dosage for the CB-1 receptor antagonists when used in the combination compositions and methods of this invention is in the range of 0.001 to 200 mg/kg/day, preferably 0.005 to 10.0 mg/kg/day.
• the compositions of the present invention are generally administered in the form of a pharmaceutical composition comprising at least one of the compounds of this invention together with a pharmaceutically acceptable vehicle or diluent.
• the compounds of this invention can be administered individually or together in any conventional oral, parenteral or transdermal dosage form.
• a pharmaceutical composition can take the form of solutions, suspensions, tablets, pills, capsules, powders, and the like.
• Tablets containing various excipient such as sodium citrate, calcium carbonate and calcium phosphate are employed along with various disintegrants such as starch and preferably potato or tapioca starch and certain complex silicates, together with binding agents such as polyvinylpyrrolidone, sucrose, gelatin and acacia. Additionally, lubricating agents such as magnesium stearate, sodium lauryl sulfate and talc are often very useful for tabletting purposes.
• Solid compositions of a similar type are also employed as fillers in soft and hard-filled gelatin capsules; preferred materials in this connection also include lactose or milk sugar as well as high molecular weight polyethylene glycols.
• the compounds of this invention can be combined with various sweetening agents, flavoring agents, coloring agents, emulsifying agents and/or suspending agents, as well as such diluents as water, ethanol, propylene glycol, glycerin and various like combinations thereof.
• solutions in sesame or peanut oil or in aqueous propylene glycol can be employed, as well as sterile aqueous solutions of the corresponding water-soluble salts.
• Such aqueous solutions may be suitably buffered, if necessary, and the liquid diluent first rendered isotonic with sufficient saline or glucose.
• aqueous solutions are especially suitable for intravenous, intramuscular, subcutaneous and intraperitoneal injection purposes.
• the sterile aqueous media employed are all readily obtainable by standard techniques well-known to those skilled in the art.
• dilute sterile, aqueous or partially aqueous solutions are prepared.
• Methods of preparing various pharmaceutical compositions with a certain amount of active ingredient are known, or will be apparent in light of this disclosure, to those skilled in this art. For examples, see Remington's Pharmaceutical Sciences. Mack Publishing Company, Easter, Pa., 15th Edition (1975).
• compositions according to the invention may contain 0.1%-95% of the compound(s) of this invention, preferably 1 %-70%.
• the composition or formulation to be administered will contain a quantity of a compound(s) according to the invention in an amount effective to treat the dependence of the subject being treated.

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