WO2008043775A1 - Substituted pyrazinone derivatives for use as a medicine - Google Patents

Substituted pyrazinone derivatives for use as a medicine Download PDF

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Publication number
WO2008043775A1
WO2008043775A1 PCT/EP2007/060748 EP2007060748W WO2008043775A1 WO 2008043775 A1 WO2008043775 A1 WO 2008043775A1 EP 2007060748 W EP2007060748 W EP 2007060748W WO 2008043775 A1 WO2008043775 A1 WO 2008043775A1
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radical
group
alkyl
disorders
compound according
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PCT/EP2007/060748
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French (fr)
Inventor
José Ignacio ANDRÉS-GIL
Manuel Jesús ALCÁZAR-VACA
Maria Lourdes Linares De La Morena
Sonia Martinez Gonzalez
Julen Oyarzabal Santamarina
Joaquin PASTOR-FERNÁNDEZ
Juan Antonio Vega-Ramiro
Francisca DELGADO-JIMÉNEZ
Wilhelmus Helena Ignatius Maria Drinkenburg
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Janssen Pharmaceutica Nv
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Priority to EP07821116A priority Critical patent/EP2091942B1/en
Priority to JP2009531832A priority patent/JP2010505908A/en
Priority to AT07821116T priority patent/ATE457985T1/en
Priority to MX2009003849A priority patent/MX2009003849A/en
Priority to AU2007306382A priority patent/AU2007306382A1/en
Priority to DE602007004881T priority patent/DE602007004881D1/en
Priority to CA002659923A priority patent/CA2659923A1/en
Priority to US12/445,243 priority patent/US20100105694A1/en
Priority to DK07821116.6T priority patent/DK2091942T3/en
Publication of WO2008043775A1 publication Critical patent/WO2008043775A1/en
Priority to IL198072A priority patent/IL198072A0/en

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    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D401/00—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom
    • C07D401/02—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing two hetero rings
    • C07D401/12—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing two hetero rings linked by a chain containing hetero atoms as chain links
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P15/00—Drugs for genital or sexual disorders; Contraceptives
    • A61P15/10—Drugs for genital or sexual disorders; Contraceptives for impotence
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A61P25/04—Centrally acting analgesics, e.g. opioids
    • 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
    • A61P25/14—Drugs for disorders of the nervous system for treating abnormal movements, e.g. chorea, dyskinesia
    • 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
    • A61P25/14—Drugs for disorders of the nervous system for treating abnormal movements, e.g. chorea, dyskinesia
    • A61P25/16—Anti-Parkinson drugs
    • 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
    • A61P25/18—Antipsychotics, i.e. neuroleptics; Drugs for mania or schizophrenia
    • 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
    • A61P25/22—Anxiolytics
    • 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
    • A61P25/24—Antidepressants
    • 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
    • A61P25/28—Drugs for disorders of the nervous system for treating neurodegenerative disorders of the central nervous system, e.g. nootropic agents, cognition enhancers, drugs for treating Alzheimer's disease or other forms of dementia
    • 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
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D241/00—Heterocyclic compounds containing 1,4-diazine or hydrogenated 1,4-diazine rings
    • C07D241/02—Heterocyclic compounds containing 1,4-diazine or hydrogenated 1,4-diazine rings not condensed with other rings
    • C07D241/10—Heterocyclic compounds containing 1,4-diazine or hydrogenated 1,4-diazine rings not condensed with other rings having three double bonds between ring members or between ring members and non-ring members
    • C07D241/14—Heterocyclic compounds containing 1,4-diazine or hydrogenated 1,4-diazine rings not condensed with other rings having three double bonds between ring members or between ring members and non-ring members with hetero atoms or with carbon atoms having three bonds to hetero atoms with at the most one bond to halogen, e.g. ester or nitrile radicals, directly attached to ring carbon atoms
    • C07D241/20—Nitrogen atoms

Definitions

  • the present invention concerns substituted pyrazinone derivatives having se- lective c ⁇ c-adrenoceptor antagonist activity. Some compounds also show moderate 5-HTT activity. It further relates to their preparation, pharmaceutical compositions comprising them and their use as a medicine, especially for the treatment of central nervous system disorders.
  • Adrenergic receptors form the interface between the endogenous catecholamines epinephrine and norepinephrine and a wide array of target cells in the body to mediate the biological effects of the sympathetic nervous system. They are divided into three major subcategories, ⁇ i, ⁇ 2 and ⁇ . To date, nine distinct adrenergic receptor subtypes have been cloned from several species: CH A , CH B , CH D , ⁇ 2A , ⁇ 2B , ⁇ 2C , ⁇ i, ⁇ 2 and ⁇ 3 (Hieble, J. P.; et al. J. Med. Chem. 1995, 38, 3415-3444).
  • ⁇ 2 -adrenoceptor ligands which are imidazoles or imidazolines, also bind with moderate-to-high affinity to non- adrenoceptor imidazoline binding sites.
  • the three ⁇ 2 -adrenoceptor subtypes share many common properties. They are
  • G-protein-coupled receptors with seven transmembrane domains of the aminebinding subfamily. All three subtypes are coupled to the Gi/o signalling system, inhibiting the activity of adenylate cyclase, the opening of voltage-gated Ca 2+ channels and the opening of K + channels.
  • the three receptors are encoded by distinct genes (Bylund, D. B.; et al. Pharmacol. Rev. 1994, 46, 121-136 and Hieble, J. P. et al. Pharmacol. Commun.
  • the ( ⁇ -adrenoceptor subtypes are differentially distributed in cells and tissues, clearly endowing the receptors with different physiological functions and pharmacological activity profiles. Different regulatory regions in the receptor genes and different protein structures also confer different regulatory properties on the three receptors, both with regard to receptor synthesis and post-translational events.
  • ⁇ 2 -Adrenergic receptors were initially characterized as presynaptic receptors that serve as parts of a negative feedback loop to regulate the release of norepinephrine. Soon it was shown that ( ⁇ -adrenoceptors are not restricted to presynaptic locations but also have postsynaptic functions.
  • the ⁇ 2A -adrenoceptor is the major inhibitory pre- synaptic receptor (autoreceptor) regulating release of norepinephrine from sympathetic neurons as part of a feedback loop.
  • autoreceptor pre- synaptic receptor
  • the ⁇ 2 c-adrenoceptor turned out to function as an additional presynaptic regulator in all central and peripheral nervous tissues investigated.
  • the relative contributions of ⁇ 2A and ⁇ 2 c-receptors differed between central and peripheral nerves, with the ⁇ 2 c-subtype being more prominent in sympa- thetic nerve endings than in central adrenergic neurons (Philipp, M. et al. Am. J. Physiol. Regul. Integr. Comput. Physiol.
  • the ⁇ 2C -adrenoceptor is particularly suited to control neurotransmitter release at low action potential frequencies.
  • the ⁇ 2A - adrenoceptor seems to operate primarily at high stimulation frequencies in sympathetic nerves and may thus be responsible for controlling norepinephrine release during maximal sympathetic activation (Bucheler, M. M. et al. Neuroscience 2002, 109, 819- 826).
  • ⁇ 2B -Adrenoceptors are located on postsynaptic cells to mediate the effects of catecholamines released from sympathetic nerves, e.g., vasoconstriction.
  • ⁇ 2 - Adrenergic receptors not only inhibit release of their own neurotransmitters but can also regulate the exocytosis of a number of other neurotransmitters in the central and peripheral nervous system.
  • ⁇ 2A - and ⁇ 2C -adrenoceptors can inhibit dopamine release in basal ganglia as well as serotonin secretion in mouse hippocampal or brain cortex slices.
  • ⁇ 2 -adrenoceptor agonists on gastrointestinal motility was mediated solely by the ⁇ 2A -subtype. Part of the functional dif- ferences between ⁇ 2A - and ⁇ 2C -receptors may be explained by their distinct subcellular localization patterns. When expressed in rat fibroblasts, ⁇ 2A - and ⁇ 2B -adrenoceptors are targeted to the plasma membrane. On stimulation with agonist, only ⁇ 2B -adrenoceptors are reversibly internalized into endosomes.
  • ⁇ 2 c-Adrenoceptors are primarily localized in an intracellular membrane compartment, from where they can be translocated to the cell surface after exposure to cold temperature (see a.o. Jardinerty J. R. et. al. Eur. J. Pharmacol. 1998, 361, 1-15).
  • mice lacking or overexpressing ⁇ 2 - adrenoceptor subtypes has yielded important information for understanding the sub- type specific functions (MacDonald, E. et al. Trends Pharmacol. ScL 1997, 18, 21 1-
  • mice The examination of the phenotype of these strains of mice demonstrated that the ⁇ 2A -subtype is responsible for inhibition of neurotransmitter release from central and peripheral sympathetic nerves and for most of the centrally mediated effects of ⁇ 2 - agonists.
  • the ⁇ 2B subtype is primarily responsible for the initial peripheral hypertensive responses evoked by the ⁇ 2 -agonists and takes part in the hypertension induced by salt (Link et al. Science 1996, 273, 803-805 and Makaritsis, K. P. et al. Hypertension
  • Clarification of the physiological role of the ⁇ 2 c subtype proved more difficult.
  • its role did not appear critical in the media- tion of the cardiovascular effects of nonselective ⁇ 2 -agonists. Its participation has been suggested in the hypothermia induced by dexmedetomidine and in the hyperlocomo- tion induced by D-amphetamine (Rohrer, D. K. et al. Annu. Rev. Pharmacol Toxicol. 1998, 38, 351-373).
  • Another potentially important response mediated by the ⁇ 2C - adrenoceptor is constriction of cutaneous arteries, leading to a reduction in cutaneous blood flow (Chotani, M. A.
  • ⁇ 2C - adrenoceptor is also expressed at the presynaptic level where, together with ⁇ 2A , it actively participates in the control of neurotransmitter release. While ⁇ 2A -adrenoceptor is particularly efficient at high stimulation frequencies, ⁇ 2 c-adrenoceptor acts rather at low stimulation frequencies. Moreover, it has been suggested that ⁇ 2C subtype participates in the modulation of motor behavior and the memory processes (Bjorklund, M. et al. Neuroscience 1999, 88, 1 187-1198 and Tanila, H.
  • ⁇ 2 - receptors affect a number of behavioral functions.
  • the effect of altered ⁇ 2 c-adrenergic receptor expression has been evaluated in several different behavioral paradigms (Kable J.W. et al., Journal of Pharmacology and Experimental Therapeutics, 2000, 293 (1 ): 1-7), proving that ⁇ 2 c-adrenergic antagonists may have therapeutic value in the treatment of stress-related psychiatric disorders.
  • the ⁇ 2 c-subtype plays some direct role in mediating behavior or whether altered ⁇ 2 c-receptor expression produces effects because of altered metabolism or downstream modulation of other neurotransmitter systems.
  • ⁇ 2 c- receptor-deficient mice had enhanced startle responses, diminished prepulse inhibition, and shortened attack latency in the isolation aggression test.
  • drugs acting via the ⁇ 2 c-adrenoceptor may have therapeutic value in disorders associated with enhanced startle responses and sensorimotor gating deficits, such as schizophrenia, attention deficit disorder, posttraumatic stress disorder, and drug withdrawal.
  • the ⁇ 2A -adrenoceptor has an important .
  • ⁇ 2A -subtype mediates most of the classical effects of ⁇ 2 -adrenergic agonists, it is doubtful that an ⁇ 2A -selective agonist would have a substantially better clinical profile than the currently available agents.
  • Drugs acting at ⁇ 2 ⁇ - or ⁇ 2 c- adrenergic receptors are likely to have fewer of the classical ⁇ 2 -adrenergic side effects than ⁇ 2A -specific agents. It would appear likely that ⁇ 2C -selective agents may be useful in at least some nervous system disorders, in particular central nervous system disorders.
  • OPC-28326 is the only compound in clinical development (in Phase 2 by Otsuka Pharmaceuticals for hypertensive disorders and peripheral vascular disease).
  • the rest of the ⁇ 2 c antagonists are in preclinical development by Oy Juvantia Pharma Ltd (JP 1514 and JP 1302, published in WO 01/64645 and WO 04/067513) and by Novartis AG (NVP-ABE651 and NVP-ABE697, published in WO 01/55132 and J. Label Compd. Radiopharm 2002, 45, 1 180), indicated mainly for depression and schizophrenia.
  • Oy Juvantia Pharma Ltd JP 1514 and JP 1302, published in WO 01/64645 and WO 04/067513
  • Novartis AG NVP-ABE697, published in WO 01/55132 and J. Label Compd. Radiopharm 2002, 45, 1 180
  • NVP-ABE697 published in WO 01/55132 and J. Label Compd. Radiopharm 2002, 45, 1 180
  • This goal was achieved by a compound according to the general Formula (I)
  • a 1 , A 2 are each, independently from each other, a nitrogen or a carbon-atom; with the provision that A 1 and A 2 are not simultaneously a carbon atom;
  • Z 1 , Z 2 are each, independently from each other, a covalent bond or N-R 4 ; wherein R 4 is selected from the group of hydrogen, (d- 3 )alkyl, aryl and aryl-(Ci -3 )alkyl ; n is an integer equal to zero, 1 , 2 or 3 ;
  • R 5 is selected from the group of hydrogen and halo ;
  • P is a radical selected from the group of phenyl, biphenyl,
  • X 2 is a covalent bond, a saturated or an unsaturated (Ci -8 )-hydrocarbon radical, wherein one or more bivalent -CH 2 -units may optionally be replaced by a respective bivalent phenyl-unit ; and/or wherein one or more hydrogen atoms may be replaced by a radical selected from the group of oxo ; (Ci -3 )alkyloxy ; halo ; cyano ; nitro ; formyl ; hydroxy ; amino ; trifluoromethyl ; mono- and di((Ci -3 )alkyl)amino ; carboxyl ; and thio ;
  • Q 2 is a radical selected from the group of hydrogen ; -NR 1 R 2 ; Pir ; -OR 3a ; SR 3b ; SO 2 R 3c ; aryl ; and Het; wherein two radicals -OR 3a may be taken together to form a bivalent radical -O-(CH 2 ) S -O- wherein s is an integer equal to 1 , 2 or 3 ;
  • R 1 and R 2 are each, independently from each other, a radical selected from the group of hydrogen ; alkyl ; alkenyl ; alkynyl ; aryl ; arylalkyl ; diarylalkyl ; alkylcarbonyl ; alkylcarbonylalkyl ; alkenylcarbonyl ; alkyloxy ; alkyloxyalkyl ; alkyloxycarbonyl ; alkyloxycarbonylalkyl ; alkyloxycarbonylalkyl ; alkyloxycarbonylalkylcarbonyl; alkylsul- fonyl ; arylsulfonyl ; arylalkylsulfonyl ; arylalkenylsulfonyl ; Het- sulfonyl ; arylcarbonyl ; aryloxyalkyl ; arylalkylcarbonyl ; Het ; Het-alky
  • X 2 -radical selected from the group of pyrrolidinyl ; imidazolidinyl ; pyra- zolidinyl ; piperidinyl ; piperazinyl ; pyrrolyl ; pyrrolinyl ; imidazolinyl ; pyrrazolinyl ; pyrrolyl ; imidazolyl ; pyrazolyl ; triazolyl ; azepyl ; di- azepyl; morpholinyl ; thiomorpholinyl ; indolyl ; isoindolyl; indolinyl ; in- dazolyl ; benzimidazolyl ; and 1 ,2,3,4-tetrahydro-isoquinolinyl ; wherein each Pir-radical is optionally substituted by 1 , 2 or 3 radicals selected from the group of hydroxy ; halo ; oxo ; (C
  • Het is a heterocyclic radical selected from the group of pyrrolidinyl ; imida- zolidinyl ; pyrazolidinyl ; piperidinyl ; piperazinyl ; pyrrolyl ; pyrrolinyl ; imidazolinyl ; pyrrazolinyl ; pyrrolyl ; imidazolyl ; pyrazolyl ; triazolyl ; pyridinyl ; pyridazinyl ; pyrimidinyl ; pyrazinyl ; triazinyl ; azepyl ; di- azepyl ; morpholinyl ; thiomorpholinyl ; indolyl ; isoindolyl ; indolinyl ; indazolyl ; benzimidazolyl ; 1 ,2,3,4-tetrahydro-isoquinolinyl ; fu
  • (Ci -3 )alkyl phenyl, optionally substituted with (Ci -3 )alkyloxy ; (Ci -3 )alkylcarbonyl ; (Ci -3 )alkenylthio ; imidazolyl-(Ci -3 )alkyl ; aryl(Ci -3 )- alkyl and (Ci -3 )alkyloxycarbonyl ; aryl is naphthyl or phenyl, each optionally substituted with 1 , 2 or 3 sub- stituents, each independently from each other, selected from the group of oxo ; (Ci -3 )alkyl; (Ci -3 )alkyloxy ; halo ; cyano ; nitro ; formyl ; ethanoyl ; hydroxy ; amino ; trifluoromethyl ; mono- and di((Ci -3 )alkyl)amino ; mono-
  • the invention also relates to a pharmaceutical composition
  • a pharmaceutical composition comprising a pharmaceutically acceptable carrier or diluent and, as active ingredient, a therapeutically effective amount of a compound according to the invention, in particular a compound ac- cording to Formula (I), a pharmaceutically acceptable acid or base addition salt thereof, an ⁇ /-oxide form thereof or a quaternary ammonium salt thereof.
  • the invention also relates to the use of a compound according to the invention for the preparation of a medicament for the prevention and/or treatment of a disorder or disease responsive to antagonism of the ⁇ 2 -adrenergic receptor, in particular to an- tagonism of the ( ⁇ -adrenergic receptor.
  • the invention relates to the use of a compound according to the invention for the preparation of a medicament for the prevention and/or treatment of central nervous system disorders, mood disorders, anxiety disorders, stress-related disorders associated with depression and/or anxiety, cognitive disorders, personality disor- ders, schizoaffective disorders, Parkinson's disease, dementia of the Alzheimer's type, chronic pain conditions, neurodegenerative diseases, addiction disorders, mood disorders and sexual dysfunction.
  • a compound according to the invention may also be suitable as add-on treatment and/or prophylaxis in the above listed diseases in combination with antidepressants, anxiolytics and/or antipsychotics which are currently available or in development or which will become available in the future, to improve efficacy and/or onset of action.
  • antidepressants anxiolytics and/or antipsychotics which are currently available or in development or which will become available in the future, to improve efficacy and/or onset of action.
  • antidepressants anxiolytics and/or antipsychotics are shown to be active.
  • compounds are evaluated in combination with antidepressants, anxiolytics and/or antipsychotics for attenuation of stress-induced hyperthermia.
  • the invention therefore also relates to the use of a compound according to the invention for use as an add-on treatment with one or more other compounds selected from the group of antidepressants, anxiolytics and antipsychotics, to a pharmaceutical composition comprising a compound according to the invention and one or more other compounds selected from the group of antidepressants, anxiolytics and antipsychotics, as well as to a process for the preparation of such pharmaceutical compositions and to the use of such a composition for the manufacture of a medicament, in particular to improve efficacy and/or onset of action in the treatment of depression and/or anxiety.
  • the invention relates to a compound according to
  • the invention relates to a compound according to the invention, wherein R 4 is hydrogen or p-aminomethylbenzyl. Most preferably, R 4 is hydrogen. In a preferred embodiment, the invention relates to a compound according to the invention, wherein n is 1 , 2 or 3.
  • the invention relates to a compound according to the invention, wherein R 5 is hydrogen.
  • the invention relates to a compound according to the invention, wherein P is phenyl.
  • the invention relates to a compound according to the invention, wherein X 2 is selected from the group of a covalent bond, a d-hydrocarbon radical, a C 2 -hydrocarbon radical, or a C 3 -hydrocarbon radical.
  • one bivalent -CH 2 -unit of the hydrocarbon radical X 2 is replaced by a bivalent phenyl-unit ; or wherein two hydrogen atoms of the hydrocarbon radical X 2 are replaced by an oxo-radical.
  • the invention relates to a compound according to the 3 iinnvveennttiioonn,, wwhheerreeiinn XX 22 iiss sseelleecctteedd from the group of a covalent bond and any one of the radicals (aa) to (bm) defined as :
  • each of the radicals can be used as a linker in which either the left side (left bond) of the linker or the right side (right bond) of the linker is connected to the central pyrazinone-moiety. This is particulary relevant for non-symmetrical linkers that can thus be used in two configurations.
  • the invention relates to a compound according to the invention, wherein X 2 is selected from the group of a covalent bond and any one of the radicals (aa), (ab), (ac), (ag), (am), (an), (aq), (as) and (be) as defined below :
  • the attachments to the unit can be in ortho, meta or para-position ; preferably the attachments to the unit are in meta or para-position, most preferably in para-position.
  • the invention relates to a compound wherein Q 2 is a radical selected from the group of hydrogen ; -NR 1 R 2 ; Pir ; -OR 3a ; SR 3b ; aryl ; and Het.
  • the invention relates to a compound wherein R 1 and R 2 are each, independently from each other, a radical selected from the group of hydrogen ; alkyl ; and alkyloxycarbonyl.
  • R 1 or R 2 comprises an alkyl moiety
  • the alkyl moiety is methyl ; f-butyl ; or a bivalent moiety derived therefrom in the sense that one hydrogen is replaced by a bond to form a bivalent radical, such as for instance is the case for alkyl in the moiety phenylalkyl.
  • the invention relates to a compound according to the invention, wherein Pir is a radical containing at least one N, by which it is at- tached to the X 2 -radical, selected from the group of piperidinyl and isoindolyl ; wherein each Pir-radical is optionally substituted by 2 oxo-radicals, such as, for instance, isoin- dolyl-1 ,3-dione.
  • the invention relates to a compound according to the invention, wherein R 3a and R 3b are each, independently from each other, an alkyl-radical.
  • R 3a and R 3b are each, independently from each other, methyl.
  • the invention relates to a compound according to the invention, wherein Het is a heterocyclic radical selected from the group of pyridinyl ; furyl ; tetrahydropyranyl; thienyl ; oxadiazolyl ; and quinolinyl ; wherein each Het-radical is optionally substituted by one or more radicals selected from the group of halo and phenyl, optionally substituted with (d -3 )alkyloxy.
  • the invention relates to a compound according to the invention, wherein aryl is naphthyl or phenyl, each optionally substituted with a substituent, selected from the group of (Ci -3 )alkyl and halo.
  • the invention relates to a compound accord- ing to the invention, wherein
  • a 1 , A 2 are each, independently from each other, a nitrogen or a carbon-atom; with the provision that A 1 and A 2 are not simultaneously a carbon atom; Z 1 , Z 2 are each, independently from each other, a covalent bond or N-R 4 ; wherein
  • R 4 is selected from the group of hydrogen and aryl-(Ci -3 )alkyl ; n is an integer equal to zero, 1 , 2 or 3 ;
  • R 5 is hydrogen ;
  • P is a radical selected from the group of phenyl, biphenyl, 1 ,1-diphenylmethyl and benzyloxyphenyl ;
  • X 2 is a bond, a saturated or an unsaturated (Ci_8)-hydrocarbon radical, wherein one or more bivalent -CH 2 -units may optionally be replaced by a respective bivalent phenyl-unit ; and/or wherein one or more hydrogen atoms may be replaced by an oxo-radical ;
  • Q 2 is a radical selected from the group of hydrogen ; -NR 1 R 2 ; Pir ; -OR 3a ;
  • R 1 and R 2 are each, independently from each other, a radical selected from the group of hydrogen ; alkyl ; and alkyloxycarbonyl ;
  • Pir is a radical containing at least one N, by which it is attached to the X 2 - radical, selected from the group of piperidinyl ; isoindolyl; wherein each Pir- radical is optionally substituted by 2 oxo-radicals ;
  • R 3a , R 3b , R 3c are each, independently from each other, an alkyl-radical ;
  • Het is a heterocyclic radical selected from the group of pyridinyl ; furyl ; tetra- hydropyranyl ; thienyl ; oxadiazolyl ; and quinolinyl ; wherein each Het- radical is optionally substituted by one or more radicals selected from the group of halo ; and phenyl, optionally substituted with (d
  • alkyl is a straight or branched saturated hydrocarbon radical having from 1 to 8 carbon atoms ; or is a cyclic saturated hydrocarbon radical having from 3 to 7 carbon atoms ; or is a cyclic saturated hydrocarbon radical having from 3 to 7 carbon atoms being part of a straight or branched saturated hydrocarbon radical having from 1 to 8 carbon atoms ; wherein each radical is optionally substituted on one or more carbon atoms with one or more radicals selected from the group of oxo ; (Ci -3 )alkyloxy ; halo ; cyano ; nitro ; formyl ; hydroxy ; amino ; carboxy ; and thio.
  • alkyl is methyl, ethyl, propyl, isopropyl, butyl, te/f-butyl, pentyl, hexyl, pentyl, oc- tyl, cyclopropyl, cyclopentyl, cyclohexyl, cyclohexylmethyl and cyclohexylethyl.
  • alkyl is a (Ci -2 )alkyl radical.
  • alkenyl is an alkyl radical as defined above having one or more double bonds.
  • alkenyl is ethenyl, propenyl and butynyl.
  • alkynyl is an alkyl radical as defined above having one or more triple bonds.
  • alkynyl is ethynyl and propynyl.
  • arylalkyl is an alkyl radical as defined above, having one CH 3 -radical replaced by a phenyl-radical.
  • An examples of such a radical is benzyl.
  • diarylalkyl is an alkyl radical as defined above, having two CH 3 -radical replaced by a phenyl-radical.
  • An examples of such a radical is diphenylmethyl and 1 ,1-diphenylethyl.
  • halo is a substituent selected from the group of fluoro, chloro, bromo and iodo and haloalkyl is a straight or branched satu- rated hydrocarbon radical having from 1 to 6 carbon atoms or a cyclic saturated hydrocarbon radical having from 3 to 7 carbon atoms, wherein one or more carbon atoms is substituted with one or more halo atoms.
  • halo is bromo, fluoro or chloro ; more preferably, halo is fluoro.
  • haloalkyl is trifluoroalkyl ; more preferably haloalkyl is trifluoromethyl.
  • a bond can be any bond, including a covalent bond, a single bond, a double bond, a triple bond, a coordination bond and a hydrogen bond.
  • a compound according to the invention is meant a compound according to the general Formula (I), a pharmaceutically accept- able acid or base addition salt thereof, an ⁇ /-oxide form thereof, or a quaternary ammonium salt thereof.
  • a pharmaceutically acceptable acid addition salt is defined to comprise a therapeutically active non-toxic acid addition salt form that a compound according to Formula (I) is able to form.
  • Said salt can be obtained by treating the base form of a com- pound according to Formula (I) with an appropriate acid, for example an inorganic acid, for example hydrohalic acid, in particular hydrochloric acid, hydrobromic acid, sulphuric acid, nitric acid and phosphoric acid ; an organic acid, for example acetic acid, hy- droxyacetic acid, propanoic acid, lactic acid, pyruvic acid, oxalic acid, malonic acid, succinic acid, maleic acid, fumaric acid, malic acid, tartaric acid, citric acid, methane- sulfonic acid, ethanesulfonic acid, benzenesulfonic acid, p-toluenesulfonic acid, cy- clamic acid, salicylic acid,
  • said acid addition salt form may be converted into the free base form by treatment with an appropriate base .
  • the compound according to Formula (I) containing an acidic proton may also be converted into a therapeutically active non-toxic metal or amine addition salt form (base addition salt) by treatment with an appropriate organic and inorganic base.
  • base salt forms comprise, for example, the ammonium salts, the alkaline and earth alkaline metal salts, in particular lithium, sodium, potassium, magnesium and calcium salts, salts with organic bases, e.g. the benzathine, ⁇ /-methyl-D-glucamine, hy- bramine salts, and salts with amino acids, for example arginine and lysine.
  • salt form can be converted into the free form by treatment with an appropriate acid.
  • addition salt as used in the framework of this application also comprises a solvate that the compound according to Formula (I), as well as a salt thereof, is able to form.
  • solvates are, for example, hydrates and alcoholates.
  • the ⁇ /-oxide form of the compound according to Formula (I) is meant to comprise a compound of Formula (I) wherein one or several nitrogen atoms are oxidized to so-called ⁇ /-oxides, particularly those ⁇ /-oxides wherein one or more tertiary nitrogens (e.g. of the piperazinyl or piperidinyl radical) are ⁇ /-oxidized.
  • ⁇ /-oxides can easily be obtained by a skilled person without any inventive skills and they are obvious alternatives for a compound according to Formula (I) since these compounds are metabolites, which are formed by oxidation in the human body upon uptake .
  • oxidation is normally the first step involved in drug metabolism (Textbook of Organic Medicinal and Pharmaceutical Chemistry, 1977, pages 70- 75).
  • the metabolite form of a compound can also be administered to a human instead of the compound per se, with much the same effects.
  • a compound of Formula (I) may be converted to the corresponding ⁇ /-oxide form following art-known procedures for converting a trivalent nitrogen into its ⁇ /-oxide form.
  • Said ⁇ /-oxidation reaction may generally be carried out by reacting the compound of Formula (I) with an appropriate organic or inorganic peroxide.
  • Appropriate inorganic peroxides comprise, for example, hydrogen peroxide, alkali metal or earth alkaline metal peroxides, e.g. sodium peroxide, potassium peroxide;
  • appropriate organic peroxides may comprise peroxy acids such as, for example, benzenecarboperoxoic acid or halo substituted benzenecarboperoxoic acid, e.g.
  • 3-chlorobenzenecarboperoxoic acid peroxoalkanoic acids, e.g. peroxoacetic acid, alkylhydroperoxides, e.g. te/f-butyl hy- droperoxide.
  • Suitable solvents are, for example, water, lower alkanols, e.g. ethanol and the like, hydrocarbons, e.g. toluene, ketones, e.g. 2-butanone, halogenated hydrocarbons, e.g. dichloromethane, and mixtures of such solvents.
  • a quaternary ammonium salt of compound according to Formula (I) defines said compound which is able to form by a reaction between a basic nitrogen of a compound according to Formula (I) and an appropriate quaternizing agent, such as, for example, an optionally substituted alkylhalide, arylhalide or arylalkylhalide, in particular methylio- dide and benzyliodide.
  • an appropriate quaternizing agent such as, for example, an optionally substituted alkylhalide, arylhalide or arylalkylhalide, in particular methylio- dide and benzyliodide.
  • Other reactants with good leaving groups may also be used, such as, for example, alkyl trifluoromethanesulfonat.es, alkyl methanesulfonates and alkyl p-toluenesulfonates.
  • a quaternary ammonium salt has at least one positively charged nitrogen.
  • the invention also comprises a derivative compound (usually called "pro-drug") of a pharmacologically-active compound according to the invention, in particular according to Formula (I), which is degraded in vivo to yield a compound according to the in- vention.
  • Pro-drugs are usually (but not always) of lower potency at the target receptor than the compounds to which they are degraded.
  • Pro-drugs are particularly useful when the desired compound has chemical or physical properties that make its administration difficult or inefficient. For example, the desired compound may be only poorly soluble, it may be poorly transported across the mucosal epithelium, or it may have an undesirably short plasma half-life. Further discussion on pro-drugs may be found in Stella, V. J. et al., "Prodrugs", Drug Delivery Systems, 1985, pp. 112-176, and Drugs, 1985, 29, pp. 455-473.
  • a pro-drug form of a pharmacologically-active compound according to the invention will generally be a compound according to Formula (I), a pharmaceutically accept- able acid or base addition salt thereof, an N-oxide form thereof, or a quaternary ammonium salt thereof, having an acid group which is esterified or amidated. Included in such esterified acid groups are groups of the formula -COOR X , where R x is a Ci -6 alkyl, phenyl, benzyl or one of the following groups :
  • Amidated groups include groups of the formula - CONR y R z , wherein R y is H,
  • Ci -6 alkyl, phenyl or benzyl and R z is -OH, H, Ci -6 alkyl, phenyl or benzyl.
  • a compound according to the invention having an amino group may be derivatised with a ketone or an aldehyde such as formaldehyde to form a Mannich base. This base will hydrolyze with first order kinetics in aqueous solution.
  • stereochemically isomeric form defines all the possible isomeric forms that a compound of Formula (I) may possess.
  • chemical designation of a compound denotes the mixture of all possible stereochemically isomeric forms, said mixtures containing all diastereomers and enan- tiomers of the basic molecular structure. More in particular, stereogenic centers may have the R- or S-configuration; substituents on bivalent cyclic (partially) saturated radicals may have either the cis- or trans-configuration.
  • Compounds encompassing double bonds can have an E or Z-stereochemistry at said double bond. Hence, all stereochemically isomeric forms of a compound of Formula (I) are intended to be embraced within the scope of this invention.
  • an R or S descriptor is as- signed (based on Cahn-lngold-Prelog sequence rule) to the lowest-numbered chiral center, the reference center.
  • the configuration of the second stereogenic center is indicated using relative descriptors [R * , R * ] or [R * ,S * ], where R * is always specified as the reference center and [R * , R * ] indicates centers with the same chirality and [R * ,S * ] indicates centers of unlike chirality.
  • the stereo descriptor would be specified as S-[R * ,S * ]. If " ⁇ " and " ⁇ ” are used : the position of the highest priority substituent on the asymmetric carbon atom in the ring system having the lowest ring number, is arbitrarily always in the " ⁇ " position of the mean plane determined by the ring system.
  • the position of the highest priority substituent on the other asymmetric carbon atom in the ring system (hydrogen atom in a compound according to Formula (I)) relative to the position of the highest priority substituent on the reference atom is denominated " ⁇ ", if it is on the same side of the mean plane determined by the ring system, or " ⁇ ", if it is on the other side of the mean plane determined by the ring system.
  • a compound according to the invention is inherently intended to comprise all isotopic combinations of its chemical elements.
  • a chemical element in particular when mentioned in relation to a compound according to Formula (I), comprises all isotopes and isotopic mixtures of this element, either naturally occuring or synthetically produced, either with natural abundance or in an isotopically enriched form.
  • a compound according to the invention therefore inherently comprises a compound with one or more isotopes of one or more element, and mixtures thereof, including a radioactive compound, also called radiolabeled compound, wherein one or more non-radioactive atoms has been replaced by one of its radioactive isotopes.
  • radioactive compound also called radiolabeled compound
  • radiolabeled compound any compound according to Formula (I), a pharmaceutically acceptable acid or base addition salt thereof, an N-oxide form thereof, or a quaternary ammonium salt thereof, which contains at least one radioactive atom.
  • a compound can be labelled with positron or with gamma emitting radioactive isotopes.
  • the 3 H-atom or the 125 l-atom is the atom of choice to be replaced.
  • PET positron emitting
  • the most commonly used positron emitting (PET) radioactive isotopes are 11 C, 18 F, 15 O and 13 N, all of which are accelerator produced and have half-lives of 20, 100, 2 and 10 minutes respectively. Since the half-lives of these radioactive isotopes are so short, it is only feasible to use them at institutions which have an accelerator on site for their production, thus limiting their use.
  • the most widely used of these are 18 F, 99m Tc, 201 TI and 123 I.
  • the handling of these radioactive isotopes, their production, isolation and incorporation in a molecule are known to the skilled person.
  • the radioactive atom is selected from the group of hydrogen, car- bon, nitrogen, sulfur, oxygen and halogen.
  • the radioactive atom is selected from the group of hydrogen, carbon and halogen.
  • the radioactive isotope is selected from the group of 3 H, 11 C, 18 F, 122 I, 123 I, 125 I, 131 I, 75 Br, 76 Br, 77 Br and 82 Br.
  • the radioactive isotope is se- lected from the group of 3 H, 11 C and 18 F.
  • a compound according to the invention can generally be prepared by a succession of steps, each of which is known to the skilled person.
  • a pyrazinone derivative can be prepared according to one or more of the following preparation methods.
  • Alkylation reactions of the starting material 2,3-dichloropyrazine with aminoderivatives may be performed in an aprotic solvent, such as, for instance DMF or DMSO, in the presence of an inorganic base, such as K 2 CO 3 , Na 2 CO 3 , NaOH or KOH, at a convenient temperature, either by conventional heating or under microwave irra- diation, for a period of time to ensure the completion of the reaction, which may typically be about 16 hours under conventional heating.
  • an aprotic solvent such as, for instance DMF or DMSO
  • an inorganic base such as K 2 CO 3 , Na 2 CO 3 , NaOH or KOH
  • Hydrolysis reactions may be performed either in acidic inorganic solvents, such as 10% HCIaq, using a co-solvent such as THF, by conventional heating or under microwave heating, for a period of time to ensure the completion of the reaction, which may typi- cally be about 16 hours under conventional heating, or under basic conditions, such as in NaOH aq or in a DMSO solvent, for a period of time to ensure the completion of the reaction, which may typically be about 0.5 hours under microwave irradiation.
  • the final compound (l-a) is the starting compound for the compounds of the reaction schemes below.
  • Variables Z 1 , Z 2 , A 1 , A 2 , n, P are defined as in Formula (I), unless otherwise specified.
  • Compound l-a can also be prepared starting from intermediate l-b by reaction with a suitable aldehyde, according to Scheme 1 B.
  • the reductive amination reaction may be performed in an aprotic solvent such as 1 ,2- dichloroethane, in the presence of the reducing agent such as sodium triacetoxyboro- hydride, for a period of time to ensure the completion of the reaction, which may typically be about 16 hours at room temperature.
  • an aprotic solvent such as 1 ,2- dichloroethane
  • the reducing agent such as sodium triacetoxyboro- hydride
  • the W-radical in the compound W-X 2 -(Q 2 ) q is a leaving group, such as for instance Cl-, Br-, MeSO 2 O- and P-MePhSO 2 O- ;
  • X 2 is a (Ci -8 )-hydrocarbon radical, more preferably a (Ci -6 )-hydrocarbon radical, even more preferably a (Ci -5 )-hydrocarbon radical, most preferably a (Ci -4 )-hydrocarbon radical.
  • Variables Z 1 , Z 2 , A 1 , A 2 , n, P are defined as in Formula (I), .
  • the alkylation reaction may be performed in an aprotic solvent, such as CH 3 CN, DMF or THF in the presence of an inorganic base, such as K 2 CO 3 , Na 2 CO 3 , CS 2 CO3, or an organic base such as TBD, PS-TBD, at a convenient temperature, either under conventional heating or microwave irradiation, for a period of time to ensure the completion of the reaction, which may typically be about 20 minutes at about 120° C under microwave irradiation.
  • an aprotic solvent such as CH 3 CN, DMF or THF
  • an inorganic base such as K 2 CO 3 , Na 2 CO 3 , CS 2 CO3, or an organic base such as TBD, PS-TBD
  • a compound according to the invention in particular compound according to
  • Formula (I) a pharmaceutically acceptable acid or base addition salt thereof, an N- oxide form thereof, or a quaternary ammonium salt thereof, has surprisingly been shown to have a binding affinity towards ⁇ 2 -adrenergic receptor, in particular towards ⁇ 2 c-adrenergic receptor, in particular as an antagonist.
  • a compound according to the invention is suitable for the prevention and/or treatment of diseases where antagonism of the ⁇ 2 -adrenergic receptor, in particular antagonism of the ⁇ 2C -adrenergic receptor is of therapeutic use.
  • a compound according to the invention may be suitable for treatment and/or prophylaxis in the following diseases :
  • Mood disorders including particularly major depressive disorder, depression with or without psychotic features, catatonic features, melancholic features, atypical fea- tures of postpartum onset and, in the case of recurrent episodes, with or without seasonal pattern, dysthymic disorder, bipolar I disorder, bipolar Il disorder, cyclothymic disorder, recurrent brief depressive disorder, mixed affective disorder, bipolar disorder not otherwise specified, mood disorder due to a general medical condi- tion, substance-induced mood disorder, mood disorder not otherwise specified, seasonal affective disorder and premenstrual dysphoric disorders.
  • Anxiety disorders including panic attack, agoraphobia, panic disorder without agoraphobia, agoraphobia without history of panic disorder, specific phobia, social phobia, obsessive-compulsive disorder, posttraumatic stress disorder, acute stress disorder, generalized anxiety disorder, anxiety disorder due to a general medical condition, substance-induced anxiety disorder and anxiety disorder not otherwise specified.
  • Stress-related disorders associated with depression and/or anxiety including acute stress reaction, adjustment disorders (brief depressive reaction, prolonged depres- sive reaction, mixed anxiety and depressive reaction, adjustment disorder with predominant disturbance of other emotions, adjustment disorder with predominant disturbance of conduct, adjustment disorder with mixed disturbance of emotions and conduct, adjustment disorders with other specified predominant symptoms) and other reactions to severe stress.
  • Dementia amnesic disorders and cognitive disorders not otherwise specified, especially dementia caused by degenerative disorders, lesions, trauma, infections, vascular disorders, toxins, anoxia, vitamin deficiency or endocrinic disorders, or amnesic disorders caused by alcohol or other causes of thiamine deficiency, bilateral temporal lobe damage due to Herpes simplex encephalitis and other limbic en- cephalitis, neuronal loss secondary to anoxia / hypoglycaemia / severe convulsions and surgery, degenerative disorders, vascular disorders or pathology around ventricle III.
  • Cognitive disorders in particular due to cognitive impairment resulting from other medical conditions.
  • Personality disorders including paranoid personality disorder, schizoid personality disorder, schizotypical personality disorder, antisocial personality disorder, borderline personality disorder, histrionic personality disorder, narcissistic personality dis- order, avoidant personality disorder, dependent personality disorder, obsessive- compulsive personality disorder and personality disorder not otherwise specified.
  • Schizoaffective disorders resulting from various causes including schizoaffective disorders of the manic type, of the depressive type, of mixed type, paranoid, disor- ganized, catatonic, undifferentiated and residual schizophrenia, schizophreniform disorder, schizoaffective disorder, delusional disorder, brief psychotic disorder, shared psychotic disorder, substance-induced psychotic disorder and psychotic disorder not otherwise specified.
  • ADHD Attention-deficit / hyperactivity disorder
  • Parkinson's disease • Parkinson's disease, drug-induced Parkinsonism, post-encephalitic Parkinsonism, progressive supranuclear palsy, multiple system atrophy, corticobasal degenera- tion, parkinsonism-ALS dementia complex and basal ganglia calcification.
  • Eating Disorders including anorexia nervosa, atypical anorexia nervosa, bulimia nervosa, atypical bulimia nervosa, overeating associated with other psychological disturbances, vomiting associated with other psychological disturbances and non- specified eating disorders.
  • Chronic pain conditions including neuropathic pain, inflammatory pain, cancer pain and post-operative pain following surgery, including dental surgery.
  • These indications might also include acute pain, skeletal muscle pain, low back pain, upper ex- tremity pain, fibromyalgia and myofascial pain syndromes, orofascial pain, abdomi- nal pain, phantom pain, tic douloureux and atypical face pain, nerve root damage and arachnoiditis, geriatric pain, central pain and inflammatory pain.
  • Neurodegenerative diseases including Alzheimer's disease, Huntington's chorea, Creutzfeld-Jacob disease, Pick's disease, demyelinating disorders, such as multiple sclerosis and ALS, other neuropathies and neuralgia, multiple sclerosis, amyotropi- cal lateral sclerosis, stroke and head trauma.
  • Substance dependence or abuse with or without physiological dependence particularly where the substance is alcohol, amphetamines, amphetamine-like sub- stances, caffeine, cannabis, cocaine, hallucinogens, inhalants, nicotine, opioids, phencyclidine, phencyclidine-like compounds, sedative-hypnotics, benzodiazepines and/or other substances, particularly useful for treating withdrawal from the above substances and alcohol withdrawal delirium.
  • Sexual dysfunction including sexual desire disorders, sexual arousal disorders, orgasmic disorders, sexual pain disorders, sexual dysfunction due to a general medical condition, substance-induced sexual dysfunction and sexual dysfunction not otherwise specified.
  • the invention therefore relates to a compound according to the invention for use as a medicine.
  • the invention also relates to the use of a compound according to the invention for the preparation of a medicament for the prevention and/or treatment of central nervous system disorders, mood disorders, anxiety disorders, stress-related disorders associated with depression and/or anxiety, cognitive disorders, personality disorders, schizoaffective disorders, Parkinson's disease, dementia of the Alzheimer's type, chronic pain conditions, neurodegenerative diseases, addiction disorders, mood disorders and sexual dysfunction.
  • a compound according to the invention may be co-administered as add-on treatment and/or prophylaxis in the above listed diseases in combination with antidepressants, anxiolytics and/or antipsychotics which are currently available or in development or which will become available in the future, in particular to improve efficacy and/or onset of action.
  • a compound of the present invention and the other agents may be present as a combined preparation for simultaneous, separate or sequential use for the prevention and/or treatment of depression and/or anxiety. Such combined preparations may be, for example, in the form of a twin pack. It will also be appreciated that a compound of the present invention and the other agents may be administered as separate pharmaceutical compositions, either simultaneously or se- quentially.
  • the invention therefore relates to the use of a compound according to the invention as an add-on treatment in combination with one or more other compounds selected from the group of antidepressants, anxiolytics and antipsychotics.
  • Suitable classes of antidepressant agents include norepinephrine reuptake inhibi- tors, selective serotonin reuptake inhibitors (SSRI's), monoamine oxidase inhibitors (MAOI's), reversible inhibitors of monoamine oxidase (RIMA's), serotonin and noradrenaline reuptake inhibitors (SNRI's), noradrenergic and specific serotonergic antidepressants (NaSSA's), corticotropin releasing factor (CRF) antagonists, ⁇ -adrenoreceptor antagonists and atypical antidepressants.
  • SSRI's selective serotonin reuptake inhibitors
  • MAOI's monoamine oxidase inhibitors
  • RIMA's reversible inhibitors of monoamine oxidase
  • SNRI's noradrenergic and specific serotonergic antidepressants
  • CRF corticotropin releasing factor
  • norepinephrine reuptake inhibitors include amitriptyline, clomipramine, doxepin, imipramine, trimipramine, amoxapine, desipramine, maprotiline, nortriptyline, protriptyline, reboxetine and pharmaceutically acceptable salts thereof.
  • Suitable examples of selective serotonin reuptake inhibitors include fluoxetine, fluvoxamine, paroxetine, sertraline and pharmaceutically acceptable salts thereof.
  • Suitable examples of monoamine oxidase inhibitors include isocarboxazid, phenelzine, tranylcypromine, selegiline and pharmaceutically acceptable salts thereof.
  • Suitable examples of reversible inhibitors of monoamine oxidase include mo- clobemide and pharmaceutically acceptable salts thereof.
  • Suitable examples of serotonin and noradrenaline reuptake inhibitors include venlafaxine and pharmaceutically acceptable salts thereof.
  • Suitable atypical antidepressants include bupropion, lithium, nefazodone, tra- zodone, viloxazine, sibutramine and pharmaceutically acceptable salts thereof.
  • antidepressants include adinazolam, alaproclate, amineptine, amitriptyline/chlordiazepoxide combination, atipamezole, azamianserin, apelinaprine, befuraline, bifemelane, binodaline, bipenamol, brofaromine, bupropion, caroxazone, cericlamine, cianopramine, cimoxatone, citalopram, clemeprol, clovoxamine, dazepinil, deanol, demexiptiline, dibenzepin, dothiepin, droxidopa, enefexine, estazolam, etoperi- done, femoxetine, fengabine, fezolamine, fluotracen, idazoxan, indalpine, indeloxazine, iprindole, levoprotiline, litoxe
  • Suitable classes of anti-anxiety agents include benzodiazepines and 5-HT 1A receptor agonists or antagonists, especially 5-HT 1A partial agonists, corticotropin releasing factor (CRF) antagonists, compounds having muscarinic cholinergic activity and compounds acting on ion channels.
  • 5-HT 1A receptor agonists or antagonists especially 5-HT 1A partial agonists, corticotropin releasing factor (CRF) antagonists, compounds having muscarinic cholinergic activity and compounds acting on ion channels.
  • CRF corticotropin releasing factor
  • nonbenzodiazepine sedative-hypnotic drugxs such as Zolpidem
  • mood-stabilizing drugs such as clobazam, gabapentin, lamotrigine, lore- clezole, oxcarbamazepine, stiripentol and vigabatrin
  • barbiturates are nonbenzodiazepine sedative-hypnotic drugxs such as Zolpidem
  • mood-stabilizing drugs such as clobazam, gabapentin, lamotrigine, lore- clezole, oxcarbamazepine, stiripentol and vigabatrin
  • barbiturates such as clobazam, gabapentin, lamotrigine, lore- clezole, oxcarbamazepine, stiripentol and vigabatrin.
  • Suitable antipsychotic agents are selected from the group consisting of aceto- phenazine, in particular the maleate salt; alentemol, in particular the hydrobromide salt; alpertine; azaperone; batelapine, in particular the maleate salt; benperidol; benzin- dopyrine, in particular the hydrochloride salt; brofoxine; bromperidol; butaclamol, in particular the hydrochloride salt; butaperazine; carphenazine, in particular the maleate salt; carvotroline, in particular the hydrochloride salt; chlorpromazine; chlorprothixene; cinperene; cintriamide; clomacran, in particular the phosphate salt; clopenthixol; clopi- mozide; clopipazan, in particular the mesylate salt; cloroperone, in particular the hydrochloride salt; clothiapine; clothixamide, in particular the maleate salt; cloza
  • Some compound according to the invention surprisingly also shows a moderate 5-HT-reuptake inhibition activity and may therefore very well be suited for use in the treatment and/or prophylaxis of depression. It is thought that a 5-HT reuptake inhibitor with associated ( ⁇ -adrenoceptor antagonistic activity might be a new type of antide- pressant, with a dual action on the central noradrenergic and serotonergic neuronal systems.
  • the immediate effect on monoamine release of autoreceptor blockade may accelerate the onset of action of such a compound, compared to currently available drugs that require desensitization of the autoreceptors involved in the feedback mechanism in order to become fully effective.
  • ⁇ 2 c-adrenoceptor antagonism improves sexual function as shown by treatment with the c ⁇ c-adrenoceptor antagonist yohimbine, thereby potentially reducing one of the side effects related to 5-HT uptake inhibition and enhancement of NEergic neurotransmission improves social function more effectively than SSRIs (J. lgnacio Andres et al., J. Med. Chem. (2005), Vol. 48, 2054-2071 ) ).
  • the invention also relates to a pharmaceutical composition
  • a pharmaceutical composition comprising a pharmaceutically acceptable carrier or diluent and, as active ingredient, a therapeutically effective amount of a compound according to the invention, in particular compound accord- ing to Formula (I), a pharmaceutically acceptable acid or base addition salt thereof, an N-oxide form thereof, or a quaternary ammonium salt thereof.
  • a compound according to the invention or any subgroup or combination thereof may be formulated into various pharmaceutical forms for administration purposes.
  • compositions there may be cited all compositions usually employed for sys- temically administering drugs.
  • an effective amount of the particular compound, optionally in addition salt form, as the active ingredient is combined in intimate admixture with a pharmaceutically acceptable carrier, which carrier may take a wide variety of forms depending on the form of preparation desired for administration.
  • a pharmaceutically acceptable carrier which carrier may take a wide variety of forms depending on the form of preparation desired for administration.
  • This pharmaceutical composition is desirable in unitary dosage form suitable, in particular, for administration orally, rectally, percutaneously, by parenteral injection or by inhalation.
  • any of the usual pharmaceutical media may be employed such as, for example, water, glycols, oils, alcohols and the like in the case of oral liquid preparations such as suspensions, syrups, elixirs, emulsions and solutions; or solid carriers such as starches, sugars, kaolin, diluents, lubricants, binders, disintegrating agents and the like in the case of powders, pills, capsules and tablets. Because of their ease in administration, tablets and capsules represent the most advantageous oral dosage unit forms in which case solid pharmaceutical carriers are obviously employed.
  • the carrier will usually comprise sterile water, at least in large part, though other ingredients, for example, to aid solubility, may be included.
  • injectable solutions for example, may be prepared in which the carrier comprises saline solution, glucose solution or a mixture of saline and glucose solution.
  • injectable suspensions may also be prepared in which case appropriate liquid carriers, suspending agents and the like may be employed.
  • solid form preparations that are intended to be converted, shortly before use, to liquid form preparations.
  • the carrier optionally comprises a penetration enhancing agent and/or a suitable wetting agent, optionally combined with suitable additives of any nature in minor proportions, which additives do not introduce a significant deleterious effect on the skin.
  • Said additives may facilitate the administration to the skin and/or may be helpful for preparing the desired compositions.
  • These compositions may be administered in various ways, e.g., as a transdermal patch, as a spot-on, as an ointment. It is especially advantageous to formulate the aforementioned pharmaceutical compositions in unit dosage form for ease of administration and uniformity of dosage.
  • Unit dosage form refers to physically discrete units suitable as unitary dosages, each unit containing a predetermined quantity of active ingredient calculated to produce the desired therapeutic effect in association with the required pharmaceuti- cal carrier
  • unit dosage forms are tablets (including scored or coated tablets), capsules, pills, powder packets, wafers, suppositories, injectable solutions or suspensions and the like, and segregated multiples thereof.
  • a compound according to the invention is a potent orally administrable dopamine antagonist
  • a pharmaceutical composition comprising said compound for administration orally is especially ad- vantageous.
  • the invention also relates to a pharmaceutical composition
  • a pharmaceutical composition comprising a compound according to the invention and one or more other compounds selected from the group of antidepressants, anxiolytics and antipsychotics as well as to the use of such a composition for the manufacture of a medicament, in particular to improve efficacy and/or onset of action in the treatment of depression and/or anxiety.
  • THF means tetrahydrofuran
  • DMF means ⁇ /, ⁇ /-dimethylformamide
  • EtOAc means ethyl acetate
  • DMSO means dimethylsulfoxide
  • DCM means di- chloromethane
  • 1 ,2-DCE means 1 ,2-dichloroethane
  • HPLC means High- performance liquid chromatography
  • PS-TBD is a polymer-supported base which consists of a bicyclic guanidine moiety (1 ,5,7-triazabicyclo[4.4.0]dec-5-ene) anchored on polystyrene
  • PS-NCO means polymer-supported isocyanate.
  • Microwave assisted reactions were performed in a single-mode reactor: EmrysTM Opti- mizer microwave reactor (Personal Chemistry A.B., currently Biotage). Description of the instrument can be found in www.personalchemistry.com. And in a multimode reactor: MicroSYNTH Labstation (Milestone, Inc.). Description of the instrument can be found in www.milestonesci.com.
  • 2,3-Dichloropyrazine 500 mg, 3.35 mmol
  • 1-([1 ,1'-biphenyl]-3-ylmethyl) piperazine, (CAS 204634-72-0, 3.2 mmol) and NaOH pellets (1 g, 25 mmol) were heated at 150 0 C in a sealed tube during 4h.
  • Table 1 List of biphenyl-substituted compounds (with amino-piperidinyl-linker).
  • Table 2 List of biphenyl-substituted compounds (with piperazinyl-linker).
  • Table 3 List of biphenyl substituted compounds (with piperazinyl-linker).
  • Table 6 List of phenyl-substituted compounds (with piperidinylamino-linker).
  • Table 7 List of phenyl-substituted compounds (with piperidinylamino-linker).
  • Table 8 List of phenyl-substituted compounds (with aminopiperidinyl-linker).
  • Table 9 List of 1 ,1-diphenylmethyl-substituted compounds (with piperidinylamino- linker).
  • Table 10 List of phenyl-substituted compounds (with piperazinyl-linker).
  • Table 11 List of phenyl-substituted compounds (with piperidinylamino-linker).
  • a compound of Formula (I) with ⁇ 2 c-3drenoceptor receptors was assessed in in vitro radioligand binding experiments.
  • a low concentration of a radioligand with a high binding affinity for a particular receptor or transporter is incubated with a sample of a tissue preparation enriched in a particular receptor or transporter or with a preparation of cells expressing cloned human receptors in a buffered medium.
  • the radioligand binds to the receptor or transporter.
  • the receptor bound radioactivity is separated from the non-bound radioactivity, and the receptor- or transporter-bound activity is counted.
  • the interaction of the test compounds with the receptor is assessed in competition binding experiments.
  • test compound Various concentrations of the test compound are added to the incubation mixture containing the receptor- or transporter preparation and the radioligand.
  • the test compound in proportion to its binding affinity and its concentration inhibits binding of the radioligand.
  • the radioligand used for h ⁇ 2A snd h ⁇ 2 c receptor binding was [ 3 H]-raulwolscine.
  • Example C.1 Binding Experiment for ⁇ go-adrenoceptor Cell culture and membrane preparation.
  • CHO cells stabile transfected with human adrenergic- ⁇ 2A snd 02c receptor cDNA, were cultured in Dulbecco's Modified Eagle's Medium (DMEM)/Nutrient mixture Ham's F12 (ratio 1 :1 )(Gibco, Gent-Belgium) supplemented with 10 % heat inactivated fetal calf serum (Life Technologies, Merelbeke-Belgium) and antibiotics (100 IU/ml penicillin G, 100 ⁇ g/ml streptomycin sulphate, 110 ⁇ g/ml pyruvic acid and 100 ⁇ g/ml L-glutamine).
  • DMEM Dulbecco's Modified Eagle's Medium
  • Ham's F12 ratio 1 :1
  • 10 % heat inactivated fetal calf serum Life Technologies, Merelbe
  • Membranes were thawed and re-homogenized in incubation buffer (glycylglycine 25 mM, pH 8.0). In a total volume of 500 ⁇ l, 2-10 ⁇ g protein was incubated with [ 3 H]raulwolscine (NET-722) (New England Nuclear, USA) (1 nM final concentration) with or without competitor for 60 minutes at 25 0 C followed by rapid filtration over GF/B filter using a Filtermate196 harvester (Packard, Meriden, CT). Filters were rinsed extensively with ice-cold rinsing buffer (Tris-HCI 50 mM pH 7.4).
  • incubation buffer glycylglycine 25 mM, pH 8.0.
  • Example C2 Binding experiment for the 5HT-transporter
  • Human platelet membranes (Oceanix Biosciences Corporation, Hanover, MD, USA) were thawed, diluted in buffer (Tris-HCI 50 mM, 120 mM NaCI and 5 mM KCI) and quickly (max 3 s) homogenised with an Ultraturrax homogenizer. In a total volume of 250 ⁇ l_, 50-100 ⁇ g protein was incubated with [ 3 H]paroxetine (NET-869) (New England Nuclear, USA) (0.5 nM final concentration) with or without competitor for 60 min at 25 0 C .
  • NET-869 New England Nuclear, USA
  • Incubation was stopped by rapid filtration of the incubation mixture over GF/B fil- ters, pre-wetted with 0.1 % polyethyleneamine, using a Filtermate196 harvester (Packard, Meriden, CT). Filters were rinsed extensively with ice-cold buffer and radioactivity on the filters was counted in a Topcount liquid scintillation counter (Packard, Meriden, CT). Data were expressed as cpm. lmipramine (at 1 ⁇ M final concentration) was used to determine the non-specific binding.
  • All compounds according to Formula (I) produced an inhibition at least at the h ⁇ 2 c-site (but often also at the h ⁇ 2A -site) of more than 50 % (plC 5 o) at a test concentration ranging between 10 "6 M and 10 "9 M in a concentration-dependent manner.
  • Some compounds also show moderate 5-HTT activity.
  • Active ingredient (a.i.) as used throughout these examples relates to a compound of formula (i), the pharmaceutically acceptable acid or base addition salts thereof, the stereochemical ⁇ isomeric forms thereof, the ⁇ /-oxide form thereof, a quaternary am- monium salt thereof and prodrugs thereof.
  • Example D.1 oral drops
  • Example D.2 oral solution 9 Grams of methyl 4-hydroxybenzoate and 1 gram of propyl 4-hydroxybenzoate are dissolved in 4 I of boiling purified water. In 3 I of this solution are dissolved first 10 grams of 2,3-dihydroxybutanedioic acid and thereafter 20 grams of the a.i. The latter solution is combined with the remaining part of the former solution and 12 I 1 ,2,3- propanetriol and 3 I of sorbitol 70 % solution are added thereto. 40 Grams of sodium saccharin are dissolved in 0.5 I of water and 2 ml of raspberry and 2 ml of gooseberry essence are added. The latter solution is combined with the former, water is added q.s. to a volume of 20 I providing an oral solution comprising 5 mg of the active ingredient per teaspoonful (5 ml). The resulting solution is filled in suitable containers.
  • Example D.3 film-coated tablets Preparation o f .tabjet.core
  • a mixture of 100 grams of the a.i., 570 grams lactose and 200 grams starch is mixed well and thereafter humidified with a solution of 5 grams sodium dodecyl sulfate and 10 grams polyvinylpyrrolidone in about 200 ml of water.
  • the wet powder mixture is sieved, dried and sieved again.
  • 100 grams microcrystalline cellulose and 15 grams hydrogenated vegetable oil is added. The whole is mixed well and compressed into tablets, giving 10,000 tablets, each containing 10 mg of the active ingredient.
  • HPLC gradient was supplied by a HP 1100 from Agilent Technologies comprising a pump (quaternary or binary) with degasser, an autosampler, a column oven (set at 40 0 C), a diode-array detector (DAD) and a column as specified in the respective methods below.
  • Flow from the column was split to a MS detector.
  • the MS detector was configured with an electrospray ionization source. Nitrogen was used as the nebulizer gas. The source temperature was maintained at 140 0 C. Data acquisition was performed with MassLynx-Openlynx software.
  • Reversed phase HPLC was carried out on an XDB-C18 cartridge (3.5 ⁇ m, 4.6 x 30 mm) from Agilent, with a flow rate of 1 ml/min.
  • the gradient conditions used are: 80 % A (0.5 g/l ammonium acetate solution), 10 % B (acetonitrile), 10 % C (methanol) to 50 % B and 50 % C in 6.0 minutes, to 100 % B at 6.5 minutes, kept till 7.0 minutes and equilibrated to initial conditions at 7.6 minutes until 9.0 minutes. Injection volume 5 ⁇ l.
  • High-resolution mass spectra (Time of Flight, TOF) were acquired by scanning from 100 to 750 in 1.0 second using a dwell time of 1.0 second.
  • the capillary needle voltage was 2.5 kV for positive ionization mode and 2.9 kV for negative ionization mode.
  • the cone voltage was 20 V for both positive and negative ionization modes.
  • Leucine-enkephaline was the standard substance used for the lock mass calibration.
  • Reversed phase HPLC was carried out on an XDB-C18 cartridge (3.5 ⁇ m, 4.6 x 30 mm) from Agilent, with a flow rate of 1 ml/min.
  • the gradient conditions used are: 80 % A (0.5 g/l ammonium acetate solution), 10 % B (acetonitrile), 10 % C (methanol) to 50 % B and 50 % C in 6.0 minutes, to 100 % B at 6.5 minutes, kept till 7.0 minutes and equilibrated to initial conditions at 7.6 minutes until 9.0 minutes. Injection volume 5 ⁇ l.
  • High-resolution mass spectra (Time of Flight, TOF) were acquired only in positive ionization mode by scanning from 100 to 750 in 0.5 seconds using a dwell time of 0.1 seconds.
  • the capillary needle voltage was 2.5 kV and the cone voltage was 20 V.
  • Leucine-enkephaline was the standard substance used for the lock mass calibration.

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Abstract

The present invention concerns substituted pyrazinone derivatives according to the general Formula (I) a pharmaceutically acceptable acid or base addition salt thereof, a stereochemically isomeric form thereof, an N-oxide form thereof or a quaternary ammonium salt thereof, wherein the variables are defined in Claim 1, having selective 2C-adrenoceptor antagonist activity. It further relates to their preparation, compositions comprising them and their use as a medicine. The compounds according to the invention are usefull for the prevention and/or treatment of central nervous system disorders, mood disorders, anxiety disorders, stress-related disorders associated with depression and/or anxiety, cognitive disorders, personality disorders, schizoaffective disorders, Parkinson's disease, dementia of the Alzheimer's type, chronic pain conditions, neurodegenerative diseases, addiction disorders, mood disorders and sexual dysfunction.

Description

SUBSTITUTED PYRAZINONE DERIVATIVES FOR USE AS A MEDICINE
Field of the Invention
The present invention concerns substituted pyrazinone derivatives having se- lective c^c-adrenoceptor antagonist activity. Some compounds also show moderate 5-HTT activity. It further relates to their preparation, pharmaceutical compositions comprising them and their use as a medicine, especially for the treatment of central nervous system disorders.
Background of the Invention
Adrenergic receptors form the interface between the endogenous catecholamines epinephrine and norepinephrine and a wide array of target cells in the body to mediate the biological effects of the sympathetic nervous system. They are divided into three major subcategories, αi, α2 and β. To date, nine distinct adrenergic receptor subtypes have been cloned from several species: CHA, CHB, CHD, α2A, α2B, α2C, βi, β2 and β3 (Hieble, J. P.; et al. J. Med. Chem. 1995, 38, 3415-3444). Available α2 ligands have only marginal subtype selectivity. A complicating factor is that α2-adrenoceptor ligands, which are imidazoles or imidazolines, also bind with moderate-to-high affinity to non- adrenoceptor imidazoline binding sites. The three α2-adrenoceptor subtypes share many common properties. They are
G-protein-coupled receptors with seven transmembrane domains of the aminebinding subfamily. All three subtypes are coupled to the Gi/o signalling system, inhibiting the activity of adenylate cyclase, the opening of voltage-gated Ca2+ channels and the opening of K+ channels. The three receptors are encoded by distinct genes (Bylund, D. B.; et al. Pharmacol. Rev. 1994, 46, 121-136 and Hieble, J. P. et al. Pharmacol. Commun. 1995, 6, 91-97), localized to different chromosomes; in humans the gene for α2A is found on chromosome 10, the α2B-gene on chromosome 2 and the α2C-gene on chromosome 4. The subtypes are well conserved across mammalian species. In rats and mice, however, there is a single amino acid substitution which decreases the affinity of the rodent α2A-adrenoceptor for the classical α2-antagonists, yohimbine and rau- wolscine. The general consensus is that this so-called α2D-adrenoceptor subtype represents the rodent homologue of the human α2A-subtype. The (^-adrenoceptor subtypes are differentially distributed in cells and tissues, clearly endowing the receptors with different physiological functions and pharmacological activity profiles. Different regulatory regions in the receptor genes and different protein structures also confer different regulatory properties on the three receptors, both with regard to receptor synthesis and post-translational events. α2-Adrenergic receptors were initially characterized as presynaptic receptors that serve as parts of a negative feedback loop to regulate the release of norepinephrine. Soon it was shown that (^-adrenoceptors are not restricted to presynaptic locations but also have postsynaptic functions. The α2A-adrenoceptor is the major inhibitory pre- synaptic receptor (autoreceptor) regulating release of norepinephrine from sympathetic neurons as part of a feedback loop. The α2c-adrenoceptor turned out to function as an additional presynaptic regulator in all central and peripheral nervous tissues investigated. However, the relative contributions of α2A and α2c-receptors differed between central and peripheral nerves, with the α2c-subtype being more prominent in sympa- thetic nerve endings than in central adrenergic neurons (Philipp, M. et al. Am. J. Physiol. Regul. Integr. Comput. Physiol. 2002,283, R287-R295 and Kable, J. W. et al. J. Pharmacol. Exp. Ther. 2000, 293, 1-7). The α2C-adrenoceptor is particularly suited to control neurotransmitter release at low action potential frequencies. In contrast, the α2A- adrenoceptor seems to operate primarily at high stimulation frequencies in sympathetic nerves and may thus be responsible for controlling norepinephrine release during maximal sympathetic activation (Bucheler, M. M. et al. Neuroscience 2002, 109, 819- 826). α2B-Adrenoceptors are located on postsynaptic cells to mediate the effects of catecholamines released from sympathetic nerves, e.g., vasoconstriction. α2- Adrenergic receptors not only inhibit release of their own neurotransmitters but can also regulate the exocytosis of a number of other neurotransmitters in the central and peripheral nervous system. In the brain, α2A- and α2C-adrenoceptors can inhibit dopamine release in basal ganglia as well as serotonin secretion in mouse hippocampal or brain cortex slices. In contrast, the inhibitory effect of α2-adrenoceptor agonists on gastrointestinal motility was mediated solely by the α2A-subtype. Part of the functional dif- ferences between α2A- and α2C-receptors may be explained by their distinct subcellular localization patterns. When expressed in rat fibroblasts, α2A- and α2B-adrenoceptors are targeted to the plasma membrane. On stimulation with agonist, only α2B-adrenoceptors are reversibly internalized into endosomes. α2c-Adrenoceptors are primarily localized in an intracellular membrane compartment, from where they can be translocated to the cell surface after exposure to cold temperature (see a.o. Docherty J. R. et. al. Eur. J. Pharmacol. 1998, 361, 1-15).
The establishment of genetically engineered mice lacking or overexpressing α2- adrenoceptor subtypes has yielded important information for understanding the sub- type specific functions (MacDonald, E. et al. Trends Pharmacol. ScL 1997, 18, 21 1-
219). The examination of the phenotype of these strains of mice demonstrated that the α2A-subtype is responsible for inhibition of neurotransmitter release from central and peripheral sympathetic nerves and for most of the centrally mediated effects of α2- agonists. The α2B subtype is primarily responsible for the initial peripheral hypertensive responses evoked by the α2-agonists and takes part in the hypertension induced by salt (Link et al. Science 1996, 273, 803-805 and Makaritsis, K. P. et al. Hypertension
1999, 33, 14-17).
Clarification of the physiological role of the α2c subtype proved more difficult. Despite a rather wide distribution in the CNS, its role did not appear critical in the media- tion of the cardiovascular effects of nonselective α2-agonists. Its participation has been suggested in the hypothermia induced by dexmedetomidine and in the hyperlocomo- tion induced by D-amphetamine (Rohrer, D. K. et al. Annu. Rev. Pharmacol Toxicol. 1998, 38, 351-373). Another potentially important response mediated by the α2C- adrenoceptor is constriction of cutaneous arteries, leading to a reduction in cutaneous blood flow (Chotani, M. A. et al. Am. J. Physiol. Heart Circ. Physiol. 2004, 286, 59-67). Recent studies carried out on double knockout mice have suggested that α2C- adrenoceptor is also expressed at the presynaptic level where, together with α2A, it actively participates in the control of neurotransmitter release. While α2A-adrenoceptor is particularly efficient at high stimulation frequencies, α2c-adrenoceptor acts rather at low stimulation frequencies. Moreover, it has been suggested that α2C subtype participates in the modulation of motor behavior and the memory processes (Bjorklund, M. et al. Neuroscience 1999, 88, 1 187-1198 and Tanila, H. et al. Eur. J. Neurosci. 1999, 11, 599-603). Other central effects triggered by this subtype include also the startle reflex and aggression response to stress and locomotion (Sallinen, J. et al. J. Neurosci. 1998, 18, 3035-3042 and Sallinen. J. et al. Neuroscience 1998, 86, 959-965). Last, it was recently pointed out that the α2C-adrenoceptor might contribute to α2-agonist-mediated spinal analgesia and adrenergic-opioid synergy (Fairbanks, C. A. et al. J. Pharm.Exp. Ther. 2002, 300, 282-290). Because of their widespread distribution in the central nervous system, α2- receptors affect a number of behavioral functions. The effect of altered α2c-adrenergic receptor expression has been evaluated in several different behavioral paradigms (Kable J.W. et al., Journal of Pharmacology and Experimental Therapeutics, 2000, 293 (1 ): 1-7), proving that α2c-adrenergic antagonists may have therapeutic value in the treatment of stress-related psychiatric disorders. In each of the behavioral paradigms, it is unclear whether the α2c-subtype plays some direct role in mediating behavior or whether altered α2c-receptor expression produces effects because of altered metabolism or downstream modulation of other neurotransmitter systems. Interestingly, α2c- receptor-deficient mice had enhanced startle responses, diminished prepulse inhibition, and shortened attack latency in the isolation aggression test. Thus drugs acting via the α2c-adrenoceptor may have therapeutic value in disorders associated with enhanced startle responses and sensorimotor gating deficits, such as schizophrenia, attention deficit disorder, posttraumatic stress disorder, and drug withdrawal. In addition to the α2c-subtype, the α2A-adrenoceptor has an important .
With more and more studies of the α2-adrenoceptor physiology in gene-targeted mice being published, the situation becomes more complicated than initially anticipated. Indeed, only a few biological functions of α2-receptors were found to be mediated by one single α2-adrenergic receptor subtype. For other α2-receptor-mediated functions, two different strategies seem to have emerged to regulate adrenergic signal transduction: some biological functions are controlled by two counteracting α2-receptor subtypes, and some require two receptor subtypes with similar but complementary effects. Because the α2A-subtype mediates most of the classical effects of α2-adrenergic agonists, it is doubtful that an α2A-selective agonist would have a substantially better clinical profile than the currently available agents. Drugs acting at α2β- or α2c- adrenergic receptors are likely to have fewer of the classical α2-adrenergic side effects than α2A-specific agents. It would appear likely that α2C-selective agents may be useful in at least some nervous system disorders, in particular central nervous system disorders.
Background prior art
Analysis of the pipeline databases to date indicate that there are several adrenergic α2-antagonists in the market, by companies including Akzo Nobel (Organon), No- vartis, Pfizer, and Schering AG. None of those compounds are selective for any of the three (^-adrenoceptors. These compounds are indicated mainly for depression, hypertensive disorders and dyskinesias associated with Parkinson's disease. Companies with (^-adrenoceptor antagonists in clinical development include Britannia Pharmaceuticals, IVAX, Juvantia Pharmaceuticals, MAP Pharmaceuticals, Novartis, Novo Nordisk, Organon, Pierre Fabre, and Sanofi-Aventis.
Regarding the development of selective c^c-adrenoceptor antagonists to date, OPC-28326 is the only compound in clinical development (in Phase 2 by Otsuka Pharmaceuticals for hypertensive disorders and peripheral vascular disease). The rest of the α2c antagonists are in preclinical development by Oy Juvantia Pharma Ltd (JP 1514 and JP 1302, published in WO 01/64645 and WO 04/067513) and by Novartis AG (NVP-ABE651 and NVP-ABE697, published in WO 01/55132 and J. Label Compd. Radiopharm 2002, 45, 1 180), indicated mainly for depression and schizophrenia. In addition, several compounds are listed at the very early stages of development (biological testing) by Juvantia and Kyowa Hakko, for depression and Parkinson's disease.
Description of the Invention
It is the object of the present invention to provide a compound with a binding affinity towards α2-adrenoceptor receptors, in particular towards α2c-adrenoceptor receptors, in particular as an antagonist. This goal was achieved by a compound according to the general Formula (I)
Figure imgf000006_0001
a pharmaceutically acceptable acid or base addition salt thereof, an Λ/-oxide form thereof or a quaternary ammonium salt thereof, wherein :
A1, A2 are each, independently from each other, a nitrogen or a carbon-atom; with the provision that A1 and A2 are not simultaneously a carbon atom;
Z1, Z2 are each, independently from each other, a covalent bond or N-R4 ; wherein R4 is selected from the group of hydrogen, (d-3)alkyl, aryl and aryl-(Ci-3)alkyl ; n is an integer equal to zero, 1 , 2 or 3 ;
R5 is selected from the group of hydrogen and halo ;
P is a radical selected from the group of phenyl, biphenyl,
1 ,1-diphenylmethyl and benzyloxyphenyl ; X2 is a covalent bond, a saturated or an unsaturated (Ci-8)-hydrocarbon radical, wherein one or more bivalent -CH2-units may optionally be replaced by a respective bivalent phenyl-unit ; and/or wherein one or more hydrogen atoms may be replaced by a radical selected from the group of oxo ; (Ci-3)alkyloxy ; halo ; cyano ; nitro ; formyl ; hydroxy ; amino ; trifluoromethyl ; mono- and di((Ci-3)alkyl)amino ; carboxyl ; and thio ;
Q2 is a radical selected from the group of hydrogen ; -NR1R2 ; Pir ; -OR3a ; SR3b ; SO2R3c ; aryl ; and Het; wherein two radicals -OR3a may be taken together to form a bivalent radical -O-(CH2)S-O- wherein s is an integer equal to 1 , 2 or 3 ;
R1 and R2 are each, independently from each other, a radical selected from the group of hydrogen ; alkyl ; alkenyl ; alkynyl ; aryl ; arylalkyl ; diarylalkyl ; alkylcarbonyl ; alkylcarbonylalkyl ; alkenylcarbonyl ; alkyloxy ; alkyloxyalkyl ; alkyloxycarbonyl ; alkyloxyalkylcarbonyl; alkyloxycarbonylalkyl ; alkyloxycarbonylalkylcarbonyl; alkylsul- fonyl ; arylsulfonyl ; arylalkylsulfonyl ; arylalkenylsulfonyl ; Het- sulfonyl ; arylcarbonyl ; aryloxyalkyl ; arylalkylcarbonyl ; Het ; Het-alkyl ; Het-alkylcarbonyl ; Het-carbonyl ; Het-carbonylalkyl ; alkyl-NRaRb ; carbonyl-NRaRb ; carbonylalkyl-NRaRb ; alkylcar- bonyl-NRaRb ; and alkylcarbonylalkyl-NRaRb ; wherein Ra and Rb are each independently selected from the group of hydrogen, alkyl, alkylcarbonyl, alkyloxyalkyl, alkyloxycarbonylalkyl, aryl, arylalkyl, Het and alkyl-NRcRd, wherein Rc and Rd are each independently from each other hydrogen or alkyl ; Pir is a radical containing at least one N, by which it is attached to the
X2-radical, selected from the group of pyrrolidinyl ; imidazolidinyl ; pyra- zolidinyl ; piperidinyl ; piperazinyl ; pyrrolyl ; pyrrolinyl ; imidazolinyl ; pyrrazolinyl ; pyrrolyl ; imidazolyl ; pyrazolyl ; triazolyl ; azepyl ; di- azepyl; morpholinyl ; thiomorpholinyl ; indolyl ; isoindolyl; indolinyl ; in- dazolyl ; benzimidazolyl ; and 1 ,2,3,4-tetrahydro-isoquinolinyl ; wherein each Pir-radical is optionally substituted by 1 , 2 or 3 radicals selected from the group of hydroxy ; halo ; oxo ; (Ci-3)alkyl ; (Ci-3)alkenyl (Ci-3)alkyloxycarbonyl ; Het-carbonyl ; (Ci-3)alkylamino ; trifluoromethyl ; phenyl(C0-3)alkyl ; pyrimidinyl ; pyrrolidinyl ; and pyridinyloxy ; R3a, R3b, R3c are each, independently from each other, a radical selected from the group of hydrogen ; alkyl ; trihaloalkyl ; aryl ; arylalkyl ; alky- loxyalkyl ; Het ; and Het-alkyl ;
Het is a heterocyclic radical selected from the group of pyrrolidinyl ; imida- zolidinyl ; pyrazolidinyl ; piperidinyl ; piperazinyl ; pyrrolyl ; pyrrolinyl ; imidazolinyl ; pyrrazolinyl ; pyrrolyl ; imidazolyl ; pyrazolyl ; triazolyl ; pyridinyl ; pyridazinyl ; pyrimidinyl ; pyrazinyl ; triazinyl ; azepyl ; di- azepyl ; morpholinyl ; thiomorpholinyl ; indolyl ; isoindolyl ; indolinyl ; indazolyl ; benzimidazolyl ; 1 ,2,3,4-tetrahydro-isoquinolinyl ; furyl ; te- trahydropyranyl ; thienyl ; oxazolyl ; isoxazolyl ; thiazolyl ; thiadiazolyl ; isothiazolyl ; dioxolyl ; dithianyl ; tetrahydrofuryl ; tetrahydropyranyl ; oxadiazolyl ; quinolinyl ; isoquinolinyl ; quinoxalinyl ; benzoxazolyl ; benzisoxazolyl; benzothiazolyl; benzisothiazolyl ; benzofuranyl ; ben- zothienyl ; benzopiperidinyl ; benzomorpholinyl ; chromenyl ; and imi- dazo[1 ,2-a]pyridinyl ; wherein each Het-radical is optionally substituted by one or more radicals selected from the group of halo ; oxo ;
(Ci-3)alkyl ; phenyl, optionally substituted with (Ci-3)alkyloxy ; (Ci-3)alkylcarbonyl ; (Ci-3)alkenylthio ; imidazolyl-(Ci-3)alkyl ; aryl(Ci-3)- alkyl and (Ci-3)alkyloxycarbonyl ; aryl is naphthyl or phenyl, each optionally substituted with 1 , 2 or 3 sub- stituents, each independently from each other, selected from the group of oxo ; (Ci-3)alkyl; (Ci-3)alkyloxy ; halo ; cyano ; nitro ; formyl ; ethanoyl ; hydroxy ; amino ; trifluoromethyl ; mono- and di((Ci-3)alkyl)amino ; mono- and di((Ci-3)alkylcarbonyl)amino ; car- boxyl; morpholinyl ; and thio ; alkyl is, unless otherwise indicated, a straight or branched saturated hydrocarbon radical having from 1 to 8 carbon atoms ; or is a cyclic saturated hydrocarbon radical having from 3 to 7 carbon atoms ; or is a cyclic saturated hydrocarbon radical having from 3 to 7 carbon atoms attached to a straight or branched saturated hydrocarbon radical hav- ing from 1 to 8 carbon atoms ; wherein each radical is optionally sub- stituted on one or more carbon atoms with one or more radicals selected from the group of oxo ; (Ci-3)alkyloxy, halo ; cyano ; nitro ; for- myl ; hydroxy ; amino ; carboxyl ; and thio ; alkenyl is an alkyl radical as defined above, further having one or more double bonds ; alkynyl is an alkyl radical as defined above, further having one or more triple bonds ; arylalkyl is an alkyl radical as defined above, further having one CH3-group replaced by phenyl ; and diarylalkyl is an alkyl radical as defined above, further having two CH3-groups replaced by phenyl.
The invention also relates to a pharmaceutical composition comprising a pharmaceutically acceptable carrier or diluent and, as active ingredient, a therapeutically effective amount of a compound according to the invention, in particular a compound ac- cording to Formula (I), a pharmaceutically acceptable acid or base addition salt thereof, an Λ/-oxide form thereof or a quaternary ammonium salt thereof.
The invention also relates to the use of a compound according to the invention for the preparation of a medicament for the prevention and/or treatment of a disorder or disease responsive to antagonism of the α2-adrenergic receptor, in particular to an- tagonism of the (^-adrenergic receptor.
In particular, the invention relates to the use of a compound according to the invention for the preparation of a medicament for the prevention and/or treatment of central nervous system disorders, mood disorders, anxiety disorders, stress-related disorders associated with depression and/or anxiety, cognitive disorders, personality disor- ders, schizoaffective disorders, Parkinson's disease, dementia of the Alzheimer's type, chronic pain conditions, neurodegenerative diseases, addiction disorders, mood disorders and sexual dysfunction.
A compound according to the invention may also be suitable as add-on treatment and/or prophylaxis in the above listed diseases in combination with antidepressants, anxiolytics and/or antipsychotics which are currently available or in development or which will become available in the future, to improve efficacy and/or onset of action. This is evaluated in rodent models in which antidepressants, anxiolytics and/or antipsychotics are shown to be active. For example, compounds are evaluated in combination with antidepressants, anxiolytics and/or antipsychotics for attenuation of stress-induced hyperthermia.
The invention therefore also relates to the use of a compound according to the invention for use as an add-on treatment with one or more other compounds selected from the group of antidepressants, anxiolytics and antipsychotics, to a pharmaceutical composition comprising a compound according to the invention and one or more other compounds selected from the group of antidepressants, anxiolytics and antipsychotics, as well as to a process for the preparation of such pharmaceutical compositions and to the use of such a composition for the manufacture of a medicament, in particular to improve efficacy and/or onset of action in the treatment of depression and/or anxiety.
Detailed description of the invention
In a preferred embodiment, the invention relates to a compound according to
the invention, wherein the moiety - - -Z2— A1 A2— Z1- - is a bivalent radical of for¬
mula (ll-a), (ll-b), (ll-c) and (ll-d), as shown below.
Figure imgf000010_0001
l-a) (ll-b) l-c) (ll-d)
In a preferred embodiment, the invention relates to a compound according to the invention, wherein R4 is hydrogen or p-aminomethylbenzyl. Most preferably, R4 is hydrogen. In a preferred embodiment, the invention relates to a compound according to the invention, wherein n is 1 , 2 or 3.
In a preferred embodiment, the invention relates to a compound according to the invention, wherein R5 is hydrogen.
In a preferred embodiment, the invention relates to a compound according to the invention, wherein P is phenyl. In a preferred embodiment, the invention relates to a compound according to the invention, wherein X2 is selected from the group of a covalent bond, a d-hydrocarbon radical, a C2-hydrocarbon radical, or a C3-hydrocarbon radical.
In one preferred embodiment of X2, one bivalent -CH2-unit of the hydrocarbon radical X2 is replaced by a bivalent phenyl-unit ; or wherein two hydrogen atoms of the hydrocarbon radical X2 are replaced by an oxo-radical.
In a further preferred embodiment, the invention relates to a compound according to the 3 iinnvveennttiioonn,, wwhheerreeiinn XX22 iiss sseelleecctteedd from the group of a covalent bond and any one of the radicals (aa) to (bm) defined as :
-
-C
Figure imgf000011_0001
-CH2CH=CHCH2- (ah) (bh)
Figure imgf000011_0002
(/ O
-CH2C=CCH2- (ai) (bi)
(/ O -CH(CH3)CH(CH3)- (aj) (bj)
Figure imgf000011_0003
Figure imgf000012_0001
-C(=O)CH2- (am) ' ' "I // — \\ ° (bm)
-C(=O)CH2CH2- (an)
-C(=O)CH2CH2CH2- (ao)
C(=O)CH2CH2CH2CH2- (ap)
-CH2C(=O)CH2- (aq)
-CH2C(=O) CH2CH2- (ar)
CH2C(=O)C(CH3)2CH2- (as)
It is within the ambit of the invention that each of the radicals can be used as a linker in which either the left side (left bond) of the linker or the right side (right bond) of the linker is connected to the central pyrazinone-moiety. This is particulary relevant for non-symmetrical linkers that can thus be used in two configurations.
In a further preferred embodiment, the invention relates to a compound according to the invention, wherein X2 is selected from the group of a covalent bond and any one of the radicals (aa), (ab), (ac), (ag), (am), (an), (aq), (as) and (be) as defined below :
-CH2- (aa) "" ΥrΛ—/ (be)
-CH2CH2- (ab)
-CH2CH2CH2- (ac)
-CH2CH=CH- (ag)
-C(=O)CH2- (am)
-C(=O)CH2CH2- (an)
-CH2C(=O)CH2- (aq)
CH2C(=O)C(CH3)2CH2- (as)
In every embodiment of this invention, when X2 is or contains a cyclic unit, i.e. a phenyl unit or a cyclohexyl unit, the attachments to the unit can be in ortho, meta or para-position ; preferably the attachments to the unit are in meta or para-position, most preferably in para-position.
In a preferred embodiment, the invention relates to a compound wherein Q2 is a radical selected from the group of hydrogen ; -NR1R2 ; Pir ; -OR3a ; SR3b ; aryl ; and Het.
In a preferred embodiment, the invention relates to a compound wherein R1 and R2 are each, independently from each other, a radical selected from the group of hydrogen ; alkyl ; and alkyloxycarbonyl.
Preferably, when R1 or R2 comprises an alkyl moiety, the alkyl moiety is methyl ; f-butyl ; or a bivalent moiety derived therefrom in the sense that one hydrogen is replaced by a bond to form a bivalent radical, such as for instance is the case for alkyl in the moiety phenylalkyl.
In a further preferred embodiment, the invention relates to a compound according to the invention, wherein Pir is a radical containing at least one N, by which it is at- tached to the X2-radical, selected from the group of piperidinyl and isoindolyl ; wherein each Pir-radical is optionally substituted by 2 oxo-radicals, such as, for instance, isoin- dolyl-1 ,3-dione.
In a further preferred embodiment, the invention relates to a compound according to the invention, wherein R3a and R3b are each, independently from each other, an alkyl-radical. Preferably, R3a and R3b are each, independently from each other, methyl.
In a further embodiment, the invention relates to a compound according to the invention, wherein Het is a heterocyclic radical selected from the group of pyridinyl ; furyl ; tetrahydropyranyl; thienyl ; oxadiazolyl ; and quinolinyl ; wherein each Het-radical is optionally substituted by one or more radicals selected from the group of halo and phenyl, optionally substituted with (d-3)alkyloxy.
Most preferably, the invention relates to a compound according to the invention, wherein aryl is naphthyl or phenyl, each optionally substituted with a substituent, selected from the group of (Ci-3)alkyl and halo.
In a further preferred embodiment, the invention relates to a compound accord- ing to the invention, wherein
A1, A2 are each, independently from each other, a nitrogen or a carbon-atom; with the provision that A1 and A2 are not simultaneously a carbon atom; Z1, Z2 are each, independently from each other, a covalent bond or N-R4 ; wherein
R4 is selected from the group of hydrogen and aryl-(Ci-3)alkyl ; n is an integer equal to zero, 1 , 2 or 3 ;
R5 is hydrogen ; P is a radical selected from the group of phenyl, biphenyl, 1 ,1-diphenylmethyl and benzyloxyphenyl ;
X2 is a bond, a saturated or an unsaturated (Ci_8)-hydrocarbon radical, wherein one or more bivalent -CH2-units may optionally be replaced by a respective bivalent phenyl-unit ; and/or wherein one or more hydrogen atoms may be replaced by an oxo-radical ;
Q2 is a radical selected from the group of hydrogen ; -NR1R2 ; Pir ; -OR3a ;
SR3b ; aryl ; and Het; R1 and R2 are each, independently from each other, a radical selected from the group of hydrogen ; alkyl ; and alkyloxycarbonyl ; Pir is a radical containing at least one N, by which it is attached to the X2- radical, selected from the group of piperidinyl ; isoindolyl; wherein each Pir- radical is optionally substituted by 2 oxo-radicals ; R3a, R3b, R3c are each, independently from each other, an alkyl-radical ; Het is a heterocyclic radical selected from the group of pyridinyl ; furyl ; tetra- hydropyranyl ; thienyl ; oxadiazolyl ; and quinolinyl ; wherein each Het- radical is optionally substituted by one or more radicals selected from the group of halo ; and phenyl, optionally substituted with (d-3)alkyloxy ; and aryl is naphthyl or phenyl, each optionally substituted with a substituent, each independently from each other, selected from the group of
Figure imgf000014_0001
and halo.
In the framework of this application, and unless the number of carbon atoms is indicated differently, alkyl is a straight or branched saturated hydrocarbon radical having from 1 to 8 carbon atoms ; or is a cyclic saturated hydrocarbon radical having from 3 to 7 carbon atoms ; or is a cyclic saturated hydrocarbon radical having from 3 to 7 carbon atoms being part of a straight or branched saturated hydrocarbon radical having from 1 to 8 carbon atoms ; wherein each radical is optionally substituted on one or more carbon atoms with one or more radicals selected from the group of oxo ; (Ci-3)alkyloxy ; halo ; cyano ; nitro ; formyl ; hydroxy ; amino ; carboxy ; and thio. Preferably, alkyl is methyl, ethyl, propyl, isopropyl, butyl, te/f-butyl, pentyl, hexyl, pentyl, oc- tyl, cyclopropyl, cyclopentyl, cyclohexyl, cyclohexylmethyl and cyclohexylethyl. Most preferably, alkyl is a (Ci-2)alkyl radical.
In the framework of this application, alkenyl is an alkyl radical as defined above having one or more double bonds. Preferably, alkenyl is ethenyl, propenyl and butynyl. In the framework of this application, alkynyl is an alkyl radical as defined above having one or more triple bonds. Preferably, alkynyl is ethynyl and propynyl.
In the framework of this application, arylalkyl is an alkyl radical as defined above, having one CH3-radical replaced by a phenyl-radical. An examples of such a radical is benzyl. In the framework of this application, diarylalkyl is an alkyl radical as defined above, having two CH3-radical replaced by a phenyl-radical. An examples of such a radical is diphenylmethyl and 1 ,1-diphenylethyl.
In the framework of this application, halo is a substituent selected from the group of fluoro, chloro, bromo and iodo and haloalkyl is a straight or branched satu- rated hydrocarbon radical having from 1 to 6 carbon atoms or a cyclic saturated hydrocarbon radical having from 3 to 7 carbon atoms, wherein one or more carbon atoms is substituted with one or more halo atoms. Preferably, halo is bromo, fluoro or chloro ; more preferably, halo is fluoro. Preferably, haloalkyl is trifluoroalkyl ; more preferably haloalkyl is trifluoromethyl. In the framework of this application, unless otherwise indicated, a bond can be any bond, including a covalent bond, a single bond, a double bond, a triple bond, a coordination bond and a hydrogen bond.
In the framework of this application, with "a compound according to the invention" is meant a compound according to the general Formula (I), a pharmaceutically accept- able acid or base addition salt thereof, an Λ/-oxide form thereof, or a quaternary ammonium salt thereof.
A pharmaceutically acceptable acid addition salt is defined to comprise a therapeutically active non-toxic acid addition salt form that a compound according to Formula (I) is able to form. Said salt can be obtained by treating the base form of a com- pound according to Formula (I) with an appropriate acid, for example an inorganic acid, for example hydrohalic acid, in particular hydrochloric acid, hydrobromic acid, sulphuric acid, nitric acid and phosphoric acid ; an organic acid, for example acetic acid, hy- droxyacetic acid, propanoic acid, lactic acid, pyruvic acid, oxalic acid, malonic acid, succinic acid, maleic acid, fumaric acid, malic acid, tartaric acid, citric acid, methane- sulfonic acid, ethanesulfonic acid, benzenesulfonic acid, p-toluenesulfonic acid, cy- clamic acid, salicylic acid, p-aminosalicylic acid and pamoic acid.
Conversely said acid addition salt form may be converted into the free base form by treatment with an appropriate base .
The compound according to Formula (I) containing an acidic proton may also be converted into a therapeutically active non-toxic metal or amine addition salt form (base addition salt) by treatment with an appropriate organic and inorganic base. Appropriate base salt forms comprise, for example, the ammonium salts, the alkaline and earth alkaline metal salts, in particular lithium, sodium, potassium, magnesium and calcium salts, salts with organic bases, e.g. the benzathine, Λ/-methyl-D-glucamine, hy- bramine salts, and salts with amino acids, for example arginine and lysine.
Conversely, said salt form can be converted into the free form by treatment with an appropriate acid. The term addition salt as used in the framework of this application also comprises a solvate that the compound according to Formula (I), as well as a salt thereof, is able to form. Such solvates are, for example, hydrates and alcoholates.
The Λ/-oxide form of the compound according to Formula (I) is meant to comprise a compound of Formula (I) wherein one or several nitrogen atoms are oxidized to so-called Λ/-oxides, particularly those Λ/-oxides wherein one or more tertiary nitrogens (e.g. of the piperazinyl or piperidinyl radical) are Λ/-oxidized. Such Λ/-oxides can easily be obtained by a skilled person without any inventive skills and they are obvious alternatives for a compound according to Formula (I) since these compounds are metabolites, which are formed by oxidation in the human body upon uptake . As is generally known, oxidation is normally the first step involved in drug metabolism (Textbook of Organic Medicinal and Pharmaceutical Chemistry, 1977, pages 70- 75). As is also generally known, the metabolite form of a compound can also be administered to a human instead of the compound per se, with much the same effects.
A compound of Formula (I) may be converted to the corresponding Λ/-oxide form following art-known procedures for converting a trivalent nitrogen into its Λ/-oxide form. Said Λ/-oxidation reaction may generally be carried out by reacting the compound of Formula (I) with an appropriate organic or inorganic peroxide. Appropriate inorganic peroxides comprise, for example, hydrogen peroxide, alkali metal or earth alkaline metal peroxides, e.g. sodium peroxide, potassium peroxide; appropriate organic peroxides may comprise peroxy acids such as, for example, benzenecarboperoxoic acid or halo substituted benzenecarboperoxoic acid, e.g. 3-chlorobenzenecarboperoxoic acid, peroxoalkanoic acids, e.g. peroxoacetic acid, alkylhydroperoxides, e.g. te/f-butyl hy- droperoxide. Suitable solvents are, for example, water, lower alkanols, e.g. ethanol and the like, hydrocarbons, e.g. toluene, ketones, e.g. 2-butanone, halogenated hydrocarbons, e.g. dichloromethane, and mixtures of such solvents.
A quaternary ammonium salt of compound according to Formula (I) defines said compound which is able to form by a reaction between a basic nitrogen of a compound according to Formula (I) and an appropriate quaternizing agent, such as, for example, an optionally substituted alkylhalide, arylhalide or arylalkylhalide, in particular methylio- dide and benzyliodide. Other reactants with good leaving groups may also be used, such as, for example, alkyl trifluoromethanesulfonat.es, alkyl methanesulfonates and alkyl p-toluenesulfonates. A quaternary ammonium salt has at least one positively charged nitrogen. Pharmaceutically acceptable counterions include chloro, bromo, iodo, trifluoroacetate and acetate ions.
The invention also comprises a derivative compound (usually called "pro-drug") of a pharmacologically-active compound according to the invention, in particular according to Formula (I), which is degraded in vivo to yield a compound according to the in- vention. Pro-drugs are usually (but not always) of lower potency at the target receptor than the compounds to which they are degraded. Pro-drugs are particularly useful when the desired compound has chemical or physical properties that make its administration difficult or inefficient. For example, the desired compound may be only poorly soluble, it may be poorly transported across the mucosal epithelium, or it may have an undesirably short plasma half-life. Further discussion on pro-drugs may be found in Stella, V. J. et al., "Prodrugs", Drug Delivery Systems, 1985, pp. 112-176, and Drugs, 1985, 29, pp. 455-473.
A pro-drug form of a pharmacologically-active compound according to the invention will generally be a compound according to Formula (I), a pharmaceutically accept- able acid or base addition salt thereof, an N-oxide form thereof, or a quaternary ammonium salt thereof, having an acid group which is esterified or amidated. Included in such esterified acid groups are groups of the formula -COORX, where Rx is a Ci-6alkyl, phenyl, benzyl or one of the following groups :
Figure imgf000018_0001
Amidated groups include groups of the formula - CONRyRz, wherein Ry is H,
Ci-6alkyl, phenyl or benzyl and Rz is -OH, H, Ci-6alkyl, phenyl or benzyl. A compound according to the invention having an amino group may be derivatised with a ketone or an aldehyde such as formaldehyde to form a Mannich base. This base will hydrolyze with first order kinetics in aqueous solution.
In the framework of this application, a compound according to the invention is inherently intended to comprise all stereochemically isomeric forms thereof. The term "stereochemically isomeric form" as used herein defines all the possible isomeric forms that a compound of Formula (I) may possess. Unless otherwise mentioned or indi- cated, the chemical designation of a compound denotes the mixture of all possible stereochemically isomeric forms, said mixtures containing all diastereomers and enan- tiomers of the basic molecular structure. More in particular, stereogenic centers may have the R- or S-configuration; substituents on bivalent cyclic (partially) saturated radicals may have either the cis- or trans-configuration. Compounds encompassing double bonds can have an E or Z-stereochemistry at said double bond. Hence, all stereochemically isomeric forms of a compound of Formula (I) are intended to be embraced within the scope of this invention.
Following CAS nomenclature conventions, when two stereogenic centers of known absolute configuration are present in a molecule, an R or S descriptor is as- signed (based on Cahn-lngold-Prelog sequence rule) to the lowest-numbered chiral center, the reference center. The configuration of the second stereogenic center is indicated using relative descriptors [R*, R* ] or [R*,S*], where R* is always specified as the reference center and [R*, R*] indicates centers with the same chirality and [R*,S*] indicates centers of unlike chirality. For example, if the lowest-numbered chiral center in the molecule has an S configuration and the second center is R, the stereo descriptor would be specified as S-[R*,S*]. If "α" and "β" are used : the position of the highest priority substituent on the asymmetric carbon atom in the ring system having the lowest ring number, is arbitrarily always in the "α" position of the mean plane determined by the ring system. The position of the highest priority substituent on the other asymmetric carbon atom in the ring system (hydrogen atom in a compound according to Formula (I)) relative to the position of the highest priority substituent on the reference atom is denominated "α", if it is on the same side of the mean plane determined by the ring system, or "β", if it is on the other side of the mean plane determined by the ring system. In the framework of this application, a compound according to the invention is inherently intended to comprise all isotopic combinations of its chemical elements. In the framework of this application, a chemical element, in particular when mentioned in relation to a compound according to Formula (I), comprises all isotopes and isotopic mixtures of this element, either naturally occuring or synthetically produced, either with natural abundance or in an isotopically enriched form. In particular, when hydrogen is mentioned, it is understood to refer to 1H, 2H, 3H and mixtures thereof ; when carbon is mentioned, it is understood to refer to 11C, 12C, 13C, 14C and mixtures thereof ; when nitrogen is mentioned, it is understood to refer to 13N, 14N, 15N and mixtures thereof ; when oxygen is mentioned, it is understood to refer to 14O, 15O, 16O, 17O, 18O and mix- tures thereof ; and when fluor is mentioned, it is understood to refer to 18F, 19F and mixtures thereof.
A compound according to the invention therefore inherently comprises a compound with one or more isotopes of one or more element, and mixtures thereof, including a radioactive compound, also called radiolabeled compound, wherein one or more non-radioactive atoms has been replaced by one of its radioactive isotopes. By the term "radiolabelled compound" is meant any compound according to Formula (I), a pharmaceutically acceptable acid or base addition salt thereof, an N-oxide form thereof, or a quaternary ammonium salt thereof, which contains at least one radioactive atom. For example, a compound can be labelled with positron or with gamma emitting radioactive isotopes. For radioligand-binding techniques (membrane receptor assay), the 3H-atom or the 125l-atom is the atom of choice to be replaced. For imaging, the most commonly used positron emitting (PET) radioactive isotopes are 11C, 18F, 15O and 13N, all of which are accelerator produced and have half-lives of 20, 100, 2 and 10 minutes respectively. Since the half-lives of these radioactive isotopes are so short, it is only feasible to use them at institutions which have an accelerator on site for their production, thus limiting their use. The most widely used of these are 18F, 99mTc, 201TI and 123I. The handling of these radioactive isotopes, their production, isolation and incorporation in a molecule are known to the skilled person.
In particular, the radioactive atom is selected from the group of hydrogen, car- bon, nitrogen, sulfur, oxygen and halogen. Preferably, the radioactive atom is selected from the group of hydrogen, carbon and halogen.
In particular, the radioactive isotope is selected from the group of 3H, 11C, 18F, 122I, 123I, 125I, 131I, 75Br, 76Br, 77Br and 82Br. Preferably, the radioactive isotope is se- lected from the group of 3H, 11C and 18F.
Preparation
A compound according to the invention can generally be prepared by a succession of steps, each of which is known to the skilled person. In particular, a pyrazinone derivative can be prepared according to one or more of the following preparation methods.
Preparation of the final compound (l-a).
Final compound l-a, which was also used as intermediate for other final compounds, can generally be prepared as shown in Scheme 1A.
Figure imgf000020_0001
(l-a) Scheme 1A
Alkylation reactions of the starting material 2,3-dichloropyrazine with aminoderivatives (Scheme 1A) may be performed in an aprotic solvent, such as, for instance DMF or DMSO, in the presence of an inorganic base, such as K2CO3, Na2CO3, NaOH or KOH, at a convenient temperature, either by conventional heating or under microwave irra- diation, for a period of time to ensure the completion of the reaction, which may typically be about 16 hours under conventional heating.
Hydrolysis reactions may be performed either in acidic inorganic solvents, such as 10% HCIaq, using a co-solvent such as THF, by conventional heating or under microwave heating, for a period of time to ensure the completion of the reaction, which may typi- cally be about 16 hours under conventional heating, or under basic conditions, such as in NaOHaq or in a DMSO solvent, for a period of time to ensure the completion of the reaction, which may typically be about 0.5 hours under microwave irradiation.
The final compound (l-a) is the starting compound for the compounds of the reaction schemes below. Variables Z1, Z2, A1, A2, n, P are defined as in Formula (I), unless otherwise specified.
Compound l-a can also be prepared starting from intermediate l-b by reaction with a suitable aldehyde, according to Scheme 1 B.
Figure imgf000021_0001
(l-b) (l-a)
Scheme 1B The reductive amination reaction may be performed in an aprotic solvent such as 1 ,2- dichloroethane, in the presence of the reducing agent such as sodium triacetoxyboro- hydride, for a period of time to ensure the completion of the reaction, which may typically be about 16 hours at room temperature.
Preparation of a final compound in which X2 is a saturated or an unsaturated hydrocarbon radical
Figure imgf000021_0002
Scheme 2A
The W-radical in the compound W-X2-(Q2)q is a leaving group, such as for instance Cl-, Br-, MeSO2O- and P-MePhSO2O- ; X2 is a (Ci-8)-hydrocarbon radical, more preferably a (Ci-6)-hydrocarbon radical, even more preferably a (Ci-5)-hydrocarbon radical, most preferably a (Ci-4)-hydrocarbon radical. Variables Z1, Z2, A1, A2, n, P are defined as in Formula (I), . The alkylation reaction may be performed in an aprotic solvent, such as CH3CN, DMF or THF in the presence of an inorganic base, such as K2CO3, Na2CO3, CS2CO3, or an organic base such as TBD, PS-TBD, at a convenient temperature, either under conventional heating or microwave irradiation, for a period of time to ensure the completion of the reaction, which may typically be about 20 minutes at about 120° C under microwave irradiation.
Preparation of a final compound : primary amines
PG deprotection
Figure imgf000022_0001
Figure imgf000022_0002
'"c Scheme 3A
In the case where fragment -(Q2)q is equal to NH2, first the corresponding compound l-c, in which the amino group is protected with a protecting group, can be synthesized according to scheme 2A. Then, deprotection reaction may be carried out by synthetic methods well known to the person skilled in the art according to scheme 3A. Variables Z1, Z2, A1, A2, n, P are defined as in Formula (I).
Pharmacology
A compound according to the invention, in particular compound according to
Formula (I), a pharmaceutically acceptable acid or base addition salt thereof, an N- oxide form thereof, or a quaternary ammonium salt thereof, has surprisingly been shown to have a binding affinity towards α2-adrenergic receptor, in particular towards α2c-adrenergic receptor, in particular as an antagonist.
In view of their above mentioned potency, a compound according to the invention is suitable for the prevention and/or treatment of diseases where antagonism of the α2-adrenergic receptor, in particular antagonism of the α2C-adrenergic receptor is of therapeutic use. In particular, a compound according to the invention may be suitable for treatment and/or prophylaxis in the following diseases :
• Central nervous system disorders, including :
• Mood disorders, including particularly major depressive disorder, depression with or without psychotic features, catatonic features, melancholic features, atypical fea- tures of postpartum onset and, in the case of recurrent episodes, with or without seasonal pattern, dysthymic disorder, bipolar I disorder, bipolar Il disorder, cyclothymic disorder, recurrent brief depressive disorder, mixed affective disorder, bipolar disorder not otherwise specified, mood disorder due to a general medical condi- tion, substance-induced mood disorder, mood disorder not otherwise specified, seasonal affective disorder and premenstrual dysphoric disorders.
• Anxiety disorders, including panic attack, agoraphobia, panic disorder without agoraphobia, agoraphobia without history of panic disorder, specific phobia, social phobia, obsessive-compulsive disorder, posttraumatic stress disorder, acute stress disorder, generalized anxiety disorder, anxiety disorder due to a general medical condition, substance-induced anxiety disorder and anxiety disorder not otherwise specified.
• Stress-related disorders associated with depression and/or anxiety, including acute stress reaction, adjustment disorders (brief depressive reaction, prolonged depres- sive reaction, mixed anxiety and depressive reaction, adjustment disorder with predominant disturbance of other emotions, adjustment disorder with predominant disturbance of conduct, adjustment disorder with mixed disturbance of emotions and conduct, adjustment disorders with other specified predominant symptoms) and other reactions to severe stress. • Dementia, amnesic disorders and cognitive disorders not otherwise specified, especially dementia caused by degenerative disorders, lesions, trauma, infections, vascular disorders, toxins, anoxia, vitamin deficiency or endocrinic disorders, or amnesic disorders caused by alcohol or other causes of thiamine deficiency, bilateral temporal lobe damage due to Herpes simplex encephalitis and other limbic en- cephalitis, neuronal loss secondary to anoxia / hypoglycaemia / severe convulsions and surgery, degenerative disorders, vascular disorders or pathology around ventricle III.
• Cognitive disorders, in particular due to cognitive impairment resulting from other medical conditions. • Personality disorders, including paranoid personality disorder, schizoid personality disorder, schizotypical personality disorder, antisocial personality disorder, borderline personality disorder, histrionic personality disorder, narcissistic personality dis- order, avoidant personality disorder, dependent personality disorder, obsessive- compulsive personality disorder and personality disorder not otherwise specified.
• Schizoaffective disorders resulting from various causes, including schizoaffective disorders of the manic type, of the depressive type, of mixed type, paranoid, disor- ganized, catatonic, undifferentiated and residual schizophrenia, schizophreniform disorder, schizoaffective disorder, delusional disorder, brief psychotic disorder, shared psychotic disorder, substance-induced psychotic disorder and psychotic disorder not otherwise specified.
• Akinesia, akinetic-rigid syndromes, dyskinesia and medication-induced parkinson- ism, Gilles de Ia Tourette syndrome and its symptoms, tremor, chorea, myoclonus, tics and dystonia.
• Attention-deficit / hyperactivity disorder (ADHD).
• Parkinson's disease, drug-induced Parkinsonism, post-encephalitic Parkinsonism, progressive supranuclear palsy, multiple system atrophy, corticobasal degenera- tion, parkinsonism-ALS dementia complex and basal ganglia calcification.
• Dementia of the Alzheimer's type, with early or late onset, with depressed mood.
• Behavioural disturbances and conduct disorders in dementia and the mentally retarded, including restlessness and agitation.
• Extra-pyramidal movement disorders. • Down's syndrome.
• Akathisia.
• Eating Disorders, including anorexia nervosa, atypical anorexia nervosa, bulimia nervosa, atypical bulimia nervosa, overeating associated with other psychological disturbances, vomiting associated with other psychological disturbances and non- specified eating disorders.
• AIDS-associated dementia.
• Chronic pain conditions, including neuropathic pain, inflammatory pain, cancer pain and post-operative pain following surgery, including dental surgery. These indications might also include acute pain, skeletal muscle pain, low back pain, upper ex- tremity pain, fibromyalgia and myofascial pain syndromes, orofascial pain, abdomi- nal pain, phantom pain, tic douloureux and atypical face pain, nerve root damage and arachnoiditis, geriatric pain, central pain and inflammatory pain.
• Neurodegenerative diseases, including Alzheimer's disease, Huntington's chorea, Creutzfeld-Jacob disease, Pick's disease, demyelinating disorders, such as multiple sclerosis and ALS, other neuropathies and neuralgia, multiple sclerosis, amyotropi- cal lateral sclerosis, stroke and head trauma.
• Addiction disorders, including :
• Substance dependence or abuse with or without physiological dependence, particularly where the substance is alcohol, amphetamines, amphetamine-like sub- stances, caffeine, cannabis, cocaine, hallucinogens, inhalants, nicotine, opioids, phencyclidine, phencyclidine-like compounds, sedative-hypnotics, benzodiazepines and/or other substances, particularly useful for treating withdrawal from the above substances and alcohol withdrawal delirium.
• Mood disorders induced particularly by alcohol, amphetamines, caffeine, cannabis, cocaine, hallucinogens, inhalants, nicotine, opioids, phencyclidine, sedatives, hypnotics, anxiolitics and other substances.
• Anxiety disorders induced particularly by alcohol, amphetamines, caffeine, cannabis, cocaine, hallucinogens, inhalants, nicotine, opioids, phencyclidine, sedatives, hypnotics, anxiolitics and other substances and adjustment disorders with anxiety. • Smoking cessation.
• Body weight control, including obesity.
• Sleep disorders and disturbances, including :
• Dyssomnias and/or parasomnias as primary sleep disorders, sleep disorders related to another mental disorder, sleep disorder due to a general medical condition and substance-induced sleep disorder.
• Circadian rhythms disorders.
• Improving the quality of sleep.
• Sexual dysfunction, including sexual desire disorders, sexual arousal disorders, orgasmic disorders, sexual pain disorders, sexual dysfunction due to a general medical condition, substance-induced sexual dysfunction and sexual dysfunction not otherwise specified. The invention therefore relates to a compound according to the invention for use as a medicine.
The invention also relates to the use of a compound according to the invention for the preparation of a medicament for the prevention and/or treatment of central nervous system disorders, mood disorders, anxiety disorders, stress-related disorders associated with depression and/or anxiety, cognitive disorders, personality disorders, schizoaffective disorders, Parkinson's disease, dementia of the Alzheimer's type, chronic pain conditions, neurodegenerative diseases, addiction disorders, mood disorders and sexual dysfunction. A compound according to the invention may be co-administered as add-on treatment and/or prophylaxis in the above listed diseases in combination with antidepressants, anxiolytics and/or antipsychotics which are currently available or in development or which will become available in the future, in particular to improve efficacy and/or onset of action. It will be appreciated that a compound of the present invention and the other agents may be present as a combined preparation for simultaneous, separate or sequential use for the prevention and/or treatment of depression and/or anxiety. Such combined preparations may be, for example, in the form of a twin pack. It will also be appreciated that a compound of the present invention and the other agents may be administered as separate pharmaceutical compositions, either simultaneously or se- quentially.
The invention therefore relates to the use of a compound according to the invention as an add-on treatment in combination with one or more other compounds selected from the group of antidepressants, anxiolytics and antipsychotics.
Suitable classes of antidepressant agents include norepinephrine reuptake inhibi- tors, selective serotonin reuptake inhibitors (SSRI's), monoamine oxidase inhibitors (MAOI's), reversible inhibitors of monoamine oxidase (RIMA's), serotonin and noradrenaline reuptake inhibitors (SNRI's), noradrenergic and specific serotonergic antidepressants (NaSSA's), corticotropin releasing factor (CRF) antagonists, α-adrenoreceptor antagonists and atypical antidepressants. Suitable examples of norepinephrine reuptake inhibitors include amitriptyline, clomipramine, doxepin, imipramine, trimipramine, amoxapine, desipramine, maprotiline, nortriptyline, protriptyline, reboxetine and pharmaceutically acceptable salts thereof. Suitable examples of selective serotonin reuptake inhibitors include fluoxetine, fluvoxamine, paroxetine, sertraline and pharmaceutically acceptable salts thereof.
Suitable examples of monoamine oxidase inhibitors include isocarboxazid, phenelzine, tranylcypromine, selegiline and pharmaceutically acceptable salts thereof. Suitable examples of reversible inhibitors of monoamine oxidase include mo- clobemide and pharmaceutically acceptable salts thereof.
Suitable examples of serotonin and noradrenaline reuptake inhibitors include venlafaxine and pharmaceutically acceptable salts thereof.
Suitable atypical antidepressants include bupropion, lithium, nefazodone, tra- zodone, viloxazine, sibutramine and pharmaceutically acceptable salts thereof.
Other suitable antidepressants include adinazolam, alaproclate, amineptine, amitriptyline/chlordiazepoxide combination, atipamezole, azamianserin, bazinaprine, befuraline, bifemelane, binodaline, bipenamol, brofaromine, bupropion, caroxazone, cericlamine, cianopramine, cimoxatone, citalopram, clemeprol, clovoxamine, dazepinil, deanol, demexiptiline, dibenzepin, dothiepin, droxidopa, enefexine, estazolam, etoperi- done, femoxetine, fengabine, fezolamine, fluotracen, idazoxan, indalpine, indeloxazine, iprindole, levoprotiline, litoxetine, lofepramine, medifoxamine, metapramine, metralin- dole, mianserin, milnacipran, minaprine, mirtazapine, monirelin, nebracetam, nefopam, nialamide, nomifensine, norfluoxetine, orotirelin, oxaflozane, pinazepam, pirlindone, pizotyline, ritanserin, rolipram, sercloremine, setiptiline, sibutramine, sulbutiamine, sulpiride, teniloxazine, thozalinone, thymoliberin, tianeptine, tiflucarbine, tofenacin, to- fisopam, toloxatone, tomoxetine, veralipride, viqualine, zimelidine and zometapine and pharmaceutically acceptable salts thereof, and St. John's wort herb, or Hypericum perforatum, or extracts thereof. Suitable classes of anti-anxiety agents include benzodiazepines and 5-HT1A receptor agonists or antagonists, especially 5-HT1A partial agonists, corticotropin releasing factor (CRF) antagonists, compounds having muscarinic cholinergic activity and compounds acting on ion channels. In addition to benzodiazepines, other suitable classes of anti-anxiety agents are nonbenzodiazepine sedative-hypnotic drugxs such as Zolpidem; mood-stabilizing drugs such as clobazam, gabapentin, lamotrigine, lore- clezole, oxcarbamazepine, stiripentol and vigabatrin; and barbiturates.
Suitable antipsychotic agents are selected from the group consisting of aceto- phenazine, in particular the maleate salt; alentemol, in particular the hydrobromide salt; alpertine; azaperone; batelapine, in particular the maleate salt; benperidol; benzin- dopyrine, in particular the hydrochloride salt; brofoxine; bromperidol; butaclamol, in particular the hydrochloride salt; butaperazine; carphenazine, in particular the maleate salt; carvotroline, in particular the hydrochloride salt; chlorpromazine; chlorprothixene; cinperene; cintriamide; clomacran, in particular the phosphate salt; clopenthixol; clopi- mozide; clopipazan, in particular the mesylate salt; cloroperone, in particular the hydrochloride salt; clothiapine; clothixamide, in particular the maleate salt; clozapine; cyclo- phenazine, in particular the hydrochloride salt; droperidol; etazolate, in particular the hydrochloride salt; fenimide; flucindole; flumezapine; fluphenazine, in particular the de- canoate, enanthate and/or hydrochloride salts; fluspiperone; fluspirilene; flutroline; gevotroline, in particular the hydrochloride salt; halopemide; haloperidol; iloperidone; imidoline, in particular the hydrochloride salt; lenperone; loxapine; mazapertine, in particular the succinate salt; mesoridazine; metiapine; milenperone; milipertine; molindone, in particular the hydrochloride salt; naranol, in particular the hydrochloride salt; neflumozide, in particular the hydrochloride salt; ocaperidone; olanzapine; oxiperomide; penfluridol; pentiapine, in particular the maleate salt; perphenazine; pimozide; pi- noxepin, in particular the hydrochloride salt; pipamperone; piperacetazine; pipotiazine, in particular the palmitate salt; piquindone, in particular the hydrochloride salt; prochlorperazine, in particular the edisylate salt; prochlorperazine, in particular the maleate salt; promazine, in particular the hydrochloride salt; quetiapine; remoxipride; risperidone; rimcazol, in particular the hydrochloride salt; seperidol, in particular the hydrochloride salt; sertindole; setoperone; spiperone; sulpiride; thioridazine; thiothixene; thorazine; tioperidone, in particular the hydrochloride salt; tiospirone, in particular the hydrochloride salt; trifluoperazine, in particular the hydrochloride salt; trifluperidol; triflu- promazine; ziprasidone, in particular the hydrochloride salt; and mixtures thereof.
Some compound according to the invention surprisingly also shows a moderate 5-HT-reuptake inhibition activity and may therefore very well be suited for use in the treatment and/or prophylaxis of depression. It is thought that a 5-HT reuptake inhibitor with associated (^-adrenoceptor antagonistic activity might be a new type of antide- pressant, with a dual action on the central noradrenergic and serotonergic neuronal systems. The immediate effect on monoamine release of autoreceptor blockade may accelerate the onset of action of such a compound, compared to currently available drugs that require desensitization of the autoreceptors involved in the feedback mechanism in order to become fully effective. In addition, α2c-adrenoceptor antagonism improves sexual function as shown by treatment with the c^c-adrenoceptor antagonist yohimbine, thereby potentially reducing one of the side effects related to 5-HT uptake inhibition and enhancement of NEergic neurotransmission improves social function more effectively than SSRIs (J. lgnacio Andres et al., J. Med. Chem. (2005), Vol. 48, 2054-2071 ) ).
Pharmaceutical compositions
The invention also relates to a pharmaceutical composition comprising a pharmaceutically acceptable carrier or diluent and, as active ingredient, a therapeutically effective amount of a compound according to the invention, in particular compound accord- ing to Formula (I), a pharmaceutically acceptable acid or base addition salt thereof, an N-oxide form thereof, or a quaternary ammonium salt thereof.
A compound according to the invention or any subgroup or combination thereof may be formulated into various pharmaceutical forms for administration purposes. As appropriate compositions there may be cited all compositions usually employed for sys- temically administering drugs.
To prepare the pharmaceutical composition of this invention, an effective amount of the particular compound, optionally in addition salt form, as the active ingredient is combined in intimate admixture with a pharmaceutically acceptable carrier, which carrier may take a wide variety of forms depending on the form of preparation desired for administration. This pharmaceutical composition is desirable in unitary dosage form suitable, in particular, for administration orally, rectally, percutaneously, by parenteral injection or by inhalation. For example, in preparing the compositions in oral dosage form, any of the usual pharmaceutical media may be employed such as, for example, water, glycols, oils, alcohols and the like in the case of oral liquid preparations such as suspensions, syrups, elixirs, emulsions and solutions; or solid carriers such as starches, sugars, kaolin, diluents, lubricants, binders, disintegrating agents and the like in the case of powders, pills, capsules and tablets. Because of their ease in administration, tablets and capsules represent the most advantageous oral dosage unit forms in which case solid pharmaceutical carriers are obviously employed. For parenteral com- positions, the carrier will usually comprise sterile water, at least in large part, though other ingredients, for example, to aid solubility, may be included. Injectable solutions, for example, may be prepared in which the carrier comprises saline solution, glucose solution or a mixture of saline and glucose solution. Injectable suspensions may also be prepared in which case appropriate liquid carriers, suspending agents and the like may be employed. Also included are solid form preparations that are intended to be converted, shortly before use, to liquid form preparations. In compositions suitable for percutaneous administration, the carrier optionally comprises a penetration enhancing agent and/or a suitable wetting agent, optionally combined with suitable additives of any nature in minor proportions, which additives do not introduce a significant deleterious effect on the skin. Said additives may facilitate the administration to the skin and/or may be helpful for preparing the desired compositions. These compositions may be administered in various ways, e.g., as a transdermal patch, as a spot-on, as an ointment. It is especially advantageous to formulate the aforementioned pharmaceutical compositions in unit dosage form for ease of administration and uniformity of dosage. Unit dosage form as used herein refers to physically discrete units suitable as unitary dosages, each unit containing a predetermined quantity of active ingredient calculated to produce the desired therapeutic effect in association with the required pharmaceuti- cal carrier, examples of such unit dosage forms are tablets (including scored or coated tablets), capsules, pills, powder packets, wafers, suppositories, injectable solutions or suspensions and the like, and segregated multiples thereof. Since a compound according to the invention is a potent orally administrable dopamine antagonist, a pharmaceutical composition comprising said compound for administration orally is especially ad- vantageous.
The invention also relates to a pharmaceutical composition comprising a compound according to the invention and one or more other compounds selected from the group of antidepressants, anxiolytics and antipsychotics as well as to the use of such a composition for the manufacture of a medicament, in particular to improve efficacy and/or onset of action in the treatment of depression and/or anxiety.
The following examples are intended to illustrate but not to limit the scope of the present invention. Experimental part
Hereinafter, "THF" means tetrahydrofuran ; "DMF" means Λ/,Λ/-dimethylformamide ; "EtOAc" means ethyl acetate ; "DMSO" means dimethylsulfoxide ; "DCM" means di- chloromethane; "1 ,2-DCE" means 1 ,2-dichloroethane "HPLC" means High- performance liquid chromatography; "PS-TBD" is a polymer-supported base which consists of a bicyclic guanidine moiety (1 ,5,7-triazabicyclo[4.4.0]dec-5-ene) anchored on polystyrene and "PS-NCO" means polymer-supported isocyanate.
Microwave assisted reactions were performed in a single-mode reactor: Emrys™ Opti- mizer microwave reactor (Personal Chemistry A.B., currently Biotage). Description of the instrument can be found in www.personalchemistry.com. And in a multimode reactor: MicroSYNTH Labstation (Milestone, Inc.). Description of the instrument can be found in www.milestonesci.com.
A. Preparation of the intermediate compounds a) Preparation of intermediate compound 1-1 a1 ) Preparation of (1 -benzyl-piperidin-4-yl)-(3-chloro-pyrazin-2-yl)-amine
Figure imgf000031_0001
2,3-Dichloropyrazine (10 g, 62.12 mmol) and 1 -(benzyl)-4-piperidinamine (13.73 ml_, 67.12 mmol) were dissolved in DMF (60 ml). Then Na2CO3 (10.09 g, 1 14.10 mmol) was added. The reaction was stirred at 130 0C for 16 hours. The solid was filtered off, washed with EtOAc and the solvent was evaporated till dryness. The product was dissolved in EtOAc, washed with H2O and brine, dried with MgSO4 and evaporated under vacuum. The product was used without any further purification yielding 15 g of (1 -benzyl-piperidin-4-yl)-(3-chloro-pyrazin-2-yl)-amine (74 %). a2) Preparation of 3-(1-benzyl-piperidin-4-ylamino)-1 H-pyrazin-2-one
Figure imgf000032_0001
(1-Benzyl-piperidin-4-yl)-(3-chloro-pyrazin-2-yl)-amine, obtained in step a1 (7 g, 23.11 mmol) was dissolved in HCI (70 ml; 10 %) and heated in a sealed tube at 1 10 0C for 16 hours. A light brown solid was precipitated, it was filtered off, washed with water and dried under vacuum yielding 4.57 g of 3-(1-benzyl-piperidin-4-ylamino)-1 H-pyrazin-2- one (70 %).
a3) Preparation of intermediate compound 1-1
Figure imgf000032_0002
CH3OH
3-(1-Benzyl-piperidin-4-ylamino)-1 H-pyrazin-2-one, obtained in step a2 (4.17 g, 14.66 mmol) was dissolved in CH3OH (62 ml_), then Pd/C (4.17 g; 10 %) and 1 ,4- cyclohexadiene (27.96 ml_, 293.2 mmol) were added. The reaction was heated in a sealed tube at 65 0C for 4 hours. The reaction was filtered over celite and the solvent was evaporated till dryness yielding 2.69 g of the desired intermediate compound 1-1 (94 %). b) Preparation of intermediate compound 1-2
Figure imgf000033_0001
Intermediate compound 1-1 (5.15 mmol), 4-biphenylcarboxaldehyde (2.81 g, 15.45 mmol) and sodium triacetoxyborohydride (1.63 g, 7.72 mmol) were solved in 1 ,2-DCE (30 ml). The reaction was stirred at room temperature for 16 h. The solvent was concentrated. The residue was solved in EtOAc and washed with Na2CO3 aqueous saturated solution, and NaCI aqueous saturated solution. The combined organic phases were dried (MgSO4), filtered and concentrated. The residue was purified by catch and release using a cartridge of isolute SCX-3, in MeOH, and then MeOH/NH3. The ammonia phase was concentrated. The residue was purified by chromatography with SiO2 (eluent DCM-MeOH(NH3) 9-1 to 7-3) to yield intermediate I-2 (0.949 g, 51 %).
b) Preparation of intermediate compound I-3
Figure imgf000033_0002
I-3
2,3-Dichloropyrazine (180 mg, 0.117 mmol), 1-([1 ,1 '-biphenyl]-4-ylmethyl)piperazine (CAS 84359-51-3, 0.0981 mmol) and NaOH pellets (400 mg) were heated at 150 0C in a sealed tube during 4h.
Then 0.4 ml of NaOH 4 M and 0.4 ml of DMSO were added, heating at 150 0C for 5 hours more. The crude was extracted with DCM and water. The combined organic phases were dried (MgSO4), filtered and concentrated. The residue was purified by chromatography in SiO2 to obtain intermediate compound I-3 which was used in next reaction step without further purification. c) Preparation of intermediate compound 1-4
Figure imgf000034_0001
I -4
2,3-Dichloropyrazine (448 mg, 3 mmol) and 4-phenylpiperidine (CAS: 771-99-3, 2.9 mmol) were dissolved in DMSO (0.400 ml). Then NaOH pellets (1 g, 25 mmol) were added. The reaction was stirred at 150 0C under microwave irradiation for 0.5 hours. Then 0.4 ml of NaOH 4 M and 0.4 ml of DMSO were added, heating at 150 0C in microwave for 0.5 hours more. The mixture was dissolved in EtOAc, washed with H2O and brine, dried (MgSO4) and evaporated . The residue was purified in a short open column chromatography of SiO2, to yield intermediate 1-4 which was used in next reaction step without further purification.
d) Preparation of intermediate compound 1-5
Figure imgf000034_0002
Compound 1-1 (5.15 mmol), benzaldehyde (2.81 g, 15.45 mmol) and sodium triace- toxyborohydride (1.63 g, 7.72 mmol) were solved in 1 ,2-DCE (30 ml). The reaction was stirred at room temperature for 16 h. The solvent was concentrated. The residue was solved in EtOAc and washed with NaHCO3 aqueous saturated solution, and NaCI aqueous saturated solution. The combined organic phases were dried (MgSO4), fil- tered and concentrated. The residue was purified by catch and release using a cartridge of isolute SCX-3, in MeOH, and then MeOH/NH3. The ammonia phase was concentrate to yield intermediate I-5 (1.30 g, 89 %) e) Preparation of intermediate compound 1-6
Figure imgf000035_0001
Compound 1-1 (1 g, 5.15 mmol), phenylacetaldehyde (CAS: 122-78-1 , 1.81 ml, 15.45 mmol) and sodium triacetoxyborohydride (1.63 g, 7.72 mmol) were solved in 1 ,2-DCE (30 ml). The reaction was stirred at room temperature for 16 h. The solvent was concentrated. The residue was solved in EtOAc and washed with NaHCC>3 aqueous saturated solution, and NaCI aqueous saturated solution. The combined organic phases were dried (MgSO4), filtered and concentrated, to yield intermediate I-6 (1.07g, 71 %).
f ) Preparation of intermediate compound 1-7
Figure imgf000035_0002
I -7
2,3-Dichloropyrazine (1 g, 4.5 mmol), N-methyl-N-(2-phenylethyl) 4 piperidinamine
(CAS: 142752-20-3, 4.5 mmol) were dissolved in DMF (7.5 ml). Then Na2CO3 (0.84 g, 7.9 mmol) were added. The reaction was stirred at 130 0C for 5 hours. The reaction mixture was washed with H2O and extracted with DCM. The combined organic phases were dried (Na2SO4), filtered and the solvent concentrated, to yield 1.2 g. This com- pound was suspended in a mixture of NaOH 4 M (6 ml) and 6 ml of DMSO, heating at 150 0C in microwave for 0.5 hours. The mixture was dissolved in EtOAc, washed with NH4CI (10 %). The combined organic phases were dried with MgSO4 and evaporated to yield intermediate compound I-7 (0.82 g, 58 %) g) Preparation of intermediate compound 1-8
Figure imgf000036_0001
Compound 1-1 (0.6 g, 3.09 mmol), diphenylacetaldehyde (CAS: 947-91-1 , 9.27 mmol) and sodium triacetoxyborohydride (0.982 g, 4.63 mmol) were solved in 1 ,2-DCE (30 ml). The reaction was stirred at room temperature for 16 h. The solvent was concentrated. The residue was solved in EtOAc and washed with NaHCO3 aqueous saturated solution, and NaCI aqueous saturated solution. The combined organic phases were dried (MgSO4), filtered and concentrated. The residue was purified by chromatography with SiO2 (eluent DCIWMeOH(NH3) 9.5 /0.5) to yield intermediate I-8 (0.867 g, 75 %) as a solid.
h) Preparation of intermediate compound 1-9
Figure imgf000036_0002
I-9
2,3-Dichloropyrazine (448 mg, 3 mmol) and 1-(2-phenylethyl)-piperazine (CAS: 5321- 49-3, 2.9 mmol) were dissolved in DMSO (0.400 ml). Then NaOH pellets (1 g, 25 mmol) were added. The reaction was stirred at 150 0C under microwave irradiation for 0.5 hours.
Then 0.4 ml of NaOH 4 M and 0.4 ml of DMSO were added, heating at 150 0C in microwave for 0.5 hours more. The mixture was dissolved in EtOAc, washed with H2O and brine, dried (Na2SO4) and evaporated The residue was purified in a short open column chromatography of SiC>2, to yield intermediate 1-9 which was used in next reaction step without further purification.
i) Preparation of intermediate compound 1-10
Figure imgf000037_0001
M 1-10
Compound 1-1 (1.2 g, 6.18 mmol), 4-benzyloxybenzaldehyde (CAS: 4397-53-9, 18.53 mmol) and sodium triacetoxyborohydride (1.96 g, 9.27 mmol) were solved in 1 ,2-DCE (30 ml). The reaction was stirred at room temperature for 64 h. The solvent was concentrated. The residue was solved in EtOAc and washed with NaHCO3 aqueous satu- rated solution, and NaCI aqueous saturated solution. The combined organic phases were dried (MgSO4), filtered and concentrated. The residue was purified by flash chromatography with SiO2 (eluent DCIWMeOH 95 /5) to yield intermediate 1-10 (2.05 g, 85 %) as a solid.
B. Preparation of the final compounds
a) Preparation of final compound 1-3
Figure imgf000037_0002
I-2 1 -3
Intermediate compound I-2 (20 mg, 0.055 mmol), 1-(2-chloroethyl)piperidine monohy- drochloride (0.16 mmol) and PS-TBD (62 mg, 0.16 mmol) were suspended in CH3CN (1 ml). The reaction was heated in the microwave at 120 0C for 20 minutes. The resin was filtered off, and the filtrate was concentrated under vacuum. The resulting crude was purified by catch and realease using a SCX-2 cartridge yielding 0.01 15 g of the purified final compound 1 -3 (60 %). b) Preparation of final compound 2-2
Figure imgf000038_0001
1-3 2-2
Intermediate compound 1-3 (72 mg, 0.2 mmol), N-(3-bromopropyl)phthalimide (0.4 mmol) and PS-TBD (207 mg, 0.6 mmol) were suspended in CH3CN (2 ml). The reaction was heated in the microwave at 120 0C for 15 minutes. The resin was filtered off, and the filtrate was concentrated under vacuum. The resulting crude was purified by HPLC yielding 0.037g of the purified final compound 2-2 (35 %).
c) Preparation of final compound 3-3
Figure imgf000038_0002
3-3
2,3-Dichloropyrazine (500 mg, 3.35 mmol), 1-([1 ,1'-biphenyl]-3-ylmethyl) piperazine, (CAS 204634-72-0, 3.2 mmol) and NaOH pellets (1 g, 25 mmol) were heated at 150 0C in a sealed tube during 4h.
Then 0.4 ml of NaOH 4 M and 0.4 ml of DMSO were added, heating at 150 0C for 5 hours more. The crude was extracted with DCM and water. The combined organic phases were dried (MgSO4), filtered and concentrated. The residue was purified by chromatography in SiO2 to obtain final compound 3-3 (0.730 g, 63 %). d) Preparation of final compound 3-5
Figure imgf000039_0001
Final compound 3-3 (69 mg, 0.2 mmol), N-(3-bromopropyl)phthalimide (0.4 mmol) and PS-TBD (207 mg, 0.6 mmol) were suspended in CH3CN (2 ml). The reaction was heated in the microwave at 120 0C for 15 minutes. The resin was filtered off, and the filtrate was concentrated under vacuum. The resulting crude was purified by HPLC yielding 0.043 g of the purified final compound 3-5 (40 %).
e) Preparation of final compound 4-1
Figure imgf000039_0002
Intermediate compound I-4 (25 mg, 0.1 mmol), 2-(bromomethyl)naphthalene (0.2 mmol) and PS-TBD (103 mg, 0.3 mmol) were suspended in CH3CN (2 ml). The reac- tion was heated in the microwave at 120 0C for 20 minutes. The resin was filtered off, and the filtrate was concentrated under vacuum. The resulting crude was purified by HPLC yielding 0.028 g of the purified final compound 4-1 (65 %).
f) Preparation of final compound 5-5
Figure imgf000039_0003
I -5
5-5
Intermediate compound I-5 (20 mg, 0.07 mmol), N-(3-bromopropyl)phthalimide (0.21 mmol) and PS-TBD (76 mg, 0.21 mmol) were suspended in CH3CN (1 ml). The reaction was heated in the microwave at 120 0C for 20 minutes. The resin was filtered off, and the filtrate was concentrated under vacuum. The resulting crude was purified by catch and realease using a SCX-2 cartridge, yielding 0.017 g of the purified final compound 5-5 (53 %).
g) Preparation of final compound 6-6
Figure imgf000040_0001
Intermediate compound I-6 (20 mg, 0.067 mmol), N-(3-bromopropyl)phthalimide (0.20 mmol) and PS-TBD (69 mg, 0.20 mmol) were suspended in CH3CN (1 ml). The reac- tion was heated in the microwave at 120 0C for 20 minutes. The resin was filtered off, and the filtrate was concentrated under vacuum. The resulting crude was purified by by catch and realease using a SCX-2 cartridge, yielding 0.014 g of the purified final compound 6-6 (43 %).
h) Preparation of final compound 7-5
Figure imgf000040_0002
Final compound 7-7 (20 mg, 0.064 mmol), N-(3-bromopropyl)phthalimide (0.192 mmol) and PS-TBD (71 mg, 0.192 mmol) were suspended in CH3CN (1 ml). The reaction was heated in the microwave at 130 0C for 20 minutes. The resin was filtered off, and the filtrate was concentrated under vacuum. The resulting crude was purified by by catch and realease using a SCX-2 cartridge, yielding 0.0122 g of the purified final compound 7-5 (36 %). i) Preparation of final compound 7-7
Figure imgf000041_0001
Compound 1-1 (5.15 mmol), hydrocinnamaldehyde (CAS: 104-53-0, 2.81 g, 15.45 mmol) and sodium triacetoxyborohydride (1.63 g, 7.72 mmol) were solved in 1 ,2-DCE (30 ml). The reaction was stirred at room temperature for 16 h. The solvent was concentrated. The residue was solved in EtOAc and washed with NaHCO3 aqueous saturated solution, and NaCI aqueous saturated solution. The combined organic phases were dried (MgSO4), filtered and concentrated. The residue was purified by catch and released using a cartridge of isolute SCX-3, in MeOH, and then MeOH/NH3. The ammonia phase was concentrated to yield compound 7-7 (1.30 g, 89 %)
j) Preparation of final compound 8-1
Figure imgf000041_0002
8-1
Intermediate compound I-7 (50 mg, 0.160 mmol), N-(3-bromopropyl)phthalimide (0.240 mmol) and PS-TBD (160 mg, 0.48 mmol) were suspended in CH3CN (2.5 ml). The reaction was heated in the microwave at 120 0C for 20 minutes. The resin was filtered off, and the filtrate was concentrated under vacuum. The resulting crude was purified by HPLC yielding 0.038 g of the purified final compound 8-1 (48 %). k) Preparation of final compound 9-3
Figure imgf000042_0001
CH3CN
1-8
9-3
Intermediate compound 1-8 (20 mg, 0.053 mmol), 3-(boc-amino)propyl bromide (0.160 mmol) and PS-TBD (55 mg, 0.160 mmol) were suspended in CH3CN (1 ml). The reaction was heated in the microwave at 120 0C for 20 minutes. The resin was filtered off, and the filtrate was concentrated under vacuum. The resulting crude was purified by catch and release using a SCX-2 cartridge to yield 0.010 g of the purified final compound 9-3 (37 %).
I) Preparation of final compound 9-3
Figure imgf000042_0002
9-3 9-1
Final compound 9-3 (15 mg, 0.028 mmol) was solved in a mixture of TFA-DCM 25 % (1 ml). The reaction was stirred at room temperature for 1 h. The solvent was concentrated. The crude was solved in MeOH and purified by catch and release using a SCX- 2 cartridge, to yield 10 mg (84 %) of compound 9-1.
m) Preparation of final compound 10-1 1
Figure imgf000042_0003
Intermediate compound I-9 (28 mg, 0.1 mmol), 2-chloro-5-(chloromethyl)thiophene (0.2 mmol) and PS-TBD (103 mg, 0.3mmol) were suspended in CH3CN (2 ml). The reac- tion was heated in the microwave at 120 0C for 20 minutes. The resin was filtered off, and the filtrate was concentrated under vacuum. The resulting crude was purified by HPLC yielding 0.031 g of the purified final compound 10-11 (75 %).
n) Preparation of final compound 1 1-5
Figure imgf000043_0001
CHXN
1-10 11-5
Intermediate compound 1-10 (29 mg, 0.073 mmol), Λ/-(3-bromopropyl)phthalimide (0.22 mmol) and PS-TBD (76 mg, 0.22 mmol) were suspended in CH3CN (2 ml). The reaction was heated in the microwave at 120 0C for 15 minutes. The resin was filtered off, and the filtrate was concentrated under vacuum. The resulting crude was purified by catch and release with a SCX-2 cartridge, to yield 0.023 g of the purified final com- pound 11 -5 (55 %).
The following compounds were prepared according to the above examples, schemes and procedures.
Table 1 : List of biphenyl-substituted compounds (with amino-piperidinyl-linker).
Figure imgf000044_0001
Table 2: List of biphenyl-substituted compounds (with piperazinyl-linker).
Figure imgf000045_0001
Table 3: List of biphenyl substituted compounds (with piperazinyl-linker).
Figure imgf000045_0002
Figure imgf000046_0001
Table 4: List of phenyl-substituted compounds (with piperidinyl-linker)
Figure imgf000046_0002
Table 5: List of phenyl-substituted compounds (with piperidinylamino-linker)
Figure imgf000047_0001
Table 6: List of phenyl-substituted compounds (with piperidinylamino-linker).
Figure imgf000047_0002
Figure imgf000048_0001
Table 7: List of phenyl-substituted compounds (with piperidinylamino-linker).
Figure imgf000048_0002
Figure imgf000049_0001
Table 8: List of phenyl-substituted compounds (with aminopiperidinyl-linker).
Figure imgf000050_0001
Table 9: List of 1 ,1-diphenylmethyl-substituted compounds (with piperidinylamino- linker).
Figure imgf000050_0002
Figure imgf000051_0001
Table 10 : List of phenyl-substituted compounds (with piperazinyl-linker).
Figure imgf000051_0002
Figure imgf000052_0001
Table 11 : List of phenyl-substituted compounds (with piperidinylamino-linker).
Figure imgf000053_0001
C. Pharmacological example General
The interaction of a compound of Formula (I) with α2c-3drenoceptor receptors was assessed in in vitro radioligand binding experiments. In general, a low concentration of a radioligand with a high binding affinity for a particular receptor or transporter is incubated with a sample of a tissue preparation enriched in a particular receptor or transporter or with a preparation of cells expressing cloned human receptors in a buffered medium. During the incubation, the radioligand binds to the receptor or transporter. When equilibrium of binding is reached, the receptor bound radioactivity is separated from the non-bound radioactivity, and the receptor- or transporter-bound activity is counted. The interaction of the test compounds with the receptor is assessed in competition binding experiments. Various concentrations of the test compound are added to the incubation mixture containing the receptor- or transporter preparation and the radioligand. The test compound in proportion to its binding affinity and its concentration inhibits binding of the radioligand. The radioligand used for hα2A snd hα2c receptor binding was [3H]-raulwolscine.
Example C.1 : Binding Experiment for αgo-adrenoceptor Cell culture and membrane preparation. CHO cells, stabile transfected with human adrenergic-α2A snd 02c receptor cDNA, were cultured in Dulbecco's Modified Eagle's Medium (DMEM)/Nutrient mixture Ham's F12 (ratio 1 :1 )(Gibco, Gent-Belgium) supplemented with 10 % heat inactivated fetal calf serum (Life Technologies, Merelbeke-Belgium) and antibiotics (100 IU/ml penicillin G, 100 μg/ml streptomycin sulphate, 110 μg/ml pyruvic acid and 100 μg/ml L-glutamine). One day before collection, cells were induced with 5 mM sodiumbutyrate. Upon 80-90 % of confluence, cells were scraped in phosphate buffered saline without Ca2+ and Mg2+ and collected by centrifugation at 1500 x g for 10 minutes. The cells were homogenised in Tris-HCI 50 mM using an Ultraturrax homogenizer and centrifuged for 10 minutes at 23,500 x g. The pellet was washed once by resuspension and rehomogenization and the final pellet was resuspended in Tris-HCI , divided in 1 ml aliquots and stored at -70 0C. Binding experiment for α?-adrenergic receptor subtypes
Membranes were thawed and re-homogenized in incubation buffer (glycylglycine 25 mM, pH 8.0). In a total volume of 500 μl, 2-10 μg protein was incubated with [3H]raulwolscine (NET-722) (New England Nuclear, USA) (1 nM final concentration) with or without competitor for 60 minutes at 250C followed by rapid filtration over GF/B filter using a Filtermate196 harvester (Packard, Meriden, CT). Filters were rinsed extensively with ice-cold rinsing buffer (Tris-HCI 50 mM pH 7.4). Filter-bound radioactivity was determined by scintillation counting in a Topcount (Packard, Meriden, CT) and results were expressed as counts per minute (cpm). Non-specific binding was deter- mined in the presence of 1 μM oxymetazoline for the hα2A receptor and 1 μM spi- roxatrine for hα2c receptors.
Example C2 : Binding experiment for the 5HT-transporter
Human platelet membranes (Oceanix Biosciences Corporation, Hanover, MD, USA) were thawed, diluted in buffer (Tris-HCI 50 mM, 120 mM NaCI and 5 mM KCI) and quickly (max 3 s) homogenised with an Ultraturrax homogenizer. In a total volume of 250 μl_, 50-100 μg protein was incubated with [3H]paroxetine (NET-869) (New England Nuclear, USA) (0.5 nM final concentration) with or without competitor for 60 min at 25 0C . Incubation was stopped by rapid filtration of the incubation mixture over GF/B fil- ters, pre-wetted with 0.1 % polyethyleneamine, using a Filtermate196 harvester (Packard, Meriden, CT). Filters were rinsed extensively with ice-cold buffer and radioactivity on the filters was counted in a Topcount liquid scintillation counter (Packard, Meriden, CT). Data were expressed as cpm. lmipramine (at 1 μM final concentration) was used to determine the non-specific binding.
Data analysis and results
Data from assays in the presence of compound were calculated as a percentage of total binding measured in the absence of test compound. Inhibition curves, plotting percent of total binding versus the log value of the concentration of the test compound, were automatically generated, and sigmoidal inhibition curves were fitted using nonlinear regression. The plC5o values of test compounds were derived from individual curves.
All compounds according to Formula (I) produced an inhibition at least at the hα2c-site (but often also at the hα2A-site) of more than 50 % (plC5o) at a test concentration ranging between 10"6 M and 10"9 M in a concentration-dependent manner.
Some compounds also show moderate 5-HTT activity.
For a selected number of compounds, covering most of the various embodiments of Formula (I), the results of the in vitro studies are given in Table 12.
Table 12. Pharmacological data for the compounds according to the invention.
Figure imgf000056_0001
Figure imgf000057_0001
Figure imgf000058_0001
D. Composition examples
"Active ingredient" (a.i.) as used throughout these examples relates to a compound of formula (i), the pharmaceutically acceptable acid or base addition salts thereof, the stereochemical^ isomeric forms thereof, the Λ/-oxide form thereof, a quaternary am- monium salt thereof and prodrugs thereof.
Example D.1 : oral drops
500 Grams of the a.i. is dissolved in 0.5 I of 2-hydroxypropanoic acid and 1.5 I of the polyethylene glycol at 60-80 °c. After cooling to 30-40 0C there are added 35 I of polyethylene glycol and the mixture is stirred well. Then there is added a solution of 1750 grams of sodium saccharin in 2.5 I of purified water and while stirring there are added 2.5 I of cocoa flavor and polyethylene glycol q.s. to a volume of 50 I, providing an oral drop solution comprising 10 mg/ml of a.i. The resulting solution is filled into suitable containers.
Example D.2 : oral solution 9 Grams of methyl 4-hydroxybenzoate and 1 gram of propyl 4-hydroxybenzoate are dissolved in 4 I of boiling purified water. In 3 I of this solution are dissolved first 10 grams of 2,3-dihydroxybutanedioic acid and thereafter 20 grams of the a.i. The latter solution is combined with the remaining part of the former solution and 12 I 1 ,2,3- propanetriol and 3 I of sorbitol 70 % solution are added thereto. 40 Grams of sodium saccharin are dissolved in 0.5 I of water and 2 ml of raspberry and 2 ml of gooseberry essence are added. The latter solution is combined with the former, water is added q.s. to a volume of 20 I providing an oral solution comprising 5 mg of the active ingredient per teaspoonful (5 ml). The resulting solution is filled in suitable containers.
Example D.3 : film-coated tablets Preparation of .tabjet.core
A mixture of 100 grams of the a.i., 570 grams lactose and 200 grams starch is mixed well and thereafter humidified with a solution of 5 grams sodium dodecyl sulfate and 10 grams polyvinylpyrrolidone in about 200 ml of water. The wet powder mixture is sieved, dried and sieved again. Then there is added 100 grams microcrystalline cellulose and 15 grams hydrogenated vegetable oil. The whole is mixed well and compressed into tablets, giving 10,000 tablets, each containing 10 mg of the active ingredient. Co.atj.ng
To a solution of 10 grams methyl cellulose in 75 ml of denaturated ethanol there is added a solution of 5 grams of ethyl cellulose in 150 ml of dichloromethane. Then there are added 75 ml of dichloromethane and 2.5 ml 1 ,2,3-propanetriol. 10 grams of poly- ethylene glycol is molten and dissolved in 75 ml of dichloromethane. The latter solution is added to the former and then there are added 2.5 grams of magnesium octa- decanoate, 5 grams of polyvinylpyrrolidone and 30 ml of concentrated color suspension and the whole is homogenated. The tablet cores are coated with the thus obtained mixture in a coating apparatus. Example D.4 : injectable solution
1.8 grams methyl 4-hydroxybenzoate and 0.2 grams propyl 4-hydroxybenzoate are dissolved in about 0.5 I of boiling water for injection. After cooling to about 50 0C there are added while stirring 4 grams lactic acid, 0.05 grams propylene glycol and 4 grams of the a. L The solution is cooled to room temperature and supplemented with water for injection q.s. ad 1 I, giving a solution comprising 4 mg/ml of a. L The solution is sterilized by filtration and filled in sterile containers.
E. Physico-chemical data
General procedure The HPLC gradient was supplied by a HP 1100 from Agilent Technologies comprising a pump (quaternary or binary) with degasser, an autosampler, a column oven (set at 40 0C), a diode-array detector (DAD) and a column as specified in the respective methods below. Flow from the column was split to a MS detector. The MS detector was configured with an electrospray ionization source. Nitrogen was used as the nebulizer gas. The source temperature was maintained at 140 0C. Data acquisition was performed with MassLynx-Openlynx software. E.1 LCMS - PROCEDURE 1
In addition to the general procedure: Reversed phase HPLC was carried out on an XDB-C18 cartridge (3.5 μm, 4.6 x 30 mm) from Agilent, with a flow rate of 1 ml/min. The gradient conditions used are: 80 % A (0.5 g/l ammonium acetate solution), 10 % B (acetonitrile), 10 % C (methanol) to 50 % B and 50 % C in 6.0 minutes, to 100 % B at 6.5 minutes, kept till 7.0 minutes and equilibrated to initial conditions at 7.6 minutes until 9.0 minutes. Injection volume 5 μl. High-resolution mass spectra (Time of Flight, TOF) were acquired by scanning from 100 to 750 in 1.0 second using a dwell time of 1.0 second. The capillary needle voltage was 2.5 kV for positive ionization mode and 2.9 kV for negative ionization mode. The cone voltage was 20 V for both positive and negative ionization modes. Leucine-enkephaline was the standard substance used for the lock mass calibration.
E.2 LCMS - PROCEDURE 2
In addition to the general procedure: Reversed phase HPLC was carried out on an XDB-C18 cartridge (3.5 μm, 4.6 x 30 mm) from Agilent, with a flow rate of 1 ml/min. The gradient conditions used are: 80 % A (0.5 g/l ammonium acetate solution), 10 % B (acetonitrile), 10 % C (methanol) to 50 % B and 50 % C in 6.0 minutes, to 100 % B at 6.5 minutes, kept till 7.0 minutes and equilibrated to initial conditions at 7.6 minutes until 9.0 minutes. Injection volume 5 μl. High-resolution mass spectra (Time of Flight, TOF) were acquired only in positive ionization mode by scanning from 100 to 750 in 0.5 seconds using a dwell time of 0.1 seconds. The capillary needle voltage was 2.5 kV and the cone voltage was 20 V. Leucine-enkephaline was the standard substance used for the lock mass calibration.
Table 13: Analytical data
Figure imgf000061_0001
Figure imgf000062_0001
Figure imgf000063_0001
Figure imgf000064_0001

Claims

1. Compound according to the general Formula (I)
Figure imgf000065_0001
a pharmaceutically acceptable acid or base addition salt thereof, an Λ/-oxide form thereof or a quaternary ammonium salt thereof, wherein :
A1, A2 are each, independently from each other, a nitrogen or a carbon-atom; with the provision that A1 and A2 are not simultaneously a carbon atom;
Z1, Z2 are each, independently from each other, a covalent bond or N-R4 ; wherein R4 is selected from the group of hydrogen, (Ci-3)alkyl, aryl and aryl-(Ci-3)alkyl ; n is an integer equal to zero, 1 , 2 or 3 ;
R5 is selected from the group of hydrogen and halo ;
P is a radical selected from the group of phenyl, biphenyl, 1 ,1-diphenylmethyl and benzyloxyphenyl ;
X2 is a covalent bond, a saturated or an unsaturated (Ci-8)-hydrocarbon radical, wherein one or more bivalent -CH2-units may optionally be replaced by a respective bivalent phenyl-unit ; and wherein one or more hydrogen atoms may be replaced by a radical selected from the group of oxo ; (Ci-3)alkyloxy ; halo ; cyano ; nitro ; formyl ; hydroxy ; amino ; trifluoromethyl ; mono- and di((Ci-3)alkyl)amino ; carboxyl ; and thio ; Q2 is a radical selected from the group of hydrogen ; -NR1R2 ; Pir ; -OR3a ;
SR3b ; SO2R3c ; aryl ; and Het; wherein two radicals -OR3a may be taken together to form a bivalent radical -O-(CH2)S-O- wherein s is an integer equal to 1 , 2 or 3 ;
R1 and R2 are each, independently from each other, a radical selected from the group of hydrogen ; alkyl ; alkenyl ; alkynyl ; aryl ; arylalkyl ; di- arylalkyl ; alkylcarbonyl ; alkylcarbonylalkyl ; alkenylcarbonyl ; alkyloxy ; alkyloxyalkyl ; alkyloxycarbonyl ; alkyloxyalkylcarbonyl; alkyloxycarbonylalkyl ; alkyloxycarbonylalkylcarbonyl; alkylsulfonyl ; arylsulfonyl ; arylalkylsulfonyl ; arylalkenylsulfonyl ; Het-sulfonyl ; arylcarbonyl ; aryloxyalkyl ; arylalkylcarbonyl ; Het ; Het-alkyl ; Het- alkylcarbonyl ; Het-carbonyl ; Het-carbonylalkyl ; alkyl-NRaRb ; car- bonyl-NRaRb ; carbonylalkyl-NRaRb ; alkylcarbonyl-NRaRb ; and al- kylcarbonylalkyl-NRaRb ; wherein Ra and Rb are each independently selected from the group of hydrogen, alkyl, alkylcarbonyl, al- kyloxyalkyl, alkyloxycarbonylalkyl, aryl, arylalkyl, Het and alkyl- NRcRd, wherein Rc and Rd are each independently from each other hydrogen or alkyl ;
Pir is a radical containing at least one N, by which it is attached to the
X2-radical, selected from the group of pyrrolidinyl ; imidazolidinyl ; pyrazolid- inyl; piperidinyl ; piperazinyl ; pyrrolyl ; pyrrolinyl ; imidazolinyl ; pyrrazolinyl
; pyrrolyl ; imidazolyl ; pyrazolyl ; triazolyl ; azepyl ; diazepyl; morpholinyl ; thiomorpholinyl ; indolyl ; isoindolyl; indolinyl ; indazolyl ; benzimidazolyl ; and 1 ,2,3,4-tetrahydro-isoquinolinyl ; wherein each Pir-radical is optionally substituted by 1 , 2 or 3 radicals selected from the group of hydroxy ; halo ; oxo ; (Ci-3)alkyl ; (d-3)alkenyl (d-3)alkyloxycarbonyl ; Het-carbonyl ;
(Ci-3)alkylamino ; trifluoromethyl ; phenyl(C0-3)alkyl ; pyrimidinyl ; pyrrolid- inyl ; and pyridinyloxy ;
R3a, R3b, R3c are each, independently from each other, a radical selected from the group of hydrogen ; alkyl ; trihaloalkyl ; aryl ; arylalkyl ; alkyloxyalkyl ; Het ; and Het-alkyl ;
Het is a heterocyclic radical selected from the group of pyrrolidinyl ; imida- zolidinyl ; pyrazolidinyl ; piperidinyl ; piperazinyl ; pyrrolyl ; pyrrolinyl ; imidazolinyl ; pyrrazolinyl ; pyrrolyl ; imidazolyl ; pyrazolyl ; triazolyl ; pyridinyl ; pyridazinyl ; pyrimidinyl ; pyrazinyl ; triazinyl ; azepyl ; diazepyl ; morpholinyl ; thiomorpholinyl ; indolyl ; isoindolyl ; indolinyl ; indazolyl ; benzimidazolyl ; 1 ,2,3,4-tetrahydro-isoquinolinyl ; furyl ; te- trahydropyranyl ; thienyl ; oxazolyl ; isoxazolyl ; thiazolyl ; thiadiazolyl ; isothiazolyl ; dioxolyl ; dithianyl ; tetrahydrofuryl ; tetrahydropyranyl ; oxadiazolyl ; quinolinyl ; isoquinolinyl ; quinoxalinyl ; benzoxazolyl ; benzisoxazolyl; benzothiazolyl; benzisothiazolyl ; benzofuranyl ; ben- zothienyl ; benzopiperidinyl ; benzomorpholinyl ; chromenyl ; and imi- dazo[1 ,2-a]pyridinyl ; wherein each Het-radical is optionally substituted by one or more radicals selected from the group of halo ; oxo ; (Ci-3)alkyl ; phenyl, optionally substituted with (d-3)alkyloxy ; (Ci-3)alkylcarbonyl ; (d-3)alkenylthio ; imidazolyl-(Ci-3)alkyl ; aryl(Ci-3)- alkyl and (Ci-3)alkyloxycarbonyl ; aryl is naphthyl or phenyl, each optionally substituted with 1 , 2 or 3 sub- stituents, each independently from each other, selected from the group of oxo ; (Ci-3)alkyl; (Ci-3)alkyloxy ; halo ; cyano ; nitro ; formyl ; ethanoyl ; hydroxy ; amino ; trifluoromethyl ; mono- and di((Ci-3)alkyl)amino ; mono- and di((Ci-3)alkylcarbonyl)amino ; car- boxyl; morpholinyl ; and thio ; alkyl is, unless otherwise indicated, a straight or branched saturated hydrocarbon radical having from 1 to 8 carbon atoms ; or is a cyclic saturated hydrocarbon radical having from 3 to 7 carbon atoms ; or is a cyclic saturated hydrocarbon radical having from 3 to 7 carbon atoms attached to a straight or branched saturated hydrocarbon radical having from 1 to 8 carbon atoms ; wherein each radical is optionally substituted on one or more carbon atoms with one or more radicals selected from the group of oxo ; (Ci-3)alkyloxy, halo ; cyano ; nitro ; formyl ; hydroxy ; amino ; carboxyl ; and thio ; alkenyl is an alkyl radical as defined above, further having one or more double bonds ; alkynyl is an alkyl radical as defined above, further having one or more triple bonds ; arylalkyl is an alkyl radical as defined above, further having one CH3-group replaced by phenyl ; and diarylalkyl is an alkyl radical as defined above, further having two CH3-groups replaced by phenyl.
2. Compound according to claim 1 , wherein the moiety — Z2— A1 A2-Z1-
is a bivalent radical of formula (ll-a), (ll-b), (ll-c) and (ll-d), as shown below.
Figure imgf000068_0001
(ll-a) (ll-b) (N-C) (ll-d)
3. Compound according to claim 2, characterized in that R4 is hydrogen or p- aminomethylbenzyl.
4. Compound according to any one of claims 1 to 3, characterized in that n is 1 , 2 or 3.
5. Compound according to any one of claims 1 to 4, characterized in that R5 is hydrogen.
6. Compound according to any one of claims 1 to 5, characterized in that P is phenyl.
7. Compound according to any one of claims 1 to 6, characterized in that X2 is se- lected from the group of a covalent bond, a d-hydrocarbon radical, a
C2-hydrocarbon radical, or a C3-hydrocarbon radical.
8. Compound according to any one of claims 1 to 7, characterized in that one bivalent -CH2-unit of the hydrocarbon radical X2 is replaced by a bivalent phenyl-unit ; or wherein two hydrogen atoms of the hydrocarbon radical X2 are replaced by an oxo-radical.
9. Compound according to any one of claims 1 to 8, characterized in that X2 is selected from the group of a covalent bond and any one of the radicals (aa), (ab), (ac), (ag), (am), (an), (aq), (as) and (be) as defined below:
-CH2- (aa) "" Y~Λ-y (be)
-CH2CH2- (ab)
-CH2CH2CH2- (ac)
-CH2CH=CH- (ag)
-C(=O)CH2- (am)
C(=O)CH2CH2- (an)
CH2C(=O)CH2- (aq) -CH2C(=O)C(CH3)2CH2- (as)
10. Compound according to any one of claims 1 to 9, characterized in that Q2 is a radical selected from the group of hydrogen ; -NR1R2 ; Pir ; -OR3a ; SR3b ; aryl ; and Het.
1 1. Compound according to any one of claims 1 to 10, characterized in that R1 and R2 are each, independently from each other, a radical selected from the group of hydrogen ; alkyl ; and alkyloxycarbonyl.
12. Compound according to any one of claims 1 to 10, characterized in that Pir is a radical containing at least one N, by which it is attached to the X2-radical, se- lected from the group of piperidinyl and isoindolyl ; wherein each Pir-radical is optionally substituted by 2 oxo-radicals.
13. Compound according to any one of claims 1 to 10, characterized in that R3a and R3b are each, independently from each other, an alkyl-radical.
14. Compound according to any one of claims 1 to 10, characterized in that Het is a heterocyclic radical selected from the group of pyridinyl ; furyl ; tetrahydropyranyl; thienyl ; oxadiazolyl ; and quinolinyl ; wherein each Het-radical is optionally substituted by one or more radicals selected from the group of halo and phenyl, optionally substituted with (d-3)alkyloxy.
15. Compound according to any one of claims 1 to 10, characterized in that aryl is naphthyl or phenyl, each optionally substituted with a substituent, selected from the group of (Ci-3)alkyl and halo.
16. Compound according to claim 1 , characterized in that :
A1, A2 are each, independently from each other, a nitrogen or a carbon-atom; with the provision that A1 and A2 are not simultaneously a carbon atom;
Z1, Z2 are each, independently from each other, a covalent bond or N-R4 ; wherein R4 is selected from the group of hydrogen and aryl-(Ci_3)alkyl ; n is an integer equal to zero, 1 , 2 or 3 ;
R5 is hydrogen ; P is a radical selected from the group of phenyl, biphenyl, 1 ,1 - diphenylmethyl and benzyloxyphenyl ; X2 is a bond, a saturated or an unsaturated (Ci-8)-hydrocarbon radical, wherein one or more bivalent -CH2-units may optionally be replaced by a respective bivalent phenyl-unit ; and/or wherein one or more hydrogen atoms may be replaced by an oxo-radical ; Q2 is a radical selected from the group of hydrogen ; -NR1R2 ; Pir ; -OR3a ;
SR3b ; aryl ; and Het;
R1 and R2 are each, independently from each other, a radical selected from the group of hydrogen ; alkyl ; and alkyloxycarbonyl ;
Pir is a radical containing at least one N, by which it is attached to the X2- radical, selected from the group of piperidinyl ; isoindolyl; wherein each Pir-radical is optionally substituted by 2 oxo-radicals ;
R3a, R3b, R3c are each, independently from each other, an alkyl-radical ;
Het is a heterocyclic radical selected from the group of pyridinyl ; furyl ; te- trahydropyranyl ; thienyl ; oxadiazolyl ; and quinolinyl ; wherein each Het-radical is optionally substituted by one or more radicals selected from the group of halo ; and phenyl, optionally substituted with (Ci-3)alkyloxy ; and aryl is naphthyl or phenyl, each optionally substituted with a substituent, each independently from each other, selected from the group of (Ci-3)alkyl and halo.
17. Compound according to any one of claims 1 to 16 for use as a medicine.
18. Pharmaceutical composition comprising a pharmaceutically acceptable carrier or diluent and, as active ingredient, a therapeutically effective amount of a compound according to any one of claims 1 to 16.
19. Pharmaceutical composition according to claim 18, characterized in that is comprises further one or more other compounds selected from the group of antidepressants, anxiolytics and antipsychotics.
20. Pharmaceutical composition according to any of of claims 18 and 19, characterized in that it is in a form suitable to be orally administered.
21 . Process for the preparation of a pharmaceutical composition as claimed in any one of claims 18 to 20, characterized in that a pharmaceutically acceptable carrier is intimately mixed with a therapeutically effective amount of a compound as claimed in any one of claims 1 to 16.
22. Process for the preparation of a pharmaceutical composition as claimed in any one of claims 18 to 20, characterized in that a pharmaceutically acceptable carrier is intimately mixed with a therapeutically effective amount of a compound as claimed in any one of claims 1 to 16 and one or more other compounds selected from the group of antidepressants, anxiolytics and antipsychotics.
23. Use of a compound according to any one of claims 1 to 16 for the preparation of a medicament for the prevention and/or treatment of diseases where antagonism of the (^-adrenergic receptor, in particular antagonism of the (^-adrenergic receptor is of therapeutic use.
24. Use of a compound according to any one of claims 1 to 16 for the preparation of a medicament for the prevention and/or treatment of central nervous system disorders, mood disorders, anxiety disorders, stress-related disorders associated with depression and/or anxiety, cognitive disorders, personality disorders, schizoaffective disorders, Parkinson's disease, dementia of the Alzheimer's type, chronic pain conditions, neurodegenerative diseases, addiction disorders, mood disorders and sexual dysfunction.
25. Use of a compound according to any one of claims 1 to 16 in combination with one or more other compounds selected from the group of antidepressants, anxiolytics and antipsychotics for the preparation of a medicament for the prevention and/or treatment of central nervous system disorders, mood disorders, anxiety disorders, stress-related disorders associated with depression and/or anxiety, cognitive disorders, personality disorders, schizoaffective disorders, Parkinson's disease, dementia of the Alzheimer's type, chronic pain conditions, neurodegenerative diseases, addiction disorders, mood disorders and sexual dysfunction.
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MX2009003849A (en) 2009-04-23
RU2009117653A (en) 2010-11-20
IL198072A0 (en) 2009-12-24
AU2007306382A1 (en) 2008-04-17

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