WO2011091418A1 - Screening method for adverse side effects of a therapeutic pharmaceutical drug - Google Patents
Screening method for adverse side effects of a therapeutic pharmaceutical drug Download PDFInfo
- Publication number
- WO2011091418A1 WO2011091418A1 PCT/US2011/022407 US2011022407W WO2011091418A1 WO 2011091418 A1 WO2011091418 A1 WO 2011091418A1 US 2011022407 W US2011022407 W US 2011022407W WO 2011091418 A1 WO2011091418 A1 WO 2011091418A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- subject
- drug
- brain
- neuronal
- control
- Prior art date
Links
- 229940079593 drug Drugs 0.000 title claims abstract description 245
- 238000000034 method Methods 0.000 title claims abstract description 127
- 230000000694 effects Effects 0.000 title claims description 45
- 238000012216 screening Methods 0.000 title claims description 11
- 230000001225 therapeutic effect Effects 0.000 title description 21
- 230000002411 adverse Effects 0.000 title description 11
- 238000012360 testing method Methods 0.000 claims abstract description 128
- 208000028017 Psychotic disease Diseases 0.000 claims abstract description 91
- 208000019901 Anxiety disease Diseases 0.000 claims abstract description 47
- 230000036506 anxiety Effects 0.000 claims abstract description 45
- 239000003814 drug Substances 0.000 claims description 160
- 230000001537 neural effect Effects 0.000 claims description 146
- 210000004556 brain Anatomy 0.000 claims description 142
- 230000002518 glial effect Effects 0.000 claims description 141
- 241001465754 Metazoa Species 0.000 claims description 73
- 238000003384 imaging method Methods 0.000 claims description 60
- 230000000338 anxiogenic effect Effects 0.000 claims description 58
- 238000013528 artificial neural network Methods 0.000 claims description 38
- 230000000994 depressogenic effect Effects 0.000 claims description 32
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 claims description 26
- 239000002131 composite material Substances 0.000 claims description 25
- 239000002249 anxiolytic agent Substances 0.000 claims description 24
- 208000035475 disorder Diseases 0.000 claims description 24
- 210000001103 thalamus Anatomy 0.000 claims description 23
- 238000002599 functional magnetic resonance imaging Methods 0.000 claims description 22
- 239000000935 antidepressant agent Substances 0.000 claims description 20
- 230000000561 anti-psychotic effect Effects 0.000 claims description 19
- 230000000949 anxiolytic effect Effects 0.000 claims description 19
- 229940049706 benzodiazepine Drugs 0.000 claims description 19
- 241000288906 Primates Species 0.000 claims description 18
- 241000283984 Rodentia Species 0.000 claims description 18
- 150000001557 benzodiazepines Chemical class 0.000 claims description 18
- ZPUCINDJVBIVPJ-LJISPDSOSA-N cocaine Chemical compound O([C@H]1C[C@@H]2CC[C@@H](N2C)[C@H]1C(=O)OC)C(=O)C1=CC=CC=C1 ZPUCINDJVBIVPJ-LJISPDSOSA-N 0.000 claims description 18
- 230000001965 increasing effect Effects 0.000 claims description 18
- 241000699666 Mus <mouse, genus> Species 0.000 claims description 17
- 230000001684 chronic effect Effects 0.000 claims description 17
- 230000001430 anti-depressive effect Effects 0.000 claims description 15
- SHXWCVYOXRDMCX-UHFFFAOYSA-N 3,4-methylenedioxymethamphetamine Chemical compound CNC(C)CC1=CC=C2OCOC2=C1 SHXWCVYOXRDMCX-UHFFFAOYSA-N 0.000 claims description 14
- 206010010144 Completed suicide Diseases 0.000 claims description 14
- -1 tricyclics Substances 0.000 claims description 13
- LFQSCWFLJHTTHZ-UHFFFAOYSA-N Ethanol Chemical compound CCO LFQSCWFLJHTTHZ-UHFFFAOYSA-N 0.000 claims description 12
- BLGXFZZNTVWLAY-CCZXDCJGSA-N Yohimbine Natural products C1=CC=C2C(CCN3C[C@@H]4CC[C@@H](O)[C@H]([C@H]4C[C@H]33)C(=O)OC)=C3NC2=C1 BLGXFZZNTVWLAY-CCZXDCJGSA-N 0.000 claims description 11
- BLGXFZZNTVWLAY-UHFFFAOYSA-N beta-Yohimbin Natural products C1=CC=C2C(CCN3CC4CCC(O)C(C4CC33)C(=O)OC)=C3NC2=C1 BLGXFZZNTVWLAY-UHFFFAOYSA-N 0.000 claims description 11
- 208000020016 psychiatric disease Diseases 0.000 claims description 11
- 241000894007 species Species 0.000 claims description 11
- 229960000317 yohimbine Drugs 0.000 claims description 11
- AADVZSXPNRLYLV-UHFFFAOYSA-N yohimbine carboxylic acid Natural products C1=CC=C2C(CCN3CC4CCC(C(C4CC33)C(O)=O)O)=C3NC2=C1 AADVZSXPNRLYLV-UHFFFAOYSA-N 0.000 claims description 11
- 230000001939 inductive effect Effects 0.000 claims description 10
- 229940125717 barbiturate Drugs 0.000 claims description 9
- 229960003920 cocaine Drugs 0.000 claims description 9
- VHFVKMTVMIZMIK-UHFFFAOYSA-N 1-(3-chlorophenyl)piperazine Chemical compound ClC1=CC=CC(N2CCNCC2)=C1 VHFVKMTVMIZMIK-UHFFFAOYSA-N 0.000 claims description 8
- VMDUABMKBUKKPG-UHFFFAOYSA-N 4-methyl-5-propan-2-yloxy-9H-pyrido[3,4-b]indole-3-carboxylic acid ethyl ester Chemical compound C1=CC(OC(C)C)=C2C3=C(C)C(C(=O)OCC)=NC=C3NC2=C1 VMDUABMKBUKKPG-UHFFFAOYSA-N 0.000 claims description 8
- QMCOPDWHWYSJSA-UHFFFAOYSA-N N-methyl-9H-pyrido[3,4-b]indole-3-carboxamide Chemical compound N1C2=CC=CC=C2C2=C1C=NC(C(=O)NC)=C2 QMCOPDWHWYSJSA-UHFFFAOYSA-N 0.000 claims description 8
- 229960004046 apomorphine Drugs 0.000 claims description 8
- VMWNQDUVQKEIOC-CYBMUJFWSA-N apomorphine Chemical compound C([C@H]1N(C)CC2)C3=CC=C(O)C(O)=C3C3=C1C2=CC=C3 VMWNQDUVQKEIOC-CYBMUJFWSA-N 0.000 claims description 8
- QWCRAEMEVRGPNT-UHFFFAOYSA-N buspirone Chemical compound C1C(=O)N(CCCCN2CCN(CC2)C=2N=CC=CN=2)C(=O)CC21CCCC2 QWCRAEMEVRGPNT-UHFFFAOYSA-N 0.000 claims description 8
- GADIKQPUNWAMEB-UHFFFAOYSA-N methyl 4-ethyl-6,7-dimethoxy-9H-pyrido[5,4-b]indole-3-carboxylate Chemical compound N1C2=CC(OC)=C(OC)C=C2C2=C1C=NC(C(=O)OC)=C2CC GADIKQPUNWAMEB-UHFFFAOYSA-N 0.000 claims description 8
- 229940005483 opioid analgesics Drugs 0.000 claims description 8
- 239000003196 psychodysleptic agent Substances 0.000 claims description 8
- KWTSXDURSIMDCE-QMMMGPOBSA-N (S)-amphetamine Chemical compound C[C@H](N)CC1=CC=CC=C1 KWTSXDURSIMDCE-QMMMGPOBSA-N 0.000 claims description 7
- FIHPZNOGJDUSOO-UHFFFAOYSA-N 1-cyclohexyl-2-phenylpiperidine Chemical compound C1CCCCC1N1C(C=2C=CC=CC=2)CCCC1 FIHPZNOGJDUSOO-UHFFFAOYSA-N 0.000 claims description 7
- 229940025084 amphetamine Drugs 0.000 claims description 7
- 229960002495 buspirone Drugs 0.000 claims description 7
- 229960001252 methamphetamine Drugs 0.000 claims description 7
- MYWUZJCMWCOHBA-VIFPVBQESA-N methamphetamine Chemical compound CN[C@@H](C)CC1=CC=CC=C1 MYWUZJCMWCOHBA-VIFPVBQESA-N 0.000 claims description 7
- QZUDBNBUXVUHMW-UHFFFAOYSA-N clozapine Chemical compound C1CN(C)CCN1C1=NC2=CC(Cl)=CC=C2NC2=CC=CC=C12 QZUDBNBUXVUHMW-UHFFFAOYSA-N 0.000 claims description 6
- LNEPOXFFQSENCJ-UHFFFAOYSA-N haloperidol Chemical compound C1CC(O)(C=2C=CC(Cl)=CC=2)CCN1CCCC(=O)C1=CC=C(F)C=C1 LNEPOXFFQSENCJ-UHFFFAOYSA-N 0.000 claims description 6
- 229940005529 antipsychotics Drugs 0.000 claims description 5
- 210000001320 hippocampus Anatomy 0.000 claims description 5
- 230000001936 parietal effect Effects 0.000 claims description 5
- ZPEIMTDSQAKGNT-UHFFFAOYSA-N chlorpromazine Chemical compound C1=C(Cl)C=C2N(CCCN(C)C)C3=CC=CC=C3SC2=C1 ZPEIMTDSQAKGNT-UHFFFAOYSA-N 0.000 claims description 4
- 229960004170 clozapine Drugs 0.000 claims description 4
- 210000001029 dorsal striatum Anatomy 0.000 claims description 4
- 230000001339 gustatory effect Effects 0.000 claims description 4
- ZQDWXGKKHFNSQK-UHFFFAOYSA-N hydroxyzine Chemical compound C1CN(CCOCCO)CCN1C(C=1C=CC(Cl)=CC=1)C1=CC=CC=C1 ZQDWXGKKHFNSQK-UHFFFAOYSA-N 0.000 claims description 4
- CEUORZQYGODEFX-UHFFFAOYSA-N Aripirazole Chemical compound ClC1=CC=CC(N2CCN(CCCCOC=3C=C4NC(=O)CCC4=CC=3)CC2)=C1Cl CEUORZQYGODEFX-UHFFFAOYSA-N 0.000 claims description 3
- 229960001076 chlorpromazine Drugs 0.000 claims description 3
- 229960000930 hydroxyzine Drugs 0.000 claims description 3
- 210000002970 posterior hypothalamus Anatomy 0.000 claims description 3
- 210000004092 somatosensory cortex Anatomy 0.000 claims description 3
- 229960003878 haloperidol Drugs 0.000 claims description 2
- KVWDHTXUZHCGIO-UHFFFAOYSA-N olanzapine Chemical compound C1CN(C)CCN1C1=NC2=CC=CC=C2NC2=C1C=C(C)S2 KVWDHTXUZHCGIO-UHFFFAOYSA-N 0.000 claims description 2
- 238000007670 refining Methods 0.000 claims description 2
- RAPZEAPATHNIPO-UHFFFAOYSA-N risperidone Chemical compound FC1=CC=C2C(C3CCN(CC3)CCC=3C(=O)N4CCCCC4=NC=3C)=NOC2=C1 RAPZEAPATHNIPO-UHFFFAOYSA-N 0.000 claims description 2
- BLGXFZZNTVWLAY-SCYLSFHTSA-N yohimbine Chemical compound C1=CC=C2C(CCN3C[C@@H]4CC[C@H](O)[C@@H]([C@H]4C[C@H]33)C(=O)OC)=C3NC2=C1 BLGXFZZNTVWLAY-SCYLSFHTSA-N 0.000 claims 4
- 229940123685 Monoamine oxidase inhibitor Drugs 0.000 claims 1
- 229960004372 aripiprazole Drugs 0.000 claims 1
- 239000002899 monoamine oxidase inhibitor Substances 0.000 claims 1
- 229960005017 olanzapine Drugs 0.000 claims 1
- 229960001534 risperidone Drugs 0.000 claims 1
- 239000012896 selective serotonin reuptake inhibitor Substances 0.000 claims 1
- 229940124834 selective serotonin reuptake inhibitor Drugs 0.000 claims 1
- 230000004913 activation Effects 0.000 description 41
- 241000700159 Rattus Species 0.000 description 31
- 230000033001 locomotion Effects 0.000 description 23
- 230000007177 brain activity Effects 0.000 description 22
- 238000011282 treatment Methods 0.000 description 21
- 230000008859 change Effects 0.000 description 20
- 230000037396 body weight Effects 0.000 description 18
- 150000001875 compounds Chemical class 0.000 description 18
- 239000000203 mixture Substances 0.000 description 17
- 208000024891 symptom Diseases 0.000 description 15
- 238000002347 injection Methods 0.000 description 11
- 239000007924 injection Substances 0.000 description 11
- 238000004458 analytical method Methods 0.000 description 10
- 229940005530 anxiolytics Drugs 0.000 description 9
- 230000008901 benefit Effects 0.000 description 9
- 230000003727 cerebral blood flow Effects 0.000 description 9
- 230000007423 decrease Effects 0.000 description 9
- AAOVKJBEBIDNHE-UHFFFAOYSA-N diazepam Chemical compound N=1CC(=O)N(C)C2=CC=C(Cl)C=C2C=1C1=CC=CC=C1 AAOVKJBEBIDNHE-UHFFFAOYSA-N 0.000 description 9
- 210000003128 head Anatomy 0.000 description 9
- 230000005291 magnetic effect Effects 0.000 description 9
- OMFXVFTZEKFJBZ-UHFFFAOYSA-N Corticosterone Natural products O=C1CCC2(C)C3C(O)CC(C)(C(CC4)C(=O)CO)C4C3CCC2=C1 OMFXVFTZEKFJBZ-UHFFFAOYSA-N 0.000 description 8
- OMFXVFTZEKFJBZ-HJTSIMOOSA-N corticosterone Chemical compound O=C1CC[C@]2(C)[C@H]3[C@@H](O)C[C@](C)([C@H](CC4)C(=O)CO)[C@@H]4[C@@H]3CCC2=C1 OMFXVFTZEKFJBZ-HJTSIMOOSA-N 0.000 description 8
- 238000002474 experimental method Methods 0.000 description 8
- 239000002547 new drug Substances 0.000 description 8
- 239000008194 pharmaceutical composition Substances 0.000 description 8
- 230000004044 response Effects 0.000 description 8
- 210000003462 vein Anatomy 0.000 description 8
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 8
- NIJJYAXOARWZEE-UHFFFAOYSA-N Valproic acid Chemical compound CCCC(C(O)=O)CCC NIJJYAXOARWZEE-UHFFFAOYSA-N 0.000 description 7
- 229940005513 antidepressants Drugs 0.000 description 7
- GQDDNDAYOVNZPG-SCYLSFHTSA-N yohimbine Chemical compound C1=CC=C[C]2C(CCN3C[C@@H]4CC[C@H](O)[C@@H]([C@H]4C[C@H]33)C(=O)OC)=C3N=C21 GQDDNDAYOVNZPG-SCYLSFHTSA-N 0.000 description 7
- CIWBSHSKHKDKBQ-JLAZNSOCSA-N Ascorbic acid Chemical compound OC[C@H](O)[C@H]1OC(=O)C(O)=C1O CIWBSHSKHKDKBQ-JLAZNSOCSA-N 0.000 description 6
- UGJMXCAKCUNAIE-UHFFFAOYSA-N Gabapentin Chemical compound OC(=O)CC1(CN)CCCCC1 UGJMXCAKCUNAIE-UHFFFAOYSA-N 0.000 description 6
- DNIAPMSPPWPWGF-UHFFFAOYSA-N Propylene glycol Chemical compound CC(O)CO DNIAPMSPPWPWGF-UHFFFAOYSA-N 0.000 description 6
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 description 6
- 238000000692 Student's t-test Methods 0.000 description 6
- 210000004369 blood Anatomy 0.000 description 6
- 239000008280 blood Substances 0.000 description 6
- 239000003795 chemical substances by application Substances 0.000 description 6
- 238000011670 long-evans rat Methods 0.000 description 6
- 239000000837 restrainer Substances 0.000 description 6
- 230000000638 stimulation Effects 0.000 description 6
- 238000012353 t test Methods 0.000 description 6
- CURLTUGMZLYLDI-UHFFFAOYSA-N Carbon dioxide Chemical compound O=C=O CURLTUGMZLYLDI-UHFFFAOYSA-N 0.000 description 5
- PEDCQBHIVMGVHV-UHFFFAOYSA-N Glycerine Chemical compound OCC(O)CO PEDCQBHIVMGVHV-UHFFFAOYSA-N 0.000 description 5
- 208000004547 Hallucinations Diseases 0.000 description 5
- 206010042458 Suicidal ideation Diseases 0.000 description 5
- 230000009471 action Effects 0.000 description 5
- 238000010171 animal model Methods 0.000 description 5
- 230000006399 behavior Effects 0.000 description 5
- 239000003937 drug carrier Substances 0.000 description 5
- 208000024714 major depressive disease Diseases 0.000 description 5
- 239000000463 material Substances 0.000 description 5
- 230000036651 mood Effects 0.000 description 5
- 229920001223 polyethylene glycol Polymers 0.000 description 5
- 239000000243 solution Substances 0.000 description 5
- WQZGKKKJIJFFOK-GASJEMHNSA-N Glucose Natural products OC[C@H]1OC(O)[C@H](O)[C@@H](O)[C@@H]1O WQZGKKKJIJFFOK-GASJEMHNSA-N 0.000 description 4
- DIWRORZWFLOCLC-UHFFFAOYSA-N Lorazepam Chemical compound C12=CC(Cl)=CC=C2NC(=O)C(O)N=C1C1=CC=CC=C1Cl DIWRORZWFLOCLC-UHFFFAOYSA-N 0.000 description 4
- 241000124008 Mammalia Species 0.000 description 4
- 229920001054 Poly(ethylene‐co‐vinyl acetate) Polymers 0.000 description 4
- 230000016571 aggressive behavior Effects 0.000 description 4
- 239000003242 anti bacterial agent Substances 0.000 description 4
- 239000000164 antipsychotic agent Substances 0.000 description 4
- WQZGKKKJIJFFOK-VFUOTHLCSA-N beta-D-glucose Chemical compound OC[C@H]1O[C@@H](O)[C@H](O)[C@@H](O)[C@@H]1O WQZGKKKJIJFFOK-VFUOTHLCSA-N 0.000 description 4
- 230000017531 blood circulation Effects 0.000 description 4
- RYYVLZVUVIJVGH-UHFFFAOYSA-N caffeine Chemical compound CN1C(=O)N(C)C(=O)C2=C1N=CN2C RYYVLZVUVIJVGH-UHFFFAOYSA-N 0.000 description 4
- 229910002092 carbon dioxide Inorganic materials 0.000 description 4
- 238000004113 cell culture Methods 0.000 description 4
- 239000002738 chelating agent Substances 0.000 description 4
- OROGSEYTTFOCAN-DNJOTXNNSA-N codeine Chemical compound C([C@H]1[C@H](N(CC[C@@]112)C)C3)=C[C@H](O)[C@@H]1OC1=C2C3=CC=C1OC OROGSEYTTFOCAN-DNJOTXNNSA-N 0.000 description 4
- 239000002872 contrast media Substances 0.000 description 4
- 238000012937 correction Methods 0.000 description 4
- 238000007405 data analysis Methods 0.000 description 4
- 230000003247 decreasing effect Effects 0.000 description 4
- 238000013461 design Methods 0.000 description 4
- 239000006185 dispersion Substances 0.000 description 4
- 208000024732 dysthymic disease Diseases 0.000 description 4
- 230000002996 emotional effect Effects 0.000 description 4
- 239000004615 ingredient Substances 0.000 description 4
- 238000002595 magnetic resonance imaging Methods 0.000 description 4
- 210000005171 mammalian brain Anatomy 0.000 description 4
- 238000005259 measurement Methods 0.000 description 4
- 230000002503 metabolic effect Effects 0.000 description 4
- 229920001200 poly(ethylene-vinyl acetate) Polymers 0.000 description 4
- 238000002600 positron emission tomography Methods 0.000 description 4
- 238000002360 preparation method Methods 0.000 description 4
- LOUPRKONTZGTKE-LHHVKLHASA-N quinidine Chemical compound C([C@H]([C@H](C1)C=C)C2)C[N@@]1[C@H]2[C@@H](O)C1=CC=NC2=CC=C(OC)C=C21 LOUPRKONTZGTKE-LHHVKLHASA-N 0.000 description 4
- 238000002603 single-photon emission computed tomography Methods 0.000 description 4
- 239000002904 solvent Substances 0.000 description 4
- ZFXYFBGIUFBOJW-UHFFFAOYSA-N theophylline Chemical compound O=C1N(C)C(=O)N(C)C2=C1NC=N2 ZFXYFBGIUFBOJW-UHFFFAOYSA-N 0.000 description 4
- 239000003981 vehicle Substances 0.000 description 4
- 229960004688 venlafaxine Drugs 0.000 description 4
- PNVNVHUZROJLTJ-UHFFFAOYSA-N venlafaxine Chemical compound C1=CC(OC)=CC=C1C(CN(C)C)C1(O)CCCCC1 PNVNVHUZROJLTJ-UHFFFAOYSA-N 0.000 description 4
- HDOZVRUNCMBHFH-UHFFFAOYSA-N zotepine Chemical compound CN(C)CCOC1=CC2=CC=CC=C2SC2=CC=C(Cl)C=C12 HDOZVRUNCMBHFH-UHFFFAOYSA-N 0.000 description 4
- WVDDGKGOMKODPV-UHFFFAOYSA-N Benzyl alcohol Chemical compound OCC1=CC=CC=C1 WVDDGKGOMKODPV-UHFFFAOYSA-N 0.000 description 3
- 206010012239 Delusion Diseases 0.000 description 3
- 208000020401 Depressive disease Diseases 0.000 description 3
- 108010010803 Gelatin Proteins 0.000 description 3
- 239000002202 Polyethylene glycol Substances 0.000 description 3
- HEMHJVSKTPXQMS-UHFFFAOYSA-M Sodium hydroxide Chemical compound [OH-].[Na+] HEMHJVSKTPXQMS-UHFFFAOYSA-M 0.000 description 3
- KLBQZWRITKRQQV-UHFFFAOYSA-N Thioridazine Chemical compound C12=CC(SC)=CC=C2SC2=CC=CC=C2N1CCC1CCCCN1C KLBQZWRITKRQQV-UHFFFAOYSA-N 0.000 description 3
- 238000010521 absorption reaction Methods 0.000 description 3
- VREFGVBLTWBCJP-UHFFFAOYSA-N alprazolam Chemical compound C12=CC(Cl)=CC=C2N2C(C)=NN=C2CN=C1C1=CC=CC=C1 VREFGVBLTWBCJP-UHFFFAOYSA-N 0.000 description 3
- 210000003484 anatomy Anatomy 0.000 description 3
- 238000013459 approach Methods 0.000 description 3
- 235000010323 ascorbic acid Nutrition 0.000 description 3
- 239000011668 ascorbic acid Substances 0.000 description 3
- 229960005070 ascorbic acid Drugs 0.000 description 3
- 229940072698 ativan Drugs 0.000 description 3
- ANTSCNMPPGJYLG-UHFFFAOYSA-N chlordiazepoxide Chemical compound O=N=1CC(NC)=NC2=CC=C(Cl)C=C2C=1C1=CC=CC=C1 ANTSCNMPPGJYLG-UHFFFAOYSA-N 0.000 description 3
- DGBIGWXXNGSACT-UHFFFAOYSA-N clonazepam Chemical compound C12=CC([N+](=O)[O-])=CC=C2NC(=O)CN=C1C1=CC=CC=C1Cl DGBIGWXXNGSACT-UHFFFAOYSA-N 0.000 description 3
- 229920001577 copolymer Polymers 0.000 description 3
- RHKZVMUBMXGOLL-UHFFFAOYSA-N cyclopentolate hydrochloride Chemical compound Cl.C1CCCC1(O)C(C(=O)OCCN(C)C)C1=CC=CC=C1 RHKZVMUBMXGOLL-UHFFFAOYSA-N 0.000 description 3
- 231100000868 delusion Toxicity 0.000 description 3
- 238000001514 detection method Methods 0.000 description 3
- 239000002612 dispersion medium Substances 0.000 description 3
- 239000002552 dosage form Substances 0.000 description 3
- 238000001647 drug administration Methods 0.000 description 3
- 238000009472 formulation Methods 0.000 description 3
- 229960002870 gabapentin Drugs 0.000 description 3
- 239000008273 gelatin Substances 0.000 description 3
- 229920000159 gelatin Polymers 0.000 description 3
- 235000019322 gelatine Nutrition 0.000 description 3
- 235000011852 gelatine desserts Nutrition 0.000 description 3
- 239000008103 glucose Substances 0.000 description 3
- 230000036541 health Effects 0.000 description 3
- 239000011159 matrix material Substances 0.000 description 3
- 230000004630 mental health Effects 0.000 description 3
- 210000004498 neuroglial cell Anatomy 0.000 description 3
- 238000002610 neuroimaging Methods 0.000 description 3
- 210000002569 neuron Anatomy 0.000 description 3
- 230000005298 paramagnetic effect Effects 0.000 description 3
- 239000000546 pharmaceutical excipient Substances 0.000 description 3
- 239000000843 powder Substances 0.000 description 3
- JZCPYUJPEARBJL-UHFFFAOYSA-N rimonabant Chemical compound CC=1C(C(=O)NN2CCCCC2)=NN(C=2C(=CC(Cl)=CC=2)Cl)C=1C1=CC=C(Cl)C=C1 JZCPYUJPEARBJL-UHFFFAOYSA-N 0.000 description 3
- 229960003015 rimonabant Drugs 0.000 description 3
- 201000000980 schizophrenia Diseases 0.000 description 3
- 230000001953 sensory effect Effects 0.000 description 3
- 239000011780 sodium chloride Substances 0.000 description 3
- 238000007920 subcutaneous administration Methods 0.000 description 3
- 229940072690 valium Drugs 0.000 description 3
- 229960004496 zotepine Drugs 0.000 description 3
- WFPIAZLQTJBIFN-DVZOWYKESA-N zuclopenthixol Chemical compound C1CN(CCO)CCN1CC\C=C\1C2=CC(Cl)=CC=C2SC2=CC=CC=C2/1 WFPIAZLQTJBIFN-DVZOWYKESA-N 0.000 description 3
- YKFCISHFRZHKHY-NGQGLHOPSA-N (2s)-2-amino-3-(3,4-dihydroxyphenyl)-2-methylpropanoic acid;trihydrate Chemical compound O.O.O.OC(=O)[C@](N)(C)CC1=CC=C(O)C(O)=C1.OC(=O)[C@](N)(C)CC1=CC=C(O)C(O)=C1 YKFCISHFRZHKHY-NGQGLHOPSA-N 0.000 description 2
- PYHRZPFZZDCOPH-QXGOIDDHSA-N (S)-amphetamine sulfate Chemical compound [H+].[H+].[O-]S([O-])(=O)=O.C[C@H](N)CC1=CC=CC=C1.C[C@H](N)CC1=CC=CC=C1 PYHRZPFZZDCOPH-QXGOIDDHSA-N 0.000 description 2
- SOFQDLYSFOWTJX-UHFFFAOYSA-N 1-phenylpropan-2-amine;sulfuric acid Chemical compound OS(O)(=O)=O.CC(N)CC1=CC=CC=C1 SOFQDLYSFOWTJX-UHFFFAOYSA-N 0.000 description 2
- FUFLCEKSBBHCMO-UHFFFAOYSA-N 11-dehydrocorticosterone Natural products O=C1CCC2(C)C3C(=O)CC(C)(C(CC4)C(=O)CO)C4C3CCC2=C1 FUFLCEKSBBHCMO-UHFFFAOYSA-N 0.000 description 2
- MFYSYFVPBJMHGN-ZPOLXVRWSA-N Cortisone Chemical compound O=C1CC[C@]2(C)[C@H]3C(=O)C[C@](C)([C@@](CC4)(O)C(=O)CO)[C@@H]4[C@@H]3CCC2=C1 MFYSYFVPBJMHGN-ZPOLXVRWSA-N 0.000 description 2
- MFYSYFVPBJMHGN-UHFFFAOYSA-N Cortisone Natural products O=C1CCC2(C)C3C(=O)CC(C)(C(CC4)(O)C(=O)CO)C4C3CCC2=C1 MFYSYFVPBJMHGN-UHFFFAOYSA-N 0.000 description 2
- DYDCUQKUCUHJBH-UWTATZPHSA-N D-Cycloserine Chemical compound N[C@@H]1CONC1=O DYDCUQKUCUHJBH-UWTATZPHSA-N 0.000 description 2
- FBPFZTCFMRRESA-FSIIMWSLSA-N D-Glucitol Natural products OC[C@H](O)[C@H](O)[C@@H](O)[C@H](O)CO FBPFZTCFMRRESA-FSIIMWSLSA-N 0.000 description 2
- FBPFZTCFMRRESA-KVTDHHQDSA-N D-Mannitol Chemical compound OC[C@@H](O)[C@@H](O)[C@H](O)[C@H](O)CO FBPFZTCFMRRESA-KVTDHHQDSA-N 0.000 description 2
- FBPFZTCFMRRESA-JGWLITMVSA-N D-glucitol Chemical compound OC[C@H](O)[C@@H](O)[C@H](O)[C@H](O)CO FBPFZTCFMRRESA-JGWLITMVSA-N 0.000 description 2
- HCYAFALTSJYZDH-UHFFFAOYSA-N Desimpramine Chemical compound C1CC2=CC=CC=C2N(CCCNC)C2=CC=CC=C21 HCYAFALTSJYZDH-UHFFFAOYSA-N 0.000 description 2
- KCXVZYZYPLLWCC-UHFFFAOYSA-N EDTA Chemical compound OC(=O)CN(CC(O)=O)CCN(CC(O)=O)CC(O)=O KCXVZYZYPLLWCC-UHFFFAOYSA-N 0.000 description 2
- PLDUPXSUYLZYBN-UHFFFAOYSA-N Fluphenazine Chemical compound C1CN(CCO)CCN1CCCN1C2=CC(C(F)(F)F)=CC=C2SC2=CC=CC=C21 PLDUPXSUYLZYBN-UHFFFAOYSA-N 0.000 description 2
- AEMRFAOFKBGASW-UHFFFAOYSA-N Glycolic acid Chemical compound OCC(O)=O AEMRFAOFKBGASW-UHFFFAOYSA-N 0.000 description 2
- VEXZGXHMUGYJMC-UHFFFAOYSA-N Hydrochloric acid Chemical compound Cl VEXZGXHMUGYJMC-UHFFFAOYSA-N 0.000 description 2
- UQSXHKLRYXJYBZ-UHFFFAOYSA-N Iron oxide Chemical compound [Fe]=O UQSXHKLRYXJYBZ-UHFFFAOYSA-N 0.000 description 2
- 206010022998 Irritability Diseases 0.000 description 2
- LPHGQDQBBGAPDZ-UHFFFAOYSA-N Isocaffeine Natural products CN1C(=O)N(C)C(=O)C2=C1N(C)C=N2 LPHGQDQBBGAPDZ-UHFFFAOYSA-N 0.000 description 2
- PIWKPBJCKXDKJR-UHFFFAOYSA-N Isoflurane Chemical compound FC(F)OC(Cl)C(F)(F)F PIWKPBJCKXDKJR-UHFFFAOYSA-N 0.000 description 2
- PWWVAXIEGOYWEE-UHFFFAOYSA-N Isophenergan Chemical compound C1=CC=C2N(CC(C)N(C)C)C3=CC=CC=C3SC2=C1 PWWVAXIEGOYWEE-UHFFFAOYSA-N 0.000 description 2
- WTDRDQBEARUVNC-LURJTMIESA-N L-DOPA Chemical compound OC(=O)[C@@H](N)CC1=CC=C(O)C(O)=C1 WTDRDQBEARUVNC-LURJTMIESA-N 0.000 description 2
- WTDRDQBEARUVNC-UHFFFAOYSA-N L-Dopa Natural products OC(=O)C(N)CC1=CC=C(O)C(O)=C1 WTDRDQBEARUVNC-UHFFFAOYSA-N 0.000 description 2
- JVTAAEKCZFNVCJ-REOHCLBHSA-N L-lactic acid Chemical compound C[C@H](O)C(O)=O JVTAAEKCZFNVCJ-REOHCLBHSA-N 0.000 description 2
- 229930195725 Mannitol Natural products 0.000 description 2
- NPPQSCRMBWNHMW-UHFFFAOYSA-N Meprobamate Chemical compound NC(=O)OCC(C)(CCC)COC(N)=O NPPQSCRMBWNHMW-UHFFFAOYSA-N 0.000 description 2
- 208000019022 Mood disease Diseases 0.000 description 2
- 241000699670 Mus sp. Species 0.000 description 2
- BRUQQQPBMZOVGD-XFKAJCMBSA-N Oxycodone Chemical compound O=C([C@@H]1O2)CC[C@@]3(O)[C@H]4CC5=CC=C(OC)C2=C5[C@@]13CCN4C BRUQQQPBMZOVGD-XFKAJCMBSA-N 0.000 description 2
- 238000012879 PET imaging Methods 0.000 description 2
- 208000002193 Pain Diseases 0.000 description 2
- RGCVKNLCSQQDEP-UHFFFAOYSA-N Perphenazine Chemical compound C1CN(CCO)CCN1CCCN1C2=CC(Cl)=CC=C2SC2=CC=CC=C21 RGCVKNLCSQQDEP-UHFFFAOYSA-N 0.000 description 2
- ISWSIDIOOBJBQZ-UHFFFAOYSA-N Phenol Chemical compound OC1=CC=CC=C1 ISWSIDIOOBJBQZ-UHFFFAOYSA-N 0.000 description 2
- CXOFVDLJLONNDW-UHFFFAOYSA-N Phenytoin Chemical compound N1C(=O)NC(=O)C1(C=1C=CC=CC=1)C1=CC=CC=C1 CXOFVDLJLONNDW-UHFFFAOYSA-N 0.000 description 2
- 229920000954 Polyglycolide Polymers 0.000 description 2
- ZGUGWUXLJSTTMA-UHFFFAOYSA-N Promazinum Chemical compound C1=CC=C2N(CCCN(C)C)C3=CC=CC=C3SC2=C1 ZGUGWUXLJSTTMA-UHFFFAOYSA-N 0.000 description 2
- 208000001431 Psychomotor Agitation Diseases 0.000 description 2
- 206010038743 Restlessness Diseases 0.000 description 2
- GIIZNNXWQWCKIB-UHFFFAOYSA-N Serevent Chemical compound C1=C(O)C(CO)=CC(C(O)CNCCCCCCOCCCCC=2C=CC=CC=2)=C1 GIIZNNXWQWCKIB-UHFFFAOYSA-N 0.000 description 2
- 208000013738 Sleep Initiation and Maintenance disease Diseases 0.000 description 2
- CZMRCDWAGMRECN-UGDNZRGBSA-N Sucrose Chemical compound O[C@H]1[C@H](O)[C@@H](CO)O[C@@]1(CO)O[C@@H]1[C@H](O)[C@@H](O)[C@H](O)[C@@H](CO)O1 CZMRCDWAGMRECN-UGDNZRGBSA-N 0.000 description 2
- 229930006000 Sucrose Natural products 0.000 description 2
- QJJXYPPXXYFBGM-LFZNUXCKSA-N Tacrolimus Chemical compound C1C[C@@H](O)[C@H](OC)C[C@@H]1\C=C(/C)[C@@H]1[C@H](C)[C@@H](O)CC(=O)[C@H](CC=C)/C=C(C)/C[C@H](C)C[C@H](OC)[C@H]([C@H](C[C@H]2C)OC)O[C@@]2(O)C(=O)C(=O)N2CCCC[C@H]2C(=O)O1 QJJXYPPXXYFBGM-LFZNUXCKSA-N 0.000 description 2
- 206010043118 Tardive Dyskinesia Diseases 0.000 description 2
- QHMBSVQNZZTUGM-UHFFFAOYSA-N Trans-Cannabidiol Natural products OC1=CC(CCCCC)=CC(O)=C1C1C(C(C)=C)CCC(C)=C1 QHMBSVQNZZTUGM-UHFFFAOYSA-N 0.000 description 2
- WPVFJKSGQUFQAP-GKAPJAKFSA-N Valcyte Chemical compound N1C(N)=NC(=O)C2=C1N(COC(CO)COC(=O)[C@@H](N)C(C)C)C=N2 WPVFJKSGQUFQAP-GKAPJAKFSA-N 0.000 description 2
- 239000002253 acid Substances 0.000 description 2
- 230000001154 acute effect Effects 0.000 description 2
- NDAUXUAQIAJITI-UHFFFAOYSA-N albuterol Chemical compound CC(C)(C)NCC(O)C1=CC=C(O)C(CO)=C1 NDAUXUAQIAJITI-UHFFFAOYSA-N 0.000 description 2
- 150000001413 amino acids Chemical class 0.000 description 2
- 229960003036 amisulpride Drugs 0.000 description 2
- NTJOBXMMWNYJFB-UHFFFAOYSA-N amisulpride Chemical compound CCN1CCCC1CNC(=O)C1=CC(S(=O)(=O)CC)=C(N)C=C1OC NTJOBXMMWNYJFB-UHFFFAOYSA-N 0.000 description 2
- 229960000836 amitriptyline Drugs 0.000 description 2
- KRMDCWKBEZIMAB-UHFFFAOYSA-N amitriptyline Chemical compound C1CC2=CC=CC=C2C(=CCCN(C)C)C2=CC=CC=C21 KRMDCWKBEZIMAB-UHFFFAOYSA-N 0.000 description 2
- 210000004727 amygdala Anatomy 0.000 description 2
- 230000000844 anti-bacterial effect Effects 0.000 description 2
- 229940121375 antifungal agent Drugs 0.000 description 2
- 239000003429 antifungal agent Substances 0.000 description 2
- 239000003963 antioxidant agent Substances 0.000 description 2
- 235000006708 antioxidants Nutrition 0.000 description 2
- 230000006400 anxiety behaviour Effects 0.000 description 2
- 230000004596 appetite loss Effects 0.000 description 2
- 238000003556 assay Methods 0.000 description 2
- 208000006673 asthma Diseases 0.000 description 2
- QVGXLLKOCUKJST-UHFFFAOYSA-N atomic oxygen Chemical compound [O] QVGXLLKOCUKJST-UHFFFAOYSA-N 0.000 description 2
- 239000003693 atypical antipsychotic agent Substances 0.000 description 2
- 229940127236 atypical antipsychotics Drugs 0.000 description 2
- 238000009227 behaviour therapy Methods 0.000 description 2
- 230000003542 behavioural effect Effects 0.000 description 2
- 239000011230 binding agent Substances 0.000 description 2
- 230000036772 blood pressure Effects 0.000 description 2
- OZVBMTJYIDMWIL-AYFBDAFISA-N bromocriptine Chemical compound C1=CC(C=2[C@H](N(C)C[C@@H](C=2)C(=O)N[C@]2(C(=O)N3[C@H](C(N4CCC[C@H]4[C@]3(O)O2)=O)CC(C)C)C(C)C)C2)=C3C2=C(Br)NC3=C1 OZVBMTJYIDMWIL-AYFBDAFISA-N 0.000 description 2
- 229960001948 caffeine Drugs 0.000 description 2
- VJEONQKOZGKCAK-UHFFFAOYSA-N caffeine Natural products CN1C(=O)N(C)C(=O)C2=C1C=CN2C VJEONQKOZGKCAK-UHFFFAOYSA-N 0.000 description 2
- QHMBSVQNZZTUGM-ZWKOTPCHSA-N cannabidiol Chemical compound OC1=CC(CCCCC)=CC(O)=C1[C@H]1[C@H](C(C)=C)CCC(C)=C1 QHMBSVQNZZTUGM-ZWKOTPCHSA-N 0.000 description 2
- 229950011318 cannabidiol Drugs 0.000 description 2
- ZTGXAWYVTLUPDT-UHFFFAOYSA-N cannabidiol Natural products OC1=CC(CCCCC)=CC(O)=C1C1C(C(C)=C)CC=C(C)C1 ZTGXAWYVTLUPDT-UHFFFAOYSA-N 0.000 description 2
- 239000002775 capsule Substances 0.000 description 2
- 150000001720 carbohydrates Chemical class 0.000 description 2
- 235000014633 carbohydrates Nutrition 0.000 description 2
- 239000000969 carrier Substances 0.000 description 2
- 210000004027 cell Anatomy 0.000 description 2
- 229940083181 centrally acting adntiadrenergic agent methyldopa Drugs 0.000 description 2
- 230000002490 cerebral effect Effects 0.000 description 2
- 210000004720 cerebrum Anatomy 0.000 description 2
- OSASVXMJTNOKOY-UHFFFAOYSA-N chlorobutanol Chemical compound CC(C)(O)C(Cl)(Cl)Cl OSASVXMJTNOKOY-UHFFFAOYSA-N 0.000 description 2
- LOUPRKONTZGTKE-UHFFFAOYSA-N cinchonine Natural products C1C(C(C2)C=C)CCN2C1C(O)C1=CC=NC2=CC=C(OC)C=C21 LOUPRKONTZGTKE-UHFFFAOYSA-N 0.000 description 2
- NJMYODHXAKYRHW-DVZOWYKESA-N cis-flupenthixol Chemical compound C1CN(CCO)CCN1CC\C=C\1C2=CC(C(F)(F)F)=CC=C2SC2=CC=CC=C2/1 NJMYODHXAKYRHW-DVZOWYKESA-N 0.000 description 2
- 238000000576 coating method Methods 0.000 description 2
- 229960004126 codeine Drugs 0.000 description 2
- 239000003246 corticosteroid Substances 0.000 description 2
- 229960004544 cortisone Drugs 0.000 description 2
- 239000000850 decongestant Substances 0.000 description 2
- 229940124581 decongestants Drugs 0.000 description 2
- 229940075925 depakote Drugs 0.000 description 2
- 229960003914 desipramine Drugs 0.000 description 2
- 229960003957 dexamethasone Drugs 0.000 description 2
- UREBDLICKHMUKA-CXSFZGCWSA-N dexamethasone Chemical compound C1CC2=CC(=O)C=C[C@]2(C)[C@]2(F)[C@@H]1[C@@H]1C[C@@H](C)[C@@](C(=O)CO)(O)[C@@]1(C)C[C@@H]2O UREBDLICKHMUKA-CXSFZGCWSA-N 0.000 description 2
- 229940099242 dexedrine Drugs 0.000 description 2
- 229960003529 diazepam Drugs 0.000 description 2
- PCXRACLQFPRCBB-ZWKOTPCHSA-N dihydrocannabidiol Natural products OC1=CC(CCCCC)=CC(O)=C1[C@H]1[C@H](C(C)C)CCC(C)=C1 PCXRACLQFPRCBB-ZWKOTPCHSA-N 0.000 description 2
- HDRXZJPWHTXQRI-BHDTVMLSSA-N diltiazem hydrochloride Chemical compound [Cl-].C1=CC(OC)=CC=C1[C@H]1[C@@H](OC(C)=O)C(=O)N(CC[NH+](C)C)C2=CC=CC=C2S1 HDRXZJPWHTXQRI-BHDTVMLSSA-N 0.000 description 2
- LOKCTEFSRHRXRJ-UHFFFAOYSA-I dipotassium trisodium dihydrogen phosphate hydrogen phosphate dichloride Chemical compound P(=O)(O)(O)[O-].[K+].P(=O)(O)([O-])[O-].[Na+].[Na+].[Cl-].[K+].[Cl-].[Na+] LOKCTEFSRHRXRJ-UHFFFAOYSA-I 0.000 description 2
- 201000010099 disease Diseases 0.000 description 2
- 238000006073 displacement reaction Methods 0.000 description 2
- 238000009826 distribution Methods 0.000 description 2
- AUZONCFQVSMFAP-UHFFFAOYSA-N disulfiram Chemical compound CCN(CC)C(=S)SSC(=S)N(CC)CC AUZONCFQVSMFAP-UHFFFAOYSA-N 0.000 description 2
- 229960005426 doxepin Drugs 0.000 description 2
- ODQWQRRAPPTVAG-GZTJUZNOSA-N doxepin Chemical compound C1OC2=CC=CC=C2C(=C/CCN(C)C)/C2=CC=CC=C21 ODQWQRRAPPTVAG-GZTJUZNOSA-N 0.000 description 2
- 229960000394 droperidol Drugs 0.000 description 2
- RMEDXOLNCUSCGS-UHFFFAOYSA-N droperidol Chemical compound C1=CC(F)=CC=C1C(=O)CCCN1CC=C(N2C(NC3=CC=CC=C32)=O)CC1 RMEDXOLNCUSCGS-UHFFFAOYSA-N 0.000 description 2
- 238000007877 drug screening Methods 0.000 description 2
- 210000000613 ear canal Anatomy 0.000 description 2
- 210000005069 ears Anatomy 0.000 description 2
- 238000005516 engineering process Methods 0.000 description 2
- XRECTZIEBJDKEO-UHFFFAOYSA-N flucytosine Chemical compound NC1=NC(=O)NC=C1F XRECTZIEBJDKEO-UHFFFAOYSA-N 0.000 description 2
- 239000012530 fluid Substances 0.000 description 2
- 229960002419 flupentixol Drugs 0.000 description 2
- 230000005251 gamma ray Effects 0.000 description 2
- 239000000499 gel Substances 0.000 description 2
- 230000004914 glial activation Effects 0.000 description 2
- RWSXRVCMGQZWBV-WDSKDSINSA-N glutathione Chemical compound OC(=O)[C@@H](N)CCC(=O)N[C@@H](CS)C(=O)NCC(O)=O RWSXRVCMGQZWBV-WDSKDSINSA-N 0.000 description 2
- 235000011187 glycerol Nutrition 0.000 description 2
- 229940088597 hormone Drugs 0.000 description 2
- 239000005556 hormone Substances 0.000 description 2
- OROGSEYTTFOCAN-UHFFFAOYSA-N hydrocodone Natural products C1C(N(CCC234)C)C2C=CC(O)C3OC2=C4C1=CC=C2OC OROGSEYTTFOCAN-UHFFFAOYSA-N 0.000 description 2
- JUMYIBMBTDDLNG-OJERSXHUSA-N hydron;methyl (2r)-2-phenyl-2-[(2r)-piperidin-2-yl]acetate;chloride Chemical compound Cl.C([C@@H]1[C@H](C(=O)OC)C=2C=CC=CC=2)CCCN1 JUMYIBMBTDDLNG-OJERSXHUSA-N 0.000 description 2
- 210000003016 hypothalamus Anatomy 0.000 description 2
- 206010022437 insomnia Diseases 0.000 description 2
- 238000001990 intravenous administration Methods 0.000 description 2
- 229960002725 isoflurane Drugs 0.000 description 2
- 239000007951 isotonicity adjuster Substances 0.000 description 2
- 229940073092 klonopin Drugs 0.000 description 2
- JVTAAEKCZFNVCJ-UHFFFAOYSA-N lactic acid Chemical compound CC(O)C(O)=O JVTAAEKCZFNVCJ-UHFFFAOYSA-N 0.000 description 2
- 229960004502 levodopa Drugs 0.000 description 2
- 230000000670 limiting effect Effects 0.000 description 2
- 230000007774 longterm Effects 0.000 description 2
- HQKMJHAJHXVSDF-UHFFFAOYSA-L magnesium stearate Chemical compound [Mg+2].CCCCCCCCCCCCCCCCCC([O-])=O.CCCCCCCCCCCCCCCCCC([O-])=O HQKMJHAJHXVSDF-UHFFFAOYSA-L 0.000 description 2
- 239000000594 mannitol Substances 0.000 description 2
- 235000010355 mannitol Nutrition 0.000 description 2
- 239000003550 marker Substances 0.000 description 2
- 230000015654 memory Effects 0.000 description 2
- 229910021645 metal ion Inorganic materials 0.000 description 2
- OSWPMRLSEDHDFF-UHFFFAOYSA-N methyl salicylate Chemical compound COC(=O)C1=CC=CC=C1O OSWPMRLSEDHDFF-UHFFFAOYSA-N 0.000 description 2
- 244000005700 microbiome Species 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- BQJCRHHNABKAKU-KBQPJGBKSA-N morphine Chemical compound O([C@H]1[C@H](C=C[C@H]23)O)C4=C5[C@@]12CCN(C)[C@@H]3CC5=CC=C4O BQJCRHHNABKAKU-KBQPJGBKSA-N 0.000 description 2
- 230000008555 neuronal activation Effects 0.000 description 2
- 238000001208 nuclear magnetic resonance pulse sequence Methods 0.000 description 2
- 239000002674 ointment Substances 0.000 description 2
- 229940127234 oral contraceptive Drugs 0.000 description 2
- 239000003539 oral contraceptive agent Substances 0.000 description 2
- 239000001301 oxygen Substances 0.000 description 2
- 229910052760 oxygen Inorganic materials 0.000 description 2
- 230000002085 persistent effect Effects 0.000 description 2
- 230000000144 pharmacologic effect Effects 0.000 description 2
- 229960001802 phenylephrine Drugs 0.000 description 2
- SONNWYBIRXJNDC-VIFPVBQESA-N phenylephrine Chemical compound CNC[C@H](O)C1=CC=CC(O)=C1 SONNWYBIRXJNDC-VIFPVBQESA-N 0.000 description 2
- 229960002036 phenytoin Drugs 0.000 description 2
- 239000002953 phosphate buffered saline Substances 0.000 description 2
- 239000006187 pill Substances 0.000 description 2
- YVUQSNJEYSNKRX-UHFFFAOYSA-N pimozide Chemical compound C1=CC(F)=CC=C1C(C=1C=CC(F)=CC=1)CCCN1CCC(N2C(NC3=CC=CC=C32)=O)CC1 YVUQSNJEYSNKRX-UHFFFAOYSA-N 0.000 description 2
- 239000000902 placebo Substances 0.000 description 2
- 229940068196 placebo Drugs 0.000 description 2
- 229920003023 plastic Polymers 0.000 description 2
- 239000004033 plastic Substances 0.000 description 2
- 229920001610 polycaprolactone Polymers 0.000 description 2
- 239000004632 polycaprolactone Substances 0.000 description 2
- 229960004618 prednisone Drugs 0.000 description 2
- XOFYZVNMUHMLCC-ZPOLXVRWSA-N prednisone Chemical compound O=C1C=C[C@]2(C)[C@H]3C(=O)C[C@](C)([C@@](CC4)(O)C(=O)CO)[C@@H]4[C@@H]3CCC2=C1 XOFYZVNMUHMLCC-ZPOLXVRWSA-N 0.000 description 2
- 230000008569 process Effects 0.000 description 2
- 108090000765 processed proteins & peptides Proteins 0.000 description 2
- 230000002035 prolonged effect Effects 0.000 description 2
- 108090000623 proteins and genes Proteins 0.000 description 2
- 102000004169 proteins and genes Human genes 0.000 description 2
- 229960001404 quinidine Drugs 0.000 description 2
- 238000011160 research Methods 0.000 description 2
- 238000012827 research and development Methods 0.000 description 2
- 230000029058 respiratory gaseous exchange Effects 0.000 description 2
- 230000036387 respiratory rate Effects 0.000 description 2
- 229940099204 ritalin Drugs 0.000 description 2
- 229960002052 salbutamol Drugs 0.000 description 2
- 229960004017 salmeterol Drugs 0.000 description 2
- 239000000932 sedative agent Substances 0.000 description 2
- 239000000600 sorbitol Substances 0.000 description 2
- 230000002269 spontaneous effect Effects 0.000 description 2
- 150000003431 steroids Chemical class 0.000 description 2
- 239000005720 sucrose Substances 0.000 description 2
- 235000000346 sugar Nutrition 0.000 description 2
- 239000000725 suspension Substances 0.000 description 2
- 229960000278 theophylline Drugs 0.000 description 2
- 210000001685 thyroid gland Anatomy 0.000 description 2
- 210000001519 tissue Anatomy 0.000 description 2
- 238000004448 titration Methods 0.000 description 2
- 230000000699 topical effect Effects 0.000 description 2
- 231100000331 toxic Toxicity 0.000 description 2
- 230000002588 toxic effect Effects 0.000 description 2
- 230000009466 transformation Effects 0.000 description 2
- 238000013519 translation Methods 0.000 description 2
- ZEWQUBUPAILYHI-UHFFFAOYSA-N trifluoperazine Chemical compound C1CN(C)CCN1CCCN1C2=CC(C(F)(F)F)=CC=C2SC2=CC=CC=C21 ZEWQUBUPAILYHI-UHFFFAOYSA-N 0.000 description 2
- 229920002554 vinyl polymer Polymers 0.000 description 2
- 229940074158 xanax Drugs 0.000 description 2
- MVWVFYHBGMAFLY-UHFFFAOYSA-N ziprasidone Chemical compound C1=CC=C2C(N3CCN(CC3)CCC3=CC=4CC(=O)NC=4C=C3Cl)=NSC2=C1 MVWVFYHBGMAFLY-UHFFFAOYSA-N 0.000 description 2
- 229960004141 zuclopenthixol Drugs 0.000 description 2
- HDTRYLNUVZCQOY-UHFFFAOYSA-N α-D-glucopyranosyl-α-D-glucopyranoside Natural products OC1C(O)C(O)C(CO)OC1OC1C(O)C(O)C(O)C(CO)O1 HDTRYLNUVZCQOY-UHFFFAOYSA-N 0.000 description 1
- AHOUBRCZNHFOSL-YOEHRIQHSA-N (+)-Casbol Chemical compound C1=CC(F)=CC=C1[C@H]1[C@H](COC=2C=C3OCOC3=CC=2)CNCC1 AHOUBRCZNHFOSL-YOEHRIQHSA-N 0.000 description 1
- WWYNJERNGUHSAO-XUDSTZEESA-N (+)-Norgestrel Chemical compound O=C1CC[C@@H]2[C@H]3CC[C@](CC)([C@](CC4)(O)C#C)[C@@H]4[C@@H]3CCC2=C1 WWYNJERNGUHSAO-XUDSTZEESA-N 0.000 description 1
- DNXHEGUUPJUMQT-UHFFFAOYSA-N (+)-estrone Natural products OC1=CC=C2C3CCC(C)(C(CC4)=O)C4C3CCC2=C1 DNXHEGUUPJUMQT-UHFFFAOYSA-N 0.000 description 1
- IGLYMJRIWWIQQE-QUOODJBBSA-N (1S,2R)-2-phenylcyclopropan-1-amine (1R,2S)-2-phenylcyclopropan-1-amine Chemical compound N[C@H]1C[C@@H]1C1=CC=CC=C1.N[C@@H]1C[C@H]1C1=CC=CC=C1 IGLYMJRIWWIQQE-QUOODJBBSA-N 0.000 description 1
- KTGRHKOEFSJQNS-BDQAORGHSA-N (1s)-1-[3-(dimethylamino)propyl]-1-(4-fluorophenyl)-3h-2-benzofuran-5-carbonitrile;oxalic acid Chemical compound OC(=O)C(O)=O.C1([C@]2(C3=CC=C(C=C3CO2)C#N)CCCN(C)C)=CC=C(F)C=C1 KTGRHKOEFSJQNS-BDQAORGHSA-N 0.000 description 1
- IVTMXOXVAHXCHI-YXLMWLKOSA-N (2s)-2-amino-3-(3,4-dihydroxyphenyl)propanoic acid;(2s)-3-(3,4-dihydroxyphenyl)-2-hydrazinyl-2-methylpropanoic acid Chemical compound OC(=O)[C@@H](N)CC1=CC=C(O)C(O)=C1.NN[C@@](C(O)=O)(C)CC1=CC=C(O)C(O)=C1 IVTMXOXVAHXCHI-YXLMWLKOSA-N 0.000 description 1
- MKJIEFSOBYUXJB-HOCLYGCPSA-N (3S,11bS)-9,10-dimethoxy-3-isobutyl-1,3,4,6,7,11b-hexahydro-2H-pyrido[2,1-a]isoquinolin-2-one Chemical compound C1CN2C[C@H](CC(C)C)C(=O)C[C@H]2C2=C1C=C(OC)C(OC)=C2 MKJIEFSOBYUXJB-HOCLYGCPSA-N 0.000 description 1
- DIWRORZWFLOCLC-HNNXBMFYSA-N (3s)-7-chloro-5-(2-chlorophenyl)-3-hydroxy-1,3-dihydro-1,4-benzodiazepin-2-one Chemical compound N([C@H](C(NC1=CC=C(Cl)C=C11)=O)O)=C1C1=CC=CC=C1Cl DIWRORZWFLOCLC-HNNXBMFYSA-N 0.000 description 1
- WSEQXVZVJXJVFP-HXUWFJFHSA-N (R)-citalopram Chemical compound C1([C@@]2(C3=CC=C(C=C3CO2)C#N)CCCN(C)C)=CC=C(F)C=C1 WSEQXVZVJXJVFP-HXUWFJFHSA-N 0.000 description 1
- RTHCYVBBDHJXIQ-MRXNPFEDSA-N (R)-fluoxetine Chemical compound O([C@H](CCNC)C=1C=CC=CC=1)C1=CC=C(C(F)(F)F)C=C1 RTHCYVBBDHJXIQ-MRXNPFEDSA-N 0.000 description 1
- PMXMIIMHBWHSKN-LJQANCHMSA-N (R)-paliperidone Chemical compound FC1=CC=C2C(C3CCN(CC3)CCC=3C(=O)N4CCC[C@@H](O)C4=NC=3C)=NOC2=C1 PMXMIIMHBWHSKN-LJQANCHMSA-N 0.000 description 1
- VSWBSWWIRNCQIJ-GJZGRUSLSA-N (R,R)-asenapine Chemical compound O1C2=CC=CC=C2[C@@H]2CN(C)C[C@H]2C2=CC(Cl)=CC=C21 VSWBSWWIRNCQIJ-GJZGRUSLSA-N 0.000 description 1
- ZEUITGRIYCTCEM-KRWDZBQOSA-N (S)-duloxetine Chemical compound C1([C@@H](OC=2C3=CC=CC=C3C=CC=2)CCNC)=CC=CS1 ZEUITGRIYCTCEM-KRWDZBQOSA-N 0.000 description 1
- WSPOMRSOLSGNFJ-AUWJEWJLSA-N (Z)-chlorprothixene Chemical compound C1=C(Cl)C=C2C(=C/CCN(C)C)\C3=CC=CC=C3SC2=C1 WSPOMRSOLSGNFJ-AUWJEWJLSA-N 0.000 description 1
- BRIPGNJWPCKDQZ-WXXKFALUSA-N (e)-but-2-enedioic acid;1-[4-(2-methoxyethyl)phenoxy]-3-(propan-2-ylamino)propan-2-ol Chemical compound OC(=O)\C=C\C(O)=O.COCCC1=CC=C(OCC(O)CNC(C)C)C=C1.COCCC1=CC=C(OCC(O)CNC(C)C)C=C1 BRIPGNJWPCKDQZ-WXXKFALUSA-N 0.000 description 1
- IIZPXYDJLKNOIY-JXPKJXOSSA-N 1-palmitoyl-2-arachidonoyl-sn-glycero-3-phosphocholine Chemical compound CCCCCCCCCCCCCCCC(=O)OC[C@H](COP([O-])(=O)OCC[N+](C)(C)C)OC(=O)CCC\C=C/C\C=C/C\C=C/C\C=C/CCCCC IIZPXYDJLKNOIY-JXPKJXOSSA-N 0.000 description 1
- PXFBZOLANLWPMH-UHFFFAOYSA-N 16-Epiaffinine Natural products C1C(C2=CC=CC=C2N2)=C2C(=O)CC2C(=CC)CN(C)C1C2CO PXFBZOLANLWPMH-UHFFFAOYSA-N 0.000 description 1
- SVUOLADPCWQTTE-UHFFFAOYSA-N 1h-1,2-benzodiazepine Chemical compound N1N=CC=CC2=CC=CC=C12 SVUOLADPCWQTTE-UHFFFAOYSA-N 0.000 description 1
- SGTNSNPWRIOYBX-UHFFFAOYSA-N 2-(3,4-dimethoxyphenyl)-5-{[2-(3,4-dimethoxyphenyl)ethyl](methyl)amino}-2-(propan-2-yl)pentanenitrile Chemical compound C1=C(OC)C(OC)=CC=C1CCN(C)CCCC(C#N)(C(C)C)C1=CC=C(OC)C(OC)=C1 SGTNSNPWRIOYBX-UHFFFAOYSA-N 0.000 description 1
- INGWEZCOABYORO-UHFFFAOYSA-N 2-(furan-2-yl)-7-methyl-1h-1,8-naphthyridin-4-one Chemical compound N=1C2=NC(C)=CC=C2C(O)=CC=1C1=CC=CO1 INGWEZCOABYORO-UHFFFAOYSA-N 0.000 description 1
- ZPDFIIGFYAHNSK-CTHHTMFSSA-K 2-[4,10-bis(carboxylatomethyl)-7-[(2r,3s)-1,3,4-trihydroxybutan-2-yl]-1,4,7,10-tetrazacyclododec-1-yl]acetate;gadolinium(3+) Chemical compound [Gd+3].OC[C@@H](O)[C@@H](CO)N1CCN(CC([O-])=O)CCN(CC([O-])=O)CCN(CC([O-])=O)CC1 ZPDFIIGFYAHNSK-CTHHTMFSSA-K 0.000 description 1
- PCZHWPSNPWAQNF-LMOVPXPDSA-K 2-[[(2s)-2-[bis(carboxylatomethyl)amino]-3-(4-ethoxyphenyl)propyl]-[2-[bis(carboxylatomethyl)amino]ethyl]amino]acetate;gadolinium(3+);hydron Chemical compound [Gd+3].CCOC1=CC=C(C[C@@H](CN(CCN(CC(O)=O)CC([O-])=O)CC([O-])=O)N(CC(O)=O)CC([O-])=O)C=C1 PCZHWPSNPWAQNF-LMOVPXPDSA-K 0.000 description 1
- UZFPOOOQHWICKY-UHFFFAOYSA-N 3-[13-[1-[1-[8,12-bis(2-carboxyethyl)-17-(1-hydroxyethyl)-3,7,13,18-tetramethyl-21,24-dihydroporphyrin-2-yl]ethoxy]ethyl]-18-(2-carboxyethyl)-8-(1-hydroxyethyl)-3,7,12,17-tetramethyl-22,23-dihydroporphyrin-2-yl]propanoic acid Chemical compound N1C(C=C2C(=C(CCC(O)=O)C(C=C3C(=C(C)C(C=C4N5)=N3)CCC(O)=O)=N2)C)=C(C)C(C(C)O)=C1C=C5C(C)=C4C(C)OC(C)C1=C(N2)C=C(N3)C(C)=C(C(O)C)C3=CC(C(C)=C3CCC(O)=O)=NC3=CC(C(CCC(O)=O)=C3C)=NC3=CC2=C1C UZFPOOOQHWICKY-UHFFFAOYSA-N 0.000 description 1
- UIAGMCDKSXEBJQ-IBGZPJMESA-N 3-o-(2-methoxyethyl) 5-o-propan-2-yl (4s)-2,6-dimethyl-4-(3-nitrophenyl)-1,4-dihydropyridine-3,5-dicarboxylate Chemical compound COCCOC(=O)C1=C(C)NC(C)=C(C(=O)OC(C)C)[C@H]1C1=CC=CC([N+]([O-])=O)=C1 UIAGMCDKSXEBJQ-IBGZPJMESA-N 0.000 description 1
- 239000003148 4 aminobutyric acid receptor blocking agent Substances 0.000 description 1
- 239000003477 4 aminobutyric acid receptor stimulating agent Substances 0.000 description 1
- RZVAJINKPMORJF-UHFFFAOYSA-N Acetaminophen Chemical compound CC(=O)NC1=CC=C(O)C=C1 RZVAJINKPMORJF-UHFFFAOYSA-N 0.000 description 1
- 206010001497 Agitation Diseases 0.000 description 1
- 208000000884 Airway Obstruction Diseases 0.000 description 1
- 241000416162 Astragalus gummifer Species 0.000 description 1
- 244000187129 Bacopa monnieria Species 0.000 description 1
- 235000015418 Bacopa monnieria Nutrition 0.000 description 1
- 241000894006 Bacteria Species 0.000 description 1
- CYGODHVAJQTCBG-UHFFFAOYSA-N Bifeprunox Chemical compound C=12OC(=O)NC2=CC=CC=1N(CC1)CCN1CC(C=1)=CC=CC=1C1=CC=CC=C1 CYGODHVAJQTCBG-UHFFFAOYSA-N 0.000 description 1
- 208000020925 Bipolar disease Diseases 0.000 description 1
- 208000032841 Bulimia Diseases 0.000 description 1
- 206010006550 Bulimia nervosa Diseases 0.000 description 1
- 102000009135 CB2 Cannabinoid Receptor Human genes 0.000 description 1
- 108010073376 CB2 Cannabinoid Receptor Proteins 0.000 description 1
- 229940127291 Calcium channel antagonist Drugs 0.000 description 1
- 241000282465 Canis Species 0.000 description 1
- 244000025254 Cannabis sativa Species 0.000 description 1
- 235000012766 Cannabis sativa ssp. sativa var. sativa Nutrition 0.000 description 1
- 235000012765 Cannabis sativa ssp. sativa var. spontanea Nutrition 0.000 description 1
- 235000007866 Chamaemelum nobile Nutrition 0.000 description 1
- 241000050051 Chelone glabra Species 0.000 description 1
- 206010008479 Chest Pain Diseases 0.000 description 1
- 206010008589 Choking Diseases 0.000 description 1
- GDLIGKIOYRNHDA-UHFFFAOYSA-N Clomipramine Chemical compound C1CC2=CC=C(Cl)C=C2N(CCCN(C)C)C2=CC=CC=C21 GDLIGKIOYRNHDA-UHFFFAOYSA-N 0.000 description 1
- RYGMFSIKBFXOCR-UHFFFAOYSA-N Copper Chemical compound [Cu] RYGMFSIKBFXOCR-UHFFFAOYSA-N 0.000 description 1
- 229920002261 Corn starch Polymers 0.000 description 1
- 229920000858 Cyclodextrin Polymers 0.000 description 1
- DYDCUQKUCUHJBH-UHFFFAOYSA-N D-Cycloserine Natural products NC1CONC1=O DYDCUQKUCUHJBH-UHFFFAOYSA-N 0.000 description 1
- 206010011971 Decreased interest Diseases 0.000 description 1
- 208000024254 Delusional disease Diseases 0.000 description 1
- 206010012335 Dependence Diseases 0.000 description 1
- 206010012422 Derealisation Diseases 0.000 description 1
- 229920002307 Dextran Polymers 0.000 description 1
- 239000004375 Dextrin Substances 0.000 description 1
- 229920001353 Dextrin Polymers 0.000 description 1
- 208000000059 Dyspnea Diseases 0.000 description 1
- 206010013975 Dyspnoeas Diseases 0.000 description 1
- 241000792859 Enema Species 0.000 description 1
- 206010016275 Fear Diseases 0.000 description 1
- 241000233866 Fungi Species 0.000 description 1
- 229910052688 Gadolinium Inorganic materials 0.000 description 1
- 208000011688 Generalised anxiety disease Diseases 0.000 description 1
- 108010024636 Glutathione Proteins 0.000 description 1
- 229940121710 HMGCoA reductase inhibitor Drugs 0.000 description 1
- WYCLKVQLVUQKNZ-UHFFFAOYSA-N Halazepam Chemical compound N=1CC(=O)N(CC(F)(F)F)C2=CC=C(Cl)C=C2C=1C1=CC=CC=C1 WYCLKVQLVUQKNZ-UHFFFAOYSA-N 0.000 description 1
- 206010019196 Head injury Diseases 0.000 description 1
- 206010019233 Headaches Diseases 0.000 description 1
- 241000282412 Homo Species 0.000 description 1
- 208000033830 Hot Flashes Diseases 0.000 description 1
- 206010060800 Hot flush Diseases 0.000 description 1
- 208000008454 Hyperhidrosis Diseases 0.000 description 1
- 235000017309 Hypericum perforatum Nutrition 0.000 description 1
- 244000141009 Hypericum perforatum Species 0.000 description 1
- 206010020710 Hyperphagia Diseases 0.000 description 1
- 102000006992 Interferon-alpha Human genes 0.000 description 1
- 108010047761 Interferon-alpha Proteins 0.000 description 1
- SHGAZHPCJJPHSC-NUEINMDLSA-N Isotretinoin Chemical compound OC(=O)C=C(C)/C=C/C=C(C)C=CC1=C(C)CCCC1(C)C SHGAZHPCJJPHSC-NUEINMDLSA-N 0.000 description 1
- GUBGYTABKSRVRQ-QKKXKWKRSA-N Lactose Natural products OC[C@H]1O[C@@H](O[C@H]2[C@H](O)[C@@H](O)C(O)O[C@@H]2CO)[C@H](O)[C@@H](O)[C@H]1O GUBGYTABKSRVRQ-QKKXKWKRSA-N 0.000 description 1
- 206010024264 Lethargy Diseases 0.000 description 1
- NNJVILVZKWQKPM-UHFFFAOYSA-N Lidocaine Chemical compound CCN(CC)CC(=O)NC1=C(C)C=CC=C1C NNJVILVZKWQKPM-UHFFFAOYSA-N 0.000 description 1
- 239000005913 Maltodextrin Substances 0.000 description 1
- 229920002774 Maltodextrin Polymers 0.000 description 1
- 206010026749 Mania Diseases 0.000 description 1
- 244000042664 Matricaria chamomilla Species 0.000 description 1
- 235000007232 Matricaria chamomilla Nutrition 0.000 description 1
- 244000246386 Mentha pulegium Species 0.000 description 1
- 235000016257 Mentha pulegium Nutrition 0.000 description 1
- 235000004357 Mentha x piperita Nutrition 0.000 description 1
- XADCESSVHJOZHK-UHFFFAOYSA-N Meperidine Chemical compound C=1C=CC=CC=1C1(C(=O)OCC)CCN(C)CC1 XADCESSVHJOZHK-UHFFFAOYSA-N 0.000 description 1
- 241001601440 Mesembryanthemum tortuosum Species 0.000 description 1
- 235000019119 Mesembryanthemum tortuosum Nutrition 0.000 description 1
- AJXPJJZHWIXJCJ-UHFFFAOYSA-N Methsuximide Chemical compound O=C1N(C)C(=O)CC1(C)C1=CC=CC=C1 AJXPJJZHWIXJCJ-UHFFFAOYSA-N 0.000 description 1
- 229920000168 Microcrystalline cellulose Polymers 0.000 description 1
- 241000680659 Mitragyna speciosa Species 0.000 description 1
- 206010027940 Mood altered Diseases 0.000 description 1
- 208000007101 Muscle Cramp Diseases 0.000 description 1
- 206010049816 Muscle tightness Diseases 0.000 description 1
- QPCDCPDFJACHGM-UHFFFAOYSA-N N,N-bis{2-[bis(carboxymethyl)amino]ethyl}glycine Chemical compound OC(=O)CN(CC(O)=O)CCN(CC(=O)O)CCN(CC(O)=O)CC(O)=O QPCDCPDFJACHGM-UHFFFAOYSA-N 0.000 description 1
- JNNOSTQEZICQQP-UHFFFAOYSA-N N-desmethylclozapine Chemical compound N=1C2=CC(Cl)=CC=C2NC2=CC=CC=C2C=1N1CCNCC1 JNNOSTQEZICQQP-UHFFFAOYSA-N 0.000 description 1
- RTHCYVBBDHJXIQ-UHFFFAOYSA-N N-methyl-3-phenyl-3-[4-(trifluoromethyl)phenoxy]propan-1-amine Chemical compound C=1C=CC=CC=1C(CCNC)OC1=CC=C(C(F)(F)F)C=C1 RTHCYVBBDHJXIQ-UHFFFAOYSA-N 0.000 description 1
- 206010028813 Nausea Diseases 0.000 description 1
- 206010029216 Nervousness Diseases 0.000 description 1
- PHVGLTMQBUFIQQ-UHFFFAOYSA-N Nortryptiline Chemical compound C1CC2=CC=CC=C2C(=CCCNC)C2=CC=CC=C21 PHVGLTMQBUFIQQ-UHFFFAOYSA-N 0.000 description 1
- 235000002195 Nymphaea caerulea Nutrition 0.000 description 1
- 244000058734 Nymphaea stellata Species 0.000 description 1
- 235000016428 Nymphaea stellata Nutrition 0.000 description 1
- KYYIDSXMWOZKMP-UHFFFAOYSA-N O-desmethylvenlafaxine Chemical compound C1CCCCC1(O)C(CN(C)C)C1=CC=C(O)C=C1 KYYIDSXMWOZKMP-UHFFFAOYSA-N 0.000 description 1
- 241000283973 Oryctolagus cuniculus Species 0.000 description 1
- 108010064719 Oxyhemoglobins Proteins 0.000 description 1
- 229910019142 PO4 Inorganic materials 0.000 description 1
- 241000940835 Pales Species 0.000 description 1
- 206010033546 Pallor Diseases 0.000 description 1
- 206010033557 Palpitations Diseases 0.000 description 1
- 206010033864 Paranoia Diseases 0.000 description 1
- 208000027099 Paranoid disease Diseases 0.000 description 1
- AHOUBRCZNHFOSL-UHFFFAOYSA-N Paroxetine hydrochloride Natural products C1=CC(F)=CC=C1C1C(COC=2C=C3OCOC3=CC=2)CNCC1 AHOUBRCZNHFOSL-UHFFFAOYSA-N 0.000 description 1
- RMUCZJUITONUFY-UHFFFAOYSA-N Phenelzine Chemical compound NNCCC1=CC=CC=C1 RMUCZJUITONUFY-UHFFFAOYSA-N 0.000 description 1
- 235000016787 Piper methysticum Nutrition 0.000 description 1
- 240000005546 Piper methysticum Species 0.000 description 1
- 229920002732 Polyanhydride Polymers 0.000 description 1
- 206010062519 Poor quality sleep Diseases 0.000 description 1
- MWQCHHACWWAQLJ-UHFFFAOYSA-N Prazepam Chemical compound O=C1CN=C(C=2C=CC=CC=2)C2=CC(Cl)=CC=C2N1CC1CC1 MWQCHHACWWAQLJ-UHFFFAOYSA-N 0.000 description 1
- 206010037180 Psychiatric symptoms Diseases 0.000 description 1
- 206010037213 Psychomotor retardation Diseases 0.000 description 1
- 241000700157 Rattus norvegicus Species 0.000 description 1
- 240000002793 Salvia rutilans Species 0.000 description 1
- 235000011607 Salvia rutilans Nutrition 0.000 description 1
- 208000020186 Schizophreniform disease Diseases 0.000 description 1
- 102000007562 Serum Albumin Human genes 0.000 description 1
- 108010071390 Serum Albumin Proteins 0.000 description 1
- VYPSYNLAJGMNEJ-UHFFFAOYSA-N Silicium dioxide Chemical compound O=[Si]=O VYPSYNLAJGMNEJ-UHFFFAOYSA-N 0.000 description 1
- 206010041243 Social avoidant behaviour Diseases 0.000 description 1
- DWAQJAXMDSEUJJ-UHFFFAOYSA-M Sodium bisulfite Chemical compound [Na+].OS([O-])=O DWAQJAXMDSEUJJ-UHFFFAOYSA-M 0.000 description 1
- 229920002472 Starch Polymers 0.000 description 1
- 206010042464 Suicide attempt Diseases 0.000 description 1
- GUGOEEXESWIERI-UHFFFAOYSA-N Terfenadine Chemical compound C1=CC(C(C)(C)C)=CC=C1C(O)CCCN1CCC(C(O)(C=2C=CC=CC=2)C=2C=CC=CC=2)CC1 GUGOEEXESWIERI-UHFFFAOYSA-N 0.000 description 1
- GFBKORZTTCHDGY-UWVJOHFNSA-N Thiothixene Chemical compound C12=CC(S(=O)(=O)N(C)C)=CC=C2SC2=CC=CC=C2\C1=C\CCN1CCN(C)CC1 GFBKORZTTCHDGY-UWVJOHFNSA-N 0.000 description 1
- 229920001615 Tragacanth Polymers 0.000 description 1
- HDTRYLNUVZCQOY-WSWWMNSNSA-N Trehalose Natural products O[C@@H]1[C@@H](O)[C@@H](O)[C@@H](CO)O[C@@H]1O[C@@H]1[C@H](O)[C@@H](O)[C@@H](O)[C@@H](CO)O1 HDTRYLNUVZCQOY-WSWWMNSNSA-N 0.000 description 1
- 206010044565 Tremor Diseases 0.000 description 1
- 244000126014 Valeriana officinalis Species 0.000 description 1
- 235000013832 Valeriana officinalis Nutrition 0.000 description 1
- 208000021017 Weight Gain Diseases 0.000 description 1
- CXFKOLCMCRBYPL-UHFFFAOYSA-L [4-[[carboxymethyl-[2-[carboxymethyl-[[3-hydroxy-6-[[hydroxy(oxido)phosphoryl]oxymethyl]-2-methylpyridin-4-yl]methyl]amino]ethyl]amino]methyl]-5-hydroxy-6-methylpyridin-2-yl]methyl hydrogen phosphate;manganese(2+) Chemical compound [Mn+2].CC1=NC(COP(O)([O-])=O)=CC(CN(CCN(CC(O)=O)CC=2C(=C(C)N=C(COP(O)([O-])=O)C=2)O)CC(O)=O)=C1O CXFKOLCMCRBYPL-UHFFFAOYSA-L 0.000 description 1
- 206010000059 abdominal discomfort Diseases 0.000 description 1
- 229940056213 abilify Drugs 0.000 description 1
- 230000002159 abnormal effect Effects 0.000 description 1
- 239000003070 absorption delaying agent Substances 0.000 description 1
- 150000001242 acetic acid derivatives Chemical class 0.000 description 1
- MKUXAQIIEYXACX-UHFFFAOYSA-N aciclovir Chemical compound N1C(N)=NC(=O)C2=C1N(COCCO)C=N2 MKUXAQIIEYXACX-UHFFFAOYSA-N 0.000 description 1
- 150000007513 acids Chemical class 0.000 description 1
- 239000004480 active ingredient Substances 0.000 description 1
- 239000002671 adjuvant Substances 0.000 description 1
- 239000000464 adrenergic agent Substances 0.000 description 1
- 239000000443 aerosol Substances 0.000 description 1
- 238000013019 agitation Methods 0.000 description 1
- 239000000556 agonist Substances 0.000 description 1
- 229940070599 ak-pentolate Drugs 0.000 description 1
- 239000000783 alginic acid Substances 0.000 description 1
- 235000010443 alginic acid Nutrition 0.000 description 1
- 229920000615 alginic acid Polymers 0.000 description 1
- 229960001126 alginic acid Drugs 0.000 description 1
- 150000004781 alginic acids Chemical class 0.000 description 1
- HDTRYLNUVZCQOY-LIZSDCNHSA-N alpha,alpha-trehalose Chemical compound O[C@@H]1[C@@H](O)[C@H](O)[C@@H](CO)O[C@@H]1O[C@@H]1[C@H](O)[C@@H](O)[C@H](O)[C@@H](CO)O1 HDTRYLNUVZCQOY-LIZSDCNHSA-N 0.000 description 1
- 229960004538 alprazolam Drugs 0.000 description 1
- 230000004075 alteration Effects 0.000 description 1
- 125000000539 amino acid group Chemical group 0.000 description 1
- 230000003444 anaesthetic effect Effects 0.000 description 1
- 229940028765 ancobon Drugs 0.000 description 1
- 230000002491 angiogenic effect Effects 0.000 description 1
- 208000022531 anorexia Diseases 0.000 description 1
- 229940098194 antabuse Drugs 0.000 description 1
- 230000002221 antabuse Effects 0.000 description 1
- 239000005557 antagonist Substances 0.000 description 1
- 230000000049 anti-anxiety effect Effects 0.000 description 1
- 230000003466 anti-cipated effect Effects 0.000 description 1
- 230000001387 anti-histamine Effects 0.000 description 1
- 230000003579 anti-obesity Effects 0.000 description 1
- 229940088710 antibiotic agent Drugs 0.000 description 1
- 229940125681 anticonvulsant agent Drugs 0.000 description 1
- 239000001961 anticonvulsive agent Substances 0.000 description 1
- 239000000739 antihistaminic agent Substances 0.000 description 1
- 230000003078 antioxidant effect Effects 0.000 description 1
- 239000007864 aqueous solution Substances 0.000 description 1
- 210000001367 artery Anatomy 0.000 description 1
- 229960005245 asenapine Drugs 0.000 description 1
- 229940065779 atarax Drugs 0.000 description 1
- METKIMKYRPQLGS-UHFFFAOYSA-N atenolol Chemical compound CC(C)NCC(O)COC1=CC=C(CC(N)=O)C=C1 METKIMKYRPQLGS-UHFFFAOYSA-N 0.000 description 1
- 230000003385 bacteriostatic effect Effects 0.000 description 1
- 230000004888 barrier function Effects 0.000 description 1
- 210000004227 basal ganglia Anatomy 0.000 description 1
- 231100000871 behavioral problem Toxicity 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 235000019445 benzyl alcohol Nutrition 0.000 description 1
- 239000002876 beta blocker Substances 0.000 description 1
- 229950009087 bifeprunox Drugs 0.000 description 1
- 239000003833 bile salt Substances 0.000 description 1
- 229940093761 bile salts Drugs 0.000 description 1
- 230000004071 biological effect Effects 0.000 description 1
- 230000000903 blocking effect Effects 0.000 description 1
- 230000008499 blood brain barrier function Effects 0.000 description 1
- 210000001218 blood-brain barrier Anatomy 0.000 description 1
- 230000003925 brain function Effects 0.000 description 1
- 229960002802 bromocriptine Drugs 0.000 description 1
- 239000000872 buffer Substances 0.000 description 1
- 239000000337 buffer salt Substances 0.000 description 1
- 239000007853 buffer solution Substances 0.000 description 1
- 229960001058 bupropion Drugs 0.000 description 1
- SNPPWIUOZRMYNY-UHFFFAOYSA-N bupropion Chemical compound CC(C)(C)NC(C)C(=O)C1=CC=CC(Cl)=C1 SNPPWIUOZRMYNY-UHFFFAOYSA-N 0.000 description 1
- 229940015273 buspar Drugs 0.000 description 1
- 229940088033 calan Drugs 0.000 description 1
- 239000000480 calcium channel blocker Substances 0.000 description 1
- 239000003557 cannabinoid Substances 0.000 description 1
- 229930003827 cannabinoid Natural products 0.000 description 1
- TZFNLOMSOLWIDK-JTQLQIEISA-N carbidopa (anhydrous) Chemical compound NN[C@@](C(O)=O)(C)CC1=CC=C(O)C(O)=C1 TZFNLOMSOLWIDK-JTQLQIEISA-N 0.000 description 1
- 239000001569 carbon dioxide Substances 0.000 description 1
- 229940088029 cardizem Drugs 0.000 description 1
- OGHNVEJMJSYVRP-UHFFFAOYSA-N carvedilol Chemical compound COC1=CC=CC=C1OCCNCC(O)COC1=CC=CC2=C1C1=CC=CC=C1N2 OGHNVEJMJSYVRP-UHFFFAOYSA-N 0.000 description 1
- 229940118922 celontin Drugs 0.000 description 1
- 210000001638 cerebellum Anatomy 0.000 description 1
- 229960004782 chlordiazepoxide Drugs 0.000 description 1
- 229960004926 chlorobutanol Drugs 0.000 description 1
- SOYKEARSMXGVTM-UHFFFAOYSA-N chlorphenamine Chemical compound C=1C=CC=NC=1C(CCN(C)C)C1=CC=C(Cl)C=C1 SOYKEARSMXGVTM-UHFFFAOYSA-N 0.000 description 1
- 229960003291 chlorphenamine Drugs 0.000 description 1
- 229960001552 chlorprothixene Drugs 0.000 description 1
- 229960001653 citalopram Drugs 0.000 description 1
- 150000001860 citric acid derivatives Chemical class 0.000 description 1
- 229960004606 clomipramine Drugs 0.000 description 1
- 229960003120 clonazepam Drugs 0.000 description 1
- 229960004362 clorazepate Drugs 0.000 description 1
- XDDJGVMJFWAHJX-UHFFFAOYSA-M clorazepic acid anion Chemical compound C12=CC(Cl)=CC=C2NC(=O)C(C(=O)[O-])N=C1C1=CC=CC=C1 XDDJGVMJFWAHJX-UHFFFAOYSA-M 0.000 description 1
- 239000011248 coating agent Substances 0.000 description 1
- 229940110456 cocoa butter Drugs 0.000 description 1
- 235000019868 cocoa butter Nutrition 0.000 description 1
- 230000001149 cognitive effect Effects 0.000 description 1
- 229940075614 colloidal silicon dioxide Drugs 0.000 description 1
- 229940088505 compazine Drugs 0.000 description 1
- 229910052802 copper Inorganic materials 0.000 description 1
- 239000010949 copper Substances 0.000 description 1
- 229940069210 coreg Drugs 0.000 description 1
- 239000008120 corn starch Substances 0.000 description 1
- 230000001054 cortical effect Effects 0.000 description 1
- 239000006071 cream Substances 0.000 description 1
- 239000003431 cross linking reagent Substances 0.000 description 1
- 229960000710 cyclopentolate hydrochloride Drugs 0.000 description 1
- 229960003077 cycloserine Drugs 0.000 description 1
- 230000006378 damage Effects 0.000 description 1
- 229940078435 darvocet Drugs 0.000 description 1
- 206010061428 decreased appetite Diseases 0.000 description 1
- 230000007123 defense Effects 0.000 description 1
- 230000006735 deficit Effects 0.000 description 1
- 230000001934 delay Effects 0.000 description 1
- 229940080861 demerol Drugs 0.000 description 1
- 108010002255 deoxyhemoglobin Proteins 0.000 description 1
- 229940075922 depacon Drugs 0.000 description 1
- 229940089052 depakene Drugs 0.000 description 1
- 230000001419 dependent effect Effects 0.000 description 1
- 229960001623 desvenlafaxine Drugs 0.000 description 1
- 239000003599 detergent Substances 0.000 description 1
- 235000019425 dextrin Nutrition 0.000 description 1
- 239000008121 dextrose Substances 0.000 description 1
- 206010012601 diabetes mellitus Diseases 0.000 description 1
- 229940074202 diastat Drugs 0.000 description 1
- 230000001079 digestive effect Effects 0.000 description 1
- UGMCXQCYOVCMTB-UHFFFAOYSA-K dihydroxy(stearato)aluminium Chemical compound CCCCCCCCCCCCCCCCCC(=O)O[Al](O)O UGMCXQCYOVCMTB-UHFFFAOYSA-K 0.000 description 1
- 239000003085 diluting agent Substances 0.000 description 1
- 230000003292 diminished effect Effects 0.000 description 1
- 229960000520 diphenhydramine Drugs 0.000 description 1
- ZZVUWRFHKOJYTH-UHFFFAOYSA-N diphenhydramine Chemical compound C=1C=CC=CC=1C(OCCN(C)C)C1=CC=CC=C1 ZZVUWRFHKOJYTH-UHFFFAOYSA-N 0.000 description 1
- QCHSEDTUUKDTIG-UHFFFAOYSA-L dipotassium clorazepate Chemical compound [OH-].[K+].[K+].C12=CC(Cl)=CC=C2NC(=O)C(C(=O)[O-])N=C1C1=CC=CC=C1 QCHSEDTUUKDTIG-UHFFFAOYSA-L 0.000 description 1
- 208000002173 dizziness Diseases 0.000 description 1
- VYFYYTLLBUKUHU-UHFFFAOYSA-N dopamine Chemical compound NCCC1=CC=C(O)C(O)=C1 VYFYYTLLBUKUHU-UHFFFAOYSA-N 0.000 description 1
- 231100000673 dose–response relationship Toxicity 0.000 description 1
- 229940000406 drug candidate Drugs 0.000 description 1
- 238000009509 drug development Methods 0.000 description 1
- 238000012362 drug development process Methods 0.000 description 1
- 230000009977 dual effect Effects 0.000 description 1
- 229960002866 duloxetine Drugs 0.000 description 1
- 230000008451 emotion Effects 0.000 description 1
- 239000007920 enema Substances 0.000 description 1
- 229940079360 enema for constipation Drugs 0.000 description 1
- 230000002708 enhancing effect Effects 0.000 description 1
- 230000007613 environmental effect Effects 0.000 description 1
- 210000003743 erythrocyte Anatomy 0.000 description 1
- 229960005086 escitalopram oxalate Drugs 0.000 description 1
- 229940011871 estrogen Drugs 0.000 description 1
- 239000000262 estrogen Substances 0.000 description 1
- JKKFKPJIXZFSSB-CBZIJGRNSA-N estrone 3-sulfate Chemical compound OS(=O)(=O)OC1=CC=C2[C@H]3CC[C@](C)(C(CC4)=O)[C@@H]4[C@@H]3CCC2=C1 JKKFKPJIXZFSSB-CBZIJGRNSA-N 0.000 description 1
- HAPOVYFOVVWLRS-UHFFFAOYSA-N ethosuximide Chemical compound CCC1(C)CC(=O)NC1=O HAPOVYFOVVWLRS-UHFFFAOYSA-N 0.000 description 1
- 230000005284 excitation Effects 0.000 description 1
- 239000000284 extract Substances 0.000 description 1
- 206010016256 fatigue Diseases 0.000 description 1
- 229960004642 ferric ammonium citrate Drugs 0.000 description 1
- 239000000796 flavoring agent Substances 0.000 description 1
- 229960004413 flucytosine Drugs 0.000 description 1
- 229940124307 fluoroquinolone Drugs 0.000 description 1
- 229960002464 fluoxetine Drugs 0.000 description 1
- 229960002690 fluphenazine Drugs 0.000 description 1
- 229960004038 fluvoxamine Drugs 0.000 description 1
- CJOFXWAVKWHTFT-XSFVSMFZSA-N fluvoxamine Chemical compound COCCCC\C(=N/OCCN)C1=CC=C(C(F)(F)F)C=C1 CJOFXWAVKWHTFT-XSFVSMFZSA-N 0.000 description 1
- 235000013305 food Nutrition 0.000 description 1
- 235000013355 food flavoring agent Nutrition 0.000 description 1
- 235000003599 food sweetener Nutrition 0.000 description 1
- 238000012048 forced swim test Methods 0.000 description 1
- 230000006870 function Effects 0.000 description 1
- IECPWNUMDGFDKC-MZJAQBGESA-N fusidic acid Chemical class O[C@@H]([C@@H]12)C[C@H]3\C(=C(/CCC=C(C)C)C(O)=O)[C@@H](OC(C)=O)C[C@]3(C)[C@@]2(C)CC[C@@H]2[C@]1(C)CC[C@@H](O)[C@H]2C IECPWNUMDGFDKC-MZJAQBGESA-N 0.000 description 1
- OCDAWJYGVOLXGZ-VPVMAENOSA-K gadobenate dimeglumine Chemical compound [Gd+3].CNC[C@H](O)[C@@H](O)[C@H](O)[C@H](O)CO.CNC[C@H](O)[C@@H](O)[C@H](O)[C@H](O)CO.OC(=O)CN(CC([O-])=O)CCN(CC([O-])=O)CCN(CC(O)=O)C(C([O-])=O)COCC1=CC=CC=C1 OCDAWJYGVOLXGZ-VPVMAENOSA-K 0.000 description 1
- 229960004455 gadobenic acid Drugs 0.000 description 1
- 229960003411 gadobutrol Drugs 0.000 description 1
- 229960005063 gadodiamide Drugs 0.000 description 1
- HZHFFEYYPYZMNU-UHFFFAOYSA-K gadodiamide Chemical compound [Gd+3].CNC(=O)CN(CC([O-])=O)CCN(CC([O-])=O)CCN(CC([O-])=O)CC(=O)NC HZHFFEYYPYZMNU-UHFFFAOYSA-K 0.000 description 1
- UIWYJDYFSGRHKR-UHFFFAOYSA-N gadolinium atom Chemical compound [Gd] UIWYJDYFSGRHKR-UHFFFAOYSA-N 0.000 description 1
- IZOOGPBRAOKZFK-UHFFFAOYSA-K gadopentetate Chemical compound [Gd+3].OC(=O)CN(CC([O-])=O)CCN(CC([O-])=O)CCN(CC(O)=O)CC([O-])=O IZOOGPBRAOKZFK-UHFFFAOYSA-K 0.000 description 1
- LGMLJQFQKXPRGA-VPVMAENOSA-K gadopentetate dimeglumine Chemical compound [Gd+3].CNC[C@H](O)[C@@H](O)[C@H](O)[C@H](O)CO.CNC[C@H](O)[C@@H](O)[C@H](O)[C@H](O)CO.OC(=O)CN(CC([O-])=O)CCN(CC([O-])=O)CCN(CC(O)=O)CC([O-])=O LGMLJQFQKXPRGA-VPVMAENOSA-K 0.000 description 1
- 229940044350 gadopentetate dimeglumine Drugs 0.000 description 1
- 229960003460 gadopentetic acid Drugs 0.000 description 1
- 229960003823 gadoteric acid Drugs 0.000 description 1
- GFSTXYOTEVLASN-UHFFFAOYSA-K gadoteric acid Chemical compound [Gd+3].OC(=O)CN1CCN(CC([O-])=O)CCN(CC([O-])=O)CCN(CC([O-])=O)CC1 GFSTXYOTEVLASN-UHFFFAOYSA-K 0.000 description 1
- 229960005451 gadoteridol Drugs 0.000 description 1
- DPNNNPAKRZOSMO-UHFFFAOYSA-K gadoteridol Chemical compound [Gd+3].CC(O)CN1CCN(CC([O-])=O)CCN(CC([O-])=O)CCN(CC([O-])=O)CC1 DPNNNPAKRZOSMO-UHFFFAOYSA-K 0.000 description 1
- 229960002059 gadoversetamide Drugs 0.000 description 1
- 229960001547 gadoxetic acid Drugs 0.000 description 1
- 239000007789 gas Substances 0.000 description 1
- 239000007903 gelatin capsule Substances 0.000 description 1
- 208000029364 generalized anxiety disease Diseases 0.000 description 1
- 229940003380 geodon Drugs 0.000 description 1
- 239000011521 glass Substances 0.000 description 1
- 229960003180 glutathione Drugs 0.000 description 1
- 125000005456 glyceride group Chemical group 0.000 description 1
- PCHJSUWPFVWCPO-UHFFFAOYSA-N gold Chemical compound [Au] PCHJSUWPFVWCPO-UHFFFAOYSA-N 0.000 description 1
- 239000010931 gold Substances 0.000 description 1
- 229910052737 gold Inorganic materials 0.000 description 1
- 229960002158 halazepam Drugs 0.000 description 1
- 229940027804 halcion Drugs 0.000 description 1
- 229940095895 haldol Drugs 0.000 description 1
- 239000000380 hallucinogen Substances 0.000 description 1
- 231100000869 headache Toxicity 0.000 description 1
- 238000004128 high performance liquid chromatography Methods 0.000 description 1
- 235000001050 hortel pimenta Nutrition 0.000 description 1
- 239000002471 hydroxymethylglutaryl coenzyme A reductase inhibitor Substances 0.000 description 1
- 239000003326 hypnotic agent Substances 0.000 description 1
- 230000000147 hypnotic effect Effects 0.000 description 1
- 229960003162 iloperidone Drugs 0.000 description 1
- XMXHEBAFVSFQEX-UHFFFAOYSA-N iloperidone Chemical compound COC1=CC(C(C)=O)=CC=C1OCCCN1CCC(C=2C3=CC=C(F)C=C3ON=2)CC1 XMXHEBAFVSFQEX-UHFFFAOYSA-N 0.000 description 1
- 229960004801 imipramine Drugs 0.000 description 1
- BCGWQEUPMDMJNV-UHFFFAOYSA-N imipramine Chemical compound C1CC2=CC=CC=C2N(CCCN(C)C)C2=CC=CC=C21 BCGWQEUPMDMJNV-UHFFFAOYSA-N 0.000 description 1
- 230000001771 impaired effect Effects 0.000 description 1
- 239000003701 inert diluent Substances 0.000 description 1
- 230000005764 inhibitory process Effects 0.000 description 1
- 239000007972 injectable composition Substances 0.000 description 1
- 230000002452 interceptive effect Effects 0.000 description 1
- 238000007912 intraperitoneal administration Methods 0.000 description 1
- 239000004313 iron ammonium citrate Substances 0.000 description 1
- 235000000011 iron ammonium citrate Nutrition 0.000 description 1
- 229960005280 isotretinoin Drugs 0.000 description 1
- 235000014655 lactic acid Nutrition 0.000 description 1
- 239000004310 lactic acid Substances 0.000 description 1
- 239000008101 lactose Substances 0.000 description 1
- 239000000787 lecithin Substances 0.000 description 1
- 235000010445 lecithin Nutrition 0.000 description 1
- 229940067606 lecithin Drugs 0.000 description 1
- 231100000518 lethal Toxicity 0.000 description 1
- 230000001665 lethal effect Effects 0.000 description 1
- 229960004194 lidocaine Drugs 0.000 description 1
- 239000003446 ligand Substances 0.000 description 1
- 230000002197 limbic effect Effects 0.000 description 1
- 239000007788 liquid Substances 0.000 description 1
- 229940089964 lodosyn Drugs 0.000 description 1
- 229940089504 lopressor Drugs 0.000 description 1
- 229960004391 lorazepam Drugs 0.000 description 1
- 208000019017 loss of appetite Diseases 0.000 description 1
- 235000021266 loss of appetite Nutrition 0.000 description 1
- 239000000314 lubricant Substances 0.000 description 1
- 235000019359 magnesium stearate Nutrition 0.000 description 1
- 238000012423 maintenance Methods 0.000 description 1
- 230000014759 maintenance of location Effects 0.000 description 1
- 229940035034 maltodextrin Drugs 0.000 description 1
- 229960002382 mangafodipir Drugs 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 238000013507 mapping Methods 0.000 description 1
- 229960004090 maprotiline Drugs 0.000 description 1
- QSLMDECMDJKHMQ-GSXCWMCISA-N maprotiline Chemical compound C12=CC=CC=C2[C@@]2(CCCNC)C3=CC=CC=C3[C@@H]1CC2 QSLMDECMDJKHMQ-GSXCWMCISA-N 0.000 description 1
- 240000004308 marijuana Species 0.000 description 1
- 230000007246 mechanism Effects 0.000 description 1
- PSGAAPLEWMOORI-PEINSRQWSA-N medroxyprogesterone acetate Chemical compound C([C@@]12C)CC(=O)C=C1[C@@H](C)C[C@@H]1[C@@H]2CC[C@]2(C)[C@@](OC(C)=O)(C(C)=O)CC[C@H]21 PSGAAPLEWMOORI-PEINSRQWSA-N 0.000 description 1
- 230000006996 mental state Effects 0.000 description 1
- 229960004815 meprobamate Drugs 0.000 description 1
- 210000001259 mesencephalon Anatomy 0.000 description 1
- 229960000300 mesoridazine Drugs 0.000 description 1
- SLVMESMUVMCQIY-UHFFFAOYSA-N mesoridazine Chemical compound CN1CCCCC1CCN1C2=CC(S(C)=O)=CC=C2SC2=CC=CC=C21 SLVMESMUVMCQIY-UHFFFAOYSA-N 0.000 description 1
- 230000004060 metabolic process Effects 0.000 description 1
- 229940042053 methotrimeprazine Drugs 0.000 description 1
- VRQVVMDWGGWHTJ-CQSZACIVSA-N methotrimeprazine Chemical compound C1=CC=C2N(C[C@H](C)CN(C)C)C3=CC(OC)=CC=C3SC2=C1 VRQVVMDWGGWHTJ-CQSZACIVSA-N 0.000 description 1
- STZCRXQWRGQSJD-GEEYTBSJSA-M methyl orange Chemical compound [Na+].C1=CC(N(C)C)=CC=C1\N=N\C1=CC=C(S([O-])(=O)=O)C=C1 STZCRXQWRGQSJD-GEEYTBSJSA-M 0.000 description 1
- 229940012189 methyl orange Drugs 0.000 description 1
- 235000010270 methyl p-hydroxybenzoate Nutrition 0.000 description 1
- 229960001047 methyl salicylate Drugs 0.000 description 1
- 229940016286 microcrystalline cellulose Drugs 0.000 description 1
- 235000019813 microcrystalline cellulose Nutrition 0.000 description 1
- 239000008108 microcrystalline cellulose Substances 0.000 description 1
- 229960001785 mirtazapine Drugs 0.000 description 1
- RONZAEMNMFQXRA-UHFFFAOYSA-N mirtazapine Chemical compound C1C2=CC=CN=C2N2CCN(C)CC2C2=CC=CC=C21 RONZAEMNMFQXRA-UHFFFAOYSA-N 0.000 description 1
- 238000012544 monitoring process Methods 0.000 description 1
- 229960005181 morphine Drugs 0.000 description 1
- 210000000337 motor cortex Anatomy 0.000 description 1
- 239000002324 mouth wash Substances 0.000 description 1
- 229940051866 mouthwash Drugs 0.000 description 1
- 238000000340 multi-photon laser scanning microscopy Methods 0.000 description 1
- HATVWQUAXNOKEY-UHFFFAOYSA-N n-iodo-1-phenylpropan-2-amine Chemical compound INC(C)CC1=CC=CC=C1 HATVWQUAXNOKEY-UHFFFAOYSA-N 0.000 description 1
- 239000007922 nasal spray Substances 0.000 description 1
- 239000006218 nasal suppository Substances 0.000 description 1
- 230000008693 nausea Effects 0.000 description 1
- 239000006199 nebulizer Substances 0.000 description 1
- 229960001800 nefazodone Drugs 0.000 description 1
- VRBKIVRKKCLPHA-UHFFFAOYSA-N nefazodone Chemical compound O=C1N(CCOC=2C=CC=CC=2)C(CC)=NN1CCCN(CC1)CCN1C1=CC=CC(Cl)=C1 VRBKIVRKKCLPHA-UHFFFAOYSA-N 0.000 description 1
- 210000000653 nervous system Anatomy 0.000 description 1
- 210000000118 neural pathway Anatomy 0.000 description 1
- 230000010004 neural pathway Effects 0.000 description 1
- 230000008062 neuronal firing Effects 0.000 description 1
- HYIMSNHJOBLJNT-UHFFFAOYSA-N nifedipine Chemical compound COC(=O)C1=C(C)NC(C)=C(C(=O)OC)C1C1=CC=CC=C1[N+]([O-])=O HYIMSNHJOBLJNT-UHFFFAOYSA-N 0.000 description 1
- UIAGMCDKSXEBJQ-UHFFFAOYSA-N nimodipine Chemical compound COCCOC(=O)C1=C(C)NC(C)=C(C(=O)OC(C)C)C1C1=CC=CC([N+]([O-])=O)=C1 UIAGMCDKSXEBJQ-UHFFFAOYSA-N 0.000 description 1
- 229960000715 nimodipine Drugs 0.000 description 1
- 229940072101 nimotop Drugs 0.000 description 1
- 231100000957 no side effect Toxicity 0.000 description 1
- 239000000820 nonprescription drug Substances 0.000 description 1
- 231100000956 nontoxicity Toxicity 0.000 description 1
- 239000000346 nonvolatile oil Substances 0.000 description 1
- 229960001158 nortriptyline Drugs 0.000 description 1
- 231100000862 numbness Toxicity 0.000 description 1
- 238000012634 optical imaging Methods 0.000 description 1
- 229940109739 orap Drugs 0.000 description 1
- 230000010355 oscillation Effects 0.000 description 1
- 235000020830 overeating Nutrition 0.000 description 1
- ADIMAYPTOBDMTL-UHFFFAOYSA-N oxazepam Chemical compound C12=CC(Cl)=CC=C2NC(=O)C(O)N=C1C1=CC=CC=C1 ADIMAYPTOBDMTL-UHFFFAOYSA-N 0.000 description 1
- DRKHJSDSSUXYTE-UHFFFAOYSA-L oxidanium;2-[bis[2-[carboxylatomethyl-[2-(2-methoxyethylamino)-2-oxoethyl]amino]ethyl]amino]acetate;gadolinium(3+) Chemical compound [OH3+].[Gd+3].COCCNC(=O)CN(CC([O-])=O)CCN(CC([O-])=O)CCN(CC([O-])=O)CC(=O)NCCOC DRKHJSDSSUXYTE-UHFFFAOYSA-L 0.000 description 1
- 229960002085 oxycodone Drugs 0.000 description 1
- 238000004806 packaging method and process Methods 0.000 description 1
- 230000036407 pain Effects 0.000 description 1
- 208000002851 paranoid schizophrenia Diseases 0.000 description 1
- 229940000596 parlodel Drugs 0.000 description 1
- 229960002296 paroxetine Drugs 0.000 description 1
- 239000002245 particle Substances 0.000 description 1
- 238000011302 passive avoidance test Methods 0.000 description 1
- 230000037361 pathway Effects 0.000 description 1
- 230000008447 perception Effects 0.000 description 1
- 229960000769 periciazine Drugs 0.000 description 1
- LUALIOATIOESLM-UHFFFAOYSA-N periciazine Chemical compound C1CC(O)CCN1CCCN1C2=CC(C#N)=CC=C2SC2=CC=CC=C21 LUALIOATIOESLM-UHFFFAOYSA-N 0.000 description 1
- 230000000737 periodic effect Effects 0.000 description 1
- 229960000762 perphenazine Drugs 0.000 description 1
- 208000022821 personality disease Diseases 0.000 description 1
- 229960000964 phenelzine Drugs 0.000 description 1
- 229940107333 phenergan Drugs 0.000 description 1
- 229960003742 phenol Drugs 0.000 description 1
- 235000021317 phosphate Nutrition 0.000 description 1
- 150000003013 phosphoric acid derivatives Chemical class 0.000 description 1
- 239000002504 physiological saline solution Substances 0.000 description 1
- 229960003634 pimozide Drugs 0.000 description 1
- 230000036470 plasma concentration Effects 0.000 description 1
- 229920001432 poly(L-lactide) Polymers 0.000 description 1
- 239000008389 polyethoxylated castor oil Substances 0.000 description 1
- 239000004633 polyglycolic acid Substances 0.000 description 1
- 229920005862 polyol Polymers 0.000 description 1
- 150000003077 polyols Chemical class 0.000 description 1
- 229920001184 polypeptide Polymers 0.000 description 1
- 229960004293 porfimer sodium Drugs 0.000 description 1
- 238000007781 pre-processing Methods 0.000 description 1
- 210000002442 prefrontal cortex Anatomy 0.000 description 1
- 229940063238 premarin Drugs 0.000 description 1
- 230000006977 prepulse inhibition Effects 0.000 description 1
- 230000002265 prevention Effects 0.000 description 1
- 229940089949 procardia Drugs 0.000 description 1
- 102000004196 processed proteins & peptides Human genes 0.000 description 1
- 238000012545 processing Methods 0.000 description 1
- 229960003111 prochlorperazine Drugs 0.000 description 1
- WIKYUJGCLQQFNW-UHFFFAOYSA-N prochlorperazine Chemical compound C1CN(C)CCN1CCCN1C2=CC(Cl)=CC=C2SC2=CC=CC=C21 WIKYUJGCLQQFNW-UHFFFAOYSA-N 0.000 description 1
- DSKIOWHQLUWFLG-SPIKMXEPSA-N prochlorperazine maleate Chemical compound [H+].[H+].[H+].[H+].[O-]C(=O)\C=C/C([O-])=O.[O-]C(=O)\C=C/C([O-])=O.C1CN(C)CCN1CCCN1C2=CC(Cl)=CC=C2SC2=CC=CC=C21 DSKIOWHQLUWFLG-SPIKMXEPSA-N 0.000 description 1
- 229940072288 prograf Drugs 0.000 description 1
- 229960003598 promazine Drugs 0.000 description 1
- 229960003910 promethazine Drugs 0.000 description 1
- 239000003380 propellant Substances 0.000 description 1
- 210000004129 prosencephalon Anatomy 0.000 description 1
- 229960002601 protriptyline Drugs 0.000 description 1
- BWPIARFWQZKAIA-UHFFFAOYSA-N protriptyline Chemical compound C1=CC2=CC=CC=C2C(CCCNC)C2=CC=CC=C21 BWPIARFWQZKAIA-UHFFFAOYSA-N 0.000 description 1
- 229960004431 quetiapine Drugs 0.000 description 1
- URKOMYMAXPYINW-UHFFFAOYSA-N quetiapine Chemical compound C1CN(CCOCCO)CCN1C1=NC2=CC=CC=C2SC2=CC=CC=C12 URKOMYMAXPYINW-UHFFFAOYSA-N 0.000 description 1
- ZTHJULTYCAQOIJ-WXXKFALUSA-N quetiapine fumarate Chemical compound [H+].[H+].[O-]C(=O)\C=C\C([O-])=O.C1CN(CCOCCO)CCN1C1=NC2=CC=CC=C2SC2=CC=CC=C12.C1CN(CCOCCO)CCN1C1=NC2=CC=CC=C2SC2=CC=CC=C12 ZTHJULTYCAQOIJ-WXXKFALUSA-N 0.000 description 1
- 150000003254 radicals Chemical class 0.000 description 1
- 239000000700 radioactive tracer Substances 0.000 description 1
- 229960003770 reboxetine Drugs 0.000 description 1
- CBQGYUDMJHNJBX-RTBURBONSA-N reboxetine Chemical compound CCOC1=CC=CC=C1O[C@H](C=1C=CC=CC=1)[C@@H]1OCCNC1 CBQGYUDMJHNJBX-RTBURBONSA-N 0.000 description 1
- 230000000452 restraining effect Effects 0.000 description 1
- 230000000717 retained effect Effects 0.000 description 1
- 238000012552 review Methods 0.000 description 1
- CVHZOJJKTDOEJC-UHFFFAOYSA-N saccharin Chemical compound C1=CC=C2C(=O)NS(=O)(=O)C2=C1 CVHZOJJKTDOEJC-UHFFFAOYSA-N 0.000 description 1
- 229940081974 saccharin Drugs 0.000 description 1
- 235000019204 saccharin Nutrition 0.000 description 1
- 239000000901 saccharin and its Na,K and Ca salt Substances 0.000 description 1
- 210000004761 scalp Anatomy 0.000 description 1
- HFHDHCJBZVLPGP-UHFFFAOYSA-N schardinger α-dextrin Chemical compound O1C(C(C2O)O)C(CO)OC2OC(C(C2O)O)C(CO)OC2OC(C(C2O)O)C(CO)OC2OC(C(O)C2O)C(CO)OC2OC(C(C2O)O)C(CO)OC2OC2C(O)C(O)C1OC2CO HFHDHCJBZVLPGP-UHFFFAOYSA-N 0.000 description 1
- 208000022610 schizoaffective disease Diseases 0.000 description 1
- 230000000698 schizophrenic effect Effects 0.000 description 1
- 208000012672 seasonal affective disease Diseases 0.000 description 1
- 229940125723 sedative agent Drugs 0.000 description 1
- 230000001624 sedative effect Effects 0.000 description 1
- 238000010187 selection method Methods 0.000 description 1
- 230000035945 sensitivity Effects 0.000 description 1
- 229940099992 seromycin Drugs 0.000 description 1
- 229940035004 seroquel Drugs 0.000 description 1
- 239000003521 serotonin 5-HT1 receptor agonist Substances 0.000 description 1
- 239000003762 serotonin receptor affecting agent Substances 0.000 description 1
- 229960000652 sertindole Drugs 0.000 description 1
- GZKLJWGUPQBVJQ-UHFFFAOYSA-N sertindole Chemical compound C1=CC(F)=CC=C1N1C2=CC=C(Cl)C=C2C(C2CCN(CCN3C(NCC3)=O)CC2)=C1 GZKLJWGUPQBVJQ-UHFFFAOYSA-N 0.000 description 1
- 229960002073 sertraline Drugs 0.000 description 1
- VGKDLMBJGBXTGI-SJCJKPOMSA-N sertraline Chemical compound C1([C@@H]2CC[C@@H](C3=CC=CC=C32)NC)=CC=C(Cl)C(Cl)=C1 VGKDLMBJGBXTGI-SJCJKPOMSA-N 0.000 description 1
- 210000002966 serum Anatomy 0.000 description 1
- 208000013220 shortness of breath Diseases 0.000 description 1
- 229940001089 sinemet Drugs 0.000 description 1
- 210000003625 skull Anatomy 0.000 description 1
- 235000010267 sodium hydrogen sulphite Nutrition 0.000 description 1
- 210000004872 soft tissue Anatomy 0.000 description 1
- 230000000392 somatic effect Effects 0.000 description 1
- VIDRYROWYFWGSY-UHFFFAOYSA-N sotalol hydrochloride Chemical compound Cl.CC(C)NCC(O)C1=CC=C(NS(C)(=O)=O)C=C1 VIDRYROWYFWGSY-UHFFFAOYSA-N 0.000 description 1
- 238000000264 spin echo pulse sequence Methods 0.000 description 1
- 239000007921 spray Substances 0.000 description 1
- 239000008107 starch Substances 0.000 description 1
- 235000019698 starch Nutrition 0.000 description 1
- 230000024188 startle response Effects 0.000 description 1
- 238000007619 statistical method Methods 0.000 description 1
- 230000001954 sterilising effect Effects 0.000 description 1
- 238000004659 sterilization and disinfection Methods 0.000 description 1
- 238000003860 storage Methods 0.000 description 1
- 150000005846 sugar alcohols Polymers 0.000 description 1
- 150000008163 sugars Chemical class 0.000 description 1
- 239000000829 suppository Substances 0.000 description 1
- 239000002511 suppository base Substances 0.000 description 1
- 230000001629 suppression Effects 0.000 description 1
- 239000004094 surface-active agent Substances 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 230000002459 sustained effect Effects 0.000 description 1
- 230000035900 sweating Effects 0.000 description 1
- 239000003765 sweetening agent Substances 0.000 description 1
- 238000007910 systemic administration Methods 0.000 description 1
- 239000003826 tablet Substances 0.000 description 1
- 229960001967 tacrolimus Drugs 0.000 description 1
- QJJXYPPXXYFBGM-SHYZHZOCSA-N tacrolimus Natural products CO[C@H]1C[C@H](CC[C@@H]1O)C=C(C)[C@H]2OC(=O)[C@H]3CCCCN3C(=O)C(=O)[C@@]4(O)O[C@@H]([C@H](C[C@H]4C)OC)[C@@H](C[C@H](C)CC(=C[C@@H](CC=C)C(=O)C[C@H](O)[C@H]2C)C)OC QJJXYPPXXYFBGM-SHYZHZOCSA-N 0.000 description 1
- 230000002123 temporal effect Effects 0.000 description 1
- 229940108485 tenormin Drugs 0.000 description 1
- 229960005333 tetrabenazine Drugs 0.000 description 1
- 231100001274 therapeutic index Toxicity 0.000 description 1
- 238000001931 thermography Methods 0.000 description 1
- RTKIYNMVFMVABJ-UHFFFAOYSA-L thimerosal Chemical compound [Na+].CC[Hg]SC1=CC=CC=C1C([O-])=O RTKIYNMVFMVABJ-UHFFFAOYSA-L 0.000 description 1
- 229940033663 thimerosal Drugs 0.000 description 1
- 229960002784 thioridazine Drugs 0.000 description 1
- 229940035248 tiazac Drugs 0.000 description 1
- 229960005013 tiotixene Drugs 0.000 description 1
- 231100000419 toxicity Toxicity 0.000 description 1
- 230000001988 toxicity Effects 0.000 description 1
- 230000009261 transgenic effect Effects 0.000 description 1
- 229940063648 tranxene Drugs 0.000 description 1
- 229960003741 tranylcypromine Drugs 0.000 description 1
- 230000000472 traumatic effect Effects 0.000 description 1
- 229960003991 trazodone Drugs 0.000 description 1
- PHLBKPHSAVXXEF-UHFFFAOYSA-N trazodone Chemical compound ClC1=CC=CC(N2CCN(CCCN3C(N4C=CC=CC4=N3)=O)CC2)=C1 PHLBKPHSAVXXEF-UHFFFAOYSA-N 0.000 description 1
- AUALKMYBYGCYNY-UHFFFAOYSA-E triazanium;2-hydroxypropane-1,2,3-tricarboxylate;iron(3+) Chemical compound [NH4+].[NH4+].[NH4+].[Fe+3].[Fe+3].[Fe+3].[O-]C(=O)CC(O)(CC([O-])=O)C([O-])=O.[O-]C(=O)CC(O)(CC([O-])=O)C([O-])=O.[O-]C(=O)CC(O)(CC([O-])=O)C([O-])=O.[O-]C(=O)CC(O)(CC([O-])=O)C([O-])=O AUALKMYBYGCYNY-UHFFFAOYSA-E 0.000 description 1
- JOFWLTCLBGQGBO-UHFFFAOYSA-N triazolam Chemical compound C12=CC(Cl)=CC=C2N2C(C)=NN=C2CN=C1C1=CC=CC=C1Cl JOFWLTCLBGQGBO-UHFFFAOYSA-N 0.000 description 1
- 229960002324 trifluoperazine Drugs 0.000 description 1
- 229960003904 triflupromazine Drugs 0.000 description 1
- XSCGXQMFQXDFCW-UHFFFAOYSA-N triflupromazine Chemical compound C1=C(C(F)(F)F)C=C2N(CCCN(C)C)C3=CC=CC=C3SC2=C1 XSCGXQMFQXDFCW-UHFFFAOYSA-N 0.000 description 1
- 229960002431 trimipramine Drugs 0.000 description 1
- ZSCDBOWYZJWBIY-UHFFFAOYSA-N trimipramine Chemical compound C1CC2=CC=CC=C2N(CC(CN(C)C)C)C2=CC=CC=C21 ZSCDBOWYZJWBIY-UHFFFAOYSA-N 0.000 description 1
- 238000001291 vacuum drying Methods 0.000 description 1
- 238000009777 vacuum freeze-drying Methods 0.000 description 1
- 229940010343 valcyte Drugs 0.000 description 1
- 235000016788 valerian Nutrition 0.000 description 1
- 229960002149 valganciclovir Drugs 0.000 description 1
- 229960000604 valproic acid Drugs 0.000 description 1
- 210000005166 vasculature Anatomy 0.000 description 1
- 230000002861 ventricular Effects 0.000 description 1
- 239000008215 water for injection Substances 0.000 description 1
- 230000004584 weight gain Effects 0.000 description 1
- 235000019786 weight gain Nutrition 0.000 description 1
- 229940063682 zarontin Drugs 0.000 description 1
- 229960000607 ziprasidone Drugs 0.000 description 1
- 229940107931 zovirax Drugs 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
- A61B5/055—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/16—Devices for psychotechnics; Testing reaction times ; Devices for evaluating the psychological state
- A61B5/165—Evaluating the state of mind, e.g. depression, anxiety
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
- A61B6/02—Arrangements for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
- A61B6/03—Computed tomography [CT]
- A61B6/037—Emission tomography
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2503/00—Evaluating a particular growth phase or type of persons or animals
- A61B2503/40—Animals
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/242—Detecting biomagnetic fields, e.g. magnetic fields produced by bioelectric currents
- A61B5/245—Detecting biomagnetic fields, e.g. magnetic fields produced by bioelectric currents specially adapted for magnetoencephalographic [MEG] signals
- A61B5/246—Detecting biomagnetic fields, e.g. magnetic fields produced by bioelectric currents specially adapted for magnetoencephalographic [MEG] signals using evoked responses
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
- A61B5/369—Electroencephalography [EEG]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
- A61B6/50—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications
- A61B6/501—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications for diagnosis of the head, e.g. neuroimaging or craniography
-
- G—PHYSICS
- G01—MEASURING; TESTING
- G01R—MEASURING ELECTRIC VARIABLES; MEASURING MAGNETIC VARIABLES
- G01R33/00—Arrangements or instruments for measuring magnetic variables
- G01R33/20—Arrangements or instruments for measuring magnetic variables involving magnetic resonance
- G01R33/44—Arrangements or instruments for measuring magnetic variables involving magnetic resonance using nuclear magnetic resonance [NMR]
- G01R33/48—NMR imaging systems
- G01R33/4806—Functional imaging of brain activation
Definitions
- the present invention is in the field of medicine. More specifically, the disclosure is in the field of drug development and screening to identify therapeutic pharmaceutical drugs that do not cause mental illness-related side effects or which are useful for treating psychosis, depression and/or anxiety.
- rimonobant a ligand antagonist directed to the cannabinoid CB 1/CB2 receptors
- rimonobant AcompliaTM was pulled from clinical trials in the United States because it increased the risk of depression and suicide.
- FDA Food and Drug Administration
- pharmaceutical companies would like to identify and develop highly efficacious drugs with little to no side effects.
- pharmaceutical companies would also prefer to identify drug candidates that are likely to fail in clinical trials due to adverse side effects earlier in the process, thus saving both time and money spent on research and development.
- a drug that causes a certain type of behavior does so by altering the activity of different areas of the brain.
- the drug could be said to have a finger print.
- Drugs that share a common action would be predicted to have similar (not necessarily identical) finger prints.
- this disclosure is based, at least in part, on the ability of certain therapeutically effective pharmaceutical drugs to induce detectable changes in neuronal/glial activity that can be compared to against known pharmaceutical drugs with known adverse side effects. This method has been exploited to develop the present disclosure, which is directed in part, to methods of drug screening.
- the method comprises treating a non-human, control mammal with a control drug, the control drug being a known psychotic, a known anxiogenic, and/or a known depressant; measuring the neuronal/glial activity in the brain of the treated control by functional imaging; treating the subject with a therapeutically effective amount of the test pharmaceutical drug; measuring the neuronal/glial activity in the brain of the treated subject by functional imaging; and comparing the neuronal/glial activity in the brain of the treated subject with the neuronal/glial activity in the brain of the control animal.
- the control drug being a known psychotic, a known anxiogenic, and/or a known depressant
- a comparable pattern of neuronal/glial activity in the brain of the treated subject relative to the pattern of neuronal/glial activity in the brain of the control after administration of the control drug indicates that the test pharmaceutical drug with therapeutic activity causes depression and/or psychosis and/or anxiety.
- the subject is a non-human mammal selected from the group consisting of a mouse, rodent, and primate.
- control psychotic is selected from the group consisting of apomorphine, cocaine, amphetamine, methamphetamine, methylenedioxymethamphetamine ("MDMA”), and phenylcyclohexylpiperidine (“PCP”).
- control anxiogenic is selected from the group consisting of DMCM, FG-7142, ZK-93426, mCPP, and yohimbine.
- control anxiogenic is selected from the group consisting of alcohol, barbiturates, benzodiazepines, non-benzodiazepines, and opioids.
- the disclosure features a method for determining whether a test pharmaceutical drug with therapeutic activity is also a psychosis-inducing drug.
- a conscious, non-human, mammalian subject is treated with a therapeutically effective amount of the test pharmaceutical drug; measuring the neuronal/glial activity in the integrated neural network of the subject by functional imaging of the subject's brain; and comparing the neuronal/glial activity in the subject after administration of the test pharmaceutical drug with the neuronal/glial activity in the integrated neural network of a control animal after administration of a control drug known to induce psychosis.
- a comparable pattern of neuronal/glial activity in the subject relative to the pattern of neuronal/glial activity in the control animal after administration of the control drug indicates that the test pharmaceutical drug is a psychosis-inducing drug.
- the nonhuman, mammalian subject is selected from the group consisting of a mouse, rodent, and primate.
- the known psychosis-inducing drug is selected from the group consisting of apomorphine, cocaine, amphetamine, methamphetamine,
- MDMA methylenedioxymethamphetamine
- PCP phenylcyclohexylpiperidine
- a method of determining whether a test pharmaceutical drug with therapeutic activity is also an anxiogenic comprises treating a conscious, non-human, mammalian subject with a therapeutically effective amount of the test pharmaceutical drug; measuring the neuronal/glial activity in the integrated neural network of the subject by functional imaging of the subject's brain; and comparing the neuronal/glial activity in the subject after administration of the test pharmaceutical drug with the neuronal/glial activity in the integrated neural network of a control animal after administration of a control angiogenic.
- a comparable pattern of neuronal/glial activity in the subject relative to the pattern of neuronal/glial activity in the control animal after administration of the control anxiogenic indicates that the test pharmaceutical drug is an anxiogenic.
- the mammalian subject is selected from the group consisting of a mouse, rodent, and primate.
- the known anxiogenic is selected from a group consisting of DMCM, FG-7142, ZK-93426, mCPP, and yohimbine.
- the disclosure provides a method for identifying whether a test pharmaceutical drug with therapeutic activity is also an anti-depressant.
- the method disclosed comprises treating a conscious, non-human, mammalian subject with a therapeutically
- test pharmaceutical drug measuring the neuronal/glial activity in the integrated neural network of the subject by functional imaging of the subject's brain; and comparing the neuronal/glial activity in the subject after administration of the test
- administration of the known depressant indicates that the test pharmaceutical drug is a depressant.
- the mammalian subject is selected from the group consisting of a mouse, rodent, and primate.
- the known depressant is selected from a group consisting of alcohol, barbiturates, benzodiazepines, non-benzodiazepines, and opioids.
- a method of identifying areas of the integrated neural network of the brain of a conscious, non-human, mammalian control that elicit psychosis comprises treating the control with an amount of a control psychotic known to cause psychosis; identifying a region of the brain of the treated control subject which shows neuronal/glial activity by functional imaging; treating a conscious, non-human, mammalian subject of the same species as the control with a therapeutically-effective amount of an anti-psychotic drug; allowing the anti-psychotic drug to achieve pharmacokinetic equilibrium in the subject; treating the subject with an amount of the control psychotic known to cause psychosis; identifying a region in the brain of the treated subject having neuronal/glial activity by functional imaging; and comparing the regions of neuronal/glial activity in the brain of the treated control with the regions of neuronal/glial activity in the brain of the treated subject. Detectable differences in the regions of the brain having neuronal/glial activity in
- the mammalian control and subject are selected from the group consisting of a mouse, rodent, and primate.
- administration of either the psychotic or anti-psychotic is chronically administered over 1 to 12 weeks, individually or simultaneously.
- the disclosure also discloses a method of identifying areas of the integrated neural network of the brain of a conscious, non-human, mammalian subject that elicit anxiety.
- the method comprises treating a control animal with an amount of a control anxiogenic known to cause anxiogenic; identifying a region of the brain of the treated subject which shows neuronal/glial activity by functional imaging; treating a conscious, non-human, mammalian subject of the same species as the control with a therapeutically effective amount of an anxiolytic drug; allowing the anxiolytic drug to achieve pharmacokinetic equilibrium in the subject; treating the subject with a an amount of the control anxiogenic which is known to cause anxiety; identifying a region in the brain of the treated subject having neuronal/glial activity by functional imaging; and comparing the regions of neuronal/glial activity in the treated control with the regions of neuronal/glial activity in the brain of the treated subject.
- the mammalian control and subject are selected from the group consisting of a mouse, rodent, and primate.
- administration of either the anxiogenic or anxiolytic is chronically administered over 1 to 12 weeks, individually or simultaneously.
- a method of identifying areas of the integrated neural network of the brain of a conscious, non-human, mammalian control that elicit depression comprises treating the control with an amount of a control depressant; identifying a region of the brain of the treated subject which shows neuronal/glial activity by functional imaging; treating a conscious, non-human, mammalian subject of the same species with a therapeutically effective amount of an anti-depressant drug; allowing the anti-depressant drug to achieve pharmacokinetic equilibrium in the subject; treating the subject with a an amount of the control depressant; identifying a region in the brain of the treated subject having neuronal/glial activity by functional imaging; and comparing the regions of neuronal/glial activity in the treated control with the regions of neuronal/glial activity in the brain of the treated subject.
- a detectable difference in the regions of the brain having neuronal/glial activity in the treated control relative to the treated subject indicates that these brain regions are involved in depression.
- the mammalian control and subject are selected from the group consisting of a mouse, rodent, and primate.
- administration of either the depressant or anti-depressant is chronically administered over 1 to 12 weeks, individually or simultaneously.
- methods of screening a test drug for increased risk of one or more of depression, psychosis, or anxiety in a conscious, non-human, mammalian subject comprise measuring a neural/glial activity in a brain of a first conscious, non-human, mammalian subject treated with a drug used to treat one or more of a psychotic, an anxiogenic, or a depression disorder and identifying a pattern of neural/glial activity of the brain of the first subject treated with the drug.
- the methods also entail treating a second conscious, non-human, mammalian subject with a test drug and measuring the neural/glial activity in the brain of the second subject treated with the test drug and identifying a pattern of the neural/glial activity of the brain of the second subject.
- the pattern of the neural/glial activity of the brain of the first subject is compared to the pattern of the neural/glial activity of the brain of the second subject.
- the neuronal/glial activity is measured by functional MRI.
- the test drug is used to treat mental illness.
- the mammalian subject is selected from the group consisting of a mouse, rodent, and primate.
- control psychotic is selected from the group consisting of apomorphine, cocaine, amphetamine, methamphetamine, methylenedioxymethamphetamine ("MDMA"), and phenylcyclohexylpiperidine (“PCP”).
- control anxiogenic is selected from the group consisting of DMCM, FG-7142, ZK-93426, mCPP, and yohimbine.
- control depressant is selected from the group consisting of alcohol, barbiturates, benzodiazepines, non-benzodiazepines, and opioids.
- the methods further comprise measuring a neural/glial activity in a brain of a first conscious, non-human, mammalian subject treated with a drug used to treat one or more of a psychotic, an anxiogenic, or a depression disorder in the brains of a plurality of conscious, non-human, mammalian subjects with a plurality of drugs used to treat one or more of a psychotic, an anxiogenic, or a depression disorder.
- the methods further comprise compiling the patterns identified into a database.
- determining a pattern of neural/glial activity comprises identifying differences between the pattern of neural/glial activity of the first subject and the pattern of the neural/glial activity of the second subject.
- patterns are identified for a plurality of test drugs.
- the methods further comprise generating a composite pattern of neural/glial activity from the patterns identified for the plurality of test drugs, the composite pattern representing a consensus of neural/glial activity associated with one or more of depression, psychosis, or anxiety as determined from the patterns identified for the plurality of test drugs.
- the methods further comprise refining the composite pattern based on additional patterns compiled in the database.
- the methods further comprise measuring a neural/glial activity in a brain of a third conscious, non-human, mammalian subject treated with a drug having no known effect on one or more of a psychotic, an anxiogenic, or a depression disorder and identifying a pattern of neural/glial activity of the brain of the first subject treated with the drug having no known effect.
- the methods further comprise determining whether the drug having no known effect has a pattern of neural/glial activity similar to any of the composite patterns in the database.
- methods of identifying a drug for increased risk of suicide in a subject comprise administering the drug to a subject and detecting the level of activity of cells in one or more brain regions of the subject, the region selected from prelimbic cortex, gustatory cortex, insular cortex, secondary somatosensory cortex, parietal cortex, medial dorsal striatum, anterior thalamus, ventral anterior lateral thalamus, reuniens thalamus, ventral medial thalamus, lateral posterior thalamus, lateral dorsal thalamus, central thalamus, CA1 hippocampus, posterior hypothalamus, and central raphe.
- An increased level of activity relative to a control is indicative of the drug having an increased risk of suicide by the subject.
- Figure 1 is a representation showing a methodological approach to screen drugs for the potential to increase the risk for a disorder such as suicidal ideation.
- Figure 1 specifically shows the generation of a map detailing a pattern of brain activity attributed to increasing the risk of the disorder by determining a common brain activity pattern following test drug administration of five hypothetical drugs to brain activity patterns following administration of drugs known to treat the specific disorder.
- Figure 2A is a graphical representation showing the median activated voxels in the insular cortex following administration of vehicle, 0.25 mg/kg body mass of corticosterone, or 1.0 mg/kg body mass of corticosterone in male, Long Evans rats.
- Figure 2B is a graphical representation showing the median activated voxels in the motor cortex following administration of vehicle, 0.25 mg/kg body mass of corticosterone, or 1.0 mg/kg body mass of corticosterone in male, Long Evans rats.
- Figure 3 is a graphical representation showing the change in BOLD signal from a stimulus (vehicle, 0.25 mg/kg or 1.0 mg/kg body mass of corticosterone) over seven minutes of monitoring by fJVIRI.
- Figure 4A is a graphical representation showing the change in respiratory rate (respirations/minute) of male, Long Evans rats over eight days of acclimation to the imaging protocol.
- Figure 4B is a graphical representation showing the change in heart rate (beats/minute) of male, Long Evans rats over eight days of acclimation to the imaging protocol.
- Figure 4C is a graphical representation showing the change in corticosterone levels (ng of corticosterone/ml of serum) of male, Long Evans rats over eight days of acclimation to the imaging protocol.
- Figure 5 is a photographic representation showing the total BOLD signal in 154 brain areas (>16,000 voxels) after administration of test drugs, Venlafaxine, Gabapentin, and
- Rimonabant as well as the pattern of expression after administration of the control drugs, Clozapine and Buspirone.
- the representation also shows the 67 areas of common brain activity after administration of the test drugs and the 17 brain areas unique to the test drugs excluding the BOLD signal in brains exposed to the control drugs.
- Figure 6 is a photographic representation showing a 3D activation map of the brain areas unique to the test drugs, with rostral at the top of the representation and caudal at the bottom of the representation.
- Figure 7 is a photographic representation showing 2D activation maps used to generate the 3D activation map.
- an "activation map” is an image showing one or more regions of a brain, the image showing the areas of the brain having increased or decreased activity.
- Activation maps can be either two-dimensional ("2D") or three-dimensional (“3D").
- An activation map can be generated using any imaging device disclosed herein or known to those of ordinary skill in the art.
- an "adverse side effect" is a harmful, undesirable, and unintended secondary consequence resulting from medication administered to address the primary symptom(s).
- administration of an antipsychotic to quell hallucinations can lead to tardive dyskinesia (the unintended and undesirable consequence of the antipsychotic).
- “Depression” is defined as a mental state of altered mood characterized by feelings of sadness, despair, loneliness, discouragement, low self-esteem, and self-reproach, often
- Depression may be induced by environmental factors (e.g., seasonal affective disorder, situational depression).
- an "anti-depressant” is a medication used to alleviate mood disorders, such as major depression and dysthymia, associated with depression.
- depression is a medication used to alleviate mood disorders, such as major depression and dysthymia, associated with depression.
- depressants are compositions that lower one's mood and induce feelings of sadness, lethargy or ambivalence.
- Anxiety is the experience of fear or apprehension in response to anticipated internal or external danger accompanied by cognitive, somatic, emotional, and of behavioral components.
- Anxiety is a generalized mood condition that occurs without an identifiable triggering stimulus.
- an anxiolytic is any drug that is prescribed to treat the symptoms of anxiety.
- an "anxiogenic” is any drug that can induce anxiety.
- "Psychosis” is a symptom or feature of mental illness typically characterized by radical changes in personality, impaired functioning, and a distorted or nonexistent sense of objective reality. Psychosis may appear as a symptom of a number of mental disorders, including mood and personality disorders. It is also the defining feature of schizophrenia, schizophreniform disorder, schizoaffective disorder, delusional disorder, and the psychotic disorders.
- Anti-psychotics are used to treat symptoms of psychosis (e.g., hallucinations, paranoia) and are divided into two classes: typical and atypical anti-psychotics.
- Psychotics are drugs that can induce psychosis.
- chronic administration is defined as dosing sustained for over one week.
- test pharmaceutical drug refers to a compound whose therapeutic abilities are unknown, e.g., whose ability to decrease the symptoms of a mental illness is unknown.
- test pharmaceutical drug with therapeutic efficacy refers to a compound whose therapeutic benefits are known.
- control drug refers to a drug with known efficacy and/or known adverse side effects.
- control drugs may be known psychotics, anxiogenics, and depressants.
- control animal describes an animal that is administered a control drug to be used as a reference in comparison to a test animal of the same species and age that is treated with a test pharmaceutical drug.
- neuronal/glial activity refers to a measurable change in the cerebral blood flow in a particular brain region.
- Increased neuronal/glial activity in a particular brain region corresponds to increased blood flow to that brain region to meet the metabolic demands of the neuronal/glial activity.
- a "decrease in neuronal/glial activity” within a particular brain region correlates to diminished cerebral blood flow due to the decrease in neuronal/glial activity.
- Detectable changes in neuronal/glial activity act as a surrogate marker for cerebral blood flow and, in turn, can provide a "molecular fingerprint" of neuronal/glial activity in response to various stimuli.
- a "comparable pattern" of neuronal/glial activity in the brain is defined as when at least 70% of the area of defined integrated neural network are activated as measured by functional imaging when compared from one subject to another.
- a "detectable difference" of neuronal/glial activity is defined as a measurable
- An "integrated neural network” is a basic unit of the nervous system controlling behavior, comprised of neural pathways conveying sensory and motor information to and from brain areas involved in integrating this information with past memories, feelings, mood, and temperament.
- the integrated neural network of aggression can comprise sensory information coming from any of the sensory modalities (smell, vision, sound, etc.) about a potential competitor, directed to an area of the brain that organizes an aggressive respond based upon, past history of the competitor, history of fighting and winning, context of the agonist encounter (e.g., protecting young, fighting for food and sex, defense of home territory), mood of the protagonist, endocrinology of the protagonist etc. This information is part of the emotional experience of an aggressive encounter. When the decision is made to fight or run there are parts of the brain involved in the organizing the motor component of attack, the output of the behavior.
- a "therapeutically effective amount" of a test pharmaceutical drug or control drug is a dosage quantity of a drug that has beneficial effects that proves to be measurably and significantly different from effects in subjects/patients treated with a placebo. This dosage amount can be determined by titration of a drug to identify the most efficacious dose.
- test pharmaceutical drug with therapeutic activity can be administered by any protocol and in a variety of unit dosage forms depending upon the method of administration.
- Dosages for test pharmaceutical compositions are well known to those of skill in the art.
- the amount of the test pharmaceutical drug adequate to generate the desired response is defined as a "therapeutically effective dose.”
- the dosage schedule and amounts effective for desired uses, i.e., the "dosing regimen,” will depend upon a variety of factors, including the pharmaceutical formulation and concentration of excipient, and the like.
- the dosage regimen also takes into consideration pharmacokinetics, i.e., the test pharmaceutical drug's rate of absorption,
- pharmacokinetic equilibrium is a plateau in the brain concentration of a drug administered at which time the drug achieves its highest levels based upon the dosing regimen.
- the term “about” or “approximately” means within 20%, within 10%, or within 5% of a given value or range.
- the term “about” or “approximately” means within an order of magnitude, preferably within a factor of 2, of a given value, e.g., a concentration of a compound that causes a half-maximal biological effect.
- the term “about” or “approximately” means that a value can fall within a scientifically acceptable error range for that type of value, which will depend on how quantitative a measurement can be given the available tools.
- “Functional imaging” as described herein is the study of brain function and activity based on the analysis of data acquired using brain imaging modalities.
- One approach to discovering new drugs for the treatment of depression, psychosis, and/or anxiety is screening the drugs in different animal models. This has been the traditional route practiced by pharmaceutical companies.
- the present disclosure is directed, in part, to a method for identifying a test pharmaceutical drug that causes depression, psychosis, and/or anxiety in a conscious, non-human mammalian subject.
- This screening method uses brain activity, not behavior, as a surrogate marker for efficacy of the test pharmaceutical drug.
- test pharmaceutical drug identified in this method may be a compound whose therapeutic benefits are known, but whose potential side affects are unknown.
- test pharmaceutical drugs with side effects associated with depression, psychosis, and anxiety are screened herein.
- the disclosed methods identify a particular area of the brain that renders a subject more likely to suffer from a particular disorder, such as those disorders described herein.
- fMRI is used to identify a pattern of brain activity (i.e., activation map) following the administration of one or more test drugs 100 to subjects ( Figure 1).
- control drugs known to treat the particular disorder are provided to a control group of subjects.
- the patterns of activity (i.e., activation map) induced by the control drugs are determined 110 and compared to the common brain activity identified in the activation maps of brains exposed to the test drugs 120. The comparison shows the areas in brains (i.e., also an activation map) exposed to the test drugs that have a higher activity than the areas of brains exposed to the control drugs 130.
- the activation maps can be stored in a database.
- database it is meant a collection of information or data stored in a system.
- Databases are typically organized based on a database model.
- common database models include row-based, column-based, hierarchical, relational, object-oriented and network models.
- the database is organized to store activation maps such that particular activation maps are associated with particular disorders.
- activation maps i.e., brain activity patterns or "fingerprints
- database capabilities are well-known in the computer arts.
- database search software products include, but are not limited to, Exorbyte Master Data Server, IMP Database Search Engine, Google Search Appliance, and Dieselpoint. Therefore, a user can search the database for activation maps relating to a particular disorder or a particular drug.
- the database stores activation maps for particular disorders.
- the activation maps can be refined as more information is obtained for drugs increasing or decreasing the likelihood of a particular disorder. For instance, an activation map is generated when a test drug associated with a particular disorder exhibits a unique activation pattern as compared to a control drug that treats a particular disorder.
- the activation map is further modified and refined as information for additional drugs associated with a particular disorder are added to the database. This information is used to modify the activation map associated with a particular disorder.
- the first set of activation maps are associated with particular drugs.
- the second set of maps are composite activation maps associated with each particular disorder.
- the composite activation maps are continually refined as more drugs are tested and their activation maps are added to the database.
- Such composite activation maps can be generated using the algorithms disclosed herein and in Example 1.
- Depression is a common but serious illness. There are several forms of depressive disorders including major depressive disorder, dysthymic disorder, and psychotic depression.
- Major depressive disorder is characterized by a combination of sy mptoms that interfere with a person's ability to work, sleep, study, eat, and enjoy once pleasurable activities.
- Dysthymic disorder also called dysthymia, is characterized by long-term (i.e., longer than two years), but less severe, symptoms that may not disable a person but can prevent one from functioning normally.
- Psychotic depression which occurs when a severe depressive illness is accompanied by some form of psychosis, such as a break with reality, hallucinations, and delusions. Symptoms of depression include: persistent sad.
- the disclosed methods allow for identification of regions of the brain that increase the risk of suicidal ideation.
- pharmacological MRI is used to compare BOLD signal changes across brain areas.
- the methods are used to reveal differences in neural activity between drugs that potentially increase the risk for suicide and those used to treat suicidal ideation and aggression.
- the methods identify specific brain areas comprising a putative neural circuit characteristic of drugs that increase the risk.
- Exemplary areas of the brain include prelimbic cortex, gustatory cortex, insular cortex, secondary somatosensory cortex, parietal cortex, medial dorsal striatum, anterior thalamus, ventral anterior lateral thalamus, reuniens thalamus, ventral medial thalamus, lateral posterior thalamus, lateral dorsal thalamus, central thalamus, CA1 hippocampus, posterior hypothalamus, and central raphe.
- Psychosis is a loss of contact with reality, usually including false ideas about what is taking place or who one is (delusions) and seeing or hearing things that aren't there (hallucinations). Symptoms include: abnormal displays of emotion; confusion; depression and sometimes suicidal thoughts; disorganized thought and speech; extreme excitement (mania); false beliefs (delusions); loss of touch with reality; mistaken perceptions (illusions); seeing, hearing, feeling, or perceiving things that are not there (hallucinations); and unfounded fear/suspicion.
- Anxiety is a feeling of nervousness, apprehension, fear, or worry. While some fears and worries are justified, problem anxiety interferes with the ability to sleep or otherwise function. Anxiety may occur without a cause, or it may occur based on a real situation but may be out of proportion to what would normally be expected.
- symptoms usually include at least four of the following: palpitations, sweating, trembling, shortness of breath, sense of choking, chest pain, nausea or other stomach upset, dizziness, derealization, being unable to think, feeling as if the mind has gone blank, a fear of dying, numbness or tingling, and chills or hot flashes.
- test pharmaceutical drug may also be a drug with unknown therapeutic benefits.
- the therapeutic benefit of the test pharmaceutical drug can be ascertained by one of ordinary skill in the art.
- a therapeutic benefit may be to treat, alleviate or reduce the symptoms associated with any disease or disorder.
- the side effects of the test pharmaceutical drug are tested in non- human mammalian subjects.
- non-human mammalian subjects include rodents, such as rats and mice, rabbits, and primates, and are commercially available from a number of sources.
- a control animal is first treated with a control drug that is a known psychotic, a known anxiogenic or a known depressant.
- the control animal should be of the same species and age as the non-human, mammalian subject. In some instances, the control animal and the test subject may be the same animal.
- the control drug used to treat the control animal is a known psychotic, a known anxiogenic, or a known depressant. These drugs may be obtained from commercial sources such as Sigma-Aldrich or Fisher Scientific.
- Known psychotic drugs include, but are not limited to, AK-Pentolate, amphetamines, ancobon, anxiolytics, Ativan, cannabis, centrax, cyclopentolate hydrochloride, cycloserine, depacon, depakene, depakote, depakote ER, depakote sprinkle, diastat, diazemuls, diazepam, diazepam intensol, flucytosine, hallucinogens, hypnotics, I-Pentolate, lodosyn, lorazepam intensol, marijuana, nimodipine, nimotop, opioids, paxipam, pentolair, prograf, sedative withdrawal, sedatives, serax, seromycin pulvules, sinemet, sinemet CR, tacrolimus, valcyte, valganciclovir, valium, valproic acid,
- Known anxiogenics include, but are not limited to, asthma medicines (such as albuterol, salmeterol, and theophylline), blood pressure medicines (such as methyldopa), hormones (such as oral contraceptives), amphetamines, medicines containing amphetamines (such as Benzedrine, Dexedrine, and Ritalin), steroids (such as cortisone, dexamethasone, and prednisone), thyroid medicines, phenytoin, levodopa, quinidine, caffeine, decongestants (such as phenylephrine), and illegal drugs such as cocaine and crack.
- asthma medicines such as albuterol, salmeterol, and theophylline
- blood pressure medicines such as methyldopa
- hormones such as oral contraceptives
- amphetamines such as Benzedrine, Dexedrine, and Ritalin
- steroids such as cortisone, dexamethasone, and prednisone
- Known depressants include, but are not limited to, Zovirax, alcohol, anticonvulsants such as Celontin and Zarontin, barbiturates, benzodiazepines such as Ativan, Dalman, Halcion, Klonopin, Librium, Valium and Xanax, beta-adrenergic blockers such as Lopressor, Tenormin and Coreg, bromocriptine (Parlodel), calcium-channel blockers such as Calan, Cardizem, Tiazac and Procardia, antabuse, estrogens including Premarin and Prempro, fluoroquinolone antibiotics, statins, interferon alpha, accutane, codeine, morphine, Demerol, Darvocet, Percodan, Oxycodone, and Norplant.
- the control drug is administered at a dosage which induces psychosis, anxiety, or depression.
- the amount of the control drug to be administered to the control animal is known to one of ordinary skill in the art (see, e.g., Remington: The Science and Practice of Pharmacy, 21 st edition, Lippincott Williams & Wilkins, Gennaro, ed. (2006) ("Remington's”)) based on published reports studying psychosis, anxiety and depression in laboratory animals.
- the dosage will be proportional to the body weight of the control animal.
- the dosage can vary within this range depending upon the dosage form employed and the route of administration utilized.
- the therapeutically effective dose can be estimated initially from the literature and/or titration studies. Information for preparing and testing such compositions are known in the art (see, e.g., Remington's supra), which is incorporated herein by reference in its entirety.
- the neuronal/glial activity in the brain of the control animal is measured by functional imaging.
- Functional imaging techniques include, but are not limited to, functional magnetic resonance imaging (fMRI), positron emission tomography (PET), single photon emission computed tomography (SPECT), optical imaging, thermal imaging, electroencephalogram (EEG), magnetoencephalogram (MEG) and two- photon laser-scanning microscopy. Due to its non-invasive nature, quick scan times, and image resolution, blood oxygen-level dependent (BOLD) fMRI is often used for neuroimaging experiments.
- fMRI functional magnetic resonance imaging
- PET positron emission tomography
- SPECT single photon emission computed tomography
- EEG electroencephalogram
- MEG magnetoencephalogram
- BOLD blood oxygen-level dependent
- BOLD fMRI measures the blood flow to the local vasculature that accompanies brain activity. Blood oxygen is released to active neurons and glia at a greater rate than to inactive neurons and glia.
- MRI scanners are available at Oxford Instrument (Oxford, U.K.).
- an increase in BOLD signal may be caused without any neuronal/glial activity, e.g., a CO 2 challenge.
- a CO 2 challenge Upon inhalation of CO 2 , the arteries dilate and this in turn causes an increase of blood flow to the area.
- the increase of blood flow to the area is not caused by an increase of neuronal/glial activity but is a consequence of CO 2 challenge.
- this "false-positive" result can be circumvented by measuring the cerebral blood flow (CBF) of the proton molecules in the water molecules of blood as the tracer. Functional MRI can thus measure direct changes in CBF, irrespective of neuronal/glial activity.
- CBF cerebral blood flow
- Another fMRI method employs paramagnetic contrast agents that alter local magnetic susceptibility and enhance the sensitivities of fMRI signals. Using this method, regional and global changes in cerebral blood volume (CBV) can be detected.
- paramagnetic contrast agents include, but are not limited to, metalloporphyrins such as gadolinium-based contrast agents (including, but not limited to, OmniscanTM or gadodiamide (GE Healthcare, UK), MagnevistTM or gadopentetate dimeglumine (Berlex Laboratories, Inc., Trenton, NJ), OptimarkTM or
- gadoversetamide (Mallinckrodt Inc., St. Louis, MO)) and monocrystalline iron oxide nanocolloid (MION) (The Center for Molecular Imaging Research, Massachusetts General Hospital,
- paramagnetic contrast agents include, but are not limited to,
- gadopentetic acid gadoteric acid, gadoteridol, mangafodipir, ferric ammonium citrate, gadobenic acid, gadobutrol, gadoxetic acid, PhotofrinTM (porfimer sodium), gold-coated and dextran-coated MIONs.
- Subject motion is an issue in fMRI data analysis; even the slightest movement during the scan can displace voxel location corresponding to a distinct physical area. Unlike human fMRI, this issue is more prevalent in small animals like rats, because voxel size is much larger than physical (anatomical) area in the brain. The change in signal intensity due to motion can be greater than the BOLD signal, especially at the edge of the brain and tissue boundaries which essentially leads to artifact in the activation map. To avoid this, "motion correction" has become common preprocessing step in fMRI data analysis. Commonly used motion correction tools include, but are not limited to, automated image registration (AIR) (Woods et al, 1992, J. Comput. Assist. Tomogr. 16:620-33; Woods et al, 1998, J. Comput. Assist. Tomogr. 22: 139-52; Woods et al., 1998, J.
- AIR automated image registration
- Motion correction may induce spurious activation in motion-free fMRI data (Freire and Mangin, 2001, Neurolmage 14:709-22). This artifact stems from the fact that activated areas behave like biasing outliers for the difference of square-based measures usually driving such registration methods. This problem is amplified in case of small mammals where the BOLD signal change can be 10% or greater over baseline. If motion parameters are included in the general linear model for event-related data, it makes little difference if motion correction is actually applied to the data (Johnstone et al, 2000, Hum. Brain Map 27:779-88).
- Image resolution using fMRI depends on the strength of the magnet. Magnets employed for fMRI studies range from 1.5 Tesla (T) to 11.7 T. The more powerful the magnet, the greater the resolution of the image. For brain imaging studies, the typical magnet strength is about 4.7 T and 7.0 T (GE Healthcare, U.K.; Bruker BioSpin, U.S.). Using a magnet field strength greater than 7.0 T may be problematic as there are limitations with high magnetic field strengths. For example, stronger magnetic field strengths shorten the T2 relaxation time, thereby making it difficult to delineate boundaries in fMRI studies that favor T2-weighted sequences.
- Positron emission tomography also measures CBF using radiolabeled compounds.
- This invasive imaging modality takes advantage of the unstable positron-emitting isotopes (for example, 15 0 and n C ) incorporated in radiolabeled water or glucose.
- the radiolabeled water or glucose is delivered to the active neurons and glia.
- a positron is emitted and eventually collides with an electron, thereby emitting two gamma rays, which are then measured using gamma ray detectors.
- the location of active regions can be imaged.
- Cyclotrons, which are used to produce the positron-emitting isotopes, and PET imaging scanners may be purchased from GE Healthcare (U.K.).
- Single photon emission computed tomography (SPECT) imaging also measures CBF using radiolabels that need to be injected into the subject.
- Red blood cells pick up and distribute the injected radiolabel (for example, 123 I-labeled iodoamphetamine) throughout the body, specifically to areas of high metabolic activity.
- the radiolabel decays, photons are emitted and detected to recreate a three-dimensional image of neuronal/glial activity.
- image resolution from SPECT is low and is thus better suited to image large regions of the brain as opposed to finer features within.
- radiolabeled tracers rather than positron- emitting isotopes, are used, a cyclotron is not needed.
- Gamma ray detectors similar to the ones used in PET imaging, are then used to detect and image the neuronal/glial activity.
- Electroencephalograms measure the electrical activity of the brain as a measure of time varying spontaneous potentials through a number of electrodes attached to the scalp. The information from the electrical activity obtained through EEG analysis is recorded as sets of traces of the amplitude of spontaneous potentials over time. While EEGs can capture oscillations created by brain electric potentials from the 10 millisecond to 100 millisecond range, its spatial resolution is quite poor. When the subjects are animals, surgery is typically required to mount the electrodes directly onto the animal's skull. Pinnacle Technology, Inc. (Lawrence, KS) manufactures a rat and mouse EEG system suitable for use with the method disclosed.
- EEG magnetoencephalograms
- MEGs magnetoencephalograms
- Superconducting magnetic detectors detect rapidly changes in magnetic fields and translate them into detectable alterations in electric current.
- MEG also has superior temporal resolution and poor spatial resolution.
- Pinnacle Technology, Inc. (Lawrence, KS) sells MEG systems for rodents.
- pharmaceutical drugs include, but are not limited to, those found in drug libraries, combinatorial drug libraries, synthetic drug libraries and other known synthetic or natural drugs or compounds with known properties, including known properties for off-label uses.
- the therapeutically-effective amount of a test pharmaceutical drug may be determined by one with ordinary skill in the art (see, e.g., Remington's supra), by administering the drug in varying amounts to identify the most efficacious dose compared to a placebo.
- test pharmaceutical drug described herein can be incorporated into pharmaceutical compositions to be used in the methods described herein.
- Such compositions typically include the test pharmaceutical drug and a pharmaceutically acceptable carrier.
- a "pharmaceutically acceptable carrier” means a carrier that can be administered to a control or subject together with a test pharmaceutical drug, which does not destroy the pharmacological activity thereof.
- Pharmaceutically acceptable carriers include, e.g., solvents, dispersion media, coatings, antibacterial and antifungal agents, isotonic and absorption delaying agents, and the like, compatible with pharmaceutical administration. Supplementary active compounds can also be incorporated into the compositions.
- Non-limiting examples of pharmaceutically acceptable carriers include poly(ethylene-co-vinyl acetate), PVA, partially hydrolyzed poly(ethylene-co-vinyl acetate), poly(ethylene-co-vinyl acetate-co-vinyl alcohol), a cross-linked poly(ethylene-co-vinyl acetate), a cross-linked partially hydrolyzed poly(ethylene-co-vinyl acetate), a cross-linked poly(ethylene-co- vinyl acetate-co-vinyl alcohol), poly-D,L-lactic acid, poly-L-lactic acid, polyglycolic acid, PGA, copolymers of lactic acid and glycolic acid (PLGA), polycaprolactone, polyvalerolactone, poly (anhydrides), copolymers of polycaprolactone with polyethylene glycol, copolymers ofpolylactic acid with polyethylene glycol, polyethylene glycol; and combinations and blends thereof.
- PVA partially hydrolyzed poly(ethylene-co-vinyl acetate),
- Other carriers include, e.g., an aqueous gelatin, an aqueous protein, a polymeric carrier, a cross-linking agent, or a combination thereof.
- the carrier is a matrix.
- the carrier includes water, a pharmaceutically acceptable buffer salt, a pharmaceutically acceptable buffer solution, a pharmaceutically acceptable antioxidant, ascorbic acid, one or more low molecular weight pharmaceutically acceptable polypeptides, a peptide comprising about 2 to about 10 amino acid residues, one or more pharmaceutically acceptable proteins, one or more pharmaceutically acceptable amino acids, an essential-to-human amino acid, one or more pharmaceutically acceptable carbohydrates, one or more pharmaceutically acceptable carbohydrate-derived materials, a non-reducing sugar, glucose, sucrose, sorbitol, trehalose, mannitol, maltodextrin, dextrins, cyclodextrin, a pharmaceutically acceptable chelating agent, EDTA, DTPA, a chelating agent for a
- a pharmaceutical composition containing a test pharmaceutical drug can be formulated to be compatible with its intended route of administration as known by those of ordinary skill in the art.
- routes of administration include parenteral, e.g., intravenous, intradermal, subcutaneous, intracerebral ventricular injection, oral (e.g., inhalation), intranasal, intraocular, transdermal (topical), transmucosal, vaginal and rectal administration, or any mode that allows a test pharmaceutical drug to cross the blood-brain barrier.
- Solutions or suspensions used for parenteral, intradermal, or subcutaneous application can include the following components: a sterile diluent such as water for injection, saline solution, fixed oils, polyethylene glycols, glycerine, propylene glycol or other synthetic solvents; antibacterial agents such as benzyl alcohol or methyl parabens; antioxidants such as ascorbic acid or sodium bisulfite; chelating agents such as ethylenediaminetetraacetic acid; buffers such as acetates, citrates or phosphates and agents for the adjustment of tonicity such as sodium chloride or dextrose.
- the pH can be adjusted with acids or bases, such as hydrochloric acid or sodium hydroxide.
- the parenteral preparation can be enclosed in ampoules, disposable syringes or multiple dose vials made of glass or plastic.
- compositions suitable for injectable use include sterile aqueous solutions (where water soluble) or dispersions and sterile powders for the extemporaneous preparation of sterile injectable solutions or dispersion.
- suitable carriers include physiological saline, bacteriostatic water, Cremophor ELTM (BASF, Parsippany, NJ) or phosphate buffered saline (PBS).
- the composition must be sterile and should be fluid to the extent that easy syringability exists. It should be stable under the conditions of manufacture and storage and must be preserved against the contaminating action of
- the carrier can be a solvent or dispersion medium containing, for example, water, ethanol, polyol (for example, glycerol, propylene glycol, and liquid polyetheylene glycol, and the like), and suitable mixtures thereof.
- the proper fluidity can be maintained, for example, by the use of a coating such as lecithin, by the maintenance of the required particle size in the case of dispersion and by the use of surfactants.
- Prevention of the action of microorganisms can be achieved by various antibacterial and antifungal agents, for example, parabens, chlorobutanol, phenol, ascorbic acid, thimerosal, and the like.
- isotonic agents for example, sugars, polyalcohols such as mannitol, sorbitol, or sodium chloride in the composition.
- Prolonged absorption of the injectable compositions can be accomplished by including in the composition an agent that delays absorption, for example, aluminum monostearate and gelatin (see, e.g., Remington's supra).
- Sterile injectable solutions can be prepared by incorporating test pharmaceutical drug in the required amount in an appropriate solvent with one or a combination of ingredients enumerated above, as required, followed by filtered sterilization.
- dispersions are prepared by incorporating the active compound into a sterile vehicle that contains a basic dispersion medium and the required other ingredients from those enumerated above.
- the methods of preparation include, without limitation, vacuum drying and freeze-drying which yields a powder of the active ingredient plus any additional desired ingredient from a previously sterile-filtered solution thereof.
- Oral compositions generally include an inert diluent or an edible carrier.
- the test pharmaceutical drug can be incorporated with excipients and used in the form of tablets, pills, troches, or capsules, e.g., gelatin capsules.
- Oral compositions can also be prepared using a fluid carrier for use as a mouthwash.
- Pharmaceutically compatible binding agents, and/or adjuvant materials can be included as part of the composition.
- the tablets, pills, capsules, troches and the like can contain any of the following ingredients, or compounds of a similar nature: a binder such as microcrystalline cellulose, gum tragacanth or gelatin; an excipient such as starch or lactose, a disintegrating agent such as alginic acid, Primogel, or corn starch; a lubricant such as magnesium stearate or Sterotes; a glidant such as colloidal silicon dioxide; a sweetening agent such as sucrose or saccharin; or a flavoring agent such as peppermint, methyl salicylate, or orange flavoring.
- a binder such as microcrystalline cellulose, gum tragacanth or gelatin
- an excipient such as starch or lactose, a disintegrating agent such as alginic acid, Primogel, or corn starch
- a lubricant such as magnesium stearate or Sterotes
- a glidant such as colloidal silicon dioxide
- test pharmaceutical drug can be delivered in the form of an aerosol spray from pressured container or dispenser that contains a suitable propellant, e.g., a gas such as carbon dioxide, or a nebulizer.
- a suitable propellant e.g., a gas such as carbon dioxide, or a nebulizer.
- Systemic administration can also be by transmucosal or transdermal means.
- penetrants appropriate to the barrier to be permeated are used in the formulation.
- penetrants are generally known in the art, and include, but are not limited to, for example, for transmucosal administration, detergents, bile salts, and fusidic acid derivatives.
- Transmucosal administration can be accomplished through the use of nasal sprays or suppositories.
- the active compounds are formulated into, e.g., ointments, salves, gels, or creams as generally known in the art.
- compositions containing a test pharmaceutical drug can also be prepared in the form of suppositories (e.g., with conventional suppository bases such as cocoa butter and other glycerides) or retention enemas for rectal delivery.
- suppositories e.g., with conventional suppository bases such as cocoa butter and other glycerides
- retention enemas for rectal delivery.
- Dosage unit form refers to physically discrete units suited as unitary dosages for the subject to be treated; each unit containing a predetermined quantity of active compound calculated to produce the desired therapeutic effect in association with the required pharmaceutical carrier.
- Toxicity and therapeutic efficacy of such compounds can be determined by standard pharmaceutical procedures in cell cultures or experimental animals, e.g., for determining the LD5 0 (the dose lethal to 50% of the population) and the ED 50 (the dose therapeutically effective in 50% of the population).
- the dose ratio between toxic and therapeutic effects is the therapeutic index and it can be expressed as the ratio LD5 0 /ED5 0 . While compounds that exhibit toxic side effects can be used, care should be taken to design a delivery system that targets such compounds to the site of affected tissue in order to minimize potential damage to uninfected cells and, thereby, reduce side effects.
- the data obtained from the cell culture assays and animal studies can be used in formulating a range of dosage for use in the test and control mammals disclosed herein.
- the dosage of such compounds lies generally within a range of circulating concentrations that include the ED5 0 with little or no toxicity.
- the dosage can vary within this range depending upon the dosage form employed and the route of administration utilized.
- the therapeutically effective dose can be estimated initially from cell culture assays.
- a dose can be formulated in animal models to achieve a circulating plasma concentration range that includes the IC 50 (i.e., the concentration of the test compound which achieves a half-maximal inhibition of symptoms) as determined in cell culture.
- IC 50 i.e., the concentration of the test compound which achieves a half-maximal inhibition of symptoms
- levels in plasma can be measured, for example, by high performance liquid chromatography. Information for preparing and testing such compositions are known in the art (see, e.g., Remington's supra).
- a therapeutically effective amount or dosage of a test pharmaceutical drug can range from about 0.001 mg/kg body weight to about 500 mg/kg body weight, e.g., from about 0.01 mg/kg body weight to about 50 mg/kg body weight, from about 0.025 mg/kg body weight to about 25 mg/kg body weight, from about 0.1 mg/kg body weight to about 20 mg/kg body weight, from about 0.25 mg/kg body weight to about 20 mg/kg body weight, from about 0.5 mg/kg body weight to about 20 mg/kg body weight, from about 0.5 mg/kg body weight to about 10 mg/kg body weight, from about 1 mg/kg body weight to about 10 mg/kg body weight, or about 5 mg/kg body weight.
- a therapeutically effective amount or dosage of a test pharmaceutical drug can range from about 0.001 mg to about 500 mg total, e.g., from about 0.01 mg to about 40 mg total, from about 0.025 mg to about 30 mg total, from about 0.05 mg to about 20 mg total, from about 0.1 mg to about 10 mg total, or from about 1 mg to about 10 mg total.
- treatment of a subject with a therapeutically effective amount of a test pharmaceutical drug can include a single treatment or a series of treatments.
- a subject is treated with a test pharmaceutical drug in the range of between about 0.06 mg to 120 mg, one time per week for between about 1 to 12 weeks, alternatively between 2 to 8 weeks, between about 3 to 7 weeks, or for about 4, 5, or 6 weeks.
- the effective dosage of a test pharmaceutical drug used for treatment may increase or decrease over the course of a particular treatment.
- Treatment of a subject with a therapeutically effective amount of a test pharmaceutical composition described herein can be a single treatment, continuous treatment, or a series of treatments divided into multiple doses.
- the treatment can include a single administration, continuous administration, or periodic administration over one or more years. Chronic, long-term administration can be indicated in many cases.
- a subject is treated for up to one year. In other instances, a subject is treated for up to 6 months. In yet another situation, a subject is treated for up to 100 days.
- a subject is treated with a test pharmaceutical drug in a time frame of one time per week for between about 1 to 12 weeks, alternatively between 2 to 8 weeks, between about 3 to 7 weeks, or for about 4, 5, or 6 weeks.
- a subject can be treated substantially continuously. In other situations, a subject can be treated once per day, twice per day, once per week, or once per month.
- each formulation is administered in an amount sufficient to reduce the symptoms associated with psychosis, depression and/or anxiety.
- the neuronal/glial activities of the subject and control animals are compared to one another. Images from the functional imaging can be compared by the human eye or by computer assisted imaging programs to identify and measure any increase or decrease increase or decrease in neuronal/glial activity of specific brain areas. As defined above, a comparable pattern of neuronal/glial activity is observed when at least 70% of the identified integrated neural network are activated in both the control animal and test subject. If a comparable pattern is observed between the test pharmaceutical drug and control drug, then the test pharmaceutical drug is a poor clinical candidate since it could induce depression, anxiety and/or psychosis.
- the disclosure also provides a method for determining whether a test pharmaceutical drug with therapeutic activity also a psychotic.
- This method entails treating a conscious, non- human mammalian subject with a therapeutically effective amount of the test pharmaceutical drug.
- a test pharmaceutical drug based on the teachings of the prior art (see, e.g., Remington's supra).
- the neuronal/glial activity of the subject is measured by functional imaging. This image is then compared to a functional image of a control subject that has been administered a control drug known to induce psychosis.
- the test pharmaceutical drug is a psychosis-inducing drug. This same method may be adapted to identify whether a test pharmaceutical drug with therapeutic activity is an anxiogenic and/or a depressant.
- the present disclosure also provides a method for identifying areas of the mammalian brain involved in eliciting psychosis.
- a non-human, mammalian control animal is treated with an amount of a known psychotic known to cause psychosis.
- the dose of the known psychotic administered to induce psychosis is known in the art or can be determined using known methodology.
- the neuronal/glial activity is measured by functional imaging to identify the regions of the brains activated by the psychotic.
- the areas that are activated are part of the integrated neural network that is involved with psychosis.
- a test subject of the same species as the control animal is treated with a therapeutically-effective amount of an anti-psychotic.
- Anti-psychotics are commercially available by prescription form (e.g., Abilify and Clorazil) and over the counter (e.g., alcohol and codeine containing OTC medication).
- prescription form e.g., Abilify and Clorazil
- counter e.g., alcohol and codeine containing OTC medication
- Known anti-psychotics include, but are not limited to haloperidol (Haldol, Serenace), droperidol (Droleptan), chlorpromazine (Thorazine, Largactil), fluphenazine (Prolixin), perphenazine (Trilafon), prochlorperazine (Compazine), thioridazine (Mellaril, Melleril), trifluoperazine (Stelazine), mesoridazine, periciazine, promazine, triflupromazine (Vesprin), levomepromazine ( ozinan), promethazine (Phenergan), pimozide (Orap), chlorprothixene , flupenthixol (Depixol, Fluanxol), thiothixene ( avane), zuclopenthixol (Clopixol, Acuphase), clozapine (Clozaril), olanza
- the anti-psychotics may be administered over a prolonged time period of time, that is, chronic administration, e.g., over 1 to 12 weeks, to allow for changes in brain plasticity to be taken into account in identifying the integrated neural networks that are involved in eliciting pyschosis.
- Drugs can be administered 1-3 times daily, at a dosage of 0.001 mg to 500 mg daily. Dose may depend on the level needed to achieve pharmokinetic equilibrium.
- the subject is then administered a control psychosis-inducing drug and the neuronal/glial activity of the subject is measured by functional imaging as described above.
- the functional images from the control and subject animals are then compared to ascertain differences in neuronal/glial activity. Any discernible/detectable differences in neuronal/glial activity observed in the subject, but not observed in the control animal, identifies the brain regions that are involved in psychosis.
- the method described above for identifying areas of the mammalian brain involved in eliciting psychosis can also be modified to identify areas of the mammalian brain involved in eliciting anxiety and depression.
- an anxiogenic (or known depressant) to the control animal, measure the neuronal/glial activity by functional imaging to identify the regions of the brains activated by the anxiogenic (or depressant), treat a test subject with a therapeutically- effective amount of an anxiolytic (or anti-depressant) (administration of the anxiolytic/anti- depressant may be chronic administration), administer a control anxiogenic (or depressant) and measure the neuronal/glial activity by functional imaging.
- the functional images from the control and subject animals are compared and any discernible/detectable differences in neuronal/glial activity observed in the subject, but not observed in the control animal, identifies the brain regions that are involved in anxiety (or depression).
- Known anxiolytics include, but are not limited to, alprazolam (Xanax), chlordiazepoxide (Librium), clonazepam (Klonopin), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), buspirone (BuSpar), barbiturates, meprobamate (Miltown), hydroxyzine (Atarax), cannabidiol, pineapple sage, chlorpheniramine, diphenhydramine and herbal treatments such as St. John's wort, valerian, kava, chamomile, kratom, blue lotus extracts, sceletium tortuosum (kanna), common skullcap and bacopa monniera.
- Known anti-depressants include, but are not limited to, CelexaTM (citalopram),
- LexaproTM escitalopram oxalate
- LuvoxTM fluvoxamine
- PaxilTM piaroxetine
- fluoxetine fluoxetine
- ZoloftTM sertraline
- CymbaltaTM duloxetine
- EffexorTM venlafaxine
- PristiqTM desvenlafaxine
- NardilTM phenelzine
- ParnateTM tranylcypromine
- AdapinTM doxepin
- AnafranilTM clomipramine
- ElavilTM amitriptyline
- EndepTM amitriptyline
- An adjustable, receive-only surface coil built into the head holder was pressed firmly on the head and locked into place.
- the body of the rat was placed into a body restrainer.
- the body restrainer "floats" down the center of the chassis connecting at the front and rear end-plates and buffered by rubber gaskets.
- the head piece locks into a mounting post on the front of the chassis. This design isolates all of the body movements from the head restrainer and minimizes motion artifact.
- a transmit-only volume coil was slid over the head restrainer and locked into position.
- Functional images were acquired using a multi-slice fast spin echo sequence.
- a single data acquisition including 12 1.2 mm slices collected in 6 seconds (field of view (FOV) 3.0 cm; data matrix 64 x 64; repetition time (TR) 1.43 sec, effective echo time (Eff TE) 53.3 msec, echo time (TE) 7 msec; rapid acquisition with relaxation enhancement (RARE) factor 16, number of excitations (NEX) 1).
- This sequence was repeated 100 times in a 10 minute imaging session, consisting of 5 min of baseline data followed by 5 min of stimulation data.
- a high resolution anatomical data set was collected using a RARE pulse sequence (12 slice; 1.2 mm; FOV 3.0 cm; 256 x 256; TR 2.1 sec; TE 12.4 msec; NEX 6; 7 min acquisition time).
- Each scanning session consisted of 100 data acquisitions with a period of 6 seconds each for a total lapse time of 600 seconds or 10 min.
- the control window was the first 50 scan repetitions, while the stimulation window was scans 51-100 after the stimulation period.
- Statistical t-tests were performed on each subject within their original coordinate system. The baseline threshold was set at 2%. The t-test statistics used a 95% confidence level, two-tailed distributions, and heteroscedastic variance assumptions.
- a false-positive detection controlling mechanism was introduced (Genovese et al, 2002, Neurolmage 15:870-8). This subsequent filter guaranteed that, on average, the false-positive detection rate was below the cutoff of 0.05.
- the formulation of the filter satisfied the following expression:
- a statistical composite was created for each group of subjects. The individual analyses were summed within groups. The composite statistics were built using the inverse transformation matrices. Each composite pixel location (i.e., row, column, and slice), premultiplied by [Ti] "1 , mapped it within a voxel of subject (i). A tri-linear interpolation of the subject's voxel values (percentage change) determined the statistical contribution of subject (i) to the composite (row, column, and slice) location. The use of [Ti] "1 ensured that the full volume set of the composite was populated with subject contributions. The average value from all subjects within the group determined the composite value. The BOLD response maps of the composite were somewhat broader in their spatial coverage than in an individual subject. Thus, only average number of activated pixels that has the highest composite percent change values in particular ROI was displayed in composite map. Activated composite pixels are calculated as follows:
- Animal models of anxiety usually involve testing inbred strains of rats that show strong behavioral phenotypes (e.g., high anxiety behavior and low anxiety behavior Wistar rat) or transgenic knock outs.
- Anxiety is associated with fear and avoidance behavior and is usually assayed in the elevated plus maze or light-dark shuttle box.
- Treatment with conventional anxiolytics like the benzodiazepines (GABA agonists), buspirone (5HT1 agonist), and hydroxyzine (antihistamine) increases the time in the open arm of the plus maze or time spent in the light of the shuttle box.
- Anxiety can be chemically induced.
- GABA antagonists such as DMCM, FG-7142 and ZK-93426
- serotonergic agents such as mCPP
- adrenergic agents such as yohimbine.
- Treatment with these different agents activates the integrated neural network involved in enhancing anxiety, fear and avoidance. Their anxiogenic activity has been shown in animals and humans showing the activation of a neural network common across species.
- asthma medicines such as albuterol, salmeterol, and theophylline
- blood pressure medicines such as methyldopa
- hormones such as oral contraceptives
- amphetamines medicines containing amphetamines (such as Benzedrine, Dexedrine, and Ritalin)
- steroids such as cortisone, dexamethasone, and prednisone
- thyroid medicines phenytoin, levodopa, quinidine, caffeine, decongestants (such as phenylephrine), and illegal drugs such as cocaine and crack.
- the change in signal intensity is determined for each voxel comparing the average signal intensity in its baseline period to the average signal intensity following drug administration.
- Voxels are assigned to one of hundreds of different regions of interests based upon their registration into a 3D segmented atlas.
- Each subject presents with a certain number of significantly activated voxels in a given region of interest or what we call volume of activation, i.e. number of 3D pixels in a 3D volume.
- Random effect analysis with different test statistics is used to compare the average (+/- SD) or median and range of all subjects in an region of interest across all doses.
- These data provide a dose-dependent profile of signal change or finger print identifying brain areas that are significantly activated (increase in signal) or deactivated (decrease in signal). From these profiles a map of an integrated neural circuit characterizing the action of yohimbine on the brain is determined. This represents the putative neural circuit of fear/anxiety.
- This finger print is compared to that of an unknown drug to determine if the unknown has potential anxiogenic activity.
- This fingerprint is also used to evaluate drug action by pretreating animals with a known anxiolytic (e.g., benzodiazepines), drugs that reduces or blocks fear and anxiety. After a period of time when the anxiolytic has achieved its effect, these animals are placed in the MR scanner and imaged in response administration of the know anxiogenic. If the finger print of the anxiogenic is altered appreciably (e.g., more than 30% - 40%) of its components (brain areas comprising the neural circuit), then the anxiolytic is effective in reducing or blocking the anxiogenic effect. Drugs thought to be anxiolytics are screened by pretreating animals with the test drug followed later by imaging brain activity in response to anxiogenic challenge. If the the know fingerprint of the anxiogenic is altered appreciably then the test drug has anxiolytic activity.
- a known anxiolytic e.g., benzodiazepines
- rimonobant affects the brain to increase the risk of depression and suicide, the identified neural network contributes to these behavioral problems. Most neuropsychotropic agents require several weeks to work suggesting a change in brain plasticity is need for efficacy. As such, the same study described above would be repeated but only after daily chronic treatment with rimonobant (1-12 weeks). Having established the rimonobant sensitive neural network for acute and chronic drug exposure, a "finger print" of the conventional anti-depressants is obtained. [0156] Animals are pretreated (SC, IP, oral, IV) with conventional anti-depressants (ranging in doses from 1 ⁇ g - 100 mg).
- the test pharmaceutical drug is likely a depressant.
- a behavioral test such as the tail suspension test and forced swim test is performed. Animals that have been administered a depressant become immobile, i.e., give up more quickly, than animals administered an anti-depressant.
- Example 1 All experimental procedures, including data analysis, statistical analysis, motion artifact assessment, and imaging, were performed as described in Example 1 except as otherwise provided below. All imaging was performed within one week of acclimation. Briefly, adult male rats were prepared for imaging as described in Example 1 above with the following modifications (Ferris et al. (2008) BMC Neurosci. 9: 1 11). Animals were positioned in the animal restrainer under 2% isoflurane and allowed to awaken for a six minute anatomical scan.
- the images shown in Figure 5 were obtained by first measuring a baseline metabolic activity (baseline signal intensity) of all voxels (3D pixels) in the brains as deduced from BOLD measurements for a period of 5 minutes followed by the administration of the drug. The change in signal intensity was determined for each voxel comparing the average signal intensity in its baseline period to the average signal intensity following drug administration. Voxels were assigned to one of hundreds of different regions of interest based upon their registration into a 3D segmented atlas. Each rat presented with a certain number of significantly activated voxels in a given region of interest or "volume of activation," i.e. number of 3D pixels in a 3D volume. Random effect analysis with different test statistics was used to compare the average (+/- SD) or median and range of all rats in a region of interest across all doses. These data provided a finger print ( Figure 5).
- Figure 6 shows the results shown in a 3D activation map.
- the map provides a detailed view of the brain and the areas showing increased BOLD signal.
- the map was built from a compilation of 2D activation maps developed from the phMRI images generated during the experiments ( Figure 7).
- the experiments identified particular areas of the rat brain activated by the test drugs.
- the particular regions of the rat brain were the Prelimbic cortex (corresponding to the human dorsal lateral and prefrontal cortex), medial dorsal striatum (corresponding to the human basal ganglia), the anterior, reuniens, and lateral posterior thalamus (corresponding to the human medial dorsal thalamus), dorsal and ventral CA1 (corresponding the human hippocampus), and insular, gustatory, and parietal cortices (corresponding to the human limbic and parietal cortices).
- Prelimbic cortex corresponding to the human dorsal lateral and prefrontal cortex
- medial dorsal striatum corresponding to the human basal ganglia
- the anterior, reuniens, and lateral posterior thalamus corresponding to the human medial dorsal thalamus
- dorsal and ventral CA1 corresponding the human hippocampus
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Medical Informatics (AREA)
- Physics & Mathematics (AREA)
- Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Veterinary Medicine (AREA)
- Pathology (AREA)
- Public Health (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Molecular Biology (AREA)
- Biophysics (AREA)
- Animal Behavior & Ethology (AREA)
- High Energy & Nuclear Physics (AREA)
- Radiology & Medical Imaging (AREA)
- Psychiatry (AREA)
- Optics & Photonics (AREA)
- Child & Adolescent Psychology (AREA)
- Developmental Disabilities (AREA)
- Educational Technology (AREA)
- Hospice & Palliative Care (AREA)
- Psychology (AREA)
- Social Psychology (AREA)
- Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
- Investigating Or Analysing Biological Materials (AREA)
Abstract
Disclosed are methods for identifying whether a test pharmaceutical drug causes depression, psychosis, or anxiety in a conscious, non-human, mammalian subject.
Description
SCREENING METHOD FOR ADVERSE SIDE EFFECTS
OF A THERAPEUTIC PHARMACEUTICAL DRUG
[0001] This Application claims the benefit of priority to U.S. Provisional Application No. 61/297,875, filed January 25, 2010 and to U.S. Provisional Application No. 61/384,948, filed September 21, 2010, the specifications of which are incorporated by reference in their entirety.
FIELD OF THE INVENTION
[0002] The present invention is in the field of medicine. More specifically, the disclosure is in the field of drug development and screening to identify therapeutic pharmaceutical drugs that do not cause mental illness-related side effects or which are useful for treating psychosis, depression and/or anxiety.
BACKGROUND OF THE INVENTION
[0003] In 2008, the pharmaceutical industry spent over $65 billion U.S. dollars ("USD") on research to discover and develop new drugs to allow patients to live longer, healthier, and more productive lives. On average, it takes around 10-15 years and more than $800 million USD to bring a new drug to market. Most drugs, however, never make it to market. A survey of the 10 largest pharmaceutical companies demonstrated that only 11% of the drugs that entered clinic trials in the United States were approved (Kola et al. (2004) Nature Rev. : Drug Develop. 3(8):71 1-15).
[0004] As a potential new drug moves further along in clinical trials, the cost to bring the drug to market increases exponentially. The earlier a drug fails in clinical trials, the less expensive the failure becomes. For example, the cost associated with a new drug that fails in Phase I or II pales in comparison to a drug that fails in Phase III. New drugs typically fail in clinical trials because they do not meet efficacy benchmarks or because they have adverse side effects.
[0005] For example, rimonobant, a ligand antagonist directed to the cannabinoid CB 1/CB2 receptors, was developed as an anti-obesity drug. However, rimonobant (Acomplia™) was pulled from clinical trials in the United States because it increased the risk of depression and suicide.
[0006] Nevertheless, the Food and Drug Administration ("FDA") may approve drugs with adverse side effects if the benefit to the patient significantly outweighs the consequences of these adverse side effects. Ideally, pharmaceutical companies would like to identify and develop highly efficacious drugs with little to no side effects. To that end, pharmaceutical companies would also
prefer to identify drug candidates that are likely to fail in clinical trials due to adverse side effects earlier in the process, thus saving both time and money spent on research and development.
[0007] One of the primary areas pharmaceutical companies are focusing their research and development dollars is on mental health. Since Americans are spending their health care dollars on mental health/illness at a faster pace than any other health care category (Olfson et al. (2009) Arch. Gen. Psychiatry 66(8):848-56), pharmaceutical companies are actively researching and developing drugs to treat mental health diseases and illnesses such as, but not limited to, schizophrenia, attention deficit hyperactive disorder, psychosis, anxiety, bipolar disorders, anorexia, bulimia, addiction, and depression.
[0008] What is needed are better ways to identify and test therapeutically effective
pharmaceutical compounds that have few, if any, adverse side effects and to do this screening early in the drug development process. In addition, a method to identify and test pharmaceutical drugs useful for the treatment of mental illness/disorders is desirable. Furthermore, there is a need to identify the neural networks involved in mental disorders to gain a better understanding of these conditions as well as to develop drugs which target these brain areas.
SUMMARY OF THE INVENTION
[0009] A drug that causes a certain type of behavior does so by altering the activity of different areas of the brain. The drug could be said to have a finger print. Drugs that share a common action would be predicted to have similar (not necessarily identical) finger prints. Thus, this disclosure is based, at least in part, on the ability of certain therapeutically effective pharmaceutical drugs to induce detectable changes in neuronal/glial activity that can be compared to against known pharmaceutical drugs with known adverse side effects. This method has been exploited to develop the present disclosure, which is directed in part, to methods of drug screening.
[0010] In one aspect, the method comprises treating a non-human, control mammal with a control drug, the control drug being a known psychotic, a known anxiogenic, and/or a known depressant; measuring the neuronal/glial activity in the brain of the treated control by functional imaging; treating the subject with a therapeutically effective amount of the test pharmaceutical drug; measuring the neuronal/glial activity in the brain of the treated subject by functional imaging; and comparing the neuronal/glial activity in the brain of the treated subject with the neuronal/glial activity in the brain of the control animal. A comparable pattern of neuronal/glial activity in the brain of the treated subject relative to the pattern of neuronal/glial activity in the brain of the control
after administration of the control drug indicates that the test pharmaceutical drug with therapeutic activity causes depression and/or psychosis and/or anxiety.
[0011] In certain embodiments, the subject is a non-human mammal selected from the group consisting of a mouse, rodent, and primate.
[0012] In some embodiments, the control psychotic is selected from the group consisting of apomorphine, cocaine, amphetamine, methamphetamine, methylenedioxymethamphetamine ("MDMA"), and phenylcyclohexylpiperidine ("PCP").
[0013] In other embodiments, the control anxiogenic is selected from the group consisting of DMCM, FG-7142, ZK-93426, mCPP, and yohimbine.
[0014] In yet other embodiments, the control anxiogenic is selected from the group consisting of alcohol, barbiturates, benzodiazepines, non-benzodiazepines, and opioids.
[0015] In another aspect, the disclosure features a method for determining whether a test pharmaceutical drug with therapeutic activity is also a psychosis-inducing drug. In this method, a conscious, non-human, mammalian subject is treated with a therapeutically effective amount of the test pharmaceutical drug; measuring the neuronal/glial activity in the integrated neural network of the subject by functional imaging of the subject's brain; and comparing the neuronal/glial activity in the subject after administration of the test pharmaceutical drug with the neuronal/glial activity in the integrated neural network of a control animal after administration of a control drug known to induce psychosis. A comparable pattern of neuronal/glial activity in the subject relative to the pattern of neuronal/glial activity in the control animal after administration of the control drug indicates that the test pharmaceutical drug is a psychosis-inducing drug.
[0016] In certain embodiments, the nonhuman, mammalian subject is selected from the group consisting of a mouse, rodent, and primate.
[0017] In some embodiments, the known psychosis-inducing drug is selected from the group consisting of apomorphine, cocaine, amphetamine, methamphetamine,
methylenedioxymethamphetamine ("MDMA"), and phenylcyclohexylpiperidine ("PCP").
[0018] In a further aspect, a method of determining whether a test pharmaceutical drug with therapeutic activity is also an anxiogenic is disclosed. This method comprises treating a conscious, non-human, mammalian subject with a therapeutically effective amount of the test pharmaceutical drug; measuring the neuronal/glial activity in the integrated neural network of the subject by functional imaging of the subject's brain; and comparing the neuronal/glial activity in the subject after administration of the test pharmaceutical drug with the neuronal/glial activity in the integrated neural network of a control animal after administration of a control angiogenic. A comparable
pattern of neuronal/glial activity in the subject relative to the pattern of neuronal/glial activity in the control animal after administration of the control anxiogenic indicates that the test pharmaceutical drug is an anxiogenic.
[0019] In some embodiments, the mammalian subject is selected from the group consisting of a mouse, rodent, and primate.
[0020] In certain embodiments, the known anxiogenic is selected from a group consisting of DMCM, FG-7142, ZK-93426, mCPP, and yohimbine.
[0021] In another aspect, the disclosure provides a method for identifying whether a test pharmaceutical drug with therapeutic activity is also an anti-depressant. The method disclosed comprises treating a conscious, non-human, mammalian subject with a therapeutically
effective amount of the test pharmaceutical drug; measuring the neuronal/glial activity in the integrated neural network of the subject by functional imaging of the subject's brain; and comparing the neuronal/glial activity in the subject after administration of the test
pharmaceutical drug with the neuronal/glial activity in the integrated neural network of a control animal after administration of a known depressant. A comparable pattern of neuronal/glial activity in the subject relative to the pattern of neuronal/glial activity in the control animal after
administration of the known depressant indicates that the test pharmaceutical drug is a depressant.
[0022] In certain embodiments, the mammalian subject is selected from the group consisting of a mouse, rodent, and primate.
[0023] In some embodiments, the known depressant is selected from a group consisting of alcohol, barbiturates, benzodiazepines, non-benzodiazepines, and opioids.
[0024] In yet another aspect of the disclosure, a method of identifying areas of the integrated neural network of the brain of a conscious, non-human, mammalian control that elicit psychosis is disclosed. The method comprises treating the control with an amount of a control psychotic known to cause psychosis; identifying a region of the brain of the treated control subject which shows neuronal/glial activity by functional imaging; treating a conscious, non-human, mammalian subject of the same species as the control with a therapeutically-effective amount of an anti-psychotic drug; allowing the anti-psychotic drug to achieve pharmacokinetic equilibrium in the subject; treating the subject with an amount of the control psychotic known to cause psychosis; identifying a region in the brain of the treated subject having neuronal/glial activity by functional imaging; and comparing the regions of neuronal/glial activity in the brain of the treated control with the regions of neuronal/glial activity in the brain of the treated subject. Detectable differences in the regions of
the brain having neuronal/glial activity in the treated control relative to the treated subject indicate that these brain regions are involved in psychosis.
[0025] In certain embodiments, the mammalian control and subject are selected from the group consisting of a mouse, rodent, and primate.
[0026] In some embodiments, administration of either the psychotic or anti-psychotic is chronically administered over 1 to 12 weeks, individually or simultaneously.
[0027] The disclosure also discloses a method of identifying areas of the integrated neural network of the brain of a conscious, non-human, mammalian subject that elicit anxiety. The method comprises treating a control animal with an amount of a control anxiogenic known to cause anxiogenic; identifying a region of the brain of the treated subject which shows neuronal/glial activity by functional imaging; treating a conscious, non-human, mammalian subject of the same species as the control with a therapeutically effective amount of an anxiolytic drug; allowing the anxiolytic drug to achieve pharmacokinetic equilibrium in the subject; treating the subject with a an amount of the control anxiogenic which is known to cause anxiety; identifying a region in the brain of the treated subject having neuronal/glial activity by functional imaging; and comparing the regions of neuronal/glial activity in the treated control with the regions of neuronal/glial activity in the brain of the treated subject. A detectable difference in the regions of the brain having neuronal/glial activity in the treated control relative to the treated subject indicates that these brain regions are involved in anxiety.
[0028] In certain embodiments, the mammalian control and subject are selected from the group consisting of a mouse, rodent, and primate.
[0029] In some embodiments, administration of either the anxiogenic or anxiolytic is chronically administered over 1 to 12 weeks, individually or simultaneously.
[0030] A method of identifying areas of the integrated neural network of the brain of a conscious, non-human, mammalian control that elicit depression is also disclosed herein. The method comprises treating the control with an amount of a control depressant; identifying a region of the brain of the treated subject which shows neuronal/glial activity by functional imaging; treating a conscious, non-human, mammalian subject of the same species with a therapeutically effective amount of an anti-depressant drug; allowing the anti-depressant drug to achieve pharmacokinetic equilibrium in the subject; treating the subject with a an amount of the control depressant; identifying a region in the brain of the treated subject having neuronal/glial activity by functional imaging; and comparing the regions of neuronal/glial activity in the treated control with the regions of neuronal/glial activity in the brain of the treated subject. A detectable difference in
the regions of the brain having neuronal/glial activity in the treated control relative to the treated subject indicates that these brain regions are involved in depression.
[0031] In certain embodiments, the mammalian control and subject are selected from the group consisting of a mouse, rodent, and primate.
[0032] In some embodiments, administration of either the depressant or anti-depressant is chronically administered over 1 to 12 weeks, individually or simultaneously.
[0033] In other aspects, methods of screening a test drug for increased risk of one or more of depression, psychosis, or anxiety in a conscious, non-human, mammalian subject are disclosed. The methods comprise measuring a neural/glial activity in a brain of a first conscious, non-human, mammalian subject treated with a drug used to treat one or more of a psychotic, an anxiogenic, or a depression disorder and identifying a pattern of neural/glial activity of the brain of the first subject treated with the drug. The methods also entail treating a second conscious, non-human, mammalian subject with a test drug and measuring the neural/glial activity in the brain of the second subject treated with the test drug and identifying a pattern of the neural/glial activity of the brain of the second subject. The pattern of the neural/glial activity of the brain of the first subject is compared to the pattern of the neural/glial activity of the brain of the second subject. A
determination of a pattern of neural/glial activity associated with one or more of depression, psychosis, or anxiety is made.
[0034] In certain embodiments, the neuronal/glial activity is measured by functional MRI. In other embodiments, the test drug is used to treat mental illness. In particular embodiments, the mammalian subject is selected from the group consisting of a mouse, rodent, and primate.
[0035] In further embodiments, the control psychotic is selected from the group consisting of apomorphine, cocaine, amphetamine, methamphetamine, methylenedioxymethamphetamine ("MDMA"), and phenylcyclohexylpiperidine ("PCP"). In additional embodiments, the control anxiogenic is selected from the group consisting of DMCM, FG-7142, ZK-93426, mCPP, and yohimbine. In still further embodiments, the control depressant is selected from the group consisting of alcohol, barbiturates, benzodiazepines, non-benzodiazepines, and opioids.
[0036] In particular embodiments, the methods further comprise measuring a neural/glial activity in a brain of a first conscious, non-human, mammalian subject treated with a drug used to treat one or more of a psychotic, an anxiogenic, or a depression disorder in the brains of a plurality of conscious, non-human, mammalian subjects with a plurality of drugs used to treat one or more of a psychotic, an anxiogenic, or a depression disorder. In more particular embodiments, the methods further comprise compiling the patterns identified into a database. In other embodiments,
determining a pattern of neural/glial activity comprises identifying differences between the pattern of neural/glial activity of the first subject and the pattern of the neural/glial activity of the second subject.
[0037] In certain embodiments, patterns are identified for a plurality of test drugs. In additional embodiments, the methods further comprise generating a composite pattern of neural/glial activity from the patterns identified for the plurality of test drugs, the composite pattern representing a consensus of neural/glial activity associated with one or more of depression, psychosis, or anxiety as determined from the patterns identified for the plurality of test drugs.
[0038] In additional embodiments, the methods further comprise refining the composite pattern based on additional patterns compiled in the database. In still more embodiments, the methods further comprise measuring a neural/glial activity in a brain of a third conscious, non-human, mammalian subject treated with a drug having no known effect on one or more of a psychotic, an anxiogenic, or a depression disorder and identifying a pattern of neural/glial activity of the brain of the first subject treated with the drug having no known effect. In more embodiments, the methods further comprise determining whether the drug having no known effect has a pattern of neural/glial activity similar to any of the composite patterns in the database.
[0039] In another aspect, methods of identifying a drug for increased risk of suicide in a subject are disclosed. The methods comprise administering the drug to a subject and detecting the level of activity of cells in one or more brain regions of the subject, the region selected from prelimbic cortex, gustatory cortex, insular cortex, secondary somatosensory cortex, parietal cortex, medial dorsal striatum, anterior thalamus, ventral anterior lateral thalamus, reuniens thalamus, ventral medial thalamus, lateral posterior thalamus, lateral dorsal thalamus, central thalamus, CA1 hippocampus, posterior hypothalamus, and central raphe. An increased level of activity relative to a control is indicative of the drug having an increased risk of suicide by the subject.
BRIEF DESCRIPTION OF THE FIGURES
[0040] The foregoing and other objects of the present invention, the various features thereof, as well as the invention itself may be more fully understood from the following description, when read together with the accompanying drawings in which:
[0041] Figure 1 is a representation showing a methodological approach to screen drugs for the potential to increase the risk for a disorder such as suicidal ideation. Figure 1 specifically shows the generation of a map detailing a pattern of brain activity attributed to increasing the risk of the disorder by determining a common brain activity pattern following test drug administration of five
hypothetical drugs to brain activity patterns following administration of drugs known to treat the specific disorder.
[0042] Figure 2A is a graphical representation showing the median activated voxels in the insular cortex following administration of vehicle, 0.25 mg/kg body mass of corticosterone, or 1.0 mg/kg body mass of corticosterone in male, Long Evans rats.
[0043] Figure 2B is a graphical representation showing the median activated voxels in the motor cortex following administration of vehicle, 0.25 mg/kg body mass of corticosterone, or 1.0 mg/kg body mass of corticosterone in male, Long Evans rats.
[0044] Figure 3 is a graphical representation showing the change in BOLD signal from a stimulus (vehicle, 0.25 mg/kg or 1.0 mg/kg body mass of corticosterone) over seven minutes of monitoring by fJVIRI.
[0045] Figure 4A is a graphical representation showing the change in respiratory rate (respirations/minute) of male, Long Evans rats over eight days of acclimation to the imaging protocol.
[0046] Figure 4B is a graphical representation showing the change in heart rate (beats/minute) of male, Long Evans rats over eight days of acclimation to the imaging protocol.
[0047] Figure 4C is a graphical representation showing the change in corticosterone levels (ng of corticosterone/ml of serum) of male, Long Evans rats over eight days of acclimation to the imaging protocol.
[0048] Figure 5 is a photographic representation showing the total BOLD signal in 154 brain areas (>16,000 voxels) after administration of test drugs, Venlafaxine, Gabapentin, and
Rimonabant, as well as the pattern of expression after administration of the control drugs, Clozapine and Buspirone. The representation also shows the 67 areas of common brain activity after administration of the test drugs and the 17 brain areas unique to the test drugs excluding the BOLD signal in brains exposed to the control drugs.
[0049] Figure 6 is a photographic representation showing a 3D activation map of the brain areas unique to the test drugs, with rostral at the top of the representation and caudal at the bottom of the representation.
[0050] Figure 7 is a photographic representation showing 2D activation maps used to generate the 3D activation map.
DETAILED DESCRIPTION OF THE INVENTION
[0051] Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Although methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present invention, suitable methods and materials are described below. All publications, patent applications, patents, and other references mentioned herein are incorporated by reference in their entirety. In case of conflict, the present specification, including definitions, will control. In addition, the materials, methods, and examples are illustrative only and not intended to be limiting.
Definitions
[0052] As used herein, an "activation map" is an image showing one or more regions of a brain, the image showing the areas of the brain having increased or decreased activity. Activation maps can be either two-dimensional ("2D") or three-dimensional ("3D"). An activation map can be generated using any imaging device disclosed herein or known to those of ordinary skill in the art.
[0053] As used herein, an "adverse side effect" is a harmful, undesirable, and unintended secondary consequence resulting from medication administered to address the primary symptom(s). For example, in the context of psychosis, administration of an antipsychotic to quell hallucinations (primary symptom) can lead to tardive dyskinesia (the unintended and undesirable consequence of the antipsychotic).
[0054] "Depression" is defined as a mental state of altered mood characterized by feelings of sadness, despair, loneliness, discouragement, low self-esteem, and self-reproach, often
accompanied by psycho-motor retardation, agitation, withdrawal from social contact, loss of appetite, and/or insomnia. Depression may be induced by environmental factors (e.g., seasonal affective disorder, situational depression).
[0055] An "anti-depressant" is a medication used to alleviate mood disorders, such as major depression and dysthymia, associated with depression. Conversely, "depressants" are compositions that lower one's mood and induce feelings of sadness, lethargy or ambivalence.
[0056] "Anxiety" is the experience of fear or apprehension in response to anticipated internal or external danger accompanied by cognitive, somatic, emotional, and of behavioral components.
Anxiety is a generalized mood condition that occurs without an identifiable triggering stimulus.
[0057] As used herein, an anxiolytic is any drug that is prescribed to treat the symptoms of anxiety. Conversely, an "anxiogenic" is any drug that can induce anxiety.
[0058] "Psychosis" is a symptom or feature of mental illness typically characterized by radical changes in personality, impaired functioning, and a distorted or nonexistent sense of objective reality. Psychosis may appear as a symptom of a number of mental disorders, including mood and personality disorders. It is also the defining feature of schizophrenia, schizophreniform disorder, schizoaffective disorder, delusional disorder, and the psychotic disorders.
[0059] "Anti-psychotics" are used to treat symptoms of psychosis (e.g., hallucinations, paranoia) and are divided into two classes: typical and atypical anti-psychotics. "Psychotics," on the other hand, are drugs that can induce psychosis.
[0060] As used herein, "chronic administration" is defined as dosing sustained for over one week.
[0061] A "test pharmaceutical drug" refers to a compound whose therapeutic abilities are unknown, e.g., whose ability to decrease the symptoms of a mental illness is unknown.
[0062] A "test pharmaceutical drug with therapeutic efficacy" refers to a compound whose therapeutic benefits are known.
[0063] A "control drug" refers to a drug with known efficacy and/or known adverse side effects. In the context of this disclosure, control drugs may be known psychotics, anxiogenics, and depressants.
[0064] A "control animal," as used herein, describes an animal that is administered a control drug to be used as a reference in comparison to a test animal of the same species and age that is treated with a test pharmaceutical drug.
[0065] As used herein, the phrase "neuronal/glial activity" refers to a measurable change in the cerebral blood flow in a particular brain region. "Increased neuronal/glial activity" in a particular brain region corresponds to increased blood flow to that brain region to meet the metabolic demands of the neuronal/glial activity. Likewise, a "decrease in neuronal/glial activity" within a particular brain region correlates to diminished cerebral blood flow due to the decrease in neuronal/glial activity. Detectable changes in neuronal/glial activity act as a surrogate marker for cerebral blood flow and, in turn, can provide a "molecular fingerprint" of neuronal/glial activity in response to various stimuli.
[0066] A "comparable pattern" of neuronal/glial activity in the brain is defined as when at least 70% of the area of defined integrated neural network are activated as measured by functional imaging when compared from one subject to another.
[0067] A "detectable difference" of neuronal/glial activity is defined as a measurable
(detectable) change in the neuronal/glial activity.
[0068] An "integrated neural network" is a basic unit of the nervous system controlling behavior, comprised of neural pathways conveying sensory and motor information to and from brain areas involved in integrating this information with past memories, feelings, mood, and temperament. For example, the integrated neural network of aggression can comprise sensory information coming from any of the sensory modalities (smell, vision, sound, etc.) about a potential competitor, directed to an area of the brain that organizes an aggressive respond based upon, past history of the competitor, history of fighting and winning, context of the agonist encounter (e.g., protecting young, fighting for food and sex, defense of home territory), mood of the protagonist, endocrinology of the protagonist etc. This information is part of the emotional experience of an aggressive encounter. When the decision is made to fight or run there are parts of the brain involved in the organizing the motor component of attack, the output of the behavior.
[0069] A "therapeutically effective amount" of a test pharmaceutical drug or control drug is a dosage quantity of a drug that has beneficial effects that proves to be measurably and significantly different from effects in subjects/patients treated with a placebo. This dosage amount can be determined by titration of a drug to identify the most efficacious dose.
[0070] The test pharmaceutical drug with therapeutic activity can be administered by any protocol and in a variety of unit dosage forms depending upon the method of administration.
Dosages for test pharmaceutical compositions are well known to those of skill in the art. The amount of the test pharmaceutical drug adequate to generate the desired response is defined as a "therapeutically effective dose." The dosage schedule and amounts effective for desired uses, i.e., the "dosing regimen," will depend upon a variety of factors, including the pharmaceutical formulation and concentration of excipient, and the like. The dosage regimen also takes into consideration pharmacokinetics, i.e., the test pharmaceutical drug's rate of absorption,
bioavailability, metabolism, clearance, and the like.
[0071] As used herein, "pharmacokinetic equilibrium" is a plateau in the brain concentration of a drug administered at which time the drug achieves its highest levels based upon the dosing regimen.
[0072] The term "about" or "approximately" means within 20%, within 10%, or within 5% of a given value or range. Alternatively, particularly in the measurement of biological processing, the term "about" or "approximately" means within an order of magnitude, preferably within a factor of 2, of a given value, e.g., a concentration of a compound that causes a half-maximal biological effect. Thus, the term "about" or "approximately" means that a value can fall within a scientifically
acceptable error range for that type of value, which will depend on how quantitative a measurement can be given the available tools.
[0073] "Functional imaging" as described herein is the study of brain function and activity based on the analysis of data acquired using brain imaging modalities.
Selection Methods
[0074] One approach to discovering new drugs for the treatment of depression, psychosis, and/or anxiety is screening the drugs in different animal models. This has been the traditional route practiced by pharmaceutical companies. The present disclosure is directed, in part, to a method for identifying a test pharmaceutical drug that causes depression, psychosis, and/or anxiety in a conscious, non-human mammalian subject. This screening method uses brain activity, not behavior, as a surrogate marker for efficacy of the test pharmaceutical drug.
[0075] The test pharmaceutical drug identified in this method may be a compound whose therapeutic benefits are known, but whose potential side affects are unknown. For example, test pharmaceutical drugs with side effects associated with depression, psychosis, and anxiety are screened herein.
[0076] In certain embodiments, the disclosed methods identify a particular area of the brain that renders a subject more likely to suffer from a particular disorder, such as those disorders described herein. In specific embodiments, fMRI is used to identify a pattern of brain activity (i.e., activation map) following the administration of one or more test drugs 100 to subjects (Figure 1). In addition, control drugs known to treat the particular disorder are provided to a control group of subjects. The patterns of activity (i.e., activation map) induced by the control drugs are determined 110 and compared to the common brain activity identified in the activation maps of brains exposed to the test drugs 120. The comparison shows the areas in brains (i.e., also an activation map) exposed to the test drugs that have a higher activity than the areas of brains exposed to the control drugs 130.
[0077] The activation maps can be stored in a database. By "database," it is meant a collection of information or data stored in a system. Databases are typically organized based on a database model. For instance, common database models include row-based, column-based, hierarchical, relational, object-oriented and network models. The database is organized to store activation maps such that particular activation maps are associated with particular disorders. In addition, activation maps (i.e., brain activity patterns or "fingerprints") can be stored such that the activation maps are associated with a particular drug. Such database capabilities are well-known in the computer arts. For instance, database search software products include, but are not limited to, Exorbyte Master
Data Server, IMP Database Search Engine, Google Search Appliance, and Dieselpoint. Therefore, a user can search the database for activation maps relating to a particular disorder or a particular drug.
[0078] In certain embodiments, the database stores activation maps for particular disorders. The activation maps can be refined as more information is obtained for drugs increasing or decreasing the likelihood of a particular disorder. For instance, an activation map is generated when a test drug associated with a particular disorder exhibits a unique activation pattern as compared to a control drug that treats a particular disorder. The activation map is further modified and refined as information for additional drugs associated with a particular disorder are added to the database. This information is used to modify the activation map associated with a particular disorder.
[0079] Accordingly, there are at least two sets of activation maps in particular embodiments. The first set of activation maps are associated with particular drugs. The second set of maps are composite activation maps associated with each particular disorder. The composite activation maps are continually refined as more drugs are tested and their activation maps are added to the database. Such composite activation maps can be generated using the algorithms disclosed herein and in Example 1.
Depression
[0080] Depression is a common but serious illness. There are several forms of depressive disorders including major depressive disorder, dysthymic disorder, and psychotic depression.
Major depressive disorder is characterized by a combination of sy mptoms that interfere with a person's ability to work, sleep, study, eat, and enjoy once pleasurable activities. Dysthymic disorder, also called dysthymia, is characterized by long-term (i.e., longer than two years), but less severe, symptoms that may not disable a person but can prevent one from functioning normally. Psychotic depression, which occurs when a severe depressive illness is accompanied by some form of psychosis, such as a break with reality, hallucinations, and delusions. Symptoms of depression include: persistent sad. anxious or "empty" feelings; feelings of hopelessness and/or pessimism; feelings of guilt, worihlessness and/or helplessness; irritability, restlessness; loss of interest in activities or hobbies once pleasurable, including sex; fatigue and decreased energy; difficulty concentrating, remembering details and making decisions; insomnia, early-morning wakefulness, or excessive sleeping; overeating, or appetite loss; thoughts of suicide, suicide attempts; and
persistent aches or pains, headaches, cramps or digestive problems that, do not ease even with treatment.
[0081] In particularly severe depression and aggression, suicidal ideation and increased risk of self-harm are possible. The disclosed methods allow for identification of regions of the brain that increase the risk of suicidal ideation. In particular embodiments, pharmacological MRI is used to compare BOLD signal changes across brain areas. The methods are used to reveal differences in neural activity between drugs that potentially increase the risk for suicide and those used to treat suicidal ideation and aggression. In certain embodiments, the methods identify specific brain areas comprising a putative neural circuit characteristic of drugs that increase the risk. Exemplary areas of the brain include prelimbic cortex, gustatory cortex, insular cortex, secondary somatosensory cortex, parietal cortex, medial dorsal striatum, anterior thalamus, ventral anterior lateral thalamus, reuniens thalamus, ventral medial thalamus, lateral posterior thalamus, lateral dorsal thalamus, central thalamus, CA1 hippocampus, posterior hypothalamus, and central raphe.
Psychosis
[0082] Psychosis is a loss of contact with reality, usually including false ideas about what is taking place or who one is (delusions) and seeing or hearing things that aren't there (hallucinations). Symptoms include: abnormal displays of emotion; confusion; depression and sometimes suicidal thoughts; disorganized thought and speech; extreme excitement (mania); false beliefs (delusions); loss of touch with reality; mistaken perceptions (illusions); seeing, hearing, feeling, or perceiving things that are not there (hallucinations); and unfounded fear/suspicion.
Anxiety
[0083] Anxiety is a feeling of nervousness, apprehension, fear, or worry. While some fears and worries are justified, problem anxiety interferes with the ability to sleep or otherwise function. Anxiety may occur without a cause, or it may occur based on a real situation but may be out of proportion to what would normally be expected. For panic anxiety, symptoms usually include at least four of the following: palpitations, sweating, trembling, shortness of breath, sense of choking, chest pain, nausea or other stomach upset, dizziness, derealization, being unable to think, feeling as if the mind has gone blank, a fear of dying, numbness or tingling, and chills or hot flashes. For generalized anxiety disorder, which is defined as excessive, unrealistic, and difficult to control worry over a period of at least six months, symptoms usually are associated with three of the following: restlessness, being easily tired, trouble concentrating, irritability, muscle tension and issues with sleeping.
[0084] In the present method, the test pharmaceutical drug may also be a drug with unknown therapeutic benefits. The therapeutic benefit of the test pharmaceutical drug can be ascertained by one of ordinary skill in the art. For example, a therapeutic benefit may be to treat, alleviate or reduce the symptoms associated with any disease or disorder.
[0085] In the present method, the side effects of the test pharmaceutical drug are tested in non- human mammalian subjects. Examples of non-human mammalian subjects include rodents, such as rats and mice, rabbits, and primates, and are commercially available from a number of sources.
[0086] In the present method, a control animal is first treated with a control drug that is a known psychotic, a known anxiogenic or a known depressant. The control animal should be of the same species and age as the non-human, mammalian subject. In some instances, the control animal and the test subject may be the same animal.
[0087] According to the method, the control drug used to treat the control animal is a known psychotic, a known anxiogenic, or a known depressant. These drugs may be obtained from commercial sources such as Sigma-Aldrich or Fisher Scientific.
[0088] Known psychotic drugs include, but are not limited to, AK-Pentolate, amphetamines, ancobon, anxiolytics, Ativan, cannabis, centrax, cyclopentolate hydrochloride, cycloserine, depacon, depakene, depakote, depakote ER, depakote sprinkle, diastat, diazemuls, diazepam, diazepam intensol, flucytosine, hallucinogens, hypnotics, I-Pentolate, lodosyn, lorazepam intensol, marijuana, nimodipine, nimotop, opioids, paxipam, pentolair, prograf, sedative withdrawal, sedatives, serax, seromycin pulvules, sinemet, sinemet CR, tacrolimus, valcyte, valganciclovir, valium, valproic acid, and valrelease.
[0089] Known anxiogenics include, but are not limited to, asthma medicines (such as albuterol, salmeterol, and theophylline), blood pressure medicines (such as methyldopa), hormones (such as oral contraceptives), amphetamines, medicines containing amphetamines (such as Benzedrine, Dexedrine, and Ritalin), steroids (such as cortisone, dexamethasone, and prednisone), thyroid medicines, phenytoin, levodopa, quinidine, caffeine, decongestants (such as phenylephrine), and illegal drugs such as cocaine and crack.
[0090] Known depressants include, but are not limited to, Zovirax, alcohol, anticonvulsants such as Celontin and Zarontin, barbiturates, benzodiazepines such as Ativan, Dalman, Halcion, Klonopin, Librium, Valium and Xanax, beta-adrenergic blockers such as Lopressor, Tenormin and Coreg, bromocriptine (Parlodel), calcium-channel blockers such as Calan, Cardizem, Tiazac and Procardia, antabuse, estrogens including Premarin and Prempro, fluoroquinolone antibiotics,
statins, interferon alpha, accutane, codeine, morphine, Demerol, Darvocet, Percodan, Oxycodone, and Norplant.
[0091] The control drug is administered at a dosage which induces psychosis, anxiety, or depression. The amount of the control drug to be administered to the control animal is known to one of ordinary skill in the art (see, e.g., Remington: The Science and Practice of Pharmacy, 21st edition, Lippincott Williams & Wilkins, Gennaro, ed. (2006) ("Remington's")) based on published reports studying psychosis, anxiety and depression in laboratory animals. In general, the dosage will be proportional to the body weight of the control animal. The dosage can vary within this range depending upon the dosage form employed and the route of administration utilized. For any drug used in the method disclosed herein, the therapeutically effective dose can be estimated initially from the literature and/or titration studies. Information for preparing and testing such compositions are known in the art (see, e.g., Remington's supra), which is incorporated herein by reference in its entirety.
[0092] After administration of the control drug to the control animal, the neuronal/glial activity in the brain of the control animal is measured by functional imaging. Functional imaging techniques include, but are not limited to, functional magnetic resonance imaging (fMRI), positron emission tomography (PET), single photon emission computed tomography (SPECT), optical imaging, thermal imaging, electroencephalogram (EEG), magnetoencephalogram (MEG) and two- photon laser-scanning microscopy. Due to its non-invasive nature, quick scan times, and image resolution, blood oxygen-level dependent (BOLD) fMRI is often used for neuroimaging experiments.
Functional Magnetic Resonance Imaging
[0093] BOLD fMRI measures the blood flow to the local vasculature that accompanies brain activity. Blood oxygen is released to active neurons and glia at a greater rate than to inactive neurons and glia. The difference in magnetic susceptibility between oxyhemoglobin and deoxyhemoglobin, and thus oxygenated or deoxygenated blood, leads to magnetic signal variation which can be detected using an MRI scanner. MRI scanners are available at Oxford Instrument (Oxford, U.K.).
[0094] However, there are times where an increase in BOLD signal may be caused without any neuronal/glial activity, e.g., a CO2 challenge. Upon inhalation of CO2, the arteries dilate and this in turn causes an increase of blood flow to the area. The increase of blood flow to the area is not caused by an increase of neuronal/glial activity but is a consequence of CO2 challenge. However,
this "false-positive" result can be circumvented by measuring the cerebral blood flow (CBF) of the proton molecules in the water molecules of blood as the tracer. Functional MRI can thus measure direct changes in CBF, irrespective of neuronal/glial activity.
[0095] Another fMRI method employs paramagnetic contrast agents that alter local magnetic susceptibility and enhance the sensitivities of fMRI signals. Using this method, regional and global changes in cerebral blood volume (CBV) can be detected. Examples of paramagnetic contrast agents include, but are not limited to, metalloporphyrins such as gadolinium-based contrast agents (including, but not limited to, Omniscan™ or gadodiamide (GE Healthcare, UK), Magnevist™ or gadopentetate dimeglumine (Berlex Laboratories, Inc., Trenton, NJ), Optimark™ or
gadoversetamide (Mallinckrodt Inc., St. Louis, MO)) and monocrystalline iron oxide nanocolloid (MION) (The Center for Molecular Imaging Research, Massachusetts General Hospital,
Charlestown, MA). Other paramagnetic contrast agents include, but are not limited to,
gadopentetic acid, gadoteric acid, gadoteridol, mangafodipir, ferric ammonium citrate, gadobenic acid, gadobutrol, gadoxetic acid, Photofrin™ (porfimer sodium), gold-coated and dextran-coated MIONs.
[0096] Subject motion is an issue in fMRI data analysis; even the slightest movement during the scan can displace voxel location corresponding to a distinct physical area. Unlike human fMRI, this issue is more prevalent in small animals like rats, because voxel size is much larger than physical (anatomical) area in the brain. The change in signal intensity due to motion can be greater than the BOLD signal, especially at the edge of the brain and tissue boundaries which essentially leads to artifact in the activation map. To avoid this, "motion correction" has become common preprocessing step in fMRI data analysis. Commonly used motion correction tools include, but are not limited to, automated image registration (AIR) (Woods et al, 1992, J. Comput. Assist. Tomogr. 16:620-33; Woods et al, 1998, J. Comput. Assist. Tomogr. 22: 139-52; Woods et al., 1998, J.
Comput. Assist. Tomogr. 22: 153-65), analysis of functional neuroimages (AFNI) (Cox, 1996, Comput. Biomed. Res. 29(3): 162-73), and statistical parametric mapping (SPM) realign tools (Friston et al., 1996, Magn. Reson. Med. 35:346-55).
[0097] Motion correction may induce spurious activation in motion-free fMRI data (Freire and Mangin, 2001, Neurolmage 14:709-22). This artifact stems from the fact that activated areas behave like biasing outliers for the difference of square-based measures usually driving such registration methods. This problem is amplified in case of small mammals where the BOLD signal change can be 10% or greater over baseline. If motion parameters are included in the general linear
model for event-related data, it makes little difference if motion correction is actually applied to the data (Johnstone et al, 2000, Hum. Brain Map 27:779-88).
[0098] Image resolution using fMRI depends on the strength of the magnet. Magnets employed for fMRI studies range from 1.5 Tesla (T) to 11.7 T. The more powerful the magnet, the greater the resolution of the image. For brain imaging studies, the typical magnet strength is about 4.7 T and 7.0 T (GE Healthcare, U.K.; Bruker BioSpin, U.S.). Using a magnet field strength greater than 7.0 T may be problematic as there are limitations with high magnetic field strengths. For example, stronger magnetic field strengths shorten the T2 relaxation time, thereby making it difficult to delineate boundaries in fMRI studies that favor T2-weighted sequences.
Positron Emission Tomography
[0099] Positron emission tomography (PET) also measures CBF using radiolabeled compounds. This invasive imaging modality takes advantage of the unstable positron-emitting isotopes (for example, 150 and nC ) incorporated in radiolabeled water or glucose. When injected into the bloodstream, the radiolabeled water or glucose is delivered to the active neurons and glia. As the unstable isotope decays, a positron is emitted and eventually collides with an electron, thereby emitting two gamma rays, which are then measured using gamma ray detectors. By reconstructing the sites of the positron-electron collisions, the location of active regions can be imaged. Cyclotrons, which are used to produce the positron-emitting isotopes, and PET imaging scanners may be purchased from GE Healthcare (U.K.).
Single Photon Emission Computed Tomography
[0100] Single photon emission computed tomography (SPECT) imaging also measures CBF using radiolabels that need to be injected into the subject. Red blood cells pick up and distribute the injected radiolabel (for example, 123I-labeled iodoamphetamine) throughout the body, specifically to areas of high metabolic activity. As the radiolabel decays, photons are emitted and detected to recreate a three-dimensional image of neuronal/glial activity. Compared to fMRI or PET, image resolution from SPECT is low and is thus better suited to image large regions of the brain as opposed to finer features within. Because radiolabeled tracers, rather than positron- emitting isotopes, are used, a cyclotron is not needed. Gamma ray detectors, similar to the ones used in PET imaging, are then used to detect and image the neuronal/glial activity.
Electroencephalogram
[0101] Electroencephalograms (EEGs) measure the electrical activity of the brain as a measure of time varying spontaneous potentials through a number of electrodes attached to the scalp. The information from the electrical activity obtained through EEG analysis is recorded as sets of traces of the amplitude of spontaneous potentials over time. While EEGs can capture oscillations created by brain electric potentials from the 10 millisecond to 100 millisecond range, its spatial resolution is quite poor. When the subjects are animals, surgery is typically required to mount the electrodes directly onto the animal's skull. Pinnacle Technology, Inc. (Lawrence, KS) manufactures a rat and mouse EEG system suitable for use with the method disclosed.
Magnetoencephalogram
[0102] Whereas EEG measures electrical activity of the brain, magnetoencephalograms (MEGs) measure the magnetic field changes associated with neuronal firing. Superconducting magnetic detectors detect rapidly changes in magnetic fields and translate them into detectable alterations in electric current. Like EEG, MEG also has superior temporal resolution and poor spatial resolution. Pinnacle Technology, Inc. (Lawrence, KS) sells MEG systems for rodents.
[0103] After the neuronal/glial activity of the control animal treated with the control drug has been measured, a non-human, mammalian subject of the same age and species as the control animal is treated with a therapeutically-effective amount of a test pharmaceutical drug. Test
pharmaceutical drugs include, but are not limited to, those found in drug libraries, combinatorial drug libraries, synthetic drug libraries and other known synthetic or natural drugs or compounds with known properties, including known properties for off-label uses. As described below, the therapeutically-effective amount of a test pharmaceutical drug may be determined by one with ordinary skill in the art (see, e.g., Remington's supra), by administering the drug in varying amounts to identify the most efficacious dose compared to a placebo.
Pharmaceutical Compositions and Administration
[0104] The test pharmaceutical drug described herein can be incorporated into pharmaceutical compositions to be used in the methods described herein. Such compositions typically include the test pharmaceutical drug and a pharmaceutically acceptable carrier.
[0105] As used herein, a "pharmaceutically acceptable carrier" means a carrier that can be administered to a control or subject together with a test pharmaceutical drug, which does not destroy the pharmacological activity thereof. Pharmaceutically acceptable carriers include, e.g.,
solvents, dispersion media, coatings, antibacterial and antifungal agents, isotonic and absorption delaying agents, and the like, compatible with pharmaceutical administration. Supplementary active compounds can also be incorporated into the compositions.
[0106] Non-limiting examples of pharmaceutically acceptable carriers that can be used include poly(ethylene-co-vinyl acetate), PVA, partially hydrolyzed poly(ethylene-co-vinyl acetate), poly(ethylene-co-vinyl acetate-co-vinyl alcohol), a cross-linked poly(ethylene-co-vinyl acetate), a cross-linked partially hydrolyzed poly(ethylene-co-vinyl acetate), a cross-linked poly(ethylene-co- vinyl acetate-co-vinyl alcohol), poly-D,L-lactic acid, poly-L-lactic acid, polyglycolic acid, PGA, copolymers of lactic acid and glycolic acid (PLGA), polycaprolactone, polyvalerolactone, poly (anhydrides), copolymers of polycaprolactone with polyethylene glycol, copolymers ofpolylactic acid with polyethylene glycol, polyethylene glycol; and combinations and blends thereof.
[0107] Other carriers include, e.g., an aqueous gelatin, an aqueous protein, a polymeric carrier, a cross-linking agent, or a combination thereof. In another instances, the carrier is a matrix. In yet another instances, the carrier includes water, a pharmaceutically acceptable buffer salt, a pharmaceutically acceptable buffer solution, a pharmaceutically acceptable antioxidant, ascorbic acid, one or more low molecular weight pharmaceutically acceptable polypeptides, a peptide comprising about 2 to about 10 amino acid residues, one or more pharmaceutically acceptable proteins, one or more pharmaceutically acceptable amino acids, an essential-to-human amino acid, one or more pharmaceutically acceptable carbohydrates, one or more pharmaceutically acceptable carbohydrate-derived materials, a non-reducing sugar, glucose, sucrose, sorbitol, trehalose, mannitol, maltodextrin, dextrins, cyclodextrin, a pharmaceutically acceptable chelating agent, EDTA, DTPA, a chelating agent for a divalent metal ion, a chelating agent for a trivalent metal ion, glutathione, pharmaceutically acceptable nonspecific serum albumin, and/or combinations thereof.
[0108] A pharmaceutical composition containing a test pharmaceutical drug can be formulated to be compatible with its intended route of administration as known by those of ordinary skill in the art. Nonlimiting examples of routes of administration include parenteral, e.g., intravenous, intradermal, subcutaneous, intracerebral ventricular injection, oral (e.g., inhalation), intranasal, intraocular, transdermal (topical), transmucosal, vaginal and rectal administration, or any mode that allows a test pharmaceutical drug to cross the blood-brain barrier. Solutions or suspensions used for parenteral, intradermal, or subcutaneous application can include the following components: a sterile diluent such as water for injection, saline solution, fixed oils, polyethylene glycols, glycerine, propylene glycol or other synthetic solvents; antibacterial agents such as benzyl alcohol or methyl parabens; antioxidants such as ascorbic acid or sodium bisulfite; chelating agents such as
ethylenediaminetetraacetic acid; buffers such as acetates, citrates or phosphates and agents for the adjustment of tonicity such as sodium chloride or dextrose. The pH can be adjusted with acids or bases, such as hydrochloric acid or sodium hydroxide. The parenteral preparation can be enclosed in ampoules, disposable syringes or multiple dose vials made of glass or plastic.
[0109] Pharmaceutical compositions suitable for injectable use include sterile aqueous solutions (where water soluble) or dispersions and sterile powders for the extemporaneous preparation of sterile injectable solutions or dispersion. For intravenous administration, suitable carriers include physiological saline, bacteriostatic water, Cremophor EL™ (BASF, Parsippany, NJ) or phosphate buffered saline (PBS). In all cases, the composition must be sterile and should be fluid to the extent that easy syringability exists. It should be stable under the conditions of manufacture and storage and must be preserved against the contaminating action of
microorganisms such as bacteria and fungi. The carrier can be a solvent or dispersion medium containing, for example, water, ethanol, polyol (for example, glycerol, propylene glycol, and liquid polyetheylene glycol, and the like), and suitable mixtures thereof. The proper fluidity can be maintained, for example, by the use of a coating such as lecithin, by the maintenance of the required particle size in the case of dispersion and by the use of surfactants. Prevention of the action of microorganisms can be achieved by various antibacterial and antifungal agents, for example, parabens, chlorobutanol, phenol, ascorbic acid, thimerosal, and the like. It may be desirable to include isotonic agents, for example, sugars, polyalcohols such as mannitol, sorbitol, or sodium chloride in the composition. Prolonged absorption of the injectable compositions can be accomplished by including in the composition an agent that delays absorption, for example, aluminum monostearate and gelatin (see, e.g., Remington's supra).
[0110] Sterile injectable solutions can be prepared by incorporating test pharmaceutical drug in the required amount in an appropriate solvent with one or a combination of ingredients enumerated above, as required, followed by filtered sterilization. Generally, dispersions are prepared by incorporating the active compound into a sterile vehicle that contains a basic dispersion medium and the required other ingredients from those enumerated above. In the case of sterile powders for the preparation of sterile injectable solutions, the methods of preparation include, without limitation, vacuum drying and freeze-drying which yields a powder of the active ingredient plus any additional desired ingredient from a previously sterile-filtered solution thereof.
[0111] Oral compositions generally include an inert diluent or an edible carrier. For the purpose of oral therapeutic administration, the test pharmaceutical drug can be incorporated with excipients and used in the form of tablets, pills, troches, or capsules, e.g., gelatin capsules. Oral
compositions can also be prepared using a fluid carrier for use as a mouthwash. Pharmaceutically compatible binding agents, and/or adjuvant materials can be included as part of the composition. The tablets, pills, capsules, troches and the like can contain any of the following ingredients, or compounds of a similar nature: a binder such as microcrystalline cellulose, gum tragacanth or gelatin; an excipient such as starch or lactose, a disintegrating agent such as alginic acid, Primogel, or corn starch; a lubricant such as magnesium stearate or Sterotes; a glidant such as colloidal silicon dioxide; a sweetening agent such as sucrose or saccharin; or a flavoring agent such as peppermint, methyl salicylate, or orange flavoring.
[0112] For administration by inhalation, the test pharmaceutical drug can be delivered in the form of an aerosol spray from pressured container or dispenser that contains a suitable propellant, e.g., a gas such as carbon dioxide, or a nebulizer.
[0113] Systemic administration can also be by transmucosal or transdermal means. For transmucosal or transdermal administration, penetrants appropriate to the barrier to be permeated are used in the formulation. Such penetrants are generally known in the art, and include, but are not limited to, for example, for transmucosal administration, detergents, bile salts, and fusidic acid derivatives. Transmucosal administration can be accomplished through the use of nasal sprays or suppositories. For transdermal administration, the active compounds are formulated into, e.g., ointments, salves, gels, or creams as generally known in the art.
[0114] The pharmaceutical compositions containing a test pharmaceutical drug can also be prepared in the form of suppositories (e.g., with conventional suppository bases such as cocoa butter and other glycerides) or retention enemas for rectal delivery.
[0115] It may be advantageous to formulate oral or parenteral compositions in dosage unit form for ease of administration and uniformity of dosage. Dosage unit form as used herein refers to physically discrete units suited as unitary dosages for the subject to be treated; each unit containing a predetermined quantity of active compound calculated to produce the desired therapeutic effect in association with the required pharmaceutical carrier.
[0116] Toxicity and therapeutic efficacy of such compounds can be determined by standard pharmaceutical procedures in cell cultures or experimental animals, e.g., for determining the LD50 (the dose lethal to 50% of the population) and the ED50 (the dose therapeutically effective in 50% of the population). The dose ratio between toxic and therapeutic effects is the therapeutic index and it can be expressed as the ratio LD50/ED50. While compounds that exhibit toxic side effects can be used, care should be taken to design a delivery system that targets such compounds to the site of
affected tissue in order to minimize potential damage to uninfected cells and, thereby, reduce side effects.
[0117] The data obtained from the cell culture assays and animal studies can be used in formulating a range of dosage for use in the test and control mammals disclosed herein. The dosage of such compounds lies generally within a range of circulating concentrations that include the ED50 with little or no toxicity. The dosage can vary within this range depending upon the dosage form employed and the route of administration utilized. For any compound used in the method of the invention, the therapeutically effective dose can be estimated initially from cell culture assays. A dose can be formulated in animal models to achieve a circulating plasma concentration range that includes the IC50 (i.e., the concentration of the test compound which achieves a half-maximal inhibition of symptoms) as determined in cell culture. Such information can be used to more accurately determine useful doses in mammals. Levels in plasma can be measured, for example, by high performance liquid chromatography. Information for preparing and testing such compositions are known in the art (see, e.g., Remington's supra).
[0118] In some instances, a therapeutically effective amount or dosage of a test pharmaceutical drug can range from about 0.001 mg/kg body weight to about 500 mg/kg body weight, e.g., from about 0.01 mg/kg body weight to about 50 mg/kg body weight, from about 0.025 mg/kg body weight to about 25 mg/kg body weight, from about 0.1 mg/kg body weight to about 20 mg/kg body weight, from about 0.25 mg/kg body weight to about 20 mg/kg body weight, from about 0.5 mg/kg body weight to about 20 mg/kg body weight, from about 0.5 mg/kg body weight to about 10 mg/kg body weight, from about 1 mg/kg body weight to about 10 mg/kg body weight, or about 5 mg/kg body weight.
[0119] In other instances, a therapeutically effective amount or dosage of a test pharmaceutical drug can range from about 0.001 mg to about 500 mg total, e.g., from about 0.01 mg to about 40 mg total, from about 0.025 mg to about 30 mg total, from about 0.05 mg to about 20 mg total, from about 0.1 mg to about 10 mg total, or from about 1 mg to about 10 mg total.
[0120] A drug developer will appreciate that certain factors may influence the dosage required to effectively treat a subject, including but not limited to previous treatments, the general health and/or age of the subject, and various other factors. Moreover, treatment of a subject with a therapeutically effective amount of a test pharmaceutical drug can include a single treatment or a series of treatments. In one example, a subject is treated with a test pharmaceutical drug in the range of between about 0.06 mg to 120 mg, one time per week for between about 1 to 12 weeks, alternatively between 2 to 8 weeks, between about 3 to 7 weeks, or for about 4, 5, or 6 weeks. It
will also be appreciated that the effective dosage of a test pharmaceutical drug used for treatment may increase or decrease over the course of a particular treatment.
[0121] Treatment of a subject with a therapeutically effective amount of a test pharmaceutical composition described herein can be a single treatment, continuous treatment, or a series of treatments divided into multiple doses. The treatment can include a single administration, continuous administration, or periodic administration over one or more years. Chronic, long-term administration can be indicated in many cases. In some instances, a subject is treated for up to one year. In other instances, a subject is treated for up to 6 months. In yet another situation, a subject is treated for up to 100 days. In one example, a subject is treated with a test pharmaceutical drug in a time frame of one time per week for between about 1 to 12 weeks, alternatively between 2 to 8 weeks, between about 3 to 7 weeks, or for about 4, 5, or 6 weeks. In other instances, a subject can be treated substantially continuously. In other situations, a subject can be treated once per day, twice per day, once per week, or once per month.
[0122] Generally, each formulation is administered in an amount sufficient to reduce the symptoms associated with psychosis, depression and/or anxiety.
[0123] After the neuronal/glial activity of the subject is measured the same way as described above for the control animal, the neuronal/glial activities of the subject and control animals are compared to one another. Images from the functional imaging can be compared by the human eye or by computer assisted imaging programs to identify and measure any increase or decrease increase or decrease in neuronal/glial activity of specific brain areas. As defined above, a comparable pattern of neuronal/glial activity is observed when at least 70% of the identified integrated neural network are activated in both the control animal and test subject. If a comparable pattern is observed between the test pharmaceutical drug and control drug, then the test pharmaceutical drug is a poor clinical candidate since it could induce depression, anxiety and/or psychosis.
[0124] The disclosure also provides a method for determining whether a test pharmaceutical drug with therapeutic activity also a psychotic. This method entails treating a conscious, non- human mammalian subject with a therapeutically effective amount of the test pharmaceutical drug. As noted previously, one of ordinary skill in the art could determine the therapeutically effective dosage of a test pharmaceutical drug based on the teachings of the prior art (see, e.g., Remington's supra). After administration of the test pharmaceutical drug, the neuronal/glial activity of the subject is measured by functional imaging. This image is then compared to a functional image of a control subject that has been administered a control drug known to induce psychosis. If the images
are similar and reveal a comparable pattern of neuronal/glial activity in the same brain regions, the test pharmaceutical drug is a psychosis-inducing drug. This same method may be adapted to identify whether a test pharmaceutical drug with therapeutic activity is an anxiogenic and/or a depressant.
[0125] The present disclosure also provides a method for identifying areas of the mammalian brain involved in eliciting psychosis. In this method, a non-human, mammalian control animal is treated with an amount of a known psychotic known to cause psychosis. As described above, the dose of the known psychotic administered to induce psychosis is known in the art or can be determined using known methodology. Having treated the control animal with the known psychotic, the neuronal/glial activity is measured by functional imaging to identify the regions of the brains activated by the psychotic. The areas that are activated are part of the integrated neural network that is involved with psychosis.
[0126] Once these brain regions are identified, a test subject of the same species as the control animal is treated with a therapeutically-effective amount of an anti-psychotic. Anti-psychotics are commercially available by prescription form (e.g., Abilify and Clorazil) and over the counter (e.g., alcohol and codeine containing OTC medication). The therapeutically-effective amount of an antipsychotic will be apparent to one of ordinary skill in the art based on the scientific literature as well as by recommended dosages on the packaging label.
[0127] Known anti-psychotics include, but are not limited to haloperidol (Haldol, Serenace), droperidol (Droleptan), chlorpromazine (Thorazine, Largactil), fluphenazine (Prolixin), perphenazine (Trilafon), prochlorperazine (Compazine), thioridazine (Mellaril, Melleril), trifluoperazine (Stelazine), mesoridazine, periciazine, promazine, triflupromazine (Vesprin), levomepromazine ( ozinan), promethazine (Phenergan), pimozide (Orap), chlorprothixene , flupenthixol (Depixol, Fluanxol), thiothixene ( avane), zuclopenthixol (Clopixol, Acuphase), clozapine (Clozaril), olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), ziprasidone (Geodon), amisulpride (Solian), asenapine, paliperidone (Invega), ilioperidone (Fanapt), zotepine (Nipolept, Losizopilon, Lodopin, Setous), sertindole (Serdolec), aripiprazole (Abilify), bifeprunox; norclozapine (ACP-104), tetrabenazine, and cannabidiol. Both typical and atypical anti-psychotics may have adverse side effects associated with them, including tardive dyskinesia, diabetes, weight gain, etc.
[0128] The anti-psychotics may be administered over a prolonged time period of time, that is, chronic administration, e.g., over 1 to 12 weeks, to allow for changes in brain plasticity to be taken into account in identifying the integrated neural networks that are involved in eliciting pyschosis.
Drugs can be administered 1-3 times daily, at a dosage of 0.001 mg to 500 mg daily. Dose may depend on the level needed to achieve pharmokinetic equilibrium.
[0129] After the anti-psychotic has reached pharmacokinetic equilibrium, the subject is then administered a control psychosis-inducing drug and the neuronal/glial activity of the subject is measured by functional imaging as described above. The functional images from the control and subject animals are then compared to ascertain differences in neuronal/glial activity. Any discernible/detectable differences in neuronal/glial activity observed in the subject, but not observed in the control animal, identifies the brain regions that are involved in psychosis.
[0130] The method described above for identifying areas of the mammalian brain involved in eliciting psychosis can also be modified to identify areas of the mammalian brain involved in eliciting anxiety and depression. For example, to identify areas of the mammalian brain involved in either anxiety (or depression), one would administer an known anxiogenic (or known depressant) to the control animal, measure the neuronal/glial activity by functional imaging to identify the regions of the brains activated by the anxiogenic (or depressant), treat a test subject with a therapeutically- effective amount of an anxiolytic (or anti-depressant) (administration of the anxiolytic/anti- depressant may be chronic administration), administer a control anxiogenic (or depressant) and measure the neuronal/glial activity by functional imaging. As described above for the psychosis pathway, the functional images from the control and subject animals are compared and any discernible/detectable differences in neuronal/glial activity observed in the subject, but not observed in the control animal, identifies the brain regions that are involved in anxiety (or depression).
[0131] Known anxiolytics include, but are not limited to, alprazolam (Xanax), chlordiazepoxide (Librium), clonazepam (Klonopin), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), buspirone (BuSpar), barbiturates, meprobamate (Miltown), hydroxyzine (Atarax), cannabidiol, pineapple sage, chlorpheniramine, diphenhydramine and herbal treatments such as St. John's wort, valerian, kava, chamomile, kratom, blue lotus extracts, sceletium tortuosum (kanna), common skullcap and bacopa monniera.
[0132] Known anti-depressants include, but are not limited to, Celexa™ (citalopram),
Lexapro™ (escitalopram oxalate), Luvox™ (fluvoxamine), Paxil™ (paroxetine), Prozac™
(fluoxetine), Zoloft™ (sertraline), Cymbalta™ (duloxetine), Effexor™ (venlafaxine), Pristiq™ (desvenlafaxine), Nardil™ (phenelzine), Parnate™ (tranylcypromine), Adapin™ (doxepin), Anafranil™ (clomipramine), Elavil™ (amitriptyline), Endep™ (amitriptyline), Ludiomil™
(maprotiline), Norpramin™ (desipramine), Pamelor™ (nortryptyline), Pertofrane™ (desipramine),
Sinequan™ (doxepin), Surmontil™ (trimipramine), Tofranil™ (imipramine), Vivactil™
(protriptyline), Buspar™ (buspirone), Desyrel™ (trazodone), Edronax™, Vestra™ (reboxetine), Remeron™ (mirtazapine), Serzone™ (nefazodone), and Wellbutrin™ (bupropion).
[0133] The invention is further illustrated by the following examples. The examples are provided for illustrative purposes only. They are not to be construed as limiting the scope or content of the invention in any way.
EXAMPLE 1
Live Animal Functional Imaging
[0134] To image the brain activity of live rats (Charles River Laboratories, Wilmington, MA), the rats were anesthetized with 2% - 3% isoflurane (Abbott Laboratories, North Chicago, IL). Nine (9) rats were used for each experimental condition. A topical anesthetic of 10% lidocaine gel was applied to the skin and soft tissue around the ear canals and over the bridge of the nose. A plastic semi-circular headpiece with blunted ear supports that fit into the ear canals was positioned over the ears. The head was placed into a cylindrical head holder with the rat's canines secured over a bite bar and ears positioned inside the head holder with adjustable screws fitted into lateral sleeves. An adjustable, receive-only surface coil built into the head holder was pressed firmly on the head and locked into place. The body of the rat was placed into a body restrainer. The body restrainer "floats" down the center of the chassis connecting at the front and rear end-plates and buffered by rubber gaskets. The head piece locks into a mounting post on the front of the chassis. This design isolates all of the body movements from the head restrainer and minimizes motion artifact. Once the rat was positioned in the body holder, a transmit-only volume coil was slid over the head restrainer and locked into position.
Acclimation to Imaging Protocol
[0135] When the rats were fully conscious, the restraining unit was placed into a black opaque tube mock scanner with a tape-recording of an MRI pulse sequence. This acclimation protocol lasted for 60 min in order to simulate the bore of the magnet and the imaging protocol. This procedure was repeated every other day for four days. With this procedure, rats show a significant decline in respiration, heart rate, motor movements, and plasma corticosteroid (CORT) when compared the first to the last acclimation periods (King et al, 2005, J. Neurosci. Methods
148(2): 154-60).
Imaging Protocol
[0136] Experiments were conducted in a Bruker Biospec 4.7-T/40-cm horizontal magnet (Oxford Instrument, Oxford, U.K.) equipped with a Biospec Bruker console (Bruker, Billerica, MA, U.S.A.) and a 20 G/cm magnetic field gradient insert (internal diameter = 12 cm) capable of a 120 μ$ rise time (Bruker). Radiofrequency (RF) signals were sent and received with the dual coil electronics built into the animal restrainer (Ludwig et al, 2004, J. Neurosci. Methods 132(2): 125- 35). The volume coil for transmitting RF signal features an 8-element microstrip line configuration in conjunction with an outer copper shield. The arch-shaped geometry of the receiving surface coil provides excellent coverage and high signal-to-noise. To prevent mutual coil interference, the volume and surface coils were actively tuned and detuned.
[0137] Functional images were acquired using a multi-slice fast spin echo sequence. A single data acquisition including 12 1.2 mm slices collected in 6 seconds (field of view (FOV) 3.0 cm; data matrix 64 x 64; repetition time (TR) 1.43 sec, effective echo time (Eff TE) 53.3 msec, echo time (TE) 7 msec; rapid acquisition with relaxation enhancement (RARE) factor 16, number of excitations (NEX) 1). This sequence was repeated 100 times in a 10 minute imaging session, consisting of 5 min of baseline data followed by 5 min of stimulation data. At the beginning of each imaging session, a high resolution anatomical data set was collected using a RARE pulse sequence (12 slice; 1.2 mm; FOV 3.0 cm; 256 x 256; TR 2.1 sec; TE 12.4 msec; NEX 6; 7 min acquisition time).
Motion Artifact
[0138] The experiments conducted in this work are a single epoch event-related design. To assess false activation due to subject motion, fJVIRI data were collected from awake rats (n = 8) over a 10 min scanning session in the absence of any stimulation. From these empirical data, a series of virtual fMRI data were numerically generated using a tri-linear interpolation algorithm with Gaussian noise and a preset amount of rigid body motion in random direction. The amount of motion introduced was in increment of 1/10 of a voxel (ca. 50 μιη) up to one voxel (486 μιη). The data was analyzed with statistical t-tests on each subject within their original coordinate system.
On an average, approximately 3,500 voxels were tested for each subject. The control window was the first 50 time periods (5 min), whereas the stimulation window was the remaining 50 time periods (5 min) as described for the fMRI studies above. The t-test statistics used a 95% confidence level, two-tailed distributions, and heteroscedastic variance assumptions. In this case, a multiple comparison control (false detection rate) was not used to avoid suppression of any
spurious activation. There is no significant change in BOLD signal or the number of activated voxels up to ca 300 μιη (or 6/10 of voxel) motion. Both, number of voxels and percent BOLD signal, increases dramatically as it approaches one voxel of motion.
[0139] For each subject, rigid body motion in x-, y- and z-direction was computed with Stimulate software (Strupp, 1996, Neurolmage 3:S607) using center of intensity method. Standard deviation of this data gives measure of how widely spread the motion is for each subject. A conservative criteria of 120 μιη standard deviation of motion in any direction was set as acceptance criteria. In these experiments, motion in the z- and x-direction was small as compared to y- direction. Animals showing an average displacement exceeding 25% of the total in-plane (x-y) voxel resolution (>120 μιη out of 468 μιη) or more than 25% displacement in the slice (z) direction (>300 μιη out of 1,200 μιη slice thickness) were excluded. Most of the motion was in y-direction (64 μιη ±42 μιη) and can be attributed to limitations in the design of the rat head holder.
Data Analysis
[0140] Anatomy images for each subject were obtained at a resolution of 2562x l2 slices and a FOV of 30 mm with a slice thickness of 1.2 mm. Subsequent functional imaging was performed at a resolution of 642* 12 slices with the same FOV and slice thickness. Each subject was registered to a segmented rat brain atlas. The alignment process was facilitated by an interactive graphic user interface. The affine registration involved translation, rotation, and scaling in all three dimensions, independently. The matrices that transformed the subject's anatomy to the atlas space were used to embed each slice within the atlas. All transformed pixel locations of the anatomy images were tagged with the segmented atlas major and minor regions creating a fully segmented representation of each subject. The inverse transformation matrix [Ti]"1 for each subject (i) was also calculated.
[0141] Twelve brain slices were collected extending from the tip of the forebrain to the end of the cerebrum stopping at the midbrain just rostral to the cerebellum. Within these rostral/caudal boundaries, 83 minor volumes were delineated. In addition, brain areas were grouped into "major volumes" (e.g., amygdala, hippocampus, hypothalamus, cerebrum, etc.). The volume of activation (number of significant voxels) can be visualized in these 3D major and minor anatomical groupings.
[0142] Each scanning session consisted of 100 data acquisitions with a period of 6 seconds each for a total lapse time of 600 seconds or 10 min. The control window was the first 50 scan repetitions, while the stimulation window was scans 51-100 after the stimulation period. Statistical
t-tests were performed on each subject within their original coordinate system. The baseline threshold was set at 2%. The t-test statistics used a 95% confidence level, two-tailed distributions, and heteroscedastic variance assumptions. As a result of the multiple t-test analyses performed, a false-positive detection controlling mechanism was introduced (Genovese et al, 2002, Neurolmage 15:870-8). This subsequent filter guaranteed that, on average, the false-positive detection rate was below the cutoff of 0.05. The formulation of the filter satisfied the following expression:
p < ^_
w V c(V) where Ρφ is the p value based on the t-test analysis. Each pixel (i) within the region of interest (ROI) containing (V) pixels was ranked based on its probability value. The false-positive filter value q was set to be 0.05 for the analyses, and the predetermined constant c(V) was set to unity, which is appropriate for data containing Gaussian noise such as fMRI data (Genovese et al., 2002, Neurolmage 15:870-8). These analysis settings provided conservative estimates for significance. Those pixels deemed statistically significant retained their percentage change values (stimulation mean minus control mean) relative to control mean. All other pixel values were set to zero.
[0143] A statistical composite was created for each group of subjects. The individual analyses were summed within groups. The composite statistics were built using the inverse transformation matrices. Each composite pixel location (i.e., row, column, and slice), premultiplied by [Ti]"1, mapped it within a voxel of subject (i). A tri-linear interpolation of the subject's voxel values (percentage change) determined the statistical contribution of subject (i) to the composite (row, column, and slice) location. The use of [Ti]"1 ensured that the full volume set of the composite was populated with subject contributions. The average value from all subjects within the group determined the composite value. The BOLD response maps of the composite were somewhat broader in their spatial coverage than in an individual subject. Thus, only average number of activated pixels that has the highest composite percent change values in particular ROI was displayed in composite map. Activated composite pixels are calculated as follows:
N
Activated Pixels Subject(i) ROI(j)
Activated Composite Pixels ROI( j) =— —
The composite percent change for the time history graphs for each region was based
weighted average of each subject, as follows:
N
Activated Pixel Subject(i) x Percent Change(i)
Composite Percent Change =—
Activated Composite Pixels where N is number of subjects.
EXAMPLE 2
Identifying the Neural Networks Associated with Anxiety
[0144] Animal models of anxiety usually involve testing inbred strains of rats that show strong behavioral phenotypes (e.g., high anxiety behavior and low anxiety behavior Wistar rat) or transgenic knock outs. Anxiety is associated with fear and avoidance behavior and is usually assayed in the elevated plus maze or light-dark shuttle box.
[0145] Treatment with conventional anxiolytics like the benzodiazepines (GABA agonists), buspirone (5HT1 agonist), and hydroxyzine (antihistamine) increases the time in the open arm of the plus maze or time spent in the light of the shuttle box. Anxiety can be chemically induced. The most common anxiogenics are GABA antagonists such as DMCM, FG-7142 and ZK-93426, serotonergic agents such as mCPP, adrenergic agents such as yohimbine. Conceptually, treatment with these different agents activates the integrated neural network involved in enhancing anxiety, fear and avoidance. Their anxiogenic activity has been shown in animals and humans showing the activation of a neural network common across species.
Method
[0146] Adult male rats are prepared for imaging as described in Example 1 above (Ferris et al. (2008) BMC Neurosci. 9: 1 1 1). While fully conscious, animals are given a tail vein injection of different doses of yohimbine in saline (1 μg - 100 mg) and imaged for changes in brain activity (see previous Methods) using fMRI. Similar studies are run for the different classes of anxiogenics. For example, other anxiogenics include, but are not limited to, asthma medicines (such as albuterol, salmeterol, and theophylline), blood pressure medicines (such as methyldopa), hormones (such as oral contraceptives), amphetamines, medicines containing amphetamines (such as Benzedrine, Dexedrine, and Ritalin), steroids (such as cortisone, dexamethasone, and prednisone), thyroid medicines, phenytoin, levodopa, quinidine, caffeine, decongestants (such as phenylephrine), and illegal drugs such as cocaine and crack.
[0147] Using a segmented 3D atlas of the rat brain, over 100 different areas are analyzed for changes in volume of activation and BOLD signal over time. Significant differences between these
areas are determined generating an activity profile of an integrated neural network unique to the different classes of anxiogenics.
[0148] Because most neuropsychotropic agents require several weeks to work, it is likely that a change in brain plasticity is useful for efficacy. As such, this study described above is repeated after daily chronic treatment with the different classes of anxiogenics (1-12 weeks). Having established the neural network(s) for acute and chronic exposure to anxiogenics, it is now possible to "finger print" the conventional anxiolytics.
[0149] Animals (mice, rats, or primates) are pretreated (SC, IP, oral, IV) with conventional anxiolytics noted above (ranging in doses from 1 μg - 100 mg). After the drugs come to equilibrium, animals are imaged for changes in brain activity in response to SC, IP, oral, or IV administration of different anxiogenics. By examining the differences in brain activity between the anxiogenic sensitive neural network(s) and that with anxiolytics, areas are identified in the putative network of anxiety, fear and avoidance that are affected by anxiolytics. This method allows for delineating between different classes of anxiolytics and enables the screening of any new drug for anti-anxiety like activity. The cortical loop of Papez circuit, together with the amygdala, are affected by drug treatments.
EXAMPLE 3
Screening for Anxiogenics
[0150] Adult male rats are prepared for imaging as previously described (Ferris et al, 2008, BMC Neuroscience 9: 11 1). While fully conscious, animals are given a tail vein injection of different doses (1 μg - 100 mg) of a therapeutically effective amount of a test pharmaceutical drug, and imaged for changes in brain activity. This image or "finger print" is obtained by measuring a baseline metabolic activity (baseline signal intensity) of all voxels (3D pixels) in the brain are assessed as deduced from cerebral blood flow, cerebral blood volume or BOLD measurements for a period of 5-15 min (or longer) followed by the administration (tail vein, intraperitoneal, subcutaneous, oral, intranasal) of different doses (1 μg - 100 mg) of yohimbine. The change in signal intensity is determined for each voxel comparing the average signal intensity in its baseline period to the average signal intensity following drug administration. Voxels are assigned to one of hundreds of different regions of interests based upon their registration into a 3D segmented atlas. Each subject presents with a certain number of significantly activated voxels in a given region of interest or what we call volume of activation, i.e. number of 3D pixels in a 3D volume. Random effect analysis with different test statistics is used to compare the average (+/- SD) or median and
range of all subjects in an region of interest across all doses. These data provide a dose-dependent profile of signal change or finger print identifying brain areas that are significantly activated (increase in signal) or deactivated (decrease in signal). From these profiles a map of an integrated neural circuit characterizing the action of yohimbine on the brain is determined. This represents the putative neural circuit of fear/anxiety.
[0151] This finger print is compared to that of an unknown drug to determine if the unknown has potential anxiogenic activity.
[0152] This fingerprint is also used to evaluate drug action by pretreating animals with a known anxiolytic (e.g., benzodiazepines), drugs that reduces or blocks fear and anxiety. After a period of time when the anxiolytic has achieved its effect, these animals are placed in the MR scanner and imaged in response administration of the know anxiogenic. If the finger print of the anxiogenic is altered appreciably (e.g., more than 30% - 40%) of its components (brain areas comprising the neural circuit), then the anxiolytic is effective in reducing or blocking the anxiogenic effect. Drugs thought to be anxiolytics are screened by pretreating animals with the test drug followed later by imaging brain activity in response to anxiogenic challenge. If the the know fingerprint of the anxiogenic is altered appreciably then the test drug has anxiolytic activity.
EXAMPLE 4
Identifying the Neural Networks Associated with Depression
[0153] Adult male rats are prepared for imaging as described in Ferris et al, 2008, BMC Neuroscience 9: 11 1. While fully conscious, animals are given a tail vein injection of different doses of rimonobant (1 μg - 100 mg) and imaged for changes in brain activity (as described supra in Example 3).
[0154] Using a segmented 3D atlas of the rat brain, over 100 different areas are analyzed for changes in volume of activation and BOLD signal over time. Significant differences between these areas are determined generating an activity profile of an integrated neural network unique to rimonobant.
[0155] Since rimonobant affects the brain to increase the risk of depression and suicide, the identified neural network contributes to these behavioral problems. Most neuropsychotropic agents require several weeks to work suggesting a change in brain plasticity is need for efficacy. As such, the same study described above would be repeated but only after daily chronic treatment with rimonobant (1-12 weeks). Having established the rimonobant sensitive neural network for acute and chronic drug exposure, a "finger print" of the conventional anti-depressants is obtained.
[0156] Animals are pretreated (SC, IP, oral, IV) with conventional anti-depressants (ranging in doses from 1 μg - 100 mg). After the drugs come to equilibrium, animals are imaged for changes in brain activity in response to SC, IP, oral, or IV administration of different levels of rimonobant. By examining the differences in brain activity between the rimonobant sensitive neural network and that with anti-depressants, areas in the putative network of depression and suicide that are affected by anti-depressants are identified. This method allows for delineating between different classes of antidepressants and enables one to screen any new drug for anti-depressant like activity. The Papez circuit involved in emotional experience and memory together with areas of the mediobasal hypothalamus involved in emotional expression are affected by drug treatments.
EXAMPLE 5
Screening for Depressants
[0157] Adult male rats are prepared for imaging as described in Ferris et al, 2008, BMC Neuroscience 9: 11 1. While fully conscious, animals are given a tail vein injection of different doses (1 μg - 100 mg) of a therapeutically effective amount a test pharmaceutical drug and imaged for changes in brain activity (see previous Examples). These imaging results are compared to the images or finger print of the same animal which had been previously treated with a known depressant, such as benzodiazepine. If the two images exhibit a comparable pattern of
neuronal/glial activation, the test pharmaceutical drug is likely a depressant. To confirm the ability of the drug to act as a depressant, a behavioral test such as the tail suspension test and forced swim test is performed. Animals that have been administered a depressant become immobile, i.e., give up more quickly, than animals administered an anti-depressant.
EXAMPLE 61
Screening for Psvchotics
[0158] Adult male rats are prepared for imaging as previously described in Ferris et al, 2008, BMC Neuroscience 2008 9: 11 1. While fully conscious, animals are given a tail vein injection of different doses of a therapeutically effective amount a test pharmaceutical drug and imaged for changes in brain activity (see previous Examples). These imaging results are compared to the images of the same animal which had been previously treated with a known psychosis inducing drug, such as apomorphine. If the two images exhibit a comparable pattern of neuronal/glial activation, the test pharmaceutical drug is likely a psychosis inducing drug. To confirm that the test pharmaceutical drug is a drug that induces psychosis, a behavioral test such as, but not limited to,
the tail-pinch test, pre-pulse inhibition of startle response test, passive avoidance test or learned helplessness test is performed.
EXAMPLE 7
Identifying an Increased Risk of Suicide
[0159] Experiments were performed using male, Long Evans rats (-350-450 g). Rats were acclimated using procedures described in Example 1. As shown in Figure 4, acclimated animals had decreasing respiratory rates, heart rates, and corticosterone levels over the course of eight days.
Method
[0160] All experimental procedures, including data analysis, statistical analysis, motion artifact assessment, and imaging, were performed as described in Example 1 except as otherwise provided below. All imaging was performed within one week of acclimation. Briefly, adult male rats were prepared for imaging as described in Example 1 above with the following modifications (Ferris et al. (2008) BMC Neurosci. 9: 1 11). Animals were positioned in the animal restrainer under 2% isoflurane and allowed to awaken for a six minute anatomical scan.
[0161] Prior to performing the tail injections, a five minute baseline control scan was performed to determine the baseline BOLD signal.
[0162] After the baseline was determined, fully conscious animals were given a tail vein injection of Venlafaxine (n=8), Rimonabant (n=9), and Gabapentin (n=10) at clinically relevant doses. phMRI was used to image changes in brain activity (see previous Methods) using phMRI. Imaging was performed using a Bruker Biospec 7.0-T/20-cm horizontal magnet (Oxford
Instrument, Oxford, U.K.). In addition, two groups of fully conscious animals were given tail vein injections of one of two control drugs known to decrease aggression and suicide risk. One group was given injections of Clozapine (n=10), which is a known anti-suicide drug prescribed for schizophrenics, and the other group was given injections of Buspirone (n=9), which is a known anti-aggression drug prescribed to victims of traumatic head injury.
[0163] The images shown in Figure 5 were obtained by first measuring a baseline metabolic activity (baseline signal intensity) of all voxels (3D pixels) in the brains as deduced from BOLD measurements for a period of 5 minutes followed by the administration of the drug. The change in signal intensity was determined for each voxel comparing the average signal intensity in its baseline period to the average signal intensity following drug administration. Voxels were assigned to one of hundreds of different regions of interest based upon their registration into a 3D segmented
atlas. Each rat presented with a certain number of significantly activated voxels in a given region of interest or "volume of activation," i.e. number of 3D pixels in a 3D volume. Random effect analysis with different test statistics was used to compare the average (+/- SD) or median and range of all rats in a region of interest across all doses. These data provided a finger print (Figure 5).
[0164] Using a segmented 3D atlas of the rat brain, 154 different areas of the brain were analyzed for changes in volume of activation and BOLD signal over time (Figure 5). After comparing the activity of brains exposed to Venlafaxine 200, Rimonabant 210, and Gabapentin 220 to brains exposed to Clozapine 230 and Buspirone 240, 67 areas of common activity were identified 250 (Figure 5). Of these 67 areas, 17 areas were determined to be active exclusive of the control drugs 260 (Figure 5). These areas appear to be associated with an increased risk of suicide.
[0165] Figure 6 shows the results shown in a 3D activation map. The map provides a detailed view of the brain and the areas showing increased BOLD signal. The map was built from a compilation of 2D activation maps developed from the phMRI images generated during the experiments (Figure 7).
Translation of Rat Brain Regions To Human Brain Regions
[0166] The experiments identified particular areas of the rat brain activated by the test drugs. In particular, the particular regions of the rat brain were the Prelimbic cortex (corresponding to the human dorsal lateral and prefrontal cortex), medial dorsal striatum (corresponding to the human basal ganglia), the anterior, reuniens, and lateral posterior thalamus (corresponding to the human medial dorsal thalamus), dorsal and ventral CA1 (corresponding the human hippocampus), and insular, gustatory, and parietal cortices (corresponding to the human limbic and parietal cortices). The corresponding human region has been associated with schizophrenia, which has the highest incidence of suicide among mental diseases (Eisenberg & Berman, Neuropsychopharmacology (Reviews) 35:258-277 (2010)). Therefore, it appears that these regions are potentially associated with suicidal ideation.
EQUIVALENTS
[0167] It is to be understood that while the invention has been described in conjunction with the detailed description thereof, the foregoing description is intended to illustrate and not limit the scope of the invention, which is defined by the scope of the appended claims. Other aspects, advantages, and modifications are within the scope of the following claims.
Claims
1. A method for identifying whether a test pharmaceutical drug also causes depression and/or psychosis and/or anxiety in a conscious, non-human, mammalian subject, comprising:
(a) treating a control animal with a control drug, the control drug being a known psychotic, a known anxiogenic, and/or a known depressant;
(b) measuring the neuronal/glial activity in the brain of the treated control by functional imaging;
(c) treating the subject with a therapeutically-effective amount of the test pharmaceutical drug;
(d) measuring the neuronal/glial activity in the brain of the treated subject by functional imaging; and
(e) comparing the neuronal/glial activity in the brain of the treated subject with the neuronal/glial activity in the brain of the control animal, a comparable pattern of neuronal/glial activity in the brain of the treated subject measured in (d) relative to the pattern of neuronal/glial activity in the brain of the control after administration of the control drug in (b) indicating that the test pharmaceutical drug also causes depression and/or psychosis and/or anxiety.
2. The method of claim 1, wherein the test pharmaceutical drug is used to treat mental illness.
3. The method of claim 1, wherein the mammalian subject is selected from the group consisting of a mouse, rodent, and primate.
4. The method of claim 1 , wherein the control psychotic is selected from the group consisting of apomorphine, cocaine, amphetamine, methamphetamine, methylenedioxymethamphetamine ("MDMA"), and phenylcyclohexylpiperidine ("PCP").
5. The method of claim 1, wherein the control anxiogenic is selected from the group consisting of DMCM, FG-7142, ZK-93426, mCPP, and yohimbine.
6. The method of claim 1, wherein the control depressant is selected from the group consisting of alcohol, barbiturates, benzodiazepines, non-benzodiazepines, and opioids.
7. A method of determining whether a test pharmaceutical drug is also a psychosis-inducing drug, comprising:
(a) treating a conscious, non-human, mammalian subject with a therapeutically
effective amount of the test pharmaceutical drug;
(b) measuring the neuronal/glial activity in the integrated neural network of the subject by functional imaging of the subject's brain; and
(c) comparing the neuronal/glial activity in the subject after administration of the test pharmaceutical drug with the neuronal/glial activity in the integrated neural network of a control animal after administration of a control drug known to induce psychosis, a comparable pattern of neuronal/glial activity in the subject measured in (b) relative to the pattern of neuronal/glial activity in the control animal after administration of the control drug in (c) indicating that the test pharmaceutical drug is a psychosis-inducing drug.
8. A method of determining whether a test pharmaceutical drug is also an anti-psychotic drug, comprising:
(a) treating a conscious, non-human, mammalian subject with a therapeutically effective amount of the test pharmaceutical drug;
(b) measuring the neuronal/glial activity in the integrated neural network of the subject by functional imaging of the subject's brain; and
(c) comparing the neuronal/glial activity in the subject after administration of the test pharmaceutical drug with the neuronal/glial activity in the integrated neural network of a control animal after administration of a control drug known to induce psychosis, a detectable difference in the regions of the brain having neuronal/glial activity in the subject measured in (b) relative to the pattern of neuronal/glial activity in the control animal after administration of the control drug in (c) indicating that the test pharmaceutical drug is an antipsychotic drug.
9. The method of claim 8, wherein the nonhuman mammalian subject is selected from the group consisting of a mouse, rodent, and primate.
10. The method of claim 8, wherein the known psychosis-inducing drug is selected from the group consisting of apomorphine, cocaine, amphetamine, methamphetamine,
methylenedioxymethamphetamine ("MDMA"), and phenylcyclohexylpiperidine ("PCP") .
11. A method of determining whether a test pharmaceutical drug is also an anxiogenic, comprising:
(a) treating a conscious, non-human, mammalian subject with a therapeutically effective amount of the test pharmaceutical drug;
(b) measuring the neuronal/glial activity in the integrated neural network of the subject by functional imaging of the subject's brain; and
(c) comparing the neuronal/glial activity in the subject after administration of the test pharmaceutical drug with the neuronal/glial activity in the integrated neural network of a control animal after administration of a control anxiogenic, a comparable pattern of neuronal/glial activity in the subject measured in (b) relative to the pattern of neuronal/glial activity in the control animal after administration of the control anxiogenic in (c) indicating that the test pharmaceutical drug is an anxiogenic.
12. The method of claim 1 1 wherein the mammalian subject is selected from the group consisting of a mouse, rodent, and primate.
13. The method of claim 1 1, wherein the known anxiogenic is selected from a group consisting of DMCM, FG-7142, ZK-93426, mCPP, and yohimbine.
14. A method of identifying whether a test pharmaceutical drug is also a depressant, comprising:
(a) treating a conscious, non-human, mammalian subject with a therapeutically
effective amount of the test pharmaceutical drug;
(b) measuring the neuronal/glial activity in the integrated neural network of the subject by functional imaging of the subject's brain; and
(c) comparing the neuronal/glial activity in the subject after administration of the test pharmaceutical drug with the neuronal/glial activity in the integrated neural network of a control animal after administration of a known depressant, a comparable pattern of neuronal/glial activity in the subject measured in (b) relative to the pattern of neuronal/glial activity in the control animal after administration of the known depressant in (c) indicating that the test pharmaceutical drug is a depressant.
15. The method of claim 14, wherein the mammalian subject is selected from the group consisting of a mouse, rodent, and primate.
16. The method of claim 14, wherein the known depressant is selected from a group consisting of alcohol, barbiturates, benzodiazepines, non-benzodiazepines, and opioids.
17. A method of identifying areas of the integrated neural network of the brain of a
conscious, non-human, mammalian subject that elicit psychosis, comprising:
(a) treating a non-human, mammalian control with an amount of a control psychotic known to cause psychosis;
(b) identifying a region of the brain of the treated control which shows neuronal/glial activity by functional imaging;
(c) treating the conscious, non-human, mammalian subject of the same species as the control with a therapeutically-effective amount of an anti -psychotic drug;
(d) allowing the anti-psychotic drug to achieve pharmacokinetic equilibrium in the subject;
(e) treating the subject with an amount of the control psychotic known to cause psychosis;
(f) identifying a region in the brain of the treated subject in (e) having neuronal/glial activity by functional imaging; and
(g) comparing the regions of neuronal/glial activity in the brain of the treated control of (b) with the regions of neuronal/glial activity in the brain of the treated subject in (f), detectable differences in the regions of the brain having neuronal/glial activity in the treated control relative to the treated subject indicating that these brain regions are involved in psychosis.
18. The method of claim 17, wherein the mammalian control and subject are selected from the group consisting of a mouse, rodent, and primate.
19. The method of claim 17, wherein (a) further comprises chronic administration of the psychotic over 1 to 12 weeks.
20. The method of claim 17, wherein (c) further comprises the chronic administration of the anti-psychotic drug over 1 to 12 weeks.
21. The method of claim 17, wherein (a) and (c) further comprise the chronic administration of both the psychotic and anti-psychotic drug over 1 to 12 weeks.
22. The method of claim 17, wherein the psychotic is selected from a group consisting of apomorphine, cocaine, amphetamine, methamphetamine, methylenedioxymethamphetamine ("MDMA"), and phenylcyclohexylpiperidine ("PCP").
23. The method of claim 17, wherein the anti-psychotic drug is selected from a group consisting of haloperidol, clozapine, chlorpromazine, olanzapine, risperidone, or aripiprazole.
24. A method of identifying areas of the integrated neural network of the brain of a
conscious, non-human, mammalian subject that elicit anxiety, comprising:
(a) treating a non-human, mammalian control with an amount of a control anxiogenic known to cause anxiogenic;
(b) identifying a region of the brain of the treated subject which shows neuronal/glial activity by functional imaging;
(c) treating the conscious, non-human, mammalian subject of the same species as the control with a therapeutically effective amount of an anxiolytic drug;
(d) allowing the anxiolytic drug to achieve pharmacokinetic equilibrium in the subject;
(e) treating the subject with a an amount of the control anxiogenic which is known to cause anxiety;
(f) identifying a region in the brain of the treated subject in (e) having neuronal/glial activity in (e) by functional imaging; and
(g) comparing the regions of neuronal/glial activity in the treated control of (b) with the regions of neuronal/glial activity in the brain of the treated subject in (f), detectable differences in the regions of the brain having neuronal/glial activity in the treated control relative to the treated subject indicating that these brain regions are involved in anxiety.
25. The method of claim 24, wherein the mammalian control and subject are selected from the group consisting of a mouse, rodent, and primate.
26. The method of claim 24, wherein (a) further comprises the chronic administration of the anxiogenic over 1 to 12 weeks.
27. The method of claim 24, wherein (c) further comprises the chronic administration of the anxiolytic over 1 to 12 weeks.
28. The method of claim 24, wherein (a) and (c) further comprise the chronic administration of both the anxiogenic and anxiolytic over 1 to 12 weeks.
29. The method of claim 24, wherein the anxiolytic drug is selected from a group consisting of benzodiazepines, buspirone, and hydroxyzine.
30 The method of claim 24, wherein the anxiogenic is selected from a group consisting of DMCM, FG-7142 ZK-93426, mCPP, and yohimbine.
31. A method of identifying areas of the integrated neural network of the brain of a conscious, non-human, mammalian subject that elicit depression, comprising:
(a) treating a non-human, mammalian control with an amount of a control depressant;
(b) identifying a region of the brain of the treated subject which shows neuronal/glial activity by functional imaging;
(c) treating the conscious, non-human, mammalian subject of the same species with a therapeutically effective amount of an anti-depressant drug;
(d) allowing the anti-depressant drug to achieve pharmacokinetic equilibrium in the subject;
(e) treating the subject with a therapeutically effective amount of the control depressant;
(f) identifying a region in the brain of the treated subject in (e) having neuronal/glial activity by functional imaging; and
(g) comparing the regions of neuronal/glial activity in the treated control of (b) with the regions of neuronal/glial activity in the brain of the treated subject in (f), detectable differences in the regions of the brain having neuronal/glial activity in the treated control relative to the treated subject indicating that these brain regions are involved in depression.
32. The method of claim 31, wherein the mammalian control and subject are selected from the group consisting of a mouse, rodent, and primate.
33. The method of claim 31, wherein (a) further comprises chronic administration of the depressant over 1 to 12 weeks.
34. The method of claim 31, wherein (c) further comprises the chronic administration of the anti-depressant over 1 to 12 weeks.
35. The method of claim 31, wherein (a) and (c) further comprise the chronic administration of both the depressant and anti-depressant over 1 to 12 weeks.
36. The method of claim 31, wherein the anti-depressant is selected from a group consisting of selective serotonin reuptake inhibitors, tricyclics, and monoamine oxidase inhibitors.
37. The method of claim 31, wherein the depressant is selected from a group consisting of alcohol, barbiturates, benzodiazepines, non-benzodiazepines, opioids, and rimonobant.
38. A method of screening a test drug for increased risk of one or more of depression, psychosis, or anxiety in a conscious, non-human, mammalian subject, comprising:
(a) measuring a neural/glial activity in a brain of a first conscious, non-human, mammalian subject treated with a drug used to treat one or more of a psychotic, an anxiogenic, or a depression disorder;
(b) identifying a pattern of neural/glial activity of the brain of the first subject treated with the drug;
(c) treating a second conscious, non-human, mammalian subject with a test drug;
(d) measuring the neural/glial activity in the brain of the second subject treated with the test drug and identifying a pattern of the neural/glial activity of the brain of the second subject;
(e) comparing the pattern of the neural/glial activity of the brain of the first subject to the pattern of the neural/glial activity of the brain of the second subject; and (f) determining a pattern of neural/glial activity associated with one or more of depression, psychosis, or anxiety.
39. The method of claim 38, wherein neuronal/glial activity is measured by functional MRI.
40. The method of claim 38, wherein the test drug is used to treat mental illness.
41. The method of claim 38, wherein the mammalian subject is selected from the group consisting of a mouse, rodent, and primate.
42. The method of claim 38, wherein the control psychotic is selected from the group consisting of apomorphine, cocaine, amphetamine, methamphetamine, methylenedioxymethamphetamine ("MDMA"), and phenylcyclohexylpiperidine ("PCP").
43. The method of claim 38, wherein the control anxiogenic is selected from the group consisting of DMCM, FG-7142, ZK-93426, mCPP, and yohimbine.
44. The method of claim 38, wherein the control depressant is selected from the group consisting of alcohol, barbiturates, benzodiazepines, non-benzodiazepines, and opioids.
45. The method of claim 38 further comprising performing (a) in the brains of a plurality of conscious, non-human, mammalian subjects with a plurality of drugs used to treat one or more of a psychotic, an anxiogenic, or a depression disorder.
46. The method of claim 45 further comprising compiling the patterns identified into a database.
47. The method of claim 38, wherein determining a pattern of neural/glial activity comprises identifying differences between the pattern of neural/glial activity of the first subject and the pattern of the neural/glial activity of the second subject.
48. The method of claim 46, wherein patterns are identified for a plurality of test drugs.
49. The method of claim 48 further comprising generating a composite pattern of neural/glial activity from the patterns identified for the plurality of test drugs, the composite pattern representing a consensus of neural/glial activity associated with one or more of depression, psychosis, or anxiety as determined from the patterns identified for the plurality of test drugs.
50. The method of claim 49 further comprising refining the composite pattern based on additional patterns compiled in the database.
51. The method of claim 50 further comprising measuring a neural/glial activity in a brain of a third conscious, non-human, mammalian subject treated with a drug having no known effect on one or more of a psychotic, an anxiogenic, or a depression disorder and identifying a pattern of neural/glial activity of the brain of the first subject treated with the drug having no known effect.
52. The method of claim 51 further comprising determining whether the drug having no known effect has a pattern of neural/glial activity similar to any of the composite patterns in the database.
53. A method of identifying a drug for increased risk of suicide in a subject, comprising: administering the drug to a subject; and detecting the level of activity of cells in one or more brain regions of the subject, the region selected from prelimbic cortex, gustatory cortex, insular cortex, secondary somatosensory cortex, parietal cortex, medial dorsal striatum, anterior thalamus, ventral anterior lateral thalamus, reuniens thalamus, ventral medial thalamus, lateral posterior thalamus, lateral dorsal thalamus, central thalamus, CA1 hippocampus, posterior hypothalamus, and central raphe; wherein an increased level of activity relative to a control is indicative of the drug having an increased risk of suicide by the subject.
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US29787510P | 2010-01-25 | 2010-01-25 | |
US61/297,875 | 2010-01-25 | ||
US38494810P | 2010-09-21 | 2010-09-21 | |
US61/384,948 | 2010-09-21 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2011091418A1 true WO2011091418A1 (en) | 2011-07-28 |
Family
ID=44307284
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US2011/022407 WO2011091418A1 (en) | 2010-01-25 | 2011-01-25 | Screening method for adverse side effects of a therapeutic pharmaceutical drug |
Country Status (1)
Country | Link |
---|---|
WO (1) | WO2011091418A1 (en) |
Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5278164A (en) * | 1991-10-24 | 1994-01-11 | Bristol-Myers Squibb Co. | Treatment of anxiety in benzodiazepine-withdrawn patients |
US20030219483A1 (en) * | 2000-01-13 | 2003-11-27 | Joaquina Faour | Osmotic device containing venlafaxine and an anti-psychotic agent |
US20050107682A1 (en) * | 2003-10-21 | 2005-05-19 | Rao Stephen M. | fMRI system for use in assessing the efficacy of therapies in treating CNS disorders |
US20070092586A1 (en) * | 2005-10-26 | 2007-04-26 | Alamo Pharmaceuticals | Compositions and methods for the administration psychotropic drugs which modulate body weight |
US20070264200A1 (en) * | 2005-11-14 | 2007-11-15 | Scott Small | Mouse MRI for drug screening |
-
2011
- 2011-01-25 WO PCT/US2011/022407 patent/WO2011091418A1/en active Application Filing
Patent Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5278164A (en) * | 1991-10-24 | 1994-01-11 | Bristol-Myers Squibb Co. | Treatment of anxiety in benzodiazepine-withdrawn patients |
US20030219483A1 (en) * | 2000-01-13 | 2003-11-27 | Joaquina Faour | Osmotic device containing venlafaxine and an anti-psychotic agent |
US20050107682A1 (en) * | 2003-10-21 | 2005-05-19 | Rao Stephen M. | fMRI system for use in assessing the efficacy of therapies in treating CNS disorders |
US20070092586A1 (en) * | 2005-10-26 | 2007-04-26 | Alamo Pharmaceuticals | Compositions and methods for the administration psychotropic drugs which modulate body weight |
US20070264200A1 (en) * | 2005-11-14 | 2007-11-15 | Scott Small | Mouse MRI for drug screening |
Non-Patent Citations (3)
Title |
---|
FRENCH ET AL.: "A Workshop on Antiepileptic Drug Monotherapy Indication.", EPILEPSIA, vol. 43, no. SUP.10, 2002, pages 3 - 27 * |
LOCKWOOD ET AL.: "Application of Clinical Trial Simulation to Compare Proof-of-Concept Study Designs for Drugs with a Slow Onset of Effect; An Example in Alzheimer's Disease.", PHARMACEUTICAL RESEARCH, vol. 23, no. 9, 2006, pages 2050 - 2059 * |
RINNE ET AL.: "SSRI Treatment of Borderline Personality Disorder: A Randomized, Placebo- Controlled Clinical Trial for Female Patients With Borderline Personality Disorder.", AM J PSYCHIATRY, vol. 159, 2002, pages 2048 - 2054 * |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
Jung et al. | Mouse BOLD fMRI at ultrahigh field detects somatosensory networks including thalamic nuclei | |
de la Fuente-Fernández et al. | Dopamine release in human ventral striatum and expectation of reward | |
Savic et al. | Odorant differentiated pattern of cerebral activation: comparison of acetone and vanillin | |
Marota et al. | Cocaine activation discriminates dopaminergic projections by temporal response: an fMRI study in rat | |
Tuor et al. | Functional magnetic resonance imaging in rats subjected to intense electrical and noxious chemical stimulation of the forepaw | |
Shin et al. | Regional cerebral blood flow during script-driven imagery in childhood sexual abuse-related PTSD: a PET investigation | |
Wise et al. | Combining fMRI with a pharmacokinetic model to determine which brain areas activated by painful stimulation are specifically modulated by remifentanil | |
Tomasi et al. | Methylphenidate enhances brain activation and deactivation responses to visual attention and working memory tasks in healthy controls | |
Binder et al. | Human brain language areas identified by functional magnetic resonance imaging | |
Xiao et al. | Thirsty heroin addicts show different fMRI activations when exposed to water-related and drug-related cues | |
Bloom et al. | Determination of drug‐induced changes in functional MRI signal using a pharmacokinetic model | |
Valles et al. | Qualitative Imaging of adeno-associated virus serotype 2–human aromatic L-amino acid decarboxylase gene therapy in a phase I study for the treatment of Parkinson disease | |
Guedj et al. | 99m Tc-ECD brain perfusion SPECT in hyperalgesic fibromyalgia | |
van Nierop et al. | MRI‐related static magnetic stray fields and postural body sway: A double‐blind randomized crossover study | |
Berman et al. | Changes in cerebral glucose metabolism during early abstinence from chronic methamphetamine abuse | |
US20110217240A1 (en) | Imaging neuroleptic compounds | |
Abel et al. | Ketamine and fMRI BOLD signal: distinguishing between effects mediated by change in blood flow versus change in cognitive state | |
US6517812B1 (en) | Inhibition of psychostimulant-induced and nicotine-induced craving | |
US6569403B1 (en) | Determining effects of external stimuli on the brain using PET | |
Liu et al. | Multi‐parametric evaluation of cerebral hemodynamics in neonatal piglets using non‐contrast‐enhanced magnetic resonance imaging methods | |
Klomp et al. | Test–retest reliability of task-related pharmacological MRI with a single-dose oral citalopram challenge | |
Bosch et al. | Gamma-hydroxybutyrate increases brain resting-state functional connectivity of the salience network and dorsal nexus in humans | |
WO2011091418A1 (en) | Screening method for adverse side effects of a therapeutic pharmaceutical drug | |
Brassen et al. | Haloperidol challenge in healthy male humans: a functional magnetic resonance imaging study | |
US20010014686A1 (en) | Determining effects of external stimuli on the brain using pet |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
121 | Ep: the epo has been informed by wipo that ep was designated in this application |
Ref document number: 11735351 Country of ref document: EP Kind code of ref document: A1 |
|
NENP | Non-entry into the national phase |
Ref country code: DE |
|
122 | Ep: pct application non-entry in european phase |
Ref document number: 11735351 Country of ref document: EP Kind code of ref document: A1 |