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  • C07—ORGANIC CHEMISTRY
  • C07D—HETEROCYCLIC COMPOUNDS
  • C07D209/00—Heterocyclic compounds containing five-membered rings, condensed with other rings, with one nitrogen atom as the only ring hetero atom
  • C07D209/02—Heterocyclic compounds containing five-membered rings, condensed with other rings, with one nitrogen atom as the only ring hetero atom condensed with one carbocyclic ring
  • C07D209/04—Indoles; Hydrogenated indoles
  • C07D209/10—Indoles; Hydrogenated indoles with substituted hydrocarbon radicals attached to carbon atoms of the hetero ring
  • C07D209/14—Radicals substituted by nitrogen atoms, not forming part of a nitro radical
  • C07D209/16—Tryptamines
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
  • A61K31/403—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil condensed with carbocyclic rings, e.g. carbazole
  • A61K31/404—Indoles, e.g. pindolol
  • A61K31/4045—Indole-alkylamines; Amides thereof, e.g. serotonin, melatonin
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• • A—HUMAN NECESSITIES
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  • A61K9/00—Medicinal preparations characterised by special physical form
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• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/24—Antidepressants
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/28—Drugs for disorders of the nervous system for treating neurodegenerative disorders of the central nervous system, e.g. nootropic agents, cognition enhancers, drugs for treating Alzheimer's disease or other forms of dementia
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07D—HETEROCYCLIC COMPOUNDS
  • C07D209/00—Heterocyclic compounds containing five-membered rings, condensed with other rings, with one nitrogen atom as the only ring hetero atom
  • C07D209/02—Heterocyclic compounds containing five-membered rings, condensed with other rings, with one nitrogen atom as the only ring hetero atom condensed with one carbocyclic ring
  • C07D209/04—Indoles; Hydrogenated indoles
  • C07D209/08—Indoles; Hydrogenated indoles with only hydrogen atoms or radicals containing only hydrogen and carbon atoms, directly attached to carbon atoms of the hetero ring
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/20—Pills, tablets, discs, rods

Definitions

• the present invention relates to novel tryptamine compounds, methods of making and using such compounds, compositions comprising such compounds, and their uses.
• Tryptamines are a class of 3-aminoethyl-indoles that bind and activate the serotonin receptor, also called the 5HT receptor.
• a psychedelic state may be achieved by activation of the 2A form of the serotonin receptor by 5HT2A receptor agonist compounds.
• the endogenous substance for this receptor is 5-hydroxy-tryptamine (serotonin).
• the tryptamine 3-(2-aminoethyl)-indole is also an endogenous neurotransmitter.
• the serotonin receptor system is implicated in depression and depressive states which are commonly treated with 5HT1A antagonists (Affective Disorders: Depression in Neuropsychopharmacology and Therapeutics, Chapter 6, First Edition. Ivor S. Wozer, 2015). More recently, 5HT2A agonists have shown potential as medicines for depression (Carhart-Harris 2018 Psychopharmacology).
• ayahuasca is a natural form of dimethyltryptamine (DMT) which when combined with a monoamine oxidase inhibitor can be ingested and produces a variable, but prolonged psychedelic state that can last for 6 to 15 hours.
• DMT is also naturally found to occur in small amounts in the brain and may act as a neurotransmitter.
• Lysergic acid diethylamide is a diethylamide derivative of a naturally occurring substance from fungus found in rye grain, which also produces a prolonged psychedelic state up to 8 to 12 hours long.
• Psilocybin is a naturally occurring plant-based tryptamine found in Psilocybe mushrooms, and produces a prolonged psychedelic state of about 6 to 8 hours. Psilocybin was first synthesized in 1958 and is currently being investigated as a treatment for depression. Psilocybin is a prodrug, with psilocin being the active species in vivo. Psilocybin contains a phosphate bound to the 4-hydroxy group of psilocin, which is cleaved in the gut when Psilcybe mushrooms or the drug substance is taken orally:
• Psychedelic substances have been shown to be effective for treating depression, and even more effective for treating depression when associated with psychotherapy (Watts 2020 J Contextual Behavioral Science).
• ester cleavage is not consistently rapid, is not predictable and can depend on the structure of the moiety attached to the drug and therefore must be investigated (Anderson 1984 JPharmaSci). Esterase enzymes are responsible for active cleavage of the prodrug ester group in vivo and species differences in esterase quantities and specificity in various tissues complicate investigations and optimizations (Bahar 2012 JPharmSci).
• the present invention relates to novel tryptamine compounds, which when administered, convert to an active form in vivo, and act as a 5HT2A agonist.
• the compounds described herein may be useful to treat mental disorders, such as a depressive condition, including unipolar and bipolar depressive conditions, such as but not limited to depression, depression from generalized anxiety, major depression, treatment resistant depression and postpartum depression.
• the present invention relates to a tryptamine or isotryptamine compound of Formula (I) (II), (III) or (IV) or a pharmaceutically acceptable salt or zwitterion thereof: wherein:
• Rl, R2, and R6 are each independently selected from hydrogen, linear or branched alkyl, preferably C1-5 alkyl, or arylalkyl;
• R4 is a. -X- C02H, where X is a linear, cyclic or branched, saturated or unsaturated carbon chain (preferably C1-5 alkyl), optionally substituted with -OH or -C02H, or an aromatic ring, optionally substituted with alkyl or C02H; or b. (R9)(R10)N-, wherein R9 is X- C02H, where X is defined as above, and RIO is hydrogen, linear or branched alkyl (preferably C1-5 alkyl) or arylalkyl, optionally substituted by -OH or -C02H;
• R5 is hydrogen, linear or branched alkyl (preferably C 1-5 alkyl), arylalkyl, or O- R5', where R5' is hydrogen, linear or branched alkyl (preferably C 1-5 alkyl); and
• R7 and R8 are each independently selected from hydrogen, linear or branched alkyl (preferably C 1-5 alkyl), or arylalkyl, or b. together form a non-aromatic N-containing heterocycle, optionally substituted with alkyl, preferably where the entire heterocyclic structure does not contain more than 12 atoms.
• the invention comprises diacid esters of a hydroxytryptamine, such as 4-hydroxy and 5-hydroxytryptamines and 6-hydroxy and 7-hydroxy isotryptamines, and other structural or functional analogs of psychedelic tryptamines.
• a hydroxytryptamine such as 4-hydroxy and 5-hydroxytryptamines and 6-hydroxy and 7-hydroxy isotryptamines, and other structural or functional analogs of psychedelic tryptamines.
• R7 and R8 are the same or different, and are linear or branched Ci- 4 alkyl; or are the same or different, and are methyl or isopropyl; such as R7 and R8 are both methyl, or R7 and R8 are both isopropyl, or where one of R7 and R8 is methyl and the other is isopropyl.
• X is a linear Cl - C3 chain, optionally substituted with OH or -C02H, such as X is an unsubstituted linear C3 chain.
• the invention in another aspect, relates to a composition
• a composition comprising a compound described herein, and a pharmaceutically acceptable excipient.
• the composition comprises an oral dosage formulation or an injectable formulation.
• the invention comprises a method of treating a mental disorder, comprising the step of administering an effective amount of a compound described herein.
• the mental disorder is a depressive condition, including unipolar and bipolar depressive conditions, such as but not limited to depression, depression from generalized anxiety, major depression, treatment resistant depression and postpartum depression.
• the invention relates to the use of a compound described herein to treat a mental disorder, or in the manufacture of a medicament for treating a mental disorder, such as depression.
• the invention in another aspect, relates to a method of making a compound described herein, comprising reacting a tryptamine comprising a hydroxytryptamine or hydroxyisotryptamine with a cyclic anhydride in a suitable anhydrous solvent.
• the solvent contains a base with pKa greater than 4 but less than 9, and the resulting compound is isolated as a zwitterion.
• the tryptamine comprises 4-hydroxy or 5-hydroxy tryptamine or a 6-hydroxy or 7-hydroxy isotryptamine.
• the solvent is pyridine.
• Figure 1 is a graph showing plasma concentration of 4-HO-DiPT (ng/ml) time after subcutaneous administration of N,N diisopropyltryptamine-4-glutarate at a rate of 2mg/kg.
• Figure 2 is a graph showing plasma concentration of 4-HO-DiPT (ng/ml) after subcutaneous administration of N,N diisopropyltryptamine-4-glutarate at a rate of 1.4mg/kg
• Embodiments of the present invention comprise novel synthetic tryptamine prodrugs.
• the prodrugs may be useful for treatment of mental disorders such as depression, including without limitation, major depression, treatment resistant depression and postpartum depression.
• mental disorders such as depression, including without limitation, major depression, treatment resistant depression and postpartum depression.
• mental disorder includes those disorders which may be diagnosed by a mental health professional as a psychological or psychiatric disorder, including those which may be diagnosed by reference to Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
• psychedelic state is an altered state of consciousness experienced by a person, which may include intensified sensory perception, perceptual distortion or hallucinations, and/or feelings of euphoria or despair.
• Psychedelic states have been described as resulting from psychedelic drugs such as DMT (dimethyltryptamine), LSD, mescaline or psilocybin.
• Other known psychedelic drugs include the 4-hydroxy analogs of N-Methyl-N- isopropyltryptamine (MiPT) and N,N-diisopropyltryptamine (DiPT).
• the present invention comprises prodrugs of hydroxy -indole 5HT2A agonists which induce a psychedelic state or which still provide a beneficial therapeutic effect without being associated with a psychedelic state.
• the prodrugs may be used in combination with other treatments known to be effective for treating mental disorders, such as psychotherapy, electroconvulsive therapy and/or other pharmaceutical compounds, for example, with concomitant use of tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), selective norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MOAIs) or other anti-depressants.
• TCAs tricyclic antidepressants
• SSRIs selective serotonin reuptake inhibitors
• SNRIs selective norepinephrine reuptake inhibitors
• MOAIs monoamine oxidase inhibitors
• the treatment may produce lasting effects, for example longer than 1 month after a
• Compounds when used herein includes any pharmaceutically acceptable derivative or variation, including conformational isomers (e.g., cis and trans isomers) and all optical isomers (e.g., enantiomers and diastereomers), racemic, diastereomeric and other mixtures of such isomers, as well as solvates, hydrates, isomorphs, polymorphs, tautomers, esters, salt forms, and prodrugs.
• prodrug refers to compounds that are drug precursors which following administration, release the drug (or “active”) in vivo via some chemical or physiological process (e.g., hydrolysis, enzymatic cleavage or hydrolysis, or metabolism is converted to the desired drug form).
• the invention includes within its scope the pharmaceutically acceptable salts of the compounds of the invention. Accordingly, the phrase “or a pharmaceutically acceptable salt thereof’ is implicit in the description of all compounds described herein unless explicitly indicated to the contrary.
• the compounds of the present invention comprise prodrug compounds that are readily purified, formulated and stable, and preferably may be used to provide highly soluble drug substances, with fast onset and elimination for convenient use in a clinical setting.
• the compounds may be produced as a zwitterion, which may be converted to a pharmaceutically acceptable salt.
• the compounds of the present invention preferably allow for fast cleavage in vivo of the prodrug moiety to give the active pharmacophore, for example, 90% conversion may occur in under 4 hours, preferably in less than 2 hours, and more preferably in less than 1 hour.
• Prodrugs may have lesser, little or no pharmacological activity themselves, however when administered to a patient, may be converted into an active compound, for example, by hydrolytic cleavage.
• Diacid hemiesters of tryptamines such as psilocin or other hydroxytryptamines or isotryptamines, have not previously been described.
• a prodrug strategy implemented by combining a diacid and a 4-hydroxy-tryptamine or 5-hydroxy-tryptamine has likely not been proposed, as a prodrug strategy is typically not necessary when the drug is already soluble. Therefore, aspects of this diacid hemiester prodrug strategy, as described herein, are believed to be novel and inventive.
• the present invention comprises a tryptamine or isotryptamine compound of Formula (I) (II), (III) or (IV), or a pharmaceutically acceptable salt or zwitterion thereof: ) wherein:
• Rl, R2, and R6 are each independently selected from hydrogen, linear or branched alkyl, preferably C1-5 alkyl, or arylalkyl;
• R4 is a. -X- C02H, where X is a linear, cyclic or branched, saturated or unsaturated carbon chain (preferably C1-5 alkyl), optionally substituted with -OH or -C02H, or an aromatic ring, optionally substituted with alkyl or C02H; or b. wherein R9 is X- C02H, where X is as defined (2)(a) above and RIO is hydrogen, linear or branched alkyl (preferably C1-5 alkyl) or arylalkyl, optionally substituted by -OH or -C02H;
• R5 is hydrogen, linear or branched alkyl (preferably C 1-5 alkyl), arylalkyl, or O- R5', where R5' is hydrogen, linear or branched alkyl (preferably C 1-5 alkyl); and
• R7 and R8 are each independently selected from hydrogen, linear or branched alkyl (preferably C 1-5 alkyl), or arylalkyl, or b. together form a non-aromatic N-containing heterocycle, optionally substituted with alkyl, preferably where the entire heterocyclic structure does not contain more than 12 atoms, for example, pyrrolidine (NC4 ring) piperidine (NC5 ring), or morpholine (NC40 ring).
• Alkyl by itself or as part of another substituent, refers to a saturated branched, straight-chain or cyclic monovalent hydrocarbon radical derived by the removal of one hydrogen atom from a single carbon atom of a parent alkane.
• alkyl includes cycloalkyl.
• Typical alkyl groups include, but are not limited to, methyl; ethyl; propyls such as propan-l-yl, propan-2-yl (isopropyl), cyclopropan- 1-yl, etc.; butanyls such as butan-l-yl, butan-2-yl (sec-butyl), 2-methyl-propan- 1-yl (isobutyl), 2-methyl-propan-2-yl (t-butyl), cyclobutan-l-yl, etc.; and the like.
• an alkyl group comprises from 1 to 20 carbon atoms (C 1 -C 20 alkyl).
• an alkyl group comprises from 1 to 10 carbon atoms (C1-C10 alkyl). In still other embodiments, an alkyl group comprises from 1 to 6 carbon atoms (C 1 -C 6 alkyl) or 1 to 4 carbon atoms (C 1 -C 4 ). C 1 -C 6 alkyl is also known as "lower alkyl”.
• arylalkyl is a term of the art and as used herein refers to an alkyl group, for example a Ci- 6 alkyl group, substituted with an aryl group, where the residue is linked to the main molecule through the alkyl group.
• An example of arylalkyl is the benzyl group, that is, the phenyl-methyl group.
• Substituted when used to modify a specified group or radical, means that one or more hydrogen atoms of the specified group or radical are each, independently of one another, replaced with the same or different substituent(s).
• substituted specifically envisions and allows for one or more substitutions that are common in the art. However, it is generally understood by those skilled in the art that the substituents should be selected so as to not adversely affect the useful characteristics of the compound or adversely interfere with its function.
• optionally substituted denotes the presence or absence of the substituent group(s). That is, it means “substituted or unsubstituted”.
• optionally substituted alkyl includes both unsubstituted alkyl and substituted alkyl.
• the substituents used to substitute a specified group can be further substituted, typically with one or more of the same or different groups selected from the various groups specified above.
• prodrug structures are converted to an active hydroxy-indole 5HT2A agonist after hydrolysis or metabolization of the ester function R4-CO-.
• the compounds comprise diacid esters of tryptamine structures such as 4-hydroxy-N,N-dimethyltryptamine (psilocin or 4-HO-DMT), 4-hydroxy- N,N-diethyltryptamine (4-HO-DET), 4-hydroxy-N,N-diisopropyltryptamine (4-OH-DiPT), 4- hydroxy-N-methyl-N-isopropyltryptamine (4-OH-MIPT), 5-hydroxy-N,N- dimethyltryptamine, 4-methyl-5-hydroxy-N,N-dimethyl)tryptamine and 4-hydroxy-5 -methyl - N,N-dialkyltryptamine.
• tryptamine structures such as 4-hydroxy-N,N-dimethyltryptamine (psilocin or 4-HO-DMT), 4-hydroxy- N,N-diethyltryptamine (4-HO-DET), 4-hydroxy-N,N-diisopropyltryptamine (4-OH-DiPT),
• the compounds include the 4- and 5- substituted hemisuccinates, hemiglutarates and citrates of 4-hydroxy derivatives of N,N- dimethyltryptamine (psilocin), N,N-diisopropyltryptamine (4-HO-DiPT), or N-methyl-N- isopropyl-tryptamine (4-HO-MiPT).
• the compound comprises a compound of Formula I, II, III or IV, wherein Rl, R2, R5, R6, are each hydrogen; X is a linear Cl-4 alkyl; and R7 and R8 are each methyl.
• the compound is a compound of Formula I or II and X is C2 alkyl, thus forming a 4- or 5-hemisuccinate of psilocin.
• the compound comprises a compound of Formula I, II, III or IV, wherein Rl, R2, R5, R6, are each hydrogen; X is a linear C1-C4 alkyl chain; and R7 and R8 are each isopropyl.
• the compound is a compound of Formula I or II, X is C2 alkyl, thus forming a hemisuccinate of 4- or 5-hydroxy-diisopropyltryptamine.
• the compound is a compound of Formula I or II, X is a C2 alkene, thus forming a hemifumarate of 4- or 5-hydroxy-diisopropyltryptamine.
• the compound is a compound of Formula I or II and X is a C3 alkyl chain, thus forming a hemiglutarate of 4- or 5-hydroxy-diisopropyltryptamine.
• R7 and R8 are each chosen on the basis of retaining or enhancing the compound's ability to induce a psychedelic state. It is known that psychedelic activity of a tryptamine is reduced if R7 or R8 become larger than C4. However, such compounds are still within the scope of the present invention if they are still 5HT2A agonists which can produce beneficial therapeutic effect without a psychedelic state.
• compounds of the present invention are diacid zwitterions.
• the diacid may comprise a common linear alkyl a, co-diacid, including without limitation oxalic, malonic, succinic, glutaric (pentanedioic), adipic (hexanedioic), pimelic (heptanedioic) and suberic acid (octanedioic).
• the diacid may comprise an acid such as maleic, fumaric, or glutaconic acid.
• the diacid may comprise a branched acid such as citraconic, mesaconic, 2,2-dimethylsuccinic acid; a substituted acid such as tartronic, 2-(2-hydroxyethyl)-malonic acid, a-hy dr oxy glutaric; citric acid; or an aryl dioic acid such as phthalic acid, isophthalic and p-phthalic, optionally with organic substituents on the aromatic ring.
• a branched acid such as citraconic, mesaconic, 2,2-dimethylsuccinic acid
• a substituted acid such as tartronic, 2-(2-hydroxyethyl)-malonic acid, a-hy dr oxy glutaric
• citric acid or an aryl dioic acid such as phthalic acid, isophthalic and p-phthalic, optionally with organic substituents on the aromatic ring.
• the compound may be one of the following:
• the diacid-modified tryptamines or isotryptamines exhibit product stability (oxidation and hydrolysis) and can be readily synthesized and purified.
• the diacid-modified tryptamines or isotryptamines preferably exhibit solubility in biological matrices in excess of the drug absent the diacid modification, making them superior drug candidates.
• the diacid-modified tryptamines preferably exhibit relatively quick rates of hydrolysis in vivo, so as to convert the prodrug rapidly to the active form of the drug. This can result in improved and desirable pharmacokinetic properties with the prodrug, including more reproducible pharmacokinetic profiles. These properties can depend on the nature of the indole, the various substituents attached to the indole and the nature of the diacid ester. Stability and hydrolysis rates can be determined experimentally.
• the compound may comprise a carbamate ester of tryptamine, where R4 is (R9)(R10)N- where R9 and R10 define a carbamate residue and are defined as above.
• the carbamate function comprises a zwitterionic amino- functional mono or dicarboxylic acid which is linked via the carbamate, including without limitation, zwitterionic compounds such as:
• linear alkyl a co-amino acids, such as 3-aminoproprionic acid, 4-amino-butyric acid;
• the invention may comprise zwitterionic compounds where R4 comprises more than one non-ester carboxy function, such as the citrate derivative of a 4- hydroxytryptamine (V) or a glutamic acid carbamate of a 4-hydroxytryptamine (VI):
• the zwitterionic compound is preferably stable at neutral or slightly acidic pH. Acylation of the hydroxy functions of an indole can prevent oxidative reactions typical of substituted phenolic compounds and indoles specifically (Manevski 2010 Drug Metabolism and Disposition and Napolitano 1989 Tetrahedron), while also allowing for solubility.
• the zwitterion has sufficient solubility (>30mg/ml) in the range of neutral and pharmaceutically-acceptable pH values (3-8) to achieve the required potency/efficacy. Conventionally, non-prodrug pharmacophore tryptamines must be placed and held in acidic medium to achieve good solubility and stability. Acidic medium can preclude use as an injectable formulation and can cause irritation.
• Embodiments of the zwitterion may also provide for convenient purification and isolation by recrystallization from common pharmaceutical solvents, such as water, methanol, ethanol, propanol or isopropanol or acetone, or mixtures thereof.
• the diacid moiety is cleaved metabolically in vivo providing the active ingredient in doses and with kinetics sufficient to achieve the psychedelic state believed to be necessary for use in the treatment of depressive conditions, such as psychedelic-assisted psychotherapy.
• the requirement of hydrolysis is an additional step and therefore can reduce the speed of onset of psychoactive properties when compared to injection of the free drug (with no acylation of the hydroxy function).
• a slightly slower speed of onset may be preferred in some cases, so as to avoid a sudden onset which can cause anxiety, particularly in the psychedelic-naive patient.
• the speed of onset may be controlled by the rate of metabolism which can be a function of the ester and the target enzyme required for hydrolysis.
• certain prodrug diacid moieties may reduce the potential for abuse by inhalation or snorting.
• a zwitterion it is not likely to be absorbed rapidly through tissue devoid of esterase activity.
• the zwitterion is likely not absorbed directly by a passive mechanism into the brain. The rate of cleavage in the gut may be slower and absorption slower versus the non-acylated version and thus delay peak rates and the “rush” feeling that may be sought by persons with the intent to abuse.
• Preferred methods may include, but are not limited to, those described below.
• the reactions are performed in a solvent or solvent mixture appropriate to the reagents and materials employed and suitable for the transformations being affected. It will be understood by those skilled in the art of organic synthesis that the functionality present on the molecule should be consistent with the transformations proposed. This will sometimes require ajudgment, well within the skill of a skilled artisan, to modify the order of the synthetic steps or to select one particular process scheme over another in order to obtain a desired compound of the invention.
• Protection and de-protection in the processes below may be carried out by procedures generally known in the art (see, for example, Greene, T.W. et al, Protecting Groups in Organic Synthesis, 3rd Edition, Wiley (1999)).
• 4- and 5-hydroxy-tryptamines can be made by adapting methods described in the art by Baumann et al. (Beilstein 2011, 7, 442) Shulgin (The Vaults of Erowid: TiHKAL: The Chemical Story, by Alexander and Ann Shulgin) and Fricke (Eur Chem J 2019, 25, 897), as well as in US Patent No. 3075992 and Chen (JOC 1994, 3738).
• succinate prodrug compounds described herein may be prepared using the synthetic scheme as outlined in Scheme 1 starting from the corresponding hydroxy-indole and the diacid anhydride.
• the reaction conditions such as temperature, time, choice of solvent and workup procedures are selected which may be suitable for experimental conditions recognized by one skilled in the art. Restrictions to the substituents that are compatible with the reaction conditions will be readily apparent to one skilled in the art and alternate or analogous methods must then be used.
• a glutarate prodrug compound may be made using glutaric anhydride, using Scheme 2 below:
• reaction with the diacid anhydride may take place in dichloromethane and triethylamine, or pyridine.
• the solvent contains a base with pKa greater than 4 but less than 9. If pyridine is used, the product precipitates directly from the reaction mixture in pure form as the zwitterion.
• the solid zwitterion may be converted to a suitable salt, for example, a hydrochloride salt, by addition of anhydrous HC1 (gas) in a suitable solvent or by triturating in anhydrous ether HC1 or dioxane HC1.
• a suitable salt for example, a hydrochloride salt
• Synthesis of the diacid hemiester prodrugs may also be produced using a variety of other methods and techniques well known to those skilled in the art (Rautio, Nature Rev in Drug Discovery 2018, 17, 559), for example, using anhydride or doubly-activated forms of the diacids, such as dichloride, di-N-hydroxysuccinimide (using dicyclohexylcarbodiimide (DCC) or l-Ethyl-3-(3-dimethylaminopropyl)carbodiimide( EDC), N-hydroxysuccinimide and DMAP), di-imizadolide (using carbonyldimidizole), or other activated form of the diacid with the hydroxy form of the active heterocyclic species.
• DCC dicyclohexylcarbodiimide
• EDC dicyclohexylcarbodiimide
• EDC dicyclohexylcarbodiimide
• EDC dicyclohexylcarbodi
• the invention also provides pharmaceutically acceptable compositions which comprise a therapeutically effective amount of one or more of the compounds described herein, formulated together with one or more pharmaceutically acceptable carriers (additives) and/or diluents, and optionally, one or more additional therapeutic agents. While it is possible for a compound described herein to be administered alone, it is preferable to administer the compound as a pharmaceutical composition.
• composition means a composition comprising a compound of the invention in combination with at least one additional pharmaceutically acceptable carrier.
• a “pharmaceutically acceptable carrier” refers to media generally accepted in the art for the delivery of biologically active agents to animals, in particular, mammals, including, i.e., adjuvant, excipient or vehicle, such as diluents, osmotic complement, preserving agents, fdlers, flow regulating agents, disintegrating agents, wetting agents, emulsifying agents, suspending agents, sweetening agents, flavoring agents, perfuming agents, antibacterial agents, antifungal agents, lubricating agents, polymers, solubilizing agents, stabilizers, antioxidants and dispensing agents, depending on the nature of the mode of administration and dosage forms.
• Each carrier must be “acceptable” in the sense of being compatible with the other ingredients of the formulation and not injurious to the patient.
• oral administration includes swallowing for ingestion in the stomach or gut, and further includes lingual, sublingual, buccal and oropharyngeal administration.
• the compounds of this invention can be administered for any of the uses or methods described herein by any suitable means, for example, orally, such as tablets, capsules (each of which may include sustained release or timed release formulations), pills, powders, granules, elixirs, suspensions (including nano suspensions, micro suspensions, spray-dried dispersions), syrups, and emulsions; sublingually (e.g.
• nasally including administration to the nasal membranes, such as by inhalation spray; or rectally such as in the form of suppositories.
• the dosage regimen for the compounds described herein will, of course, vary depending upon known factors, such as the pharmacokinetic and pharmacodynamic characteristics of the particular agent and its mode and route of administration; the species, age, sex, health, medical condition, and weight of the recipient; the nature and extent of the symptoms; the kind of concurrent treatment; the frequency of treatment; the route of administration, the renal and hepatic function of the patient; and, the effect desired.
• the selected dosage level may also depend on the additional factors including the activity of the particular compounds and pharmaceutical compositions described herein, whether an ester, salt or amide substituent is of the compound is used, the time of administration, the rate of excretion or metabolism of the particular compound being employed, the rate and extent of absorption, the duration of the treatment, other drugs that may be administered to the patient, compounds and/or materials used in combination with the particular compound employed and like factors well known in the medical arts.
• the dosage of the prodrug for a therapy session when used for the indicated effects, will range between about 0.001 to about 500 mg per dose, preferably between about 0.01 to about 200 mg per dose, and most preferably between about 0.1 to about 50 mg per dose, such as 10, 20, 30, 40, 50, 100 or 200 mg.
• the most preferred doses will range from about 0.01 to about 10 mg/kg/minute during a constant rate infusion.
• Compounds of this invention may be administered in a single daily dose, or the total daily dosage may be administered in multiple divided doses, such as two, three, or four times daily. Alternatively, the doses may be provided on a weekly, biweekly, or monthly basis. In a preferred embodiment, only one or two doses are required for an anti-depressant effect than may extend for 1 , 2, 3 or 6 months, or more.
• the drug may make up from 1 wt % to 80 wt % of the dosage form, more typically from 5 wt % to 60 wt % of the dosage form.
• tablets generally contain a disintegrant.
• disintegrants include sodium starch glycolate, sodium carboxymethyl cellulose, calcium carboxymethyl cellulose, croscarmellose sodium, crospovidone, polyvinylpyrrolidone, methyl cellulose, microcrystalline cellulose, lower alkyl substituted hydroxypropyl cellulose, starch, pregelatinized starch and sodium alginate.
• the disintegrant will comprise from 1 wt % to 25 wt %, preferably from 5 wt % to 20 wt % of the dosage form.
• Binders are generally used to impart cohesive qualities to a tablet formulation.
• Suitable binders include microcrystalline cellulose, gelatin, sugars, polyethylene glycol, natural and synthetic gums, polyvinylpyrrolidone, pregelatinized starch, hydroxypropyl cellulose and hydroxypropyl methylcellulose. Tablets may also contain diluents, such as lactose (monohydrate, spray dried monohydrate, anhydrous and the like), mannitol, xylitol, dextrose, sucrose, sorbitol, microcrystalline cellulose, starch and dibasic calcium phosphate dihydrate.
• lactose monohydrate, spray dried monohydrate, anhydrous and the like
• mannitol xylitol
• dextrose dextrose
• sucrose sucrose
• sorbitol microcrystalline cellulose
• starch dibasic calcium phosphate dihydrate
• Tablets may also optionally include surface active agents, such as sodium lauryl sulfate and polysorbate 80, and glidants such as silicon dioxide and talc.
• surface active agents such as sodium lauryl sulfate and polysorbate 80
• glidants such as silicon dioxide and talc.
• surface active agents are typically in amounts of from 0.2 wt % to 5 wt % of the tablet, and glidants typically from 0.2 wt % to 1 wt % of the tablet.
• Tablets also generally contain lubricants such as magnesium stearate, calcium stearate, zinc stearate, sodium stearyl fumarate, and mixtures of magnesium stearate with sodium lauryl sulphate.
• Lubricants generally are present in amounts from 0.25 wt % to 10 wt %, preferably from 0.5 wt % to 3 wt % of the tablet.
• Other conventional ingredients include anti-oxidants, colorants, flavoring agents, preservatives and taste masking agents.
• Exemplary tablets contain up to about 80 wt % drug, from about 10 wt % to about 90 wt % binder, from about 0 wt % to about 85 wt % diluent, from about 2 wt % to about 10 wt % disintegrant, and from about 0.25 wt % to about 10 wt % lubricant.
• Tablet blends may be compressed directly or by roller to form tablets. Tablet blends or portions of blends may alternatively be wet, dry, or melt granulated, melt congealed, or extruded before tableting.
• the final formulation may include one or more layers and may be coated or uncoated; or encapsulated.
• a typical capsule for oral administration contains at least one of the compounds of the present invention (e.g. 25 mg), lactose (e.g. 75 mg), and magnesium stearate (e.g. 15 mg).
• the mixture is passed through a 60 mesh sieve and packed into a No. 1 gelatin capsule.
• Liquid formulations include suspensions, solutions, syrups and elixirs. Such formulations may be used as fdlers in soft or hard capsules and typically include a carrier, for example, water, ethanol, polyethylene glycol, propylene glycol, methylcellulose, or a suitable oil, and one or more emulsifying agents and/or suspending agents. Liquid formulations may also be prepared by the reconstitution of a solid, for example, from a sachet.
• a carrier for example, water, ethanol, polyethylene glycol, propylene glycol, methylcellulose, or a suitable oil
• emulsifying agents and/or suspending agents may also be prepared by the reconstitution of a solid, for example, from a sachet.
• the compounds of the invention may also be administered directly into the blood stream, into muscle, or into an internal organ.
• Suitable means for parenteral administration include intravenous, intraarterial, intraperitoneal, intrathecal, intraventricular, intraurethral, intrastemal, intracranial, intramuscular and subcutaneous.
• Suitable devices for parenteral administration include needle (including micro needle) injectors, needle free injectors and infusion techniques.
• Parenteral formulations are typically aqueous solutions which may contain excipients such as salts, carbohydrates and pH adjusting or buffering agents (preferably to a pH of from 3.0 and 7.0, preferably 4.0 to 6.0, and more preferably 4.5 to 5.5), but, for some applications, they may be more suitably formulated as a sterile non aqueous solution or as a dried form to be used in conjunction with a suitable vehicle such as sterile, pyrogen free water or pre fabricated, ready -to-mix aqueous buffer. Osmotic agents may be included to control tonicity.
• parenteral kits for reconstitution at point-of-care under sterile conditions for example, by lyophilization, may readily be accomplished using standard pharmaceutical techniques well known to those skilled in the art.
• a typical injectable preparation is produced by aseptically placing at least one of the compounds of the present invention (e.g. 25 mg) into a vial as a sterile filtered solution, aseptically freeze-drying and sealing.
• the contents of the vial are mixed with e.g. 2 mL of physiological saline for injection, optionally with an appropriate amount of osmotic complements and pH adjusters to achieve a slightly acidic to neutral pH (e.g. pH 4-7), to produce an injectable preparation with low irritation but retain solubility and/or stability of the prodrug.
• Compounds of the invention may be combined with soluble macromolecular entities, such as cyclodextrin and suitable derivatives thereof or polyethylene glycol containing polymers, in order to improve their solubility, dissolution rate, taste masking, bioavailability and/or stability for use in any of the aforementioned modes of administration.
• soluble macromolecular entities such as cyclodextrin and suitable derivatives thereof or polyethylene glycol containing polymers
• Drug cyclodextrin complexes are found to be generally useful for most dosage forms and administration routes. Both inclusion and non inclusion complexes may be used.
• the cyclodextrin may be used as an auxiliary additive, i.e. as a carrier, diluent, or solubilizer. Most commonly used for these purposes are alpha, beta and gamma cyclodextrins, examples of which may be found in PCT Publication Nos. WO 91/11172, WO 94/02518 and WO 98/55148, the disclosures of which are incorporated herein by reference in their entireties.
• the compounds of the present invention which may be used in a suitable hydrated form, and/or the pharmaceutical compositions of the present invention, are formulated into pharmaceutically acceptable dosage forms by conventional methods known to those of skill in the art.
• Actual dosage levels of the active ingredients in the pharmaceutical compositions of this invention may be varied so as to obtain an amount of the active ingredient which is effective to achieve the desired therapeutic response for a particular patient, composition, and mode of administration.
• a physician or veterinarian having ordinary skill in the art can readily determine and prescribe the effective amount of the pharmaceutical composition required.
• the physician or veterinarian could start doses of the compounds of the invention employed in the pharmaceutical composition at levels lower than that required in order to achieve the desired therapeutic effect and gradually increase the dosage until the desired effect is achieved.
• a suitable daily dose of a compound of the invention will be that amount of the compound which is the lowest dose effective to produce a therapeutic effect. Such an effective dose will generally depend upon the factors described above.
• a “therapeutically effective amount” refers to that amount of a compound being administered which will relieve to some extent one or more of the symptoms of the disorder being treated.
• a therapeutically effective amount refers to that amount which has the effect of reducing the severity of depression. Depression severity may be assessed using well-known structured assessment tools such as Structured Clinical Interview for DSM-5 (SCID-5) and the GRID-Hamilton Depression Rating Scale (GRID-HAMD).
• a therapeutically effective amount may be less than that required for a psychedelic state.
• an effective dosage can be administered in one or more administrations.
• an effective dosage of drug, compound, or pharmaceutical composition is an amount sufficient to accomplish prophylactic or therapeutic treatment either directly or indirectly.
• an effective dosage of drug, compound or pharmaceutical composition may or may not be achieved in conjunction with another therapy, drug, compound or pharmaceutical composition.
• Treatment with the novel prodrugs of the present invention may substantially alleviate clinical or subclinical depression and may avoid relapse, particularly if used in combination with psychotherapy for the treatment of depression. It is known that administration of an effective dose of psilocybin produced rapid and large reductions in depressive symptoms, and many subjects achieve remission through a four-week follow up (Davis et. al.) Without restriction to a theory, it is believed that the psychedelic state is associated with the beneficial effects, however, some compounds which are 5HT2A agonists may provide the desired therapeutic effect without the psychedelic state.
• One aspect of the invention comprises prodrugs of those 5HT2A agonists which do provide a beneficial therapeutic state.
• the present invention includes the use of a compound of the present invention herein, to treat any disease or disorder which may be alleviated by a 5HT2A agonist, or the use of a compound of the present invention herein to manufacture a medicament to treat any disease or disorder which may be alleviated by a 5HT2A agonist, or a method of treating any disease or disorder which may be alleviated by a 5HT2A agonist.
• the invention may comprise the use of the compounds of the present invention to treat mental disorders.
• the invention may comprise the use of the compounds of the present invention to treat depression, and particularly drug resistant depression.
• Other conditions that may be treated include: anxiety disorders, including anxiety in advanced stage illness e.g.
• cancer as well as generalized anxiety disorder, depression including major depressive disorder, postpartum depression, cluster headaches, obsessive compulsive disorder, personality disorders including conduct disorder, drug disorders including: alcohol dependence, nicotine dependence, opioid dependence, cocaine dependence and other addictions including gambling disorder, eating disorder and body dysmorphic disorder, chronic pain, or chronic fatigue.
• the invention may comprise a method of treating mental disorders comprising administering to a subject in need thereof a therapeutically effective amount of a compound of the present invention.
• a method of treating depression comprising administering to a subject in need thereof therapeutically effective amount of a compound of the present invention.
• the depression may be drug-resistant depression or major depressive disorder.
• a patient diagnosed with depression may be screened prior to treatment, and then prepared for a dosing session by a trained psychotherapist.
• a compound of the present invention may be administered by injection of a sterile solution at a rate of 0.01-0.3 mg/kg to the patient.
• the patient is preferably seated for the duration of the session while being blindfolded.
• a trained health care professional may monitor the patient throughout the dosing session, which may last up to 12 hours. In some cases, music may be played for the patient.
• the psychotherapist may assist the patient with any questions relating to the psychedelic experience, and then the patient may be discharged.
• the physician may prefer to divide the therapeutic dose and thereby reduce the initial onset of psychoactivity before applying the full complement of the dosage to achieve the full effect.
• treatment with a compound of the present invention may be combined with concomitant treatment with another anti-depressant drugs, either concurrently or consecutively.
• treatment with a compound of the present invention is combined with psychotherapy, which may be applied prior to or after treatment.
• the session may focus the patient on the intent of treatment. If after, psychotherapy is preferably performed within 48 hours of the dosing session to help the patient integrate any feelings, emotions, visions or thoughts that may have occurred during the session, as well as to allow the psychotherapist may offer advice on how best to change thinking or behavior patterns so as to improve anti-depression outcomes. Psychotherapy may continue as needed after the dosing session, for example, up to an additional 3 months, to help the patient integrate any experiences or learnings that occurred to the patient during the dosing session.
• a compound is referred to as a glutaroyl or succinoyl, or hemiglutarate or hemisuccinate, it is understood to be same as the succinate or glutarate.
• the 4- hemiglutarate of psilocin is the same as psilocin-4-glutarate or N,N dimethyltryptamine-4- glutarate.
• the 4-hemiglutarate of 4-OH-DiPT is the same as N,N diisopropyltryptamine-4-glutarate.
• 4-Hydroxyindoles were prepared using methods or modestly adapted from methods described in the literature, such as in Kargbo 2020 ACS Omega): Accordingly, 4- acetoxyindole was reacted with oxalyl chloride in methyl-t-butyl ether (MTBE) and the resulting intermediate was quenched with dimethylamine.
• MTBE methyl-t-butyl ether
• the indole-oxalyl-dimethylamide was reduced with Lithium Aluminum Hydride (LAH) in tetrahydrofuran (THF) to give the 4- acetoxy-3-(N,N-dimethylaminoethyl)indole, which was deprotected using aqueous base to give 4-hydroxy-dimethyltryptamine (psilocin).
• LAH Lithium Aluminum Hydride
• THF tetrahydrofuran
• psilocin 4-hydroxy-dimethyltryptamine
• the 4-hydroxytryptamine was reacted with an excess of succinic anhydride in dichloromethane (DCM) containing triethylamine, and catalyzed by N,N- dimethylaminopyridine, to give psilocin-4-succinate.
• DCM dichloromethane
• the resulting oxalyl-amide is reduced with Lithium Aluminum Hydride (LAH) in THF to give the 4-methyl-5-benzyloxy-3-(N,N- dimethylaminoethyl)indole, which is in turn deprotected using aH2 and Pd/C to give 4- methyl-5-hydroxy-3-(N,N-dimethylaminoethyl)indole.
• LAH Lithium Aluminum Hydride
• Pd/C 4-methyl-5-hydroxy-3-(N,N-dimethylaminoethyl)indole.
• succinic anhydride in dichloromethane, catalyzed by N,N-dimethylamino-pyridine to give 4- methyl-5-succinoyl-3-( N,N-dimethylaminoethyl)indole.
• 6-O-Benzyl- dimethylisotryptamine is prepared by N-alkylation of 5-BzO-indole using NaH.
• the benzyl group is removed by catalytic hydrogenation using Pd/C/H2 to give the HO- function which is succinylated in a subsequent step using succinic anhydride, resulting in the named species.
• a precipitate formed in the reaction was recovered by decantation and trituration in THF.
• psilocin 4-Hydroxy dimethyltryptamine (psilocin) was reacted with an excess of glutaric anhydride in dichloromethane (DCM) containing triethylamine to give psilocin-4-glutarate.
• DCM dichloromethane
• the reaction occurred in pyridine. In either case, a precipitate was formed which was recovered after decantation and trituration with THF. The solid was washed with DCM and then dried. The structure was confirmed by NMR.
• reaction product was suspended in 1M HCl-ether to yield the corresponding HC1 salt form of the product which was recovered by filtration in high yield and purity.
• Table 1 provides the mean concentrations of prodrug remaining at different time points of the experiment. The experiment demonstrates the rapid enzymatic cleavage of the prodrug in plasma versus slow non-enzymatic hydrolysis in relevant biological media.
• the compound from example 9 was administered to rats by injection (intravenous and subcutaneous) with a sterile solution (2mg/ml) at a rate of 1.4-2 mg/kg. Blood samples were taken at 15, 30, 45, 60, 120, 240 min and 360 min and analyzed by LCMS for drug and prodrug. PK profde for the prodrug and active species were obtained and relative bioavailability was determined for each of the routes of administration.
• PK-PD type curves were generated to demonstrate the activity of the drug ( Figures 1 and 2). In rodent, prodrug was not observed, as it was rapidly converted to the active form. Relevant PK parameters for i.v. and s.c administrations 4-HO-DiPT were determined and are shown in Table 2:
• PK parameters (% coefficient of variation in parentheses) for 4-HO-DiPT after subcutaneous administration of N,N diisopropyltryptamine-4-glutarate (2mg/kg).
• HTR Head Twitch Response
• WDS Wet Dog Shakes
• Figure 1 show plasma concentration of 4-HO-DiPT (ng/ml) and versus time after subcutaneous administration of N,N diisopropyltryptamine-4-glutarate at a rate of 2mg/kg.
• PK parameters (% coefficient variation in parentheses) for 4-HO-DiPT after subcutaneous administration of N,N diisopropyltryptamine-4-glutarate (2mg/kg).
• the compound from example 6 is administered to human volunteers by subcutaneous injection of a sterile solution (lmg/ml) at a dosage of 0.1-0.6 mg/kg. Blood samples are taken at 5, 15, 30, 45, 60, 120, 240 and 480 min and 24h. Samples are analyzed by LCMS for drug and prodrug. Subjective effects are measured using standardized questionnaires. The PK analysis shows a maximal plasma concentration (CMax) at approx. 45 min after the injection. Subjective effects show an intensity of psychoactivity that correlates with blood levels.
• CMax maximal plasma concentration
• the compound from example 2 (4-hemisuccinate of 4-OH-DiPT) is administered to human volunteers by oral ingestion of a tablet containing 50 mg of the prodrug. Blood samples are taken at 5, 15, 30, 45, 60, 120, 240 and 480 min and 24h.
• Samples are analyzed by LCMS for drug and prodrug. Subjective effects are measured using standardized questionnaires.
• the PK analysis shows a CMax at approx. 90 min for the injection. Subjective effects show an intensity of psychoactivity that correlates with blood levels.
• the compound of example 6 (N,N diisopropyltryptamine-4-glutarate) is administered by i.m. or s.c. injection (ca. 25mg; 0.4-0.5 mg/kg) to a human patient suffering depression, or by oral administration (ca. 50-200 mg; 0.8-3.2 mg/kg) with tablets.
• the compound of example 6 (4-hemiglutarate of 4-OH-DiPT) is similarly administered.
• the patient Prior to the dosing session, the patient is qualified for the experience by measurement of depression scores, screened for exclusions (e.g. history of psychoses, unfavorable heart condition, pregnancy) and finally, the patient is encouraged to formulate an intent for the dosing session.
• Dosing is performed in a quiet clinic setting with the patient resting comfortably in an inclined, but unrestrained, position to avoid falls.
• the patients’ eyes are covered, and music is applied.
• the drug is administered.
• the patient reports no longer feeling the effects of the drug and is asked to sit up while under supervision.
• Feeling normal the patient is allowed to stand (supervised) and feeling in control, is allowed to move around.
• One hour later the patient is discharged.
• 24h the patient returns to the clinic to meet with a psychotherapist to recount the session.
• the patient records a depression score via questionnaire and is again discharged. At regular intervals the patient is consulted for recurrence of depressive symptoms.
• a vial is prepared with 25mg of compound in Example 6 as a hydrochloride salt (sterilized powder or lyophilizate).
• a separate vial is placed 1 ml of a sterile filtered solution containing 70 mM Na2HP04.
• the final pH of the solution is 4.0 - 5.0.
• references in the specification to "one embodiment”, “an embodiment”, etc., indicate that the embodiment described may include a particular aspect, feature, structure, or characteristic, but not every embodiment necessarily includes that aspect, feature, structure, or characteristic. Moreover, such phrases may, but do not necessarily, refer to the same embodiment referred to in other portions of the specification. Further, when a particular aspect, feature, structure, or characteristic is described in connection with an embodiment, it is within the knowledge of one skilled in the art to combine, affect or connect such aspect, feature, structure, or characteristic with other embodiments, whether or not such connection or combination is explicitly described. In other words, any element or feature may be combined with any other element or feature in different embodiments, unless there is an obvious or inherent incompatibility between the two, or it is specifically excluded.
• ranges recited herein also encompass any and all possible sub-ranges and combinations of sub-ranges thereof, as well as the individual values making up the range, particularly integer values.
• a recited range e.g., weight percents or carbon groups
• Any listed range can be easily recognized as sufficiently describing and enabling the same range being broken down into at least equal halves, thirds, quarters, fifths, or tenths.
• each range discussed herein can be readily broken down into a lower third, middle third and upper third, etc.

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