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if- cZ(9O Antipsychotics Contributors V.P. Bakshi, M.E. Bardgett, D.L. Braff, E.S. Brodkin, O. Civelli J.G. Csemansky, S.G. Dahl, M. Davidson, A.Y. Deutch, H.S. Fatemi W.O. Faustman, J.Gerlach, M.A. Geyer, J.Golier, A.A. Grace, D.Hartman A.L. Hoff, P.W. Kalivas, A.R. Koreen, J.F. Leckman, J. Lieberman C.J. McDougle, H.Y. Meltzer, S.A. Minchin, F. Monsma, B.H. Mulsant P. O'Donnell S.-O. Ogren, L. Peacock, B.G. Pollock, R. Ranjan, B.L. Roth, R.E. See B. Sheitman, N.R. Swerdlow Editor J.G. Csernaiisky Springer Contents CHAPTER 1 Classification Schemes for Antipsychotic Drugs SUSAN A. MINCHIN and JOHN G. CSERNANSKY. With 1 Figure 1 A. Introduction 1 I. Historical Perspective 1 B. Classification by Patterns of Efficacy and Neurological Side Effects 4 C. Classification by Chemical Structure 6 I. Phenothiazines 7 II. Thioxanthenes 8 III. Butyrophenones 9 IV. Diphenylbutylpiperidines 11 V. Indoles 11 VI. Benzamides 12 VII. Dibenzapines 12 VIII. Others 12 D. Classification by Potency and Nonneurologic Side-Effect Profile 12 E. Classification by Pharmacological Mechanism 14 I. Selective Dopamine Receptor D2 Antagonists 15 II. Combined D2/D3 Antagonists 16 III. Combined DJ/DJ Antagonists 16 IV. Combined 5-HT2-D2 Antagonists 17 F. Future Classification Schemes 17 I. Selective Serotonin Receptor Antagonists 18 II. Partial D2 Agonists 19 III. Sigma Site Antagonists and Excitatory Amino Acid Agonists 19 IV. GABA-Mimetics and Partial Benzodiazepine Agonists 20 G. Conclusions 20 References 21 XII Contents CHAPTER 2 Molecular Models and Structure-Activity Relationships SVEIN G. DAHL. With 3 Figures 29 A. Introduction 29 B. Structure-Activity Relationships of Antipsychotic Drugs 29 C. Neurotransmitter Receptor Models 32 D. Molecular Modelling of Drug-Receptor Interactions 35 I. Electrostatic Fields Around Drug and Receptor Molecules 35 II. Molecular Dynamics of Drug-Receptor Interactions 37 E. Conclusions 37 References 39 CHAPTER 3 Interaction of Antipsychotic Drugs with Dopamine Receptor Subtypes DEBORAH HARTMAN, FREDERICK MONSMA, and OLIVIER CIVELLI With 3 Figures 43 A. Introduction 43 B. Molecular Biology of Dopamine Receptor Subtypes 43 I. General Structural Features of Dopamine Receptors 44 II. The Di Family of Dopamine Receptors 44 1. The Dopamine Dj Receptor 46 2. The Dopamine D5 Receptor 47 III. The D2 Family of Dopamine Receptors 47 1. The Dopamine D2 Receptor 48 2. The Dopamine D3 Receptor 49 3. The Dopamine D4 Receptor 51 C. Pharmacology of Neuroleptics at Recombinant Dopamine Receptors 52 I. Traditional Neuroleptics and Related Compounds 53 II. Clozapine and the Atypical Neuroleptics 59 III. New Antipsychotics 63 1. Olanzapine: A Second-Generation Clozapine-Like Compound 64 2. Remoxipride: A D2 Receptor-Selective Substituted Benzamide 65 3. Risperidone: A D2/5-HT2 Receptor Antagonist 66 D. Future Outlook and Hopes for Subtype-Specific Drugs ...' 67 References 68 Contents XIII CHAPTER 4 Atypical Antipsychotic Drugs: Clinical and Preclinical Studies HOSSEIN S. FATEMI, HERBERT Y. MELTZER, and BRYAN L. ROTH 77 A. Introduction 77 B. Glutamate 78 I. Glutamate Receptors 79 II. Glutamate Hypothesis of Schizophrenia 79 III. Glutamatergic Drugs 81 1. Glycine and Milacemide 81 2. Umespirone 82 3. Others 82 C. 7-Aminobutyric Acid (GABA) 82 I. GABA Receptors 82 II. GABA Hypothesis of Schizophrenia and Clinical Studies of GABA-ergic Drugs 84 D. Acetylcholine 85 I. Acetylcholine Receptors 85 II. Muscarinic Hyperactivity in Schizophrenia? • 85 E. Norepinephrine 87 I. a,-Adrenergic Receptor Involvement in Atypical Antipsychotic Drug Actions 88 F. Cholecystokinin (CCK) 88 I. CCK-ergic Drugs 89 1. LY262691 89 2. Caerulin 89 3. Others 89 G. Neurotensin 89 I. Neurotensin and Schizophrenia 90 II. Effects of Atypical Antipsychotic Drugs on Neurotensin Systems 90 H. Sigma Receptors 91 I. Sigma Receptors 91 II. Preclinical Studies 92 III. Specific Agents 92 I. Opioids 94 J. Serotonin 95 I. 5-HT Receptors and Schizophrenia 96 II. Selective 5-HT2A/2C Antagonists 98 1. Ritanserin 98 2. ICI169369andMDL100907 98 3. Mianserin 98 III. Mixed 5-HT2/D2 Antagonists 98 1. Clozapine 99 XIV Contents 2. Risperidone 99 3. Melperone 99 4. Olanzapine 100 5. Amperozide 100 6. Fluperlapine 100 7. Tiosperone 100 8. Zotepine 101 9. Others 101 IV. 5-HT3 Antagonists 101 V. Nonselective 5-HT Receptor Antagonists 101 VI. 5-HT Reuptake Inhibitors 102 K. Conclusions 102 References 103 CHAPTER 5 Sites and Mechanisms of Action of Antipsychotic Drugs as Revealed by Immediate-Early Gene Expression ARIEL Y. DEUTCH ." 117 A. Introduction 117 B. Immediate-Early Gene Expression as a Method to Assess the Sites and Mechanisms of Action of Antipsychotic Drugs (APDs) 118 C. Effects of APDs on Immediate-Early Gene Induction in the Striatal Complex 120 I. Effects of APDs on Regionally Specific Striatal Immediate-Early Gene Expression 120 1. Dorsal Striatum 120 2. Ventral Striatum 122 II. Striatal Immediate-Early Gene Induction: Fos, Fos-Related Antigens, and Others 123 1. Fos Versus Fras 123 2. Other Immediate-Early Genes 125 III. Mechanisms of Antipsychotic Drug-Elicited Striatal Fos Expression 126 1. Dopamine Receptors and APD-Elicited Increases in Striatal Fos 126 a) D2 Dopamine Receptors 126 b) D, Dopamine Receptors 127 c) Concurrent D2/Di Receptor Occupancy and Striatal Fos Expression 128 2. Involvement of Excitatory Amino Acid Receptors in Neuroleptic-Elicited Striatal Fos Expression 129 Contents XV 3. Cholinergic and Adenosine Receptors 130 a) Muscarinic Cholinergic Receptors 130 b) Adenosine A2 Receptors 131 IV. Acute Versus Chronic Effects of APDs on Striatal Fos Expression 131 V. What Is the Transcriptional Target of APD-Elicited Striatal Fos Expression? 132 1. Neurotensin 133 2. Enkephalin 134 3. Glutamic Acid Decarboxylase 135 D. Preferential Induction of Fos in the Prefrontal Cortex (PFC) by Clozapine 135 I. Regional Effects of APDs on Fos Expression in the PFC 136 1. Effects of APDs on Fos Expression in the Medial PFC 136 2. Correlations Between PFC Expression and Clinical Status 137 II. Receptor Mechanisms of Clozapine-Elicited Increase in PFC Fos Expression 138 1. D! and D2 Dopamine (DA) Receptors and Clozapine-Elicited Fos Expression 138 2. Nondopaminergic Receptors and the PFC Fos Response to Clozapine 140 3. Mechanisms of Clozapine-Elicited Increases in PFC Fos Expression 141 a) Possible Role of a Novel DA Receptor in Mediating Clozapine-Elicited Effects 141 b) Targeting of Multiple Receptors 143 c) Transsynaptic Events as a Possible Determinant of Clozapine-Induced Changes 143 III. Transcriptional Targets of Clozapine's Actions in the PFC 144 E. Effects of APDs on Immediate-Early Gene Expression in Other CNS Sites 145 I. Thalamic Paraventricular Nucleus 145 II. Lateral Septal Nucleus 147 III. Other CNS Regions 147 F. Conclusions 148 I. Methodological Issues 149 II. Validity of Fos Expression as a Model of the Actions of APDs 150 III. Future Directions 150 References 151 XVI Contents CHAPTER 6 Basic Neurophysiology of Antipsychotic Drug Action PATRICIO O'DONNELL and ANTHONY A. GRACE. With 9 Figures 163 A. Introduction 163 B. The Dopamine Hypothesis of Schizophrenia 163 I. Antipsychotic Drugs as D2 Blockers 163 II. Shortcomings of the Dopamine Hypothesis 164 C. Acute Physiology of Antipsychotic Drug Action 165 I. Dopamine Cell Identification and Physiology 165 II. Acute Actions of Antipsychotic Drugs on Dopamine Cell Physiology 167 1. Acute Antipsychotic Drugs Increase Firing Rate 167 2. Acute Antipsychotic Drug Administration Increases Dopamine Cell Burst Firing 169 3. Acute Antipsychotic Drug Treatment Increase the Number of Dopamine Cells Firing Spontaneously 171 D. Physiology of Chronic Antipsychotic Drug Treatment 171 I. Tolerance to Antipsychotic Drug Action 171 II. Chronic Treatment with Antipsychotic Drugs and Dopamine Cell Depolarization Block 172 III. Analysis of Mechanisms Contributing to Depolarization Block: Compensatory Systems Involved in the Recovery of Function After Dopamine Lesions 175 E. Dual Mode of Dopamine Release: Tonic Versus Phasic 177 F. Antipsychotic Drug Treatment and Electrotonic Transmission Within the Basal Ganglia 181 I. Dopaminergic Control of Electrotonic Coupling in the Striatum 181 II. Effects of Subchronic Treatment with Haloperidol or Clozapine on Striatal Cell Dye Coupling Observed In Vitro 185 III. Effects of Subchronic Treatment with Haloperidol or Clozapine on Striatal Cell Dye Coupling Observed In Vivo 187 G. Conclusions 189 References 191 Contents XVII CHAPTER 7 Tolerance and Sensitization to the Effects of Antipsychotic Drugs on Dopamine Transmission RONALD E. SEE and PETER W. KALIVAS. With 1 Figure 203 A. Introduction 203 B. Effects of Single Administration on Dopamine and Related Behaviors 204 C. Effects of Repeated Administration and the Induction of Sensitization and Tolerance 205 I. Tolerance 206 II. Sensitization 209 D. Atypical Antipsychotic Drugs 212 E. Conclusions 213 References 217 CHAPTER 8 The Behavioural Pharmacology of Typical and Atypical Antipsychotic Drugs SVEN OVE OGREN. With 1 Figure 225 A. Introduction 225 B. Typical and Atypical Antipsychotic Drugs 226 I. Concepts and Nomenclature 226 II. Atypical Antipsychotic Drugs 228 III. Behavioural Testing Procedures for Typical and Atypical Antipsychotic Drugs 230 C. Basic Actions of Antipsychotic Drugs and Their Behavioural Effects 232 D. Effects on Motor Function 234 I. Spontaneous Locomotor Activity 234 II. Catalepsy and the Paw Test 236 E. Effects of Antipsychotic Drugs on Behavioural Effects Elicited by DA Receptor Agonists or Glutamate Antagonists ... 240 I. d-Amphetamine
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    USOO83 04431B2 (12) United States Patent (10) Patent No.: US 8,304,431 B2 Buntinx (45) Date of Patent: *Nov. 6, 2012 (54) USE OF D4 AND 5-HT2A ANTAGONISTS, 5,955.459 A 9/1999 Bradley et al. NVERSEAGONSTS OR PARTAL 6,150,353 A 11/2000 Broekkamp et al. 6, 191,133 B1 2/2001 Coppen AGONSTS 6,300,354 B1 10/2001 Steiner et al. 6,358,698 B1 3/2002 Weiner et al. (75) Inventor: Erik Buntinx, Alken (BE) 6,486,153 B1 1 1/2002 Pineiro et al. 2002fOO86899 A1* 7/2002 Sanchez et al. ............... 514,469 2003/0032636 A1 2/2003 Cremers et al. (73) Assignee: PharmaNeuroBoost N.V., Alken (BE) 2004.0002482 A1 1/2004 Dudley et al. 2004/021381.6 A1 10/2004 Weiner et al. (*) Notice: Subject to any disclaimer, the term of this 2004/0266790 A1 12/2004 Bartlet al. patent is extended or adjusted under 35 2005, 0119248 A1 6/2005 Buntinx 2005, 0119249 A1 6/2005 Buntinx U.S.C. 154(b) by 1007 days. 2005/01 19253 A1 6/2005 Buntinx This patent is Subject to a terminal dis 2005, 0148018 A1 7/2005 Weiner et al. 2005/0203130 A1 9, 2005 Buntinx claimer. 2005/0261278 A1 11/2005 Weiner et al. 2005/0261340 A1 11/2005 Weiner et al. (21) Appl. No.: 10/580,962 2005/0288328 A1 12/2005 Weiner et al. 2006, O199842 A1 9, 2006 Weiner et al. 2006/0264465 A1 11/2006 Weiner et al. (22) PCT Filed: Dec. 2, 2004 2006/0264466 A1 11/2006 Weiner et al.