US 2008O1086O2A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2008/0108602 A1 Nagy et al. (43) Pub. Date: May 8, 2008 (54) PREVENTION OF OBESITY IN (21) Appl. No.: 11/687,954 ANTIPSYCHOTIC, ANTIDEPRESSANT AND ANTIEPLEPTIC MEDCATION (22) Filed: Mar. 19, 2007 (75) Inventors: Peter Literati Nagy, Budapest Related U.S. Application Data (HU); Jesse Roth, Whitestone, NY (US); Zoltan Szilvassy, (60) Provisional application No. 60/856,177, filed on Nov. Debrecen-Jozsa (HU); Kalman 2, 2006. Tory, Budapest (HU); Mike Brownstein, Rockville, MD (US); Publication Classification Kalman Takacs, Budapest (HU); Laszlo Vigh, Szeged (HU); Jozsef (51) Int. Cl. Mandi, Budapest (HU); Balazs A6II 3/445 (2006.01) Sumegi. Pecs (HU); Sandor A 6LX 3/59 (2006.01) Bernath, Telki (HU); Attila A6II 3/55 (2006.01) Kolonics, Budapest (HU); Gabor A6IP3/04 (2006.01) Balogh, Szeged (HU); Janos Egri. Budapest (HU) (52) U.S. Cl. .................... 514/220; 514/259.41: 514/318 Correspondence Address: (57) ABSTRACT FSH & RICHARDSON PC P.O. BOX 1022 O-(3-piperidino-2-hydroxypropyl)-nicotinic amidoxime or a MINNEAPOLIS, MN 55440-1022 pharmaceutically suitable acid addition salt thereof (BGP 15) can be used for the prevention or reduction of weight (73) Assignee: N-Gene Research Laboratories, gain or obesity in a patient treated with an antipsychotic drug Inc. or an antidepressant drug or an antiepileptic drug. US 2008/0108602 A1 May 8, 2008 PREVENTION OF OBESITY IN amidoximic acid derivative including BGP-15. A preferred ANTIPSYCHOTIC, ANTIDEPRESSANT AND myopathy is cardiomyopathy. Neurodegenerative diseases ANTIEPLEPTIC MEDCATION include Parkinson's disease, Huntington's disease and amyotrophic lateral Sclerosis. RELATED APPLICATION INFORMATION 0006 U.S. Pat. No. 6,458,371 refers to a composition 0001. This application claims priority to U.S. provisional comprising 0.1-30% of a hydroximic acid derivative includ application Ser. No. 60/856,177, filed Nov. 2, 2006. ing BGP-15 as the active ingredient and a carrier that is in the form of a cream, lotion, foam or spray. The composition BACKGROUND is suitable for reducing the incidence of photodamage by 0002 Anti-psychotic drugs are used for the treatment of radiation with UV-B. psychiatric disorders, particularly schizophrenia, while anti 0007 U.S. Pat. No. 6,884,424 refers to a method for depressants are administered to alleviate the symptoms of preventing actinic keratosis by applying a hydroximic acid depression. Many patients treated with anti-psychotics, e.g., derivative including BGP-15 to the affected skin surface. olanzapine or clozapine feel acoria due to a failure in the 0008 U.S. Pat. No. 6,451,851 refers to a method of regulation of food uptake, thus, the treatment frequently treating a patient Suffering from a viral infection comprising leads to weight gain. Overweight and even obesity may administering to the patient a pharmaceutically effective occur within 3-6 months after the beginning of the treatment amount of a known antivirally active agent together with a as evidenced by reports on treated patients Blin, Can. J hydroximic acid derivative including BGP-15. Psychiatry 44:235-44 (1999). In a similar manner, medi cation with many antidepressants e.g. amitriptyline, imi 0009 U.S. Pat. No. 6,440,998 refers to a pharmaceutical pramine etc. or antiepileptics (anticonvulsants) e.g. Valproic composition having antitumor activity with reduced side acid, sodium valproate etc. results in weight gain that may effect comprising cisplatin or carboplatin and a hydroximic lead to obesity Ruetsch et al., L. Encéphale 31:507-16 acid derivative including BGP-15. (2005). Overweight and obesity themselves are associated (0010 U.S. Pat. No. 6,656,955 refers to a pharmaceutical with hypertension and abnormal metabolic changes Such as composition having antitumor activity with reduced side insulin resistance and dyslipidemia which are risk factors for effect comprising paclitaxel or docetaxel and a hydroximic diabetes. Obesity (particularly abdominal obesity), insulin acid derivative including BGP-15. resistance and dyslipidemia are major features of “pre (0011 U.S. Pat. No. 6,720,337 refers to a pharmaceutical diabetes’ (metabolic syndrome) that leads to type 2 diabetes composition having antitumor activity with reduced side mellitus. Diabetes is associated with serious complications Such as retinopathy, nephropathy, and neuropathy. In addi effect comprising oxaliplatin and a hydroximic acid deriva tion, diabetes is accompanied by increased mortality due to tive including BGP-15. a greater risk of cardiovascular disease. (0012 U.S. Pat. No. 6,838,469 refers to a pharmaceutical 0003. Due to the extensive and growing administration of composition having antitumor activity with reduced side antipsychotic and antiepileptic drugs and antidepressants to effect comprising pyrimidine derivatives and BGP-15. patients in the United States and throughout the developed 0013 PCT Patent Application WO 00/07580 disclosed countries, the above undesirable side effects are considered experimental data for the antidiabetic effect of BGP-15 in as an increasing problem which is related to increased rates the treatment of type 1 diabetes mellitus. It is to be noted that of mortality and morbidity. In addition, patients requiring a type 1 diabetes mellitus is an autoimmune disease occurring treatment with an antipsychotic or an antidepressant or an at young age, while type 2 diabetes mellitus is a metabolic antiepileptic may decide to stop treatment because of the disease occurring at higher age. induced weight gain. (0014 PCT Application WO 03/007951 refers to a phar 0004 O-(3-piperidino-2-hydroxy-1-propyl)-nicotinic maceutical combination of hydroximic acid derivatives amidoxime) (abbreviated as BGP-15) was patented in 1976 including BGP-15 and an antidiabetic or anti-hyperlipi as a new compound useful in the treatment of diabetic demic active agent for the prevention or treatment of a angiopathy, a complication of diabetes resulting in the prediabetic state, metabolic X-syndrome or diabetes mellitus damage of blood vessels (see, e.g., U.S. Pat. No. 4,187.220). as well as disorders which are associated with the states BGP-15 has the structure depicted below. listed above, namely endogenic metabolic disorders, insulin resistance, dislipidemia, alopecia, diffuse effluvium and/or female endocrine disorders based on androgenic preponder ance. In the description, laboratory data indicate that BGP NH2 OH 15 enhances, synergistically, the effect of the known antidia betic agent metformin and troglitaZone, respectively. The N N N1 N-- laboratory data also show that BGP-15 in itself enhances the insulin sensitivity (thus, reduces the insulin resistance) in 2 both normal and hyper-cholesterolemic animals relative to N the control. (0.015 PCT Application WO 2005/122678 refers to the 0005 U.S. Pat. No. 6,306,878 refers to a method for the use of BGP-15 in a pharmaceutical composition having protection of the mitochondrial genome and/or mitochon prokinetic effect (i.e. induces activity in the stomach and drion from damage leading to myopathies and neurodegen intestines. Prokinetic effect includes possible treatment of erative diseases which comprises administering an effective reflux esophagitis, gastroparesis, influencing bile flow from non-toxic dose to a patient Susceptible to such damage of an the gall bladder etc. US 2008/0108602 A1 May 8, 2008 0016 PCT Application WO 2005/123049 refers to the treated with an antipsychotic medication, the antipsychotic use of BGP-15 for mitochondrial genesis i.e. to increase the medication is an atypical antipsychotic medication; the number of mitochondria in the cells resulting in a roborating antipsychotic medicine causes weight gain in at least some effect. patient; the antipsychotic medication is selected from the 0017 PCT Application WO 2006/079910 refers to the group consisting of olanzapine, clozapine, risperidone, que use of BGP-15 for the treatment of lesions in the oral cavity, tiapine, Sulpiride, Ziprasidone, aripiprazole, sertindole, especially periodontal disease. Zotepine, amisulpride and N-desmethylclozapine; the phar maceutically acceptable salt of O-(3-piperidino-2-hydroxy SUMMARY 1-propyl)-nicotinic amidoxime is O-(3-piperidino-2-hy 0018. It has been found that O-(3-piperidino-2-hydrox droxy-1-propyl)-nicotinic amidoxime dihydrochloride; the ypropyl)-nicotinic amidoxime or a pharmaceutically Suit medication is an antidepressant; the patient has suffered able acid addition salt thereof (BGP-15) can be used for the weight gain after being administered the antipsychotic or prevention or reduction of weight gain or obesity in a patient antidepressant medication; the patient has a body mass index treated with an antipsychotic drug or an antidepressant drug greater than 25 kg/m; the patient has a body mass index or an antiepileptic drug. greater than 30 kg/m; and the antipsychotic medication is 0019 Described herein are methods for preventing or olanzapine, risperidone or clozapine. reducing the side effect leading to weight gain or obesity in 0023. Also described herein are pharmaceutical compo a patient requiring a treatment with an antipsychotic or sitions comprising an antipsychotic or antidepressant or antidepressant or antiepileptic drug comprising administer antiepileptic medication and O-(3-piperidino-2-hydroxy-1- ing an effective amount of a known antipsychotic or anti propyl)-nicotinic amidoxime or a pharmaceutically accept depressant or antiepileptic and an