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(12) Patent Application Publication (10) Pub. No.: US 2010/0166889 A1 Sanfilippo (43) Pub

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(12) Patent Application Publication (10) Pub. No.: US 2010/0166889 A1 Sanfilippo (43) Pub US 20100166889A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2010/0166889 A1 Sanfilippo (43) Pub. Date: Jul. 1, 2010 (54) METHOD OF TREATING DEPRESSIVE A63/495 (2006.01) DSORDERS A 6LX 3/553 (2006.01) A 6LX 3/59 (2006.01) (75) Inventor: Louis Sanfilippo, New Haven, CT A63L/454 (2006.01) (US) A6II 3/445 (2006.01) A6II 3/19 (2006.01) Correspondence Address: A6II 3/405 (2006.01) CANTOR COLBURN, LLP A63L/4525 (2006.01) 20 Church Street, 22nd Floor A63L/35 (2006.01) Hartford, CT 06103 (US) A 6LX 3L/95 (2006.01) A6II 3/423 (2006.01) (73) Assignee: LCS GROUP, LLC, New Haven, A6II 3/428 (2006.01) CT (US) A6IP 25/24 (2006.01) (21) Appl. No.: 12/646,441 G06O 90/00 (2006.01) (52) U.S. Cl. ... 424/722: 514/626; 514/317: 514/254.11: (22) Filed: Dec. 23, 2009 514/469: 514/438: 514/214.02: 514/239.2: 514/254.05; 514/450; 514/211.13: 514/217; Related U.S. Application Data 514/378; 514/252.15; 514/419:514/415; 514/253.13: 514/407: 514/252.18; 514/620; (63) Continuation of application No. 12/666,460, filed as 514/245; 514/221; 514/331; 514/255.01; application No. PCT/US08/01002 on Jan. 24, 2008. 514/254.09:514/253.07: 514/220; 514/259.41: (60) Provisional application No. 60/972,046, filed on Sep. 514/323: 514/321; 514/329; 514/557: 514/242: 13, 2007. 514/424; 514/326; 514/455; 514/561; 514/379; 514/367; 514/215; 705/500 Publication Classification (57) ABSTRACT (51) Int. Cl. A6 IK33/00 (2006.01) The invention provides methods of treating depressive disor A6 IK3I/I65 (2006.01) ders, in particular major depression but other depressive A6 IK 3L/45 (2006.01) orders also, with prodrug stimulants or analogs including A6 IK 3/496 (2006.01) amphetamine prodrugs, methylphenidate prodrugs, and A6 IK3I/343 (2006.01) methylphenidate analogs. Such methods of treatment may A6 IK3I/38 (2006.01) utilize the prodrug stimulant or analog as monotherapy or, A6 IK3I/55 (2006.01) more commonly, as an adjunct to antidepressant medication A 6LX 3/5.375 (2006.01) treatment to augment their effect. The invention includes A6 IK3I/335 (2006.01) combination methods of treatment in which an amphetamine A 6LX 3/553 (2006.01) prodrug, methylphenidate prodrug, or methylphenidate ana A6 IK 3/42 (2006.01) log is administered to an individual in need with one or more A6 IK3I/506 (2006.01) other active agents, either in separate forms or as a single A6 IK 3/405 (2006.01) pharmaceutical formulation. Packaged pharmaceutical com A6 IK 3/404 (2006.01) positions containing an amphetamine or methylphenidate A6 IK 3L/45 (2006.01) prodrug, instructions for using the prodrug to treat certain A6 IK3I/53 (2006.01) disorders, and optionally one or more other active agents are A6 IK3I/55 (2006.01) provided by the invention. US 2010/0166889 A1 Jul. 1, 2010 METHOD OF TREATING DEPRESSIVE behaviors and weight gain may be a direct effect of Such DISORDERS medication(s). Psychotropic medications may also exacer bate an underlying binge eating disorder in Some patients. FIELD OF INVENTION 0005 Medical complications associated with binge eating 0001. The inventor has discovered that amphetamine pro disorder include high blood pressure, high cholesterol and drugs and methylphenidate prodrugs are useful for treating a triglycerides, kidney disease (and failure), gallbladder dis number of central nervous system disorders. Methods of ease, arthritis, bone deterioration, stroke, upper respiratory treating binge eating disorders, obesity resulting from binge infections, skin disorders, menstrual irregularities, ovarian eating behavior, and depression are included herein. The abnormalities, and pregnancy complications. Psychiatric invention includes methods of treating certain co-morbidities problems associated with, or exacerbated by, binge eating in ADHD (Attention-Deficit Hyperactivity Disorder) and disorder include depressive disorders, mood disorders, anxi ADD patients; for example the invention includes methods of ety disorders, ADHD and ADD, personality disorders, other treating generalized anxiety disorder, obsessional and rumi eating disorders, Suicidal thoughts, and Substance abuse dis native thought disorders, and obsessive/compulsive behavior orders. in ADHD and ADD patients. Methods of treatment include 0006 Individuals with binge eating disorder may respond methods in which the amphetamine prodrug, methylpheni to treatment with antidepressants, though Such medications date prodrug, or methylphenidate analog is the only active may contribute to a worsening of binge eating symptoms, agent. The invention also includes combination methods of along with weight gain, either at the outset of treatment or treatment in which an amphetamine prodrug, methylpheni over time. date prodrug, or methylphenidate analog is administered with Depression one or more other active agents. Methods of use described herein include informing a user that an amphetamine prodrug, 0007 Depression is often difficult to treat, as some methylphenidate prodrug, or methylphenidate analog may be patients fail to respond to an initial pharmacologic interven used to treat any of the disorders listed above. The invention tion and a decision must be made to Switch agents, augment includes pharmaceutical compositions comprising an with another medication(s), or combine multiple pharmaco amphetamine prodrug, methylphenidate prodrug, or meth logic agents. Combining medications, while often helpful, ylphenidate analog together with one or more other active can sometimes be problematic with added side effect bur agents in a single dosage form. Packaged pharmaceutical dens. Side effects of certain psychotropic medication some compositions containing an amphetamine prodrug, meth times used to offer adjunct treatment to patients already tak ylphenidate prodrug, or methylphenidate analog with instruc ing antidepressants may include weight gain and obesity. tions for using the composition to treat one of the disorders 0008 Individuals treated for major depressive disorders listed above are also provided. may show a positive response or full remission of symptoms to medication treatment, though recent clinical evidence Sug BACKGROUND gests remission rates following an adequate course of mono therapy treatment may as low as 30-40%. Further, clinical Binge Eating Disorder and Obesity Resulting from studies suggest an unusually large percentage of depressed Binge Eating Disorder individuals treated with antidepressant medication, greater 0002 Binge Eating Disorder is a form of Eating Disorder than 30-40% in various clinical studies, show only a partial Not Otherwise Specified according the Diagnostic and Sta response (for example, full remission is not achieved but there tistical Manual of Mental Disorders (DSM-IV-TR). As is some measure of improvement in depressive symptoms). defined by the DSM-IV-TR, it is characterized by recurrent Some patients may be refractory or resistant to treatment binge eating episodes. and fail to respond to one, or in Some cases, multiple mono 0003 Commonly described symptoms of binge eating therapy and combination antidepressant medication treat disorder include frequent dieting and weight loss, hoarding of mentS. food, hiding empty food containers, eating late at night, attri 0009 Major depressive disorders similarly may lead to bution of one's Successes and failures to weight, avoiding deteriorating physical health and may increase the risk of Social situations where food may be present, and feeling morbidity and mortality in patients with concurrent medical depressed or anxious. Binge eating also may cause rapid and conditions. unhealthy weight gain (or loss), weight fluctuations, and 0010. Similarly, depressive disorders are often associated chronic erratic eating behavior. Binge eating disorder and with, or may exacerbate, other mood disorders, anxiety dis symptoms associated with binge eating disorder may result in orders, attention deficit hyperactivity disorder (ADHD or obesity though obesity is not necessarily a result of binge ADD), psychotic disorders, personality disorders, eating dis eating disorder. Further, patients with binge eating disorder orders, cognition and cognitive disorders, Substance abuse are often not obese and may even have a below normal disorders, and Suicidal ideation. weight. 0011. There exists an unmet and important clinical need 0004. The biological basis of binge eating disorder is for treatments for binge eating disorders, obesity resulting poorly understood. Binge eating disorder is difficult to treat from binge eating behavior, and depression that is only par and carries significant medical and psychiatric risks. Pharma tially responsive to medication and intractable (e.g. treat cologic interventions have been of limited Success and some ment-resistant) depression. The present invention fulfills this times cause a worsening of binge eating symptoms. A number need and provides additional advantages described herein. of psychotropic medications, including but not limited to antidepressants, antipsychotics, antimanic agents, and mood SUMMARY OF THE INVENTION modulating medications are known to cause binge eating, 0012. The inventor has discovered that amphetamine pro dysregulation of appetite, and weight gain. Binge eating drugs, including lisdexamfetamine dimesylate, methylpheni US 2010/0166889 A1 Jul. 1, 2010 date prodrugs, and certain methylphenidate analogs, are use includes (i) lisdexamfetamine dimeSylate and (ii) one or more ful for treating binge eating disorders, obesity resulting from other active agent(s) combined in a single dosage form.
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