(12) Patent Application Publication (10) Pub. No.: US 2005/0004105 A1 Leahy Et Al
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US 2005.0004105A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2005/0004105 A1 Leahy et al. (43) Pub. Date: Jan. 6, 2005 (54) TREATMENT FOR AATTENTION-DEFICIT Related U.S. Application Data HYPERACTIVITY DISORDER (60) Provisional application No. 60/443,457, filed on Jan. 29, 2003. (76) Inventors: Emer Leahy, Bedford, NY (US); Berend Olivier, Lelytstad (NL) Publication Classification (51) Int. Cl." ....................... A61K 31/55; A61K 31/496; Correspondence Address: A61K 31/495 MORGAN & FINNEGAN, L.L.P. (52) U.S. Cl. ............... 514/218; 514/252.13; 514/255.03 3 WORLD FINANCIAL CENTER NEW YORK, NY 10281-2101 (US) (57) ABSTRACT (21) Appl. No.: 10/767,788 A method for treating Attention Deficit/Hyperactivity Dis order (ADHD) in humans using a 5-HT1A receptor agonist is (22) Filed: Jan. 29, 2004 provided. Patent Application Publication Jan. 6, 2005 Sheet 1 of 15 US 2005/0004105 A1 sc) s.CO SRg Cd 8 3. wO N <16 s s 3 Cd Co (%) 3.e3Suodsay unuxeW Patent Application Publication Jan. 6, 2005 Sheet 2 of 15 US 2005/0004105 A1 FIGURE 2 2A -O- Vehicle -a- Fiesinoxan.03mg 2B 100 -O- Vehicle -A- Flesinoxan.03mg 40 2O v-v- -v- v-ve v-v-v- SN alolo all-we-de- s1-0-1 de O Time Bin Patent Application Publication Jan. 6, 2005 Sheet 3 of 15 US 2005/0004105 A1 FIGURE 3 3A 100 90 80 9. 70 dt 60 -O- Vehicle E 50 -A- FlesinoxanPloei 0.1mg/kg S 40 S 30 20 10 O cNCO YOONOOC)- - - - -ttittittstittstycyyyy overe cacy) wild conlood V-C cort Time Bin 3B -O- Vehicle -a- Flesinoxan 0.1mg/kg Patent Application Publication Jan. 6, 2005 Sheet 4 of 15 US 2005/0004105 A1 FIGURE 4 0.010 O.CO<>5CD3 CD O·+= 0.010 Patent Application Publication Jan. 6, 2005 Sheet 5 of 15 US 2005/0004105 A1 O O O O O O O LO rt cy (uo) peewell edueSpelo Patent Application Publication Jan. 6, 2005 Sheet 6 of 15 US 2005/0004105 A1 6 A 8000 Flesinoxan (0.3 mg/kg) 7OOO Vehicle 6OOO 5000 4000 3000 2000 1000 Crn WT 6 B 3000 - Cm, Flesinoxan (0.3 mg/kg) - Cm, Vehicle 2500 -O- WT, Flesinoxan (0.3 mg/kg) 2000 O WT, Vehicle. 1500 Patent Application Publication Jan. 6, 2005 Sheet 7 of 15 US 2005/0004105 A1 -••-• 9ETRIQOIH • OyGº09GZOzG\0\9 O9 GZZ Patent Application Publication Jan. 6, 2005 Sheet 8 of 15 US 2005/0004105 A1 D 5 O O O O O O O O O O O O O O O O O O O L) O ) O D (y) CN CN w v (uo) peene LeOueSIO le).O. 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Patent Application Publication Jan. 6, 2005 Sheet 12 of 15 US 2005/0004105 A1 O V : O Cy) O cy LO CN O CN H9eun61 LO v O v D 008 00/ 009 OOZ 00|| SeSSOJO euoz Patent Application Publication US 2005/0004105 A1 I-I-T-I-IIae555,-155,5€SÕES-BEZI S3SSONOQuOZJOJ3|qe1V/AONV Patent Application Publication Jan. 6, 2005 Sheet 14 of 15 US 2005/0004105 A1 O) O) -Y4 -Y N N O) O) E E o a C a H 5 H 5 SC E SC E - G - G O O D C) > r E E - 55s is cy)LO O O O g CY)O O CN H O t CN O v o w D O5 O O3 Oas 3O 8 O O cy) CN CN v- v N SeSSOJO euoz Patent Application Publication Jan. 6, 2005 Sheet 15 of 15 US 2005/0004105 A1 FIGURE 7 7 A DPAT 0.1 mg/kg Vehicle Cm, DPAT 0.1 mg/kg - Cm, Vehicle -O- WT, DPAT 0.1 mg/kg -O WT, Vehicle 2 5 O O 5 10 15 20 25 30 35 40 US 2005/0004 105 A1 Jan. 6, 2005 TREATMENT FOR AATTENTION-DEFICT and ADHD associated hyperactivity-impulsivity: meth HYPERACTIVITY DISORDER ylphenidate, d-amphetamine, pemoline, and a mixture of amphetamine salts (Spender et al., Arch. Gen. Psychiatry, FIELD OF THE INVENTION 52:434-443, 1995). These drugs block uptake sites for catecholamines on presynaptic neurons or Stimulate the 0001. The present invention is directed to a novel method release of granular Stores of catecholamines. They are of treating Attention-Deficit/Hyperactivity Disorder metabolized and leave the body fairly rapidly, and have a (“ADHD"). therapeutic duration of action of 1 to 4 hours. The psycho Stimulants do not appear, however, to effect long-term BACKGROUND OF THE INVENTION changes in Social or academic skills (Pelham et al., J. Clin. Child Psychology, 27:190-205, 1998). Stimulants are gen 0002 Attention-Deficit/Hyperactivity Disorder (ADHD) erally started at a low dose and adjusted weekly. Common is a behavior disorder characterized by problems with con Stimulant Side effects include insomnia, decreased appetite, trol of attention and hyperactivity-impulsivity. The atten Stomachaches, headaches, and jitterineSS. PsychoStimulants tional difficulties and impulsivity associated with ADHD have been persuasively documented in laboratory investi also have the potential for abuse, because they are addictive. gations using cognitive tasks. Although these problems Thus, current methods of treating ADHD provide inadequate typically present together, one may be present without the treatment for Some patients and/or have side effects that limit other to qualify for a diagnosis (Am. Psychiatric ASSoc. their usefulness. Diagnostic and Statistical Manual of Mental Disorders, 4" 0007 Children who cannot tolerate psychostimulants Ed., Text Revision, 2000) (DSM-IV-TR). Generally, atten often use the atypical antidepressant bupropion (Buck, Pedi tion deficit or inattention becomes apparent when a child atr. Pharmacother. Vol. 8, No. 4, April, 2002). While bupro enters elementary School. A modified form of the disorder pion is not as effective as Stimulants, it may be used as an can persist into adulthood (Am. Psychiatric ASSoc. Diag adjunct to augment Stimulant treatment. nostic and Statistical Manual of Mental Disorders, 3" Ed., 0008) Effective pharmacotherapy for ADHD is compli 1987). With respect to the attention component, the child is cated by the presence of comorbid behavioral disorders, easily distracted by outside Stimuli, neglects finishing tasks, including aggression, impulse control disorders, and depres and has difficulty maintaining attention. Regarding the activ Sion, which may be relieved by compounds that do not ity component, the child is often fidgety, impulsive, and address the core behavioral Symptoms of inattentiveness and overactive. The symptoms of ADHD may be apparent as impulsivity/hyperactivity. young as preschoolers and are virtually always present prior to the age of 7 (Halperinet al., J. Am. Acad. Child Adoles 0009 Castellanos et al. concluded that ADHD is a geneti cent Psychiatry, 32:1038-1043, 1993). cally programmed disorder of brain development resulting from altered function of the frontal-striatal-pallidal-thalamo 0003) According to the DSM-IV-TR, diagnostic criteria cortical loops which regulate cognitive processes, attention, for Attention-Deficit/Hyperactivity Disorder relate to symp and motor output behaviors (Castellanos et al., Arch. Gen. toms associated with inattention and/or hyperactivity-impul Psychiatry, 53:607-616, 1996). Although the precise etiol sivity. Three subtypes of ADHD are diagnosed based on the ogy of ADHD is unknown, neurotransmitter deficits, genet predominant Symptoms presented. ics, and perinatal complications have been implicated. 0004. Many of the symptoms that are characteristic of 0010 Individuals with ADHD have been reported to have ADHD occur occasionally in normal children. Children with impairments in their ability to perceive intervals of time ADHD, however, exhibit these symptoms frequently, which (Conners & Levin, Psychopharmacol. Bulletin, 32(1):67-73, tends to interfere with the child's day to day functioning. 1996). Time perception is a useful measure of cognitive Such children are often challenged by academic under function, Sensitive to dopaminergic and cholinergic manipu achievement because of excitability and impaired interper lations in animals and humans. AS in all behavioral tasks, Sonal relationships. Several processes underlie good steady State performance in 0005 ADHD affects 2-6% of grade school children. a temporal task. These behavioral tasks include: attention, Pediatricians report that approximately 4% of their patients motivation, Short and long term memory, motor coordina have ADHD; however, in practice the diagnosis is made in tion, and instrumental learning. Scaling, discrimination, and children who meet Several, but not all of the diagnostic reproduction are the three main types of temporal tasks that criteria that is recommended in DMS-IV-TR (Wolraich et have been identified. In Scaling, Subjects must, for example, al., Pediatrics, 86(1):95-101, 1990). Boys are four times categorize a stimulus into a given set of categories (“that was more likely to have the disorder than girls and the disorder a long duration”) or verbally estimate the duration (“that was is found in all cultures (Ross & Ross, Hyperactivity, New a 4 S duration'). In discrimination, a comparison is made York, 1982). between two durations (“the Second stimulus was longer 0006 Psychomotor stimulants are the most common than the first'). Finally, in reproduction, a response is made treatment for ADHD. Safer & Krager (1988) reported that that bears Some relation with the stimulus (e.g. only 99% of the children with ADHD were treated with Stimu responses that are as long or longer than the Stimulus are lants, of which 93% were given methylphenidate hydrochlo correct).