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Maprotiline
|
|
Systematic (IUPAC) name |
N-Methyl-9,10-ethanoanthracene-9(10H)-propanamine |
Clinical data |
AHFS/Drugs.com |
monograph |
MedlinePlus |
a682158 |
Pregnancy cat. |
? (US) |
Legal status |
Prescription Only (S4) (AU) ℞-only (US) |
Routes |
oral, intramuscular, intravenous (infusion) |
Pharmacokinetic data |
Bioavailability |
66 to 70% |
Protein binding |
88% |
Metabolism |
hepatic |
Half-life |
27-58 hours |
Excretion |
biliar (30%) and urine (57%) as gluconurides, 3 to 4% as unchanged drug |
Identifiers |
CAS number |
10262-69-8 Y |
ATC code |
N06AA21 |
PubChem |
CID 4011 |
IUPHAR ligand |
2402 |
DrugBank |
DB00934 |
ChemSpider |
23719117 |
UNII |
2U1W68TROF Y |
KEGG |
D02566 Y |
ChEMBL |
CHEMBL21731 Y |
Chemical data |
Formula |
C20H23N |
Mol. mass |
277.403 g/mol |
SMILES
- CNCCC[C@@]12C3=CC=CC=C3[C@@H](C4=CC=CC=C14)CC2
|
InChI
-
InChI=1S/C20H23N/c1-21-14-6-12-20-13-11-15(16-7-2-4-9-18(16)20)17-8-3-5-10-19(17)20/h2-5,7-10,15,21H,6,11-14H2,1H3/t15-,20+
Key:QSLMDECMDJKHMQ-GSXCWMCISA-N
|
Y (what is this?) (verify) |
Maprotiline (sold as Deprilept, Ludiomil, Psymion) is a tetracyclic antidepressant (TeCA). It is a strong norepinephrine reuptake inhibitor with only weak effects on serotonin and dopamine reuptake.[1][2]It exerts strong blocking effect at H1 receptors, moderate at 5-HT2 and alpha1 and weak blocking effect at D2 and mACh postsynaptic receptors.
It exerts blocking effects at the following postsynaptic receptors:
- Strong : H1
- Moderate : 5-HT2, alpha1
- Weak : D2, mACh
The pharmacologic profile of Maprotiline explains its antidepressant, sedative, anxiolytic, and sympathomimetic activities. In accordance to the pharmacological characteristics it is used in the treatment of depression, such as depression associated with agitation or anxiety. Additionally, it shows a strong antagonism against Reserpine-induced effects in animal studies, as do the other 'classical' antidepressants. Although Maprotiline behaves in most regards as a 'first generation antidepressant' it is commonly referred to as 'second generation antidepressant'.
Contents
- 1 History
- 2 Pharmacokinetics
- 3 The mechanism of action
- 4 Indications
- 5 Side effects
- 6 Necessary examinations during therapy
- 7 Drug abuse and dependence
- 8 Contraindications
- 8.1 Absolute
- 8.2 Special caution needed
- 8.3 Suicidal patients
- 9 Special populations
- 9.1 Pregnancy
- 9.2 Nursing Mothers
- 9.3 Pediatric Use
- 9.4 Elderly Patients
- 10 Necessary examinations during therapy
- 11 Interactions
- 12 Chemistry
- 13 Overdose
- 14 Dosage
- 15 Dose forms
- 16 Brand names
- 17 External links
- 18 References
History
Maprotiline was developed and has been marketed by the Swiss manufacturer Geigy (now operated by Novartis) since the early 1980s under the brand name Ludiomil. Generics are widely available.
Pharmacokinetics
After oral use absorption is good. It binds to plasma proteins 80-90 %. Maximal plasma concentration is reached 6 hours after use. The mean time to peak is 12 hours. The half-life of elimination averages 51 hours.
The mechanism of action
The postulated mechanism of Maprotiline is that it acts primarily by potentiation of central adrenergic synapses by blocking reuptake of norepinephrine at nerve endings. This pharmacologic action is thought to be responsible for the drug's antidepressant and anxiolytic effects. It is a strong norepinephrine reuptake inhibitor with only weak effects on serotonin and dopamine reuptake. At higher doses, however, maprotiline increases serotonergic transmission and increases the level of serotonin available.[3]
Indications
Maprotiline is used in the treatment of depression, such as depression associated with agitation or anxiety and has similar efficacy to the antidepressant drug moclobemide.[4]
- Treatment of depressions of all forms and severities (endogenous, psychotic, involutional, and neurotic) especially for depression associated with agitation or anxiety
- Panic disorder
- Neuropathic pain
- Treatment of the depressive phase in bipolar depression
- For the symptomatic relief of anxiety, tension or insomnia
N.B. The use of maprotiline in the treatment of enuresis in pediatric patients has so far not been systematically explored and its use is not recommended.[2]
Side effects
The side-effect profile is comparable to other tri-/tetracyclic antidepressants and many of the following are due to anticholinergic (which are less prominent than those of most tricyclic antidepressants) and antihistaminergic effects.[2] Most often seen are:
- Dizziness
- Drowsiness
- Somnolence
- fatigue
- Dry mouth (and complications of long-term uncontrolled dry mouth such as dental caries)
- Constipation
- Vertigo
- Nausea (rare, incidence of ~2%) and vomiting
- Increased appetite and weight gain
- Orthostatic hypotension, hypertension, sinus tachycardia, heart-block, arrhythmias and other cardiac effects
- Sexual dysfunction in men: impotence, priapism, delayed ejaculation, anejaculation, decreased libido.
- Sexual dysfunction in women: decreased libido, vaginal dryness, painful sexual intercourse, anorgasmia.
- Allergic skin reactions such as rash or urticaria (more often than with other antidepressants). Rarely, severe skin reactions such as erythema multiforme can occur.
- Photosensitivity
- Agitation, confusion
- Induction of hypomania or mania in patients suffering from underlying bipolar affective disorder
- Psychotic symptoms
- Tremor
- Extrapyramidal symptoms
- Headache
- Seizures (at high doses)
- Rare haematological complications: leukopenia and agranulocytosis (dangerous fall in white blood cells)
- Fever
- Urinary retention
Maprotiline causes a strong initial sedation (first 2 to 3 weeks of therapy) and is therefore indicated to treat agitated patients or those with suicidal risks. It causes anticholinergic side effects (dry mouth, constipation, confusion, tachycardia) with a lower incidence than amitriptyline. Originally, the manufacturer claimed that maprotiline is better tolerated than other tri-/tetracyclic drugs. However, seizures, leukopenia and skin reactions occur more often with maprotiline than with comparable drugs like amitriptyline.
Necessary examinations during therapy
All patients should have frequent blood pressure checks and periodic white blood cell counts. At-risk patients need regular EKG and EEG monitoring as well.
Drug abuse and dependence
Maprotiline has no known potential for abuse and psychological dependence.
Withdrawal symptoms frequently seen when treatment with maprotiline is stopped abruptly (agitation, anxiety, insomnia, sometimes activation of mania or rebound depression) are not indicative of addiction and can be avoided by reducing the daily dose of Maprotiline gradually by approximately 25% each week. If treatment has to be stopped at once due to medical reasons, the use of a benzodiazepine (e.g. lorazepam, clonazepam, or alprazolam) for a maximum of 4 weeks as needed will usually suppress withdrawal symptoms.
Contraindications
Maprotiline may worsen psychotic conditions like schizophrenia and should be given with caution. The antipsychotic treatment should be continued. Patients with bipolar affective disorder should not receive antidepressants whilst in a manic phase, as antidepressants can worsen mania.
Absolute
- Hypersensitivity to Maprotiline or to other tri-/tetracyclic antidepressants
- Hypertrophy of the prostate gland with urine hesitancy
- Closed Angle Glaucoma
Special caution needed
- Concomitant treatment with a MAO-Inhibitor
- Serious impairment of liver and kidney function
- Epilepsy and other conditions that lower the seizure threshold (active brain tumors, alcohol withdrawal, other medications)
- Serious cardiovascular conditions (arrhythmias, heart insufficience, state after myocardial infarction etc.)
- Treatment of patients under age 18[5]
Suicidal patients
Same as other antidepressants, Maprotiline increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of Maprotiline or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Maprotiline is not approved for use in pediatric patients.[6]
Special populations
Pregnancy
Reproduction studies have been performed in female laboratory rabbits, mice, and rats at doses up to 1.3, 7, and 9 times the maximum daily human dose respectively and have revealed no evidence of impaired fertility or harm to the fetus due to Maprotiline. There are, however, no adequate and well controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
Nursing Mothers
Maprotiline is excreted in breast milk. At steady-state, the concentrations in milk correspond closely to the concentrations in whole blood. Caution should be exercised when Maprotiline hydrochloride is administered to a nursing woman.
Pediatric Use
Safety and effectiveness in the pediatric population have not been established. Anyone considering the use of Maprotiline in a child or adolescent must balance the potential risks with the clinical need.
Elderly Patients
In general, lower dosages are recommended for patients over 60 years of age. Dosages of 50 mg to 75 mg daily are usually satisfactory as maintenance therapy for elderly patients who do not tolerate higher amounts.[7][8]
Necessary examinations during therapy
All patients should have frequent blood pressure checks and periodic white blood cell counts. At-risk patients need regular EKG and EEG monitoring as well.
Interactions
Maprotiline has a wide range of possible interactions. Some are typical for tri-/tetracyclic antidepressants, others are caused by specific metabolic effects (e.g. high plasma-protein-binding) of Maprotiline:
- Irreversible MAO-Inhibitors: agitation, delirium, coma, hyperpyrexia (high fever), seizures and severe changes in blood pressure. N.B. Treatment-resistant and hospitalized patients may be treated concomitantly with an MAO-Inhibitor, if they are closely monitored and if the initial dose of the MAO-Inhibitor is low.
Increased drug actions:
- Other antidepressants, barbiturates, narcotics, sedating antihistaminics, anticonvulsive drugs, alcohol - resulting in increased central depression
- Anticholinergics (antiparkinsonian agents, tri- and tetracyclic antidepressants) - resulting in increased anticholinergic action (dry mouth, constipation etc.)
- Sympathomimetics (also those used in local anesthetics like Noradrenaline) : sympathomimetic effects increased (increased blood pressure, pulse rate, paleness of skin etc.)
- Nitrates and Antihypertensives (e.g. Beta-Blockers) - increased antihypertensive action with pronounced fall in blood pressure
Decreased drug actions:
- Guanethidine, Reserpine, Guanfacine : antihypertensive effects decreased
- Clonidine : antihypertensive effects decreased and risk of (massive) rebound hypertension.
Other types of interaction:
- Drugs, which induce certain enzymes in the liver, e.g. Barbiturates, Phenytoin, Carbamazepine and oral anticonceptive drugs, enhance the elimination of Maprotiline and decrease its antidepressant effects. Additionally the blood-concentrations of Phenytoin or Carbamazepine may be increased, leading to a higher incidents of side effects.
- The concomitant use of Maprotiline and neuroleptics can lead to increased Maprotiline blood-levels and to seizures. Combining Maprotiline and Thioridazine could induce severe arrhythmias.
- Additionally, increased blood-levels of Maprotiline are possible, if certain beta-blocking agents (e.g. Propranolol) are given concomitantly.
- Maprotiline may amplify the actions of coumarin-type anticogulants (e.g. Warfarin, Phenprocoumon). The plasma-prothrombin-activity must be assessed closely in order to avoid overt bleedings.
- Maprotiline can increase the actions of oral antidiabetic drugs (sulfonylureas) and Insulin. Diabetic patients should have regular assessments of their blood-glucose-levels.
- The concomitant application with Fluoxetine or Fluvoxamine may lead to significantly increased plasma-levels of Maprotiline with a high incidence of Maprotiline side effects. Due to the long half-lives of Fluoxetine and Fluvoxamine this effect may persist.
Chemistry
The first step in the preparation of the antidepressant maprotiline takes advantage of the acidity of anthrone protons for incorporation of the side chain. Thus treatment of (1) with ethyl acrylate and a relatively mild base leads to the Michael adduct; saponification of the ester group gives the corresponding acid (2). The ketone group is then reduced by means of zinc and ammonium hydroxide. Dehydration of the first-formed alcohol under acidic conditions leads to the formation of fully aromatic anthracene (3). Diels–Alder addition of ethylene under high pressure leads to the addition across the 9,10 positions and the formation of the central 2,2,2-bicyclooctyl moiety (4). The final steps involve the construction of the typical antidepressant side chain. The acid in (4) is thus converted to an acid chloride and that function reacted with methylamine to form the amide.[9][10]
Overdose
Symptoms of overdose may include flushing, fast or irregular heartbeat, dry mouth, drowsiness, confusion, agitation, enlarged pupils, seizures, and loss of consciousness.
Drugs commonly used to treat overdose are Physostigmine to counteract central and peripheral anticholinergic effects and Diazepam to control convulsion. Symptomatic measures are stabilization of blood pressure and correction of water- and electrolyt-deficits. Lidocaine can be given intravenously in small doses against cardial arrhythmias.
Due to milder anticholinergic and cardiotoxic effects of Maprotiline the acute lethal dose may be higher compared with other classical antidepressants (e.g. Amitriptyline, Doxepin). Maprotiline is more toxic than the other tetracyclic drugs Mianserin and Mirtazapine.
Dosage
- Oral: Usually, treatment is started with 3 times 25 mg or 75 mg in a single dose at bedtime. The daily dose is gradually increased to 150 mg daily (2 times 75 mg or 3 times 50 mg). Doses up to 225 mg are possible, but carry the risk of a higher incidence of seizures.
- Parenteral: i.m.-injections and slow iv.-infusions with total daily doses of 75 to 150 mg are possible. Parenteral treatment may lead to an earlier onset of action of Maprotiline but may also be associated with an increased risk of seizures.
Dose forms
- Coated Tablets, 10 mg, 25 mg, 50 mg, and 75 mg
- Injectable concentrate, 25 mg
Brand names
- Ludiomil, Deprilept Psymion
- Generics
External links
- Maprotiline drug information
- rxlist.com
- Schweizer Arzneikompendium (German)
- List of suppliers
References
- ^ Peng, Wen-Huang; Kuan-Lin Lo, Yi-Hsuen Lee, Tai-Huang Hung, Ying-Chih Lin (2007). "Berberine produces antidepressant-like effects in the forced swim test and in the tail suspension test in mice". Life Sciences 81 (11): 933–938. doi:10.1016/j.lfs.2007.08.003. PMID 17804020.
- ^ a b c "DRUGDEX Evaluations - Maprotiline". Retrieved 25 April 2013.
- ^ Miyake K, Fukuchi H, Kitaura T, Kimura M, Kimura Y, Nakahara T (1991). Pharmacokinetics of maprotiline and its demethylated metabolite in serum and specific brain regions of rats after acute and chronic administration of maprotiline. J Pharm Sci.;80(12):1114-8.
- ^ Delini-Stula A, Mikkelsen H, Angst J (October 1995). "Therapeutic efficacy of antidepressants in agitated anxious depression--a meta-analysis of moclobemide studies". J Affect Disord 35 (1-2): 21–30. doi:10.1016/0165-0327(95)00034-K. PMID 8557884.
- ^ Simeon J, Maguire J, Lawrence S (1981). Maprotiline effects in children with enuresis and behavioural disorders. Progress in Neuro-Psychopharmacology 5 ( 5–6), 495–8.
- ^ http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682158.html. Retrieved 29 September 2013
- ^ http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682158.html. Retrieved 29 September 2013.
- ^ http://www.drugs.com/pro/maprotiline.html. Retrieved 29 September 2013.
- ^ Miyake K, Fukuchi H, Kitaura T, Kimura M, Kimura Y, Nakahara T (1991). Pharmacokinetics of maprotiline and its demethylated metabolite in serum and specific brain regions of rats after acute and chronic administration of maprotiline. J Pharm Sci.;80(12):1114-8.
- ^ Wilhelm, M.; Schmidt, P.; Helv. Chim. Acta 1969, 52, 1385.
- B. Bandelow, S. Bleich, S. Kropp : Handbuch Psychopharmaka (German), 2nd. edition, 2004
- Benkert, Hippius : Kompendium der Psychiatrischen Pharmakotherapie (German), 4th. edition, 2003
Antidepressants (N06A)
|
|
Specific reuptake inhibitors (RIs), and releasing agents (RAs)
|
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Selective serotonin reuptake inhibitors (SSRIs)
|
- Alaproclate
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Serotonin–norepinephrine reuptake inhibitors (SNRIs)
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Serotonin–norepinephrine–dopamine reuptake inhibitors (SNDRIs)
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Norepinephrine reuptake inhibitors (NRIs)
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- Amedalin
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|
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Dopamine reuptake inhibitors (DRIs)
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Norepinephrine-dopamine reuptake inhibitors (NDRIs)
|
- Amineptine
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|
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Norepinephrine-dopamine releasing agents (NDRAs)
|
- Amphetamine
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|
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Serotonin-norepinephrine-dopamine releasing agents (SNDRAs)
|
- 4-Methyl-αMT
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|
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Others
|
- Indeloxazine
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|
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Receptor antagonists and/or reuptake inhibitors
|
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Serotonin antagonists and reuptake inhibitors (SARIs)
|
- Etoperidone
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|
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Noradrenergic and specific serotonergic antidepressants (NaSSAs)
|
- Aptazapine
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|
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Norepinephrine-dopamine disinhibitors (NDDIs)
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Serotonin modulators and stimulators (SMSs)
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Others
|
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Heterocyclic antidepressants (bi-, tri-, and tetracyclics)
|
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Bicyclics
|
|
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Tricyclics
|
- Amezepine
- Amineptine
- Amitriptyline#
- Amitriptylinoxide
- Azepindole
- Butriptyline
- Cianopramine
- Clomipramine#
- Cotriptyline
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- Pipofezine
- Propizepine
- Protriptyline
- Quinupramine
- Tampramine
- Tianeptine
- Tienopramine
- Trimipramine
|
|
Tetracyclics
|
- Amoxapine
- Aptazapine
- Azipramine
- Ciclazindol
- Ciclopramine
- Esmirtazapine
- Maprotiline
- Mazindol
- Mianserin
- Mirtazapine
- Oxaprotiline
- Setiptiline/Teciptiline
|
|
|
|
Monoamine oxidase inhibitors (MAOIs)
|
|
Nonselective
|
- Irreversible: Benmoxin
- Carbenzide
- Cimemoxin
- Domoxin
- Echinopsidine
- Iproclozide
- Iproniazid
- Isocarboxazid
- Mebanazine
- Metfendrazine
- Nialamide
- Octamoxin
- Phenelzine
- Pheniprazine
- Phenoxypropazine
- Pivalylbenzhydrazine
- Safrazine
- Tranylcypromine
- Reversible: Caroxazone
- Paraxazone
- Quercetin
|
|
MAOA-Selective
|
- Reversible: Amiflamine
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- Befloxatone
- Berberine
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|
|
MAOB-Selective
|
- Irreversible: Ladostigil
- Mofegiline
- Pargyline
- Rasagiline
- Selegiline
- Reversible: Lazabemide
- Milacemide
|
|
|
|
Azapirones and other 5-HT1A receptor agonists
|
|
- Alnespirone
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- Ipsapirone
- Oxaflozane
- Tandospirone
- Vilazodone
- Zalospirone
|
|
|
- #WHO-EM
- ‡Withdrawn from market
- Clinical trials:
- †Phase III
- §Never to phase III
|
|
|
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dsrd (o, p, m, p, a, d, s), sysi/epon, spvo
|
proc (eval/thrp), drug (N5A/5B/5C/6A/6B/6D)
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|
|
|
Anxiolytics (N05B)
|
|
GABAA
PAMs |
non-N05B
|
- Alcohols (2M2B, Ethanol (beverage), Ethchlorvynol, Methylpentynol)
- Chlormezanone
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|
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Benzodiazepine
|
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- Imidazenil
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- Lorazepam#
- Medazepam
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- Pinazepam
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|
|
Carbamates
|
- Difebarbamate
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- Phenprobamate
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|
|
Nonbenzodiazepines
|
- Abecarnil
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- CGS-8216
- CGS-9896
- CGS-13767
- CGS-20625
- Divaplon
- ELB-139
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- Gedocarnil
- L-838,417
- NS-2664
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- Pipequaline
- RWJ-51204
- SB-205,384
- SL-651,498
- Taniplon
- TP-003
- TP-13
- TPA-023
- Y-23684
- ZK-93423
|
|
Pyrazolopyridines
|
- Cartazolate
- Etazolate
- ICI-190,622
- Tracazolate
|
|
|
α2δ VDCC Blockers |
- Atagabalin
- Gabapentin
- Imagabalin
- PD-217,014
- Pregabalin
- 4-methylpregabalin
|
|
5-HT1A Agonists |
- Azapirones: Buspirone
- Gepirone
- Tandospirone; Others: Flesinoxan
- Naluzotan
- Oxaflozane
|
|
H1 Antagonists |
- Diphenylmethanes: Captodiame
- Hydroxyzine; Others: Brompheniramine
- Chlorphenamine
- Pheniramine
|
|
CRH1 Antagonists |
- Antalarmin
- CP-154,526
- Pexacerfont
- Pivagabine
|
|
NK2 Antagonists |
- GR-159,897
- Saredutant
- Ibodutant
|
|
MCH1 antagonists |
|
|
mGluR2/3 Agonists |
- Biphenylindanone A
- DCG-IV
- Eglumegad
- HYDIA
- LY-379,268
- LY-404,039
|
|
mGluR5 NAMs |
- Fenobam
- GRN-529
- MPEP
- MTEP
|
|
TSPO agonists |
- DAA-1097
- DAA-1106
- Emapunil
- FGIN-127
- FGIN-143
|
|
σ1 agonists |
- Afobazole
- BD1031
- BD1052
- L-687,384
- Opipramol
- Pentoxyverine
- PRE-084
- SA-4503
- 4-PPBP
|
|
Antidepressants |
- Clomipramine
- Duloxetine
- Escitalopram
- Fluoxetine
- Fluvoxamine
- Imipramine
- Lofepramine
- Maprotiline
- Moclobemide
- Nefazodone
- Paroxetine
- Phenelzine
- Sertraline
- Tianeptine
- Venlafaxine
|
|
Others |
- Benzoctamine
- Cannabidiol
- Carbetocin
- Clozapine
- Cycloserine
- Demoxytocin
- Emoxypine
- Kava
- Mephenoxalone
- Mepiprazole
- Oxanamide
- Oxytocin
- Periciazine
- Promoxolane
- Quetiapine
- Risperidone
- Tofisopam
- Tramadol
- Trimetozine
- Valproate
- WAY-267,464
|
|
- #WHO-EM
- ‡Withdrawn from market
- Clinical trials:
- †Phase III
- §Never to phase III
|
|
dsrd (o, p, m, p, a, d, s), sysi/epon, spvo
|
proc (eval/thrp), drug (N5A/5B/5C/6A/6B/6D)
|
|
|
|
Adrenergics
|
|
Receptor ligands
|
|
α1
|
- Agonists: 5-FNE
- 6-FNE
- Amidephrine
- Anisodamine
- Anisodine
- Cirazoline
- Dipivefrine
- Dopamine
- Ephedrine
- Epinephrine
- Etilefrine
- Ethylnorepinephrine
- Indanidine
- Levonordefrin
- Metaraminol
- Methoxamine
- Methyldopa
- Midodrine
- Naphazoline
- Norepinephrine
- Octopamine
- Oxymetazoline
- Phenylephrine
- Phenylpropanolamine
- Pseudoephedrine
- Synephrine
- Tetrahydrozoline
Antagonists: Abanoquil
- Adimolol
- Ajmalicine
- Alfuzosin
- Amosulalol
- Arotinolol
- Atiprosin
- Benoxathian
- Buflomedil
- Bunazosin
- Carvedilol
- CI-926
- Corynanthine
- Dapiprazole
- DL-017
- Domesticine
- Doxazosin
- Eugenodilol
- Fenspiride
- GYKI-12,743
- GYKI-16,084
- Hydroxyzine
- Indoramin
- Ketanserin
- L-765,314
- Labetalol
- Mephendioxan
- Metazosin
- Monatepil
- Moxisylyte
- Naftopidil
- Nantenine
- Neldazosin
- Nicergoline
- Niguldipine
- Pelanserin
- Phendioxan
- Phenoxybenzamine
- Phentolamine
- Piperoxan
- Prazosin
- Quinazosin
- Ritanserin
- RS-97,078
- SGB-1,534
- Silodosin
- SL-89.0591
- Spiperone
- Talipexole
- Tamsulosin
- Terazosin
- Tibalosin
- Tiodazosin
- Tipentosin
- Tolazoline
- Trimazosin
- Upidosin
- Urapidil
- Zolertine
* Note that many TCAs, TeCAs, antipsychotics, ergolines, and some piperazines like buspirone and trazodone all antagonize α1-adrenergic receptors as well, which contributes to their side effects such as orthostatic hypotension.
|
|
α2
|
- Agonists: (R)-3-Nitrobiphenyline
- 4-NEMD
- 6-FNE
- Amitraz
- Apraclonidine
- Brimonidine
- Cannabivarin
- Clonidine
- Detomidine
- Dexmedetomidine
- Dihydroergotamine
- Dipivefrine
- Dopamine
- Ephedrine
- Ergotamine
- Epinephrine
- Esproquin
- Etilefrine
- Ethylnorepinephrine
- Guanabenz
- Guanfacine
- Guanoxabenz
- Levonordefrin
- Lofexidine
- Medetomidine
- Methyldopa
- Mivazerol
- Naphazoline
- Norepinephrine
- Oxymetazoline
- Phenylpropanolamine
- Piperoxan
- Pseudoephedrine
- Rilmenidine
- Romifidine
- Talipexole
- Tetrahydrozoline
- Tizanidine
- Tolonidine
- Urapidil
- Xylazine
- Xylometazoline
Antagonists: 1-PP
- Adimolol
- Aptazapine
- Atipamezole
- BRL-44408
- Buflomedil
- Cirazoline
- Efaroxan
- Esmirtazapine
- Fenmetozole
- Fluparoxan
- GYKI-12,743
- GYKI-16,084
- Idazoxan
- Mianserin
- Mirtazapine
- MK-912
- NAN-190
- Olanzapine
- Phentolamine
- Phenoxybenzamine
- Piperoxan
- Piribedil
- Rauwolscine
- Rotigotine
- SB-269,970
- Setiptiline
- Spiroxatrine
- Sunepitron
- Tolazoline
- Yohimbine
* Note that many atypical antipsychotics and azapirones like buspirone (via metabolite 1-PP) antagonize α2-adrenergic receptors as well.
|
|
β
|
|
|
|
|
Reuptake inhibitors
|
|
NET
|
- Selective norepinephrine reuptake inhibitors: Amedalin
- Atomoxetine (Tomoxetine)
- Ciclazindol
- Daledalin
- Edivoxetine
- Esreboxetine
- Lortalamine
- Mazindol
- Nisoxetine
- Reboxetine
- Talopram
- Talsupram
- Tandamine
- Viloxazine; Norepinephrine-dopamine reuptake inhibitors: Amineptine
- Bupropion (Amfebutamone)
- Fencamine
- Fencamfamine
- Lefetamine
- Levophacetoperane
- LR-5182
- Manifaxine
- Methylphenidate
- Nomifensine
- O-2172
- Radafaxine; Serotonin-norepinephrine reuptake inhibitors: Bicifadine
- Desvenlafaxine
- Duloxetine
- Eclanamine
- Levomilnacipran
- Milnacipran
- Sibutramine
- Venlafaxine; Serotonin-norepinephrine-dopamine reuptake inhibitors: Brasofensine
- Diclofensine
- DOV-102,677
- DOV-21,947
- DOV-216,303
- JNJ-7925476
- JZ-IV-10
- Methylnaphthidate
- Naphyrone
- NS-2359
- PRC200-SS
- SEP-225,289
- SEP-227,162
- Tesofensine; Tricyclic antidepressants: Amitriptyline
- Butriptyline
- Cianopramine
- Clomipramine
- Desipramine
- Dosulepin
- Doxepin
- Imipramine
- Lofepramine
- melitracen
- Nortriptyline
- Protriptyline
- Trimipramine; Tetracyclic antidepressants: Amoxapine
- Maprotiline
- Mianserin
- Oxaprotiline
- Setiptiline; Others: Cocaine
- CP-39,332
- Ethanol
- EXP-561
- Fezolamine
- Ginkgo biloba
- Indeloxazine
- Nefazodone
- Nefopam
- Pridefrine
- Tapentadol
- Tedatioxetine
- Teniloxazine
- Tofenacin
- Tramadol
- Ziprasidone
|
|
VMAT
|
- Ibogaine
- Reserpine
- Tetrabenazine
|
|
|
|
|
|
Enzyme inhibitors
|
|
Anabolism
|
PAH
|
|
|
TH
|
- 3-Iodotyrosine
- Aquayamycin
- Bulbocapnine
- Metirosine
- Oudenone
|
|
AAAD
|
- Benserazide
- Carbidopa
- DFMD
- Genistein
- Methyldopa
|
|
DBH
|
- Bupicomide
- Disulfiram
- Dopastin
- Fusaric acid
- Nepicastat
- Phenopicolinic acid
- Tropolone
|
|
PNMT
|
- CGS-19281A
- SKF-64139
- SKF-7698
|
|
|
Catabolism
|
MAO
|
- Nonselective: Benmoxin
- Caroxazone
- Echinopsidine
- Furazolidone
- Hydralazine
- Indantadol
- Iproclozide
- Iproniazid
- Isocarboxazid
- Isoniazid
- Linezolid
- Mebanazine
- Metfendrazine
- Nialamide
- Octamoxin
- Paraxazone
- Phenelzine
- Pheniprazine
- Phenoxypropazine
- Pivalylbenzhydrazine
- Procarbazine
- Safrazine
- Tranylcypromine; MAO-A selective: Amiflamine
- Bazinaprine
- Befloxatone
- Brofaromine
- Cimoxatone
- Clorgiline
- Eprobemide
- Esuprone
- Harmala alkaloids (Harmine,
- Harmaline
- Tetrahydroharmine
- Harman
- Norharman, etc)
- Methylene blue
- Metralindole
- Minaprine
- Moclobemide
- Pirlindole
- Sercloremine
- Tetrindole
- Toloxatone
- Tyrima; MAO-B selective:
- Ladostigil
- Lazabemide
- Milacemide
- Mofegiline
- Pargyline
- Rasagiline
- Safinamide
- Selegiline (also D-Deprenyl)
* Note that MAO-B inhibitors also influence norepinephrine/epinephrine levels since they inhibit the breakdown of their precursor dopamine.
|
|
COMT
|
- Entacapone
- Nitecapone
- Tolcapone
|
|
|
|
|
Others
|
|
Precursors
|
- L-Phenylalanine → L-Tyrosine → L-DOPA (Levodopa) → Dopamine
- L-DOPS (Droxidopa)
|
|
Cofactors
|
- Ferrous Iron (Fe2+)
- S-Adenosyl-L-Methionine
- Vitamin B3 (Niacin
- Nicotinamide → NADPH)
- Vitamin B6 (Pyridoxine
- Pyridoxamine
- Pyridoxal → Pyridoxal Phosphate)
- Vitamin B9 (Folic acid → Tetrahydrofolic acid)
- Vitamin C (Ascorbic acid)
- Zinc (Zn2+)
|
|
Others
|
- Activity enhancers: BPAP
- PPAP; Release blockers: Bethanidine
- Bretylium
- Guanadrel
- Guanazodine
- Guanclofine
- Guanethidine
- Guanoxan; Toxins: 6-OHDA
|
|
|
|
List of adrenergic drugs
|
|
Cholinergics
|
|
Receptor ligands
|
|
mAChR
|
- Agonists: 77-LH-28-1
- AC-42
- AC-260,584
- Aceclidine
- Acetylcholine
- AF30
- AF150(S)
- AF267B
- AFDX-384
- Alvameline
- AQRA-741
- Arecoline
- Bethanechol
- Butyrylcholine
- Carbachol
- CDD-0034
- CDD-0078
- CDD-0097
- CDD-0098
- CDD-0102
- Cevimeline
- Choline
- cis-Dioxolane
- Ethoxysebacylcholine
- LY-593,039
- L-689,660
- LY-2,033,298
- McNA343
- Methacholine
- Milameline
- Muscarine
- NGX-267
- Ocvimeline
- Oxotremorine
- PD-151,832
- Pilocarpine
- RS86
- Sabcomeline
- SDZ 210-086
- Sebacylcholine
- Suberylcholine
- Talsaclidine
- Tazomeline
- Thiopilocarpine
- Vedaclidine
- VU-0029767
- VU-0090157
- VU-0152099
- VU-0152100
- VU-0238429
- WAY-132,983
- Xanomeline
- YM-796
Antagonists: 3-Quinuclidinyl Benzilate
- 4-DAMP
- Aclidinium Bromide
- Anisodamine
- Anisodine
- Atropine
- Atropine Methonitrate
- Benactyzine
- Benzatropine/Benztropine
- Benzydamine
- BIBN 99
- Biperiden
- Bornaprine
- CAR-226,086
- CAR-301,060
- CAR-302,196
- CAR-302,282
- CAR-302,368
- CAR-302,537
- CAR-302,668
- CS-27349
- Cyclobenzaprine
- Cyclopentolate
- Darifenacin
- DAU-5884
- Dimethindene
- Dexetimide
- DIBD
- Dicyclomine/Dicycloverine
- Ditran
- EA-3167
- EA-3443
- EA-3580
- EA-3834
- Etanautine
- Etybenzatropine/Ethylbenztropine
- Flavoxate
- Himbacine
- HL-031,120
- Ipratropium bromide
- J-104,129
- Hyoscyamine
- Mamba Toxin 3
- Mamba Toxin 7
- Mazaticol
- Mebeverine
- Methoctramine
- Metixene
- N-Ethyl-3-Piperidyl Benzilate
- N-Methyl-3-Piperidyl Benzilate
- Orphenadrine
- Otenzepad
- Oxybutynin
- PBID
- PD-102,807
- PD-0298029
- Phenglutarimide
- Phenyltoloxamine
- Pirenzepine
- Piroheptine
- Procyclidine
- Profenamine
- RU-47,213
- SCH-57,790
- SCH-72,788
- SCH-217,443
- Scopolamine/Hyoscine
- Solifenacin
- Telenzepine
- Tiotropium bromide
- Tolterodine
- Trihexyphenidyl
- Tripitamine
- Tropatepine
- Tropicamide
- WIN-2299
- Xanomeline
- Zamifenacin; Others: 1st Generation Antihistamines (Brompheniramine
- chlorphenamine
- cyproheptadine
- dimenhydrinate
- diphenhydramine
- doxylamine
- mepyramine/pyrilamine
- phenindamine
- pheniramine
- tripelennamine
- triprolidine, etc)
- Tricyclic Antidepressants (Amitriptyline
- doxepin
- trimipramine, etc)
- Tetracyclic Antidepressants (Amoxapine
- maprotiline, etc)
- Typical Antipsychotics (Chlorpromazine
- thioridazine, etc)
- Atypical Antipsychotics (Clozapine
- olanzapine, etc.)
|
|
nAChR
|
- Agonists: 5-HIAA
- A-84,543
- A-366,833
- A-582,941
- A-867,744
- ABT-202
- ABT-418
- ABT-560
- ABT-894
- Acetylcholine
- Altinicline
- Anabasine
- Anatoxin-a
- AR-R17779
- Butinoline
- Butyrylcholine
- Carbachol
- Choline
- Cotinine
- Cytisine
- Decamethonium
- Desformylflustrabromine
- Dianicline
- Dimethylphenylpiperazinium
- Epibatidine
- Epiboxidine
- Ethanol
- Ethoxysebacylcholine
- EVP-4473
- EVP-6124
- Galantamine
- GTS-21
- Ispronicline
- Lobeline
- MEM-63,908/RG-3487
- Nicotine
- NS-1738
- PHA-543,613
- PHA-709,829
- PNU-120,596
- PNU-282,987
- Pozanicline
- Rivanicline
- RJR-2429
- Sazetidine A
- Sebacylcholine
- SIB-1508Y
- SIB-1553A
- SSR-180,711
- Suberylcholine
- Suxamethonium/Succinylcholine
- TC-1698
- TC-1734
- TC-1827
- TC-2216
- TC-5214
- TC-5619
- TC-6683
- Tebanicline
- Tropisetron
- UB-165
- Varenicline
- WAY-317,538
- XY-4083
Antagonists: 18-Methoxycoronaridine
- α-Bungarotoxin
- α-Conotoxin
- Alcuronium
- Amantadine
- Anatruxonium
- Atracurium
- Bupropion
- Chandonium
- Chlorisondamine
- Cisatracurium
- Coclaurine
- Coronaridine
- Dacuronium
- Decamethonium
- Dextromethorphan
- Dextropropoxyphene
- Dextrorphan
- Diadonium
- DHβE
- Dihydrochandonium
- Dimethyltubocurarine/Metocurine
- Dipyrandium
- Dizocilpine/MK-801
- Doxacurium
- Esketamine
- Fazadinium
- Gallamine
- Hexafluronium
- Hexamethonium/Benzohexonium
- Ibogaine
- Isoflurane
- Ketamine
- Kynurenic acid
- Laudexium/Laudolissin
- Levacetylmethadol
- Malouetine
- Mecamylamine
- Memantine
- Methadone (Levomethadone)
- Methorphan/Racemethorphan
- Methyllycaconitine
- Metocurine
- Mivacurium
- Morphanol/Racemorphan
- Neramexane
- Nitrous Oxide
- Pancuronium
- Pempidine
- Pentamine
- Pentolinium
- Phencyclidine
- Pipecuronium
- Radafaxine
- Rapacuronium
- Rocuronium
- Surugatoxin
- Thiocolchicoside
- Toxiferine
- Trimethaphan
- Tropeinium
- Tubocurarine
- Vecuronium
- Xenon
|
|
|
|
Reuptake inhibitors
|
|
Plasmalemmal
|
CHT Inhibitors
|
- Hemicholinium-3/Hemicholine
- Triethylcholine
|
|
|
Vesicular
|
|
|
|
|
Enzyme inhibitors
|
|
Anabolism
|
ChAT inhibitors
|
- 1-(-Benzoylethyl)pyridinium
- 2-(α-Naphthoyl)ethyltrimethylammonium
- 3-Chloro-4-stillbazole
- 4-(1-Naphthylvinyl)pyridine
- Acetylseco hemicholinium-3
- Acryloylcholine
- AF64A
- B115
- BETA
- CM-54,903
- N,N-Dimethylaminoethylacrylate
- N,N-Dimethylaminoethylchloroacetate
|
|
|
Catabolism
|
AChE inhibitors
|
|
|
BChE inhibitors
|
- Cymserine * Many of the acetylcholinesterase inhibitors listed above act as butyrylcholinesterase inhibitors.
|
|
|
|
|
Others
|
|
Precursors
|
- Choline (Lecithin)
- Citicoline
- Cyprodenate
- Dimethylethanolamine
- Glycerophosphocholine
- Meclofenoxate/Centrophenoxine
- Phosphatidylcholine
- Phosphatidylethanolamine
- Phosphorylcholine
- Pirisudanol
|
|
Cofactors
|
- Acetic acid
- Acetylcarnitine
- Acetyl-coA
- Vitamin B5 (Pantethine
- Pantetheine
- Panthenol)
|
|
Others
|
- Acetylcholine releasing agents: α-Latrotoxin
- β-Bungarotoxin; Acetylcholine release inhibitors: Botulinum toxin (Botox); Acetylcholinesterase reactivators: Asoxime
- Obidoxime
- Pralidoxime
|
|
|
|
Histaminergics
|
|
Receptor |
H1
|
- Agonists: 2-Pyridylethylamine
- Betahistine
- Histamine
- HTMT
- UR-AK49
Antagonists: 1st generation: 4-Methyldiphenhydramine
- Alimemazine
- Antazoline
- Azatadine
- Bamipine
- Benzatropine/Benztropine
- Bepotastine
- Bromazine
- Brompheniramine
- Buclizine
- Captodiame
- Carbinoxamine
- Chlorcyclizine
- Chloropyramine
- Chlorothen
- Chlorphenamine
- Chlorphenoxamine
- Cinnarizine
- Clemastine
- Clobenzepam
- Clocinizine
- Cyclizine
- Cyproheptadine
- Dacemazine
- Deptropine
- Dexbrompheniramine
- Dexchlorpheniramine
- Dimenhydrinate
- Dimetindene
- Diphenhydramine
- Diphenylpyraline
- Doxylamine
- Embramine
- Etodroxizine
- Etybenzatropine/Ethylbenztropine
- Etymemazine
- Flunarizine
- Histapyrrodine
- Homochlorcyclizine
- Hydroxyethylpromethazine
- Hydroxyzine
- Isopromethazine
- Isothipendyl
- Meclozine
- Mepyramine/Pyrilamine
- Mequitazine
- Methafurylene
- Methapyrilene
- Methdilazine
- Moxastine
- Niaprazine
- Orphenadrine
- Oxatomide
- Oxomemazine
- Phenindamine
- Pheniramine
- Phenyltoloxamine
- Pimethixene
- Piperoxan
- Pipoxizine
- Promethazine
- Propiomazine
- Pyrrobutamine
- Talastine
- Thenalidine
- Thenyldiamine
- Thiazinamium
- Thonzylamine
- Tolpropamine
- Tripelennamine
- Triprolidine
- 2nd generation: Acrivastine
- Alinastine
- Astemizole
- Azelastine
- Bamirastine
- Barmastine
- Bepiastine
- Bepotastine
- Bilastine
- Cabastinen
- Carebastine
- Cetirizine
- Clemastine
- Clemizole
- Clobenztropine
- Dorastine
- Ebastine
- Emedastine
- Epinastine
- Flezelastine
- Ketotifen
- Latrepirdine
- Levocabastine
- Linetastine
- Loratadine
- Mapinastine
- Mebhydrolin
- Mizolastine
- Moxastine
- Noberastine
- Octastine
- Olopatadine
- Perastine
- Piclopastine
- Rocastine
- Rupatadine
- Setastine
- Talastine
- Temelastine
- Terfenadine
- Zepastine
- 3rd generation: Desloratadine
- Fexofenadine
- Levocetirizine
- Ungrouped: Belarizine
- Efletirizine
- Elbanizine
- Flotrenizine
- Medrylamine
- Napactadine
- Pibaxizine
- Tagorizine
- Trelnarizine
- Trenizine
- Vapitadine
- Miscellaneous: Tricyclic antidepressants (amitriptyline,
- doxepin,
- trimipramine, etc)
- Tetracyclic antidepressants (mianserin,
- mirtazapine, etc)
- Typical antipsychotics (chlorpromazine,
- thioridazine, etc)
- Atypical antipsychotics (clozapine,
- olanzapine,
- quetiapine, etc)
|
|
H2
|
- Agonists: Amthamine
- Betazole
- Dimaprit
- Histamine
- HTMT
- Impromidine
- UR-AK49
Antagonists: Bisfentidine
- Burimamide
- Cimetidine
- Dalcotidine
- Donetidine
- Ebrotidine
- Etintidine
- Famotidine
- Lafutidine
- Lamtidine
- Lavoltidine/Loxtidine
- Lupitidine
- Metiamide
- Mifentidine
- Niperotidine
- Nizatidine
- Osutidine
- Oxmetidine
- Pibutidine
- Quisultazine/Quisultidine
- Ramixotidine
- Ranitidine
- Roxatidine
- Sufotidine
- Tiotidine
- Tuvatidine
- Venritidine
- Xaltidine
|
|
H3
|
- Agonists: α-Methylhistamine
- Cipralisant
- Histamine
- Imetit
- Immepip
- Immethridine
- Methimepip
- Proxyfan
Antagonists: A-349,821
- A-423,579
- ABT-239
- Betahistine
- Burimamide
- Ciproxifan
- Clobenpropit
- Conessine
- GSK-189,254
- Impentamine
- Iodophenpropit
- JNJ-5,207,852
- MK-0249
- NNC-38-1,049
- PF-03654746
- Pitolisant
- SCH-79,687
- Thioperamide
- VUF-5,681
|
|
H4
|
- Agonists: 4-Methylhistamine
- α-Methylhistamine
- Histamine
- VUF-8,430
Antagonists: JNJ-7,777,120
- Thioperamide
- VUF-6,002
|
|
|
Transporter |
VMAT
|
- Inhibitors: Ibogaine
- Reserpine
- Tetrabenazine
|
|
|
Enzyme |
HDC
|
- Inhibitors: Catechin
- Meciadanol
- Naringenin
- Tritoqualine
|
|
HNMT
|
- Inhibitors: Amodiaquine
- Diphenhydramine
- Harmaline
- Metoprine
- Quinacrine
- SKF-91,488
- Tacrine
|
|
DAO
|
- Inhibitors: Aminoguanidine
|
|
|
Others |
Endogenous
|
- Histamine; Precursors: L-Histidine; Cofactors: Vitamin B6
|
|
|
Serotonergics
|
|
5-HT1 receptor ligands
|
|
5-HT1A
|
- Agonists: Azapirones: Alnespirone
- Binospirone
- Buspirone
- Enilospirone
- Eptapirone
- Gepirone
- Ipsapirone
- Perospirone
- Revospirone
- Tandospirone
- Tiospirone
- Umespirone
- Zalospirone; Antidepressants: Etoperidone
- Nefazodone
- Trazodone
- Vortioxetine; Antipsychotics: Aripiprazole
- Asenapine
- Clozapine
- Quetiapine
- Ziprasidone; Ergolines: Dihydroergotamine
- Bromocriptine
- Ergotamine
- Lisuride
- Methysergide
- LSD; Tryptamines: 5-CT
- 5-MeO-DMT
- 5-MT
- Bufotenin
- DMT
- Indorenate
- Psilocin
- Psilocybin; Others: 8-OH-DPAT
- Adatanserin
- Bay R 1531
- Befiradol
- BMY-14802
- Cannabidiol
- Dimemebfe
- Ebalzotan
- Eltoprazine
- F-11,461
- F-12,826
- F-13,714
- F-14,679
- F-15,063
- F-15,599
- Flesinoxan
- Flibanserin
- Lesopitron
- LY-293,284
- LY-301,317
- MKC-242
- Naluzotan
- NBUMP
- Osemozotan
- Oxaflozane
- Pardoprunox
- Piclozotan
- Rauwolscine
- Repinotan
- Roxindole
- RU-24,969
- S 14,506
- S-14,671
- S-15,535
- Sarizotan
- SSR-181,507
- Sunepitron
- U-92,016-A
- Urapidil
- Vilazodone
- Xaliproden
- Yohimbine
Antagonists: Antipsychotics: Iloperidone
- Risperidone
- Sertindole; Beta blockers: Alprenolol
- Cyanopindolol
- Iodocyanopindolol
- Oxprenolol
- Pindobind
- Pindolol
- Propranolol
- Tertatolol; Others: AV965
- BMY-7,378
- CSP-2503
- Dotarizine
- Flopropione
- GR-46611
- Isamoltane
- Lecozotan
- Mefway
- Metitepine/Methiothepin
- MPPF
- NAN-190
- Robalzotan
- S-15535
- SB-649,915
- SDZ 216-525
- Spiperone
- Spiramide
- Spiroxatrine
- UH-301
- WAY-100,135
- WAY-100,635
- Xylamidine
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5-HT1B
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- Agonists: Lysergamides: Dihydroergotamine
- Ergotamine
- Methysergide; Piperazines: Eltoprazine
- TFMPP; Triptans: Avitriptan
- Eletriptan
- Sumatriptan
- Zolmitriptan; Tryptamines: 5-CT
- 5-MT; Others: CGS-12066A
- Bromocriptine
- CP-93,129
- CP-94,253
- CP-135,807
- RU-24,969
- Vortioxetine
Antagonists: Lysergamides: Metergoline; Others: AR-A000002
- Elzasonan
- GR-127,935
- Isamoltane
- Metitepine/Methiothepin
- SB-216,641
- SB-224,289
- SB-236,057
- Yohimbine
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5-HT1D
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- Agonists: Lysergamides: Dihydroergotamine
- Methysergide; Triptans: Almotriptan
- Avitriptan
- Eletriptan
- Frovatriptan
- Naratriptan
- Rizatriptan
- Sumatriptan
- Zolmitriptan; Tryptamines: 5-CT
- 5-Ethyl-DMT
- 5-MT
- 5-(Nonyloxy)tryptamine; Others: CP-135,807
- Bromocriptine
- CP-286,601
- GR-46611
- L-694,247
- L-772,405
- PNU-109,291
- PNU-142633
Antagonists: Lysergamides: Metergoline; Others: Alniditan
- BRL-15,572
- Elzasonan
- GR-127,935
- Ketanserin
- LY-310,762
- LY-367,642
- LY-456,219
- LY-456,220
- Metitepine/Methiothepin
- Ritanserin
- Yohimbine
- Ziprasidone
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5-HT1E
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- Agonists: Lysergamides: Methysergide; Triptans: Eletriptan; Tryptamines: BRL-54443
- Tryptamine
Antagonists: Metitepine/Methiothepin
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5-HT1F
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- Agonists: Triptans: Eletriptan
- Naratriptan
- Sumatriptan; Tryptamines: 5-MT; Others: BRL-54443
- Bromocriptine
- Lasmiditan
- LY-334,370
Antagonists: Metitepine/Methiothepin
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5-HT2 receptor ligands
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5-HT2A
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5-HT2B
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- Agonists: Oxazolines: 4-Methylaminorex
- Aminorex; Phenethylamines: Chlorphentermine
- Cloforex
- DOB
- DOC
- DOI
- DOM
- Fenfluramine (Dexfenfluramine, Levofenfluramine)
- MDA
- MDMA
- Norfenfluramine; Tryptamines: 5-CT
- 5-MT
- α-Methyl-5-HT; Others: BW-723C86
- Bromocriptine
- Cabergoline
- mCPP
- Pergolide
- PNU-22394
- Ro60-0175
Antagonists: Agomelatine
- Asenapine
- EGIS-7625
- Ketanserin
- Lisuride
- LY-272,015
- Metitepine/Methiothepin
- PRX-08066
- Rauwolscine
- Ritanserin
- RS-127,445
- Sarpogrelate
- SB-200,646
- SB-204,741
- SB-206,553
- SB-215,505
- SB-221,284
- SB-228,357
- SDZ SER-082
- Tegaserod
- Yohimbine
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5-HT2C
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- Agonists: Phenethylamines: 2C-B
- 2C-E
- 2C-I
- 2C-T-2
- 2C-T-7
- 2C-T-21
- DOB
- DOC
- DOI
- DOM
- MDA
- MDMA
- Mescaline; Piperazines: Aripiprazole
- mCPP
- TFMPP; Tryptamines: 5-CT
- 5-MeO-α-ET
- 5-MeO-α-MT
- 5-MeO-DET
- 5-MeO-DiPT
- 5-MeO-DMT
- 5-MeO-DPT
- 5-MT
- α-ET
- α-Methyl-5-HT
- α-MT
- Bufotenin
- DET
- DiPT
- DMT
- DPT
- Psilocin
- Psilocybin; Others: A-372,159
- AL-38022A
- Alstonine
- Bromocriptine
- CP-809,101
- Dimemebfe
- Lorcaserin
- Medifoxamine
- MK-212
- Org 12,962
- ORG-37,684
- Oxaflozane
- PHA-57378
- PNU-22394
- PNU-181731
- Ro60-0175
- Ro60-0213
- Vabicaserin
- WAY-629
- WAY-161,503
- YM-348
Antagonists: Atypical antipsychotics: Clorotepine
- Clozapine
- Iloperidone
- Melperone
- Olanzapine
- Paliperidone
- Quetiapine
- Risperidone
- Sertindole
- Ziprasidone
- Zotepine; Typical antipsychotics: Chlorpromazine
- Loxapine
- Pimozide
- Pipamperone; Antidepressants: Agomelatine
- Amitriptyline
- Amoxapine
- Aptazapine
- Etoperidone
- Fluoxetine
- Mianserin
- Mirtazapine
- Nefazodone
- Nortriptyline
- Tedatioxetine
- Trazodone; Others: Adatanserin
- CEPC
- Cinanserin
- Cyproheptadine
- Deramciclane
- Dotarizine
- Eltoprazine
- Esmirtazapine
- FR-260,010
- Ketanserin
- Ketotifen
- Latrepirdine
- Metitepine/Methiothepin
- Methysergide
- Pizotifen
- Ritanserin
- RS-102,221
- S-14,671
- SB-200,646
- SB-206,553
- SB-221,284
- SB-228,357
- SB-242,084
- SB-243,213
- SDZ SER-082
- Xylamidine
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- 5-HT3
- 5-HT4
- 5-HT5
- 5-HT6
- 5-HT7 ligands
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5-HT3
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- Agonists: Piperazines: BZP
- Quipazine; Tryptamines: 2-Methyl-5-HT
- 5-CT; Others: Chlorophenylbiguanide
- Butanol
- Ethanol
- Halothane
- Isoflurane
- RS-56812
- SR-57,227
- SR-57,227-A
- Toluene
- Trichloroethane
- Trichloroethanol
- Trichloroethylene
- YM-31636
Antagonists: Antiemetics: AS-8112
- Alosetron
- Azasetron
- Batanopride
- Bemesetron
- Cilansetron
- Dazopride
- Dolasetron
- Galanolactone
- Granisetron
- Lerisetron
- Ondansetron
- Palonosetron
- Ramosetron
- Renzapride
- Tropisetron
- Zacopride
- Zatosetron; Atypical antipsychotics: Clozapine
- Olanzapine
- Quetiapine; Tetracyclic antidepressants: Amoxapine
- Mianserin
- Mirtazapine; Others: CSP-2503
- ICS-205,930
- MDL-72,222
- Memantine
- Nitrous Oxide
- Ricasetron
- Sevoflurane
- Tedatioxetine
- Thujone
- Tropanserin
- Vortioxetine
- Xenon
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5-HT4
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- Agonists: Gastroprokinetic Agents: Cinitapride
- Cisapride
- Dazopride
- Metoclopramide
- Mosapride
- Prucalopride
- Renzapride
- Tegaserod
- Velusetrag
- Zacopride; Others: 5-MT
- BIMU8
- CJ-033,466
- PRX-03140
- RS-67333
- RS-67506
- SL65.0155
- Antagonists: GR-113,808
- GR-125,487
- L-Lysine
- Piboserod
- RS-39604
- RS-67532
- SB-203,186
- SB-204,070
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5-HT5A
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- Agonists: Lysergamides: Ergotamine
- LSD; Tryptamines: 5-CT; Others: Valerenic Acid
Antagonists: Asenapine
- Latrepirdine
- Metitepine/Methiothepin
- Ritanserin
- SB-699,551
* Note that the 5-HT5B receptor is not functional in humans.
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5-HT6
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- Agonists: Lysergamides: Dihydroergotamine
- Ergotamine
- Lisuride
- LSD
- Mesulergine
- Metergoline
- Methysergide; Tryptamines: 2-Methyl-5-HT
- 5-BT
- 5-CT
- 5-MT
- Bufotenin
- E-6801
- E-6837
- EMD-386,088
- EMDT
- LY-586,713
- N-Methyl-5-HT
- Tryptamine; Others: WAY-181,187
- WAY-208,466
Antagonists: Antidepressants: Amitriptyline
- Amoxapine
- Clomipramine
- Doxepin
- Mianserin
- Nortriptyline; Atypical antipsychotics: Aripiprazole
- Asenapine
- Clorotepine
- Clozapine
- Fluperlapine
- Iloperidone
- Olanzapine
- Tiospirone; Typical antipsychotics: Chlorpromazine
- Loxapine; Others: BGC20-760
- BVT-5182
- BVT-74316
- Cerlapirdine
- EGIS-12,233
- GW-742,457
- Ketanserin
- Latrepirdine
- Lu AE58054
- Metitepine/Methiothepin
- MS-245
- PRX-07034
- Ritanserin
- Ro04-6790
- Ro 63-0563
- SB-258,585
- SB-271,046
- SB-357,134
- SB-399,885
- SB-742,457
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5-HT7
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- Agonists: Lysergamides: LSD; Tryptamines: 5-CT
- 5-MT
- Bufotenin; Others: 8-OH-DPAT
- AS-19
- Bifeprunox
- E-55888
- LP-12
- LP-44
- RU-24,969
- Sarizotan
Antagonists: Lysergamides: 2-Bromo-LSD
- Bromocriptine
- Dihydroergotamine
- Ergotamine
- Mesulergine
- Metergoline
- Methysergide; Antidepressants: Amitriptyline
- Amoxapine
- Clomipramine
- Imipramine
- Maprotiline
- Mianserin; Atypical antipsychotics: Amisulpride
- Aripiprazole
- Asenapine
- Clorotepine
- Clozapine
- Olanzapine
- Risperidone
- Sertindole
- Tiospirone
- Ziprasidone
- Zotepine; Typical antipsychotics: Chlorpromazine
- Loxapine;
- Pimozide; Others: Butaclamol
- EGIS-12,233
- Ketanserin
- LY-215,840
- Metitepine/Methiothepin
- Ritanserin
- SB-258,719
- SB-258,741
- SB-269,970
- SB-656,104
- SB-656,104-A
- SB-691,673
- SLV-313
- SLV-314
- Spiperone
- SSR-181,507
- Vortioxetine
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Reuptake inhibitors
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SERT
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- Selective serotonin reuptake inhibitors (SSRIs): Alaproclate
- Citalopram
- Dapoxetine
- Desmethylcitalopram
- Desmethylsertraline
- Escitalopram
- Femoxetine
- Fluoxetine
- Fluvoxamine
- Indalpine
- Ifoxetine
- Litoxetine
- Lubazodone
- Omiloxetine
- Panuramine
- Paroxetine
- Pirandamine
- RTI-353
- Seproxetine
- Sertraline
- Vilazodone
- Vortioxetine
- Zimelidine; Serotonin-norepinephrine reuptake inhibitors (SNRIs): Bicifadine
- Desvenlafaxine
- Duloxetine
- Eclanamine
- Levomilnacipran
- Milnacipran
- Sibutramine
- Venlafaxine; Serotonin-norepinephrine-dopamine reuptake inhibitors (SNDRIs): Brasofensine
- Diclofensine
- DOV-102,677
- DOV-21,947
- DOV-216,303
- NS-2359
- SEP-225289
- SEP-227,162
- Tedatioxetine
- Tesofensine; Tricyclic antidepressants (TCAs): Amitriptyline
- Butriptyline
- Cianopramine
- Clomipramine
- Desipramine
- Dosulepin
- Doxepin
- Imipramine
- Lofepramine
- Nortriptyline
- Pipofezine
- Protriptyline
- Trimipramine; Tetracyclic antidepressants (TeCAs): Amoxapine; Piperazines: Nefazodone
- Trazodone; Antihistamines: Brompheniramine
- Chlorphenamine
- Diphenhydramine
- Mepyramine/Pyrilamine
- Pheniramine
- Tripelennamine; Opioids: Pethidine
- Methadone
- Propoxyphene; Others: Cocaine
- CP-39,332
- Cyclobenzaprine
- Dextromethorphan
- Dextrorphan
- EXP-561
- Fezolamine
- Mesembrine
- Nefopam
- PIM-35
- Pridefine
- Roxindole
- SB-649,915
- Tofenacin
- Ziprasidone
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VMAT
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- Ibogaine
- Reserpine
- Tetrabenazine
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Releasing agents
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- Aminoindanes: 5-IAI
- AMMI
- ETAI
- MDAI
- MDMAI
- MMAI
- TAI; Aminotetralins: 6-CAT
- 8-OH-DPAT
- MDAT
- MDMAT; Oxazolines: 4-Methylaminorex
- Aminorex
- Clominorex
- Fluminorex; Phenethylamines (also Amphetamines, Cathinones, Phentermines, etc): 2-Methyl-MDA
- 4-CAB
- 4-FA
- 4-FMA
- 4-HA
- 4-MTA
- 5-APDB
- 5-Methyl-MDA
- 6-APDB
- 6-Methyl-MDA
- AEMMA
- Amiflamine
- BDB
- BOH
- Brephedrone
- Butylone
- Chlorphentermine
- Cloforex
- Amfepramone
- Metamfepramone
- DCA
- DFMDA
- DMA
- DMMA
- EBDB
- EDMA
- Ethylone
- Etolorex
- Fenfluramine (Dexfenfluramine, Levofenfluramine)
- Flephedrone
- IAP
- IMP
- Iofetamine
- Lophophine
- MBDB
- MDA
- MDEA
- MDHMA
- MDMA
- MDMPEA
- MDOH
- MDPEA
- Mephedrone
- Methedrone
- Methylone
- MMA
- MMDA
- MMDMA
- MMMA
- NAP
- Norfenfluramine
- 4-TFMA
- pBA
- pCA
- pIA
- PMA
- PMEA
- PMMA
- TAP; Piperazines: 2C-B-BZP
- 3-MeOPP
- BZP
- DCPP
- MBZP
- mCPP
- MDBZP
- MeOPP
- Mepiprazole
- pCPP
- pFPP
- pTFMPP
- TFMPP; Tryptamines: 4-Methyl-αET
- 4-Methyl-αMT
- 5-CT
- 5-MeO-αET
- 5-MeO-αMT
- 5-MT
- αET
- αMT
- DMT
- Tryptamine (itself); Others: Indeloxazine
- Tramadol
- Viqualine
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Enzyme inhibitors
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Anabolism
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TPH
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AAAD
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- Benserazide
- Carbidopa
- Genistein
- Methyldopa
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Catabolism
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MAO
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- Nonselective: Benmoxin
- Caroxazone
- Echinopsidine
- Furazolidone
- Hydralazine
- Indantadol
- Iproclozide
- Iproniazid
- Isocarboxazid
- Isoniazid
- Linezolid
- Mebanazine
- Metfendrazine
- Nialamide
- Octamoxin
- Paraxazone
- Phenelzine
- Pheniprazine
- Phenoxypropazine
- Pivalylbenzhydrazine
- Procarbazine
- Safrazine
- Tranylcypromine; MAO-A Selective: Amiflamine
- Bazinaprine
- Befloxatone
- Brofaromine
- Cimoxatone
- Clorgiline
- Eprobemide
- Esuprone
- Harmala alkaloids (Harmine
- Harmaline
- Tetrahydroharmine
- Harman
- Norharman, etc)
- Methylene Blue
- Metralindole
- Minaprine
- Moclobemide
- Pirlindole
- Sercloremine
- Tetrindole
- Toloxatone
- Tyrima
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Others
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Precursors
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Cofactors
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- Ferrous iron (Fe2+)
- Magnesium (Mg2+)
- Tetrahydrobiopterin
- Vitamin B3 (Niacin
- Nicotinamide → NADPH)
- Vitamin B6 (Pyridoxine
- Pyridoxamine
- Pyridoxal → Pyridoxal phosphate)
- Vitamin B9 (Folic Acid → Tetrahydrofolic acid)
- Vitamin C (Ascorbic acid)
- Zinc (Zn2+)
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Others
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- Activity enhancers: BPAP
- PPAP; Steroids: Anabolic-androgenic steroids
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