Olanzapine
|
|
| Systematic (IUPAC) name |
| 2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno[2,3-b][1,5]benzodiazepine |
| Clinical data |
| Trade names |
Zyprexa |
| AHFS/Drugs.com |
monograph |
| MedlinePlus |
a601213 |
| Pregnancy cat. |
B3 (AU) C (US) |
| Legal status |
Prescription Only (S4) (AU) POM (UK) ℞-only (US) |
| Routes |
oral, intramuscular |
| Pharmacokinetic data |
| Bioavailability |
87%[1] |
| Metabolism |
Hepatic (direct glucuronidation and CYP mediated oxidation) |
| Half-life |
21–54 hours (average 30 hours)[2] |
| Excretion |
urine 57%, feces 30% |
| Identifiers |
| CAS number |
132539-06-1 Y |
| ATC code |
N05AH03 |
| PubChem |
CID 4585 |
| IUPHAR ligand |
47 |
| DrugBank |
DB00334 |
| ChemSpider |
10442212 Y |
| UNII |
N7U69T4SZR Y |
| KEGG |
D00454 Y |
| ChEBI |
CHEBI:7735 N |
| ChEMBL |
CHEMBL715 Y |
| Chemical data |
| Formula |
C17H20N4S |
| Mol. mass |
312.439 |
SMILES
- CN1CCN(CC1)C/2=N/c4ccccc4Nc3sc(C)cc\23
|
InChI
-
InChI=1S/C17H20N4S/c1-12-11-13-16(21-9-7-20(2)8-10-21)18-14-5-3-4-6-15(14)19-17(13)22-12/h3-6,11,19H,7-10H2,1-2H3 Y
Key:KVWDHTXUZHCGIO-UHFFFAOYSA-N Y
|
| Physical data |
| Melt. point |
195 °C (383 °F) |
| Solubility in water |
Practically insoluble in water mg/mL (20 °C) |
N (what is this?) (verify)
|
Olanzapine (sold under the brand names Zyprexa, or in combination with fluoxetine Symbyax) is an atypical antipsychotic, approved by the U.S. Food and Drug Administration (FDA) for the treatment of schizophrenia and bipolar disorder.[3] Olanzapine is structurally similar to clozapine and quetiapine, but is classified as a thienobenzodiazepine. The olanzapine formulations are manufactured and marketed by the pharmaceutical company Eli Lilly and Company; the drug went generic in 2011. Sales of Zyprexa in 2008 were $2.2B in the US alone, and $4.7B in total.[4]
Contents
- 1 Medical uses
- 1.1 Schizophrenia
- 1.2 Other
- 1.3 Elderly
- 2 Adverse effects
- 2.1 Paradoxical effects
- 2.2 Metabolic effects
- 2.3 Pregnancy/Lactation
- 2.4 Animal toxicology
- 2.5 Discontinuation
- 2.6 Overdose
- 3 Pharmacology
- 4 Dosage Forms
- 5 Metabolism
- 6 Society and culture
- 6.1 Regulatory status
- 6.2 Controversy, lawsuits and settlements
- 7 Chemistry
- 8 Research
- 9 References
- 10 External links
Medical uses[edit]
Schizophrenia[edit]
The benefits of olanzapine in schizophrenia are difficult to determine as more than half of people in trials quit before the six week completion date.[5] In light of this, the positive effects of olanzapine appear equivalent to typical antipsychotics with fewer extrapyramidal side effects but greater weight gain.[5] When compared to other atypical antipsychotics, the available data suggests that olanzapine may be slightly more effective (although amisulpride and clozapine do appear to be slightly more effective[6]); however, it produced more weight gain and other metabolic problems.[7][6]
Other[edit]
Evidence does not support the use of atypical antipsychotics including olanzapine in eating disorders.[8]
Case-reports, open-label, and small pilot studies suggest efficacy of olanzapine for the treatment of some anxiety spectrum disorders (e.g. generalized anxiety disorder,[9] panic disorder,[10] delusional parasitosis,[11] post-traumatic stress disorder);[12] however, olanzapine has not been rigorously evaluated in randomized, placebo-controlled trials for this use. Olanzapine is no less effective than lithium or valproate, and more effective than placebo in treating bipolar disorder.[13] It has also been used for Tourette syndrome and stuttering.[14]
Elderly[edit]
Citing an increased risk of stroke, in 2004 the Committee on the Safety of Medicines (CSM) in the UK issued a warning that olanzapine and risperidone, both atypical antipsychotic medications, should not be given to elderly patients with dementia. In the U.S., olanzapine comes with a black box warning for increased risk of death in elderly patients. It is not approved for use in patients with dementia-related psychosis.[15] However, a BBC investigation in June 2008 found that this advice was being widely ignored by British doctors.[16]
Adverse effects[edit]
The principal side effect of olanzapine is weight gain (a recent meta-analysis of the efficacy and tolerability of 15 antipsychotic drugs [APDs] found that it had the highest propensity for causing weight gain out of the 15 APD compared with a SMD of 0.74[6]), which may be profound in some cases and/or associated with derangements in the blood lipid and blood sugar profiles (see section: Metabolic side effects). Extrapyramidal side effects, although potentially serious, are infrequent to rare from olanzapine[17] but may include tremors and muscle rigidity.
Olanzapine is considered moderately to highly sedating,[17][6] especially at the commencement of therapy; as such, patients being treated with olanzapine should use caution when driving and, if sedated, avoid operating machinery.
Blood dyscrasias are rare with olanzapine[17] but do occur in a very small number of patients.
Recognised common side effects (which occur with an incidence of equal to or greater than 1 in 100) include:[17][2][18][19]
- Akathisia[20]
- Somnolence (sleepiness)
- Amblyopia
- Dizziness
- Asthenia
- Accidental injury
- Personality change
- Speech disorder
- Insomnia
- Dyspepsia
- Constipation
- Urinary retention
- Orthostatic hypotension
- Tachycardia
- Peripheral oedema
- Hyperglycaemia
- Hypercholesterolaemia
- Serum triglycerides raised
- Hyperprolactinaemia
- Xerostomia
whereas recognised rare potential side effects include:[19][18][2]
- Sudden cardiac death
- Angle-closure glaucoma
- Increased body temperature
- Hypothermia
- Diabetic coma with ketoacidosis
- Diabetic ketoacidosis
- Hyperglycaemic hyperosmolar state
- Acute haemorrhagic pancreatitis
- Venous thromboembolism
- Immune hypersensitivity reaction
- Stroke
- Seizure
- Status epilepticus
- Suicidal ideation
- Pulmonary embolism
- Rhabdomyolysis
- Hypotension
- Hepatitis
- Pancreatitis
- Priapism
- Neutropenia
- Alopecia
- Thrombocytopenia
- Leukopenia
- Bradycardia
- QT interval prolongation
- Speech difficulty
- Photosensitivity
- Urinary incontinence
- Rash
Several patient groups are at a heightened risk of side effects from olanzapine and antipsychotics in general. Olanzapine may produce non-trivial hyperglycemia in patients with Diabetes mellitus. Likewise, the elderly are at a greater risk of falls and accidental injury. Young males appear to be at heightened risk of dystonic reactions, although these are relatively rare with olanzapine.
Most antipsychotics, including olanzapine, may disrupt the body's natural thermoregulatory systems, thus permitting excursions to dangerous levels when situations (exposure to heat, strenuous exercise) occur.[21]
Hyperprolactinaemia caused by olanzapine can hinder sexual and reproductive activities by reducing the production of sex steroids, which may eventually lower bone density.[22]
Paradoxical effects[edit]
While olanzapine is used therapeutically to treat serious mental illness, occasionally it can have the opposite effect and provoke serious paradoxical reactions in a small subgroup of people, with the drug causing unusual changes in personality, thoughts or behavior; hallucinations and suicidal ideation have also been linked to olanzapine use.[23]
Metabolic effects[edit]
The U.S. Food and Drug Administration requires all atypical antipsychotics to include a warning about the risk of developing hyperglycemia and diabetes, both of which are factors in the metabolic syndrome. These effects may be related to the drugs' ability to induce weight gain, although there are some reports of metabolic changes in the absence of weight gain,[24][25] Studies have indicated that olanzapine carries a greater risk of causing and exacerbating diabetes than another commonly prescribed atypical antipsychotic, Risperidone. Of all the atypical antipsychotics, olanzapine is one of the most likely to induce weight gain based on various measures.[26][27][28][29][30] The effect is dose dependent in humans[31] and animal models of olanzapine-induced metabolic side effects.[32] Olanzapine may directly affect adipocyte function, promoting fat deposition.[33] There are some case reports of olanzapine-induced diabetic ketoacidosis.[34] Olanzapine may decrease insulin sensitivity,[35][36] though one 3-week study seems to refute this.[37] It may also increase triglyceride levels.[27]
Recent studies have established that:
- olanzapine and clozapine disturb normal metabolism by forcing the body to preferentially derive its energy from fat (instead of privileging carbohydrates). Thus forcing levels of carbohydrates to remain high which, in turn, would cause the body would develop insulin resistance (reduction of insulin sensitivity).[38]
- olanzapine promotes fat accumulation: due to disturbances in fat metabolism, rodents become fatter (but don't have their weight increasing at first). Being fatter, they do less exercise, burning less fat and gaining weight.[39]
- olanzapine may cause body weight gain and hyperphagia by altering appetite signaling in the brain and periphery[40]
- olanzapine may induce hyperglycaemia leading to diabetes side effects by altering insulin secretion from the pancreatic beta cell through blockade of the muscarinic M3 receptor[41]
Despite weight gain, a large multi-center randomized National Institute of Mental Health study found that olanzapine was better at controlling symptoms because patients were more likely to remain on olanzapine than the other drugs.[42] One small, open-label, non-randomized study suggests that taking olanzapine by orally dissolving tablets may induce less weight gain,[43] but this has not been substantiated in a blinded experimental setting.
Pregnancy/Lactation[edit]
Olanzapine is in the pregnancy category C. Pregnancy category C means: Drugs which, owing to their pharmacological effects, have caused or may be suspected of causing, harmful effects on the human fetus or neonate without causing malformations. Olanzapine can cross the placenta and is excreted in mothers' milk.[44] Potential benefits to the mother may outweigh the risks to the foetus / infant, therefore as per the Prescribing Information from the packet insert: Patients should be advised to notify their doctor if they become pregnant or intend to become pregnant during treatment with olanzapine.
Animal toxicology[edit]
In a placebo-compared study of six Macaque monkeys receiving doses of olanzapine resulting in drug levels comparable to those seen in subjects with schizophrenia treated with these medications for between 17 and 27 months, significant brain volume and weight decreases (8-11%) were detected.[45] In latter studies of the stored samples, the changes were attributed to astrocyte and oligodendrocyte loss,[46] There was a 5% loss in the number of neurons. Even though this was not statistically significant it is highly clinically significant and in line with the loss found in the brains of patients diagnosed with schizophrenia (see the references in Konopaske et al. 2008 above). This study however was contradicted by an earlier primate study, conducted by Selemon et al. in 1999,[47] which found that at therapeutic dosages, olanzapine increased glial counts in monkeys. To date, the effect of olanzapine on glia remains an open question.
Olanzapine has demonstrated carcinogenic effects in multiple studies when exposed chronically to female mice and rats, but not male mice and rats. The tumors found were in either the liver or mammary glands of the animals.[48]
Discontinuation[edit]
The British National Formulary recommends a gradual withdrawal when discontinuing anti-psychotic treatment to avoid acute withdrawal syndrome or rapid relapse.[49] Due to compensatory changes at dopamine, serotonin, adrenergic and histamine receptor sites in the central nervous system, withdrawal symptoms can occur during abrupt or over-rapid reduction in dosage. However, despite increasing demand for safe and effective antipsychotic withdrawal protocols or dose-reduction schedules, no specific guidelines with proven safety and efficacy are currently available. Support groups such as the Icarus Project, and other online forums provide resources and social support for those attempting to discontinue antipsychotics and other psychiatric medications.[50] Withdrawal symptoms reported to occur after discontinuation of antipsychotics include nausea, emesis, lightheadedness, diaphoresis, dyskinesia, orthostatic hypotension, tachycardia, nervousness, dizziness, headache, excessive non-stop crying, and anxiety.[51][52] Some have argued additional somatic and psychiatric symptoms associated with dopaminergic hypersensitivity, including dyskinesia and acute psychosis, are common features of withdrawal in individuals treated with neuroleptics.[53][54][55][56] Thus, some to suggest the withdrawal process itself may be schizo-mimetic, producing schizophrenia-like symptoms even in previously healthy patients.[57]
Overdose[edit]
Symptoms of an overdose include tachycardia, agitation, dysarthria, decreased consciousness and coma. Death has been reported after an acute overdose of 450 mg, but also survival after an acute overdose of 1500 mg.[58] There is no known specific antidote for olanzapine overdose, and even physicians are recommended to call a certified poison control center for information on the treatment of such a case.[58] Prescription should be kept in small quantity to reduce risk of overdose as acute bipolar disorder and schizophrenic patients can be at a high risk of suicide (Eli Lilly, 2010).
Pharmacology[edit]
Zyprexa (olanzapine) 10 mg tablets (AU)
Olanzapine has a higher affinity for 5-HT2 serotonin receptors than D2 dopamine receptors. Affinities are (Ki, nM). Olanzapine binds as an antagonist/inverse agonist at the following receptors:[59][60][61][62]
- dopamine D1: 70
- dopamine D2: 31
- dopamine D3: 11
- dopamine D4: 18
- serotonin 5-HT1A: 2300
- serotonin 5-HT2A: 3.7
- serotonin 5-HT2B: 8.2
- serotonin 5-HT2C: 10
- serotonin 5-HT3: 57
- serotonin 5-HT6: 5
- serotonin 5-HT7: 7.1
- muscarinic M1: 2.5
- muscarinic M2: 18-96
- muscarinic M3: 25-132
- muscarinic M4: 13-32
- muscarinic M5: 48
- adrenergic α1A: 110
- adrenergic α2A: 310
- histamine H1: 2.2
Olanzapine is a potent antagonist of the muscarinic M3 receptor,[63] which may underlie its diabetes side effects.[64] Additionally olanzapine also exhibits a relatively low affinity for serotonin 5-HT1, GABAA, beta-adrenergic receptors, and benzodiazepine binding sites.[60][65] The mode of action of olanzapine's antipsychotic activity is unknown. It may involve antagonism of dopamine and serotonin receptors. Antagonism of dopamine receptors is associated with extrapyramidal effects such as tardive dyskinesia (TD), and with therapeutic effects. Antagonism of muscarinic acetylcholine receptors is associated with anticholinergic side effects such as dry mouth and constipation, in addition it may suppress or reduce the emergence of extrapyramidal effects for the duration of treatment, however it offers no protection against the development of tardive dyskinesia. In common with other second generation (atypical) antipsychotics, olanzapine poses a relatively low risk of extrapyramidal side effects including TD, due to its high affinity for the D2 receptor over the D1 receptor.[66]
Antagonizing H1 histamine receptors causes sedation and may cause weight gain, although antagonistic actions at serotonin 5-HT2C and dopamine D2 receptors have also been associated with weight gain and appetite stimulation.[67]
Olanzapine also binds weakly to the GABA-A, beta-adrenergic and benzodiazepine (BZD) receptors.[17]
Dosage Forms[edit]
Olanzapine is marketed in a number of countries, with tablets ranging from 2.5 to 20 milligrams. Zyprexa (and generic Olanzapine) is available as an orally-disintegrating "wafer" which rapidly dissolves in saliva. It is also available in 10 milligram vials for intramuscular injection.[3]
Metabolism[edit]
Olanzapine is metabolized by the cytochrome P450 system; principally by isozyme 1A2 and to a lesser extent by 2D6. By these mechanisms more than 40% of the oral dose, on average, is removed by the hepatic first-pass effect.[17] Drugs or agents that increase the activity of CYP1A2, notably tobacco smoke, may significantly increase hepatic first-pass clearance of Olanzapine; conversely, drugs which inhibit 1A2 activity (examples: Ciprofloxacin, Fluvoxamine) may reduce Olanzapine clearance.[3]
Society and culture[edit]
Regulatory status[edit]
FDA approved for:
- Treatment — in combination with fluoxetine — of depressive episodes associated with bipolar disorder (December 2003).[68]
- Long-term treatment of bipolar I disorder (January 2004).[69][70]
- Treatment — in combination with fluoxetine — of resistant depression (March 2009).[71]
- Oral formulation: acute and maintenance treatment of schizophrenia in adults, acute treatment of manic or mixed episodes associated with bipolar I disorder (monotherapy and in combination with lithium or sodium valproate)
- Intramuscular formulation: acute agitation associated with schizophrenia and bipolar I mania in adults
- Oral formulation combined with fluoxetine: treatment of acute depressive episodes associated with bipolar I disorder in adults, or treatment of acute, resistant depression in adults [72]
- Treatment of the manifestations of psychotic disorders (September 1996[73]—March 2000).[74]
- Short-term treatment of acute manic episodes associated with bipolar I disorder (March 2000).[74]
- Short term treatment of schizophrenia instead of the management of the manifestations of psychotic disorders (March 2000).[74]
- Maintaining treatment response in schizophrenic patients who had been stable for approximately eight weeks and were then followed for a period of up to eight months (November 2000).[74]
Controversy, lawsuits and settlements[edit]
Eli Lilly has faced many lawsuits by from people who claimed they developed diabetes or other diseases after taking Zyprexa. In 2006, Lilly paid $700 million to settle 8,000 of these lawsuits.[75] In 2007, Eli Lilly agreed to pay up to $500 million to settle 18,000 more lawsuits.[citation needed]
In 2009 Eli Lilly pled guilty to a criminal misdemeanor charge of illegally marketing Zyprexa for off-label use and agreed to pay $1.4 billion.[76] Although Lilly had evidence that it is not effective for dementia, Zyprexa was marketed for elderly Alzheimer's patients.[77] The drug carries an F.D.A. warning that it increases the risk of death in older patients with dementia-related psychosis.[78]
According to the New York Times, "Eli Lilly has engaged in a decade-long effort to play down the health risks of Zyprexa according to hundreds of internal Lilly documents and e-mail messages among top company managers",[79] most of which had been disclosed as the result of the lawsuits by individuals who had taken the drug, though other documents had been stolen.[80] Eli Lilly filed a protection order to stop the dissemination of some of the documents which the judge believed to be confidential and "not generally appropriate for public consumption".[80] Temporary injunctions required those who had received the documents to return them and to remove them from websites.[81] Judge Jack B. Weinstein issued a permanent judgement against further dissemination of the documents and requiring their return by a number of parties named by Lilly.[80] On January 8, 2007, Judge Jack B. Weinstein refused the Electronic Frontier Foundation's motion to stay his order.[82] The documents given to The New York Times by Jim Gottstein show that Lilly executives may have kept important information from doctors about Zyprexa’s links to obesity and its tendency to raise blood sugar — both known risk factors for diabetes. The Times of London also reported that as early as October 1998, Lilly considered the risk of drug-induced obesity to be a "top threat" to Zyprexa sales.[83] On October 9, 2000, senior Lilly research physician Robert Baker noted that an academic advisory board he belonged to was "quite impressed by the magnitude of weight gain on olanzapine and implications for glucose."[83]
Chemistry[edit]
Olanzapine can be prepared starting from malononitrile and propionaldehyde:[84]
Research[edit]
Olanzapine has been investigated for use as an antiemetic, particularly for the control of chemotherapy-induced nausea and vomiting (CINV). A 2007 study demonstrated its successful potential for this use, achieving a complete response in the acute prevention of nausea and vomiting in 100% of patients treated with moderately and highly-emetogenic chemotherapy, when used in combination with palonosetron and dexamethasone.[85]
Olanzapine has been considered as part of an early psychosis approach for schizophrenia. The Prevention through Risk Identification, Management, and Education (PRIME) study, funded by the National Institute of Mental Health and Eli Lilly, tested the hypothesis that olanzapine might prevent the onset of psychosis in people at very high risk for schizophrenia. The study examined 60 patients with prodromalschizophrenia, who were at an estimated risk of 36–54% of developing schizophrenia within a year, and treated half with olanzapine and half with placebo.[86] In this study, patients receiving olanzapine did not have a significantly lower risk of progressing to psychosis. Olanzapine was effective for treating the prodromal symptoms, but was associated with significant weight gain.[87]
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- ^ Chiu, Chih-Chiang; Chen, Chun-Hsin; Chen, Bo-Yu; Yu, Shu-Han; Lu, Mong-Liang (2010). "The time-dependent change of insulin secretion in schizophrenic patients treated with olanzapine". Progress in Neuro-Psychopharmacology and Biological Psychiatry 34 (6): 866–70. doi:10.1016/j.pnpbp.2010.04.003. PMID 20394794.
- ^ Sacher, Julia; Mossaheb, Nilufar; Spindelegger, Christoph; Klein, Nikolas; Geiss-Granadia, Thomas; Sauermann, Robert; Lackner, Edith; Joukhadar, Christian; Müller, Markus; Kasper, Siegfried (2007). "Effects of Olanzapine and Ziprasidone on Glucose Tolerance in Healthy Volunteers". Neuropsychopharmacology 33 (7): 1633–41. doi:10.1038/sj.npp.1301541. PMID 17712347.
- ^ Sowell, M.; Mukhopadhyay, N; Cavazzoni, P; Carlson, C; Mudaliar, S; Chinnapongse, S; Ray, A; Davis, T et al. (2003). "Evaluation of Insulin Sensitivity in Healthy Volunteers Treated with Olanzapine, Risperidone, or Placebo: A Prospective, Randomized Study Using the Two-Step Hyperinsulinemic, Euglycemic Clamp". Journal of Clinical Endocrinology & Metabolism 88 (12): 5875–80. doi:10.1210/jc.2002-021884. PMID 14671184.
- ^ Albaugh, V. L.; Vary, T. C.; Ilkayeva, O.; Wenner, B. R.; Maresca, K. P.; Joyal, J. L.; Breazeale, S.; Elich, T. D.; Lang, C. H.; Lynch, C. J. (2010). "Atypical Antipsychotics Rapidly and Inappropriately Switch Peripheral Fuel Utilization to Lipids, Impairing Metabolic Flexibility in Rodents". Schizophrenia Bulletin 38 (1): 153–66. doi:10.1093/schbul/sbq053. PMC 3245588. PMID 20494946.
- ^ Albaugh, V L; Judson, J G; She, P; Lang, C H; Maresca, K P; Joyal, J L; Lynch, C J (2010). "Olanzapine promotes fat accumulation in male rats by decreasing physical activity, repartitioning energy and increasing adipose tissue lipogenesis while impairing lipolysis". Molecular Psychiatry 16 (5): 569–81. doi:10.1038/mp.2010.33. PMC 2892549. PMID 20308992.
- ^ Weston-Green, Katrina; Huang, Xu-Feng; Deng, Chao (2012). "Alterations to Melanocortinergic, GABAergic and Cannabinoid Neurotransmission Associated with Olanzapine-Induced Weight Gain". In Chang, Alice Y. W. PLoS ONE 7 (3): e33548. Bibcode:2012PLoSO...733548W. doi:10.1371/journal.pone.0033548. PMC 3306411. PMID 22438946.
- ^ Weston-Green, Katrina; Huang, Xu-Feng; Lian, Jiamei; Deng, Chao (2012). "Effects of olanzapine on muscarinic M3 receptor binding density in the brain relates to weight gain, plasma insulin and metabolic hormone levels". European Neuropsychopharmacology 22 (5): 364–73. doi:10.1016/j.euroneuro.2011.09.003. PMID 21982116.
- ^ Carey, Benedict (September 20, 2005). "Little Difference Found in Schizophrenia Drugs". The New York Times. Retrieved 2007-12-03.
- ^ de Haan, Lieuwe; Van Amelsvoort, Therese; Rosien, Kim; Linszen, Don (2004). "Weight loss after switching from conventional olanzapine tablets to orally disintegrating olanzapine tablets". Psychopharmacology 175 (3): 389–90. doi:10.1007/s00213-004-1951-2. PMID 15322727.
- ^ Ambresin, Gilles; Berney, Patricia; Schulz, Pierre; Bryois, Christian (2004). "Olanzapine Excretion Into Breast Milk: A Case Report". Journal of Clinical Psychopharmacology 24 (1): 93–5. doi:10.1097/01.jcp.0000106225.36344.58. PMID 14709955.
- ^ Dorph-Petersen, Karl-Anton; Pierri, Joseph N; Perel, James M; Sun, Zhuoxin; Sampson, Allan R; Lewis, David A (2005). "The Influence of Chronic Exposure to Antipsychotic Medications on Brain Size before and after Tissue Fixation: A Comparison of Haloperidol and Olanzapine in Macaque Monkeys". Neuropsychopharmacology 30 (9): 1649–61. doi:10.1038/sj.npp.1300710. PMID 15756305.
- ^ Konopaske, Glenn T.; Dorph-Petersen, Karl-Anton; Sweet, Robert A.; Pierri, Joseph N.; Zhang, Wei; Sampson, Allan R.; Lewis, David A. (2008). "Effect of Chronic Antipsychotic Exposure on Astrocyte and Oligodendrocyte Numbers in Macaque Monkeys". Biological Psychiatry 63 (8): 759–65. doi:10.1016/j.biopsych.2007.08.018. PMC 2386415. PMID 17945195.
- ^ Selemon, Lynn D.; Lidow, Michael S.; Goldman-Rakic, Patricia S. (1999). "Increased volume and glial density in primate prefrontal cortex associated with chronic antipsychotic drug exposure". Biological Psychiatry 46 (2): 161–72. doi:10.1016/S0006-3223(99)00113-4. PMID 10418690.
- ^ Brambilla, Giovanni; Mattioli, Francesca; Martelli, Antonietta (2009). "Genotoxic and carcinogenic effects of antipsychotics and antidepressants". Toxicology 261 (3): 77–88. doi:10.1016/j.tox.2009.04.056. PMID 19410629.
- ^ "4.2.1 Antipsychotic drugs". British National Formulary (57th ed.). London and Chicago: Pharmaceutical Press. March 2009. pp. 221–31. ISBN 978-0-85711-065-7. "Withdrawal of antipsychotic drugs after long-term therapy should always be gradual and closely monitored to avoid the risk of acute withdrawal syndromes or rapid relapse."
- ^ "Harm Reduction Guide To Coming Off Psychiatric Drugs & Withdrawal". Icarus Project. April 23, 2008.
- ^ Kim, Deborah R. (2005). "Quetiapine Discontinuation Syndrome". American Journal of Psychiatry 162 (5): 1020. doi:10.1176/appi.ajp.162.5.1020.
- ^ Michaelides, Costas; Thakore-James, Manisha; Durso, Raymon (2005). "Reversible withdrawal dyskinesia associated with quetiapine". Movement Disorders 20 (6): 769–70. doi:10.1002/mds.20427. PMID 15747370.
- ^ Chouinard, G; Jones, BD (1980). "Neuroleptic-induced supersensitivity psychosis: Clinical and pharmacologic characteristics". The American Journal of Psychiatry 137 (1): 16–21. PMID 6101522.
- ^ Miller, R; Chouinard, G (1993). "Loss of striatal cholinergic neurons as a basis for tardive and L-dopa-induced dyskinesias, neuroleptic-induced supersensitivity psychosis and refractory schizophrenia". Biological Psychiatry 34 (10): 713–38. doi:10.1016/0006-3223(93)90044-E. PMID 7904833.
- ^ Chouinard, G; Jones, BD; Annable, L (1978). "Neuroleptic-induced supersensitivity psychosis". The American Journal of Psychiatry 135 (11): 1409–10. PMID 30291.
- ^ Seeman, Philip; Weinshenker, David; Quirion, Remi; Srivastava, Lalit K.; Bhardwaj, Sanjeev K.; Grandy, David K.; Premont, Richard T.; Sotnikova, Tatyana D.; Boksa, Patricia; El-Ghundi, M; O'Dowd, BF; George, SR; Perreault, ML; Männistö, PT; Robinson, S; Palmiter, RD; Tallerico, T (2005). "Dopamine supersensitivity correlates with D2High states, implying many paths to psychosis". Proceedings of the National Academy of Science 102 (9): 3513–8. Bibcode:2005PNAS..102.3513S. doi:10.1073/pnas.0409766102. JSTOR 3374957. PMC 548961. PMID 15716360.
- ^ Moncrieff, J. (2006). "Does antipsychotic withdrawal provoke psychosis? Review of the literature on rapid onset psychosis (supersensitivity psychosis) and withdrawal-related relapse". Acta Psychiatrica Scandinavica 114 (1): 3–13. doi:10.1111/j.1600-0447.2006.00787.x. PMID 16774655.
- ^ a b "Symbyax (Olanzapine and fluoxetine) drug overdose and contraindication information". RxList: The Internet Drug Index. WebMD. 2007. Retrieved 2007-12-03.
- ^ Bymaster, Frank P; Calligaro, David O; Falcone, Julie F; Marsh, Richard D; Moore, Nicholas A; Tye, Nicholas C; Seeman, Philip; Wong, David T (1996). "Radioreceptor Binding Profile of the Atypical Antipsychotic Olanzapine". Neuropsychopharmacology 14 (2): 87–96. doi:10.1016/0893-133X(94)00129-N. PMID 8822531.
- ^ a b "Zyprexa, Zyprexa Zydis". RxList. January 18, 2011.
- ^ Selent, Jana; López, Laura; Sanz, Ferran; Pastor, Manuel (2008). "Multi-Receptor Binding Profile of Clozapine and Olanzapine: A Structural Study Based on the New β2Adrenergic Receptor Template". ChemMedChem 3 (8): 1194–8. doi:10.1002/cmdc.200800074. PMID 18465762.
- ^ Brunton, Laurence (2011). Goodman & Gilman's The Pharmacological Basis of Therapeutics (12th ed.). China: McGraw-Hill. p. 427. ISBN 978-0-07-162442-8.
- ^ Johnson, D. E.; Yamazaki, H.; Ward, K. M.; Schmidt, A. W.; Lebel, W. S.; Treadway, J. L.; Gibbs, E. M.; Zawalich, W. S. et al. (2005). "Inhibitory Effects of Antipsychotics on Carbachol-Enhanced Insulin Secretion from Perifused Rat Islets: Role of Muscarinic Antagonism in Antipsychotic-Induced Diabetes and Hyperglycemia". Diabetes 54 (5): 1552–8. doi:10.2337/diabetes.54.5.1552. PMID 15855345.
- ^ Silvestre, J.S.; Prous, J. (2005). "Research on adverse drug events. I. Muscarinic M3 receptor binding affinity could predict the risk of antipsychotics to induce type 2 diabetes". Methods and Findings in Experimental and Clinical Pharmacology 27 (5): 289–304. doi:10.1358/mf.2005.27.5.908643. PMID 16082416.
- ^ "olanzapine". NCI Drug Dictionary. National Cancer Institute.
- ^ Lemke TL, Williams DA (2009) Foye's Medicinal Chemistry, 6th edition. Wolters Kluwer: New Delhi. ISBN 978-81-89960-30-8.
- ^ "Medication and Weight Control"
- ^ "NDA 21-520" (PDF). Food and Drug Administration. 2003-12-24. Retrieved 2009-09-06.
- ^ "NDA 20-592 / S-019" (PDF). Food and Drug Administration. 2004-01-14. Retrieved 2009-09-06.
- ^ Pillarella J, Higashi A, Alexander GC, Conti R (2012). "Trends in the use of atypical antipsychotics for the treatment of bipolar disorder in the United States, 1998-2009". Psychiatric Services 63 (1): 83–86. doi:10.1176/appi.ps.201100092. PMID 22227765.
- ^ Forbes.com[dead link]
- ^ treatment resistant depression defined as major depressive disorder in adult patients who do not respond to two separate trials of different antidepressants of adequate dose and duration in the current episode
- ^ "NDA 20-592" (PDF). Food and Drug Administration. 1996-09-06. Retrieved 2009-09-06.
- ^ a b c d "Eli Lilly and Company Agrees to Pay $1.415 Billion to Resolve Allegations of Off-label Promotion of Zyprexa". U.S. Justice Department. 2009-01-15. Retrieved 2012-07-09.
- ^ Berenson, Alex (January 4, 2007). "Mother Wonders if Psychosis Drug Helped Kill Son". The New York Times. Retrieved May 21, 2013.
- ^ MSN.com Lilly settles Zyprexa suit for $1.42 billion. The Associated Press, January 15, 2009
- ^ Fisk, Margaret Cronin; Lopatto, Elizabeth; Feeley, Jef (June 1, 2009). "Lilly Sold Drug for Dementia Knowing It Didn't Help, Files Show". Bloomberg. Retrieved May 21, 2013.
- ^ Berenson, Alex (December 18, 2006). "Drug Files Show Maker Promoted Unapproved Use". The New York Times. Retrieved May 21, 2013.
- ^ Berenson, Alex (December 17, 2006). "Eli Lilly Said to Play Down Risk of Top Pill". The New York Times. Retrieved May 21, 2013.
- ^ a b c U:\Cases\Civil L-Z\In re Zyprexa\Documents Leak\Injunction Memo & Order\FINAL INJUNCTION MEMO 2.13.07.wpd
- ^ EFF.org
- ^ Press Releases: January, 2007 | Electronic Frontier Foundation
- ^ a b Eli Lilly was Concerned by Zyprexa Side-Effects from 1998,[dead link] The Times (London), January 23, 2007
- ^ US 5229382
- ^ Navari, Rudolph M.; Einhorn, Lawrence H.; Loehrer Pj, Patrick J.; Passik, Steven D.; Vinson, Jake; McClean, John; Chowhan, Naveed; Hanna, Nasser H. et al. (2007). "A phase II trial of olanzapine, dexamethasone, and palonosetron for the prevention of chemotherapy-induced nausea and vomiting: A Hoosier oncology group study". Supportive Care in Cancer 15 (11): 1285–91. doi:10.1007/s00520-007-0248-5. PMID 17375339.
- ^ McGlashan, T.H; Zipursky, R.B; Perkins, D; Addington, J; Miller, T.J; Woods, S.W; Hawkins, K.A; Hoffman, R; Lindborg, S; Tohen, M; Breier, A (2003). "The PRIME North America randomized double-blind clinical trial of olanzapine versus placebo in patients at risk of being prodromally symptomatic for psychosis". Schizophrenia Research 61 (1): 7–18. doi:10.1016/S0920-9964(02)00439-5. PMID 12648731.
- ^ McGlashan, Thomas H.; Zipursky, Robert B.; Perkins, Diana; Addington, Jean; Miller, Tandy; Woods, Scott W.; Hawkins, Keith A.; Hoffman, Ralph E.; Preda, Adrian; Epstein, I; Addington, D; Lindborg, S; Trzaskoma, Q; Tohen, M; Breier, A (2006). "Randomized, Double-Blind Trial of Olanzapine Versus Placebo in Patients Prodromally Symptomatic for Psychosis". American Journal of Psychiatry 163 (5): 790–9. doi:10.1176/appi.ajp.163.5.790. PMID 16648318.
External links[edit]
- Zyprexa.com - official Zyprexa brand website from Eli Lilly and Company
- Zyprexa package insert
- Berenson, Alex (December 17, 2006). "Lilly Settles With 18,000 Over Zyprexa". New York Times.
|
Antipsychotics (neuroleptics) (N05A)
|
|
| Typical |
- Benzamides
- Levosulpiride
- Nemonapride
- Sulpiride
- Sultopride
- Tiapride
- Veralipride
- Butyrophenones
- Azaperone
- Benperidol
- Bromperidol
- Droperidol
- Fluanisone
- Haloperidol
- Lenperone
- Moperone
- Pipamperone
- Spiperone
- Timiperone
- Trifluperidol
- Diphenylbutylpiperidines
- Clopimozide
- Fluspirilene
- Penfluridol
- Pimozide
- Phenothiazines
- Acepromazine
- Acetophenazine
- Butaperazine
- Carphenazine
- Chloracizine
- Chlorproethazine
- Chlorpromazine
- Cyamemazine
- Dixyrazine
- Fluacizine
- Fluphenazine
- Levomepromazine/Methotrimeprazine
- Mesoridazine
- Perazine
- Pericyazine
- Perphenazine
- Piperacetazine
- Pipotiazine
- Prochlorperazine
- Promazine
- Promethazine
- Propiomazine
- Sulforidazine
- Thiethylperazine
- Thiopropazate
- Thioproperazine
- Thioridazine
- Trifluoperazine
- Triflupromazine
- Thioxanthenes
- Chlorprothixene
- Clopenthixol
- Flupentixol
- Thiothixene
- Zuclopenthixol
- Tricyclics
- Butaclamol
- Fluotracen
- Loxapine
- Trimipramine
- Others
- Prothipendyl
|
|
| Atypical |
- Benzamides
- Amisulpride
- Remoxipride‡
- Butyrophenones
- Cinuperone
- Melperone
- Setoperone
- Benzo(iso)oxazolepiperidines
- Iloperidone
- Ocaperidone
- Paliperidone
- Risperidone
- Benzo(iso)thiazolepiperazines
- Lurasidone
- Perospirone
- Revospirone
- Tiospirone
- Ziprasidone
- Diphenylbutylpiperazines
- Amperozide
- Phenylpiperazines
- Aripiprazole
- Bifeprunox
- Brexpiprazole†
- Elopiprazole
- Umespirone
- Tricyclics
- Amoxapine
- Asenapine
- Carpipramine
- Clocapramine
- Clorotepine
- Clotiapine
- Clozapine
- Fluperlapine
- Gevotroline
- Metitepine
- Mosapramine
- NDMC
- Olanzapine
- Piquindone
- Quetiapine
- Tenilapine
- Zotepine
- Others
- Blonanserin
- Cariprazine
- Molindone
- Pimavanserin
- Roxindole
- Sarizotan
- Sertindole
- Spiramide
- Zicronapine†
|
|
| Others |
- Azacyclonol
- Cannabidiol
- Mazapertine§
- Mifepristone
- Oxypertine
- Reserpine
- Rimcazole
- Secretin
- Talnetant§
- Tetrabenazine
- Vabicaserin
|
|
- #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)
|
|
|
|
|
Orexigenics (A15)
|
|
| Exogenous |
- Amitriptyline
- Clonidine
- Cyproheptadine
- Dexamethasone
- Dronabinol/Tetrahydrocannabinol (Cannabis)
- Medroxyprogesterone acetate
- Megestrol acetate
- Mirtazapine
- Nabilone
- Nandrolone
- Olanzapine
- Omega-3 fatty acids
- Oxandrolone
- Pentoxifylline
- Prednisone
- Sugars
- Testosterone
- Thalidomide
|
|
| Endogenous |
- ACTH/Corticotropin
- Adiponectin
- Agouti-related peptide
- Anandamide
- Cortisol/Hydrocortisone
- Cortisone
- Ghrelin
- Melanin-concentrating hormone
- Melatonin
- Neuropeptide Y
- Orexin/Hypocretin
|
|
|
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
- Dimethyltubocurarine/Metocurine
- Dipyrandium
- Dizocilpine/MK-801
- Doxacurium
- Duador
- 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
|
|
|
|
|
Dopaminergics
|
|
|
Receptor ligands
|
|
|
Agonists
|
- Adamantanes: Amantadine
- Memantine
- Rimantadine; Aminotetralins: 7-OH-DPAT
- 8-OH-PBZI
- Rotigotine
- UH-232; Benzazepines: 6-Br-APB
- Fenoldopam
- SKF-38,393
- SKF-77,434
- SKF-81,297
- SKF-82,958
- SKF-83,959; Ergolines: Bromocriptine
- Cabergoline
- Dihydroergocryptine
- Epicriptine
- Lisuride
- LSD
- Pergolide; Dihydrexidine derivatives: 2-OH-NPA
- A-86,929
- Ciladopa
- Dihydrexidine
- Dinapsoline
- Dinoxyline
- Doxanthrine; Others: A-68,930
- A-77636
- A-412,997
- ABT-670
- ABT-724
- Aplindore
- Apomorphine
- Aripiprazole
- Bifeprunox
- BP-897
- CY-208,243
- Dizocilpine
- Etilevodopa
- Flibanserin
- Ketamine
- Melevodopa
- Modafinil
- Pardoprunox
- Phencyclidine
- PD-128,907
- PD-168,077
- PF-219,061
- Piribedil
- Pramipexole
- Propylnorapomorphine
- Pukateine
- Quinagolide
- Quinelorane
- Quinpirole
- RDS-127
- Ro10-5824
- Ropinirole
- Rotigotine
- Roxindole
- Salvinorin A
- SKF-89,145
- Sumanirole
- Terguride
- Umespirone
- WAY-100,635
|
|
|
Antagonists
|
- Typical antipsychotics: Acepromazine
- Azaperone
- Benperidol
- Bromperidol
- Clopenthixol
- Chlorpromazine
- Chlorprothixene
- Droperidol
- Flupentixol
- Fluphenazine
- Fluspirilene
- Haloperidol
- Levosulpiride
- Loxapine
- Mesoridazine
- Methotrimeprazine
- Nemonapride
- Penfluridol
- Perazine
- Periciazine
- Perphenazine
- Pimozide
- Prochlorperazine
- Promazine
- Sulforidazine
- Sulpiride
- Sultopride
- Thioridazine
- Thiothixene
- Trifluoperazine
- Triflupromazine
- Trifluperidol
- Zuclopenthixol; Atypical antipsychotics: Amisulpride
- Asenapine
- Blonanserin
- Cariprazine
- Carpipramine
- Clocapramine
- Clorotepine
- Clozapine
- Gevotroline
- Iloperidone
- Lurasidone
- Melperone
- Molindone
- Mosapramine
- Olanzapine
- Paliperidone
- Perospirone
- Piquindone
- Quetiapine
- Remoxipride
- Risperidone
- Sertindole
- Tiospirone
- Zicronapine
- Ziprasidone
- Zotepine; Antiemetics: AS-8112
- Alizapride
- Bromopride
- Clebopride
- Domperidone
- Metoclopramide
- Thiethylperazine; Others: Amoxapine
- Buspirone
- Butaclamol
- Ecopipam
- EEDQ
- Eticlopride
- Fananserin
- Hydroxyzine
- L-745,870
- Nafadotride
- Nuciferine
- PNU-99,194
- Raclopride
- Sarizotan
- SB-277,011-A
- SCH-23,390
- SKF-83,959
- Sonepiprazole
- Spiperone
- Spiroxatrine
- Stepholidine
- Tetrahydropalmatine
- Tiapride
- UH-232
- Yohimbine
|
|
|
|
|
Reuptake inhibitors
|
|
|
Plasmalemmal
|
|
DAT inhibitors
|
- Piperazines: DBL-583
- GBR-12,935
- Nefazodone
- Vanoxerine; Piperidines: BTCP
- Desoxypipradrol
- Dextromethylphenidate
- Difemetorex
- Ethylphenidate
- Methylnaphthidate
- Methylphenidate
- Phencyclidine
- Pipradrol; Pyrrolidines: Diphenylprolinol
- MDPV
- Naphyrone
- Prolintane
- Pyrovalerone; Tropanes: Altropane
- Brasofensine
- CFT
- Cocaine
- Dichloropane
- Difluoropine
- FE-β-CPPIT
- FP-β-CPPIT
- Ioflupane (123I)
- Iometopane
- RTI-112
- RTI-113
- RTI-121
- RTI-126
- RTI-150
- RTI-177
- RTI-229
- RTI-336
- Tenocyclidine
- Tesofensine
- Troparil
- Tropoxane
- WF-11
- WF-23
- WF-31
- WF-33; Others: Adrafinil
- Armodafinil
- Amfonelic acid
- Amphetamine
- Amineptine
- Benzatropine
- Bromantane
- BTQ
- BTS-74,398
- Bupropion
- Ciclazindol
- Diclofensine
- Dimethocaine
- Diphenylpyraline
- Dizocilpine
- DOV-102,677
- DOV-21,947
- DOV-216,303
- Etybenzatropine
- EXP-561
- Fencamine
- Fencamfamine
- Fezolamine
- GYKI-52,895
- Indatraline
- Ketamine
- Lefetamine
- Levophacetoperane
- LR-5182
- Manifaxine
- Mazindol
- Medifoxamine
- Mesocarb
- Modafinil
- Nefopam
- Nomifensine
- NS-2359
- O-2172
- Pridefrine
- Propylamphetamine
- Radafaxine
- SEP-225,289
- SEP-227,162
- Sertraline
- Sibutramine
- Tametraline
- Tedatioxetine
- Tripelennamine
|
|
|
|
Vesicular
|
|
VMAT inhibitors
|
- Deserpidine
- Ibogaine
- Reserpine
- Tetrabenazine
|
|
|
|
|
|
|
|
|
Allosteric modulators
|
|
- Quinazolinamines: SoRI-9804
- SoRI-20040
- SoRI-20041
|
|
|
|
Enzyme inhibitors
|
|
|
Anabolism
|
|
PAH inhibitors
|
|
|
|
TH inhibitors
|
- 3-Iodotyrosine
- Aquayamycin
- Bulbocapnine
- Metirosine
- Oudenone
|
|
|
AAAD/DDC inhibitors
|
- Benserazide
- Carbidopa
- DFMD
- Genistein
- Methyldopa
|
|
|
|
Catabolism
|
|
MAO inhibitors
|
- 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
- Befol
- Brofaromine
- Cimoxatone
- Clorgiline
- Esuprone
- Harmala alkaloids
- Methylene Blue
- Metralindole
- Minaprine
- Moclobemide
- Pirlindole
- Sercloremine
- Tetrindole
- Toloxatone
- Tyrima; MAO-B selective: D-Deprenyl
- Ethanol
- L-Deprenyl (Selegiline)
- Ladostigil
- Lazabemide
- Milacemide
- Nicotine
- Pargyline
- Rasagiline
- Safinamide
|
|
|
COMT inhibitors
|
- Entacapone
- Nitecapone
- Tolcapone
|
|
|
DBH inhibitors
|
- Disulfiram
- Dopastin
- Fusaric acid
- Nepicastat
- Tropolone
|
|
|
|
|
|
Others
|
|
|
Precursors
|
- L-Phenylalanine → L-Tyrosine → L-DOPA (Levodopa)
|
|
|
Cofactors
|
- Ferrous iron (Fe2+)
- 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+)
|
|
|
Others
|
- Activity enhancers: BPAP
- PPAP; Toxins: 6-OHDA
|
|
|
|
|
List of dopaminergic drugs
|
|
|
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
- 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
|
|
|
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
|
|
|
5-HT1B
|
- 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
|
|
|
5-HT1D
|
- 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
|
|
|
5-HT1E
|
- Agonists: Lysergamides: Methysergide; Triptans: Eletriptan; Tryptamines: BRL-54443
- Tryptamine
Antagonists: Metitepine/Methiothepin
|
|
|
5-HT1F
|
- Agonists: Triptans: Eletriptan
- Naratriptan
- Sumatriptan; Tryptamines: 5-MT; Others: BRL-54443
- Bromocriptine
- Lasmiditan
- LY-334,370
Antagonists: Metitepine/Methiothepin
|
|
|
|
|
5-HT2 receptor ligands
|
|
|
5-HT2A
|
|
|
|
5-HT2B
|
- 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
|
|
|
5-HT2C
|
- 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
- Bromocriptine
- AL-38022A
- 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
- Pimozide
- Quetiapine
- Risperidone
- Sertindole
- Ziprasidone
- Zotepine; Typical antipsychotics: Chlorpromazine
- Loxapine
- 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
|
|
|
|
- 5-HT3
- 5-HT4
- 5-HT5
- 5-HT6
- 5-HT7 ligands
|
|
|
5-HT3
|
- 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
|
- 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; Others: Butaclamol
- EGIS-12,233
- Ketanserin
- LY-215,840
- Metitepine/Methiothepin
- Pimozide
- 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
|
- 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
- Befol
- Brofaromine
- Cimoxatone
- Clorgiline
- 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; Reuptake enhancers: Tianeptine
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Piperazines
|
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Simple piperazines
(no additional rings) |
- 1-Cyclohexylpiperazine
- Aminoethylpiperazine
- Diethylcarbamazine
- HEPPS
- Midafotel
- Piperazine
- PIPES
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| Phenylpiperazines |
- Acaprazine
- Antrafenine
- Aripiprazole
- Batoprazine
- Bifeprunox
- BRL-15,572
- Ciprofloxacin
- CSP-2503
- Dapiprazole
- DCPP
- DMPP
- Diphenylpiperazine
- Dropropizine
- EGIS-12,233
- Elopiprazole
- Eltoprazine
- Enpiprazole
- Ensaculin
- Etoperidone
- Flesinoxan
- Flibanserin
- Fluprazine
- Itraconazole
- Ketoconazole
- Levodropropizine
- Lorpiprazole
- mCPP
- Mefway
- MeOPP
- Mepiprazole
- Naftopidil
- Naluzotan
- Naphthylpiperazine
- Nefazodone
- Niaprazine
- Oxypertine
- Pardoprunox
- pCPP
- pFPP
- Posaconazole
- S-14,506
- S-14,671
- S-15,535
- SB-258,585
- SB-271,046
- SB-357,134
- SB-399,885
- Sonepiprazole
- TFMPP
- Tolpiprazole
- Trazodone
- Urapidil
- Vesnarinone
- Vilazodone
- Vortioxetine
- WAY-100,135
- WAY-100,635
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| Benzylpiperazines |
- 2C-B-BZP
- Befuraline
- Bifeprunox
- Buclizine
- BZP
- Chlorbenzoxamine
- DBZP
- Fipexide
- Imatinib
- MBZP
- MDBZP
- Meclozine
- Piberaline
- Piribedil
- Trimetazidine
- Vesnarinone
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Diphenylalkylpiperazines
(benzhydrylalkylpiperazines) |
- Almitrine
- Amperozide
- BRL-15,572
- Buclizine
- BW373U86
- Cetirizine
- Chlorbenzoxamine
- Chlorcyclizine
- Cinnarizine
- Clocinizine
- Cyclizine
- DBL-583
- Diphenylmethylpiperazine
- Dotarizine
- DPI-221
- DPI-287
- DPI-3290
- GBR-12,783
- GBR-12,935
- GBR-13,069
- GBR-13,098
- GBR-13,119
- Hydroxyzine
- Lidoflazine
- Manidipine
- Meclozine
- Oxatomide
- SNC-80
- Vanoxerine
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| Pyrimidinylpiperazines |
- Buspirone
- Dasatinib
- Eptapirone
- Gepirone
- Ipsapirone
- Piribedil
- Prazitone
- Pyrimidinylpiperazine
- Revospirone
- Tandospirone
- Tirilazad
- Trimazosin
- Umespirone
- Zalospirone
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| Pyridinylpiperazines |
- Atevirdine
- Azaperone
- Mirtazapine
- Pyridinylpiperazine
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| Benzo(iso)thiazolylpiperazines |
- Lurasidone
- Perospirone
- Revospirone
- Tiospirone
- Ziprasidone
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Tricyclics
(piperazine attached via side chain) |
- Amoxapine
- Clopenthixol
- Clorotepine
- Clozapine
- Cyanothepin
- Doclothepin
- Docloxythepin
- Flupentixol
- Fluphenazine
- Isofloxythepin
- Loxapine
- Meperathiepin
- Metitepine
- Octomethothepin
- Olanzapine
- Opipramol
- Oxyclothepin
- Oxyprothepin
- Peradithiepin
- Perathiepin
- Perazine
- Perphenazine
- Pirenzepine
- Prochlorperazine
- Thiethylperazine
- Thiothixene
- Trifluoperazine
- Trifluthepin
- Zuclopenthixol
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| Others/Uncategorized |
- 6-Nitroquipazine
- Azimilide
- Cinepazet
- Cyclohexylpiperazine
- Hexocyclium
- Indinavir
- JNJ-7777120
- Lodenafil
- Mirodenafil
- PB-28
- Quipazine
- Ranolazine
- SA-4503
- Sildenafil
- Tadalafil
- Vardenafil
- VUF-6002
- Zipeprol
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