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Alpidem
Systematic (IUPAC) name
2-[3-chloro-8-(4-chlorophenyl)-1,7-diazabicyclo[4.3.0]nona-2,4,6,8-tetraen-9-yl]-N,N-dipropyl-acetamide
Identifiers
CAS number 82626-01-5
ATC code none
PubChem 54897
ChemSpider 49570
Chemical data
Formula C21H23Cl2N3O 
Mol. mass 404.332 g/mol
SMILES eMolecules & PubChem
Pharmacokinetic data
Excretion Renal
Therapeutic considerations
Pregnancy cat.  ?
Legal status
Routes Oral

Alpidem (Ananxyl) is an anxiolytic drug from the imidazopyridine family, related to the more well known sleeping medication zolpidem. Unlike zolpidem however, alpidem does not produce sedative effects at normal doses, and is instead used specifically for the treatment of anxiety.[1][2]

Alipidem was developed by Synthélabo (now part of Sanofi-Aventis). It was approved for marketing in France in 1991. Clinical trial to obtain US FDA approval were halted in 1992 and the drug never received FDA approval. It was withdrawn from the French market by 1994 and is not approved for marketing anywhere in the world. [3]

Alpidem was known to act selectively on the α3 receptor subtype and to a lesser extent at the α1 subtype (Kd of 0.33nM and 1.67nM respectively), of the benzodiazepine receptor.[4][5] However the chemical structure of alpidem is not related to that of the benzodiazepines, and alpidem is thus sometimes referred to as a nonbenzodiazepine.[6]

Contents

Indications

Alpidem is not approved for any indication.

Use prior to removal from market

Alpidem was generally prescribed to patients with moderate to severe anxiety.[7] Most of these patients had exhibited either sensitivity or resistance to benzodiazepine therapy, and therefore switched to a non-benzodiazepine medication due to the reduced incidence of side effects relative to benzodiazepine drugs.[8][9] Alpidem produced little or no sedative or hypnotic action at normal doses but may have produced sedation when used at a high dose, and only had anticonvulsant actions at much higher doses than those used clinically for the treatment of anxiety.[10]

Dangers

In 1996, Alpidem was withdrawn from the market in most of the world following reports of severe liver damage caused by Ananxyl,[11][12].

See also

References

  1. ^ Zivkovic B, Morel E, Joly D, Perrault G, Sanger DJ, Lloyd KG. Pharmacological and behavioral profile of alpidem as an anxiolytic. Synthelabo Recherche, L.E.R.S., Bagneux, France. 1990 May;23 Suppl 3:108-13. PMID 1974069
  2. ^ Sanger DJ, Zivkovic B. Discriminative stimulus effects of alpidem, a new imidazopyridine anxiolytic. Synthelabo Recherche, Bagneux, France. 1994 Jan;113(3-4):395-403. PMID 7862851
  3. ^ WHO Drug Information Vol. 8, No. 2, 1994, page 64.[1]
  4. ^ Langer SZ, Arbilla S, Benavides J, Scatton B. Zolpidem and alpidem: two imidazopyridines with selectivity for omega 1- and omega 3-receptor subtypes. Advances in Biochememical Psychopharmacology. 1990;46:61-72.
  5. ^ Langer SZ, Arbilla S, Tan S, Lloyd KG, George P, Allen J, Wick AE. Selectivity for omega-receptor subtypes as a strategy for the development of anxiolytic drugs. Pharmacopsychiatry. 1990 May;23 Suppl 3:103-7.
  6. ^ Diamond BI, Nguyen H, O'Neal E, Ochs R, Kaffeman M, Borison RL. A comparative study of alpidem, a nonbenzodiazepine, and lorazepam in patients with nonpsychotic anxiety. Psychopharmacology Bulletin. 1991;27(1):67-71.
  7. ^ Kunovac JL, Stahl SM. Future directions in anxiolytic pharmacotherapy. Psychiatric Clinics of North America. 1995 Dec;18(4):895-909.
  8. ^ Morton S, Lader M. Studies with alpidem in normal volunteers and anxious patients. Pharmacopsychiatry. 1990 May;23 Suppl 3:120-3.
  9. ^ Frattola L, Garreau M, Piolti R, Bassi S, Albizzati MG, Borghi C, Morselli PL. Comparison of the efficacy, safety and withdrawal of alpidem and alprazolam in anxious patients. British Journal of Psychiatry. 1994 Jul;165(2):94-100.
  10. ^ Zivkovic B, Morel E, Joly D, Perrault G, Sanger DJ, Lloyd KG. Pharmacological and behavioral profile of alpidem as an anxiolytic. Pharmacopsychiatry. 1990 May;23 Suppl 3:108-13.
  11. ^ Baty V, Denis B, Goudot C, Bas V, Renkes P, Bigard MA, Boissel P, Gaucher P. Hepatitis induced by alpidem (Ananxyl). Four cases, one of them fatal. Gastroenterologie Clinique et Biologique. 1994;18(12):1129-31. (French).
  12. ^ Ausset P, Malavialle P, Vallet A, Miremont G, Le Bail B, Dumas F, Saric J, Winnock S. Subfulminant hepatitis caused by alpidem and treated by liver transplantation. Gastroenterologie Clinique et Biologique. 1995 Feb;19(2):222-3. (French).







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