Chemistry:Cyamemazine

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Short description: Antipsychotic medication

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Cyamemazine
Cyamemazine.svg
Clinical data
Trade namesTercian
AHFS/Drugs.comInternational Drug Names
Routes of
administration
Oral, IM, IV
ATC code
Legal status
Legal status
  • In general: ℞ (Prescription only)
Pharmacokinetic data
Bioavailability10-70%
MetabolismHepatic
Elimination half-life10 hours
ExcretionUrine
Identifiers
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEMBL
Chemical and physical data
FormulaC19H21N3S
Molar mass323.46 g·mol−1
3D model (JSmol)
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Cyamemazine (Tercian), also known as cyamepromazine, is a typical antipsychotic drug of the phenothiazine class which was introduced by Theraplix in France in 1972 and later in Portugal as well.[1][2][3][4]

Medical use

It is used for the treatment of schizophrenia and, especially, for psychosis-associated anxiety, due to its unique anxiolytic efficacy.[5][6]

It is also used to reduce anxiety associated with benzodiazepine withdrawal syndrome and anxiety in depression with suicidal tendency.[7]

Side effects

Here are some of the most common side effects and related incidence:[8]

Mechanism

Cyamemazine differs from other phenothiazine neuroleptics in that aside from the usual profile of dopamine, α1-adrenergic, H1, and mACh receptor antagonism,[9] it additionally produces potent blockade of several serotonin receptors, including 5-HT2A, 5-HT2C, and 5-HT7.[9][10][11][12] These actions have been implicated in cyamemazine's anxiolytic effects (5-HT2C) and lack of extrapyramidal side effects (5-HT2A),[9][10] and despite being classified as a typical antipsychotic, it actually behaves like an atypical antipsychotic.[13]

Site Ki (nM) Species Ref
H1 9.3 Guinea pig [14]
H2 351 Guinea pig [14]
H3 >10,000 Rat [14]
M1 13 Human [14]
M2 42 Human [14]
M3 32 Human [14]
M4 12 Human [14]
M5 35 Human [14]
5-HT1A 517 Human [14]
5-HT2A 1.5 Human [14]
5-HT2C 12 Human [14]
5-HT3 2,943 Human [14]
5-HT7 22 Human [14]
D1 3.8 Human [14]
D2 5.8 Human [14]
D3 2.5 Human [14]
D4 5.3 Human [14]
α1 2.3 Rat [14]
α2 1320 Rat [14]
GABAA >10,000 Rat [14]
GABAB >10,000 Rat [14]
Values are Ki (nM). The smaller the value,

the more strongly the drug binds to the site.

Synthesis

Synthesis:[15] Patent:[16]

2-Cyanophenothiazine [38642-74-9] (1) 3-Chloro-2-methylpropyl(dimethyl)amine [23349-86-2] (2)

References

  1. Index Nominum, International Drug. Taylor & Francis. 2000. ISBN 978-3-88763-075-1. https://books.google.com/books?id=5GpcTQD_L2oC&q=cyamemazine%20tercian&pg=PA280. 
  2. Dictionary of Pharmacological Agents. Boca Raton: Chapman & Hall/CRC. 1996. p. 534. ISBN 0-412-46630-9. https://books.google.com/books?id=DeX7jgInYFMC&pg=RA1-PA534. 
  3. Pharmaceutical manufacturing ... - Google Books. Noyes Publications. January 1988. ISBN 9780815511441. https://books.google.com/books?id=X2EyLsG4bcUC&q=cyamemazine%20introduced&pg=PA397. 
  4. "[Prescribing patterns of antipsychotics in 13 French psychiatric hospitals"] (in fr). L'Encephale 35 (2): 129–138. April 2009. doi:10.1016/j.encep.2008.03.007. PMID 19393381. http://www.masson.fr/masson/S0013-7006(08)00103-6. 
  5. "Cyamemazine". Stahl's Essential Psychopharmacology. Cambridge University Press. http://stahlonline.cambridge.org/prescribers_drug.jsf?page=0521683505c20_p115-120.html.therapeutics&name=Cyamemazine. 
  6. "Cyamemazine as an anxiolytic drug on the elevated plus maze and light/dark paradigm in mice". Behavioural Brain Research 124 (1): 87–95. September 2001. doi:10.1016/S0166-4328(01)00238-8. PMID 11423169. 
  7. "Potential role of cortical 5-HT(2A) receptors in the anxiolytic action of cyamemazine in benzodiazepine withdrawal". Psychiatry Research (Elsevier BV) 198 (2): 307–312. July 2012. doi:10.1016/j.psychres.2012.01.009. PMID 22421069. 
  8. "Preclinical and clinical pharmacology of cyamemazine: anxiolytic effects and prevention of alcohol and benzodiazepine withdrawal syndrome". CNS Drug Reviews (Wiley) 10 (3): 219–229. 2006-06-07. doi:10.1111/j.1527-3458.2004.tb00023.x. PMID 15492772. 
  9. 9.0 9.1 9.2 "Affinity of cyamemazine, an anxiolytic antipsychotic drug, for human recombinant dopamine vs. serotonin receptor subtypes". Biochemical Pharmacology 65 (3): 435–440. February 2003. doi:10.1016/S0006-2952(02)01515-0. PMID 12527336. 
  10. 10.0 10.1 "5-HT3- and 5-HT2C-antagonist properties of cyamemazine: significance for its clinical anxiolytic activity". Psychopharmacology 147 (4): 412–417. January 2000. doi:10.1007/s002130050010. PMID 10672635. http://link.springer.de/link/service/journals/00213/bibs/0147004/01470412.htm. Retrieved 2010-02-11. 
  11. "5-HT2A receptor antagonist properties of cyamemazine in rat and guinea pig smooth muscle". European Journal of Pharmacology 454 (2–3): 235–239. November 2002. doi:10.1016/S0014-2999(02)02489-5. PMID 12421652. 
  12. "Affinity of cyamemazine metabolites for serotonin, histamine and dopamine receptor subtypes". European Journal of Pharmacology 578 (2–3): 142–147. January 2008. doi:10.1016/j.ejphar.2007.09.025. PMID 17936750. 
  13. "Reduction of extracellular dopamine and metabolite concentrations in rat striatum by low doses of acute cyamemazine". Naunyn-Schmiedeberg's Archives of Pharmacology 367 (2): 134–139. February 2003. doi:10.1007/s00210-002-0665-4. PMID 12595954. 
  14. 14.00 14.01 14.02 14.03 14.04 14.05 14.06 14.07 14.08 14.09 14.10 14.11 14.12 14.13 14.14 14.15 14.16 14.17 14.18 14.19 14.20 "Affinity of cyamemazine, an anxiolytic antipsychotic drug, for human recombinant dopamine vs. serotonin receptor subtypes". Biochemical Pharmacology 65 (3): 435–440. February 2003. doi:10.1016/s0006-2952(02)01515-0. PMID 12527336. 
  15. "Synthesis of Phenothiazines. VI. Certain 2-Substituted Phenothiazines and Their 10-Aminoalkyl Derivatives". The Journal of Organic Chemistry 26 (4): 1138–1143. 1961. doi:10.1021/jo01063a040. 
  16. Jacob RM, Georges RJ gdate = 1959, US patent 2877224, assigned to Rhone Poulenc Sa