Chemistry:Mesocarb
Mesocarb, sold under the brand name Sidnocarb or Sydnocarb and known by the developmental code name MLR-1017, is a psychostimulant medication which has been used in the treatment of psychiatric disorders and for a number of other indications in the Soviet Union and Russia.[1][2][3][4] It is currently under development for the treatment of Parkinson's disease and sleep disorders.[5][6] It is taken by mouth.
The drug is a selective dopamine reuptake inhibitor (DRI).[7][8][9][10] It is an unusual and unique DRI, acting as a negative allosteric modulator and non-competitive inhibitor of the dopamine transporter (DAT).[7][8][9] Chemically, mesocarb contains amphetamine within its structure but has been modified and extended at the amine with a sydnone imine-containing moiety.[11][1][2]
Mesocarb was first described by 1971.[1][12][13][10] It was used as a pharmaceutical drug until 2008.[14] In 2021, its nature as a DAT allosteric modulator was reported.[7][8][9] As of February 2023, mesocarb was in phase 1 clinical trials for Parkinson's disease.[6] The active enantiomer, armesocarb, is also being developed.[15]
Medical uses
Mesocarb was originally developed in the Soviet Union in the 1970s[16][17] for a variety of indications including asthenia, apathy, adynamia, and some clinical aspects of depression and schizophrenia.[18][19] Mesocarb was used for counteracting the sedative effects of benzodiazepines,[20] increasing workload capacity and cardiovascular function,[21] treatment of attention deficit hyperactivity disorder (ADHD) in children,[22][23] as a nootropic,[24] and as a drug to enhance resistance to extremely cold temperatures.[25][26] It has also been reported to have antidepressant and anticonvulsant properties.[27]
Available forms
Mesocarb was sold in Russia as 5 mg oral tablets under the brand name Sydnocarb.
Pharmacology
Pharmacodynamics
Mesocarb has been found to act as a selective dopamine reuptake inhibitor (DRI) by blocking the actions of the dopamine transporter (DAT),[10][28] and lacks the dopamine release characteristic of stimulants such as dextroamphetamine.[29][30][31] It was the most selective DAT inhibitor amongst an array of other DAT inhibitors to which it was compared and, in 2017, was reported as the most selective DAT inhibitor described to date.[28][4]
The affinities (Ki) of mesocarb at the human monoamine transporters in vitro have been reported to be 8.3 nM for the dopamine transporter (DAT), 1,500 nM for the norepinephrine transporter (NET) (181-fold lower than for the DAT), and >10,000 nM for the serotonin transporter (SERT) (>1,205-fold lower than for the DAT).[4] The inhibitory potencies (IC50) of mesocarb at the human monoamine transporters in vitro have been reported to be 0.49 ± 0.14 μM at the DAT, 34.9 ± 14.08 μM at the NET (71-fold lower than for the DAT), and 494.9 ± 17.00 μM at the SERT (1,010-fold lower than for the DAT).[9]
In 2021, it was discovered that mesocarb is not a conventional DRI but acts as a DAT allosteric modulator or non-competitive inhibitor.[7][8][9] In accordance with its nature as an atypical DAT blocker, the drug has atypical effects relative to conventional DRIs.[7][8][9][4] As an example, it shows greater antiparkinsonian activity relative to other DRIs in animals.[4]
Similarly to other DRIs, mesocarb has been found to possess wakefulness-promoting effects.[4]
Pharmacokinetics
Hydroxylated metabolites can be detected in urine for up to 10 days after consumption.[32]
Mesocarb had erroneously been referred to as a prodrug of amphetamine.[33] However, this was based on older literature that relied on gas chromatography as an analytical method. Subsequently, with the advent of mass spectroscopy, it has been shown that presence of amphetamine in prior studies was an artifact of the gas chromatography method.[34] More recent studies using mass spectroscopy show that negligible levels of amphetamine are released from mesocarb metabolism.[32]
Chemistry
Mesocarb, also known as 3-(β-phenylisopropyl)-N-phenylcarbamoylsydnonimine, is a substituted phenethylamine and amphetamine and a mesoionic sydnone imine.[11][1][2] It has the amphetamine backbone present, except that the RN has a complicated imine side chain present.[11][1][2]
Whereas mesocarb (MLR-1017) is a racemic mixture, the enantiopure levorotatory or (R)-enantiomer is known as armesocarb (MLR-1019).[14] Armesocarb is described as the active enantiomer of mesocarb, whereas the (S)- or D-enantiomer is said to be virtually inactive.[4][14][35]
It is structurally related to feprosidnine (Sydnophen; 3-(α-methylphenylethyl)sydnone imine).[27]
Synthesis

Feprosidnine (Sydnophen) is converted from the hydrochloride salt (1) into the freebase amine (2). This is then treated with phenylisocyanate (3).
History
Mesocarb was first described in the scientific literature by 1971.[1][12][13][10] It is said to have been used as a pharmaceutical drug from 1971 until 2008.[14] It was said to have been discontinued by its manufacturer in 2008 for business reasons unrelated to the drug itself.[14]
Society and culture
Names
Mesocarb is the generic name of the drug and its INN.[11] It is also known by the synonym fensidnimine as well as by the brand names Sydnocarb and Synocarb.[1][2][11][37] The drug is additionally known by its developmental code name MLR-1017 (for Parkinson's disease).[6]
Status
Mesocarb is almost unknown in the western world and is neither used in medicine nor studied scientifically to any great extent outside of Russia and other countries in the former Soviet Union. It has however been added to the list of drugs under international control and is a scheduled substance in most countries, despite its multiple therapeutic applications and reported lack of significant abuse potential.[38]
Research
Parkinson's disease
Mesocarb, has been under development for the treatment of Parkinson's disease since 2016.[5][6] As of February 2023, it is in phase 1 clinical trials for this indication.[6] However, no recent development has been reported.[6] Mesocarb's active enantiomer armesocarb is also under development.[15]
See also
- List of Russian drugs
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 The Dictionary of Drugs: Chemical Data: Chemical Data, Structures and Bibliographies. Springer US. 2014. p. 774. ISBN 978-1-4757-2085-3. https://books.google.com/books?id=0vXTBwAAQBAJ&pg=PA774. Retrieved 16 September 2024.
- ↑ 2.0 2.1 2.2 2.3 2.4 Schweizerischer Apotheker-Verein (2000). Index Nominum 2000: International Drug Directory. Medpharm Scientific Publishers. p. 655. ISBN 978-3-88763-075-1. https://books.google.com/books?id=5GpcTQD_L2oC&pg=PA655. Retrieved 16 September 2024.
- ↑ "Cognitive enhancers (nootropics). Part 3: drugs interacting with targets other than receptors or enzymes. disease-modifying drugs". J Alzheimers Dis 34 (1): 1–114. 2013. doi:10.3233/JAD-121729. PMID 23186990. https://www.researchgate.net/publication/236142322. "MLR-1017 (mesocarb, sydnocarb, sidnocarb, Melior Pharmaceuticals, Exton, PA) (Fig. 4) is a dopamine transporter inhibitor for the potential treatment of ADHD and levodopa-induced side effects in PD. The drug was previously launched in Russia [271, 272] (Thomson Reuters Pharma, update of April 12, 2012).".
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 "Phenotypic Screening". Drug Repositioning. Frontiers in Neurotherapeutics. Boca Raton: CRC Press. 14 July 2017. pp. 121–145. doi:10.4324/9781315373669-7. ISBN 978-1-315-37366-9. https://www.researchgate.net/publication/333583200.
- ↑ 5.0 5.1 "Melior Discovery Announces Spinout of Melior Pharmaceuticals II, LLC.". 10 May 2016. https://www.businesswire.com/news/home/20160510005485/en/Melior-Discovery-Announces-Spinout-Melior-Pharmaceuticals-II.
- ↑ 6.0 6.1 6.2 6.3 6.4 6.5 "MLR-1017 - Melior Pharmaceuticals". 28 February 2023. https://adisinsight.springer.com/drugs/800043871.
- ↑ 7.0 7.1 7.2 7.3 7.4 "Overview of the structure and function of the dopamine transporter and its protein interactions". Front Physiol 14. 2023. doi:10.3389/fphys.2023.1150355. PMID 36935752.
- ↑ 8.0 8.1 8.2 8.3 8.4 "Allosteric modulation of serotonin and dopamine transporters: New insights from computations and experiments". Curr Res Physiol 7. 2024. doi:10.1016/j.crphys.2024.100125. PMID 38836245.
- ↑ 9.0 9.1 9.2 9.3 9.4 9.5 "Functional Characterization of the Dopaminergic Psychostimulant Sydnocarb as an Allosteric Modulator of the Human Dopamine Transporter". Biomedicines 9 (6): 634. June 2021. doi:10.3390/biomedicines9060634. PMID 34199621.
- ↑ 10.0 10.1 10.2 10.3 "Inhibition of dopamine uptake by a new psychostimulant mesocarb (Sydnocarb)". Pol J Pharmacol Pharm 33 (2): 141–147. 1981. PMID 7312716.
- ↑ 11.0 11.1 11.2 11.3 11.4 "Mesocarb". https://pubchem.ncbi.nlm.nih.gov/compound/9551611.
- ↑ 12.0 12.1 "Osobennosti mekhanizma tsentral'nogo deĭstviia sidnokarba" (in Russian). Zh Nevropatol Psikhiatr Im S S Korsakova 74 (4): 594–602. 1974. PMID 4825943.
- ↑ 13.0 13.1 "Sydnocarb metabolizmusának vizsgálata pathányban" (in Hungarian). Acta Pharm Hung 48 (Suppl): 23–24. 1978. PMID 749521.
- ↑ 14.0 14.1 14.2 14.3 14.4 Adhera Therapeutics (7 June 2021). "Adhera Therapeutics Signs Letter of Intent with Melior Pharmaceuticals II to Acquire a New Class of Drug for Parkinson's Disease". GlobeNewswire News Room (Press release). Retrieved 25 September 2024.
Armesocarb is the active pharmaceutical ingredient (API) of the racemic mixture mesocarb, a highly selective dopamine reuptake inhibitor first approved in the former Soviet Union in 1971 and marketed for select psychiatric and central nervous system (CNS) indications until 2008. At that time, which coincided with the Great Recession, the Russian manufacturer discontinued operations for business reasons unrelated to the compound itself.
- ↑ 15.0 15.1 "Melior Pharmaceuticals". 28 April 2023. https://adisinsight.springer.com/drugs/800034792.
- ↑ 16.0 16.1 Mashkovskii ME, Yashunskii VG, Altshuler RA, Kholodov LE, Avrutskii GY, Aleksandrovskii YA, Shmulevich AB, "N-(Phenylcarbamoyl)-3-(1-phenyl-2-propyl)sydnone imine", DE patent 2028880, issued 8 March 1979
- ↑ "[Characteristics of the central action of sidnocarb]" (in ru). Zhurnal Nevropatologii I Psikhiatrii imeni S.S. Korsakova 74 (4): 594–602. 1974. PMID 4825943.
- ↑ "Peculiarities of clinical activity and pharmacokinetics of sydnocarb (sydnocarbum), an original psychostimulant". Agressologie 20 (D): 265–270. 1979. PMID 45391.
- ↑ "Behavioral, toxic, and neurochemical effects of sydnocarb, a novel psychomotor stimulant: comparisons with methamphetamine". The Journal of Pharmacology and Experimental Therapeutics 288 (3): 1298–1310. March 1999. doi:10.1016/S0022-3565(24)38086-3. PMID 10027871. http://jpet.aspetjournals.org/cgi/pmidlookup?view=long&pmid=10027871.
- ↑ "[Sidnocarb correction of the adverse effects of benzodiazepine tranquilizers]" (in ru). Zhurnal Nevropatologii I Psikhiatrii imeni S.S. Korsakova 82 (8): 92–97. 1982. PMID 6127851.
- ↑ "A survey of psychotropic medications not available in the United States". Neuropsychopharmacology 5 (4): 201–217. December 1991. PMID 1804161.
- ↑ "[Excretion of monoamines, their precursors and metabolites in the hyperactivity syndrome in mentally defective children]" (in ru). Voprosy Meditsinskoi Khimii 34 (1): 47–50. 1988. PMID 3369126.
- ↑ "[Sidnocarb treatment of young schoolchildren with the hyperdynamic syndrome]" (in ru). Zhurnal Nevropatologii I Psikhiatrii imeni S.S. Korsakova 88 (8): 97–101. 1988. PMID 3195293.
- ↑ "[Effect of sidnocarb on learning and memory]" (in ru). Biulleten' Eksperimental'noi Biologii I Meditsiny 104 (10): 453–454. October 1987. PMID 3676468.
- ↑ "[Pharmacologic correction of the effect of cold on man]" (in ru). Kosmicheskaia Biologiia I Aviakosmicheskaia Meditsina 22 (6): 66–73. Nov–Dec 1988. PMID 2906380.
- ↑ "[Thermoprotector properties of a combination of sydnocarb with ladasten]" (in ru). Eksperimental'naia i Klinicheskaia Farmakologiia 69 (1): 71–73. 2006. PMID 16579065.
- ↑ 27.0 27.1 "The Chemistry of Bioactive Mesoionic Heterocycles". Bioactive Heterocycles VII. Topics in Heterocyclic Chemistry. 16. Berlin, Heidelberg: Springer Berlin Heidelberg. 2007. pp. 135–152. doi:10.1007/7081_2007_096. ISBN 978-3-642-00335-6. "Mesocarb (sydnocarb) (13) and Feprosidnine (sydnofen) (14) are stimulants developed in Russia in the 1970s. Mesocarb is sold as a drug in Russia. However, it is almost unknown in Western countries and is not used in medicine. It has been shown to act as a dopamine reuptake inhibitor, antidepressant, and anticonvulsant [7, 8]."
- ↑ 28.0 28.1 "Characterization of pharmacological and wake-promoting properties of the dopaminergic stimulant sydnocarb in rats". The Journal of Pharmacology and Experimental Therapeutics 337 (2): 380–390. May 2011. doi:10.1124/jpet.111.178947. PMID 21300706.
- ↑ "Effects of amphetamine and sydnocarb on dopamine release and free radical generation in rat striatum". Pharmacology, Biochemistry, and Behavior 69 (3–4): 653–658. 2001. doi:10.1016/S0091-3057(01)00574-3. PMID 11509228.
- ↑ "Effect of d-amphetamine and sydnocarb on the extracellular level of dopamine, 3,4-dihydroxyphenylacetic acid, and hydroxyl radicals generation in rat striatum". Annals of the New York Academy of Sciences 914 (1): 137–145. September 2000. doi:10.1111/j.1749-6632.2000.tb05191.x. PMID 11085316. Bibcode: 2000NYASA.914..137A.
- ↑ "Effects of a psychostimulant drug sydnocarb on rat brain dopaminergic transmission in vivo". European Journal of Pharmacology 340 (1): 53–58. December 1997. doi:10.1016/S0014-2999(97)01407-6. PMID 9527506.
- ↑ 32.0 32.1 "Validation of liquid chromatography-electrospray ionization ion trap mass spectrometry method for the determination of mesocarb in human plasma and urine". Journal of Chromatographic Science 43 (1): 11–21. January 2005. doi:10.1093/chromsci/43.1.11. PMID 15808002.
- ↑ Forensic Medicine: Fundamentals and Perspectives. Springer Science & Business Media. 9 October 2013. pp. 519–. ISBN 978-3-642-38818-7. https://books.google.com/books?id=yHHABAAAQBAJ&pg=PA519.
- ↑ "Liquid chromatography-electrospray ionization ion trap mass spectrometry for analysis of mesocarb and its metabolites in human urine". Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences 800 (1–2): 281–289. February 2004. doi:10.1016/j.jchromb.2003.10.071. PMID 14698267.
- ↑ Al'tshuler, R. A. (2005). "Comparative Molecular Model Estimation of the Affinity of Phenylethylamines to the Binding Sites of Membrane Transporters". Pharmaceutical Chemistry Journal 39 (4): 169–175. doi:10.1007/s11094-005-0110-3. ISSN 0091-150X.
- ↑ Mashkovsky MD, Yashunsky YG, Altshuller RA, Knolodov LE, Avrutsky GY, Alexandrovsky JA, Smulevich AB, "Novel sydnonimine derivative", GB patent 1262830, published 9 February 1972
- ↑ "Mesocarb". CAS Common Chemistry. American Chemical Society. 16 September 2024. https://commonchemistry.cas.org/detail?cas_rn=34262-84-5.
- ↑ "[Experimental and clinical study of Sydnocarb]" (in ru). Hung Pharmacotherapy 124: 150–154. 1978.
