NEW SCHIZOPHRENIA MEDICATIONS

NEW SCHIZOPHRENIA MEDICATIONS IN DEVELOPMENT
Schizophrenia Medications Currently in Phase III trials:
Asenapine (for positive/negative symptoms)
bifepronox (positive, negative, cognitive symptoms; may also relieve side effects)
lioperidone/Zomaril (positive, negative, cognitive symptoms)
Lamictal (adjunct therapy; may improve positive symptoms)
Osanetant (for movement side-effects caused by traditional neoroleptics)
Palperidone (for treatment-refractory patients)
RG1068 (for autistic-type symptoms in schizophrenia patients)
Seromycin/d-cycloserine (adjunct atreatment, for negative symptoms)
Schizophrenia Medications Currently in Phase II trials:
AMPAkines/CX-516 (to enhance the therapeutic effects of current medications)
Galantamine (for cognitive/negative symptoms and learning deficits)
Memantine (for cognitive symptoms)
Modafinil (for cognitive symptoms and working memory)
Ocaperidone (for positive symptoms, with few side effects)
Talnetant (for movement side-effects, cognitive symptoms)
Tolcapone (for cognitive symptoms)
Asenapine is a serotonin and dopamine (5HT/D2) antagonist, part of a class of atypical antipsychotics
that have typically been more effective than medications that act only at D2 receptors. For example, clozapine, risperadone, and olanzapine all have serotonin-dopamine antagonist properties, and these drugs are popular for their low incidence of side effects (particularly EPS side effects) and their efficacy against both positive and negative symptoms. Asenapine is being jointly developed by Pfizer and Oranon, and is in phase III clinical trials. Early data from previous trials (according to a press release from Pfizer) shows good tolerability and superior efficacy when tested against a placebo. No information was available about the nature or the methods of the study.
The evolution of the serotin-dopamine antagonist concept. J Clin Psychopharmacol. 1995 Feb; 15 (1 Suppl 1); 4S-10S.
The role of serotin in schizophrenia and the place of serotin-dopamine antagonist antippsychotics. J Clin Psychopharmacol. 1995 Feb; 15(1 Suppl 1): 2S-3S
Bifepronox is in phase III clinical trials, set to launch in the U.S. Market sometime in 2007. It is a partial dopamine agonist/antagonist, as well as a serotin receptor agonist. It is expected that partial dopamine agonist action will have beneficial effects for positive, negative, and cognitive symptoms, while the serotonergic agonist action will help alleviate some side effects and possibly combat depression and anxiety that can accompany schizophrenia treatment. Early results report little to no weight gain, and no cardiac or EPS effects.
Psychiatric News-Med Checks (May 2004). This is the only public source available that details anything about the results of early trials. Therer were no links to the actual trials themselves, nor any further data on research on this compound.
Lloperidone (Zomari) is current ly being developed by Titan Pharmaceuticals, after being dropped by Movartis due to concerns that the drug may cause cardiac arrhythmias (specifically, it might increase the QT interval of the heartbeat). A study in the Nov 2001 issue of psychiaatric times noted to cardiac abnormalities in 10 paatients receiving 0.5 mg-8mg of loperidone; however, this is an extraordinarily small sample size, and the study was sponsored by Novartis. In other words, these safety concerns have yet to be resolved in the public domain. However, loperidone is still in development (currently in phase III FDA clinical trials). Because it acts as an antigonist on many different receptors-including several different classes of dopamine, serotonin, and norepinephrine receptors-it has the potential to alleviate a wide range of symptoms.
Extended redioligand binding profile of loperidone: a broad spectrum dopamine/serotonin/norepinephrine receptor antagonist for the management of psychotic disorders. Neuropsychophamacology. 2001 Dec 25(6): 904-14.
An Assesssment of lloperidone for the Treatment of Schizophrenia. Expert Opin Investig Drugs. 2000 Dec; 9(12): 2935-43.
Lamictal is an FDA approved mood-stabilizer for bipolar disorder, and is now in phase III clinical trials as an adjunct treatment for schizophrenia. Research shows that a combination therapy of slozapine and lamictal in treatment-resistant schizophrenia patients results in reduced positive symptoms and improved general pathophysiology.
Placebo-controlled trail of lamotrigine added to conventional and atypical antipsychotics in schizophrenia. Biol Psychiatry. 2004 Sept 15;56(6): 441-6.
http://www.schizophrenia.com/newmeds2004.html