PHARMACEUTICAL COMPOSITIONS

Abstract: A pharmaceutical composition comprising folic acid and an anti-depressant or anti-manic drug, the ratio of amount of folic acid to drug being such that there is present approximately the normal daily dietary requirement of folic acid per daily dose of the drug.

Description: PHARMACEUTICAL COMPOSITIONS. This invention relates to anti-depressant or anti- manic pharmaceutical_compositions containing folic acid. Folic acid is a vitamin widely distributed in, especially, green vegetables, yeast and liver. An _ ^ _- ^ o dinary ~ Westem-diet for normal people generally supplies just.enough folic acid to meet daily requirements. Folic acid deficiency has been observed- to result in anaemia and the acid has been used for some time as ' a hematopoietic vitamin. In this connection it is known to administer synthetic folic acid (5 nig) orally; 10 to 30 mg daily are usually given. In addition, to prevent deficiency occurring during pregnancy when there is an increased folic acid requirement, folic acid is often administered during pregnancy. More recently it has been observed that a substantial proportion of patients suffering from neuro- psychiatric disorders have low serum folate concentra¬ tions. Treatment of the- disorders by use of conventional doses of folic acid have been suggested (sea "Dementia and Folate Deficiency", Strachan and Henderson, Quarterly Journal of Medicine, New Series XXXVI, No. 142, April 1967, page 189; "Effects of Folic Acid on the Mental State and Fit-Frequency of Drug- Treated Epileptic Patients", Reynolds, The Lancet, May 1967, page 106; "Folate-Responsive Neuropathy: Report of 10 Cases", Manzoo and Runcie, British Medical Journal, 15th May 1976, page 1176; and "Neurological Disorders Responsive to Folic Acid Therapy", Botez et al,CMA Journal August 7 1976, Volume 115, page 217). In all cases patients were treated with folic acid supplements at the conventional rate used in the field of __ •haematology. In addition Reynolds et al •. ("Folate f Deficiency in Depressive Illness", Brit J. Psychiatry 1970, 117, 287) studied the patients with depressive illness and while a relationship between folic acid deficiency and * depression was reported the writers were unable tc elucidate it. It is generally agreed that there is a wealth of evidence for the neurotransmitter 5-hydroxytryptamine (5-HT) being essential for the normal maintenance of mood-. It is recognised that common?_y used anti- depressants, whose mode of action is understood, generally act by manipulating brain amines including in most cases 5-HT. Bote ' et al ("Folate Deficiency and Decreased Brain 5-Hydroxytryptamine Synthesis in Man and Rat", Nature,-? Volume 278, 8th March 1979 182), found that brain 5-HT synthesis is reduced in both man-and animals which are folate deficient. However administration of folic acid to provide a folate excess, as in conventional therapy, was ineffective in restoring brain 5-HT to normal. Only replacement of folate by folic acid in normal dietary quantities was found to restore- 5-HT synthesis to normal. According to the present invention there, is provided a pharmaceutical composition comprising folic acid and an anti-depressant or anti-manic drug, the ratio of amount of folic acid to drug being such that there is present approximately the normal daily dietary require¬ ment of folic acid per daily dose of the drug. 5 - The normal daily intake of folic acid, as recommended by DHSS Report on Health and Social Subjects NOT^ST ~ ts* generally 200μg per day. Thus the composition according to the present invention will generally contain the folic acid and drug in the ratio of 100 to 300, preferably 200, 10 μg, of folic acid per daily dose of the drug. The daily dose of the drug is of course that of accepted medical practice and will vary from drug to drug. If for example the composition is made up in the form of a tablet or capsule containing a .proportion of the daily 15 dose of drug, a number of the tablets or capsules to be taken daily, then, in accordance with the present invention, the composition should contain the same proportion of the normal daily dietary requirement of folic acid. Thus if two tablets are to be taken daily, 20 the tablets will each contain one half of the normal daily dietary requirement cf folic acid. ¥hile it is not wished to be bound by the mode of action of the present composition, it is believed that the provision of folic acid enables the synthesis .of 5-HT •25 to be returned to normal and thus increasing the effectiveness of the anti-depressant or anti-manic drug. The drug may be a tricyclic anti-depressant or other anti-depressant such as imipramine, chlomimipramine, zimelidine, norzimelidine, nortriptyline, protriptyline, amitriptyline, fluxpenthixol, butriptyline, maprotiline, nomifensine, prothiaden, fluphenazine, 1-tryptophan, desimipramine, iprindole, viloxazine, dothiepin, doxepin, trimipramine, mianserin, or a monoamineoxidase 'inhibitor such as phenelzine, isocarboxizid, iproniazid, tranylcypromine. The folic acid can also be used with lithium carbonate (given usually to treat mania and to prevent recurrences of- depression and πiania), in normal or slow or sustained release form. Anti-manic drugs v.'hich can be used in the composition of the present invention include phenothiazines and other anti-manic drugs such as chlorpromazine, flupenthixol, haloperidol, thioridazine, luphenazine, thiothixene, pimozide, promazine and tri-f uoperazine. OMPI

Claims: - 5 - CLAIMS 1. A pharmaceutical composition comprising folic acid and an anti-depressant or anti-manic drug, the ratio of amount of folic acid to drug being such that there is present - approximately the normal daily dietary requirement of folic acid per daily dose of the drug. 2. A composition according to claim 1 which contains the folic acid and drug in the ratio of 100 to 300μg folic acid per daily dose o ' f the drug. 3. A composition according to claim 1 which contains the folic acid and drug in the ratio of about 200μg of folic acid ■ per daily dose of the drug. 4. A composition according to any one of the preceding " claims wherein the drug is specifically named herein. 5. A composition according to any one of the preceding claims which is in- the form of a tablet or capsule. "'

Inventors: COPPEN ALEC JAMES, COPPEN, ALEC, JAMES
Applicants: COPPEN ALEC JAMES, COPPEN, ALEC, JAMES
Application year: 1981
Main classification: A61K45
IPC codes: A61K31, A61K33