USE OF 1-AMINOINDAN DERIVATIVES FOR TREATMENT OF MANIA IN BIPOLAR MOOD DISORDER

Abstract: The subject invention provides a method of treating mania in bipolar disorder in a subject comprising administering to the subject a therapeutically effective amount of derivatives of 1-aminoindan or their racemic mixtures, enantiomers, or salts, of general formula (I).

Description: USE OF 1-AMINOINDAN DERIVATIVES FOR TREATMENT OF MANIA IN BIPOLAR MOOD DISORDER This application claims the priority of U.S. Provisional Application No. 60/161,817, filed October 27, 1999, the contents of which are incorporated into this application. Throughout this application, various references are identified by authors and full citations. Disclosures of these publications in their entireties are hereby incorporated by reference into this application to more fully describe the state of the art to which this invention pertains . Background of the Invention Bipolar mood disorder commonly begins with depression and is characterized by at least one elated period sometime during the course of the illness. In bipolar I disorder, full blown manic and major depressive episodes alternate. In bipolar II disorder, depressive episodes alternate with hypomanias (i.e., mild, nonpsychotic periods of excitement) of relatively short duration. Although insomnia and poor appetite do occur during the depressive phase of bipolar illness, such atypical depressive signs as hypersomnia and overeating are more characteristic and may recur on a seasonal basis (e.g., in the autumn or winter) . In full blown manic psychosis, the mood typically is one of elation, but irritability and frank hostility are not uncommon. The patient's lack of insight and inordinate capacity for activity lead to a dangerously explosive psychotic state, in which the individual is impatient, intrusive, and meddlesome and responds with aggressive irritability when crossed. Interpersonal friction results and may lead to secondary paranoid delusional interpretations of being persecuted. Audio and visual hallucinations are sometime present, occur at the high mania, and are usually understandably linked with the morbid mood. The need for sleep is decreased. Manic persons are inexhaustibly, excessively, and impulsively involved in various activities without recognizing the inherent social dangers . Mixed states are labile mixtures between depressive and manic manifestations or rapid alternation from one state to the other and commonly occur in manic depressive at one time or another. (The Merck Manual 16 th edition, 1992, p. 1592, 1593, 1599) . Bipolar disorder (BP) affects 1-2% of the population. The classical psychopharmaceuticals effective in the treatment of mood disorders can be grouped into three classes: the heterocyclic antidepressants (HCA) , monoamine oxidase inhibitors (MAOI) and lithium salts. (Merck, p. 1603) . While HCA and MAOI drugs are indicated for the depressive phase of the bipolar disorder, lithium is known to attenuate the bipolar mood swings. Only around 70% of the patients are considered to respond to the treatment with HCA or lithium drugs (Merck, p. 1604, 1607) . For the resistant and refractory disease, combinations of drugs are used, increasing even more the panel of characteristic side effects. In light of this situation, there is a continuous search for new drugs aimed to solve the problems of drug resistance and severe side effects. Lately, drugs like valproic acid, carbamazepm, verapamil, propanolol, clonidine and adenyl cyclase inhibitors have been found to be beneficial either alone or as adjunct therapy for manic patients. (O. Kaufman and R.H. Belmaker, P. Soubπe, ed. : Anxiety, Depression and Mania. Anim. Models Psychiatr. Disord. , Basel, Karger, 1991, 3, pp. 103-121) . In order to discover new drugs, rodent models relevant to the manic phase, like amphetamine, amphetamine with chlordiazepoxide, morphine or desmethylimipramme induced hyperactivity or to the depression phase like immobilizations, are usually used (D.L. Murphy, Anim. Mod. Psych. Neur., 1977, pp. 211-225). These mania models focus on an induced increase in the activity level of the animal (e.g., locomotor or/and vertical activity) as a parallel to the hyperactivity of the maniac patient. The reversal of the induced hyperactivity m rodents by their pretreatment with a drug of interest indicates the possible efficacy of this drug m the treatment of human mania. A variety of substituted 1-amιnomdans have been proposed to have some activity m the central nervous system (CNS) . This group of compounds has a wide range of activities, for example, U.S. Patent No. 4,096,173 discloses 1-amιnomdans with ring chloro substituents as having anti-allergic, anti- spasmodic and local anesthetic activities, whereas U.S Patent No. 3,886,168 discloses the antl-inflammatory and vasodilatory activity of certain 1-ammomdans . It is hypothesized therein that the activity may be based in the CNS though no evidence is provided or suggested to support the hypothesis. British Patent No. 852,735 discloses 1-ammomdans with a lower alkoxy group in the five position as being active in dilating coronary blood vessels . U.S. Patent No. 3,637,740 discloses dl - l -N, N- dimethylammo- 4 -met oxy-7-chloromdane as an antidepressant and/or an antianxiety agent. However, no clear evidence is provided of either activity. Home et al . (J. Pharm. Exp . Ther. 1972, 180(3), p. 523) have shown that 2-amιnoιndan is a far superior inhibitor of catecholamme uptake than 1-ammomdan and therefore dismissed the latter as a candidate for use m the treatment of Parkinson's Disease. Martin et al . (J. Med. Chem. 1973, 16(2), p. 147; J. Med. Chem. 1974, 17(4), p. 409) describe experiments wherein N-methyl- 5 -methoxy derivatives of 1- ammomdan are investigated as having monoam e oxidase (MAO) inhibitory activity. Oshiro et al . (J. Med. Chem. 1991, 34, pp. 2004-2013) disclose a wide range of 7 -hydroxy-1-ammomdan derivatives that they subjected to screening for use as cerebroprotective agents using an antihypoxic test and as CNS stimulatory agents using a cerebral trauma test. In the resultant structure-activity-analysis , it was found that replacement of the 7-hydroxy group by a methoxy group resulted m loss of activity m the antihypoxic test but not in the cerebral trauma test. Their conclusion was that the 7 -hydroxy is essential to obtain the desired activity. This is evident from their subsequent paper wherein a broader range of 7 -hydroxy derivatives are screened (J. Med. Chem. 5 1991, 34, 2014-2020) . These 7-hydroxy- 1-aminoindans are defined in U.S. Patent Nos . 4,788,130; 4,792,628; 4,895,847; 5,055,474; and 5,242,919, all assigned to Otsuka Pharmaceutical Co., Japan. 0 Cohen et al . describe the use of a series of aminoindans for the treatment of Parkinson's disease, dementia, epilepsy, convulsions or seizures and neurotrauma and disclose the preparation of certain novel representatives of that class. (U.S. Patent Nos. 5,877,221; 5,880,159; 5,877,218). Summary of the Invention The subject mvention describes a method of treating mania the bipolar mood disorder in a subject comprising administering to the subject a therapeutically effective amount of derivatives of 1-ammomdan, their racemic mixtures, enantiomers, and salts thereof, of the general formula : wherein n is 0 or 1; each of R 1 and R 2 are hydrogen, C 1 -C 4 alkyl , halogen; R 3 is hydrogen, C 1 -C 4 alkyl, hydroxy, C 1 -C 4 alkoxy; R 4 is hydrogen, Ci-C 4 alkyl; R 6 is hydrogen, substituted or unsubstituted alkyl, C 6 - C 12 aryl, C 7 -C 12 aralkyl or A-N-R 9 R 10 , provided that R 6 is not methyl when R 1 , R 2 , R 3 and R 4 are hydrogen atoms, wherein A is substituted or unsubstituted C 1 -C 12 alkyl, substituted or unsubstituted C 6 -C 12 aryl, substituted or unsubstituted C 7 -C 12 aralkyl, and each of R 9 and R 10 are independently hydrogen, C 1 -C 12 alkyl, C 6 -C 12 aryl, C 7 -C 12 aralkyl, COOtBu, or danyl ; and racemic mixtures, enantiomers, and salts thereof. Description of the Figures FIG. 1 shows four specific compounds discussed m the experiments: (R) -N-acetyl ammomdan (1), (S)-N-mdanyl glycinamide HC1 (2), (rac) -N- (2-ammoacetyl) -1 -ammomdan HC1 (3), (S) -N-formyl ammomdan (4). FIG. 2A-5B hereinafter describe the means ±SE for activity counts measured for each group for 30 minutes, at 10 minute time intervals. The asterisk "*" denotes a significant difference from the control. Drug administration is mterpeπtoneal (IP) . FIG. 2A shows the locomotor activity level for rats which have been administered (R) -N-acetyl ammomdan (1) as compared to the control . FIG. 2B shows the vertical activity level for rats which have been administered (R) -N-acetyl ammomdan (1) as compared to the control. FIG. 3A shows the locomotor activity level for rats which have been administered (S) -N-mdanyl glycinamide HC1 (2) as compared to the control . FIG. 3B shows the vertical activity level for rats which have been administered (S) -N-mdanyl glycinamide HC1 (2) as compared to the control . FIG. 4A shows the locomotor activity level for rats which have been administered (rac) -N- (2-ammoacetyl) -1-ammomdan (3) as compared to the control. FIG. 4B shows the vertical activity level for rats which have been administered (rac) -N- (2 -ammoacetyl) -1-ammomdan (3) as compared to the control. FIG. 5A shows the locomotor activity level for rats which have been administered (S) -N-formyl ammomdan (4) as compared to the control . FIG. 5B shows the vertical activity level for rats which have been administered (S) -N-formyl ammomdan (4) as compared to the control . Detailed Description of the Invention It has now been surprisingly observed that a particular class of 1-ammomdan derivatives decrease the amphetamme- induced hyperactivity levels while another class increases this hyperactivity. This invention provides a method for the treatment of mania bipolar mood disorder using derivatives of 1-ammomdan or their racemic mixtures, enantiomers, and salts thereof. In particular, the present invention discloses a method of treating mania m bipolar mood disorder m a subject comprising administering to the subject a therapeutically effective amount of a compound of the formula: wherein n is 0 or 1; each of R 1 and R 2 are hydrogen, C 1 -C 4 alkyl, halogen; R 3 is hydrogen, C x -C 4 alkyl, hydroxy, C 1 -C 4 alkoxy; R 4 is hydrogen, C x -C 4 alkyl; R 6 is hydrogen, substituted or unsubstituted C λ - C 12 alkyl, C 6 -C 12 aryl, C 7 -C 12 aralkyl or A-N-R 9 R 10 , provided that R 6 is not methyl when R 1 , R 2 , R 3 and R 4 are hydrogen atoms, wherein A is substituted or unsubstituted alkyl, substituted or unsubstituted C 6 -C 12 aryl, substituted or unsubstituted C 7 -C 12 aralkyl, and each of R 9 and R 10 are independently hydrogen, C 1 -C 12 alkyl, C 6 -C 2 aryl, C 7 -C 12 aralkyl, COOtBu, or mdanyl ; and racemic mixtures, enantiomers, and salts thereof. In another embodiment of the invention, the compound is selected from the group consisting of (R) -N-acetyl ammomdan, (rac) -N-2-ammoacetyl -1-amιnoιndan HC1 and (S) - N-formyl ammomdan. In one embodiment of the invention, the subject is a human sub ect . In a further embodiment of the invention, the salt is selected from the group consisting of a hydrochloride salt, a mesylate salt, an ethylsulfonate salt, and a sulfate salt. In a specific embodiment of the invention, the salt is a hydrochloride salt. In one embodiment of the invention, the administration is selected from the group consisting of oral, mtrapeπtoneal , parenteral, topical, transdermal, rectal, nasal, and buccal administration. In yet another embodiment of the invention, the therapeutically effective amount is an amount from 30 mg/kg to 150 mg/kg . In a further embodiment of the invention, the therapeutically effective amount is an amount from 30 mg/kg to 100 mg/kg. In a preferred embodiment of the invention, the therapeutically effective amount is an amount from 30 mg/kg to 75 mg/kg. Experimental Details I . Synthesis of Compounds Cohen et al . disclose the preparation of the (R) -l- am omdan starting material, and certain novel representatives of ammomdan (U.S. Patents 5,877,221; 5,880,159; 5,877,218). The R- and S- enantiomers of each compound may be obtained by optical resolution of the corresponding racemic mixtures. Such a resolution can be accomplished by any conventional resolution method also disclosed in Cohen et al . II . Experimental Examples Evaluation of possible anti-bipolar effects of compounds 1 to 4 was effected by an amphetamine-induced hyperactivity model of mania m rats. Each of the compounds was examined in a separate experiment and compared with a control group, treated with the same dose of amphetamine. Twenty Sprague Dawley rats, weighing 200-250 g served for each of the four (4) experiments. Rats were housed in a colony room with constant temperature (22°C) , 12 h light/dark cycle and free access to food and water. Each experiment consisted of two groups (n=10 per group) , one group was treated with the compound (1 to 4) and the other with vehicle solution. In experiments 1-4, the drugs were administered mtrapeπtoneally (IP). All experimental procedures were conducted during the light phase of the light/dark cycle. Amphetamine (0.5 mg/kg, sub-cutaneous (s.c.), diluted in de- ionized water) was injected into all rats (both groups of each experiment) immediately prior to behavioral testing. In experiments 1 to 4, compounds (R) -N-acetyl aminoindan (1); (S) -N-indanyl glycinamide HC1 (2); (rac)-N-(2- aminoacetyl) -1-aminoindan HC1 (3); and (S) -N-formyl aminoindan (4) were injected twice intraperitoneally (IP) at a dose of 75 mg/kg, 19 h and 3 h prior to behavioral testing in experiments. All compounds were suspended in a 5% methyl cellulose solution. The vehicle solution was administered to the control animals. Immediately after amphetamine injection, rats were placed in automated activity monitors and their activity levels were scored every 10 minutes in the 30 minute time span for experiments 1 to 4. Activity scores included separate measurements of horizontal (locomotion) and of vertical (rearing) activity. Statistical analysis Repeated ANOVA measurements were used to examine the effects of compounds 1 to 4 on locomotor and on vertical activity. One factor measured the treatment of the rats using compounds 1 to 4 or the control vehicle; the repeated measure factor was time (three 10 minute intervals) . Post hoc LSD (least significant difference) tests were used to determine whether significant differences occurred in different time periods, where relevant. A. (R) -N-acetyl aminoindan (1) The results of the experiment employing (R) -N-acetyl aminoindan (1) are shown in Tables 1 and 2, as well as FIG. 2A and 2B. Table 1 compares the activity counts for rats which have been administered intraperitoneal (R) -N-acetyl aminoindan (1) to control rats for three 10 minute intervals. FIG. 2A shows the locomotor activity level for rats which have been administered intraperitoneally (R) -N- acetyl-aminoindan (1) as compared to the control. FIG. 2B shows the vertical activity level for rats which have been administered intraperitoneally (R) -N-acetyl -aminoindan (1) as compared to the control . Subacute treatment with 75 mg/kg (R) -N-acetyl aminoindan significantly reduced locomotion following amphetamine treatment (FIG. 2A) (ANOVA: Drug effect: F(l) =10.85, p<0.005; Time effect: F(2)=7.03, p<0.003; Interaction: F(2)=0.63, NS) . Post hoc analysis indicates that the effect of the drug was significant at all time points (FIG. 2A) . Similar effects were observed for vertical activity (ANOVA: Drug effect: F(l)=7.44, p<0.02; Time effect: F(2)=2.96, NS ; Interaction: F(2)=2.32, NS) . Post hoc analysis indicates significant differences during the first and second 10 minute time periods (FIG 2B) . TABLE 1. Effect of (R) -N-acetyl aminoindan (1) on Activity Levels B. (S) -N-indanyl glycinamide HCl (2) The results of the experiment employing (S) -N-mdanyl glycinamide HCl (2) are shown in Table 2, FIG. 3A and FIG. 3B. Table 2 compares the activity counts for rats which have been administered (S) -N-indanyl glycinamide HCl (2) to control rats for three 10 minute intervals. FIG. 3A shows the locomotor activity level for rats which have been administered (S) -N-mdanyl glycinamide HCl (2) as compared to the control. FIG. 3B shows the vertical activity level for rats which have been administered (S) -N-mdanyl glycinamide HCl (2) as compared to the control. Subacute treatment with (S) -N-indanyl glycinamide HCl (75mg/kg) did not have a significant effect on amphetamine- induced locomotor activity (ANOVA: Drug effect: F(l)=0.89, NS; Time e fect: F(2)=15.923, p<0.001; Interaction: F(2)=1.5, NS; FIG. 3A) . Contrary to expectations, the compound significantly increased the level of vertical activity (ANOVA: Drug effect: F(l)=5.499, p=0.031; Time effect: F(2)=8.533, p=0.001; Interaction: F(2)=2.537, NS) . Post hoc analysis indicates that the difference between the groups was significant during the first and second 10 minute time periods (FIG. 3B) . TABLE 2. Effect of (S) -N-indanyl glycinamide HCl (2) on Activity Levels C. (rac) -N- (2-aminoacetyl) -1-aminoindan HCl (3) The results of the experiment employing (rac)-N-(2- am oacetyl) -1-ammomdan HCl (3) are shown m Table 3, FIG. 4A and FIG. 4B. Table 3 compares the activity counts for rats which have been administered (rac) -N- (2-ammoacetyl) -1- ammo dan HCl (3) to control rats for three 10 mmute intervals. FIG. 4A shows the locomotor activity level for rats which have been administered (rac) -N- (2-ammoacetyl) -1- ammomdan HCl (3) as compared to the control. FIG. 4B shows the vertical activity level for rats which have been administered (rac) -N- (2-ammoacetyl) -1-ammomdan HCl (3) as compared to the control . Injections of (rac) -N- (2-ammoacetyl) -1-ammomdan HCl (75 mg/kg) , 19 and 3 hours prior to testing significantly reduced locomotor activity of rats treated with amphetamine (ANOVA: Drug effect: F(l)=9.32, p<0.007; Time effect: F(2)=11.29, p<0.002; Interaction: F(2)=0.21, NS) . Post hoc comparisons indicated that the difference was significant at all time periods (FIG. 4A) . A similar, albeit nonsignificant, effect was demonstrated for vertical activity (FIG. 4B) . TABLE 3. Effect of (rac) -N- (2-aminoacetyl) -1-aminoindan HCl (3) on Activity Levels D. (S) -N-formyl aminoindan (4) The results of the experiment employing (S) -N-formyl aminoindan (4) are shown in Table 4, FIG. 5A and FIG. 5B. Table 4 compares the activity counts for rats which have been administered (S) -N-formyl aminoindan (4) to control rats for three 10 minute intervals. FIG. 5A shows the locomotor activity level for rats which have been administered (S) -N-formyl aminoindan (4) as compared to the control. FIG. 5B shows the vertical activity level for rats which have been administered (S) -N-formyl aminoindan (4) as compared to the control . (S) -N-formyl aminoindan significantly reduced amphetamine- induced locomotor activity (ANOVA: Drug effect: F(l)=8.18, p<0.011; Time effect: F(2)=5.2, p<0.011; Interaction: F(2) = 0.42 NS) . Post hoc analysis indicates difference at all time points (FIG. 5A) . Similar significant effects were demonstrated for vertical activity (ANOVA: Drug effect: F(l)=14.1, p<0.002; Time effect: F(2)=10.64, p<0.0003; Interaction: F(2)=0.58, NS) . Post hoc analysis indicated a difference at all time points (FIG. 5B) . TABLE 4. Effect of (S)-N-formyl aminoindan (4) on Activity Levels Summary and Conclusion Significant effects on behavior were demonstrated m the present experiment for the compounds (R) -N-acetyl ammomdan (1), (S) -N-mdanyl glycinamide HCl (2), (rac)-N-(2- ammoacetyl) -1-ammomdan HCl (3) and (S) -N-formyl am omdan (4) . Interestingly, while (R) -N-acetyl - ammomdan (1), (rac) -N- (2-ammoacetyl) -1-ammomdan HCl (3) and (S) -N-formyl ammomdan (4) reduced the activity levels of rats, by contrast, (S) -N-mdanyl glycinamide HCl (2) surprisingly increased activity. From the tested model, the compounds (R) -N-acetyl am omdan (1) , (rac) -N- (2- ammoacetyl) -1-ammomdan HCl (3) and (S) -N-formyl ammomdan (4) show anti-manic potential m humans. The compound (S) -N-mdanyl glycinamide HCl (2) does not show anti -manic potential based on the tested model and doses.

Claims: What is claimed is: 1 A method of treating mania in bipolar mood disorder in a subject comprising administering to the subject a therapeutically effective amount of a compound of the formula : wherein n is 0 or 1 ; each of R 1 and R 2 are hydrogen, C x -C 4 alkyl, halogen; R 3 is hydrogen, C 1 -C 4 alkyl, hydroxy, C 1 -C 4 alkoxy; R 4 is hydrogen, C 1 -C 4 alkyl; R 6 is hydrogen, substituted or unsubstituted C^C^ alkyl, C 6 - C 12 aryl, C 7 -C 12 aralkyl or A-N-R 9 R 10 , provided that R 6 is not methyl when R 1 , R 2 , R 3 and R 4 are hydrogen atoms, wherein A is substituted or unsubstituted C 1 -C 12 alkyl, substituted or unsubstituted C 6 -C 12 aryl, substituted or unsubstituted C 7 -C 12 aralkyl, and each of R 9 and R 10 are independently hydrogen, C^C^ alkyl, C 6 -C 12 aryl, C 7 -C 12 aralkyl, COOtBu, or mdanyl ; and racemic mixtures, enantiomers, and salts thereof. 2. The method of claim 1, wherein the compound is selected from the group consisting of (R) -N-acetyl am omdan, (rac) - N- (2-ammoacetyl) -1-ammomdan HCl and (S) -N-formyl ammolndan . 3. The method of claim 1, wherein the subject is a human subject . 4. The method according to claim 1, wherein the salt is selected from the group consisting of a hydrochloride salt, a mesylate salt, an ethylsulfonate salt, and a sulfate salt. 5. The method according to claim 4, wherein the salt is a hydrochloride salt. 6. The method according to claim 1, wherein the administration is selected from the group consisting of oral, intraperitoneal , parenteral, topical, transdermal, rectal, nasal, and buccal administration. 7. The method according to claim 1, wherein the therapeutically effective amount is an amount from 30 mg/kg to 150 mg/kg. 8. The method according to claim 7, wherein the therapeutically effective amount is an amount from 30 mg/kg to 100 mg/kg. 9. The method according to claim 8, wherein the therapeutically effective amount is an amount from 30 mg/kg to 75 mg/kg.

Inventors: BARAK GABRIELA, LEVY RUTH, BARAK, GABRIELA, LEVY, RUTH
Applicants: BARAK GABRIELA, LEVY RUTH, TEVA PHARMA, BARAK, GABRIELA, LEVY, RUTH, TEVA PHARMACEUTICAL INDUSTRIES, LTD., TEVA PHARMACEUTICALS USA, INC.
Application year: 2000
Main classification: A61K31
IPC codes: A61K31, A61P25