Mecamylamine

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Mecamylamine
Mecamylamine3.svg
Systematic (IUPAC) name
(1S,2R,4R)-N,2,3,3-Tetramethylbicyclo[2.2.1]heptan-2-amine
Clinical data
AHFS/Drugs.com Consumer Drug Information
Legal status
  • ℞ (Prescription only)
Routes of
administration
Oral
Pharmacokinetic data
Protein binding 40%
Identifiers
CAS Number 60-40-2 YesY
ATC code C02BB01 (WHO)
PubChem CID: 4032
IUPHAR/BPS 3990
DrugBank DB00657 YesY
ChemSpider 5036243 YesY
UNII 6EE945D3OK YesY
ChEMBL CHEMBL1398031 N
Chemical data
Formula C11H21N
Molecular mass 167.291 g/mol
 NYesY (what is this?)  (verify)

Mecamylamine (INN, BAN) (brand names Inversine, Vecamyl[1] ) or mecamylamine hydrochloride (USAN) is a non-selective, non-competitive antagonist of the nicotinic acetylcholine receptors (nAChRs) that was introduced in the 1950s as an antihypertensive drug.[2] It was withdrawn from the market for the treatment of hypertension in 2009 in the United States.[1]

Chemically, mecamylamine is a secondary aliphatic amine, with a pKaH of 11.2[3]

Pharmacology and clinical applications

Mecamylamine has been used as an orally-active ganglionic blocker in treating autonomic dysreflexia and hypertension,[4] but, like most ganglionic blockers, it is more often used now as a research tool.

Mecamylamine is also sometimes used as an antiaddictive drug to help people stop smoking tobacco,[5] and is now more widely used for this application than it is for lowering blood pressure. This effect is thought to be due to its blocking α3β4 nicotinic receptors in the brain. It has also been reported to bring about sustained relief from tics in Tourette's Disorder when a series of more usually used agents had failed [22].

In a recent double-blind, placebo-controlled Phase II trial in Indian patients with major depression, (S)-mecamylamine (TC-5214) appeared to have efficacy as an augmentation therapy. This is the first substantive evidence that shows that compounds where the primary pharmacology is antagonism to neuronal nicotinic receptors will have antidepressant properties.[6][7] TC-5214 is currently in Phase III of clinical development as an add-on treatment and on stage II as a monotherapy treatment for major depression. The first results reported from the Phase III trials showed that TC-5214 failed to meet the primary goal and the trial did not replicate the effects that had been encouraging in the Phase II trial.[8][9] Development is funded by Targacept and AstraZeneca.[10] It did not produce meaningful, beneficial results on patients as measured by changes on the Montgomery-Asberg Depression Rating Scale after eight weeks of treatment as compared with placebo.

(S)-(+)-Mecamylamine dissociates more slowly from α4β2 and α3β4 receptors than does the (R)-(−)-enantiomer.[11]

A large SAR study of mecamylamine and its analogs was reported by a group from Merck in 1962.[12] Another, more recent SAR study was undertaken by Suchocki et al.[13]

A comprehensive review of the pharmacology of mecamylamine was published in 2001.[14]

Toxicology

The LD50 for the HCl salt[15] in mice: 21 mg/kg (i.v.); 37 mg/kg (i.p.); 96 mg/kg (p.o.).[16]

See also

References

  1. drugs.com [drugs.com international availability of Mecamylamine] Page accessed May 15, 2015
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  3. Schanker, L. S.; et al. (1957). J. Pharmacol. Exp. Ther. 120: 528. Missing or empty |title= (help) <templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  4. T. O. Soine (1966), Textbook of Organic Medicinal and Pharmaceutical Chemistry, 5th Ed., (C. O. Wilson, O. Gisvold and R. F. Doerge, Eds.), pp. 468-546, Philadelphia: Lippincott.
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  8. John Carroll. "Key AZ/Targacept depression drug flunks first Phase III test". Fiercebiotech.com. Retrieved 2011-11-09.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  9. "Targacept Shares Fall After Depression Medicine Misses Goal". News.businessweek.com. 2007-01-15. Retrieved 2011-11-09.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  10. "AstraZeneca Pipeline as of the 27th of January 2011". Retrieved 2011-11-09.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  11. Papke RL, Sanberg PR, Shytle RD (May 2001). "Analysis of mecamylamine stereoisomers on human nicotinic receptor subtypes". J. Pharmacol. Exp. Ther. 297 (2): 646–56. PMID 11303054. <templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  12. Stone, C. A.; et al. (1962). J. Med. Pharm. Chem. 5: 665–690. Missing or empty |title= (help) <templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
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  15. In view of the time period when these data were generated, they presumably refer to the HCl salt of the racemic drug - see discussion of stereochemical issues in "Chemistry" section.
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