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Munayco Maldonado GM, Schwartz TL. Differentiating the third generation of antipsychotics: a focus on lumateperone's similarities and differences. Int Clin Psychopharmacol 2024; 39:4-16. [PMID: 37781859 DOI: 10.1097/yic.0000000000000510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
The development of atypical antipsychotics has evolved to include newer pharmacodynamic properties. Lumateperone, aripiprazole, brexpiprazole, and cariprazine are all dopamine-2 receptor partial agonists with varying receptor affinities. This review aims to compare the clinical and pharmacodynamic differences among these four atypical antipsychotics, all of which are unique when compared to first- and second-generation antipsychotics. For consideration is further delineating these agents as being third-generation antipsychotics. PubMed searches were conducted to compile preclinical and clinical studies derived from animal models and human subjects. Information gathered included pharmacological mechanisms, clinical efficacy, future-oriented clinical approaches, and adverse effects. Efficacy for the shared indications of these drugs seems comparable. Differences among these drugs lie more in their adverse effect profiles. For example, lumateperone was found to have the lowest rate of weight gain while brexpiprazole was found to have the highest rate of weight gain associated with increased appetite. Aripiprazole had the lowest rates of extrapyramidal symptoms not including akathisia while cariprazine had the highest. All four agents reviewed have a variety of receptor affinities, which likely generates a variety of different adverse effects. This suggests that in any given patient, clinicians may see differential clinical effects.
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Affiliation(s)
| | - Thomas L Schwartz
- SUNY Distinguished Teaching Professor and Chair of Psychiatry, Norton College of Medicine at SUNY Upstate Medical University
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Gajda M, Rybakiewicz R, Cieplak M, Żołek T, Maciejewska D, Gilant E, Rudzki PJ, Grab K, Kutner A, Borowicz P, Kutner W, Noworyta KR. Low-oxidation-potential thiophene-carbazole monomers for electro-oxidative molecular imprinting: Selective chemosensing of aripiprazole. Biosens Bioelectron 2020; 169:112589. [PMID: 32942142 DOI: 10.1016/j.bios.2020.112589] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/29/2020] [Accepted: 09/01/2020] [Indexed: 01/16/2023]
Abstract
New thiophene-carbazole functional and cross-linking monomers electropolymerizing at potentials sufficiently low for molecular imprinting of an electroactive aripiprazole antipsychotic drug were herein designed and synthesized. Numerous conducting molecularly imprinted polymer (MIP) films are deposited by electropolymerization at relatively low potentials by electro-oxidation of pyrrole, aniline, phenol, or 3,4-ethylenedioxythiophene (EDOT). However, their interactions with templates are not sufficiently strong. Hence, it is necessary to introduce additional recognizing sites in these cavities to increase their affinity to the target molecules. For that, functional monomers derivatized with substituents forming stable complexes with the templates are used. However, oxidation potentials of these derivatives are often, disadvantageously, higher than that of parent monomers. Therefore, we designed and synthesized new functional and cross-linking monomers, which are oxidized at sufficiently low potentials. The deposited MIP and non-imprinted polymer (NIP) films were characterized by PM-IRRAS and UV-vis spectroscopy and imaged with AFM. The structure of the aripiprazole pre-polymerization complex with functional monomers was optimized with density functional theory (DFT), and aripiprazole interactions with imprinted cavities were simulated with molecular mechanics (MM) and molecular dynamics (MD). MIP-aripiprazole film-coated electrodes were used as extended gates for selective determination of aripiprazole with the extended-gate field-effect transistor (EG-FET) chemosensor. The linear dynamic concentration range was 30-300 pM, and the limit of detection was 22 fM. An apparent imprinting factor of the MIP-1 was IF = 4.95. The devised chemosensor was highly selective to glucose, urea, and creatinine interferences. The chemosensor was successfully applied for aripiprazole determination in human plasma. The results obtained were compared to those of the validated HPLC-MS method.
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Affiliation(s)
- Marianna Gajda
- Institute of Physical Chemistry, Polish Academy of Sciences, Kasprzaka 44/52, 01-224, Warsaw, Poland; Department of Organic Chemistry, Faculty of Pharmacy, Medical University of Warsaw, Banacha 1, 02-097, Warsaw, Poland
| | - Renata Rybakiewicz
- Faculty of Mathematics and Natural Sciences. School of Sciences, Institute of Chemical Sciences, Cardinal Stefan Wyszynski University in Warsaw, Wóycickiego 1/3, 01-815, Warsaw, Poland; Laboratory of Organic Electronics, Linköping University, Bredgatan 33, 602 21, Norrköping, Sweden
| | - Maciej Cieplak
- Institute of Physical Chemistry, Polish Academy of Sciences, Kasprzaka 44/52, 01-224, Warsaw, Poland.
| | - Teresa Żołek
- Department of Organic Chemistry, Faculty of Pharmacy, Medical University of Warsaw, Banacha 1, 02-097, Warsaw, Poland
| | - Dorota Maciejewska
- Department of Organic Chemistry, Faculty of Pharmacy, Medical University of Warsaw, Banacha 1, 02-097, Warsaw, Poland
| | - Edyta Gilant
- Łukasiewicz Research Network - Pharmaceutical Research Institute, Rydygiera 8, 01-793, Warsaw, Poland
| | - Piotr J Rudzki
- Łukasiewicz Research Network - Pharmaceutical Research Institute, Rydygiera 8, 01-793, Warsaw, Poland
| | - Katarzyna Grab
- Łukasiewicz Research Network - Pharmaceutical Research Institute, Rydygiera 8, 01-793, Warsaw, Poland
| | - Andrzej Kutner
- Faculty of Mathematics and Natural Sciences. School of Sciences, Institute of Chemical Sciences, Cardinal Stefan Wyszynski University in Warsaw, Wóycickiego 1/3, 01-815, Warsaw, Poland
| | - Paweł Borowicz
- Institute of Physical Chemistry, Polish Academy of Sciences, Kasprzaka 44/52, 01-224, Warsaw, Poland
| | - Wlodzimierz Kutner
- Institute of Physical Chemistry, Polish Academy of Sciences, Kasprzaka 44/52, 01-224, Warsaw, Poland; Faculty of Mathematics and Natural Sciences. School of Sciences, Institute of Chemical Sciences, Cardinal Stefan Wyszynski University in Warsaw, Wóycickiego 1/3, 01-815, Warsaw, Poland
| | - Krzysztof R Noworyta
- Institute of Physical Chemistry, Polish Academy of Sciences, Kasprzaka 44/52, 01-224, Warsaw, Poland.
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Cuomo A, Beccarini Crescenzi B, Goracci A, Bolognesi S, Giordano N, Rossi R, Facchi E, Neal SM, Fagiolini A. Drug safety evaluation of aripiprazole in bipolar disorder. Expert Opin Drug Saf 2019; 18:455-463. [DOI: 10.1080/14740338.2019.1617847] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Alessandro Cuomo
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- Department of Mental Health and Addiction Services, ASST Lombardy Health Care System, Carlo Poma Hospital, Mantova, Italy
| | | | - Arianna Goracci
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Simone Bolognesi
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Nicola Giordano
- Department of Medicine, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Rodolfo Rossi
- Department of System Medicine (RR), Tor Vergata University, Rome, Italy
- Department of Mental Health & Drug Abuse, AUSL Modena, Modena, Italy
| | - Edvige Facchi
- Department of Mental Health, USL Toscana Sud East (EF), Siena, Italy
| | - Stephen M Neal
- Department of Psychiatry, West Virginia School of Osteopathic Medicine, Lewisburg, WV, USA
| | - Andrea Fagiolini
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
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