piperidines and tipepidine

We have previously found that antitussive drugs inhibit G protein-coupled inwardly rectifying potassium (GIRK) channel currents in brain neurons. Potassium efflux through GIRK channels causes membrane hyperpolarization, and thus plays an important role in the inhibitory regulation of neuronal excitability. Because GIRK channels are coupled to various G protein-coupled receptors including monoamine receptors, antitussives are possible to affect the levels of various neurotransmitters in the brain. Many currently available antidepressants have been developed based on the monoamine theory for the etiology of depression. We hypothesized that new drugs such as tipepidine may lead to changes in the balance of monoamine levels in the brain resulting in improvement in symptoms of depression. Therefore, we investigated whether or not the drugs have antidepressant activity in the animal models. Male Wistar rats (200-240 g) were used. Tipepidine, cloperastine and caramiphen significantly reduced the immobility in forced swimming test (FST) using normal rats. All drugs had little effect on loco-motor activity. The effects on the forced swimming were inhibited by treatment with AMPT, but not PCPA. Tipepidine also inhibited hyperactivity in olfactory bulbectomized rats. Interestingly, tipepidine also significantly reduced the immobility in FST using ACTH-treated rats which is a model of depression resistant to treatment with antidepressants. Given these results together with cumulated findings, it is suggested that tipepidine may have a novel antidepressant-like action, and that the effect may be caused at least partly through the action on the catecholaminergic system in the brain.

Topics: Animals; Antidepressive Agents; Biogenic Monoamines; Brain; Cyclopentanes; Disease Models, Animal; G Protein-Coupled Inwardly-Rectifying Potassium Channels; Humans; Male; Piperidines; Rats; Rats, Wistar

Tipepidine, a synthetic, non-opioid expectorant, has been shown to improve depressive-like behavior in animal models of depression. In this study, we assessed the efficacy and tolerability of tipepidine combination therapy with citalopram in treatment of major depressive disorder (MDD).. In a randomized, double-blinded, placebo-controlled clinical trial, 62 patients with MDD were assigned into two parallel groups to receive citalopram (up to 40 mg/day) plus placebo or citalopram plus tipepidine (30 mg twice daily) for 6 weeks. Participants were assessed with the Hamilton Rating Scale for Depression (HAM-D) at baseline and Weeks 2, 4, and 6.. Fifty-six patients completed the trial. The tipepidine group showed greater improvement in HAM-D scores from baseline to all three study time points (P = 0.048 for all). The remission and response-to-treatment rates were significantly higher in the tipepidine group (53.6% and 100%) compared to the placebo group (25.0% and 75%) at the study end-point (P = 0.029 and 0.005, respectively). The remission and response times in patients in the tipepidine group were also shorter compared with the placebo group (log-rank P = 0.020 and 0.004). There was no significant difference between the two groups in baseline parameters or frequency of side-effects.. Tipepidine combination therapy with citalopram can effectively improve symptoms of patients with MDD in a shorter period of treatment. However, further studies with larger sample sizes and longer follow-up treatment are needed to confirm our findings.

Topics: Adult; Citalopram; Depressive Disorder, Major; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Outcome Assessment, Health Care; Piperidines; Selective Serotonin Reuptake Inhibitors; Time Factors

Asverin® (tipepidine hibenzate) has been used as an antitussive for > 50 years in Japan. Studies revealed that tipepidine modulates monoamine levels, by inhibiting G-protein-activated inwardly rectifying potassium (GIRK) channels, expecting the potential therapeutic effects of tipepidine for attention-deficit/hyperactivity disorder (ADHD) in recent years. In this study, TS-141, a sustained-release tablet of tipepidine, was developed for the treatment of ADHD through a drug repositioning approach.. The sustained-release profile of TS-141 in healthy adults was investigated, and tipepidine exposure in the plasma after the TS-141 administration was compared to that of Asverin in the phase I study. Phase II study was conducted to examine the effects of TS-141 30 (once a day), 60 (once a day), 120 mg (60 mg twice a day), or placebo, that is within the exposure in the maximum dosage of Asverin, in children and adolescents with ADHD, and was designed as an 8-week treatment, randomized, parallel group, double-blind, placebo-controlled trial recruiting 6-17-year-old children and adolescents diagnosed with ADHD. A total of 216 patients were randomized according to the CYP2D6 phenotype. The primary end-point was ADHD Rating Scale IV-J changes. Furthermore, effects of CYP2D6 phenotype on the efficacy in the subgroup analysis were investigated.. TS-141 had the sustained-release profile, and the CYP2D6 phenotype had effects on the plasma exposure of tipepidine. ADHD RS-IV-J scores in all TS-141 dosages decreased from their baseline scores; however, no significant difference was observed in ADHD RS-IV-J score changes between the placebo and TS-141-administered groups. In patients with intermediate metabolizer CYP2D6, ADHD RS-IV-J score changes in the 120 mg group tended to be larger than that in the placebo group.. ADHD RS-IV-J changes on TS-141 may depend on the interaction between the TS-141 dose and CYP2D6 phenotype, suggesting that further clinical trials should be conducted with careful consideration of polymorphism. Drug repositioning approach of TS-141 was attempted at the same dose as that of antitussive; however, dose setting according to the indication was necessary.. Phase I study: JapicCTI-205235 (Registered 25 March 2020), Phase II study: JapicCTI-163244 (Registered 9 May 2016), https://www.clinicaltrials.jp/cti-user/trial/Show.jsp.

Topics: Adolescent; Adult; Attention Deficit Disorder with Hyperactivity; Central Nervous System Stimulants; Child; Delayed-Action Preparations; Dose-Response Relationship, Drug; Double-Blind Method; Drug Repositioning; Humans; Japan; Piperidines; Psychiatric Status Rating Scales; Tablets; Treatment Outcome

This study evaluated the efficacy and safety of tipepidine as an add-on to methylphenidate in the drug treatment of attention-deficit/hyperactivity disorder (ADHD).. This study was an 8-week, randomized, parallel group, double-blind, placebo-controlled trial recruiting 53 ADHD-diagnosed children. Patients were randomly divided to receive methylphenidate + tipepidine or methylphenidate + placebo for 8 weeks. Participants were assessed using the parent version of ADHD Rating Scale-IV and the Clinical Global Impression scale at baseline, at week 4, and at the end of the trial. Moreover, the safety and tolerability of the treatment strategies were compared.. On general linear model repeated measures analysis a significant effect was seen for time × treatment interaction on the total and hyperactivity-impulsivity subscales of the Parent ADHD Rating Scale-IV during the trial period (Greenhouse-Geisser corrected: F = 3.45, d.f. = 1.52, P = 0.049, and F = 5.17, d.f. = 1.52, P = 0.014, respectively). The effect for time × treatment interaction, however, was not significant on Clinical Global Impression-Severity scale (Greenhouse-Geisser corrected: F = 1.79, d.f. = 1.43, P = 0.182). The frequencies of adverse events were similar between the two groups.. Eight weeks of treatment with tipepidine, as a supplementary medication, resulted in satisfactory efficacy and safety of the adjuvant therapy in management of patients with ADHD. Rigorous investigations, however, involving larger sample sizes, more extended treatment periods, and dose responses should be considered.

Topics: Adolescent; Attention Deficit Disorder with Hyperactivity; Central Nervous System Stimulants; Child; Diagnostic and Statistical Manual of Mental Disorders; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Male; Methylphenidate; Piperidines; Psychiatric Status Rating Scales; Treatment Outcome

Treatment-resistant depression is a challenging problem in the clinical setting. Tipepidine has been used as a non-narcotic antitussive in Japan since 1959.. We administered tipepidine to 11 patients with treatment-resistant depression. Tipepidine was given for 8 weeks as an augmentation.. Tipepidine significantly improved depression scores on the Hamilton Rating Scale for depression. Add-on treatment with tipepidine significantly improved scores on the trail making test and Rey auditory verbal learning test. However, no changes were observed in blood concentrations of stress-related hormones (adrenocorticotropic hormone, cortisol, dehydroepiandrosterone sulphate) with tipepidine augmentation.. Tipepidine might be a potential therapeutic drug for treatment-resistant depression.

Topics: Adult; Antidepressive Agents; Cognition; Dehydroepiandrosterone Sulfate; Depressive Disorder, Treatment-Resistant; Dose-Response Relationship, Drug; Female; Humans; Hydrocortisone; Male; Memory; Motor Activity; Neuropsychological Tests; Pilot Projects; Piperidines; Swimming

Topics: Antidepressive Agents; Humans; Piperidines

Epilepsy of infancy with migrating focal seizures (EIMFS) is one of the early-onset epileptic encephalopathies resistant to antiepileptic drugs, therefore carrying an extremely poor neurodevelopmental outcome. KCNT1, encoding for a sodium-activated potassium channel (K. Our case was an infant diagnosed with EIMFS with confirmed mutation in KCNT1 gene. Quinidine therapy was started as early as 9 months old. Within the first month of treatment, the number of seizures reduced to about one third. However, seizure-free state was not obtained and his neuropsychological development remained severely delayed. After 16 months of treatment, quinidine had to be discontinued because of cardiac side effects. At 27 months of age, however, his seizures suddenly stopped and he remained seizure-free for five days. This coincided with the prescription of tipepidine, a commonly used antitussive, administered for his persistent cough. Reduction in seizure frequency was also observed with dextromethorphan, another conventional antitussive drug. Although the relation between these treatments and his symptom improvement is a matter of elucidation, there is a possibility that these nonnarcotic antitussive drugs might play a role in the treatment of EIFMS.

Topics: Antitussive Agents; Dextromethorphan; Electroencephalography; Epilepsy; Humans; Infant; Magnetic Resonance Imaging; Male; Mutation; Nerve Tissue Proteins; Piperidines; Potassium Channels, Sodium-Activated; Quinidine; Seizures; Treatment Failure; Treatment Outcome

We previously reported that centrally acting non-narcotic antitussives, including tipepidine, inhibit G-protein-coupled inwardly rectifying potassium (GIRK) channel-activated currents of neurons. In addition, when administered at a cough suppressant dose, the drugs ameliorated the symptoms of various models of intractable brain disease in rodents. In the current study, we investigated whether tipepidine causes recovery from schizophrenia-like cognitive dysfunction, which was induced by MK-801 (0.2 mg/kg, i.p.) in mice. We also examined the effect of tipepidine and clozapine co-administration on the dysfunction. Moreover, we studied whether clozapine inhibits GIRK channel activated currents in single brain neurons using the patch-clamp technique. Tipepidine elicited recovery from MK-801-induced cognitive impairment in the novel objective recognition test and Y-maze test. Further, co-administration of tipepidine and clozapine, at subthreshold doses of each drug, improved MK-801-induced cognitive impairment in the novel objective recognition test. Clozapine (3 × 10

Topics: Animals; Antidepressive Agents; Antitussive Agents; Clozapine; Cognitive Dysfunction; Disease Models, Animal; Dizocilpine Maleate; Dopaminergic Neurons; G Protein-Coupled Inwardly-Rectifying Potassium Channels; Male; Mice; Patch-Clamp Techniques; Piperidines; Rats; Rats, Wistar; Schizophrenia; Ventral Tegmental Area

Topics: Adjuvants, Pharmaceutic; Ambroxol; Carbocysteine; Drug Compounding; Drugs, Generic; Ointments; Piperidines; Powders; Water

We investigated whether tipepidine exerts an antidepressant-like effect in the forced swimming test in adrenocorticotropic hormone (ACTH)-treated rats, which is known as a treatment-resistant depression model, and we studied the pharmacological mechanisms of the effects of tipepidine. Male Wistar rats (5-7 weeks old) were used in this study. Tipepidine (20 and 40 mg/kg, i.p.) decreased the immobility time in the forced swimming test in ACTH-treated rats. The anti-immobility effect of tipepidine was blocked by a catecholamine-depleting agent, alpha-methyl-p-tyrosine (300 mg/kg, s.c.), but not by a serotonin-depleting agent, p-chlorophenylalanine. The anti-immobility effect of tipepidine was also blocked by a dopamine D1 receptor antagonist, SCH23390 (0.02 mg/kg, s.c.) and an adrenaline α2 receptor antagonist, yohimbine (2 mg/kg, i.p.). In microdialysis technique, tipepidine (40 mg/kg, i.p.) increased the extracellular dopamine level of the nucleus accumbens (NAc) in ACTH-treated rats. These results suggest that tipepidine exerts an antidepressant-like effect in the forced swimming test in ACTH-treated rats, and that the effect of tipepidine is mediated by the stimulation of dopamine D1 receptors and adrenaline α2 receptors. The results also suggest that an increase in the extracellular dopamine level in the NAc may be involved in the antidepressant-like effect of tipepidine in ACTH-treated rats.

Topics: Adrenocorticotropic Hormone; Animals; Antidepressive Agents; Benzazepines; Depression; Disease Models, Animal; Dopamine Antagonists; Dose-Response Relationship, Drug; Drug Interactions; Fenclonine; Hormones; Imipramine; Immobility Response, Tonic; Locomotion; Male; Piperidines; Rats; Rats, Wistar; Serotonin Antagonists; Swimming

We previously reported that the novel antidepressant-like effect of tipepidine may be produced at least partly through the activation of mesolimbic dopamine neurons via inhibition of G protein-coupled inwardly rectifying potassium channels. In this study, we investigated whether tipepidine increases dopamine levels in the nucleus accumbens (NAc) in rats using an in vivo microdialysis technique. We further assessed whether tipepidine at antidepressant-like effective doses induces behavioral- and cross-sensitization of locomotor activity in rats using the open field test. We found that acute administration of tipepidine increased dopamine levels in the NAc in freely moving rats without increasing locomotor activity. Tipepidine at antidepressant-like effective doses (20 and 40 mg/kg, i.p.) did not cause behavioral sensitization in rats. Furthermore, cross-sensitization between tipepidine and methamphetamine was not observed in rats. These results further support our working hypothesis that tipepidine may produce a novel antidepressant-like effect through activation of ventral tegmental area-NAc dopaminergic neurons whose mechanisms differ from those contributing to the reinforcing effects of addictive drugs.

Topics: Akathisia, Drug-Induced; Animals; Antidepressive Agents; Dopamine; Dopamine Agents; Dose-Response Relationship, Drug; Male; Methamphetamine; Microdialysis; Motor Activity; Nucleus Accumbens; Piperidines; Rats, Sprague-Dawley

Topics: Administration, Oral; Attention Deficit Disorder with Hyperactivity; Child; Follow-Up Studies; Humans; Piperidines; Treatment Outcome

We previously reported that tipepidine, a centrally acting non-narcotic antitussive, has an antidepressant-like effect in normal and imipramine treatment-resistant depression model rats. Recently, mapping the induction of c-fos-like immunoreactivity (FLI) in the rat brain showed FLI-positive neurons in several brain areas after acute administration of different classes of antidepressants. Here, the effect of a single injection of an antidepressive dose of tipepidine on FLI was studied in seven areas of the rat brain including the central nucleus of the amygdala (CeA) and the nucleus accumbens (NAc). Desipramine was also used for comparison. Rats were anesthetized and perfused 2h after injection with tipepidine (20 and 40mg/kg, i.p.), desipramine (10mg/kg, i.p.), or saline. Then, immunostaining of FLI-positive neurons in brain slices was performed with conventional methods. A single injection of tipepidine increased FLI-positive neurons in the CeA, similar to preexisting antidepressants, and induced the characteristic pattern of an increase in FLI-positive neurons in six other brain areas including the NAc, an effect that was different from other antidepressants. In addition, a single injection of desipramine (10mg/kg) or tipepidine (20mg/kg) decreased the immobility time in the forced swimming test to a similar extent. The results obtained from the previous behavioral study and the current immunohistochemical study suggest that tipepidine may be a novel antidepressant.

Topics: Animals; Antidepressive Agents; Brain; Desipramine; Dose-Response Relationship, Drug; Gene Expression Regulation; Male; Piperidines; Proto-Oncogene Proteins c-fos; Rats; Rats, Wistar; Swimming

We previously reported that the novel antidepressant-like effect of tipepidine may be produced at least partly through the activation of mesolimbic dopamine (DA) neurons via inhibiting G protein-coupled inwardly rectifying potassium (GIRK) channels. In this study, we investigated the action of tipepidine on DA D2 receptor-mediated GIRK currents (IDA(GIRK)) and membrane excitability in DA neurons using the voltage clamp and current clamp modes of the patch-clamp techniques, respectively. DA neurons were acutely dissociated from the ventral tegmental area (VTA) in rats and identified by the presence of the hyperpolarization-activated currents. Tipepidine reversibly inhibited IDA(GIRK) with IC50 7.0 μM and also abolished IDA(GIRK) irreversibly activated in the presence of intracellular GTPγS. Then tipepidine depolarized membrane potential and generated action potentials in the neurons current-clamped. Furthermore, the drug at 40 mg/kg, i.p. increased the number of cells immunopositive both for c-Fos and tyrosine hydroxylase (TH) in the VTA. These results suggest that tipepidine may activate DA neurons in VTA through the inhibition of GIRK channel-activated currents.

Topics: Animals; Antidepressive Agents; Dopaminergic Neurons; G Protein-Coupled Inwardly-Rectifying Potassium Channels; Immunohistochemistry; Patch-Clamp Techniques; Piperidines; Rats; Rats, Wistar; Receptors, Dopamine D2; Ventral Tegmental Area

We previously reported that the centrally acting non-narcotic antitussive, tipepidine, produces a novel antidepressant-like effect in the forced swimming test in rats, but the mechanism of the antidepressant-like effect of tipepidine is not clear. We investigated the pharmacological mechanism of the antidepressant-like effect of tipepidine in the forced swimming test in rats. A catecholamine-depleting agent, alpha-methyl-p-tyrosine (AMPT; 300 mg/kg, s.c.), was given 6h before the first injection and with the last injection of tipepidine (40 mg/kg, i.p.). A serotonin (5-HT)-depleting agent, p-chlorophenylalanine (PCPA; 350 mg/kg, i.p.), was given 72 h and 48 h before the pretest session. The dopamine D(1) receptor antagonist, SCH23390 (0.02 mg/kg, s.c.) was given 15min before each of the three injections of tipepidine. The dopamine D(2) receptor antagonist raclopride (0.2mg/kg, s.c.), the alpha 1 adrenoceptor antagonist prazosin (1mg/kg, i.p.), the alpha 2 adrenoceptor antagonist yohimbine (2mg/kg, i.p.) and the beta adrenoceptor antagonist propranolol (2mg/kg, i.p.) were given 30 min before each of the three injections of tipepidine. AMPT, but not PCPA, significantly inhibited the immobility time-reducing effect of tipepidine in the forced swimming test. Furthermore, the effect of tipepidine was significantly inhibited by SCH23390 and yohimbine. However, raclopride, prazosin, and propranolol failed to block the effect of tipepidine. The results suggest that the antidepressant-like effect of tipepidine in the forced swimming test may be due at least in part to the effects of dopamine and noradrenaline released at the dopamine D(1) receptor and alpha 2 adrenoceptor, respectively.

Topics: alpha-Methyltyrosine; Animals; Antidepressive Agents; Benzazepines; Drug Interactions; Fenclonine; Immobility Response, Tonic; Male; Motor Activity; Piperidines; Prazosin; Propranolol; Raclopride; Rats; Rats, Wistar; Yohimbine

Our previous study revealed that centrally acting non-narcotic antitussives inhibited G-protein-coupled inwardly rectifying K(+) (GIRK) channel currents in brain neurons, and that the tipepidine antitussives had a novel antidepressive-like effect on rats. Furthermore, the antitussives revealed multiplexed ameliorating actions on intractable brain disease models. This study evaluated the therapeutic potential of tipepidine in obsessive-compulsive disorder (OCD) subjects using marble-burying behavior (MBB) tests in mice. In fact, OCD is classified as an anxiety disorder characterized by obsession or compulsion. Although selective 5-HT reuptake inhibitors (SSRIs) are considered first choice agents for the pharmacological treatment of OCD, 50% of patients with OCD failed to respond to SSRIs. The burying of harmless objects such as marbles by mice might reflect the formation of compulsive behavior. The results show that tipepidine reduced MBB in a dose-dependent manner. The effect of tipepidine was significant even at a dosage as small as 5 mg/kg. The tipepidine at 10 mg/kg s.c. nearly abolished MBB without reducing the locomotor activity in mice. It is particularly interesting that the dopamine D₂ antagonist or 5-HT(1A) antagonist partly inhibited the effect of tipepidine on MBB. The results suggest that tipepidine has more of a potent inhibitory effect on MBB, compared with known drugs used for the treatment of OCD, and that the tipepidine action mechanism might differ from that of known drugs.

Topics: Analysis of Variance; Animals; Behavior, Animal; Compulsive Behavior; Disease Models, Animal; Dose-Response Relationship, Drug; Male; Mice; Motor Activity; Piperidines

Several antidepressants have been used to treat severe pain in clinics. Recently, we reported that the centrally acting non-narcotic antitussive (cough suppressant drug), tipepidine produces an antidepressant-like effect in the forced swimming test, although the mechanism of action appears to be quite different from that of known antidepressants. In the present study, we investigated whether a combination of tipepidine and carbamazepine acts synergistically to induce an antinociceptive effect in the acetic acid-induced writhing test in mice. Prior to studying the combination of tipepidine and carbamazepine, the analgesic action of tipepidine alone was also examined in mice. Tipepidine at 5-40mg/kg i.p. significantly reduced the number of writhes induced by acetic acid in mice. Carbamazepine at 20mg/kg i.p. also significantly reduced the writhing reaction. Furthermore, co-administration of carbamazepine (5 and 10mg/kg, i.p.) and tipepidine (2.5mg/kg i.p.) significantly decreased the number of writhes induced by acetic acid. This finding suggests that a combination of carbamazepine and tipepidine may be a new strategy for the treatment of neuropathic pain such as what occurs in trigeminal neuralgia, because the use of carbamazepine is often limited by its adverse effects and by reduction of its analgesic efficacy by microsomal enzyme induction.

Topics: Acetates; Analgesics; Animals; Behavior, Animal; Carbamazepine; Drug Synergism; Male; Mice; Piperidines

Topics: Antitussive Agents; Child, Preschool; Delirium; Drug Overdose; Humans; Male; Piperidines

Topics: Antitussive Agents; Child; Drug Eruptions; Erythema; Humans; Japan; Male; Piperidines

The antidepressant-like effect of tipepidine was studied in rats. Tipepidine at 20 and 40 mg/kg i.p. reduced immobility in the forced swimming test and tipepidine at 40 mg/kg, i.p. increased climbing in the test. The drug at 40 mg/kg, i.p. had no effect on the locomotor activity and motor coordination. These results suggest that tipepidine may be a novel drug with antidepressant-like activity.

Topics: Analysis of Variance; Animals; Antidepressive Agents; Depression; Disease Models, Animal; Dose-Response Relationship, Drug; Locomotion; Male; Motor Activity; Neuropsychological Tests; Piperidines; Rats; Rats, Wistar; Swimming; Time Factors

Elderly people, children and patients sometimes have difficulties swallowing tablets. To solve this problem, a novel method of preparing tablets that disintegrate rapidly in the mouth was developed. A tablet with high porosity is required for rapid disintegration, but such a tablet is generally fragile. To make a tablet having both high porosity and practical strength, amorphous sucrose, which has good compactability, was used. Mannitol powder with freeze-dried amorphous sucrose was tableted at low compression and stored under certain conditions. The tablet disintegrated rapidly in the mouth, because of its high porosity. The tensile strength of the tablet increased remarkably during storage, while the porosity of the tablet seemed almost unchanged. The results of thermal analysis and powder x-ray diffraction measurement showed that the amorphous sucrose in tablet crystallized during storage. The increase in the tensile strength of the tablet was due to crystallization of the amorphous sucrose and formation of new internal contact points in the tablet. It was concluded that this crystalline transition method is a very useful method to prepare a rapidly disintegrating tablet.

Topics: Administration, Oral; Chemistry, Pharmaceutical; Crystallization; Freeze Drying; Humans; Mannitol; Mouth; Piperidines; Porosity; Solubility; Sucrose; Tablets; Technology, Pharmaceutical; Tensile Strength

We have examined the actions of non-narcotic antitussive drugs on the response evoked by electrical field stimulation or by acetylcholine (ACh) and neurokinin A (NKA) on guinea-pig bronchial strip chain. Electrical field stimulation (1-32 Hz, 0.5 ms, 30 V for 5 s) evoked a biphasic contraction in a frequency-dependent manner, consisting of a cholinergically mediated fast contraction followed by a non-cholinergically mediated slow contraction. Dextromethorphan (1-300 microM) and tipepidine (0.1-100 microM) caused a concentration-dependent inhibition in the height of the biphasic contraction, but noscapine (1-300 microM) was less effective. Submaximal contractions of bronchial muscle evoked by exogenous ACh (1-30 microM) were inhibited by tipepidine (10-100 microM), but not by dextromethorphan (10-100 microM) or noscapine (10-100 microM), while those evoked by exogenous NKA (10-300 nM) were augmented by these drugs. The results indicate that in guinea-pig isolated bronchial muscle, dextromethorphan inhibited both neurally-mediated responses but not those to the exogenously applied agent. Tipepidine caused an inhibition similar to the non-cholinergically mediated response of dextromethorphan, it also caused a more profound inhibition of the cholinergically mediated response and selectively antagonized ACh. Noscapine had no effect.

Topics: Animals; Antitussive Agents; Bronchi; Dextromethorphan; Electric Stimulation; Guinea Pigs; In Vitro Techniques; Male; Muscle Contraction; Muscle, Smooth; Noscapine; Parasympathetic Nervous System; Piperidines

In order to elucidate the interaction between cyproheptadine (CPH) and tipepidine (TP), the disposition of CPH and its metabolites from plasma and the hepatic drug metabolizing enzyme activities in rats dosed singly or repeatedly were investigated. The elimination of CPH and its metabolites, desmethylCPH (DMCPH) and DMCPH-epoxide (DMCPHEPO), from plasma after a single intravenous (i.v.) administration of both CPH and TP was not significantly altered compared with that after CPH alone, although the i.v. administration of DMCPH and TP enhanced the plasma levels of DMCPHEPO. The elimination of TP from plasma was not affected by the coadministration with CPH. The single oral administration of both CPH and TP (50 mg/kg) significantly enhanced the plasma levels of CPH and DMCPH compared with those after CPH alone, consequently resulting in their delayed elimination. However, the coadministration with TP at a low dose (5 mg/kg) hardly affected the plasma decay of CPH and its metabolites. The repeated dosing of them for 7 d obscured the interactive effect. The hepatic drug-metabolizing enzyme activities, cytochrome P-450 and aminopyrine demethylase activity, were greatly increased after the repeated administration of CPH, especially showing much more increased activities after the coadministration with TP. These results suggest that the competition of hepatic oxidative metabolism between CPH or its metabolites and TP based on the depletion of the enzymes might largely be involved in the drug interaction on a single dosing of them and that the repeated dosing of them would dissolve the depletion due to their strongly inductive effect.

Topics: Administration, Oral; Aminopyrine N-Demethylase; Animals; Blood; Cyproheptadine; Cytochrome P-450 Enzyme System; Drug Interactions; Enzyme Induction; Injections, Intravenous; Male; Microsomes, Liver; Piperidines; Rats; Rats, Inbred Strains

Topics: Adult; Electroencephalography; Female; Humans; Piperidines; Seizures

Topics: Akathisia, Drug-Induced; Child, Preschool; Diazepam; Female; Humans; Medication Errors; Piperidines; Psychomotor Agitation