Zimelidine
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| Image:Zimelidine.png | |
| Zimelidine
| |
| Systematic (IUPAC) name | |
| 3-(4-bromophenyl)-N,N-dimethyl-3-pyridin-3-yl-prop-2-en-1-amine | |
| Identifiers | |
| CAS number | 60525-15-7 (anhydrous dihydrochloride), 61129-30-4 (dihydrochloride monohydrate) |
| ATC code | N06 |
| PubChem | |
| Chemical data | |
| Formula | C16H17BrN2 |
| Mol. mass | 317.224 |
| Pharmacokinetic data | |
| Bioavailability | ? |
| Metabolism | ? |
| Half life | 8.4 +/- 2.0 hours (parent compound) 19.4 +/- 3.6 hours (norzimelidine) |
| Excretion | ? |
| Therapeutic considerations | |
| Pregnancy cat. |
? |
| Legal status |
Withdrawn from market |
| Routes | Oral |
Zimelidine (Normud®, Zelmid®) was the first marketed selective serotonin reuptake inhibitor (SSRI) antidepressant. It is a pyridylallylamine, structurally different from other antidepressants. The substance was developed in the early 1980s by the Swedish company Astra AB following a search for drugs with structures similar to chlorpheniramine (it is a derivative of Chlorphenamine), an antihistamine with antidepressant activity. It was then licensed to other drug producers.
Zimelidine has been banned worldwide due to serious, sometimes fatal, cases of central and/or peripheral neuropathy known as Guillain-Barré syndrome and due to a peculiar hypersensitivity reaction involving many organs including skin exanthema, flu-like symptoms, arthralgias, and sometimes eosinophilia. Additionally, zimelidine was charged to cause an increase in suicidal ideation and/or attempts among depressive patients. After its ban, it was succeeded by fluvoxamine and fluoxetine (derived from the antihistamine diphenhydramine) in that order, and the other SSRIs.
Mechanism of action
The mode of action is a strong reuptake inhibition of serotonin from the synaptic cleft. Postsynaptic receptors are not acted upon.
Other uses
Zimelidine was reported by Montplaisir and Godbout to be very effective for cataplexy in 1986, back when this was usually controlled by tricyclic antidepressants, which often had anticholinergic effects. Zimelidine was able to improve cataplexy without causing daytime sleepiness.
Side effects
Most often reported were:
- Dry mouth, dryness of pharyngeal and nasal membranes
- Increased sweating (hyperhidrosis)
- Vertigo
- Nausea
Interactions
- MAO inhibitors - severe or life-threatening reactions possible
Dosage
The former doses were 200 to 400mg daily in outpatients and up to 600mg in inpatients.
References
- PubChem Substance Summary: Zimelidine National Center for Biotechnology Information.
- Bruce G. Charlton, Self-management of psychiatric symptoms using over-the-counter (OTC) psychopharmacology: the S-DTM therapeutic model - self-diagnosis, self-treatment, self-monitoring. Medical Hypotheses 2005; 65: 823-828.
- ^ Caille G, Kouassi E, de Montigny C. (1986). "Pharmacokinetic study of zimelidine using a new GLC method". Clinical Pharmacokinetics 8 (6): 530-40. PMID 6228368.
- ^ Godbout R, Montplaisir J. (1986). "The effect of zimelidine, a serotonin-reuptake blocker, on cataplexy and daytime sleepiness of narcoleptic patients.". Clinical Neuropharmacology 9 (1): 46-51. PMID 2950994.
- ^ see Godbout et al. 1986
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Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
