Alpidem

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Alpidem
160px
Clinical data
Routes of
administration
Oral
Pharmacokinetic data
ExcretionRenal
Identifiers
CAS Number
PubChem CID
E number{{#property:P628}}
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Chemical and physical data
FormulaC21H23Cl2N3O
Molar mass404.332 g/mol

Alpidem (Ananxyl®) is an anxiolytic drug from the imidazopyridine family, related to the more well known sleeping medication zolpidem. Unlike zolpidem however, alpidem does not produce sedative effects at normal doses, and is instead used specifically for the treatment of anxiety.[1][2]

Alpidem is a fairly recently introduced drug, and is not widely used. Alpidem acts selectively on the omega 1 (BZ1) receptor subtype, a benzodiazepine receptor.[3][4] However the chemical structure of alpidem is not related to that of the benzodiazepines, and alpidem is thus sometimes referred to as a nonbenzodiazepine.[5]


Indications

Alpidem is generally prescribed to patients with moderate to severe anxiety.[6] Most of these patients have exhibited either sensitivity or resistance to benzodiazepine therapy, and therefore switched to a non-benzodiazepine medication due to the reduced incidence of side effects relative to benzodiazepine drugs.[7][8] Alpidem produces little or no sedative or hypnotic action at normal doses but may produce sedation when used at a high dose, and only has anticonvulsant actions at much higher doses than those used clinically for the treatment of anxiety.[9]


Dangers

Alpidem was withdrawn from the market in most of the world following reports of severe liver damage caused by Ananxyl,[10][11] although other brands of alpidem may still be on sale in some countries.

See also

References

  1. Zivkovic B, Morel E, Joly D, Perrault G, Sanger DJ, Lloyd KG. Pharmacological and behavioral profile of alpidem as an anxiolytic. Synthelabo Recherche, L.E.R.S., Bagneux, France. 1990 May;23 Suppl 3:108-13. PMID 1974069
  2. Sanger DJ, Zivkovic B. Discriminative stimulus effects of alpidem, a new imidazopyridine anxiolytic. Synthelabo Recherche, Bagneux, France. 1994 Jan;113(3-4):395-403. PMID 7862851
  3. Langer SZ, Arbilla S, Benavides J, Scatton B. Zolpidem and alpidem: two imidazopyridines with selectivity for omega 1- and omega 3-receptor subtypes. Advances in Biochememical Psychopharmacology. 1990;46:61-72.
  4. Langer SZ, Arbilla S, Tan S, Lloyd KG, George P, Allen J, Wick AE. Selectivity for omega-receptor subtypes as a strategy for the development of anxiolytic drugs. Pharmacopsychiatry. 1990 May;23 Suppl 3:103-7.
  5. Diamond BI, Nguyen H, O'Neal E, Ochs R, Kaffeman M, Borison RL. A comparative study of alpidem, a nonbenzodiazepine, and lorazepam in patients with nonpsychotic anxiety. Psychopharmacology Bulletin. 1991;27(1):67-71.
  6. Kunovac JL, Stahl SM. Future directions in anxiolytic pharmacotherapy. Psychiatric Clinics of North America. 1995 Dec;18(4):895-909.
  7. Morton S, Lader M. Studies with alpidem in normal volunteers and anxious patients. Pharmacopsychiatry. 1990 May;23 Suppl 3:120-3.
  8. Frattola L, Garreau M, Piolti R, Bassi S, Albizzati MG, Borghi C, Morselli PL. Comparison of the efficacy, safety and withdrawal of alpidem and alprazolam in anxious patients. British Journal of Psychiatry. 1994 Jul;165(2):94-100.
  9. Zivkovic B, Morel E, Joly D, Perrault G, Sanger DJ, Lloyd KG. Pharmacological and behavioral profile of alpidem as an anxiolytic. Pharmacopsychiatry. 1990 May;23 Suppl 3:108-13.
  10. Baty V, Denis B, Goudot C, Bas V, Renkes P, Bigard MA, Boissel P, Gaucher P. Hepatitis induced by alpidem (Ananxyl). Four cases, one of them fatal. Gastroenterologie Clinique et Biologique. 1994;18(12):1129-31. (French).
  11. Ausset P, Malavialle P, Vallet A, Miremont G, Le Bail B, Dumas F, Saric J, Winnock S. Subfulminant hepatitis caused by alpidem and treated by liver transplantation. Gastroenterologie Clinique et Biologique. 1995 Feb;19(2):222-3. (French).



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