Enantiomers' potential in psychopharmacology-a critical analysis with special emphasis on the antidepressant escitalopram
by
Baumann P, Zullino D, Eap C.
Departement Universitaire de Psychiatrie Adulte,
Unite de Biochimie et Psychopharmacologie Clinique,
Hopitalde Cery, CH-1008, Prilly-Lausanne, Switzerland
Eur Neuropsychopharmacol 2002 Oct;12(5):433

ABSTRACT

Stereochemistry is now influencing most areas of pharmacotherapy, with a growing awareness in the field of psychiatry and, more specifically, depression. This is due to the fact that the enantiomers of many chiral drugs may have distinct pharmacological, pharmacokinetic and/or pharmacogenetic profiles. Consequently, in some instances there may be an advantage in using a single enantiomer over the racemic form-thus providing a basis for the development of new therapeutic agents, as well as the potential to improve current treatments. This review highlights some of the potential advantages and disadvantages that using single enantiomers might offer. The principles are exemplified through reference to the stereoselective properties of several established chiral psychotropic drugs, including thioridazine, methadone, trimipramine, mianserin, mirtazapine, fluoxetine and citalopram. Emphasis is given to the treatment of depression and how the potential of one pure enantiomer-escitalopram, the S-enantiomer of the selective serotonin reuptake inhibitor citalopram-appears to be fulfilling its preclinical promise in the clinic.

Review
Neurogenesis
Escitalopram (Lexapro)
Citalopram and ecstasy
Long-term escitalopram
SSRIs and panic disorder
Citalopram and selegiline
Citalopram v amitriptyline
Citalopram and depression
Citalopram and panic disorder
Serotonin and romantic lovers
Escitalopram (Lexapro): profile
Big Pharma meets Madison Avenue
New antidepressants: escitalopram (Lexapro)
Escitalopram in the treatment of panic disorder
Single isomer SSRI escitalopram as an antidepressant
Escitalopram (Lexapro): mechanism of antidepressant action

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