Etifoxine

From Wikipedia, the free encyclopedia
Jump to: navigation, search
Etifoxine
Etifoxine.svg
Etifoxine ball-and-stick.png
Systematic (IUPAC) name
6-Chloro-N-ethyl-4-methyl-4-phenyl-4H-benzo[d][1,3]oxazin-2-amine
Clinical data
AHFS/Drugs.com International Drug Names
Pregnancy
category
  • Not recommended. Crosses the placental barrier
Routes of
administration
Oral
Legal status
Legal status
  • US: Not FDA approved; unscheduled
Pharmacokinetic data
Bioavailability 90%
Metabolism Hepatic (no CYP450 interactions)[1]
Biological half-life 2 to 6 hours (etifoxine), 20 to 30 hours (active metabolite)[2]
Excretion Renal[1]
Identifiers
CAS Number 21715-46-8 YesY
ATC code N05BX03 (WHO)
PubChem CID 30768
IUPHAR/BPS 5468
DrugBank DB08986 N
ChemSpider 28547 YesY
UNII X24X82MX4X YesY
KEGG D07320 YesY
ChEMBL CHEMBL2106227 N
Chemical data
Formula C17H17ClN2O
Molar mass 300.782 g/mol
3D model (Jmol) Interactive image
 NYesY (what is this?)  (verify)

Etifoxine (INN,[3] also known as etafenoxine; trade name Stresam) is an anxiolytic and anticonvulsant drug[4][5] developed by Hoechst in the 1960s.[3] It is used in some countries for anxiety disorders.[6] It has similar effects to benzodiazepine drugs, but is structurally distinct and does not bind to the benzodiazepine receptor.[7] It is more effective than lorazepam as an anxiolytic, and has fewer side effects.[8] Etifoxine is not approved by the U.S. Food and Drug Administration or the European Medicines Agency.

Side effects[edit]

Etifoxine has been associated with acute liver injury.[1]

Mechanism of action[edit]

Unlike benzodiazepines, etifoxine appears to produce its anxiolytic effects by binding to β2 and β3 subunits of the GABAA receptor complex, and so is acting at a different target site to benzodiazepines, although the physiological effect that is produced is similar to that of benzodiazepines.[9] This difference in binding means that etifoxine can be used alongside benzodiazepines to potentiate their effects without competing for binding sites;[10] however, it also means that the effects of etifoxine are not reversed by the benzodiazepine antagonist flumazenil.[11]

References[edit]

  1. ^ a b c Mennecier D, Rimlinger H, Gidenne S, et al. (November 2003). "[Etifoxine chlorhydrate-induced acute hepatitis]". Gastroenterol. Clin. Biol. (in French). 27 (11): 1050–1. PMID 14732859. 
  2. ^ "Stresam PI" (PDF). Adcock Ingram. n.d. Retrieved 2008-08-30. [dead link]
  3. ^ a b U.S. Patent 3,725,404
  4. ^ Kruse HJ, Kuch H (1985). "Etifoxine: evaluation of its anticonvulsant profile in mice in comparison with sodium valproate, phenytoin and clobazam". Arzneimittelforschung. 35 (1): 133–135. 
  5. ^ The Merck Index, 12th Edition. 3910.
  6. ^ Girard C, Liu S, Cadepond F, Adams D, Lacroix C, Verleye M, Gillardin JM, Baulieu EE, Schumacher M, Schweizer-Groyer G (2008). "Etifoxine improves peripheral nerve regeneration and functional recovery". Proc Natl Acad Sci U S A. 105 (51): 20505–10. doi:10.1073/pnas.0811201106. 
  7. ^ Schlichter R, Rybalchenko V, Poisbeau P, Verleye M, Gillardin J (2000). "Modulation of GABAergic synaptic transmission by the non-benzodiazepine anxiolytic etifoxine". Neuropharmacology. 39 (9): 1523–35. doi:10.1016/s0028-3908(99)00253-1. 
  8. ^ Nguyen N, Fakra E, Pradel V, Jouve E, Alquier C, Le Guern ME, Micallef J, Blin O (2006). "Efficacy of etifoxine compared to lorazepam monotherapy in the treatment of patients with adjustment disorders with anxiety: a double-blind controlled study in general practice". Human Psychopharmacology. 21 (3): 139–49. 
  9. ^ Hamon A, Morel A, Hue B, Verleye M, Gillardin JM (2003). "The modulatory effects of the anxiolytic etifoxine on GABA(A) receptors are mediated by the beta subunit". Neuropharmacology. 45 (3): 293–303. doi:10.1016/s0028-3908(03)00187-4. 
  10. ^ Kruse HJ, Kuch H (1986). "Potentiation of clobazam's anticonvulsant activity by etifoxine, a non-benzodiazepine tranquilizer, in mice. Comparison studies with sodium valproate". Arzneimittelforschung. 36 (9): 1320–2. 
  11. ^ Verleye M, Schlichter R, Gillardin JM (1999). "Interactions of etifoxine with the chloride channel coupled to the GABA(A) receptor complex". Neuroreport. 10 (15): 3207–10. doi:10.1097/00001756-199910190-00015.