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Neuroprotection by NMDA Receptor Antagonists in a Variety of Neuropathologies

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Because of adverse reactions, early efforts to introduce high affinity competitive or use-dependent NMDA receptor antagonists into patients suffering from stroke, head trauma or epilepsy met with failure. Later it was discovered that both low affinity use-dependent NMDA receptor antagonists and compounds with selective affinity for the NR2B receptor subunit met the criteria for safe administration into patients. Furthermore, these low affinity antagonists exhibit significant mechanistic differences from their higher affinity counterparts. Success of the latter is attested to the ability of the following low affinity compounds to be marketed: 1) Cough suppressant - dextromethorphan (available for decades) 2) Parkinsons disease - amantadine, memantine and budipine 3) Dementia - memantine and 4) Epilepsy - felbamate. Moreover, Phase III clinical trials are ongoing with remacemide for epilepsy and Huntingtons disease and head trauma for HU-211. A host of compounds are or were under evaluation for the possible treatment of stroke, head trauma, hyperalgesia and various neurodegenerative disorders. Despite the fact that other drugs with associated NMDA receptor mechanisms have reached clinical status, this review focuses only on those competitive and use-dependent NMDA receptor antagonists that reached clinical trails. The ensuing discussions link the in vivo pharmacological investigations that led to the success / mistakes / failures for eventual testing of promising compounds in the clinic.

Keywords: CPPene; Dextromethorphan; Felbamate; MK801; NMDA Receptor; NR1 / NR2A receptor; Neuropathologies; STROKE PRECLINICAL; Selfotel; TRAUMATIC BRAIN INJURY (TBI); transient neuronal vacuoles

Document Type: Review Article


Publication date: September 1, 2001

More about this publication?
  • Current Drug Targets aims to cover the latest and most outstanding developments on the medicinal chemistry and pharmacology of molecular drug targets e.g. disease specific proteins, receptors, enzymes, genes. Each issue of the journal will be devoted to a single timely topic, with series of in-depth reviews, written by leaders in the field, covering a range of current topics on drug targets. These issues will be organized and led by a guest editor who is a recognized expert in the overall topic. As the discovery, identification, characterisation and validation of novel human drug targets for drug discovery continues to grow; this journal will be essential reading for all pharmaceutical scientists involved in drug discovery and development.

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