Strategically replacing hydrogen with deuterium at sites of metabolism in small molecule drugs can significantly alter clearance and potentially enhance clinical safety. Bupropion is an antidepressant and smoking cessation medication with the potential to cause seizures. We hypothesized that incorporating deuterium at specific sites in bupropion may greatly reduce epimerization, potentially slow metabolism, and reduce the formation of toxic metabolites, namely hydroxybupropion which has been associated with bupropion's toxicity. Four deuterated analogues were synthesized incorporating deuterium at sites of metabolism and epimerization with the aim of altering the metabolic profile of bupropion. Spectroscopic binding and metabolism studies with bupropion and R-or S-d4 and R-or S-d10 analogs were performed with recombinant CYP2B6, human liver microsomes, and human hepatocytes. Results demonstrate that deuterated bupropion analogues exhibited 20-25% decrease in racemization and displayed a significant decrease in the formation of CYP2B6-mediated R,R - or S,S-hydroxybupropion with recombinant protein and human liver microsomes. In primary human hepatocytes, metabolism of deuterated analogs to R,R - and S,S-hydroxybupropion and threo- and erythro-hydrobupropion was significantly less than R/S-d0 bupropion. Selective deuterium substitution at metabolic soft spots in bupropion has the potential to provide a drug with a simplified pharmacokinetic profile, reduced toxicity and improved tolerability in patients.
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http://dx.doi.org/10.1016/j.bmcl.2022.129009 | DOI Listing |
Clin Ther
January 2025
Department of Pharmacology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia. Electronic address:
Purpose: This systematic review was conducted to determine which type of oral medication for obesity provides the best weight loss effect.
Methods: This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guideline. For this systematic review, we used 3 databases for journal searches: PubMed, ScienceDirect, and Scopus.
Cureus
December 2024
Ernest Mario School of Pharmacy, Rutgers University, Piscataway, USA.
Objective: Patients with major depressive disorder (MDD) often face poor health outcomes. Additionally, patients with multiple hospitalizations tend to have worse predicted disease prognosis. Antidepressant medications remain a first-line treatment option for MDD, but data evaluating the effects of different antidepressants on psychiatric readmission rates is lacking.
View Article and Find Full Text PDFFront Neurol
January 2025
Department of Public Health, Atish Dipankar University of Science and Technology, Dhaka, Bangladesh.
Introduction: Restless Legs Syndrome (RLS), also known as Willis-Ekbom Disease (WED), is a sensorimotor disorder characterized by an uncontrollable urge to move the legs, typically accompanied by discomfort. Low iron levels, pregnancy, and age are some identified risk factors. RLS is treated using various pharmacological options, including dopamine agonists, benzodiazepines, anticonvulsants, opioids, and bupropion.
View Article and Find Full Text PDFJ Comp Eff Res
January 2025
Dorn Research Institute, Columbia VA Health Care System, Columbia, SC, USA.
To compare the safety and efficacy of antidepressants (AD) among older adults with major depressive disorder (MDD) by assessing treatment change, augmentation and hospitalization rates. This retrospective study analyzed data from the Veterans Affairs (VA) database, including 142,138 patients aged ≥60 years diagnosed with MDD. Patients prescribed bupropion, citalopram, duloxetine, escitalopram, fluoxetine, mirtazapine, paroxetine, sertraline, or venlafaxine were included.
View Article and Find Full Text PDFSwiss Med Wkly
November 2024
Department of Medicine, University of California at San Francisco, San Francisco, CA, USA.
Cigarette smoking remains an enormous public health problem causing millions of preventable deaths annually worldwide. Although safe and efficient smoking cessation pharmacotherapies such as nicotine replacement products and the medications varenicline and bupropion are available, long-term abstinence rates remain low and new approaches to help smokers successfully quit smoking are needed. In recent years, electronic nicotine delivery systems such as e-cigarettes and heated-tobacco products, and novel smokeless nicotine delivery products like nicotine pouches have gained widespread popularity.
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