Tetrabenazine

(RR, SS) -1,3,4,6,7,11 b- hexahydro -9 ,10- dimethoxy- 3 - (2 -methylpropyl) -2H -benzo [ a] quinoline

  • C19H27NO3 ( tetrabenazine )
  • C19H27NO3 · HCl ( tetrabenazine · hydrochloride)
  • 58-46-8 ( tetrabenazine )
  • 2105-47-7 ( tetrabenazine · hydrochloride)

N07XX06

  • Insoluble in cold water ( tetrabenazine · hydrochloride)
  • Soluble in DMSO
  • Soluble in hot water, insoluble in acetone ( tetrabenazine )
  • Insoluble in ethanol, chloroform, tert -butyl methyl ether and diethyl ether

Attention

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Tetrabenazine is a drug which has been approved in Germany since 2007 and in Austria since 2010 for the treatment of Huntington's disease and moderate to severe tardive dyskinesia, and decreed even before that as a so -called orphan drug for the treatment of these and some other rare movement disorder was or is. In Germany, Denmark and Canada, it is marketed under the brand name Nitoman, Switzerland Xenazine sold. It was developed in the 1950s. Its action unfolds it on the promotion of early metabolic degradation of the neurotransmitter dopamine. More precisely, it empties the presynaptic dopamine storage.

Clinical Effects

Tetrabenazine is used to reduce hyperkinesia (particularly chorea and dystonia ). Here may be mentioned in particular:

  • Huntington's disease
  • Tourette's syndrome
  • Tardive dyskinesia ( tardive dyskinesia )
  • Hemiballism

The dose should be adjusted slowly einschleichend. Concomitant use of MAO inhibitors is contraindicated.

Pharmacology

Pharmacodynamics

Tetrabenazine ( TBZ abbreviation ) acts as a potent VMAT inhibitors. Of clinical significance is its ability to deplete the dopamine resources in the CNS, thus reducing its availability as a neurotransmitter in the synaptic cleft. In his VMAT inhibitierenden property TBZ similar to reserpine, although the mechanism of action in detail does not seem to be identical. The strongest affinity for VMAT, the stereoisomer (3R, 11bR )-configuration. TBZ additionally acts as an antagonist of dopamine receptors. 11C -labeled TBZ can be used as a PET radioligand.

Pharmacokinetics

TBZ is subject to an extensive first -pass effect. The active metabolite is the hydroxy- analogue dihydrotetrabenazine ( DTBZ ).

CAS registry number PubChem Anatomical Therapeutic Chemical Classification System Dangerous Substances Directive (67/548/EEC) Huntington's disease Potency (pharmacology) Molecular configuration Receptor antagonist
248244
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