Progabide

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Progabide
Systematic (IUPAC) name
4-[(4-chlorophenyl)- (5-fluoro-2-hydroxy-phenyl)- methylidene]aminobutanamide
Identifiers
CAS number	62666-20-0
ATC code	N03 AG05
PubChem	5361323
DrugBank	APRD00072
Chemical data
Formula	C₁₇H₁₆N₂Cl F O₂
Mol. weight	334.772 g/mol
Pharmacokinetic data
Bioavailability	60%
Protein binding	95%
Metabolism	Hepatic
Half life	4 hours
Excretion	Renal
Therapeutic considerations
Pregnancy cat.	?
Legal status	Prescription only
Routes	Oral

Progabide (INN) (Gabrene®, Sanofi-Synthelabo) is an analog and prodrug of gamma-aminobutyric acid used in the treatment of epilepsy. It has agonistic activity at both the GABA_A and GABA_B receptors.

1 Uses
- 1.1 Approved
- 1.2 Unapproved/Off-Label/Investigational
2 References and End Notes

[edit] Uses

[edit] Approved

Progabide is approved in France for either monotherapy or adjunctive use in the treatment of epilepsy—specifically, generalized tonic-clonic, myoclonic, partial, and Lennox-Gastaut syndrome seizures—in both children and adults.^[1]

[edit] Unapproved/Off-Label/Investigational

Progabide has been investigated for many diseases besides epilepsy, including Parkinson's disease, schizophrenia, clinical depression, anxiety disorder and spasticity with various levels of success.

In 1979, Progabide's actions on dopamine are contradictory, decreasing dopamine release, dopamine receptor density and postsynaptic receptor responsivity to dopamine while reducing striatal cholinergic activity so as to increase dopaminergic effects.^[2] Bartholini and colleagues concluded that it was this that caused Parkinson's patients in human clinical trials to either see an improvement in their Parkinson's with a worsening of L-dopa dyskinesia or an improvement in dyskinesia but with sometimes aggravated Parkinson's symptoms.^[3] The cholinergic effect takes only a single injection to achieve in rats; when given with haloperidol, the development of tolerance to haloperidol's cataleptic effects did not develop.^[4] It was hoped that this would be effective for tardive dyskinesia. However, Soares, Rathbone and Deeks wrote in the 2004 issue of The Cochrane Database of Systematic Reviews that "Any possible benefits are likely to be outweighed by the adverse effects associated with their [GABAergic agents'] use."^[5]

In addition to being tested for antipsychotic-induced tardive dyskinesia, progabide was itself tested as an antipsychotic; as early as 1979, it was obvious that it was ineffective for psychosis.^[6] While progabide may have devoid of antipsychotic effects, it did have the effect in schizoaffective and hebephrenic patients of improving environmental responsiveness and social interactions.^[7]

[edit] References and End Notes

^ PROGABIDE Biam. 5 March 2001." (French)
^ Bartholini G, Scatton B, Zivkovic B, Lloyd KG. "GABA receptor agonists and extrapyramidal motor function: therapeutic implications for Parkinson's disease." Advances in Neurology. 1987;45:79-83. PMID 3030072
^ Bartholini G, Scatton B, Zivkovic B, Lloyd KG. "GABA receptor agonists and extrapyramidal motor function: therapeutic implications for Parkinson's disease." Advances in Neurology. 1987;45:79-83. PMID 3030072
^ Bartholini G., Scatton B, Zivkovic B. (1980). "Effect of the new gamma-aminobutyric acid agonist SL 76 002 on striatal acetylcholine: relation to neuroleptic-induced extrapyramidal alterations". Advances in Biochemical Psychopharmacology 24: 207-13. PubMed.
^ Soares, K, Rathbone J, Deeks J. (18 October 2004). "Gamma-aminobutyric acid agonists for neuroleptic-induced tardive dyskinesia". The Cochrane Database of Systematic Reviews (4). DOI:10.1002/14651858.CD000203.pub2.
^ Bartholini, G. (1979). "[Potential therapeutic activity of GABA-mimetic drugs in neuropsychiatry]". Schweizer Archiv fur Neurologie, Neurochirurgie und Psychiatrie = Archives suisses de neurologie, neurochirurgie et de psychiatrie 125 (2): 265-9. PubMed. (French)
^ Lloyd KG, Morselli PL, Depoortere H, Fournier V, Zivkovic B, Scatton B, Broekkamp C, Worms P, Bartholini G. (June 1983). "The potential use of GABA agonists in psychiatric disorders: evidence from studies with progabide in animal models and clinical trials". Pharmacology, Biochemistry, and Behavior 18 (6): 957-66. PubMed.