Dibenzepin: Difference between revisions

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Updating {{drugbox}} (no changed fields - added verified revid - updated 'DrugBank_Ref', 'ChEMBL_Ref', 'ChEBI_Ref', 'DrugBank_Ref', 'ChEBI_Ref') per Chem/Drugbox validation (report [[Wikipedia ta
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{{Short description|Chemical compound}}
{{Drugbox
{{Infobox drug
| verifiedrevid = 445384837
| Verifiedfields = changed
| verifiedrevid = 447436237
| IUPAC_name = 10-(2-(dimethylamino)ethyl)-5-methyl-5''H''-dibenzo[''b,e''][1,4]diazepin-11(10''H'')-one
| IUPAC_name = 10-(2-(dimethylamino)ethyl)-5-methyl-5''H''-dibenzo[''b,e''][1,4]diazepin-11(10''H'')-one
| image = Dibenzepin.png
| image = Dibenzepin Structural Formula V1.svg
| alt = Skeletal formula of dibenzepin
| width = 190
| image2 = Dibenzepin 3D spacefill.png
| alt2 = Space-filling model of the dibenzepin molecule


<!--Clinical data-->
<!--Clinical data-->
| tradename =
| tradename = Noveril, Anslopax, Deprex, Ecatril, Neodit, Victoril
| Drugs.com = {{drugs.com|international|dibenzepin}}
| Drugs.com = {{drugs.com|international|dibenzepin}}
| pregnancy_category =
| pregnancy_category =
| legal_AU = <!-- Unscheduled / S2 / S3 / S4 / S5 / S6 / S7 / S8 / S9 -->
| legal_BR = C1
| legal_BR_comment = <ref>{{Cite web |author=Anvisa |author-link=Brazilian Health Regulatory Agency |date=2023-03-31 |title=RDC Nº 784 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial |trans-title=Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control|url=https://www.in.gov.br/en/web/dou/-/resolucao-rdc-n-784-de-31-de-marco-de-2023-474904992 |url-status=live |archive-url=https://web.archive.org/web/20230803143925/https://www.in.gov.br/en/web/dou/-/resolucao-rdc-n-784-de-31-de-marco-de-2023-474904992 |archive-date=2023-08-03 |access-date=2023-08-16 |publisher=[[Diário Oficial da União]] |language=pt-BR |publication-date=2023-04-04}}</ref>
| legal_CA = <!-- / Schedule I, II, III, IV, V, VI, VII, VIII -->
| legal_DE = <!-- Anlage I, II, III or Unscheduled -->
| legal_NZ = <!-- Class A, B, C -->
| legal_UK = <!-- GSL / P / POM / CD / Class A, B, C -->
| legal_US = <!-- OTC / Rx-only / Schedule I, II, III, IV, V -->
| legal_EU =
| legal_UN = <!-- N I, II, III, IV / P I, II, III, IV -->
| legal_status = Rx-only
| legal_status = Rx-only
| routes_of_administration = [[oral administration|Oral]]
| routes_of_administration = [[oral administration|Oral]]


<!--Pharmacokinetic data-->
<!--Pharmacokinetic data-->
| bioavailability = 25% (Oral)
| bioavailability = 25%
| protein_bound = 80%
| protein_bound = 80%
| metabolism = [[Hepatic]]
| metabolism = [[Hepatic]]
| elimination_half-life = 5 hours
| elimination_half-life = 5 hours
| excretion = [[Urine]] (80%), [[Feces]] (20%)
| excretion = [[Urine]] (80%), [[feces]] (20%)


<!--Identifiers-->
<!--Identifiers-->
| CAS_number_Ref = {{cascite|correct|??}}
| CAS_number = 4498-32-2
| CAS_number = 4498-32-2
| ATC_prefix = N06
| ATC_prefix = N06
Line 25: Line 42:
| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
| ChemSpiderID = 9048
| ChemSpiderID = 9048
| ChEMBL_Ref = {{ebicite|changed|EBI}}
| ChEMBL = 1442422
| UNII_Ref = {{fdacite|correct|FDA}}
| UNII_Ref = {{fdacite|correct|FDA}}
| UNII = 510SJZ1Y6L
| UNII = 510SJZ1Y6L
Line 32: Line 51:
<!--Chemical data-->
<!--Chemical data-->
| C=18 | H=21 | N=3 | O=1
| C=18 | H=21 | N=3 | O=1
| SMILES = O=C2c1c(cccc1)N(c3c(N2CCN(C)C)cccc3)C
| molecular_weight = 295.379 g/mol
| smiles = O=C2c1c(cccc1)N(c3c(N2CCN(C)C)cccc3)C
| InChI = 1/C18H21N3O/c1-19(2)12-13-21-17-11-7-6-10-16(17)20(3)15-9-5-4-8-14(15)18(21)22/h4-11H,12-13H2,1-3H3
| InChIKey = QPGGEKPRGVJKQB-UHFFFAOYAT
| StdInChI_Ref = {{stdinchicite|correct|chemspider}}
| StdInChI_Ref = {{stdinchicite|correct|chemspider}}
| StdInChI = 1S/C18H21N3O/c1-19(2)12-13-21-17-11-7-6-10-16(17)20(3)15-9-5-4-8-14(15)18(21)22/h4-11H,12-13H2,1-3H3
| StdInChI = 1S/C18H21N3O/c1-19(2)12-13-21-17-11-7-6-10-16(17)20(3)15-9-5-4-8-14(15)18(21)22/h4-11H,12-13H2,1-3H3
Line 42: Line 58:
}}
}}


'''Dibenzepin''' ('''Noveril''', '''Anslopax''', '''Deprex''', '''Ecatril''', '''Neodit''', '''Victoril''') is a [[tricyclic antidepressant]] (TCA) used widely throughout [[Europe]] for the treatment of [[major depressive disorder|depression]].<ref name="isbn3-88763-075-0">{{cite book | author = Swiss Pharmaceutical Society | title = Index Nominum 2000: International Drug Directory (Book with CD-ROM) | publisher = Medpharm Scientific Publishers | location = Boca Raton | year = 2000 | pages = | isbn = 3-88763-075-0 | oclc = | doi = | url = http://books.google.com/books?id=5GpcTQD_L2oC&lpg=PA323&dq=dibenzepin&as_brr=3&pg=PA323#v=onepage&q=&f=false}}</ref><ref name="isbn0-8155-1144-2">{{cite book | author = Sittig, Marshall | title = Pharmaceutical manufacturing encyclopedia | publisher = Noyes Publications | location = Park Ridge, N.J., U.S.A | year = 1988 | pages = | isbn = 0-8155-1144-2 | oclc = | doi = | url = http://books.google.com/books?id=X2EyLsG4bcUC&lpg=PA470&dq=dibenzepin&as_brr=3&pg=PA470#v=onepage&q=&f=false}}</ref><ref name="pmid1687987">{{cite journal | author = Beresewicz M, Bidzińska E, Koszewska I, Puzyński S | title = [Results of using tricyclic antidepressive drugs in the treatment of endogenous depression (comparative analysis of 7 drugs)] | language = Polish | journal = Psychiatria Polska | volume = 25 | issue = 3-4 | pages = 13–8 | year = 1991 | pmid = 1687987 | doi = | url = }}</ref> It has similar efficacy and effects relative to other TCAs like [[imipramine]] but with fewer [[side effect]]s.<ref name="urlwww.health.gov.il">{{cite web | url = http://www.health.gov.il/units/pharmacy/trufot/alonim/2107.pdf | title = Novartis (dibenzepin) - Prescribing Information}}</ref><ref name="isbn1-4200-4479-6">{{cite book | author = Paloucek, Frank P.; Leikin, Jerrold B. | title = Poisoning and Toxicology Handbook, Fourth Edition (Poisoning and Toxicology Handbook (Leiken & Paloucek's)) | publisher = Informa Healthcare | location = | year = 2007 | pages = | isbn = 1-4200-4479-6 | oclc = | doi = | url = http://books.google.com/books?id=0Bw2UJTC_uMC&lpg=PA242&dq=dibenzepin&lr=lang_en&as_drrb_is=q&as_minm_is=0&as_miny_is=&as_maxm_is=0&as_maxy_is=&as_brr=3&pg=PA242#v=onepage&q=&f=false}}</ref><ref name="pmid6928">{{cite journal | author = Gowardman M, Brown RA | title = Dibenzepin and amitriptyline in depressive states: comparative double-blind trial | journal = The New Zealand Medical Journal | volume = 83 | issue = 560 | pages = 194–7 | year = 1976 | month = March | pmid = 6928 | doi = | url = }}</ref><ref name="pmid8749">{{cite journal | author = Baron DP, Unger HR, Williams HE, Knight RG | title = A double blind study of the antidepressants dibenzepin (Noveril) and amitriptyline | journal = The New Zealand Medical Journal | volume = 83 | issue = 562 | pages = 273–4 | year = 1976 | month = April | pmid = 8749 | doi = | url = }}</ref> Dibenzepin acts as a [[norepinephrine reuptake inhibitor]], potent [[antihistamine]], and weak [[anticholinergic]].<ref name="urlwww.health.gov.il">{{cite web | url = http://www.health.gov.il/units/pharmacy/trufot/alonim/2107.pdf | title = Novartis (dibenzepin) - Prescribing Information}}</ref><ref name="isbn1-4200-4479-6">{{cite book | author = Paloucek, Frank P.; Leikin, Jerrold B. | title = Poisoning and Toxicology Handbook, Fourth Edition (Poisoning and Toxicology Handbook (Leiken & Paloucek's)) | publisher = Informa Healthcare | location = | year = 2007 | pages = | isbn = 1-4200-4479-6 | oclc = | doi = | url = http://books.google.com/books?id=0Bw2UJTC_uMC&lpg=PA242&dq=dibenzepin&lr=lang_en&as_drrb_is=q&as_minm_is=0&as_miny_is=&as_maxm_is=0&as_maxy_is=&as_brr=3&pg=PA242#v=onepage&q=&f=false}}</ref><ref name="pmid20647">{{cite journal | author = Rehavi M, Maayani S, Goldstein L, Assael M, Sokolovsky M | title = Antimuscarinic properties of antidepressants: dibenzepin (Noveril) | journal = Psychopharmacology | volume = 54 | issue = 1 | pages = 35–8 | year = 1977 | month = August | pmid = 20647 | doi = 10.1007/BF00426538| url = }}</ref> It lacks any [[5-HT2 receptor|5-HT<sub>2</sub>]] [[receptor antagonist|antagonistic]] properties.<ref name="pmid6148707">{{cite journal | author = Closse A, Jaton AL | title = Investigation of the influence of lithium upon the down-regulation of serotonin2 receptors in rat frontal cortex induced by long-term treatment with dibenzepin, an antidepressant without appreciable affinity to serotonin2 receptors | journal = Naunyn-Schmiedeberg's Archives of Pharmacology | volume = 326 | issue = 4 | pages = 291–3 | year = 1984 | month = July | pmid = 6148707 | doi = | url = }}</ref>
'''Dibenzepin''', sold under the brand name '''Noveril''' among others, is a [[tricyclic antidepressant]] (TCA) used widely throughout [[Europe]] for the treatment of [[major depressive disorder|depression]].<ref name="isbn3-88763-075-0">{{cite book | author = Swiss Pharmaceutical Society | title = Index Nominum 2000: International Drug Directory (Book with CD-ROM) | publisher = Medpharm Scientific Publishers | location = Boca Raton | year = 2000 | isbn = 3-88763-075-0 | url = https://books.google.com/books?id=5GpcTQD_L2oC&q=dibenzepin&pg=PA323}}</ref><ref name="isbn0-8155-1144-2">{{cite book | vauthors = Sittig M | title = Pharmaceutical manufacturing encyclopedia | publisher = Noyes Publications | location = Park Ridge, N.J., U.S.A | year = 1988 | isbn = 0-8155-1144-2 | url = https://books.google.com/books?id=X2EyLsG4bcUC&q=dibenzepin&pg=PA470 }}</ref><ref name="pmid1687987">{{cite journal | vauthors = Beresewicz M, Bidzińska E, Koszewska I, Puzyński S | title = [Results of using tricyclic antidepressive drugs in the treatment of endogenous depression (comparative analysis of 7 drugs)] | language = pl | journal = Psychiatria Polska | volume = 25 | issue = 3–4 | pages = 13–8 | year = 1991 | pmid = 1687987 }}</ref> It has similar efficacy and effects relative to other TCAs like [[imipramine]] but with fewer [[side effect]]s.<ref name="urlwww.health.gov.il">{{cite web | url = http://www.health.gov.il/units/pharmacy/trufot/alonim/2107.pdf | title = Novartis (dibenzepin) - Prescribing Information}}</ref><ref name="isbn1-4200-4479-6">{{cite book | vauthors = Paloucek FP, Leikin JB | title = Poisoning and Toxicology Handbook, Fourth Edition (Poisoning and Toxicology Handbook (Leiken & Paloucek's)) | publisher = Informa Healthcare | year = 2007 | isbn = 978-1-4200-4479-9 | url = https://books.google.com/books?id=0Bw2UJTC_uMC&q=dibenzepin&pg=PA242}}</ref><ref name="pmid6928">{{cite journal | vauthors = Gowardman M, Brown RA | title = Dibenzepin and amitriptyline in depressive states: comparative double-blind trial | journal = The New Zealand Medical Journal | volume = 83 | issue = 560 | pages = 194–7 |date=March 1976 | pmid = 6928 }}</ref><ref name="pmid8749">{{cite journal | vauthors = Baron DP, Unger HR, Williams HE, Knight RG | title = A double blind study of the antidepressants dibenzepin (Noveril) and amitriptyline | journal = The New Zealand Medical Journal | volume = 83 | issue = 562 | pages = 273–4 |date=April 1976 | pmid = 8749 }}</ref>


== See also ==
==Medical uses==
Dibenzepin is used mainly in the treatment of [[major depressive disorder]].
* [[Tricyclic antidepressant]]


Like other TCAs, dibenzepin may have potential use in the treatment of chronic [[neuropathic pain]].
== References ==
{{Reflist}}


==Overdose==
== External links ==
{{Main|Tricyclic antidepressant overdose}}
* {{cite web | url = http://www.health.gov.il/units/pharmacy/trufot/alonim/2107.pdf | title = Novartis - Noveral (dibenzepin) - Prescribing Information}}


As TCAs have a relatively narrow therapeutic index, the likelihood of [[overdose]] (both accidental and intentional) is fairly high and should be considered carefully by the prescribing physician prior to patient use. Symptoms of overdose are similar to those of other TCAs, with cardiac toxicity (due to inhibition of sodium and calcium channels) generally occurring before the threshold for [[serotonin syndrome]] is reached. Due to this risk, TCAs are rarely selected as the first-line treatment for depression.

==Pharmacology==

===Pharmacodynamics===
{{See also|Pharmacology of antidepressants|Tricyclic antidepressant#Binding profiles}}
{| class="wikitable floatleft"
|+ Dibenzepin<ref name="PDSP">{{cite web | title = PDSP K<sub>i</sub> Database | work = Psychoactive Drug Screening Program (PDSP) | vauthors = [[Bryan Roth|Roth BL]], Driscol J | publisher = University of North Carolina at Chapel Hill and the United States National Institute of Mental Health | access-date = 14 August 2017 | url = https://kidbdev.med.unc.edu/databases/pdsp.php?knowID=0&kiKey=&receptorDD=&receptor=&speciesDD=&species=&sourcesDD=&source=&hotLigandDD=&hotLigand=&testLigandDD=&testFreeRadio=testFreeRadio&testLigand=dibenzepin&referenceDD=&reference=&KiGreater=&KiLess=&kiAllRadio=all&doQuery=Submit+Query}}</ref>
|-
! Site !! K<sub>i</sub> (nM) !! Species !! Ref
|-
| {{abbrlink|SERT|Serotonin transporter}} || {{abbr|ND|No data}} || {{abbr|ND|No data}} || {{abbr|ND|No data}}
|-
| '''{{abbrlink|NET|Norepinephrine transporter}}''' || '''{{abbr|ND|No data}}''' || '''{{abbr|ND|No data}}''' || <ref name="pmid1161046" />
|-
| {{abbrlink|DAT|Dopamine transporter}} || >100,000 || Rat || <ref name="pmid656154">{{cite journal | vauthors = Hyttel J | title = Inhibition of [3H]dopamine accumulation in rat striatal synaptosomes by psychotropic drugs | journal = Biochem. Pharmacol. | volume = 27 | issue = 7 | pages = 1063–8 | year = 1978 | pmid = 656154 | doi = 10.1016/0006-2952(78)90159-4}}</ref>
|-
| [[5-HT1A receptor|5-HT<sub>1A</sub>]] || >10,000 || Rat || <ref name="pmid6148707">{{cite journal | vauthors = Closse A, Jaton AL | title = Investigation of the influence of lithium upon the down-regulation of serotonin2 receptors in rat frontal cortex induced by long-term treatment with dibenzepin, an antidepressant without appreciable affinity to serotonin2 receptors | journal = Naunyn-Schmiedeberg's Arch. Pharmacol. | volume = 326 | issue = 4 | pages = 291–3 | year = 1984 | pmid = 6148707 | doi = 10.1007/bf00501432| s2cid = 24925602 }}</ref>
|-
| [[5-HT2A receptor|5-HT<sub>2A</sub>]] || ≥1,500 || Rat || <ref name="pmid6148707" />
|-
| [[5-HT2C receptor|5-HT<sub>2C</sub>]] || {{abbr|ND|No data}} || {{abbr|ND|No data}} || {{abbr|ND|No data}}
|-
| [[Alpha-1 adrenergic receptor|α<sub>1</sub>]] || >10,000 || Rat || <ref name="pmid6148707" />
|-
| [[Alpha-2 adrenergic receptor|α<sub>2</sub>]] || >10,000 || Rat || <ref name="pmid6148707" />
|-
| [[Dopamine receptor|DA]] || >10,000 || Bovine || <ref name="pmid6148707" />
|-
| '''[[Histamine H1 receptor|H<sub>1</sub>]]''' || '''23''' || '''Human''' || <ref name="pmid22033803">{{cite journal | vauthors = Appl H, Holzammer T, Dove S, Haen E, Strasser A, Seifert R | title = Interactions of recombinant human histamine H<sub>1</sub>R, H<sub>2</sub>R, H<sub>3</sub>R, and H<sub>4</sub>R receptors with 34 antidepressants and antipsychotics | journal = Naunyn-Schmiedeberg's Arch. Pharmacol. | volume = 385 | issue = 2 | pages = 145–70 | year = 2012 | pmid = 22033803 | doi = 10.1007/s00210-011-0704-0 | s2cid = 14274150 }}</ref>
|-
| [[Histamine H2 receptor|H<sub>2</sub>]] || 1,950 || Human || <ref name="pmid22033803" />
|-
| [[Histamine H3 receptor|H<sub>3</sub>]] || >100,000 || Human || <ref name="pmid22033803" />
|-
| [[Histamine H4 receptor|H<sub>4</sub>]] || >100,000 || Human || <ref name="pmid22033803" />
|-
| {{abbrlink|mACh|Muscarinic acetylcholine receptor}} || 1,750 || Rat || <ref name="pmid6148707" /><ref name="pmid20647">{{cite journal | vauthors = Rehavi M, Maayani S, Goldstein L, Assael M, Sokolovsky M | title = Antimuscarinic properties of antidepressants: dibenzepin (Noveril) | journal = Psychopharmacology | volume = 54 | issue = 1 | pages = 35–8 | year = 1977 | pmid = 20647 | doi = 10.1007/bf00426538| s2cid = 27031652 }}</ref>
|- class="sortbottom"
| colspan="4" style="width: 1px;" | Values are K<sub>i</sub> (nM). The smaller the value, the more strongly the drug binds to the site.
|}

Dibenzepin acts as a [[binding selectivity|selective]] [[norepinephrine reuptake inhibitor]] (NRI), with similar [[potency (pharmacology)|potency]] to that of [[imipramine]].<ref name="pmid1161046">{{cite journal | vauthors = Barth N, Manns M, Muscholl E | title = Arrhythmias and inhibition of noradrenaline uptake caused by tricyclic antidepressants and chlorpromazine on the isolated perfused rabbit heart | journal = Naunyn-Schmiedeberg's Arch. Pharmacol. | volume = 288 | issue = 2–3 | pages = 215–31 | year = 1975 | pmid = 1161046 | doi = 10.1007/bf00500528| s2cid = 11641400 }}</ref> It is also a potent [[antihistamine]].<ref name="pmid6148707" /><ref name="pmid22033803" /> The drug has weak or negligible effects on [[serotonin]] and [[dopamine]] [[reuptake]].<ref name="pmid12111448">{{cite journal | vauthors = Rao ML, Frahnert C, Zagorski O | title = Initial serotonin transport into viable platelets and imipramine binding to platelet membranes | journal = J Neural Transm (Vienna) | volume = 109 | issue = 5–6 | pages = 547–56 | year = 2002 | pmid = 12111448 | doi = 10.1007/s007020200045 | s2cid = 9703461 }}</ref><ref name="pmid656154" /> Unlike many other TCAs, dibenzepin has no [[antiadrenergic]] ([[alpha-1 adrenergic receptor|α<sub>1</sub>]], [[alpha-2 adrenergic receptor|α<sub>2</sub>]]), [[antiserotonergic]] ([[5-HT1A receptor|5-HT<sub>1A</sub>]], [[5-HT2 receptor|5-HT<sub>2A</sub>]]), or [[antidopaminergic]] effects and has few or no [[anticholinergic]] ({{abbrlink|mACh|muscarinic acetylcholine receptor}}) effects.<ref name="pmid6148707" /><ref name="pmid20647" />

===Pharmacokinetics===
Therapeutic levels of dibenzepin are approximately 85 to 850&nbsp;nM.<ref name="pmid22033803" /> Its [[plasma protein binding]] is approximately 80%.<ref name="Aldenhoff2007">{{cite book| vauthors = Aldenhoff J | chapter = Medikamente und andere Behandlungsverfahren |title=Psychiatrische Therapie | chapter-url = https://books.google.com/books?id=Ag8-W3IqG4wC&pg=PA270 |year=2007|publisher=Schattauer Verlag|isbn=978-3-7945-2189-0|pages=270–}}</ref>

==History==
Dibenzepin was first introduced, in [[Switzerland]] and [[West Germany]], in 1965.<ref name="isbn0-8155-1144-2" /> It was introduced in [[France]] in 1967, in [[Italy]] in 1968, in the [[United Kingdom]] in 1970, and in [[Japan]] in 1975.<ref name="isbn0-8155-1144-2" /> It was also marketed in a number of other countries, including [[Portugal]] and [[Israel]].<ref name="isbn0-8155-1144-2" />

==Society and culture==

===Brand names===
Dibenzepin is or was marketed mainly under the brand name Noveril.<ref name="isbn0-8155-1144-2" /> It has also been marketed under a number of other brand names, including Ansiopax, Deprex, Ecatril, Neodit, and Victoril.<ref name="isbn0-8155-1144-2" />

==References==
{{Reflist|30em}}

==External links==
* {{cite web | url = http://www.health.gov.il/units/pharmacy/trufot/alonim/2107.pdf | title = Novartis - Noveral (dibenzepin) - Prescribing Information}}


{{Antidepressants}}
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[[Category:Tricyclic antidepressants]]
[[Category:Dimethylamino compounds]]
[[Category:Dibenzodiazepines]]
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[[Category:H1 receptor antagonists]]
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[[Category:Tricyclic antidepressants]]
[[de:Dibenzepin]]
[[hu:Dibenzepin]]
[[pl:Dibenzepina]]