A Multicenter Double-Blind Study of Three Different Doses of the New cAMP-Phosphodiesterase Inhibitor Rolipram in Patients with Major Depressive Disorder

Abstract

A multicenter randomized 4-week interindividual double-blind study was carried out in 58 hospitalized patients with major depressive disorder (DSM III 296.23,296.22,296.33,296.32,296.53 and 296.52) to test the dose-effect relationship of three different doses of the new cAMP-phosphodiesterase inhibitor rolipram: 3 × 0.25 mg, 3 × 0.50 mg and 3 × 1.00 mg rolipram/day. With respect to the desired effect, the 3 × 0.50 mg dosage stood out from the others in almost all relevant parameters. With respect to the response rate, the efficacy of the 3 × 0.25 mg dosage was about the same as that reported in the literature for placebo. The inferior performance of the 3 × 1.00 mg dosage compared to the 3 × 0.50 mg dosage might indicate a reverse U-shaped dose-effect relationship. There was good tolerance to all three dosages. There were no findings that might cast doubt on the safety of the dosages tested.

A whole genome association study of neuroticism using DNA pooling

“…A PDE4-specific inhibitor rolipram has antidepressant effects on animals and patients with major depression. [61][62][63] PDE4D knockout mice show antidepressant-like behavior, which is further increased by the antidepressants desipramine and fluoxetine but not by rolipram. This suggests that the PDE4D subtype is an essential mediator of the antidepressant effects of rolipram.…”

The cyclic AMP phenotype of fragile X and autism

“…Through cAMP-mediated mechanisms, pharmacotherapy that inhibits PDE4 is prone to increase the transcription and function (Miller, Vogt et al 2002;Pace, Hu et al 2007) of reduced numbers of FX dendritic glucocorticoid receptors (Miyashiro, Beckel-Mitchener et al 2003) involved in hypothalamic-pituitaryadrenal (HPA) regulation (Hessl, Rivera et al 2004). A clinical trial of rolipram reported acceptable tolerance levels at clinically relevant doses (Fleischhacker, Hinterhuber et al 1992). In clinical and preclinical trials, the main human PDE4 inhibitor side effect, thought to be due to PDE4D activity (Robichaud, Savoie et al 2002;Robichaud, Stamatiou et al 2002;Conti, Richter et al 2003), is emesis at clinical doses while rats are more susceptible to toxic effects like arteriopathy.…”

Enhancing neuronal plasticity and cellular resilience to develop novel, improved therapeutics for Difficult-to-Treat depression

“…In the 1980s and early 1990s, a number of open (Zeller et al 1984) and controlled clinical trials (Bertolino et al 1988;Bobon et al 1988;Fleischhacker et al 1992;Hebenstreit et al 1989) demonstrated that rolipram, a specific inhibitor of the high-affinity cAMP PDE4, may have antidepressant efficacy in depressed patients. In addition, there is evidence that rolipram may have a faster onset of response compared with the standard antidepressants.…”