Antimanic effects of verapamil

Aj, Giannini; Wl, Houser; Rh, Loiselle; Mc, Giannini; Wa, Price

doi:10.1176/ajp.141.12.1602

Cited by 118 publications

(2 citation statements)

References 7 publications

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“…Interestingly, clinical studies also examined three widely used antihypertensive medications with LTCC activity (verapamil, diltiazem, and nimodipine) for the treatment of BD. When verapamil was compared with lithium and placebo in the treatment of manic episodes, lithium and verapamil both had similar antimanic effects that were superior to placebo ( Giannini et al, 1984 ). However, subsequent studies with all three antihypertensive medications failed to replicate the antimanic efficacy of these agents over placebo ( Janicak et al, 1998 ; Keck et al, 2000 ).…”

Section: Calcium Channelsmentioning

confidence: 99%

Non-canonical pathways in the pathophysiology and therapeutics of bipolar disorder

Machado-Vieira,

Courtes,

Zarate

et al. 2023

Front. Neurosci.

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Bipolar disorder (BD) is characterized by extreme mood swings ranging from manic/hypomanic to depressive episodes. The severity, duration, and frequency of these episodes can vary widely between individuals, significantly impacting quality of life. Individuals with BD spend almost half their lives experiencing mood symptoms, especially depression, as well as associated clinical dimensions such as anhedonia, fatigue, suicidality, anxiety, and neurovegetative symptoms. Persistent mood symptoms have been associated with premature mortality, accelerated aging, and elevated prevalence of treatment-resistant depression. Recent efforts have expanded our understanding of the neurobiology of BD and the downstream targets that may help track clinical outcomes and drug development. However, as a polygenic disorder, the neurobiology of BD is complex and involves biological changes in several organelles and downstream targets (pre-, post-, and extra-synaptic), including mitochondrial dysfunction, oxidative stress, altered monoaminergic and glutamatergic systems, lower neurotrophic factor levels, and changes in immune-inflammatory systems. The field has thus moved toward identifying more precise neurobiological targets that, in turn, may help develop personalized approaches and more reliable biomarkers for treatment prediction. Diverse pharmacological and non-pharmacological approaches targeting neurobiological pathways other than neurotransmission have also been tested in mood disorders. This article reviews different neurobiological targets and pathophysiological findings in non-canonical pathways in BD that may offer opportunities to support drug development and identify new, clinically relevant biological mechanisms. These include: neuroinflammation; mitochondrial function; calcium channels; oxidative stress; the glycogen synthase kinase-3 (GSK3) pathway; protein kinase C (PKC); brain-derived neurotrophic factor (BDNF); histone deacetylase (HDAC); and the purinergic signaling pathway.

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Section: Calcium Channelsmentioning

confidence: 99%

Non-canonical pathways in the pathophysiology and therapeutics of bipolar disorder

Machado-Vieira,

Courtes,

Zarate

et al. 2023

Front. Neurosci.

View full text Add to dashboard Cite

show abstract

“…[17][18] In Veterinary Science, following surgery in rabbits the drug is used to prevent intra-abdominal adhesions [19][20][21] . In cell biology [22][23][24] the drug is used to study the P-Glycoprotein [25][26][27][28] and ABC transport protein functions [29][30][31][32] due to the inhibition of drug efflux pump proteins [33][34][35] . Verapamil Hydrochloride is a commonly prescribed medicine in India of about 20 million doses [36][37] and in the United States about 4 million doses per year.…”

Section: Introductionmentioning

confidence: 99%

Stable and Bio-Equivalent Formulation of Alginate Matrix-Based Verapamil Hydrochloride Extended-Release Tablets

Manohari¹,

Seshadri²,

Reddy³

et al. 2022

Int J Life Sci Pharm Res

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Verapamil Hydrochloride is indicated to control blood pressure in individuals due to postural and nocturnal–diurnal variations in the biological clock. The once-daily administration of Verapamil Hydrochloride is handy for patients to comply with the dosing regimen prescribed. This research aims to develop stable, bio-equivalent, cost-effective, and commercially feasible Verapamil Hydrochloride extended-release tablets, 120 mg, 180 mg and 240 mg. Inorder to achieve this aim, our objective was to explore a simple aqueous granulation involving conventional excipients viz. Sodium Alginate, Povidone, Microcrystalline Cellulose and Magnesium Stearate. The drug to polymer ratio of 1:1.35 was found to be optimum. Every unit operation involved in the process was completely optimized to achieve reproducibility and to avoid drug release variation. The designed process was scaled-up from a batch size of 75,000 tablets to 750,000 tablets. During scalability, no difference is observed in the physico-chemical characteristics of the blend or tablets. The blend and content uniformity results were found to comply with USP requirements. The manufactured product was found stable in bottle and strip packs at accelerated stability conditions for 6 months. The maximum level of the highest unknown impurity observed was 0.1% and is well within the ICH Q3BR3 requirements. Hence based on stability study results, shelf-life storage of 24 months at controlled room temperature was prescribed for the product. The end product was found to be more cost-effective (3.2 to 6.4 Indian rupees) than the brand product available nationally (within India) priced at 4.7 to 9 Indian rupees, and the physico-chemical characteristics, drug release, and stability of the manufactured drug product were comparable to the brand product available in the USA market. The similarity factor 'f2' was found to be more than 75. In the Pharmacokinetic study, the test to brand product ratio at 90% confidence interval was within 80.00-125.00%, exhibiting the developed product's bio-equivalence with the brand product. Novelty in this research is in the comprehensiveness of work done to demonstrate stability, bio-equivalence, cost-effectiveness and commercial ability aspects which were not reported elsewhere in the already published research work on Verapamil extended release tablets.

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Diltiazem-Induced Psychosis and a Possible Diltiazem-Lithium Interaction

et al. 1991

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Antimanic effects of verapamil

Abstract: When the authors compared the antimanic effects of verapamil, lithium carbonate, and placebo, no differences were seen between lithium and verapamil and both were more effective than placebo in reducing symptoms. No major side effects emerged during the study.

Cited by 118 publications

References 7 publications

Non-canonical pathways in the pathophysiology and therapeutics of bipolar disorder

Non-canonical pathways in the pathophysiology and therapeutics of bipolar disorder

Stable and Bio-Equivalent Formulation of Alginate Matrix-Based Verapamil Hydrochloride Extended-Release Tablets

Diltiazem-Induced Psychosis and a Possible Diltiazem-Lithium Interaction

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