Muscarinic agonists and antagonists in the treatment of Alzheimer's disease

• Published in: Farmaco (Società chimica italiana : 1989) 2001-04, Vol.56 (4), p.247-250
• Main Authors: Greenlee, W, Clader, J, Asberom, T, McCombie, S, Ford, J, Guzik, H, Kozlowski, J, Li, S, Liu, C, Lowe, D, Vice, S, Zhao, H, Zhou, G, Billard, W, Binch, H, Crosby, R, Duffy, R, Lachowicz, J, Coffin, V, Watkins, R, Ruperto, V, Strader, C, Taylor, L, Cox, K
• Format: Article
• Language: English
• Subjects: Alzheimer Disease - drug therapy; Alzheimer's disease; Animals; Biological and medical sciences; Cholinergic; Cholinergic system; Humans; M 2 Receptors; Medical sciences; Muscarinic; Muscarinic Agonists - chemistry; Muscarinic Agonists - therapeutic use; Muscarinic Antagonists - chemistry; Muscarinic Antagonists - therapeutic use; Neuropharmacology; Neurotransmitters. Neurotransmission. Receptors; Pharmacology. Drug treatments; Structure-Activity Relationship
• ISSN: 0014-827X; 1879-0569
• DOI: 10.1016/S0014-827X(01)01102-8

Alzheimer's disease (AD) is a neurodegenerative disease characterized by cognitive impairment and personality changes. The development of drugs for the treatment of the cognitive deficits of AD has focused on agents which counteract loss in cholinergic activity. Although symptoms of AD have been successfully treated with acetylcholinesterase inhibitors (tacrine, donepezil, rivastigmine, galanthamine), limited success has been achieved with direct M 1 agonists, probably due to their lack of selectivity versus other muscarinic receptor subtypes. Muscarinic M 2 antagonists have been reported to increase synaptic levels of acetylcholine after oral administration to rats (e.g. BIBN-99, SCH-57790), but their selectivity versus other muscarinic receptor subtypes is modest. Exploration of a series of piperidinylpiperidines has yielded the potent and selective M 2 antagonist SCH-217443. This antagonist has excellent bioavailability in rats and dogs and shows activity in a rat model of cognition.