Journal
EXPERT OPINION ON PHARMACOTHERAPY
Volume 10, Issue 16, Pages 2709-2721Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1517/14656560903329102
Keywords
alcohol dependence; Alzheimer's disease; autism; cocaine dependence; epilepsy; hypertension; mecamylamine; mood disorders; nicotine dependence; nicotinic acetylcholine receptor; schizophrenia; smoking cessation; Tourette's syndrome
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Funding
- Canadian Institutes of Health Research Funding Source: Medline
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Mecamylamine (Inversine (R)), the first orally available anti hypertensive agent launched in the 1950s, is rarely used today for hypertension because of its widespread ganglionic side effects at anti hypertensive doses (25 - 90 mg/day). However, more recent clinical studies suggest that mecamylamine is effective at much lower doses for blocking the central and peripheral effects of nicotine. Pharmacologically, mecamylamine has been well characterized as a nonselective and noncompetitive antagonist of nicotinic acetylcholine receptors (nAChRs). Because mecamylamine easily crosses the blood - brain barrier at relatively low doses (2.5 - 10 mg), it has been used by several research groups over the past two decades investigating the role of central nAChRs in the etiology and treatment of various neuropsychiatric disorders, including addiction disorders, Tourette's syndrome, schizophrenia and various cognitive and mood disorders. Two independent Phase II clinical trials recently confirmed mecamylamine's hypothesized antidepressant activity and suggest that it may be effective as an augmentation pharmacotherapy for SSRI treatment resistant major depression. These areas of investigation for mecamylamine are reviewed and recommendations for future research directions are proposed.
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