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Other names | THIP; 4,5,6,7-tetrahydroisoxazolo(5,4-c)pyridin-3-ol; OV101; OV-101 |
Drug class | GABAA receptor agonist |
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ECHA InfoCard | 100.059.039 |
Chemical and physical data | |
Formula | C6H8N2O2 |
Molar mass | 140.142 g·mol−1 |
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Gaboxadol, also known as 4,5,6,7-tetrahydroisoxazolo(5,4-c)pyridin-3-ol (THIP), is a conformationally constrained derivative of the alkaloid muscimol (a constituent of Amanita muscaria ) that was first synthesized in 1977 by the Danish chemist Povl Krogsgaard-Larsen. [1]
In the early 1980s, gaboxadol was the subject of a series of pilot studies that tested its efficacy as an analgesic and anxiolytic, as well as a treatment for tardive dyskinesia, Huntington's disease, Alzheimer's disease, and spasticity. [1] It was not until 1996 that researchers attempted to harness gaboxadol's frequently reported sedative "adverse effect" for the treatment of insomnia, resulting in a series of clinical trials sponsored by Lundbeck and Merck. [1] [2] In March 2007, Merck and Lundbeck cancelled work on the drug, citing safety concerns and the failure of an effectiveness trial.
The drug acts on the GABA system, but in a different way from benzodiazepines, Z-Drugs, and barbiturates. More specifically, gaboxadol acts as a direct GABAA receptor agonist. Lundbeck states that gaboxadol also increases deep sleep (stage 4). Unlike benzodiazepines, gaboxadol does not demonstrate reinforcement in mice or baboons despite activation of dopaminergic neurons in the ventral tegmental area. [3]
In 2015, Lundbeck sold its rights to the molecule to Ovid Therapeutics, whose plan is to develop it for fragile X syndrome (FXS) and Angelman syndrome. [4] [5] It is known internally in Ovid as OV101. [4] By March 2023, development of gaboxadol for FXS and Angelman syndrome was discontinued. [4] The drug is no longer under development for any indication. [4]
Gaboxadol acts as a GABAA receptor agonist. It is specifically a supra-maximal agonist at α4β3δ, low-potency agonist at α1β3γ2, partial agonist at α4β3γ, and antagonist at ρ1 GABAA receptors. [6] [7] [8] Its affinity for extrasynaptic α4β3δ GABAA receptors is 10-fold greater than for other subtypes. [9] Gaboxadol has a unique affinity for extrasynaptic α4β3δ GABAA receptors, which mediate tonic inhibition and are typically activated by ambient, low levels of GABA in the extrasynaptic space. [10]
Compared to muscimol, gaboxadol binds less potently to α4β3δ GABAA receptors (EC50 = 0.2 μM vs. 13 μM), but is capable of evoking a greater maximum response (Emax = 120% vs. 224%). [8] The supra-maximial efficacy of gabaxadol at α4β3δ GABAA receptors has been attributed to an increase in the duration and frequency of channel openings relative to the endogenous agonist GABA. [8]
Gaboxadol produced effects in clinical studies including sedation, euphoria, and dissociation or perceptual changes. [11] [12] It showed less euphoria and misuse potential, more negative and dissociative effects, and fewer sedative effects than zolpidem at the assessed doses. [12] According to Hamilton Morris, gaboxadol can produce hallucinogenic effects at high doses. [13]
In cancer patients and also in patients with chronic anxiety (Hoehn‐Saric, 1983) the desired effects of Gaboxadol were accompanied by side effects, notably sedation, nausea, and in a few cases euphoria. The side effects of Gaboxadol have, however, been described as mild and similar in quality to those of other GABA‐mimetics (Hoehn‐Saric, 1983). This combination of analgesic and anxiolytic effects of THIP obviously has therapeutic prospects.
[...] they did produce enough [gaboxadol] [...] to conduct a number of self-experiments, some at very high doses. He experienced extremely dramatic psychedelic effects at those high doses. [...] I have a written report—I mentioned that I had a friend [...] [a]nd he took a very, very large dose of [gaboxadol] [...] it was 63 mg of the zwitterion. [...] It's you know very, very dramatic hallucinogenic effects. He describes his entire reality being fragmented. [...]