Department of BioMolecular Sciences, University of Mississippi, University, Mississippi, USA.
Center of Biomedical Research Excellence in Natural Products Neuroscience, University of Mississippi, University, Mississippi, USA.
J Biomed Mater Res A. 2023 Jun;111(6):790-800. doi: 10.1002/jbm.a.37497. Epub 2023 Jan 6.
There is an urgent unmet medical need to develop therapeutic options for the ~50% of depression patients suffering from treatment-resistant depression, which is difficult to treat with existing psycho- and pharmaco-therapeutic options. Classical psychedelics, such as the 5HT agonists, have re-emerged as a treatment paradigm for depression. Recent clinical trials highlight the potential effectiveness of 5HT agonists to improve mood and psychotherapeutic growth in treatment-resistant depression patients, even in those who have failed a median of four previous medications in their lifetime. Moreover, microdosing could be a promising way to achieve long-term alleviation of depression symptoms without a hallucinogenic experience. However, there are a gamut of practical barriers that stymie further investigation of microdosing 5HT agonists, including: low compliance with the complicated dosing regimen, high risk of diversion of controlled substances, and difficulty and cost administering the long-term treatment regimens in controlled settings. Here, we developed a drug delivery system composed of multilayered cellulose acetate phthalate (CAP)/Pluronic F-127 (P) films for the encapsulation and interval delivery of 5HT agonists from a fully biodegradable and biocompatible implant. CAPP film composition, thickness, and layering strategies were optimized, and we demonstrated three distinct pulses from the multilayered CAPP films in vitro. Additionally, the pharmacokinetics and biodistribution of the 5HT agonist 2,5-Dimethoxy-4-iodoamphetamine (DOI) were quantified following the subcutaneous implantation of DOI-loaded single and multilayered CAPP films. Our results demonstrate, for the first time, the interval delivery of psychedelics from an implantable drug delivery system and open the door to future studies into the therapeutic potential of psychedelic delivery.
有一种迫切的未满足的医学需求,即开发治疗方案,以应对约 50%的抑郁症患者,他们患有难治性抑郁症,而现有的心理和药物治疗方案难以治疗。经典迷幻剂,如 5-HT 激动剂,已重新成为抑郁症治疗的范例。最近的临床试验强调了 5-HT 激动剂改善情绪和促进心理治疗的潜力,即使在那些一生中平均已经尝试过四种药物治疗均失败的难治性抑郁症患者中也是如此。此外,微剂量可能是一种有前途的方法,可以在没有致幻体验的情况下长期缓解抑郁症症状。然而,存在一系列实际障碍,阻碍了对 5-HT 激动剂微剂量的进一步研究,包括:复杂剂量方案的依从性低、受控物质滥用的高风险,以及在受控环境中管理长期治疗方案的难度和成本。在这里,我们开发了一种由多层醋酸邻苯二甲酸纤维素(CAP)/聚氧乙烯-聚氧丙烯共聚物 F-127(P)膜组成的药物输送系统,用于封装和间隔释放完全可生物降解和生物相容的植入物中的 5-HT 激动剂。优化了 CAPP 膜的组成、厚度和分层策略,并在体外证明了多层 CAPP 膜的三个明显脉冲。此外,还定量研究了 5-HT 激动剂 2,5-二甲氧基-4-碘苯丙胺(DOI)在皮下植入 DOI 负载的单层和多层 CAPP 膜后的药代动力学和生物分布。我们的结果首次证明了从可植入药物输送系统中间隔释放迷幻剂,并为未来研究迷幻剂输送的治疗潜力开辟了道路。