Glutethimide

Last updated
Glutethimide
Glutethimide.svg
Glutethimide ball-and-stick model.png
Clinical data
Trade names Doriden, Elrodorm, Noxyron, others
Pregnancy
category
  • C: (United States)
Dependence
liability
Moderate - high
Routes of
administration
By mouth
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability Variable (Tmax = 1–6 hours) [2]
Protein binding ~50%
Metabolism Extensive hepatic
Elimination half-life 8–12 hours
Excretion Renal
Identifiers
  • 3-ethyl-3-phenyl-piperidine-2,6-dione
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard 100.000.921 OOjs UI icon edit-ltr-progressive.svg
Chemical and physical data
Formula C13H15NO2
Molar mass 217.268 g·mol−1
3D model (JSmol)
Melting point 84 °C (183 °F)
Solubility in water 999 mg/L (30 °C/86 °F) mg/mL (20 °C)
  • O=C1NC(CCC1(CC)C2=CC=CC=C2)=O
  • InChI=1S/C13H15NO2/c1-2-13(10-6-4-3-5-7-10)9-8-11(15)14-12(13)16/h3-7H,2,8-9H2,1H3,(H,14,15,16) Yes check.svgY
  • Key:JMBQKKAJIKAWKF-UHFFFAOYSA-N Yes check.svgY
   (verify)

Glutethimide is a hypnotic sedative that was introduced by Ciba [3] in 1954 as a safe alternative to barbiturates to treat insomnia. Before long, however, it had become clear that glutethimide was just as likely to cause addiction and caused similar withdrawal symptoms. Doriden was the brand-name version. Current production levels in the United States (the annual quota for manufacturing imposed by the DEA has been three grams, enough for six Doriden tablets, for a number of years) point to its use only in small-scale research. Manufacturing of the drug was discontinued in the US in 1993 and discontinued in several eastern European countries in 2006.

Contents

Glutethimide DOJ.jpg

Long term use

Long-term use rebound effects, which resemble those seen in barbiturate withdrawal, have anecdotally been described in patients who were still taking a stable dose of the drug. The symptoms include delirium, hallucinosis, convulsions and fever. [4]

Recreational use

Glutethimide is a CYP2D6 enzyme inducer. When taken with codeine, (known on the streets as "hits", "cibas and codeine", "Dors and 4s") it enables the body to convert higher amounts of the codeine to morphine. The general sedative effect of the glutethimide also adds to the effect of the combination. [5] It produces an intense, long lasting euphoria similar to IV heroin use.[ citation needed ] A number of deaths have occurred from abuse of this combination. [6] The effect was also used clinically, including some research in the 1970s in various countries of using it under carefully monitored circumstances as a form of oral opioid agonist substitution therapy, e.g. as a Substitutionmittel that may be a useful alternative to methadone. [7] [8] The demand for this combination in Philadelphia, Pittsburgh, Newark, NYC, Boston, Baltimore, and surrounding areas of other states and perhaps elsewhere, has led to small-scale clandestine synthesis of glutethimide since 1984, [9] :203 a process that is, like methaqualone (Quaalude) synthesis, somewhat difficult and fraught with potential bad outcomes when amateur chemists manufacture the drugs with industrial-grade precursors without adequate quality control. The fact that the simpler clandestine synthesis of other extinct pharmaceutical depressants like ethchlorvynol, methyprylon, or the oldest barbiturates is not reported would seem to point to a high level of motivation surrounding a unique drug, again much like methaqualone. Production of glutethimide was discontinued in the US in 1993 and in several eastern European countries, most notably Hungary, in 2006. Analysis of confiscated glutethimide seems to invariably show the drug or the results of attempted synthesis, whereas purported methaqualone is in a significant majority of cases found to be inert, or contain diphenhydramine or benzodiazepines. [9]

Glutethimide is a Schedule II drug under the Convention on Psychotropic Substances. [10] It was originally a Schedule III drug in the United States under the Controlled Substances Act, but in 1991 it was upgraded to Schedule II, [11] several years after it was discovered that misuse combined with codeine increased the effect of the codeine and deaths had resulted from the combination. [12] [13] It has a DEA ACSCN of 2550 and a 2013 production quota of 3 g.

Synthesis

The (R) isomer has a faster onset and more potent anticonvulsant activity in animal models than the (S) isomer. [14]

Thieme Synthesis: Patent: Glutethimide synthesis.svg
Thieme Synthesis: Patent:

The base catalyzed conjugate addition of 2-phenylbutyronitrile [769-68-6] (1) to ethyl acrylate (2) gives ethyl 4-cyano-4-phenylhexanoate, CID:139890735 (3). Alkaline hydrolysis of the nitrile group into an amide group, and subsequent acidic cyclization of the product affords the desired glutethimide (4).

See also

Related Research Articles

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Methaqualone is a hypnotic sedative. It was sold under the brand names Quaalude and Sopor among others, which contained 300 mg of methaqualone, and sold as a combination drug under the brand name Mandrax, which contained 250 mg methaqualone and 25 mg diphenhydramine within the same tablet, mostly in Europe. Commercial production of methaqualone was halted in the mid-1980s due to widespread abuse and addictiveness. It is a member of the quinazolinone class.

<span class="mw-page-title-main">Sedative</span> Drug that reduces excitement without inducing sleep

A sedative or tranquilliser is a substance that induces sedation by reducing irritability or excitement. They are CNS depressants and interact with brain activity causing its deceleration. Various kinds of sedatives can be distinguished, but the majority of them affect the neurotransmitter gamma-aminobutyric acid (GABA). In spite of the fact that each sedative acts in its own way, most produce relaxing effects by increasing GABA activity.

<span class="mw-page-title-main">Ethchlorvynol</span> Group of stereoisomers

Ethchlorvynol is a GABA-ergic sedative and hypnotic/soporific medication first developed by Pfizer in the 1950s. In the United States it was sold by Abbott Laboratories under the trade name Placidyl. Placidyl was available in 200 mg, 500 mg, and 750 mg strength gel filled capsules. While the 500 mg and 750 mg strength capsules were for use in reducing sleep latency, the 200 mg strength capsules were intended to be used to re-induce sleep in case of early awakening. Abbott discontinued production in 1999, due to it being replaced by the benzodiazepine family and its widespread abuse, after which Placidyl was available for about a year in the United States. Although, theoretically, ethchlorvynol could be manufactured for sale in the United States by another pharmaceutical company, no pharmaceutical company has chosen to do so. Individuals with a valid prescription for the substance may legally transport a reasonable amount of ethclorvynol with them into the United States.

Colloquially known as "downers", depressants or central nervous system (CNS) depressants are drugs that lower neurotransmission levels, decrease the electrical activity of brain cells, or reduce arousal or stimulation in various areas of the brain. Some specific depressants do influence mood, either positively or negatively, but depressants often have no clear impact on mood. In contrast, stimulants, or "uppers", increase mental alertness, making stimulants the opposite drug class from depressants. Antidepressants are defined by their effect on mood, not on general brain activity, so they form an orthogonal category of drugs.

<span class="mw-page-title-main">Phenobarbital</span> Medication of the barbiturate type

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<span class="mw-page-title-main">Meprobamate</span> Carbamate derivative used as an anxiolytic drug

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<span class="mw-page-title-main">Nordazepam</span> Benzodiazepine derivative medication

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<span class="mw-page-title-main">Nimetazepam</span> Benzodiazepine medication

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<span class="mw-page-title-main">Rolicyclidine</span> Chemical compound

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