Delayed- Maturation Theory of Obsessive Compulsive Disorder
Drug treatment of OCD may be assumed to affect a proposed functional imbalance between the frontal lobes and other parts of the brain. Serotonin reuptake inhibitors, SRI, especially potent ones given at high doses over long periods of time, are often effective in the treatment of obsessive-compulsive disorder. However, a large percentage of patients do not respond to treatment with the SRI, and those who do respond often do not fully remit, which should be the standard goal of treatment in OCD. If a patient has been treated for several months and has not yet responded to treatment with several types of SRI medication, the physician should perform a careful assessment of resistant and/or residual clinical symptoms. Any comorbid conditions to determine which next-step treatment would be the most appropriate. One strategy for patients who have not responded to treatment with a SRI is to switch them to aserotonin-norepinephrine reuptake inhibitors.
Besipirdine
Besipirdine was first considered for the treatment of obsessive-compulsive disorder (OCD). Hoechst-Roussel Pharmaceuticals, Inc. (Hoecst AG) filed a patent in July 1993 protecting the use of N-(pyridinyl)-1H-indol-1-amines, including besipirdine, for the treatment of OCD, supported by preliminary data gathered from rat studies . In 1995, Hoechst AG filed a patent protecting the production of besipirdine, this time describing its memory-enhancing, analgetic and antidepressant qualities . With increasing research on besipirdine uncovering its effects on the cholinergic system, Hoechst AG filed a patent in the following year to protect substituted n-(pyrrol-1-yl)pyridinamines as anticonvulsant agents
. In the midst of Phase II clinical studies of besipirdine in Alzheimer's disease, Hoechst AG merged with Rhône-Poulenc S.A. to form Aventis Pharma Limited. Under the new company Aventis, besipirdine ultimately failed in Phase III clinical trials due to severe cardiovascular side effects observed in a few patients in separate studies. In January 2004, UroGene acquired exclusive development and commercialization rights to besipirdine from Aventis in order to study its application in urology
. In February 2007, UroGene filed its own patent protecting the crystal form of besipirdine chlorhydrate, its production process, and its applications in the pharmaceutical field. The drug is currently undergoing Phase III development for treatment of Lower Urinary Tract Dysfunctions