NSI-189 Treatment for Depression with Impaired Memory
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Solution Overview
Problem
Current treatments for depression, particularly major depressive disorder and bipolar depression, are often ineffective and rely on trial-and-error due to the lack of biological or quantitative behavioral measures for medication selection.
Innovation Solution
The use of (4-benzylpiperazin-1-yl)-[2-(3-methylbutylamino)pyridin-3-yl]methanone (NSI-189) or its pharmaceutically acceptable salt, specifically at a daily dose of 40 to 240 mg, in patients with objectively determined impaired learning and/or memory, and specific electroencephalogram (EEG) patterns, to treat depressive symptoms.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional antidepressant medications (SSRIs, SNRIs, NDRIs) are used for treating depression, then they are generally well-tolerated and have established safety profiles, but they lack biological or quantitative behavioral measures to inform medication selection and require trial-and-error approach
Solution Approach 1:
The patent performs preliminary assessment of cognitive function (learning and memory) and EEG characteristics before medication selection. This preliminary action identifies patients with impaired learning/memory and specific EEG patterns who are likely to respond to NSI-189, thereby guiding medication choice in advance and reducing trial-and-error time
Solution Approach 2:
The patent uses objective cognitive test results and EEG measurements as feedback to inform medication selection. These quantitative measures provide feedback about patient characteristics that predict response to NSI-189, enabling more reliable medication selection without trial-and-error
2Reliability
If NSI-189 is administered to the general depression population, then previous studies showed no efficacy for the 80 mg dose, but the patent identifies a specific patient subgroup that responds effectively
Solution Approach 1:
The patent applies local quality by identifying a specific subgroup of patients with impaired learning/memory and particular EEG patterns who respond to NSI-189. Rather than treating all depression patients uniformly, the treatment is tailored to patients with these specific local characteristics, explaining why the drug showed no efficacy in general population studies but works in this identified subgroup
3Adaptability or versatility
If trial-and-error medication selection is used, then multiple antidepressant types can be tried to find an effective treatment, but most patients fail to respond adequately to the first medication and require multiple medication trials
Solution Approach 1:
The patent performs preliminary assessment of cognitive function and EEG characteristics before medication selection. This preliminary action identifies patients with impaired learning/memory and specific EEG patterns who are likely to respond to NSI-189, thereby guiding medication choice in advance and reducing trial-and-error time
Solution Approach 2:
The patent uses objective cognitive test results and EEG measurements as feedback to inform medication selection. These quantitative measures provide feedback about patient characteristics that predict response to NSI-189, enabling more reliable medication selection without trial-and-error
Data Source
AI summary
This invention relates to the use of (4-benzylpiperazin-1-yl)-[2-(3-methylbutylamino)pyridin-3-yl]methanone (NSI-189) or a pharmaceutically acceptable salt thereof in the treatment of a psychiatric condition in which depressive symptoms are prominent, including major depressive disorder (MDD), bipolar disorder, post-traumatic stress disorder, substance use disorder, and depression-related aspects of schizophrenia (e.g. negative symptoms) in select patients who exhibit impaired learning and/or memory. The invention also relates to the use of NSI-189 or a pharmaceutically acceptable salt thereof in the treatment of a psychiatric condition in which depressive symptoms are prominent, including major depressive disorder (MDD), in select patients who exhibit impaired learning and/or memory or certain EEG characteristics.