Pharmaceutical compositions comprising bupropion and cysteine

Information

  • Patent Grant
  • 12357697
  • Patent Number
    12,357,697
  • Date Filed
    Monday, October 21, 2024
    a year ago
  • Date Issued
    Tuesday, July 15, 2025
    4 months ago
Abstract
This disclosure relates to pharmaceutical compositions comprising bupropion and cysteine, and pharmaceutical dosage forms comprising bupropion and cysteine. The disclosure also relates to molecular complexes of bupropion and cysteine. These compositions and dosage forms may have improved stability of bupropion.
Description
BACKGROUND

Bupropion is FDA approved for the treatment of depression and for smoking cessation.


SUMMARY

This disclosure relates to pharmaceutical compositions, and dosage forms containing bupropion and cysteine, and uses of such compositions and dosage forms. The disclosure also relates to molecular complexes of bupropion and cysteine.


Some embodiments, including embodiments containing a molecular complex of bupropion and cysteine, have a molar ratio of bupropion to cysteine of about 0.9:1 to about 1.1:1. These molecular complexes may be more stable than bupropion alone.


Some embodiments include a pharmaceutical composition comprising a molecular complex of bupropion and cysteine, wherein the molar ratio of bupropion to cysteine in the molecular complex is about 0.5:1 to about 2:1 or about 0.9:1 to about 1.1:1. These pharmaceutical compositions may be more stable than a similar pharmaceutical composition having bupropion without cysteine.


Some embodiments include a pharmaceutical dosage form comprising bupropion and cysteine, possibly including a molecular complex of bupropion and cysteine, wherein the dosage form comprises about 90 mg to about 120 mg of bupropion and about 30 mg to about 100 mg of cysteine.







DETAILED DESCRIPTION

This disclosure relates to a pharmaceutical composition comprising bupropion and cysteine. It has been found that cysteine in the amounts described herein is effective in stabilizing bupropion in the presence of common excipients such as calcium phosphate, methylcellulose, hydroxypropylmethylcelluloses, sodium carboxycellulose, etc.


A pharmaceutical composition, dosage form, or molecular complex, may include, or be prepared from, any suitable form of bupropion, such as a salt form, e.g., bupropion hydrochloride, the free base form, hydrates, solvates, polymorphs, other solid forms, etc. In some embodiments, the pharmaceutical composition is free of any other active pharmaceutical agents.


The pharmaceutical dosage form may include any suitable amount of bupropion, such as about 80-150 mg, about 80-120 mg, about 80-90 mg, about 90-100 mg, about 100-110 mg, about 110-120 mg, about 103-107 mg, or about 105 mg of the bupropion, such as bupropion hydrochloride, another salt form of bupropion, or the free base form of bupropion.


A pharmaceutical composition, dosage form, or molecular complex, may include, or be prepared from, any suitable form of cysteine, such as a neutral form, a zwitterionic form, a salt form, e.g., cysteine hydrochloride, hydrates, solvates, polymorphs, other solid forms, etc.


The pharmaceutical composition may include any suitable amount of cysteine (e.g., L-cysteine), such as about 30-100 mg, about 30-40 mg, about 40-50 mg, about 50-60 mg, about 60-70 mg, about 70-80 mg, about 80-90 mg, about 90-100 mg, about 65-70 mg, or about 67 mg of the cysteine, such as L-cysteine hydrochloride, another salt form of L-cysteine, or the neutral or zwitterionic form of L-cysteine. Cysteine in these amounts may be helpful in stabilizing bupropion in the presence of other excipients. The cysteine may be in the form of a hydrate of cysteine. For example, the cysteine may be in the form of a hydrate. For example, the cysteine may be in the form of cysteine hydrochloride monohydrate or L-cysteine hydrochloride monohydrate.


In some pharmaceutical compositions, bupropion and cysteine may be in the form of a molecular complex, or may be non-covalently bound or associated with one another, molecular complexes include both salts and other forms of non-covalent binding interactions such as hydrogen bonding, van der Waals interactions, etc.


One potential bupropion-cysteine molecular complex is represented by a structure:




embedded image


In some embodiments, the molar ratio of bupropion to cysteine may be about 0.2:1 (e.g. 0.2 moles of bupropion to 1 mole of cysteine) to about 4:1, about 0.2:1 to about 0.5:1, about 0.5:1 to about 0.7:1 about 0.7:1 to about 0.9:1, about 0.9:1 to about 1.1:1, about 1.1:1 to about 1.3:1, about 1.3:1 to about 1.5:1, about 1.5:1 to about 2:1, about 2:1 to about 3:1, about 3:1 to about 4:1, about 0.5:1, or about 1:1.


The pharmaceutical composition or dosage form may further comprise a sustained release or controlled release polymer, such as a crosslinked or uncross linked acrylate polymer or copolymer (e.g., a carbomer copolymer Type A such as Carbopol 971P), a cellulose derivative, such as methylcellulose, etc. In some embodiments, the controlled release polymer is about 1-40%, about 1-5%, about 5-10%, about 10-15%, about 15-20%, about 20-30%, about 30-40%, about 11-13%, or about 12% of the weight of the pharmaceutical composition. In some embodiments, the controlled release polymer is about 0.1-20%, about 0.1-2%, about 2-4%, about 4-6%, about 6-8%, about 8-10%, about 10-15%, about 15-20%, or about 7% of the weight of the dosage form.


The pharmaceutical composition or dosage form may further comprise a filler such as microcrystalline cellulose. In some embodiments, the filler may be about 20-60%, about 20-30%, about 30-40%, about 40-50%, or about 50-60% of the weight of the pharmaceutical composition or the dosage form.


The pharmaceutical composition or dosage form may further comprise a lubricant such as magnesium stearate. In some embodiments, the lubricant is about 0.1-10%, about 0.1-2%, about 2-4%, about 4-6%, about 6-8%, or about 8-10% of the weight of the pharmaceutical composition or the dosage form.


The dosage form may be formulated for any suitable route of administration, such as oral administration.


Dosage forms, such as solid dosage forms, e.g., capsules, tablets, or pills, for oral administration may also contain one or more of the following: a binder such as gum tragacanth, acacia, corn starch, or gelatin; an excipient, such as dicalcium phosphate; a disintegrating agent such as corn starch, potato starch, alginic acid, and the like; a sweetening agent such as sucrose, lactose, or saccharin; or a flavoring agent such as peppermint, oil of wintergreen, or cherry flavoring. When the dosage unit form is a capsule, it may contain, in addition to materials of the above type, a liquid carrier. Various other materials may be present as a coating, for example, tablets, pills, or capsules may be coated with shellac, sugar, or both. It may be desirable for material in a dosage form or pharmaceutical composition to be pharmaceutically pure and substantially nontoxic in the amounts employed.


The dosage form may further contain a second active pharmaceutical ingredient, such as dextromethorphan, e.g., dextromethorphan hydrochloride. In some embodiments, the dosage form may contain bupropion and dextromethorphan, and no other active pharmaceutical ingredients. In some embodiments, the bupropion and the dextromethorphan are in two different layers or phases of the dosage form, e.g., each layer contains only bupropion or dextromethorphan and none of the other.


In some embodiments, the dosage form contains cysteine, Carbopol 971P, microcrystalline cellulose, silicon dioxide, and magnesium. In some embodiments, the dosage form contains a first layer comprising bupropion and cysteine, and a second layer comprising dextromethorphan, microcrystalline cellulose, croscarmellose sodium, and magnesium stearate.


An example of a single layer dosage form is show below:















Ingredient
Amount (mg)








Bupropion
90-120



Cysteine
50-100



Carbopol 971P
20-60 



Microcrystalline Cellulose
200-300 



Colloidal Silicon Dioxide
1-10



Magnesium Stearate
1-10









A two layer dosage form may contain a first layer with the composition above, and a second layer detailed below.












Layer 2










Ingredient
Amount (mg)






Dextromethorphan
30-60



Microcrystalline Cellulose
100-150



Croscarmellose sodium
 1-20



Magnesium Stearate
 1-10









The pharmaceutical compositions, dosage forms, or molecular complexes described herein may be useful in treating neurological or psychiatric conditions, such as depression, including major depressive disorder or treatment-resistant major depressive disorder, agitation, such as agitation associated with Alzheimer's disease, addiction, such as nicotine addiction, etc.


The subject combination may be used for adjunctive treatment of major depressive disorder or depression.


In addition to major depressive disorder, the subject combination may be used to treat other diseases in conditions in the patient populations or circumstances described herein. For example, the subject combination may be used to treat pain or a neurological disorder. Examples of neurological disorders that may be treated with the subject combination include, but are not limited to: affective disorders, psychiatric disorders, cerebral function disorders, movement disorders, dementias, motor neuron diseases, neurodegenerative diseases, seizure disorders, and headaches.


Affective disorders that may be treated by the subject combination include, but are not limited to, depression, major depression, treatment resistant depression, treatment resistant bipolar depression, bipolar disorders including cyclothymia, seasonal affective disorder, mood disorders, chronic depression (dysthymia), psychotic depression, postpartum depression, premenstrual dysphoric disorder (PMDD), situational depression, atypical depression, mania, anxiety disorders, attention deficit disorder (ADD), attention deficit disorder with hyperactivity (ADDH), and attention deficit/hyperactivity disorder (AD/HD), bipolar and manic conditions, obsessive-compulsive disorder, bulimia, obesity or weight-gain, narcolepsy, chronic fatigue syndrome, premenstrual syndrome, substance addiction or abuse, nicotine addiction, psycho-sexual dysfunction, pseudobulbar affect, and emotional lability.


Depression may be manifested by depressive symptoms. These symptoms may include psychological changes such as changes in mood, feelings of intense sadness, despair, mental slowing, loss of concentration, pessimistic worry, agitation, anxiety, irritability, guilt, anger, feelings of worthlessness, reckless behavior, suicidal thoughts, or attempts, and/or self-deprecation. Physical symptoms of depression may include insomnia, anorexia, appetite loss, weight loss, weight gain, decreased energy and libido, fatigue, restlessness, aches, pains, headaches, cramps, digestive issues, and/or abnormal hormonal circadian rhythms.


Psychiatric disorders that may be treated by the subject combination, include, but are not limited to, anxiety disorders, including but not limited to, phobias, generalized anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, obsessive-compulsive disorder, and post-traumatic stress disorder (PTSD); mania, manic depressive illness, hypomania, unipolar depression, depression, stress disorders, somatoform disorders, personality disorders, psychosis, schizophrenia, delusional disorder, schizoaffective disorder, schizotypy, aggression, aggression in Alzheimer's disease, agitation, and agitation in Alzheimer's disease. Alzheimer's disease may also be referred to as dementia of the Alzheimer's type. Other neurobehavioral symptoms of Alzheimer's disease that may be treated include disinhibition and apathy.


Agitation in Alzheimer's disease occurs as the disease progresses. Agitation may present itself as inappropriate verbal, emotional, and/or physical behaviors. Inappropriate behaviors may include, but are not limited to, incoherent babbling, inappropriate emotional response, demands for attention, threats, irritability, frustration, screaming, repetitive questions, mood swings, cursing, abusive language, physical outbursts, emotional distress, restlessness, shredding, sleeping disturbances, delusions, hallucinations, pacing, wandering, searching, rummaging, repetitive body motions, hoarding, shadowing, hitting, scratching, biting, combativeness, hyperactivity, and/or kicking.


Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline, and behavioral and psychological symptoms including agitation. AD is the most common form of dementia and afflicts an estimated 6 million individuals in the United States, a number that is anticipated to increase to approximately 14 million by 2050. Agitation is reported in up to 70% of patients with AD and is characterized by emotional distress, aggressive behaviors, disruptive irritability, and disinhibition. Managing agitation is a priority in AD. Agitation in patients with AD has been associated with increased caregiver burden, decreased functioning, accelerated cognitive decline, earlier nursing home placement, and increased mortality. There are currently no therapies approved by the FDA for the treatment of agitation in patients with AD.


Neurobehavioral symptoms have been known to appear during dementia and may be treated by the combination. Caregivers or families may feel more overwhelmed by patients' behavioral/psychological symptoms than by their cognitive impairment. Common forms of the syndrome are Alzheimer's disease, vascular dementia, dementia with Lewy bodies (abnormal aggregates of protein that develop inside nerve cells), and a group of diseases that contribute to frontotemporal dementia (degeneration of the frontal lobe of the brain). The symptoms that dementia patients have are similar to those of psychiatric disorders, but some are slightly different from each other. Neurobehavioral symptoms associated with dementia include depression, apathy, agitation, disinhibition, hallucinations, delusions, psychosis, impulsiveness, aggressiveness, compulsion, excessive sex drive, and personality disorders. Neurobehavioral symptoms such as disinhibition may also be found in other conditions such as traumatic brain injury.


Agitation in patients with Alzheimer's disease may be assessed using the Cohen Mansfield Agitation Inventory or CMAI. The CMAI assesses various behaviors including, Hitting (including self), Kicking, Grabbing onto people, Pushing, Throwing things, Biting, Scratching, Spitting, Hurting self or others, Tearing things or destroying property, Making physical sexual advances, Pacing, aimless wandering, Inappropriate dress or disrobing, Trying to get to a different place, Intentional falling, Eating/drinking inappropriate substances, Handling things inappropriately, Hiding things, Hoarding things, Performing repetitive mannerisms, General restlessness, Screaming, Making verbal sexual advances, Cursing or verbal aggression, Repetitive sentences or questions, Strange noises (weird laughter or crying), Complaining, Negativism, Constant unwarranted request for attention or help.


Schizophrenia may be treated by the combination including positive symptoms and/or negative symptoms of schizophrenia, or residual symptoms of schizophrenia. Other conditions that may treated include intermittent explosive disorder.


Cerebral function disorders that may be treated by the subject combination include, but are not limited to, disorders involving intellectual deficits such as senile dementia, Alzheimer's type dementia, memory loss, amnesia/amnestic syndrome, epilepsy, disturbances of consciousness, coma, lowering of attention, speech disorders, voice spasms, Parkinson's disease, Lennox-Gastaut syndrome, autism, hyperkinetic syndrome, and schizophrenia. Cerebral function disorders also include disorders caused by cerebrovascular diseases including, but not limited to, stroke, cerebral infarction, cerebral bleeding, cerebral arteriosclerosis, cerebral venous thrombosis, head injuries, and the like where symptoms include disturbance of consciousness, senile dementia, coma, lowering of attention, and speech disorders.


Substance addiction abuse that may be treated by the subject combination includes, but is not limited to, drug dependence, addiction to cocaine, psychostimulants (e.g., crack, cocaine, speed, meth), nicotine, alcohol, opioids, anxiolytic and hypnotic drugs, cannabis (marijuana), amphetamines, hallucinogens, phencyclidine, volatile solvents, and volatile nitrites. Nicotine addiction includes nicotine addiction of all known forms, such as smoking cigarettes, cigars and/or pipes, e-cigarettes or vaping, and addiction to chewing tobacco.


Movement disorders that may be treated by the subject combination include, but are not limited to, akathisia, akinesia, associated movements, athetosis, ataxia, ballismus, hemiballismus, bradykinesia, cerebral palsy, chorea, Huntington's disease, Huntington's disease chorea, rheumatic chorea, Sydenham's chorea, dyskinesia, tardive dyskinesia, dystonia, blepharospasm, spasmodic torticollis, dopamine-responsive dystonia, Parkinson's disease, restless legs syndrome (RLS), tremor, essential tremor, and Tourette's syndrome, and Wilson's disease.


Dementias that may be treated by the subject combination include, but are not limited to, Alzheimer's disease, Parkinson's disease, vascular dementia, dementia with Lewy bodies, mixed dementia, fronto-temporal dementia, Creutzfeldt-Jakob disease, normal pressure hydrocephalus, Huntington's disease, Wernicke-Korsakoff Syndrome, and Pick's disease.


Motor neuron diseases that may be treated by the subject combination include, but are not limited to, amyotrophic lateral sclerosis (ALS), progressive bulbar palsy, primary lateral sclerosis (PLS), progressive muscular atrophy, post-polio syndrome (PPS), spinal muscular atrophy (SMA), spinal motor atrophies, Tay-Sach's disease, Sandhoff disease, and hereditary spastic paraplegia.


Neurodegenerative diseases that may be treated the subject combination include, but are not limited to, Alzheimer's disease, prion-related diseases, cerebellar ataxia, spinocerebellar ataxia (SCA), spinal muscular atrophy (SMA), bulbar muscular atrophy, Friedrich's ataxia, Huntington's disease, Lewy body disease, Parkinson's disease, amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease), multiple sclerosis (MS), multiple system atrophy, Shy-Drager syndrome, corticobasal degeneration, progressive supranuclear palsy, Wilson's disease, Menkes disease, adrenoleukodystrophy, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), muscular dystrophies, Charcot-Marie-Tooth disease (CMT), familial spastic paraparesis, neurofibromatosis, olivopontine cerebellar atrophy or degeneration, striatonigral degeneration, Guillain-Barré syndrome, and spastic paraplesia.


Seizure disorders that may be treated by the subject combination include, but are not limited to, epileptic seizures, nonepileptic seizures, epilepsy, febrile seizures; partial seizures including, but not limited to, simple partial seizures, Jacksonian seizures, complex partial seizures, and epilepsia partialis continua; generalized seizures including, but not limited to, generalized tonic-clonic seizures, absence seizures, atonic seizures, myoclonic seizures, juvenile myoclonic seizures, and infantile spasms; and status epilepticus.


Types of headaches that may be treated by the subject combination include, but are not limited to, migraine, tension, and cluster headaches.


Other neurological disorders that may be treated by the subject combination include, Rett Syndrome, autism, tinnitus, disturbances of consciousness disorders, sexual dysfunction, intractable coughing, narcolepsy, cataplexy; voice disorders due to uncontrolled laryngeal muscle spasms, including, but not limited to, abductor spasmodic dysphonia, adductor spasmodic dysphonia, muscular tension dysphonia, and vocal tremor; diabetic neuropathy, chemotherapy-induced neurotoxicity, such as methotrexate neurotoxicity; incontinence including, but not limited, stress urinary incontinence, urge urinary incontinence, and fecal incontinence; and erectile dysfunction.


In some embodiments, the subject combination may be used to treat pain, joint pain, pain associated with sickle cell disease, pseudobulbar affect, depression (including treatment resistant depression), disorders related to memory and cognition, schizophrenia, Parkinson's disease, amyotrophic lateral sclerosis (ALS), Rhett's syndrome, seizures, cough (including chronic cough), etc.


In some embodiments, the subject combination may be administered orally to relieve musculoskeletal pain including low back pain, and pain associated with rheumatoid arthritis, juvenile rheumatoid arthritis, osteoarthritis, erosive osteoarthritis, sero-negative (non-rheumatoid) arthropathies, non-articular rheumatism, peri-articular disorders, axial spondyloarthritis including ankylosing spondylitis, Paget's disease, fibrous dysplasia, SAPHO syndrome, transient osteoarthritis of the hip, vertebral crush fractures, osteoporosis, etc.


In some embodiments, the subject combination may be administered to relieve inflammatory pain including musculoskeletal pain, arthritis pain, and complex regional pain syndrome.


Arthritis refers to inflammatory joint diseases that can be associated with pain. Examples of arthritis pain include pain associated with osteoarthritis, erosive osteoarthritis, rheumatoid arthritis, juvenile rheumatoid arthritis, sero-negative (non-rheumatoid) arthropathies, non-articular rheumatism, peri-articular disorders, neuropathic arthropathies including Charcot's foot, axial spondyloarthritis including ankylosing spondylitis, and SAPHO syndrome.


In some embodiments, the subject combination is used to treat chronic musculoskeletal pain.


In some embodiments, the subject composition may be administered to relieve complex regional pain syndrome, such as complex regional pain syndrome type I (CRPS-I), complex regional pain syndrome type II (CRPS-II), CRPS-NOS, or another type of CRPS. CRPS is a type of inflammatory pain. CRPS can also have a neuropathic component. Complex regional pain syndrome is a debilitating pain syndrome. It is characterized by severe pain in a limb that can be accompanied by edema, and autonomic, motor, and sensory changes.


In some embodiments, the subject composition may be administered orally to relieve neuropathic pain.


Examples of neuropathic pain include pain due to diabetic peripheral neuropathy or diabetic peripheral neuropathic pain, post-herpetic neuralgia, trigeminal neuralgia, monoradiculopathies, phantom limb pain, central pain, pain due to multiple sclerosis, etc. Other causes of neuropathic pain include cancer-related pain, lumbar nerve root compression, spinal cord injury, post-stroke pain, central multiple sclerosis pain, HIV-associated neuropathy, and radio- or chemo-therapy associated neuropathy, etc.


In some embodiments, the subject composition may be administered to relieve fibromyalgia.


Bupropion may not be stable in the presence of (or incompatible with) an excipient. Bupropion may be incompatible with many commonly used excipients including, but not limited to, dibasic calcium phosphate anhydrous, sodium carboxymethylcellulose, hydroxypropyl cellulose, hydroxyethylcellulose, croscarmellose sodium, or sodium starch glycolate.


Methylcellulose or poly(acrylic acid) (PAA or Carbomer) may have low incompatibility as a release controlling polymer.


Bupropion in combination with ascorbic acid may be relatively stable. Cysteine may have a stabilizing effect on bupropion. The stability of bupropion in the presence of cysteine may be significantly higher as compared to ascorbic acid.


Dextromethorphan may pose no incompatibility issue with (or stable in the presence of) many commonly used excipients including, but not limited to, dibasic calcium phosphate anhydrous, hydroxypropyl cellulose, hydroxyethylcellulose, methylcellulose, poly(acrylic acid) (PAA or Carbomer), croscarmellose sodium, or sodium starch glycolate. Dextromethorphan may not be compatible with sodium carboxymethylcellulose. Dextromethorphan may not be stable in the presence of sodium carboxymethylcellulose.


In some embodiments, the molar ratio of bupropion to cysteine may affect the stability of the bupropion. The molar ratio of bupropion to cysteine of 1:2 may provide significantly higher stability of bupropion than the molar ratio of 1:0.5. The molar ratio of 1:1 may provide best stability.


The most stable mixture of bupropion and cysteine may be achieved using a 1:1 molar ratio of bupropion to cysteine. The most stable mixture of bupropion and ascorbic may be achieved using a 1:1 molar ratio of bupropion to ascorbic acid.


Bupropion in combination with dextromethorphan may exhibit good stability. A combination of bupropion and dextromethorphan may be in a form of a bilayer tablet.


In the formulation for a bilayer tablet comprising bupropion, cysteine, and dextromethorphan, the molar ratio of bupropion to cysteine that provides good stability of bupropion, may be about 1:1 to about 1:2, about 1:1, or about 1:2.


In some embodiments, a bilayer tablet may comprise 105 mg of bupropion hydrochloride, 45 mg of dextromethorphan hydrobromide, and cysteine hydrochloride monohydrate with the molar ratio of the bupropion to the cysteine of about 1:1 to about 1:2. In some embodiments, the bilayer tablet may further comprise Carbopol 971P, microcrystalline cellulose PH 101, microcrystalline cellulose PH 102, colloidal silicon dioxide (Cabosil M5P), magnesium stearate, or croscarmellose sodium, or a combination thereof. In some embodiments, the bilayer tablet may further comprise Carbopol 971P, microcrystalline cellulose PH 101, microcrystalline cellulose PH 102, colloidal silicon dioxide (Cabosil M5P), magnesium stearate, and croscarmellose sodium.


The term “treating” or “treatment” includes the diagnosis, cure, mitigation, treatment, or prevention of disease in man or other animals, or any activity that otherwise affects the structure or any function of the body of man or other animals.


A subject combination may be used to treat any disease or condition identified as treatable by the combination of bupropion and dextromethorphan in any of the following U.S. Pat. Nos. 8,569,328, 9,168,234, 9,189,905 9,205,083, 9,238,032, 9,278,095, 9,314,462, 9,370,513, 9,375,429, 9,408,815, 9,421,176, 9,457,023, 9,457,025, 9,474,731, 9,486,450, 9,700,528, 9,700,553, 9,707,191, 9,763,932, 9,861,595, 9,867,819, 9,968,568, 10,058,518, 10,064,857, 10,080,727, 10,092,560, 10,092,561, 10,105,327, 10,105,361, 10,251,879, 10,463,634, 10,512,643, 10,548,857, 10,596,167, 10,772,850, 10,780,064, 10,780,066, 10,786,469, 10,786,496, 10,799,497, 10,806,710, 10,864,209, 10,874,663, 10,874,664, 10,874,665, 10,881,624, 10,881,657, 10,894,046, 10,894,047, 10,898,453, all of which are incorporated by reference herein in their entireties for their disclosure of diseases that may be treated by a combination of bupropion and dextromethorphan, including specific embodiments and combinations described therein.


The following documents are incorporated by reference herein in their MEDICATION GUIDE for AUVELITY™ (www.axsome.com/auvelity-medication-entireties: guide.pdf), and HIGHLIGHTS OF PRESCRIBING INFORMATION for AUVELITY™ (www.axsome.com/auvelity-prescribing-information.pdf).


Specifically Contemplated Embodiments

The following are examples of embodiments that are specifically contemplated by the inventor:


Embodiment 1. A molecular complex of bupropion and cysteine, wherein the molecular complex is in solid form and has a molar ratio of bupropion to cysteine that is from about 0.5:1 to about 2:1.


Embodiment 2. The molecular complex of embodiment 1, wherein the molar ratio of bupropion to cysteine is about 0.9:1 to about 1.3:1.


Embodiment 3. A pharmaceutical composition comprising bupropion and cysteine, wherein the pharmaceutical composition is in a solid form, and the molar ratio of bupropion to cysteine is from about 0.5:1 to about 1.5:1.


Embodiment 4. The pharmaceutical composition of embodiment 3, wherein the molar ratio of bupropion to cysteine is about 0.9:1 to about 1.3:1.


Embodiment 5. The pharmaceutical composition of embodiment 3 or 4, further comprising a sustained release polymer.


Embodiment 6. The pharmaceutical composition of embodiment 5, wherein the sustained release polymer is an acrylate polymer or copolymer, a poly(acrylic acid), a methylcellulose, or a combination thereof.


Embodiment 7. The pharmaceutical composition of embodiment 3, 4, 5, or 6, further comprising a filler.


Embodiment 8. The pharmaceutical composition of embodiment 7, wherein the filler is microcrystalline cellulose.


Embodiment 9. A pharmaceutical dosage form comprising bupropion and cysteine, wherein the dosage form is a solid and comprises about 80 mg to about 120 mg of bupropion, and about 30 mg to about 100 mg of cysteine.


Embodiment 10. The pharmaceutical dosage form of embodiment 9, wherein the dosage form has a molar ratio of bupropion to cysteine that is about 0.5:1 to about 2:1.


Embodiment 11. The pharmaceutical dosage form of embodiment 9 or 10, wherein the molar ratio of bupropion to cysteine is about 1:1.


Embodiment 12. The pharmaceutical dosage form of embodiment 9, 10, or 11, further comprising a sustained release polymer.


Embodiment 13. The pharmaceutical dosage form of embodiment 12, wherein the sustained release polymer is an acrylate polymer or copolymer, a methylcellulose, or a combination thereof.


Embodiment 14. The pharmaceutical dosage form of embodiment 9, 10, 11, 12, or 13, which is in the form of a capsule, pill, or tablet.


Embodiment 15. The pharmaceutical dosage form of embodiment 9, 10, 11, 12, 13, or 14, wherein the dosage form further comprises dextromethorphan.


Embodiment 16. The pharmaceutical dosage form of embodiment 15, wherein the bupropion and the cysteine are in a first layer and the dextromethorphan is in a second layer.


Embodiment 17. The pharmaceutical dosage form of embodiment 9, 10, 11, 12, 13, 14, 15, or 16, further comprising a filler.


Embodiment 18. The pharmaceutical dosage form of embodiment 17, wherein the filler is microcrystalline cellulose.


Embodiment 19. The pharmaceutical dosage form of embodiment 9, 10, 11, 12, 13, 14, 15, 16, 17, or 18, further comprising a lubricant.


Embodiment 20. The pharmaceutical dosage form of embodiment 19, wherein the lubricant is magnesium stearate.


Embodiment 21. The pharmaceutical dosage form of embodiment 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20, wherein the cysteine is L-cysteine hydrochloride monohydrate.


Embodiment 22. The molecular complex of bupropion and cysteine of embodiment 1 or 2, wherein the bupropion is more stable than bupropion alone.


Embodiment 23. The pharmaceutical dosage form of embodiment 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or 21, wherein the bupropion is more stable than bupropion alone.


Embodiment 24. A pharmaceutical composition comprising the molecular complex of embodiment 1 or 2.


Embodiment 25. The pharmaceutical composition of embodiment 3, wherein bupropion and cysteine form a molecular complex.


Embodiment 26. The molecular complex of embodiment 1, wherein the molar ratio of bupropion to cysteine is about 0.5:1 to about 1:1.


Embodiment 27. A pharmaceutical composition comprising the molecular complex of embodiment 26.


Embodiment 28. The pharmaceutical composition of embodiment 3, wherein the molar ratio of bupropion to cysteine is about 0.5:1 to about 1:1.


Example 1
INTRODUCTION

The scope of project 0328-150079-0001 was to develop two formulations containing Bupropion hydrochloride suitable for Phase III clinical studies. The first formulation was developed as a bilayer tablet for a combination of bupropion hydrochloride 105 mg (BUP105) and dextromethorphan hydrobromide monohydrate (DEX45) 45 mg. The second formulation was developed as bupropion hydrochloride 150 mg (BUP150) tablet using a common blend approach.


Design of Experiments


Formulation activities were initiated with excipient compatibility studies performed using a binary mixture of each API with known excipients typically used in solid dosage forms per Xcelience protocol #P328-001A. Significant compatibility issues were observed with bupropion hydrochloride with most of the excipients evaluated. The possible cause could be the absence of cysteine hydrochloride, which has shown to have a stabilizing effect on bupropion. A follow-up blend compatibility study was performed per protocol P0328-001B. Bupropion was observed to be stable in presence of cysteine hydrochloride in both studies. Based on these results prototype development was initiated with a top-spray granulation approach towards making a bilayer tablet for BUP105-DEX45 and a single layer tablet of BUP150 using a common blend approach for the bupropion hydrochloride portion.


Excipient Compatibility Study An excipient compatibility study was initiated using the excipients listed in Table 1. Commonly used excipients which were already a part of the currently available commercial products were not included in this study. Excipient compatibility samples were individually prepared as listed in Table 1 and placed at 25° C./60% RH, 40° C./75% RH and 50° C. in closed containers to avoid moisture penetration. These samples were pulled from the stability chambers per the schedule listed in Table 2 and tested for assay and related substances.









TABLE 1







Excipient compatibility samples

















Mixture







Ratioa







Drug:Ex-


Functionality
Material
Trade Name
Grade
Manufacturer
cipient





Fillers
Dibasic calcium
Emcompress ®
USP/NF
JRS Pharma
1:10



phosphate anhydrous






Release
Sodium
Aqualon ™
USP/NF
Ashland
1:10


controlling
Carboxymethylcellulose
CMC 7MF PH





polymers
Hydroxypropylcellulose
Klucel ™ JXF
USP/NF
Ashland
1:10




PHARM






Hydroxyethylcellulose
Natrosol ™
USP/NF
Ashland
1:10




250HHX







PHARM






Methylcellulose
Benecel ™
USP/NF
Dow
1:10




A4M PHARM






Carbomer
Carbopol
USP/NF
Lubrizol
1:10




971P





Acidifiers
Cystein HCl
Cystein HCl
USP/NF
Spectrum
1:1 






Chemicals




Ascorbic acid
Ascorbic acid
USP/NF
Spectrum
1:1 






Chemicals



Disintegrant
Croscarmellose sodium
Ac-Di-Sol
USP/NF
FMC
1:1 






Biopolymer




Sodium starch glycolate
Explotab ®
USP/NF
JRS Pharma
1:1 






aRatio refers to molar ratio.














TABLE 2







Excipient compatibility schedule











Time Points
Initial
2 Weeks
4 Weeks
8 Weeks





Conditions
NA
25° C./60% RH
25° C./60% RH
25° C./60% RH




(Storage only)






40° C./75% RH
40° C./75% RH
40° C./75% RH




50° C./ambient
50° C./ambient
50° C./ambient





(Storage only)
(Storage only)





Note:


RH represents relative humidity.






The results from the excipient compatibility study have been compiled in Table 3 and Table 4. The level of impurities at each time point compared to initial (t=0) was used as an indication of compatibility issues, based on which, following observations were made.


Bupropion hydrochloride exhibited incompatibility with most of the excipients from the 2 week time point, with total impurities significantly higher than t=0.


Samples containing bupropion hydrochloride only and a combination of dextromethorphan hydrobromide monohydrate-bupropion hydrochloride were observed to be stable for the entire 8 weeks.


Samples containing bupropion hydrochloride in combination with cysteine hydrochloride and ascorbic acid were found to be relatively stable.


Amongst the five polymers tested, Methocel A4M and Carbopol 971P appeared to have the least incompatibility.


Dextromethorphan hydrobromide monohydrate was observed to be significantly more stable as compared to bupropion hydrochloride up to the 8 week time point. The low assay values observed were deemed sampling errors during sample prep or testing due to the nature of the experiment and were not examined any further.









TABLE 3







Excipient compatibility data for bupropion hydrochloride













Time




Sample

Point/
TOTAL RS > LOQ
ASSAY

















ID
Sample
Cond
T = 0
2 wks
4 wks
8 wks
T = 0
2 wks
4 wks
8 wks




















AB
Bupropion
25/60
<LOQ

<LOQ
0.13
100.4

97.6
100.2




40/75

0.43
0.94
1.16

100.4
99.3
101.3




50

0.14



100.6




BB
Bupropion
25/60
<LOQ

0.11
0.22
97.4

98.9
97.3



Dextromethor-
40/75

0.37
1.02
2.08

98.4
101.3
99.7



phan
50

0.14



100.2




CB
Dibasic calcium
25/60
<LOQ

2.91

88.4

87.4




phosphate
40/75

8.76
14.43


85.4
92.7




anhydrous
50

15.33



78.1




DB
Sodium
25/60
<LOQ

2.66

83.6

78.9




carboxymethyl
40/75

52.09
94.64


50.9
4.6




cellulose 7MF
50

99.74



0.1





PH











EB
Hydroxypropyl
25/60
<LOQ

7.96

75.1

79.2




cellulose JXF
40/75

33.63
53.33


54.7
40.3





50

65.54



35.1




FB
Hydroxyethyl-
25/60
<LOQ

7.55

80.7

74.0




cellulose
40/75

24.42
30.13


71.1
78.1




250HHX
50

46.80



62.0




GB
Methyl-
25/60
0.34

0.46
0.89
67.2

82.1
90.4



cellulose A4M
40/75

1.83
4.44
8.62

91.5
75.8
89.4




50

6.22



92.2




HB
Carbomer
25/60
1.03

1.56
2.05
47.1

69.1
81.7



971P
40/75

1.65
2.05
3.40

48.7
48.3
34.6




50

1.85








IB
Cysteine HCl
25/60
<LOQ


ND
87.0

87.1
87.7




40/75

<LOQ
0.20
ND

75.8
80.1
84.8




50

<LOQ








JB
Ascorbic Acid
25/60
<LOQ

0.18
ND
92.9

86.0
71.7




40/75

<LOQ
0
ND

74.3
63.0
64.0




50

<LOQ








KB
Croscarmellose
25/60
12.94

10.88

78.5

92.0




sodium
40/75

91.56
99.72


15.0
0.1





50

99.48








LB
Sodium starch
25/60
0.44

2.77

91.1

95.8




glycolate
40/75

98.62
99.39


1.1
0.1





50

99.30





Note:


RS represents related substances. LOQ means Limit of Quantification.













TABLE 4







Excipient compatibility data for dextromethorphan hydrobromide monohydrate













Time




Sample

Point/
TOTAL RS
ASSAY

















ID
Sample
Condition
T = 0
2 wks
4 wks
8 wks
T = 0
2 wks
4 wks
8 wks




















AD
Dextromethor-
25/60
0.21

0.25
0.20
101.4

102.5
100.2



phan
40/75


0.18
0.72


101.5
100.1




50










BD
Dibasic calcium
25/60
0.38

0.51
0.83
99.8

94.2
88.9



phosphate
40/75


0.60
1.06


94.9
99.9



anhydrous
50










CD
Sodium
25/60
2.47

2.26
3.76
100.4

100.6
88.2



carboxymethyl
40/75


1.21
4.83


96.7
84.0



cellulose 7MF
50











PH











DD
Hydroxypropyl
25/60
0.22

0.21
0.17
102.7

98.3
95.7



cellulose JXF
40/75


0.20
0.18


78.2
98.0




50










ED
Hydroxyethyl-
25/60
<LOQ

<LOQ

75.2

86.7
68.8



cellulose
40/75



0.16


66.0
101.7



250HHX
50










FD
Methyl-
25/60
0.29

0.27
0.26
87.2

94.1
70.7



cellulose A4M
40/75


0.25
0.26


93.3
60.1




50










GD
Carbomer
25/60
0.25

0.24
1.11
81.8

101.7
79.4



971P
40/75


0.28
0.29


64.7
42.9




50










HD
Cysteine HCl
25/60
0.25

0.21
0.52
75.1

92.7
80.1




40/75


0.18
0.20


102.1
60.6




50










ID
Ascorbic Acid
25/60
0.22

0.21
1.18
99.6

97.1
96.5




40/75


0.19
0.64


92.1
105.0




50










JD
Croscarmellose
25/60
0.35

0.30
1.20
73.6

78.5
77.6



sodium
40/75


0.30
0.87


69.2
72.5




50










KD
Sodium starch
25/60
0.24

0.24
1.11
104.2

98.4
89.8



glycolate
40/75


0.23
0.63


85.9
116.8




50










Blend Compatibility:


The excipient compatibility studies clearly indicated instability of bupropion hydrochloride in presence of excipients. The most stable mixtures were observed using a 1:1 molar ratio of bupropion:cysteine hydrochloride and a 1:1 molar ratio of bupropion:ascorbic acid.


A blend stability study was set-up to evaluate the compatibility of bupropion hydrochloride with cysteine hydrochloride in a 1:0.5 molar ratio and a 1:2 ratio in combination with other commonly used excipients. The polymers were restricted to Carbopol971P and Methocel A4M. Similarly, a study was set-up using a combination of bupropion hydrochloride and ascorbic acid. The details of this study and the sample ID #'s are listed in Xcelience protocol #P0328-001B. The composition of samples as well as the results of the blend compatibility study have been presented in Table 5.









TABLE 5







Blend compatibility study













Time




Sample

Point/
TOTAL RS
ASSAY

















ID
Sample
Cond
T = 0
2 wks
4 wks
8 wks
T = 0
2 wks
4 wks
8 wks




















Ai
Bup (1)/Cys HCl
25/60
ND



80.4






(0.5)/MC
40/75

1.1
1.8
1.34

80.2
97.1
108.3




50










Aii
Bup (1)/Cys HCl
25/60
ND



59.2






(2)/MC
40/75

0.13
0.3
0.1

102.6
102.3
98.9




50










Bi
Bup (1)/Asc Acid
25/60
<LOQ



66.5






(0.5)/MC
40/75

11.7
16.43
NA

60.1
82.86
NA




50










Bii
Bup (1)/Asc Acid
25/60
ND



103.1






(2)/MC
40/75

8.4
21.64
NA

78.1
84.7
NA




50










Ci
Bup (1)/Asc Acid
25/60
ND



89.0






(0.5)/HPC
40/75

14.7
33.00
NA

67.8
71.4
NA




50










Cii
Bup (1)/Asc Acid
25/60
ND



79.4






(2)/HPC
40/75

24.9
34.6
NA

81.4
69.9
NA




50










Di
Bup (1)/Asc Acid
25/60
0.20



46.7






(0.5)/NaCMC
40/75

17.9
49.1
NA

34.8
43.9
NA




50










Dii
Bup (1)/Asc Acid
25/60
0.16



45.1






(2)/NaCMC
40/75

19.4
34.2
NA

42.0
53.8
NA




50










Ei
Bup (1)/Cys HCl
25/60
<LOQ



83.8






(0.5)/Carbopol
40/75

0.47
1.0
1.98

39.4
72.4
84.3



971P
50










Eii
Bup (1)/Cys HCl
25/60
ND



86.5






(2)/Carbopol
40/75

0.12
0.10
0.28

55.2
87.3
93.3



971P
50





Note:


Bup: Bupropion;


Cys HCl: Cysteine hydrochloride;


MC: Methyl cellulose;


Asc Acid: Ascorbic acid;


HPC: Hydroxypropyl cellulose;


NaCMC: Sodium carboxymethylcellulose;


NA: Not tested based on results of t = 2 weeks.







Excipient Compatibility Study Conclusion


The data clearly demonstrated the stability of bupropion in presence of cysteine was significantly better as compared to ascorbic acid, specifically when cysteine was used at twice the molar amount of bupropion hydrochloride. This data was used to initiate formulation development with bupropion hydrochloride and cysteine hydrochloride in a 1:2 molar ratio. Based on the results of the excipient compatibility study as well as blend compatibility study, following conclusions were derived.


Bupropion hydrochloride in combination with dextromethorphan exhibited stability and thus, a combination product in form of a bilayer tablet was feasible


Dextromethorphan posed no incompatibility issue with the excipients used in the study, except sodium carboxymethylcellulose


To maintain the stability of bupropion hydrochloride in the formulation, cysteine hydrochloride will be used in 1:2 molar ratio.


Prototypes containing either methyl cellulose or Carbopol as release controlling polymer will be designed, due to the least incompatibility observed with these polymers.


Formulation Development


Formulation development was initiated for BUP105/DEX45 bilayer tablets.


The proposal was to develop the bilayer tablets and use the BUP105 portion to a weight proportional BUP150 tablet with a placebo second layer to match the appearance of both tablets.


In the bupropion hydrochloride layer, Cysteine hydrochloride was used as a stabilizing agent for bupropion hydrochloride, methyl cellulose or Carbopol was used as a release controlling polymer (and binder), microcrystalline cellulose was used as the filler, and magnesium stearate was used as the lubricant. In the dextromethorphan hydrobromide, microcrystalline cellulose was used as filler, croscarmellose sodium was used as the disintegrant, and magnesium stearate was used as the lubricant.


Cysteine hydrochloride was maintained at a 2:1 molar ratio with the API. Prototype 1 and 2 used Methocel A4M as the release controlling polymer at 75 mg/tablet and 39.97 mg/tablet. Prototype 3 and 4 were formulated using Carbopol 971P as the release controlling polymer.


The formulation for the bilayer tablet comprising bupropion hydrochloride, Cysteine hydrochloride monohydrate, and dextromethorphan hydrobromide, used prototypes 9 and 10 as shown in Table 6 below, wherein the molar ratio of the bupropion to the cysteine was 1:1.









TABLE 6







Formulation recipe - prototypes 9-10








Material
Qty. (mg/tablet)












Prototype #
9
10


Blend Batch #
N3123-42
N3123-43











Compression Batch #
N3123-46B
N3123-46A
N3123-47B
N3123-47A







Layer 1


Intragranular











Bupropion HCl
105
150.0
105
150.0


Cysteine HCl, Monohydrate
66.76
95.37
66.76
95.37


Carbopol 971P
50
71.43
40
57.14


Microcrystalline Cellulose PH 101
109.5
156.43
119.52
170.74







Extragranular











Microcrystalline Cellulose PH 102
59.76
85.37
59.76
85.37


Colloidal Silicon dioxide (Cabosil M5P)
4
5.71
4
5.71


Magnesium Stearate
5
7.14
5
7.14


Total layer weight
400
570
400
570







Layer 2 (N3123-45)











Dextromethorphan HBr
45
NA
45
NA


Microcrystalline cellulose PH 102
114.37
NA
114.37
NA


Croscarmellose sodium
8.5
NA
8.5
NA


Magnesium stearate
2.13
NA
2.13
NA


Total layer weight
170
NA
170
NA


Total bilayer core tablet weight
570
570
570
570







COATING











Coating Batch #
N/A3
N3123-49A
N3123-48B
N3123-48A


Opadry II1
22.8
22.8
22.8
22.8


Purified Water2






Total
592.8
592.8
592.8
592.8






1Target weight gain during coating: 4%.




2Evaporated during coating/drying process.




3Coating was not performed on this batch.







CONCLUSIONS

Prototype 10 was chosen to be used for future clinical trial batches. The above data was used to support the GMP manufacturing of bupropion hydrochloride 150 mg tablets, and bupropion hydrochloride 105 mg/dextromethorphan hydrobromide 45 mg tablets. The coating evaluation study performed in Batch #N3123-49A (prototype 9) was used to support the coating process to minimize the tablet surface abrasion issue. The coated tablets from prototype 10 (N3123-48A and 48B) were placed on informal stability testing at accelerated conditions.


Unless otherwise indicated, all numbers expressing quantities of ingredients, properties such as amounts, percentage, and so forth used in the specification and embodiments are to be understood in all instances as indicating both the exact values as shown and as being modified by the term “about.” Accordingly, unless indicated to the contrary, the numerical parameters set forth in the specification and attached embodiments are approximations that may vary depending upon the desired properties sought to be obtained. At the very least, and not as an attempt to limit the application of the doctrine of equivalents to the scope of the embodiments, each numerical parameter should at least be construed in light of the number of reported significant digits and by applying ordinary rounding techniques.


Use of the term “comprising” or “comprises” herein also contemplates that use of “consisting essentially of,” “consists essentially of,” “consisting of,” or “consists of” in its place.


Affirmative recitation of an element anywhere herein should be understood to contemplate both including and excluding that element.


The terms “a,” “an,” “the” and similar referents used in the context of describing the embodiments (especially in the context of the following embodiments) are to be construed to cover both the singular and the plural, unless otherwise indicated herein or clearly contradicted by context. All methods described herein can be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. The use of any and all examples, or exemplary language (e.g., “such as”) provided herein is intended merely to better illuminate the embodiments and does not pose a limitation on the scope of any embodiment. No language in the specification should be construed as indicating any non-claimed element essential to the practice of the embodiments.


Groupings of alternative elements or embodiments disclosed herein are not to be construed as limitations. Each group member may be referred to and claimed individually or in any combination with other members of the group or other elements found herein. It is anticipated that one or more members of a group may be included in, or deleted from a group, for reasons of convenience and/or to expedite prosecution. When any such inclusion or deletion occurs, the specification is deemed to contain the group as modified thus fulfilling the written description of all Markush groups if used in the appended embodiments.


Certain embodiments are described herein, including the best mode known to the inventors for carrying out the claimed embodiments. Of course, variations on these described embodiments will become apparent to those of ordinary skill in the art upon reading the foregoing description. The inventor expects skilled artisans to employ such variations as appropriate, and the inventors intend for the claimed embodiments to be practiced otherwise than specifically described herein. Accordingly, the embodiments include all modifications and equivalents of the subject matter recited in the embodiments as permitted by applicable law. Moreover, any combination of the above-described elements in all possible variations thereof is contemplated unless otherwise indicated herein or otherwise clearly contradicted by context.


In closing, it is to be understood that the embodiments disclosed herein are illustrative of the principles of the embodiments. Other modifications that may be employed are within the scope of the embodiments. Thus, by way of example, but not of limitation, alternative embodiments may be utilized in accordance with the teachings herein. Accordingly, the embodiments are not limited to embodiments precisely as shown and described.

Claims
  • 1. A method of treating depression in a human being in need thereof with a dosage form comprising dextromethorphan, bupropion and cysteine, comprising orally administering the dosage form comprising the dextromethorphan, the bupropion, and the cysteine, wherein the dosage form is a solid and comprises the dextromethorphan in the free base form or a salt form, about 100 mg to about 120 mg of the bupropion in the free base form or a salt form, and about 50 mg to about 100 mg of the cysteine in the neutral form or a salt form, wherein the dosage form has a molar ratio of the bupropion to the cysteine that is about 0.5:1 to about 1.1:1, wherein bupropion and dextromethorphan, are the only therapeutic active agents in the dosage form, wherein the dosage form is a bilayer dosage form, and wherein the bupropion and the cysteine are in a first layer and the dextromethorphan is in a second layer.
  • 2. The method of claim 1, wherein the dosage form has a molar ratio of the bupropion to the cysteine that is about 0.7:1 to about 1.1:1.
  • 3. The method of claim 1, wherein the molar ratio of the bupropion to the cysteine is about 1:1.
  • 4. The method of claim 1, wherein the dosage form further comprises a sustained release polymer.
  • 5. The method of claim 4, wherein the sustained release polymer is an acrylate polymer or copolymer, a methylcellulose, or a combination thereof.
  • 6. The method of claim 1, wherein the dosage form is in the form of a capsule, a pill, or a tablet.
  • 7. The method of claim 1, wherein the dosage form further comprises a filler.
  • 8. The method of claim 7, wherein the filler is microcrystalline cellulose.
  • 9. The method of claim 1, wherein the dosage form further comprises a lubricant.
  • 10. The method of claim 9, wherein the lubricant is magnesium stearate.
  • 11. The method of claim 1, wherein the cysteine is L-cysteine hydrochloride monohydrate.
  • 12. The method of claim 1, wherein the dosage form comprises a molecular complex of bupropion and cysteine.
  • 13. The method of claim 1, wherein the bupropion in the dosage form is more stable than bupropion alone.
  • 14. The method of claim 12, wherein the bupropion in the dosage form is more stable than bupropion alone.
  • 15. The method of claim 1, wherein the bupropion is bupropion hydrochloride.
  • 16. The method of claim 15, wherein the cysteine is L-cysteine hydrochloride monohydrate.
  • 17. The method of claim 16, wherein the molar ratio of the bupropion to the cysteine is about 1:1.
CROSS REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Pat. App. No. 63/578,241, filed Aug. 23, 2023; which is incorporated by reference in its entirety.

US Referenced Citations (357)
Number Name Date Kind
5358970 Ruff Oct 1994 A
5731000 Ruff et al. Mar 1998 A
5763493 Ruff et al. Jun 1998 A
6306436 Chungi et al. Oct 2001 B1
6780871 Glick et al. Aug 2004 B2
8088786 McKinney et al. Jun 2012 B2
8569328 Tabuteau Oct 2013 B1
9168234 Tabuteau Oct 2015 B2
9198905 Tabuteau Dec 2015 B2
9205083 Tabuteau Dec 2015 B2
9238032 Tabuteau Jan 2016 B2
9278095 Tabuteau Mar 2016 B2
9314462 Tabuteau Apr 2016 B2
9364458 Huang Jun 2016 B2
9370513 Tabuteau Jun 2016 B2
9375429 Tabuteau Jun 2016 B2
9402843 Tabuteau Aug 2016 B2
9402844 Tabuteau Aug 2016 B2
9408815 Tabuteau Aug 2016 B2
9421176 Tabuteau Aug 2016 B1
9457023 Tabuteau Oct 2016 B1
9457025 Tabuteau Oct 2016 B2
9474731 Tabuteau Oct 2016 B1
9486450 Tabuteau Nov 2016 B2
9700528 Tabuteau Jul 2017 B2
9700553 Tabuteau Jul 2017 B2
9707191 Tabuteau Jul 2017 B2
9763932 Tabuteau Sep 2017 B2
9861595 Tabuteau Jan 2018 B2
9867819 Tabuteau Jan 2018 B2
9968568 Tabuteau May 2018 B2
10058518 Tabuteau Aug 2018 B2
10064857 Tabuteau Sep 2018 B2
10080727 Tabuteau Sep 2018 B2
10092560 Tabuteau Oct 2018 B2
10092561 Tabuteau Oct 2018 B2
10105327 Tabuteau Oct 2018 B2
10105361 Tabuteau Oct 2018 B2
10251879 Tabuteau Apr 2019 B2
10463634 Tabuteau Nov 2019 B2
10512643 Tabuteau Dec 2019 B2
10548857 Tabuteau Feb 2020 B2
10596167 Tabuteau Mar 2020 B2
10688066 Tabuteau Jun 2020 B2
10695304 Tabuteau Jun 2020 B2
10772850 Tabuteau Sep 2020 B2
10780064 Tabuteau Sep 2020 B2
10780066 Tabuteau Sep 2020 B2
10786469 Tabuteau Sep 2020 B2
10786496 Tabuteau Sep 2020 B2
10799497 Tabuteau Oct 2020 B2
10806710 Tabuteau Oct 2020 B2
10813924 Tabuteau Oct 2020 B2
10864209 Tabuteau Dec 2020 B2
10874663 Tabuteau Dec 2020 B2
10874664 Tabuteau Dec 2020 B2
10874665 Tabuteau Dec 2020 B2
10881624 Tabuteau Jan 2021 B2
10881657 Tabuteau Jan 2021 B2
10894046 Tabuteau Jan 2021 B2
10894047 Tabuteau Jan 2021 B2
10898453 Tabuteau Jan 2021 B2
10925842 Tabuteau Feb 2021 B2
10933034 Tabuteau Mar 2021 B2
10940124 Tabuteau Mar 2021 B2
10945973 Tabuteau Mar 2021 B2
10966941 Tabuteau Apr 2021 B2
10966942 Tabuteau Apr 2021 B2
10966974 Tabuteau Apr 2021 B2
10980800 Tabuteau Apr 2021 B2
11007189 Tabuteau May 2021 B2
11020389 Tabuteau Jun 2021 B2
11058648 Tabuteau Jul 2021 B2
11065248 Tabuteau Jul 2021 B2
11090300 Tabuteau Aug 2021 B2
11096937 Tabuteau Aug 2021 B2
11123343 Tabuteau Sep 2021 B2
11123344 Tabuteau Sep 2021 B2
11129826 Tabuteau Sep 2021 B2
11141388 Tabuteau Oct 2021 B2
11141416 Tabuteau Oct 2021 B2
11147808 Tabuteau Oct 2021 B2
11185515 Tabuteau Nov 2021 B2
11191739 Tabuteau Dec 2021 B2
11197839 Tabuteau Dec 2021 B2
11207281 Tabuteau Dec 2021 B2
11213521 Tabuteau Jan 2022 B2
11229640 Tabuteau Jan 2022 B2
11234946 Tabuteau Feb 2022 B2
11253491 Tabuteau Feb 2022 B2
11253492 Tabuteau Feb 2022 B2
11273133 Tabuteau Mar 2022 B2
11273134 Tabuteau Mar 2022 B2
11285118 Tabuteau Mar 2022 B2
11285146 Tabuteau Mar 2022 B2
11291638 Tabuteau Apr 2022 B2
11291665 Tabuteau Apr 2022 B2
11298351 Tabuteau Apr 2022 B2
11298352 Tabuteau Apr 2022 B2
11311534 Tabuteau Apr 2022 B2
11344544 Tabuteau May 2022 B2
11357744 Tabuteau Jun 2022 B2
11364233 Tabuteau Jun 2022 B2
11382874 Tabuteau Jul 2022 B2
11419867 Tabuteau Aug 2022 B2
11426370 Tabuteau Aug 2022 B2
11426401 Tabuteau Aug 2022 B2
11433067 Tabuteau Sep 2022 B2
11439636 Tabuteau Sep 2022 B1
11478468 Tabuteau Oct 2022 B2
11497721 Tabuteau Nov 2022 B2
11510918 Tabuteau Nov 2022 B2
11517542 Tabuteau Dec 2022 B2
11517543 Tabuteau Dec 2022 B2
11517544 Tabuteau Dec 2022 B2
11524007 Tabuteau Dec 2022 B2
11524008 Tabuteau Dec 2022 B2
11534414 Tabuteau Dec 2022 B2
11541021 Tabuteau Jan 2023 B2
11541048 Tabuteau Jan 2023 B2
11571399 Tabuteau Feb 2023 B2
11571417 Tabuteau Feb 2023 B2
11576877 Tabuteau Feb 2023 B2
11576909 Tabuteau Feb 2023 B2
11590124 Tabuteau Feb 2023 B2
11596627 Tabuteau Mar 2023 B2
11617728 Tabuteau Apr 2023 B2
11617747 Tabuteau Apr 2023 B2
11628149 Tabuteau Apr 2023 B2
11660273 Tabuteau May 2023 B2
11660274 Tabuteau May 2023 B2
11717518 Tabuteau Aug 2023 B1
11730706 Tabuteau Aug 2023 B1
11752144 Tabuteau Sep 2023 B1
11779579 Tabuteau Oct 2023 B2
11839612 Tabuteau Dec 2023 B1
11844797 Tabuteau Dec 2023 B1
11883373 Tabuteau Jan 2024 B1
11896563 Tabuteau Feb 2024 B2
11925636 Tabuteau Mar 2024 B2
11969421 Tabuteau Apr 2024 B2
11986444 Tabuteau May 2024 B2
12036191 Tabuteau Jul 2024 B1
12042473 Tabuteau Jul 2024 B2
12109178 Tabuteau Oct 2024 B2
12138260 Tabuteau Nov 2024 B2
12146889 Tabuteau Nov 2024 B1
12156914 Tabuteau Dec 2024 B2
12194005 Tabuteau Jan 2025 B2
12194006 Tabuteau Jan 2025 B2
12194036 Tabuteau Jan 2025 B2
20020035105 Caruso Mar 2002 A1
20030044462 Subramanian et al. Mar 2003 A1
20080044462 Trumbore et al. Feb 2008 A1
20100040679 Chang Feb 2010 A1
20100291225 Fanda et al. Nov 2010 A1
20150126541 Tabuteau May 2015 A1
20150126542 Tabuteau May 2015 A1
20150126543 Tabuteau May 2015 A1
20150126544 Tabuteau May 2015 A1
20150133485 Tabuteau May 2015 A1
20150133486 Tabuteau May 2015 A1
20150150830 Tabuteau Jun 2015 A1
20150157582 Tabuteau Jun 2015 A1
20150342947 Pollard et al. Dec 2015 A1
20160008352 Tabuteau Jan 2016 A1
20160030420 Tabuteau Feb 2016 A1
20160030421 Tabuteau Feb 2016 A1
20160128944 Chawrai et al. May 2016 A1
20160128998 Tabuteau May 2016 A1
20160136155 Tabuteau May 2016 A1
20160199321 Tabuteau Jul 2016 A1
20160228390 Tabuteau Aug 2016 A1
20160263099 Tabuteau Sep 2016 A1
20160263100 Tabuteau Sep 2016 A1
20160317475 Tabuteau Nov 2016 A1
20160317476 Tabuteau Nov 2016 A1
20160324807 Tabuteau Nov 2016 A1
20160339017 Tabuteau Nov 2016 A1
20160346276 Tabuteau Dec 2016 A1
20160361305 Tabuteau Dec 2016 A1
20160375008 Tabuteau Dec 2016 A1
20160375012 Tabuteau Dec 2016 A1
20170007558 Tabuteau Jan 2017 A1
20170014357 Tabuteau Jan 2017 A1
20170252309 Tabuteau Sep 2017 A1
20170281617 Tabuteau Oct 2017 A1
20170304229 Tabuteau Oct 2017 A1
20170304230 Tabuteau Oct 2017 A1
20170304298 Tabuteau Oct 2017 A1
20170354619 Tabuteau Dec 2017 A1
20170360773 Tabuteau Dec 2017 A1
20170360774 Tabuteau Dec 2017 A1
20170360776 Tabuteau Dec 2017 A1
20180092906 Tabuteau Apr 2018 A1
20180116980 Tabuteau May 2018 A1
20180133195 Tabuteau May 2018 A1
20180207151 Tabuteau Jul 2018 A1
20180256518 Tabuteau Sep 2018 A1
20180360823 Tabuteau Dec 2018 A1
20190000835 Tabuteau Jan 2019 A1
20190008800 Tabuteau Jan 2019 A1
20190008801 Tabuteau Jan 2019 A1
20190008805 Tabuteau Jan 2019 A1
20190015407 Tabuteau Jan 2019 A1
20190083426 Tabuteau Mar 2019 A1
20190142768 Tabuteau May 2019 A1
20190192450 Tabuteau Jun 2019 A1
20190192507 Tabuteau Jun 2019 A1
20190216798 Tabuteau Jul 2019 A1
20190216800 Tabuteau Jul 2019 A1
20190216801 Tabuteau Jul 2019 A1
20190290601 Tabuteau Sep 2019 A1
20200022929 Tabuteau Jan 2020 A1
20200093762 Tabuteau Mar 2020 A1
20200147008 Tabuteau May 2020 A1
20200147075 Tabuteau May 2020 A1
20200197388 Bear Jun 2020 A1
20200206217 Tabuteau Jul 2020 A1
20200215055 Tabuteau Jul 2020 A1
20200215056 Tabuteau Jul 2020 A1
20200215057 Tabuteau Jul 2020 A1
20200215058 Tabuteau Jul 2020 A1
20200215059 Tabuteau Jul 2020 A1
20200222389 Tabuteau Jul 2020 A1
20200230078 Tabuteau Jul 2020 A1
20200230129 Tabuteau Jul 2020 A1
20200230130 Tabuteau Jul 2020 A1
20200230131 Tabuteau Jul 2020 A1
20200237751 Tabuteau Jul 2020 A1
20200237752 Tabuteau Jul 2020 A1
20200246280 Tabuteau Aug 2020 A1
20200261431 Tabuteau Aug 2020 A1
20200297666 Tabuteau Sep 2020 A1
20200338022 Tabuteau Oct 2020 A1
20200360310 Tabuteau Nov 2020 A1
20200397723 Tabuteau Dec 2020 A1
20200397724 Tabuteau Dec 2020 A1
20200405664 Tabuteau Dec 2020 A1
20210000763 Tabuteau Jan 2021 A1
20210000764 Tabuteau Jan 2021 A1
20210000765 Tabuteau Jan 2021 A1
20210000768 Tabuteau Jan 2021 A1
20210000820 Tabuteau Jan 2021 A1
20210015768 Tabuteau Jan 2021 A1
20210015814 Tabuteau Jan 2021 A1
20210015815 Tabuteau Jan 2021 A1
20210023075 Tabuteau Jan 2021 A1
20210023076 Tabuteau Jan 2021 A1
20210030747 Tabuteau Feb 2021 A1
20210030749 Tabuteau Feb 2021 A1
20210030750 Tabuteau Feb 2021 A1
20210030751 Tabuteau Feb 2021 A1
20210046067 Tabuteau Feb 2021 A1
20210052521 Tabuteau Feb 2021 A1
20210060004 Tabuteau Mar 2021 A1
20210060005 Tabuteau Mar 2021 A1
20210069125 Tabuteau Mar 2021 A1
20210069128 Tabuteau Mar 2021 A1
20210077428 Tabuteau Mar 2021 A1
20210077429 Tabuteau Mar 2021 A1
20210077483 Tabuteau Mar 2021 A1
20210106546 Tabuteau Apr 2021 A1
20210177834 Tabuteau Jun 2021 A1
20210186899 Tabuteau Jun 2021 A1
20210186900 Tabuteau Jun 2021 A1
20210186901 Tabuteau Jun 2021 A1
20210186955 Tabuteau Jun 2021 A1
20210186956 Tabuteau Jun 2021 A1
20210196704 Tabuteau Jul 2021 A1
20210196705 Tabuteau Jul 2021 A1
20210205239 Tabuteau Jul 2021 A1
20210205240 Tabuteau Jul 2021 A1
20210205297 Tabuteau Jul 2021 A1
20210220293 Tabuteau Jul 2021 A1
20210220294 Tabuteau Jul 2021 A1
20210220348 Tabuteau Jul 2021 A1
20210260054 Tabuteau Aug 2021 A1
20210267967 Tabuteau Sep 2021 A1
20210338605 Tabuteau Nov 2021 A1
20210346370 Tabuteau Nov 2021 A1
20210361645 Tabuteau Nov 2021 A1
20210401828 Tabuteau Dec 2021 A1
20210401829 Tabuteau Dec 2021 A1
20210401830 Tabuteau Dec 2021 A1
20210401831 Tabuteau Dec 2021 A1
20220008363 Tabuteau Jan 2022 A1
20220071930 Tabuteau Mar 2022 A1
20220071931 Tabuteau Mar 2022 A1
20220079892 Tabuteau Mar 2022 A1
20220096462 Tabuteau Mar 2022 A1
20220105086 Tabuteau Apr 2022 A1
20220133655 Tabuteau May 2022 A1
20220142950 Tabuteau May 2022 A1
20220193012 Tabuteau Jun 2022 A1
20220218631 Tabuteau Jul 2022 A1
20220218698 Tabuteau Jul 2022 A1
20220233470 Tabuteau Jul 2022 A1
20220233474 Tabuteau Jul 2022 A1
20220233518 Tabuteau Jul 2022 A1
20220233519 Tabuteau Jul 2022 A1
20220241220 Tabuteau Aug 2022 A1
20220241221 Tabuteau Aug 2022 A1
20220241269 Tabuteau Aug 2022 A1
20220241270 Tabuteau Aug 2022 A1
20220265639 Tabuteau Aug 2022 A1
20220280504 Tabuteau Sep 2022 A1
20220313689 Tabuteau Oct 2022 A1
20220323381 Tabuteau Oct 2022 A1
20220378779 Tabuteau Dec 2022 A1
20230045675 Tabuteau Feb 2023 A1
20230096437 Tabuteau Mar 2023 A1
20230099206 Tabuteau Mar 2023 A1
20230100008 Tabuteau Mar 2023 A1
20230100913 Tabuteau Mar 2023 A1
20230114111 Tabuteau Apr 2023 A1
20230131854 Tabuteau Apr 2023 A1
20230142244 Tabuteau May 2023 A1
20230210843 Tabuteau Jul 2023 A1
20230218550 Tabuteau Jul 2023 A1
20230225995 Tabuteau Jul 2023 A1
20230233491 Tabuteau Jul 2023 A1
20230241010 Tabuteau Aug 2023 A1
20230248668 Tabuteau Aug 2023 A1
20230248669 Tabuteau Aug 2023 A1
20230255905 Tabuteau Aug 2023 A1
20230263750 Tabuteau Aug 2023 A1
20230270740 Tabuteau Aug 2023 A1
20230277478 Tabuteau Sep 2023 A1
20230277479 Tabuteau Sep 2023 A1
20230277480 Tabuteau Sep 2023 A1
20230277481 Tabuteau Sep 2023 A1
20230293456 Tabuteau Sep 2023 A1
20240000770 Tabuteau Jan 2024 A1
20240016797 Tabuteau Jan 2024 A1
20240024309 Tabuteau Jan 2024 A1
20240041862 Tabuteau Feb 2024 A1
20240041863 Tabuteau Feb 2024 A1
20240050383 Tabuteau Feb 2024 A1
20240066025 Tabuteau Feb 2024 A1
20240115524 Tabuteau Apr 2024 A1
20240148719 Tabuteau May 2024 A1
20240156751 Tabuteau May 2024 A1
20240165104 Tabuteau May 2024 A1
20240189302 Tabuteau Jun 2024 A1
20240197656 Tabuteau Jun 2024 A1
20240197720 Tabuteau Jun 2024 A1
20240238276 Tabuteau Jul 2024 A1
20240252451 Tabuteau Aug 2024 A1
20240269130 Tabuteau Aug 2024 A1
20240299319 Tabuteau Sep 2024 A1
20240299320 Tabuteau Sep 2024 A1
20240307408 Tabuteau Sep 2024 A1
20240390297 Tabuteau Nov 2024 A1
20240408040 Tabuteau Dec 2024 A1
20250009754 Tabuteau Jan 2025 A1
20250012821 Tabuteau Jan 2025 A1
Foreign Referenced Citations (15)
Number Date Country
102016010170 Nov 2017 BR
4183391 May 2023 EP
101612197 Apr 2016 KR
1998050044 Nov 1998 WO
2003086362 Oct 2003 WO
2004089873 Oct 2004 WO
2009006194 Jan 2009 WO
2009050726 Apr 2009 WO
2015069809 May 2015 WO
2016125108 Aug 2016 WO
2020146412 Jul 2020 WO
2021202329 Oct 2021 WO
2021202419 Oct 2021 WO
2022119981 Jun 2022 WO
2023004064 Jan 2023 WO
Non-Patent Literature Citations (58)
Entry
Spravato (esketamine), Highlights of Prescribing Information, revised Jul. 2020.
Nuedexta (dextromethorphan hydrobromide and quinidine sulfate), Highlights of Prescribing Information, revised Dec. 2022.
Aplenzin (bupropion hydrobromide), Highlights of Prescribing Information, revised Mar. 2022.
Tod et al., Quantitative Prediction of Cytochrome P450 (Cyp) 2D6-Mediated Drug Interactions, Clinical Pharmacokinetics, 50(8), 519-530, Aug. 2011.
Kotlyar et al., Inhibition of CYP2D6 Activity by Bupropion, Journal of Clinical Psychopharmacology, 25(2), 226-229, Jun. 2005.
Pope et al., Pharmacokinetics of Dextromethorphan after Single or Multiple Dosing in Combination with Quinidine in Extensive and Poor Metabolizers, The Journal of Clinical Pharmacology, 44(10), 1132-1142, Oct. 2004.
Auvelity (dextromethorphan hydrobromide and bupropion hydrochloride), Highlights of Prescribing Information and Medication Guide, issued Dec. 2022.
International Preliminary Report on Patentability, PCT/US2021/061492, mailed on Jun. 15, 2023.
International Search Report and Written Opinion, PCT/US2021/061492 received on Jun. 15, 2023.
International Search Report and Written Opinion, PCT/US2022/012768 received on Jul. 5, 2023.
International Search Report and Written Opinion, PCT/US2023/067062 mailed on Jul. 12, 2023.
Axsome Therapeutics Announces Topline Results of the Stride-1 Phase 3 Trial in Treatment Resistant Depression and Expert Call to Discuss Clinical Implications, Mar. 2020 (retrieved from internet on Jul. 19, 2023). <axsometherapeuticsinc.gcs-web.com/node/9176/pdf>.
Anderson, A.; et al. “Efficacy and Safety of AXS-05, an Oral NMDA Receptor Antagonist with Multimodal Activity, in Major Depressive Disorder: Results of a Phase 2, Double-Blind, Active-Controlled Trial” ASCP Annual Meeting 2019 (retrieved from internet on Jul. 19, 2023). <d3dyybxyjb4kyh.cloudfront.net/pdfs/SOBP+2021+AXS-05+MDD+Poster+FINAL.pdf> (May 2019).
O'Gorman, C; et al. “Rapid Effects of AXS 05, an Oral NMDA Receptor Antagonist, in Major Depressive Disorder: Results from Two Randomized, Double Blind, Controlled Trials” ASCP Annual Meeting 2021 (retrieved from internet on Jul. 19, 2023). <d3dyybxyjb4kyh.cloudfront.net/pdfs/SOBP+2021+AXS-05+MDD+Poster+FINAL.pdf> (Jun. 2021).
O'Gorman, C.; et al. “PMH40 Effects of AXS-05 on Patient Reported Depressive Symptoms in Major Depressive Disorder: Results from the Gemini Trial” <doi.org/10.1016/j.jval.2021.04.662> (retrieved from internet on Jul. 19, 2023). Value in Health, Jun. 2021, vol. 24, Supplement 1, pp. S135.
O'Gorman, C.; et al. “P246. Rapid Antidepressant Effects and MADRS Core Symptom Improvements With AXS-05, an Oral NMDA Receptor Antagonist, in Major Depressive Disorder: Results From Two Randomized, Double-Blind, Controlled Trials” ACNP 60th Annual Meeting: Poster Abstracts P246 <nature.com/articles/s41386-021-01236-7> (retrieved from internet on Jul. 19, 2023). Neuropsychopharmacol. 46 (Suppl 1), 72-217, Dec. 2021.
International Preliminary Report on Patentability, PCT/US2022/012768, mailed on Jul. 27, 2023.
Nofziger et al., Evaluation of dextromethorphan with select antidepressant therapy for the treatment of depression in the acute care psychiatric setting, Mental Health Clinician, 9(2), 76-81, Mar. 2019.
Update: Bupropion Hydrochloride Extended-Release 300 mg Bioequivalence Studies, FDA, retrieved Mar. 2021.
FDA Draft Guidance on Bupropion Hydrochloride, revised Mar. 2013.
Forfivo XL (bupropion hydrochloride) extended-release tablets, for oral use, Highlights of Prescribing Information, revised Dec. 2019.
Forfivo XL (Bupropion HCI) extended-release tablet, NDA 22497, Jan. 25, 2010.
Wellbutrin XL (bupropion hydrochloride extended-release), Highlights of Prescribing Information, revised Mar. 2022.
Baker T. E. et al., Human Milk and Plasma Pharmacokinetics of Single-Dose Rimegepant 75mg in Healthy Lactating Women, Breastfeeding Medicine, 17(3), 277-282, 2022.
Berle J. O. et al., Antidepressant Use During Breastfeeding, Current Women's Health Reviews, 7(1), 28-34, Feb. 2011.
Briggs G. G. et al., Excretion of bupropion in breast milk, Annals of Pharmacotherapy, 27(4):431-433, Apr. 1993.
Chad L. et al., Update on antidepressant use during breastfeeding, Canadian Family Physician, 59(6), 633-634, Jun. 2013.
Chaudron L. H. et al., Bupropion and Breastfeeding: A case of a possible Infant Seizure, The Journal of clinical psychiatry, 65(6), 881-882, Jun. 2004.
Davis M. F. et al., Bupropion Levels in Breast Milk for 4 Mother-Infant Pairs: More Answers to Lingering Questions, J. Clin. Psychiatry, 70(2), 297-298, Feb. 2009.
Di Scalea T. L. et al., Antidepressant Medication Use during Breastfeeding, Clinical obstetrics and gynecology, 52 (3): 483-497, Sep. 2009.
Dwoskin L. P. et al., Review of the Pharmacology and Clinical Profile of Bupropion, and Antidepressant and Tobacco Use Cessation Agent, CNS Drug Reviews, 12(3-4), 178-207, Sep. 2006.
Gentile S, The safety of newer antidepressants in pregnancy and breastfeeding, Drug Safety, 28(2), 137-152, Feb. 2005. [doi: 10.2165/00002018-200528020-00005. PMID: 15691224.].
Haas J. S. et al., Bupropion in breast milk: an exposure assessment for potential treatment to prevent post-partum tobacco use, Tobacco Control, 13(1), 52-56, Mar. 2004.
Ram D. et al., Antidepressants, anxiolytics, and hypnotics in pregnancy and lactation, Indian J Psychiatry, 57(Suppl 2): S354-S371, Jul. 2015. [doi:10.4103/0019-5545.161504].
Weissman A. M. et al., Pooled Analysis of Antidepressant Levels in Lactating Mothers, Breast Milk, and Nursing Infants, Am J Psychiatry, 161(6), 1066-1078, Jun. 2004.
Horn J. R. et al., Get to Know an Enzyme: CYP2D6, Pharmacy Times, Jul. 2008, retrieved on Aug. 28, 2023.
International Search Report and Written Opinion, PCT/US2023/069286 mailed on Aug. 22, 2023.
International Search Report and Written Opinion, PCT/US2023/069239 mailed on Aug. 28, 2023.
International Search Report and Written Opinion, PCT/US2023/069367 mailed on Aug. 28, 2023.
International Search Report and Written Opinion, PCT/US2023/069655 mailed on Sep. 15, 2023.
International Search Report and Written Opinion, PCT/US2023/069371 mailed on Sep. 26, 2023.
International Search Report and Written Opinion, PCT/US2022/037913 mailed on Sep. 21, 2022.
Jones A et al., “Early Improvements in Functioning and Quality of Life With AXS-05 in Major Depressive Disorder: Results From the Gemini Trial ,” Value in Health, Jun. 2021, vol. 24, abstract No. PHM42, p. S135. Doi:10.1016/j.jval.2021.04.662.
International Search Report and Written Opinion, PCT/US2022/074713 mailed on Sep. 21, 2022.
Axsome Therapeutics, Inc.: “Merit: A Randomized, Double-blind, Placebo-controlled Study of AXS-05 for Relapse Prevention in Treatment Resistant Depression,” ClinicalTrials.gov, NCT04608396 version 2, Mar. 24, 2021.
International Preliminary Report on Patentability, PCT/US2022/037913, issued on Jan. 18, 2024.
International Preliminary Report on Patentability, PCT/US2022/074713, issued on Feb. 22, 2024.
Chinese Pat. No. 202080004041.1 Invalidation Notice and Request issued on Jan. 15, 2024. (English translation included).
Ward K. and Citrome L.: “AXS-05: an investigational treatment for Alzheimer's disease-associated agitation”, Expert Opinion on Investigational Drugs, Jul. 6, 2022, vol. 31, issue 8, pp. 773-780, DOI: 10.1080/13543784.2022.2096006.
Defendant Teva Pharmaceuticals, Inc.'s Invalidity Contentions for U.S. Pat. Nos. 11,752,144, 11,717,518, 11,730,706 and Exhibits A-C dated Apr. 11, 2024.
Goodnick, Psychotropic drugs and the ECG: focus on the QTc interval, Expert Opinion on Pharmacotherapy, vol. 3, No. 5, p. 479-498, 2002.
International Search Report and Written Opinion, PCT/US2024/046359 mailed on Nov. 28, 2024.
Tabuteau H, et al. “Effect of AXS-05 (Dextromethorphan-Bupropion) in Major Depressive Disorder: A Randomized Double-Blind Controlled Trial” Am J Psychiatry (2022) vol. 179 pp. 490-499. doi: 10.1176/appi.ajp.21080800.
International Preliminary Report on Patentability, PCT/US2023/067062, mailed on Nov. 28, 2024.
International Search Report and Written Opinion, PCT/US2024/043903 mailed on Nov. 28, 2024.
International Preliminary Report on Patentability, PCT/US2023/069286, mailed on Jan. 9, 2025.
International Preliminary Report on Patentability, PCT/US2023/069371, mailed on Jan. 9, 2025.
International Preliminary Report on Patentability, PCT/US2023/069655, mailed on Jan. 16, 2025.
Related Publications (1)
Number Date Country
20250041426 A1 Feb 2025 US
Provisional Applications (3)
Number Date Country
63370777 Aug 2022 US
63370554 Aug 2022 US
63357318 Jun 2022 US
Continuations (1)
Number Date Country
Parent 18169402 Feb 2023 US
Child 18921291 US