JDTic is a selective, long-acting ("inactivating") antagonist of the κ-opioid receptor (KOR). JDTic is a 4-phenylpiperidine derivative, distantly related structurally to analgesics such as pethidine and ketobemidone, and more closely to the MOR antagonist alvimopan. In addition, it is structurally distinct from other KOR antagonists such as norbinaltorphimine. JDTic has been used to create crystal structures of KOR [ ].
Pharmacology JDTic is a potent KOR antagonist, and is highly selective for KOR over μ- (MOR) and δ-opioid receptors (DOR), along with many non-opioid receptors. However, it shows modest affinity for the nociceptin receptor (NOP). In one study, JDTic showed little binding selectivity over the μ-opioid receptor, but it failed to block the effects of the selective μ-opioid receptor agonist sufentanil across a wide range of doses in animals. It has a very long duration of action, with effects in animals seen for up to several weeks after administration of a single dose, although its binding to the KOR is not irreversible; its long duration of action is instead caused by activation of a c-Jun N-terminal kinase.
Animal studies suggest that JDTic may produce antidepressant, anxiolytic, and anti-stress effects, as well as having possible application in the treatment of addiction to cocaine and morphine. JDTic shows robust activity in animal models of depression, anxiety, stress-induced cocaine relapse, and nicotine withdrawal.
Discontinuation of clinical development During phase I human clinical trials for the treatment of cocaine abuse, development of JDTic was halted due to the occurrence of non-sustained ventricular tachycardia, a type of arrhythmia that can potentially be life-threatening. As a result, new KOR antagonists with more favorable drug profiles (e.g., short-acting, improved brain penetration, etc.), such as ALKS-5461 (a combination of buprenorphine and samidorphan) and CERC-501 (formerly LY-2456302), are being developed instead.
The discontinuation of the clinical development of JDTic is detailed in the following important literature quote:
In the same paper, LY-2456302 (now CERC-501) was described, "The LY2456302 compound developed by Eli Lilly is an example of a KOR antagonist that does not strongly activate JNK. In a recent phase 1 trial of LY2456302, the authors concluded that the drug was well-tolerated with no clinically significant findings (Lowe et al, 2014)." Note that KOR antagonists that strongly activate JNK are inactivating (long-acting) while those that do not are non-inactivating (short-acting), and that inactivating KOR antagonists are more "complete" and hence potentially more risky inhibitors of the KOR than are non-inactivating antagonists.
See also κ-Opioid receptor § Antagonists List of investigational antidepressants
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