Thioridazine Research Articles

UV-Light Effects on Cytochrome C Modulated by the Aggregation State of Phenothiazines

The present study shows the factors that modulate the photodamage promoted by phenothiazines. Cytochrome c was irradiated with UV light for 120 min, over a pH range from 4.0 to 8.0, in the absence and in the presence of different concentrations of thioridazine (TR) and fluphenazine (FP). In the absence of phenothiazines, the maximal rate of a Soret band blue shift (nm/min) from 409 to 406 nm was obtained at pH 4.0 (0.028 nm/min). The presence of phenothiazines at the concentration range 10-25 µmol/L amplified and accelerated a cytochrome c blue shift (409 to 405 nm, at a rate = 0.041 nm/min). Above 25 µmol/L, crescent concentrations of phenothiazines contributed to cytochrome c protection with (maximal at 2500 µmol/L). Scanning electronic microscopy revealed the formation of nanostructures. The pH also influenced the effect of low phenothiazine concentrations on cytochrome c. Thus, the predominance of phenothiazine-promoted cytochrome c damage or protection depends on a balance of the following factors: the yield of photo-generated drug cation radicals, which is favored by acidic pH; the stability of the cation radicals, which is favored by the drug aggregation; and the cytochrome c structure, modulated by the pH.

Thioridazine Induces Major Changes in Global Gene Expression and Cell Wall Composition in Methicillin-Resistant Staphylococcus aureus USA300

Subinhibitory concentrations of the neuroleptic drug thioridazine (TDZ) are well-known to enhance the killing of methicillin-resistant Staphylococcus aureus (MRSA) by β-lactam antibiotics, however, the mechanism underlying the synergy between TDZ and β-lactams is not fully understood. In the present study, we have examined the effect of a subinhibitory concentration of TDZ on antimicrobial resistance, the global transcriptome, and the cell wall composition of MRSA USA300. We show that TDZ is able to sensitize the bacteria to several classes of antimicrobials targeting the late stages of peptidoglycan (PGN) synthesis. Furthermore, our microarray analysis demonstrates that TDZ modulates the expression of genes encoding membrane and surface proteins, transporters, and enzymes involved in amino acid biosynthesis. Interestingly, resemblance between the transcriptional profile of TDZ treatment and the transcriptomic response of S. aureus to known inhibitors of cell wall synthesis suggests that TDZ disturbs PGN biosynthesis at a stage that precedes transpeptidation by penicillin-binding proteins (PBPs). In support of this notion, dramatic changes in the muropeptide profile of USA300 were observed following growth in the presence of TDZ, indicating that TDZ can interfere with the formation of the pentaglycine branches. Strikingly, the addition of glycine to the growth medium relieved the effect of TDZ on the muropeptide profile. Furthermore, exogenous glycine offered a modest protective effect against TDZ-induced β-lactam sensitivity. We propose that TDZ exposure leads to a shortage of intracellular amino acids, including glycine, which is required for the production of normal PGN precursors with pentaglycine branches, the correct substrate of S. aureus PBPs. Collectively, this work demonstrates that TDZ has a major impact on the cell wall biosynthesis pathway in S. aureus and provides new insights into how MRSA may be sensitized towards β-lactam antibiotics.

Spectrofluorimetric determination of certain antidepressant drugs in human plasma

BackgroundCertain antidepressant drugs namely Sertraline hydrochloride, Fluoxetine hydrochloride, Paroxetine hydrochloride, Thioridazine hydrochloride and Amineptine hydrochloride were studied throughout this work using spectrofluorimetric method.MethodsThe spectrofluorimetric method is based on the charge-transfer reaction of these drugs as n-electron donors with 7,7,8,8-tetracyanoquinodimethane (TCNQ) as π-electron acceptor. The drug-TCNQ complexes showed excitation maxima ranged from 290-301 nm and emission maxima ranged from 443-460 nm.Results and discussionThe different experimental parameters affecting the formation and stability of the complexes were carefully studied and optimized. The calibration plots were constructed over the range of 50-450 ng mL-1 for Fluoxetine and Sertraline, 50-550 ng mL-1 for Paroxetine, 50-650 ng mL-1 for Thioridazine and 50-750 ng mL-1 for Amineptine. The proposed method was validated according to ICH and USP guidelines with respect to specificity, linearity, accuracy, precision and robustness.ConclusionA simple, reliable, sensitive and selective spectrofluorimetric method has been developed for determination of certain antidepressant. The proposed method was successfully applied to the analysis of the cited drugs in dosage forms. The high sensitivity of the proposed method allows determination of investigated drugs in spiked and real human plasma.

Influence of Thioridazine Hydrochloride on the Phase Profile of Phosphatidylcholine Liposome

Influence of Thioridazine Hydrochloride on the Phase Profile of Phosphatidylcholine Liposome

Phenothiazine Inhibitors of TLKs Affect Double-Strand Break Repair and DNA Damage Response Recovery and Potentiate Tumor Killing with Radiomimetic Therapy

The Tousled-like kinases (TLKs) are involved in chromatin assembly, DNA repair, and transcription. Two TLK genes exist in humans, and their expression is often dysregulated in cancer. TLKs phosphorylate Asf1 and Rad9, regulating double-strand break (DSB) repair and the DNA damage response (DDR). TLKs maintain genomic stability and are important therapeutic intervention targets. We identified specific inhibitors of TLKs from several compound libraries, some of which belong to the family of phenothiazine antipsychotics. The inhibitors prevented the TLK-mediated phosphorylation of Rad9(S328) and impaired checkpoint recovery and DSB repair. The inhibitor thioridazine (THD) potentiated tumor killing with chemotherapy and also had activity alone. Staining for γ-H2AX revealed few positive cells in untreated tumors, but large numbers in mice treated with low doxorubicin or THD alone, possibly the result of the accumulation of DSBs that are not promptly repaired as they may occur in the harsh tumor growth environment.

Nanodiamond Decorated with Silver Nanoparticles as a Sensitive Film Modifier in a Jeweled Electrochemical Sensor: Application to Voltammetric Determination of Thioridazine

AbstractNanodiamondgraphite (NDG) decorated with Ag nanoparticles (AgNPs‐NDG) was prepared and used to construct a novel sensitive sensor for the voltammetric determination of thioridazine (TR). The results indicate a remarkable increase in the oxidation peak currents together with a negative shift in the oxidation peak potentials, in comparison to the bare pyrolytic graphite electrode. Remarkable enhancement in microscopic area of the electrode along with strong adsorption of TR on the surface of the modified electrode resulted in a considerable increase in the peak current of TR. The surface morphology and the nature of the composite film deposited on PGE were characterized by scanning electron microscopy, atomic force microscopy, cyclic voltammetry and electrochemical impedance spectroscopy. Experimental variables, such as the deposited amount of the modifier suspension, pH of the supporting electrolyte, the accumulation potential and time are optimized by monitoring the CV responses of TR. Under the optimal conditions, the modified electrode showed a wide linear response to the concentration of TR in the range of 0.08–100 µM with a detection limit of 0.01 µM. The prepared modified electrode showed several advantages: simple preparation method, high stability and uniformity in the composite film, high sensitivity, long‐term stability and remarkable voltammetric reproducibility in response to TR. The modified electrode can be successfully applied for accurate determination of trace amounts of TR in pharmaceutical and clinical preparations.

Electrochemical Studies and Selective Detection of Thioridazine Using a Carbon Paste Electrode Modified with ZnS Nanoparticles and Simultaneous Determination of Thioridazine and Olanzapine

AbstractA novel ZnS nanoparticle‐modified carbon paste electrode (ZnSNP‐MCPE) was fabricated and used to study the electrooxidation of thioridazine (TR) using cyclic voltammetry (CV) and differential pulse voltammetry (DPV). The determination conditions, such as accumulation time, pH of solution, and modifier amount were optimized. The mechanism of the electrooxidation process on the surface of the modified electrode was studied electrochemically. A linear range of 0.1–36.0 µM with detection limit of 65.0 nM was obtained for TR. In a mixture containing TR and olanzapine (OLZ), the DPV peaks of two compounds can be well separate from each other with a potential difference of 425 mV. Finally, this method was successfully applied to determinate the TR content in real samples.

Identification and Characterization of a Compound That Protects Cardiac Tissue from Human Ether-à-go-go-related Gene (hERG)-related Drug-induced Arrhythmias

The human Ether-à-go-go-related gene (hERG)-encoded K(+) current, I(Kr) is essential for cardiac repolarization but is also a source of cardiotoxicity because unintended hERG inhibition by diverse pharmaceuticals can cause arrhythmias and sudden cardiac death. We hypothesized that a small molecule that diminishes I(Kr) block by a known hERG antagonist would constitute a first step toward preventing hERG-related arrhythmias and facilitating drug discovery. Using a high-throughput assay, we screened a library of compounds for agents that increase the IC(70) of dofetilide, a well characterized hERG blocker. One compound, VU0405601, with the desired activity was further characterized. In isolated, Langendorff-perfused rabbit hearts, optical mapping revealed that dofetilide-induced arrhythmias were reduced after pretreatment with VU0405601. Patch clamp analysis in stable hERG-HEK cells showed effects on current amplitude, inactivation, and deactivation. VU0405601 increased the IC(50) of dofetilide from 38.7 to 76.3 nM. VU0405601 mitigates the effects of hERG blockers from the extracellular aspect primarily by reducing inactivation, whereas most clinically relevant hERG inhibitors act at an inner pore site. Structure-activity relationships surrounding VU0405601 identified a 3-pyridiyl and a naphthyridine ring system as key structural components important for preventing hERG inhibition by multiple inhibitors. These findings indicate that small molecules can be designed to reduce the sensitivity of hERG to inhibitors.

Why and How the Old Neuroleptic Thioridazine Cures the XDR-TB Patient

This mini-review provides the entire experimental history of the development of the old neuroleptic thioridazine (TZ) for therapy of antibiotic resistant pulmonary tuberculosis infections. TZ is effective when used in combination with antibiotics to which the initial Mycobacterium tuberculosis was resistant. Under proper cardiac evaluation procedures, the use of TZ is safe and does not produce known cardiopathy such as prolongation of QT interval. Because TZ is cheap, it should be considered for therapy of XDR and TDR-Mtb patients in economically disadvantaged countries.

Spectrofluorimetric determination of certain biologically active phenothiazines in commercial dosage forms and human plasma

A validated simple and sensitive spectrofluorimetric method was developed for the determination of chlorpromazine hydrochloride, promethazine hydrochloride, trifluperazine hydrochloride, thioridazine hydrochloride, perazine maleate and oxomemazine. The method was based on condensation of malonic acid/acetic anhydride (MAA) under the catalytic effect of the tertiary amine moiety of the studied phenothiazines to provide a deep yellow to brown colour with green fluorescence. Relative fluorescence intensity of the products was measured at λ exc 398 nm and λ em 432 nm. Different variables affecting the reaction were studied and optimized. The method was successfully applied for the determination of the studied drugs in commercial dosage forms. The lower detection limits allowed the application of this method for the determination of the compounds in plasma as an example of a biological fluid. In addition, the method was considered specific for the determination of tertiary amines in the presence of primary and secondary amines; as a result, it was deemed suitable for the determination of the cited drugs in the presence of their degradation products resulting from N-dealkylation or oxidation of the corresponding sulphoxides or sulphones.

Thioridazine: an old neuroleptic effective against totally drug resistant tuberculosis.

Globally, tuberculosis infections continue to increase their resistance to antibiotics. Multidrug resistant tuberculosis infections (MDR TB) have progressed to extensively drug resistance status (XDR TB) and the latter have evolved in some parts of the world to totally drug resistant (TDR TB) infections. MDR TB is difficult to treat successfully, and when therapy is ineffective, a single case can cost almost $500,000. When the infection is XDR TB therapy is mostly unsuccessful and is accompanied with high mortality. TDR TB-a yet to be defined infection, is resistant to all forms of therapy and mortality is almost certain. We have, over a period of 14 years, studied thioridazine (TZ) an old neuroleptic that we have shown to: i) have in vitro activity against all antibiotic resistant forms of Mycobacterium tuberculosis; ii) have activity against intracellular Mycobacterium tuberculosis regardless of its antibiotic resistance status; iii) cure the infected mouse of an antibiotic susceptible and MDR TB infections; and, iv) when used in combination with antibiotics used for therapy of tuberculosis, would render the organism significantly more susceptible. These studies have guided our Argentinian colleagues to treat successfully XDR TB infections with thioridazine in combination with three antibiotics to which the infection was initially resistant. This mini review will describe our further work and the mechanisms by which TZ alone and in combination with antibiotics cures an XDR TB infection and why it is expected to cure TDR TB infections as well. The concepts presented are totally new and because they focus on the activation of killing by non-killing macrophages where Mycobacterium tuberculosis normally resides during infection, and coupled to the inhibition of efflux pumps which contribute to the antibiotic resistant status, effective therapy of any antibiotic resistant TB infection is possible. Because TZ is cheap and therefore affordable to any economically disadvantaged country, and will produce no harm when appropriate measures are taken, it is the ideal drug for immediate use in countries that have high frequencies of MDR, XDR and TDR TB infections.

Combined Therapy With Thioridazine Decreases Plasma Levels of Quetiapine in Taiwanese Schizophrenic Patients

In this study, the authors studied the effect of thioridazine (TDZ) on the pharmacokinetic profile of quetiapine (QTP) in Taiwanese patients with schizophrenia. Sixteen subjects with schizophrenia were recruited for this study. The authors pretreated 8 patients with TDZ 50 mg daily continuously given until the end of the study. QTP was administered to all the participants, and their doses were escalated to 300 mg once daily over a 7-day period and maintained for another week. On day 15, blood samples were collected at 12 time points within an 8-hour interval. The authors assayed the plasma levels of QTP with a high-performance liquid chromatography system coupled with ultraviolet detector. Significantly decreased plasma levels of QTP after oral administration were observed in patients comedicated with TDZ compared with the QTP monotherapy group at 1.5, 2, and 2.5 hours, and the P values were 0.046, 0.001, and 0.005, respectively. The Cmax of QTP was significantly lower in the group comedicated with TDZ (776.9 ± 175.2 versus 1452.3 ± 707.5 ng/mL; P = 0.002). The oral clearance of QTP was significantly higher in the combined group than in the monothreapy group (123.3 ± 66.8 versus 60.3 ± 28.5 L/h; P = 0.03). Other pharmacokinetic parameters were not significantly different. The coadministration of TDZ significantly decreased plasma QTP level and significantly increased the oral clearance of QTP. Although TDZ is switched to QTP, choosing larger doses of QTP for titration may be necessary to avoid the emergence of psychotic symptoms among schizophrenic patients.

Why thioridazine in combination with antibiotics cures extensively drug-resistant Mycobacterium tuberculosis infections

Thioridazine (TDZ) in combination with antibiotics to which extensively drug-resistant Mycobacterium tuberculosis (XDR-TB) is initially resistant yields a cure. This is due to the fact that TDZ enhances the killing of intracellular M. tuberculosis by non-killing macrophages, inhibits the genetic expression of efflux pumps of M. tuberculosis that extrude antibiotics prior to reaching their intended targets, and inhibits the activity of existing efflux pumps that contribute to the multidrug-resistant phenotype of M. tuberculosis. The combination of these effects of TDZ probably contributes to the successful recent cures of XDR-TB cases when the phenothiazine TDZ is used in combination with antibiotics to which the patient with XDR-TB was initially unresponsive.

The synthesis of nitrogen-doped carbon nanotubes/gold composites and their application to the detection of thioridazine

Nitrogen-doped carbon nanotubes (N-CNTs)/gold composites were synthesized through a simple self-assembly method. The morphology, composition, and optical properties of the resulted composites were investigated by transmission electron microscopy, scanning electron microscopy, X-ray diffraction, Raman spectra, ultraviolet–visible absorption spectrum, and X-ray photoelectron spectroscopic. This nanocomposite combines the advantages of N-CNTs and gold nanoparticales showing many excellent properties such as good dispersibility in water and satisfactory biocompatibility. Cyclic voltammogram experiment shows that N-CNTs/gold composite has high conductivity. Based on these aspects, N-CNTs/gold-modified electrode was applied to the voltammetric determination of thioridazine hydrochloride (TH) successfully. The linear calibration range for the TH sensor was 12 ~ 850 μM with a detection limit of 1.3 μM at a signal-to-noise ratio of 3, long-term stability, and good reproducibility.

Spectrophotometric Determination of Thioridazine Hydrochloride in Tablets and Biological Fluids by Ion-Pair and Oxidation Reactions

Two simple, sensitive and selective spectrophotometric methods have been described for the determination of the psychoactive drug, thioridazine HCl in tablets and in biological fluids. The first method is based on the oxidation of thioridazine HCl with measured excess of KMnO4under acidic conditions followed by the determination of unreacted oxidant using indigo carmine and methyl orange. The second method is based on the formation of ion-pair complexes with the acidic sulphophthalein dyes such as bromocresol green and bromocresol purple at pH 1.8 of KCl-HCl buffer. The formed complexes were extracted into methylene chloride and their absorbance was measured at 412 nm. Optimizations of the different experimental conditions are described for both methods. The proposed methods were successfully applied for determination of the drug in tablets and biological fluids with good accuracy and precision. Statistical comparison of the results with those obtained by an official method showed good agreement and indicated no significant difference in accuracy and precision.

Thermal decomposition of new chlorido(p-cymene) ruthenium(II) complexes containing N-alkylphenothiazines

The thermal decomposition of [RuCl2(η6-p-cymene)]2 (1) and its biologically active N-alkylphenothiazine compounds of composition L[RuCl3(η6-p-cymene)] where L = CPH+ (2), TFH+·HCl (3), and TRH+ (4) (chlorpromazine hydrochloride, CP·HCl; trifluoperazine dihydrochloride, TF·2HCl; and thioridazine hydrochloride, TR·HCl, respectively) has been studied. The crystal and molecular structure of compound 3 was determined earlier by single crystal X-ray diffraction analysis. The thermal data were collected by simultaneous TG/DSC measurements. For evolved gas detection, the qualitative reaction of chlorides with AgNO3 in an acidic solution was applied. The measurements were carried out in the temperature range to 700 °C in nitrogen atmosphere. Compounds of L[RuCl3(η6-p-cymene)] crystallize with water or water/2-propanole. On the basis of thermal data, the trend in the solvent bonding energies was assessed.

Genetic response of Salmonella enterica serotype Enteritidis to thioridazine rendering the organism resistant to the agent

Thioridazine (TZ)-induced accumulation of the universal efflux pump substrate ethidium bromide and its subsequent efflux by Salmonella strains with various degrees of overexpressed efflux pumps takes place automatically at pH 7.4, is independent of a metabolic source, is not affected by a proton ionophore and is precluded by palmitic acid. Salmonella enterica serotype Enteritidis cultured in medium containing increasing concentrations of TZ does not grow during the first 6–8 h, after which time its growth is similar to unexposed controls. At the end of a 16-h exposure period, the organism is resistant to >250 mg/L TZ. Parallel assessment by real-time reverse transcription quantitative polymerase chain reaction (RT-qPCR) of the activity of genes that regulate and code for the AcrB transporter of the main efflux pump (AcrAB) of the organism at periodic intervals suggests a sequence of activation beginning with the stress gene soxS, followed by the global regulator ramA, then by the local regulator marA and then by the transporter acrB. These activations take place during the period of no growth. By the end of a 16-h culture period, only the acrB transporter gene is still highly overexpressed. Assessment of the activity of genes of the two-component regulon PmrA/B indicates that TZ also activates this regulon. Because activation of pmrA/ B also activates acrB, development of high resistance to TZ during a 16-h culture period is in part due to activation of the two-component regulon.

Solubility and pKa determination of six structurally related phenothiazines

Solubilities of six structurally related phenothiazines, namely chlorpromazine hydrochloride, fluphenazine dihydrochloride, promazine hydrochloride, thioridazine hydrochloride, trifluoperazine dihydrochloride, and triflupromazine hydrochloride at constant pH were measured in the temperature range from 290K to 350K in three important drugs solvents: water, ethanol and 1-octanol using the dynamic method and UV–vis method. Dissociation constants and corresponding pKa values of drugs were obtained with Bates–Schwarzenbach method at temperature 298.15K in the buffer solutions. Our experimental pKa values for chlorpromazine hydrochloride, fluphenazine dihydrochloride, promazine hydrochloride, thioridazine hydrochloride, trifluoperazine dihydrochloride, and triflupromazine hydrochloride are 9.15, 10.01, 9.37, 8.89, 8.97, and 9.03, respectively. The basic thermal properties of pure drugs i.e. melting and solid–solid phase transition as well as glass-transition temperatures, the enthalpy of melting and phase transitions and the molar heat capacity at glass transition (at constant pressure) were measured with differential scanning microcalorimetry (DSC) technique. Molar volumes were calculated with Barton group contribution method. The experimental solubility data were correlated by means of three commonly known GE equations: the Wilson, NRTL and UNIQUAC with the assumption that the systems studied here have revealed simple eutectic mixtures. The root-mean-square deviations of temperature were used for the precision of the correlation. The activity coefficients of drugs at saturated solutions in each correlated binary mixture were calculated from the experimental data. These new data will help in all prediction-methods and their precision.

Synthesis, structural and spectroscopic characterization, in vitro cytotoxicity and in vivo activity as free radical scavengers of chlorido( p-cymene) complexes of ruthenium(II) containing N-alkylphenothiazines

Three new ruthenium(II) complexes 1– 3 containing N-alkylphenothiazine molecules were synthesized by reaction of [RuCl 2(η 6- p-cymene)] 2 with chlorpromazine hydrochloride ( 1), trifluoperazine dihydrochloride ( 2) or thioridazine hydrochloride ( 3). The compounds of the general formula L[RuCl 3(η 6- p-cymene)] were characterized by elemental analysis and spectroscopic methods (FT-IR, UV–Vis, 1H and 13C NMR). Complex 2 was structurally characterized by single crystal X-ray diffraction. In vitro cytotoxic activity of complexes 1– 3 were assayed in four human carcinoma cell lines MCF-7, MDA-MB-453 (breast carcinoma), SW-480 (colon carcinoma) and IM9 (myeloma multiple cells). The highest cytotoxicity (12.1 ≤ IC 50 ≤ 17.3 μM) and induced a total (SW-480) or almost total cell death (MCF-7, MDA-MB-453) at 25 μM in 48 h of treatment were observed for complex 2. The influence of three different doses (0.4, 4.5 and 90.4 μM/kg bw) of complex 2 on activities of antioxidants enzymes (superoxide dismutase (SOD) and catalase (CAT)) and lactate dehydrogenase (LDH) were investigated under physiological conditions. The effects on nitrite production ( NO 2 − ) and level of erythrocytes malondialdehyde (MDA) in rats blood were evaluated, too.

Effective Therapy with the Neuroleptic Thioridazine as an Adjunct to Second Line of Defence Drugs, and the Potential that Thioridazine Offers for New Patents that Cover a Variety of “New Uses”

New and active infections of tuberculosis continue to increase globally. Although antibiotic susceptible infections can be readily cured with isoniazide and rifampicin, infections resistant to these two antibiotics, named Multi-Drug Resistant TB (MDR TB), are problematic for therapy, extol high costs in terms of human suffering and finances, and when these MDR infections progress to Extensive Drug Resistant TB (XDR TB) status, they are not only difficult to treat, they produce high levels of mortality regardless of therapeutic modality employed. The neuroleptic thioridazine (TZ) has been shown to have wide spectrum in vitro and ex vivo activities against antibiotic susceptible, MDR and XDR strains, and has been successfully used for curing mice of active tuberculosis produced by antibiotic susceptible and MDR strains, and has cured 10 out of 12 XDR TB patients when used in combination with three antibiotics to which the XDR TB patients were non-responsive. Mycobacterium tuberculosis TZ has been recommended for "Compassionate Therapy" of MDR/XDR TB infections whose prognoses are significantly serious and anticipated to result in mortality. This review of TZ activity and its potential to cure MDR/XDR TB supports the contention that this neuroleptic offers patenting opportunities for "New Use". The motivation for patents therefore is expected to rapidly bring TZ to the forefront for therapy of MDR/XDR TB and therefore, the striving for new patents is expected to contribute to the prevention of new infections of antibiotic resistant tuberculosis.