Zuranolone

Zuranolone (INN;[1] developmental code names SAGE-217, S-812217) is an investigational medication which is under development by SAGE Therapeutics for the treatment of depressive disorders and a variety of other indications.[2][3] It is a synthetic, orally active, inhibitory pregnane neurosteroid, and acts as a positive allosteric modulator of the GABA_A receptor.[2][3][4] The drug was developed as an improvement of allopregnanolone (brexanolone) with high oral bioavailability and a biological half-life suitable for once-daily administration.[3] As of October 2019, zuranolone is in phase III clinical trials for major depressive disorder, postpartum depression, and insomnia and is in phase II clinical studies for bipolar depression, essential tremor, and Parkinson's disease.[2] It is also in the preclinical stage of development for dyskinesias.[2]

Zuranolone

Clinical data
Other names	SAGE-217; S-812217; 3α-Hydroxy-3β-methyl-21-(4-cyano-1H-pyrazol-1'-yl)-19-nor-5β-pregnan-20-one; 3β-Methyl-21-(4-cyano-1H-pyrazol-1'-yl)-19-norpregnanolone; 3α-Hydroxy-3β-methyl-5β-dihydro-21-(4-cyano-1H-pyrazol-1'-yl)-19-norprogesterone
Routes of administration	By mouth
Drug class	Neurosteroid; GABAA receptor positive allosteric modulator
Identifiers
IUPAC name 1-(2-((3R,5R,8R,9R,10S,13S,14S,17S)-3-Hydroxy-3,13-dimethylhexadecahydro-1H-cyclopenta[a]phenanthren-17-yl)-2-oxoethyl)-1H-pyrazole-4-carbonitrile
CAS Number	1632051-40-1
PubChem CID	86294073
UNII	7ZW49N180B
KEGG	D11793
Chemical and physical data
Formula	C25H35N3O2
Molar mass	409.574 g·mol^−1
3D model (JSmol)	Interactive image
SMILES O=C(CN1N=CC(C#N)=C1)[C@H]2CC[C@@]3([H])[C@]4([H])CC[C@]5([H])C[C@](C)(O)CC[C@]5([H])[C@@]4([H])CC[C@@]32C
InChI InChI=1S/C25H35N3O2/c1-24(30)9-7-18-17(11-24)3-4-20-19(18)8-10-25(2)21(20)5-6-22(25)23(29)15-28-14-16(12-26)13-27-28/h13-14,17-22,30H,3-11,15H2,1-2H3/t17-,18+,19-,20-,21+,22-,24-,25+/m1/s1 Key:HARRKNSQXBRBGZ-GVKWWOCJSA-N

See also

• List of investigational antidepressants
• List of investigational sleep drugs
• List of neurosteroids

References

1. "International Nonproprietary Names for Pharmaceutical Substances" (PDF). WHO Drug Information. 32 (4). 2018.
2. "SAGE 217". AdisInsight. Retrieved 2018-02-10.
3. Blanco MJ, La D, Coughlin Q, Newman CA, Griffin AM, Harrison BL, Salituro FG (2018). "Breakthroughs in neuroactive steroid drug discovery". Bioorg. Med. Chem. Lett. 28 (2): 61–70. doi:10.1016/j.bmcl.2017.11.043. PMID 29223589.
4. Martinez Botella G, Salituro FG, Harrison BL, Beresis RT, Bai Z, Blanco MJ, Belfort GM, Dai J, Loya CM, Ackley MA, Althaus AL, Grossman SJ, Hoffmann E, Doherty JJ, Robichaud AJ (2017). "Neuroactive Steroids. 2. 3α-Hydroxy-3β-methyl-21-(4-cyano-1H-pyrazol-1'-yl)-19-nor-5β-pregnan-20-one (SAGE-217): A Clinical Next Generation Neuroactive Steroid Positive Allosteric Modulator of the (γ-Aminobutyric Acid)A Receptor". J. Med. Chem. 60 (18): 7810–7819. doi:10.1021/acs.jmedchem.7b00846. PMID 28753313.