Ascending single-dose study of the safety, pharmacokinetics, and pharmacodynamics of CSTI-500, a novel monoamine triple reuptake inhibitor, first-in-human.

Rationale: Monoamine triple reuptake inhibitors (TRIs) inhibit central dopamine, norepinephrine, and serotonin transporters, restoring functional monoamine neurotransmission. Objectives: This clinical trial evaluated the safety, tolerability, and pharmacokinetics in healthy volunteers after single-a...

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Publicado en:Psychopharmacology Vol. 243; no. 3; pp. 565 - 581
Autores principales: Appel, Lieuwe, Risinger, Robert, Wall, Anders, Murck, Harald, Liu, Shuang, Antoni, Gunnar, Lane, Roger
Formato: Journal Article
Publicado: Springer Nature Mar2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2026
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00213-025-06861-4
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        atl: Ascending single-dose study of the safety, pharmacokinetics, and pharmacodynamics of CSTI-500, a novel monoamine triple reuptake inhibitor, first-in-human.
      aug:
        au:
          Appel, Lieuwe
          Risinger, Robert
          Wall, Anders
          Murck, Harald
          Liu, Shuang
          Antoni, Gunnar
          Lane, Roger
        affil: https://ror.org/048a87296 Molecular Imaging and Medical Physics, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
      sug:
      ab: Rationale: Monoamine triple reuptake inhibitors (TRIs) inhibit central dopamine, norepinephrine, and serotonin transporters, restoring functional monoamine neurotransmission. Objectives: This clinical trial evaluated the safety, tolerability, and pharmacokinetics in healthy volunteers after single-ascending-doses (SAD) of the novel monoamine TRI CSTI-500. In addition, we estimated the peak and duration of striatal serotonin transporter (SERT) and dopamine transporter (DAT) occupancies, by using positron emission tomography (PET). Methods: Part A was a double-blinded, randomized, placebo-controlled, sequential SAD study with seven sequential dose panels (0.5-150 mg) where subjects in each panel received either a single oral dose of CSTI-500 (n=6) or placebo (n=2). Part B was an open-label, single-dose PET study to assess the peak and duration of SERT (n=4) and DAT (n=5) striatal occupancies, using the radioligands [11C]MADAM and [11C]PE2I, respectively. Results: The maximum tolerable acute single-dose of CSTI-500 was determined as 100 mg. No serious adverse events occurred. The median maximum CSTI-500 concentrations were attained at 1-2 hours post-dose (h pd); the estimated plasma elimination half-life was 44-50 h pd. Subsequent to a single-dose of 100 mg CSTI-500, mean striatal SERT occupancy was 72% and 62% at 4-6 and 24 h pd, respectively. Mean striatal DAT occupancy was 36% and 31% at 4-9 and 24 h pd, respectively. Conclusions: CSTI-500 is a potent monoamine TRI with substantial striatal SERT and moderate DAT occupancies in healthy subjects. Together with promising safety-tolerability and pharmacokinetics profiles, the continued clinical development of CSTI-500 is strongly supported.
      pubtype: Academic Journal
      doctype: Journal Article
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    language: English
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