Effects of Oral Contraceptive Androgenicity on Visuospatial and Social-Emotional Cognition: A Prospective Observational Trial

Oral contraceptives (OCs) containing estrogen and progesterone analogues are widely used amongst reproductive-aged women, but their neurocognitive impact is poorly understood. Preliminary studies suggest that OCs improve verbal memory and that OCs with greater androgenic activity may improve visuospatial ability. We sought to explore the cognitive impact of OCs by assessing performance of OC users at different stages of the OC cycle, and comparing this performance between users of different OC formulations according to known androgenic activity. We conducted a prospective, observational trial of OC users, evaluating cognitive performance with CogState software on two occasions: days 7–10 of active hormonal pill phase, and days 3–5 of the inactive pill phase (coinciding with the withdrawal bleed resembling menstruation). Thirty-five OC users (18 taking androgenic formulations, 17 taking anti-androgenic) were assessed. Analysis by androgenic activity showed superior performance by users of androgenic OCs, as compared to anti-androgenic OCs, in visuospatial ability and facial affect discrimination tasks. A growing understanding of cognitive effects of OC progestin androgenicity may have implications in choice of OC formulation for individuals and in future OC development.

Method of molecular docking in the design of new progesterone analogues

The aim of this study is to carry out the molecular docking of gestagenic preparations and structurally related compounds to the isoform A of human progesterone receptor and to assess the applicability of this method for the active progestins search. Docking was done (using Autodock 4.2) of progesterone and 13 compounds with different gestagenic/antigestagenic activity (megestrol acetate; (3)-3-Hydroxy-6-methyl-20-oxopregna-4,6-dien-17-yl acetate (AMOL); Medroxyprogesterone-17-acetate; Levonorgestrel; Dydrogesterone; RU-486; Ulipristal acetate; (3)-17-Acetoxy-6-methyl-20-oxopregna-4,6-dien-3-yl butyrate; 16,17-Cyclohexanoprogesterone; 6-Methyl-16,17-cyclohexanoprogesterone; Proligestone; 16,17-Cyclopentanoprogesterone; 16,17-Cyclohex-3-enoprogesterone). Calculations of theoretical dissociation constants (Kd) of ligand-progesterone receptor complexes showed that it is possible to evaluate the probability of activity of a candidate compound using the Autodock 4.2 program, but it requires caution, taking into account the lack of the link between Kd and gestagen activity. In addition, the method allows to identify compounds that change the position of amino acid residues in the ligand-binding domain of PR-A after binding (that is possibly have a different mechanism of action), as well as substances that do not interact with the agonistic form of the receptor due to other causes.

Progesterone improves porcine in vitro fertilisation system

In an effort to improve the quality of in vitro produced porcine embryos, the effect of progestagens — progesterone analogues — on the in vitro developmental competence of porcine oocytes was studied. A total of 1421 in vitro matured oocytes, from 4 replicates, were inseminated with frozen-thawed spermatozoa. Progestagens were added to late maturation and embryo cultures (10 IU/ml). Fertilisation success (pre-maturation, penetration, monospermy and efficiency) and nuclear maturation were evaluated. There were no differences among prematuration rates between groups (P = 0.221). Penetration rates were higher (P < 0.001) in the presence of progestagens (75.0%) as compared to the control (51.7%). However, no differences were observed in monospermy percentages (P = 0.246). The results indicated that supplementation with progestagens increased the efficiency of the in vitro fertilisation system (P < 0.001). An additional beneficial effect was observed in nuclear maturation with progestagens (P = 0.035). In summary, progestagen supplementation is an important factor to improve the in vitro fertilisation procedure.

Modifications of Antiepileptic Drugs for Improved Tolerability and Efficacy

Introduction A large number of antiepileptic drugs (AEDs) are available today, but they may not be satisfactory regarding clinical efficacy, tolerance, toxicity or pharmacokinetic properties. The purpose of this review is to focus upon the rationale behind the chemical modifications of several recently marketed AEDs or drugs in development and to categorize them according to the main purposes for the improvements: better efficacy or tolerability accompanied by improved pharmacokinetic properties. Material and Method AEDs that have been chemically modified to new derivatives during the last years are reviewed based on recent publications and PubMed-searches. Results and Discussion Improvement in pharmacokinetic parameters may affect both tolerability and efficacy. Modifications to improve tolerability include various valproate analogues, divided into aliphatic amides, cyclic derivatives or amino acid conjugates. Furthermore, there are the carbamazepine analogues oxcarbazepine and eslicarbazepine, the felbamate analogues fluorofelbamate and carisbamate (RWJ 33369), and the lamotrigine analogue JZP-4. The levetiracetam analogues brivaracetam and seletracetam and the derivatives of gabapentin, pregabalin and XP13512, have improved selectivity compared to their parent compounds. Other new drugs have new mechanisms of action related to GABA and glutamate receptors; the glutamate antagonists like topiramate (talampanel and NS-1209), and GABAA receptor agonists, benzodiazepine or progesterone analogues (ELB-139 and ganaxolone). Conclusion Further challenges for development of new AEDs include investigations of target molecules affected by pathophysiological processes and detailed structure-activity relationships with focus on stereoselectivity. These potential drugs may become of importance in future drug therapy in epilepsy and other CNS disorders.