Efficacy and Safety Study of a IMSS Developed Phytopharmaceutical for the Treatment of Anxiety.

Summary

The investigator's group at the Mexican Institute of Social Security has worked for more than 20 years in the scientific research of the plant species Galphimia glauca Cav., which is used in Mexican Traditional Medicine for the treatment of mental disorders. With the obtained results it was possible the development of a phytopharmaceutical elaborated with the extract of this plant, which was standardized in its content of Galphimine-B (G-B). This new compound is a nor, seco-triterpene, which possesses selective effects on the central nervous system. Through electrophysiological neuronal unitary records it was identified that G-B acts on the ventral tegmental area (VTA), and exerts its effect on (N-methyl-D-aspartate) NMDA receptors in dopaminergic neurons. The new phytopharmaceutical, elaborated from a standardized extract (in its G-B content) of G. glauca, was subjected to a double blind and randomized clinical study that compared its efficacy and therapeutic tolerability with a similar drug formulated with lorazepam in patients with diagnosis of generalized anxiety disorder (GAD). In a total of 152 patients, it was evidenced that the phytomedicine administered orally (for 4 weeks) was able to significantly reduce anxiety, in a similar way as lorazepam did, but with better tolerability. Several patients who were treated with lorazepam had to leave the study because they had daytime sleepiness. In clinical practice, different benzodiazepines have specific indications. In the case of anxiety disorders, the drug of first choice is Alprazolam, this, because it manifests a more powerful anxiolytic effect with a lower degree of sedation and daytime sleepiness. Objective: The present project aims to compare the efficacy and therapeutic safety of an elaborated phytopharmaceutical with the standardized extract of Galphimia glauca with Alprazolam .

Timeline

Start

2016-03-16

Primary completion

2020-09-19

Completion

2020-10-19

Publications

• Results Tortoriello J, Lozoya X. Effect of Galphimia glauca methanolic extract on neuropharmacological tests. Planta Med. 1992 Jun;58(3):234-6. doi: 10.1055/s-2006-961442.
• Results Tortoriello J, Ortega A. Sedative effect of galphimine B, a nor-seco-triterpenoid from Galphimia glauca. Planta Med. 1993 Oct;59(5):398-400. doi: 10.1055/s-2006-959717.
• Results Tortoriello J, Ortega A, Herrera-Ruiz M, Trujillo J, Reyes-Vazquez C. Galphimine-B modifies electrical activity of ventral tegmental area neurons in rats. Planta Med. 1998 May;64(4):309-13. doi: 10.1055/s-2006-957440.
• Results Osuna L, Pereda-Miranda R, Tortoriello J, Villarreal ML. Production of the sedative triterpene galphimine B in Galphimia glauca tissue culture. Planta Med. 1999 Mar;65(2):149-52. doi: 10.1055/s-1999-14057.
• Results Prieto-Gomez B, Tortoriello J, Vazquez-Alvarez A, Reyes-Vazquez C. Galphimine B modulates synaptic transmission on dopaminergic ventral tegmental area neurons. Planta Med. 2003 Jan;69(1):38-43. doi: 10.1055/s-2003-37043.
• Results Gonzalez-Cortazar M, Tortoriello J, Alvarez L. Norsecofriedelanes as spasmolytics, advances of structure-activity relationships. Planta Med. 2005 Aug;71(8):711-6. doi: 10.1055/s-2005-871224.
• Results Rojas G, Aranda E, Navarro V, Zamilpa A, Tortoriello J. In vitro propagation of Galphimia glauca and content of the sedative compound galphimine-B in wild and micropropagated plants. Planta Med. 2005 Nov;71(11):1076-8. doi: 10.1055/s-2005-873136.
• Results Herrera-Ruiz M, Jimenez-Ferrer JE, De Lima TC, Aviles-Montes D, Perez-Garcia D, Gonzalez-Cortazar M, Tortoriello J. Anxiolytic and antidepressant-like activity of a standardized extract from Galphimia glauca. Phytomedicine. 2006 Jan;13(1-2):23-8. doi: 10.1016/j.phymed.2005.03.003. Epub 2005 Jun 28.
• Results Herrera-Ruiz M, Gonzalez-Cortazar M, Jimenez-Ferrer E, Zamilpa A, Alvarez L, Ramirez G, Tortoriello J. Anxiolytic effect of natural galphimines from Galphimia glauca and their chemical derivatives. J Nat Prod. 2006 Jan;69(1):59-61. doi: 10.1021/np050305x.
• Results Mangas S, Bonfill M, Osuna L, Moyano E, Tortoriello J, Cusido RM, Pinol MT, Palazon J. The effect of methyl jasmonate on triterpene and sterol metabolisms of Centella asiatica, Ruscus aculeatus and Galphimia glauca cultured plants. Phytochemistry. 2006 Sep;67(18):2041-9. doi: 10.1016/j.phytochem.2006.06.025. Epub 2006 Jul 28.
• Results Aguilar-Santamaria L, Ramirez G, Herrera-Arellano A, Zamilpa A, Jimenez JE, Alonso-Cortes D, Cortes-Gutierrez EI, Ledesma N, Tortoriello J. Toxicological and cytotoxic evaluation of standardized extracts of Galphimia glauca. J Ethnopharmacol. 2007 Jan 3;109(1):35-40. doi: 10.1016/j.jep.2006.06.013. Epub 2006 Jul 8.
• Results Herrera-Arellano A, Jimenez-Ferrer E, Zamilpa A, Morales-Valdez M, Garcia-Valencia CE, Tortoriello J. Efficacy and tolerability of a standardized herbal product from Galphimia glauca on generalized anxiety disorder. A randomized, double-blind clinical trial controlled with lorazepam. Planta Med. 2007 Jul;73(8):713-7. doi: 10.1055/s-2007-981539. Epub 2007 Jun 11.
• Results Osuna L, Moyano E, Mangas S, Bonfill M, Cusido RM, Pinol MT, Zamilpa A, Tortoriello J, Palazon J. Immobilization of Galphimia glauca plant cell suspensions for the production of enhanced amounts of Galphimine-B. Planta Med. 2008 Jan;74(1):94-9. doi: 10.1055/s-2007-993763. Epub 2008 Jan 4.
• Results Jimenez-Ferrer E, Herrera-Ruiz M, Ramirez-Garcia R, Herrera-Arellano A, Tortoriello J. Interaction of the natural anxiolytic Galphimine-B with serotonergic drugs on dorsal hippocampus in rats. J Ethnopharmacol. 2011 Sep 1;137(1):724-9. doi: 10.1016/j.jep.2011.06.029. Epub 2011 Jul 1.
• Results Herrera-Arellano A, Jimenez-Ferrer JE, Zamilpa A, Garcia-Alonso G, Herrera-Alvarez S, Tortoriello J. Therapeutic effectiveness of Galphimia glauca vs. lorazepam in generalized anxiety disorder. A controlled 15-week clinical trial. Planta Med. 2012 Sep;78(14):1529-35. doi: 10.1055/s-0032-1315110. Epub 2012 Jul 24.
• Results Gonzalez-Cortazar M, Herrera-Ruiz M, Zamilpa A, Jimenez-Ferrer E, Marquina S, Alvarez L, Tortoriello J. Anti-inflammatory activity and chemical profile of Galphimia glauca. Planta Med. 2014 Jan;80(1):90-6. doi: 10.1055/s-0033-1360150. Epub 2013 Dec 11.
• Results Abarca Vargas R, Zamilpa A, Aguilar FA, Herrera-Ruiz M, Tortoriello J, Jimenez-Ferrer E. Pharmacokinetic study in mice of galphimine-A, an anxiolytic compound from Galphimia glauca. Molecules. 2014 Mar 12;19(3):3120-34. doi: 10.3390/molecules19033120.
• Results Jimenez-Ferrer E, Santillan-Urquiza MA, Alegria-Herrera E, Zamilpa A, Nogueron-Merino C, Tortoriello J, Navarro-Garcia V, Aviles-Flores M, Fuentes-Mata M, Herrera-Ruiz M. Anxiolytic effect of fatty acids and terpenes fraction from Aloysia triphylla: Serotoninergic, GABAergic and glutamatergic implications. Biomed Pharmacother. 2017 Dec;96:320-327. doi: 10.1016/j.biopha.2017.10.024. Epub 2017 Oct 7.
• Results Santillan-Urquiza MA, Herrera-Ruiz M, Zamilpa A, Jimenez-Ferrer E, Roman-Ramos R, Tortoriello J. Pharmacological interaction of Galphimia glauca extract and natural galphimines with Ketamine and Haloperidol on different behavioral tests. Biomed Pharmacother. 2018 Jul;103:879-888. doi: 10.1016/j.biopha.2018.04.082. Epub 2018 Apr 24.
• Romero-Cerecero O, Islas-Garduno AL, Zamilpa A, Herrera-Arellano A, Jimenez-Ferrer E, Tortoriello J. Galphimine-B Standardized Extract versus Alprazolam in Patients with Generalized Anxiety Disorder: A Ten-Week, Double-Blind, Randomized Clinical Trial. Biomed Res Int. 2019 Jan 30;2019:1037036. doi: 10.1155/2019/1037036. eCollection 2019.

Drugs

Indications