Specific GABA(A) agonists and partial agonists

The GABA(A) receptor system is implicated in a number of neurological and psychiatric diseases, making GABA(A) receptor ligands interesting as potential therapeutic agents. Only a few different classes of structures are currently known as ligands for the GABA recognition site on the hetero-pentameric GABA(A) receptor complex, reflecting the very strict structural requirements for GABA(A) receptor recognition and activation. Within the series of compounds showing agonist activity at the GABA(A) receptor site that have been developed, most of the ligands are structurally derived from the GABA(A) agonists muscimol, THIP, or isoguvacine, which we developed in the initial stages of the project. Using recombinant GABA(A) receptors, functional selectivity was demonstrated for a number of compounds, including THIP, showing highly subunit-dependent potency and maximal response. In light of the interest in partial GABA(A) receptor agonists as potential therapeutics, structure-activity studies of a number of analogs of 4-PIOL, a low-efficacy partial GABA(A) agonist derived from THIP, have been performed. In this connection, a series of GABA(A) ligands has been developed that exhibit pharmacological profiles from moderately potent low-efficacy partial GABA(A) agonist activity to potent and selective antagonist effects. Very little information is available on direct-acting GABA(A) receptor agonists in clinical studies. However, the results of clinical studies on the effect of the partial GABA(A) agonist THIP on human sleep patterns show that the functional consequences of a direct-acting agonist are different from those seen after the administration of GABA(A) receptor modulators, such as benzodiazepines and barbiturates.