title: What one hand giveth the other taketh away: some unpredicted effects of enantiomers in psychopharmacology.
abstract: It is well known that many medicines are a mixture of two enantiomers, or mirror-image molecules. Two enantiomers occur when a molecule has a single chiral centre and the two mirror images, called S or L (left handed) and R or D (right handed), are usually found in equal amounts in the parent (racemic) mixture. While for many compounds used in clinical practice the active moiety is found in one of the two enantiomers with the other being seen as an unnecessary and redundant component of the racemic mixture, the difference between enantiomers can mean a difference between therapeutic and adverse effects, as well as in beneficial pharmacological effect and potency.
authors.affiliation: Neuropsychopharmacology Unit, Centre for Pharmacology and Therapeutics, Imperial College London, Hammersmith Hospital, London, UK. D.Nutt@imperial.ac.uk
authors.forename: David J
authors.initials: DJ
authors.lastname: Nutt
authors.forename: Celia L
authors.initials: CL
authors.lastname: Feetam
mesh_terms: D000818:Animals; D053961:Azabicyclo Compounds / Q000737:chemistry / Q000493:pharmacokinetics / Q000494:pharmacology; D015283:Citalopram / Q000009:adverse effects / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use; D000069582:Eszopiclone; D005473:Fluoxetine / Q000737:chemistry / Q000494:pharmacology; D006801:Humans; D001523:Mental Disorders / Q000188:drug therapy*; D015394:Molecular Structure; D010879:Piperazines / Q000737:chemistry / Q000493:pharmacokinetics / Q000494:pharmacology; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000737:chemistry* / Q000494:pharmacology* / Q000627:therapeutic use; D051381:Rats; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000737:chemistry / Q000494:pharmacology; D013237:Stereoisomerism
chemical_list: D053961:Azabicyclo Compounds; D015283:Citalopram; D000069582:Eszopiclone; D005473:Fluoxetine; D010879:Piperazines; D011619:Psychotropic Drugs; D017367:Selective Serotonin Reuptake Inhibitors; C515050:zopiclone