Pimavanserin tartrate, a 5-HT(2A) receptor inverse agonist, increases slow wave sleep as measured by polysomnography in healthy adult volunteers.
OBJECTIVE
Determine the effects of pimavanserin tartrate [ACP-103; N-(4-flurophenylmethyl)-N-(1-methylpiperidin-4-yl)-N'-(4-(2-methylpropyloxy)phenylmethyl)carbamide], a selective serotonin 5-HT(2A) receptor inverse agonist, on slow wave sleep (SWS), other sleep parameters, and attention/vigilance.


METHODS
Forty-five healthy adults were randomized to pimavanserin (1, 2.5, 5, or 20 mg) or placebo in a double-blind fashion (n=9/group). Pimavanserin or placebo was administered once daily in the morning for 13 consecutive days. The effects of pimavanserin were measured after the first dose and again after 13 days. Sleep parameters were measured by polysomnography. Effects on attention/vigilance were measured by a continuous performance task.


RESULTS
Compared to placebo, pimavanserin significantly increased SWS following single and multiple dose administration. Pimavanserin also decreased number of awakenings. PSG variables not affected by pimavanserin included sleep period time, total sleep time, sleep onset latency, number of stage shifts, total time awake, early morning wake, and microarousal index. Changes in sleep architecture parameters, sleep profile parameters, and spectral power density parameters were consistent with a selective increase in SWS. Pimavanserin did not adversely affect performance on the continuous performance test measured in the evening before or morning after polysomnography.


CONCLUSIONS
These data suggest that pimavanserin selectively increases slow wave sleep and decreases awakenings, an effect that does not diminish with repeated administration.
Department of Psychiatry, University of California San Diego, La Jolla, CA 92093-0733, USA. sancoliisrael@ucsd.edu
Sonia
S
Ancoli-Israel
Kimberly E
KE
Vanover
David M
DM
Weiner
Robert E
RE
Davis
Daniel P
DP
van Kammen
D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D005260:Female; D006805:Human Experimentation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010880:Piperidines / Q000008:administration & dosage* / Q000009:adverse effects; D015990:Placebo Effect; D017286:Polysomnography; D058830:Serotonin 5-HT2 Receptor Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D012890:Sleep / Q000187:drug effects*; D014508:Urea / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
D010880:Piperidines; D058830:Serotonin 5-HT2 Receptor Antagonists; D014508:Urea; C510793:pimavanserin
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