Pharmacokinetics of N,N-Dimethyltryptamine Fumarate in Humans.
journal Article
2022
Meghan, Good
Tiffanie, Benway
Zelah, Joel
Carol, Routledge
Christopher, Timmermann
David, Erritzoe
Richard, Weaver
Graham, Allen
Charlotte, Hughes
Helen, Topping
Ellen, James
Aim: N,N-dimethyltryptamine (DMT) is a psychedelic compound under
development for the treatment of major depressive disorder (MDD). This
study evaluated the in vitro metabolism and clinical pharmacokinetics
(PK) of DMT fumarate (SPL026) in healthy subjects. Methods: Results are
from the Phase I component of an ongoing Phase I/IIa randomised,
double-blind, placebo-controlled, parallel-group, dose-escalation trial.
Healthy adults received escalating doses of SPL026 via a 2-phase
intravenous (IV) infusion. Dosing regimens were calculated based on PK
modelling and predictions, with progression to each subsequent dose
level according to safety and tolerability. In vitro experiments
assessed hepatic clearance and metabolism of DMT by monoamine oxidase
(MAO) and cytochrome P450 enzymes. Results: 24 healthy subjects received
escalating doses of SPL026 which were safe and well-tolerated.
Dose-proportional increases in DMT exposure were observed over the range
of 9–21.5 mg. For all doses, median time to peak plasma concentration
was ~10 min and mean elimination half-life was 9–12
min. There was no relationship between peak DMT plasma concentration and
body mass index, weight or age. In vitro hepatic mitochondrial fraction
clearance of SPL026 was inhibited by MAO-A, but not MAO-B, inhibition.
CYP2D6 and CYP2C19 modified SPL026 clearance in vitro. The unbound
fraction of SPL026 was approximately 70%. Conclusion: This is the first
study to determine, in detail, the full PK profile of DMT in humans,
confirming rapid attainment of peak plasma concentrations followed by
accelerated clearance. These findings provide evidence which support the
development of novel DMT infusion regimens for the treatment of MDD.