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NeuroRx. 2005 October; 2(4): 554–571.
PMCID: PMC1201315
Drug Metabolism and Pharmacokinetics, the Blood-Brain Barrier, and Central Nervous System Drug Discovery
Mohammad S. Alavijeh, Mansoor Chishty, M. Zeeshan Qaiser, and Alan M. Palmer
Pharmidex, London W1S 1RR, United Kingdom
Address correspondence and reprint requests to Alan M. Palmer, Pharmidex, 72 New Bond Street, London W1S 1RR, United Kingdom. E-mail: alan.palmer/at/pharmidex.com
Abstract
Summary: The worldwide market for therapies for CNS disorders is worth more than $50 billion and is set to grow substantially in the years ahead. This is because: 1) the incidence of many CNS disorders (e.g., Alzheimer’s disease, stroke, and Parkinson’s disease) increase exponentially after age 65 and 2) the number of people in the world over 65 is about to increase sharply because of a marked rise in fertility after World War II. However, CNS research and development are associated with significant challenges: it takes longer to get a CNS drug to market (12–16 years) compared with a non-CNS drug (10–12 years) and there is a higher attrition rate for CNS drug candidates than for non-CNS drug candidates. This is attributable to a variety of factors, including the complexity of the brain, the liability of CNS drugs to cause CNS side effects, and the requirement of CNS drugs to cross the blood-brain barrier (BBB). This review focuses on BBB penetration, along with pharmacokinetics and drug metabolism, in the process of the discovery and development of safe and effective medicines for CNS disorders.
Keywords: Blood-brain barrier, CNS drug discovery, DMPK, pharmacokinetics, pharmacodynamics, microdialysis, MDCK cells, in silico prediction of brain permeation, aging, brain disorders