U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry ACHIRAL
Molecular Formula C19H29N5O2.ClH
Molecular Weight 395.927
Optical Activity NONE
Defined Stereocenters 0 / 0
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of GEPIRONE HYDROCHLORIDE

SMILES

Cl.CC1(C)CC(=O)N(CCCCN2CCN(CC2)C3=NC=CC=N3)C(=O)C1

InChI

InChIKey=DGOCVISYYYQFEP-UHFFFAOYSA-N
InChI=1S/C19H29N5O2.ClH/c1-19(2)14-16(25)24(17(26)15-19)9-4-3-8-22-10-12-23(13-11-22)18-20-6-5-7-21-18;/h5-7H,3-4,8-15H2,1-2H3;1H

HIDE SMILES / InChI

Molecular Formula C19H29N5O2
Molecular Weight 359.4659
Charge 0
Count
Stereochemistry ACHIRAL
Additional Stereochemistry No
Defined Stereocenters 0 / 0
E/Z Centers 0
Optical Activity NONE

Molecular Formula ClH
Molecular Weight 36.461
Charge 0
Count
Stereochemistry ACHIRAL
Additional Stereochemistry No
Defined Stereocenters 0 / 0
E/Z Centers 0
Optical Activity NONE

Gepirone (brand name Travivo) is an investigational azapirone antidepressant and anxiolytic drug in development for the treatment of major depressive disorder but has yet to be marketed. Like other azapirones, it acts as a selective partial agonist of the 5-HT1A receptor. Gepirone has been under development in the U.S. in an extended release form (referred to as Gepirone ER). It has been rejected multiple times by the FDA during the drug approval process and Phase III studies evaluating its use in the treatment of MDD were prematurely terminated. These were the initial Phase III studies of gepirone ER in MDD, and the effective dose range had not been determined. In March 2016, the FDA reversed its decision and gave gepirone ER a positive review, clearing the way for the drug to finally gain market approval in the U.S. In addition to its antidepressant and anxiolytic properties, gepirone has been found to improve symptoms of sexual dysfunction in men and women, similarly to the marketed 5-HT1A receptor agonist flibanserin. The pro-sexual effects appear to be independent of its antidepressant and anxiolytic effects. Mechanism of action studies have demonstrated that gepirone possesses a much greater selectivity for 5-HT1A receptors over dopamine D2 receptors. Long-term studies have shown that gepirone has a differential action at presynaptic (agonist) and post-synaptic (partial agonist) 5-HT1A receptors. Treatment with gepirone ER desensitizes presynaptic 5-HT1A receptors, which decreases serotonin autoregulatory inhibition and enhances activation of postsynaptic 5-HT1A receptors. As a partial agonist gepirone ER acts as an agonist when endogenous serotonin is not present and as an antagonist when endogenous serotonin is present. Overall, gepirone ER increases serotonin production when insufficient amounts are present, and decreases serotonin production when excess amounts are present. Gepirone has been tested in Phase II clinical trial as antidepressant medication for pharmacotherapy for cocaine dependent subjects.

Originator

Curator's Comment: Gepirone was originally developed by Bristol-Myers Squibb in 1986, but was out-licensed to Fabre-Kramer in 1993. # Bristol-Myers Squibb

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
Conditions
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
2.55 ng/mL
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
GEPIRONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
4.13 ng/mL
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
GEPIRONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: HIGH-FAT
3.21 ng/mL
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
1-(2-PYRIMIDINYL)PIPERAZINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: HIGH-FAT
2.8 ng/mL
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
1-(2-PYRIMIDINYL)PIPERAZINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
6.54 ng/mL
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
3-HYDROXYGEPIRONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
7.69 ng/mL
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
3-HYDROXYGEPIRONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: HIGH-FAT
6.1 ng/mL
10 mg 2 times / day multiple, oral
dose: 10 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
GEPIRONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
6.3 ng/mL
10 mg 2 times / day multiple, oral
dose: 10 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
1-(2-PYRIMIDINYL)PIPERAZINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
4.3 ng/mL
20 mg 1 times / day multiple, oral
dose: 20 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
GEPIRONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
4.2 ng/mL
20 mg 1 times / day multiple, oral
dose: 20 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
1-(2-PYRIMIDINYL)PIPERAZINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
3.6 ng/mL
25 mg 1 times / day multiple, oral
dose: 25 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
1-(2-PYRIMIDINYL)PIPERAZINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
3.6 ng/mL
25 mg 1 times / day multiple, oral
dose: 25 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
GEPIRONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
18.73 ng/mL
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
GEPIRONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
12.03 ng/mL
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
1-(2-PYRIMIDINYL)PIPERAZINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
12.55 ng/mL
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
1-(2-PYRIMIDINYL)PIPERAZINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FED
16.98 ng/mL
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
GEPIRONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FED
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
31.14 ng × h/mL
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
GEPIRONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
38.71 ng × h/mL
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
GEPIRONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: HIGH-FAT
52.77 ng × h/mL
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
1-(2-PYRIMIDINYL)PIPERAZINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: HIGH-FAT
55.39 ng × h/mL
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
1-(2-PYRIMIDINYL)PIPERAZINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
138 ng × h/mL
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
3-HYDROXYGEPIRONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
157 ng × h/mL
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
3-HYDROXYGEPIRONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: HIGH-FAT
54.9 ng × h/mL
10 mg 2 times / day multiple, oral
dose: 10 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
GEPIRONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
92.8 ng × h/mL
10 mg 2 times / day multiple, oral
dose: 10 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
1-(2-PYRIMIDINYL)PIPERAZINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
55.3 ng × h/mL
20 mg 1 times / day multiple, oral
dose: 20 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
GEPIRONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
74 ng × h/mL
20 mg 1 times / day multiple, oral
dose: 20 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
1-(2-PYRIMIDINYL)PIPERAZINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
67.6 ng × h/mL
25 mg 1 times / day multiple, oral
dose: 25 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
1-(2-PYRIMIDINYL)PIPERAZINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
51.8 ng × h/mL
25 mg 1 times / day multiple, oral
dose: 25 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
GEPIRONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
55.26 ng × h/mL
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
GEPIRONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
93 ng × h/mL
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
1-(2-PYRIMIDINYL)PIPERAZINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
99.2 ng × h/mL
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
1-(2-PYRIMIDINYL)PIPERAZINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FED
75.69 ng × h/mL
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
GEPIRONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FED
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
2.94 h
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
GEPIRONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
5.76 h
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
1-(2-PYRIMIDINYL)PIPERAZINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
6.06 h
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
1-(2-PYRIMIDINYL)PIPERAZINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FED
3.32 h
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
GEPIRONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FED
Doses

Doses

DosePopulationAdverse events​
120 mg 1 times / day steady-state, oral
Highest studied dose
Dose: 120 mg, 1 times / day
Route: oral
Route: steady-state
Dose: 120 mg, 1 times / day
Sources:
healthy, ADULT
Health Status: healthy
Age Group: ADULT
Sex: M
Food Status: UNKNOWN
Sources:
Disc. AE: Nausea...
Other AEs: Dizziness...
AEs leading to
discontinuation/dose reduction:
Nausea (grade 1-2, 40%)
Other AEs:
Dizziness (grade 1-2, 70%)
Sources:
AEs

AEs

AESignificanceDosePopulation
Nausea grade 1-2, 40%
Disc. AE
120 mg 1 times / day steady-state, oral
Highest studied dose
Dose: 120 mg, 1 times / day
Route: oral
Route: steady-state
Dose: 120 mg, 1 times / day
Sources:
healthy, ADULT
Health Status: healthy
Age Group: ADULT
Sex: M
Food Status: UNKNOWN
Sources:
Dizziness grade 1-2, 70%
120 mg 1 times / day steady-state, oral
Highest studied dose
Dose: 120 mg, 1 times / day
Route: oral
Route: steady-state
Dose: 120 mg, 1 times / day
Sources:
healthy, ADULT
Health Status: healthy
Age Group: ADULT
Sex: M
Food Status: UNKNOWN
Sources:
PubMed

PubMed

TitleDatePubMed
Practical application of cure mixture model for long-term censored survivor data from a withdrawal clinical trial of patients with major depressive disorder.
2010-04-23
Emotional reactivity and cognitive performance in aversively motivated tasks: a comparison between four rat strains.
2009-12-15
Olanzapine and fluoxetine combination therapy for treatment-resistant depression: review of efficacy, safety, and study design issues.
2009
Assessing the neuronal serotonergic target-based antidepressant stratagem: impact of in vivo interaction studies and knockout models.
2008-09
Gepirone extended-release in the treatment of adult outpatients with major depressive disorder: a double-blind, randomized, placebo-controlled, parallel-group study.
2008-04
Differential response to gepirone but not to chlordiazepoxide in malnourished rats subjected to learned helplessness.
2008-01
Acute and constitutive increases in central serotonin levels reduce social play behaviour in peri-adolescent rats.
2007-12
Early response and 8-week treatment outcome in GAD.
2006
The 5-HT1A receptor and the stimulus effects of LSD in the rat.
2005-10
Remission rates with 3 consecutive antidepressant trials: effectiveness for depressed outpatients.
2005-06
Novel, flexible, and conformationally defined analogs of gepirone: synthesis and 5-HT1A, 5-HT2A, and D2 receptor activity.
2005-02-15
Relapse prevention with gepirone ER in outpatients with major depression.
2005-02
[Review of antidepressants from the TCAs to the third generation drugs].
2004-12
Gepirone extended-release treatment of anxious depression: evidence from a retrospective subgroup analysis in patients with major depressive disorder.
2004-08
Cellular consequences of stress and depression.
2004-06
The design and preparation of metabolically protected new arylpiperazine 5-HT1A ligands.
2004-04-05
Use of physicochemical calculation of pKa and CLogP to predict phospholipidosis-inducing potential: a case study with structurally related piperazines.
2004-03
Metabolism of the newest antidepressants: comparisons with related predecessors.
2004-02
Differential effects of the 5-HT1A agonist gepirone on food intake in rats may depend on their motivation to eat.
2003-11
Pharmacokinetic evaluation of gepirone immediate-release capsules and gepirone extended-release tablets in healthy volunteers.
2003-09
A review of the efficacy and tolerability of immediate-release and extended-release formulations of gepirone.
2003-06
Sustained efficacy of gepirone-IR in major depressive disorder: a double-blind placebo substitution trial.
2003-04-19
Gepirone extended-release: new evidence for efficacy in the treatment of major depressive disorder.
2003-03
Human cytochromes mediating gepirone biotransformation at low substrate concentrations.
2003-03
Is there a role for 5-HT1A agonists in the treatment of depression?
2003-02-01
Influence of housing conditions on the effects of serotonergic drugs on feeding behavior in non-deprived rats.
2003
Rigid analogues of buspirone and gepirone, 5-HT1A receptors partial agonists.
2002-11
5-HT1A receptor-mediated regulation of mitogen-activated protein kinase phosphorylation in rat brain.
2002-10-04
The clinical pharmacology of depressive states.
2002-03
Gepirone. Organon.
2001-08
Effects of serotonergic compounds on aqueous humor dynamics in monkeys.
2001-08
5-HT1A receptor agonists buspirone and gepirone attenuate apomorphine-induced aggressive behaviour in adult male Wistar rats.
2000-12
Involvement of 5-hydroxytryptamine(1A) receptors in nicotine-induced tail tremor in rats.
2000-11-10
Prenatal exposure to cocaine: effects on aggression in Sprague-Dawley rats.
1994-05
Effects of 5-HT1A agonists and 5-HT2 antagonists on haloperidol-induced dyskinesias in squirrel monkeys: no evidence for reciprocal 5-HT-dopamine interaction.
1989
Strychnine seizure potentiation by azaspirodecanedione anxiolytics in rats.
1988-10-18
Patents

Sample Use Guides

Gepirone ER (20 mg to 80 mg) was administered once per day in the morning for 8 weeks (56 days). Patients with moderate to severe depression initiated treatment by taking a 20 mg tablet once daily in the morning with food, followed by an increase to 40 mg daily between days 4 and 7. The dose could be increased to 60 mg daily after day 7, and to 80 mg daily after 14 days.
Route of Administration: Oral
In Vitro Use Guide
Unknown
Substance Class Chemical
Created
by admin
on Mon Mar 31 17:59:10 GMT 2025
Edited
by admin
on Mon Mar 31 17:59:10 GMT 2025
Record UNII
80C9L8EP6V
Record Status Validated (UNII)
Record Version
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Name Type Language
EXXUA
Preferred Name English
GEPIRONE HYDROCHLORIDE
DASH   MART.   USAN  
USAN  
Official Name English
3,3-Dimethyl-1-[4-[4-(2-pyrimidinyl)-1-piperazinyl]butyl]glutarimide monohydrochloride
Common Name English
ORG-33062
Common Name English
ORG 33062
Code English
GEPIRONE HYDROCHLORIDE [MART.]
Common Name English
GEPIRONE HCL
Common Name English
Gepirone hydrochloride [WHO-DD]
Common Name English
BMY-13805-1
Code English
BMY 13805-1
Code English
TRAVIVO
Brand Name English
GEPIRONE HYDROCHLORIDE [USAN]
Common Name English
2,6-PIPERIDINEDIONE, 4,4-DIMETHYL-1-(4-(4-(2-PYRIMIDINYL)-1-PIPERAZINYL)BUTYL)-, MONOHYDROCHLORIDE
Common Name English
TGFK07AD
Code English
Classification Tree Code System Code
NCI_THESAURUS C28197
Created by admin on Mon Mar 31 17:59:10 GMT 2025 , Edited by admin on Mon Mar 31 17:59:10 GMT 2025
NCI_THESAURUS C47794
Created by admin on Mon Mar 31 17:59:10 GMT 2025 , Edited by admin on Mon Mar 31 17:59:10 GMT 2025
Code System Code Type Description
NCI_THESAURUS
C72795
Created by admin on Mon Mar 31 17:59:10 GMT 2025 , Edited by admin on Mon Mar 31 17:59:10 GMT 2025
PRIMARY
PUBCHEM
55190
Created by admin on Mon Mar 31 17:59:10 GMT 2025 , Edited by admin on Mon Mar 31 17:59:10 GMT 2025
PRIMARY
DAILYMED
80C9L8EP6V
Created by admin on Mon Mar 31 17:59:10 GMT 2025 , Edited by admin on Mon Mar 31 17:59:10 GMT 2025
PRIMARY
EPA CompTox
DTXSID30232812
Created by admin on Mon Mar 31 17:59:10 GMT 2025 , Edited by admin on Mon Mar 31 17:59:10 GMT 2025
PRIMARY
DRUG BANK
DBSALT002148
Created by admin on Mon Mar 31 17:59:10 GMT 2025 , Edited by admin on Mon Mar 31 17:59:10 GMT 2025
PRIMARY
ChEMBL
CHEMBL284092
Created by admin on Mon Mar 31 17:59:10 GMT 2025 , Edited by admin on Mon Mar 31 17:59:10 GMT 2025
PRIMARY
CAS
83928-66-9
Created by admin on Mon Mar 31 17:59:10 GMT 2025 , Edited by admin on Mon Mar 31 17:59:10 GMT 2025
PRIMARY
USAN
W-38
Created by admin on Mon Mar 31 17:59:10 GMT 2025 , Edited by admin on Mon Mar 31 17:59:10 GMT 2025
PRIMARY
FDA UNII
80C9L8EP6V
Created by admin on Mon Mar 31 17:59:10 GMT 2025 , Edited by admin on Mon Mar 31 17:59:10 GMT 2025
PRIMARY
SMS_ID
300000055127
Created by admin on Mon Mar 31 17:59:10 GMT 2025 , Edited by admin on Mon Mar 31 17:59:10 GMT 2025
PRIMARY
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