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AU2003263179B2 - 1-phenyl-2-dimethylaminomethyl cyclohexane compounds used for the therapy of depressive symptoms, pain, and incontinence - Google Patents

1-phenyl-2-dimethylaminomethyl cyclohexane compounds used for the therapy of depressive symptoms, pain, and incontinence Download PDF

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AU2003263179B2
AU2003263179B2 AU2003263179A AU2003263179A AU2003263179B2 AU 2003263179 B2 AU2003263179 B2 AU 2003263179B2 AU 2003263179 A AU2003263179 A AU 2003263179A AU 2003263179 A AU2003263179 A AU 2003263179A AU 2003263179 B2 AU2003263179 B2 AU 2003263179B2
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cyclohexyl
dimethylaminomethyl
phenol
phenyl
methoxy
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Helmut Buschmann
Werner Englberger
Elmar Friderichs
Hagen-Heinrich Hennies
Jorg Holenz
Ulrich Jahnel
Derek Saunders
Wolfgang Strassburger
Oswald Zimmer
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Gruenenthal GmbH
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Chemie Gruenenthal GmbH
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    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D309/00—Heterocyclic compounds containing six-membered rings having one oxygen atom as the only ring hetero atom, not condensed with other rings
    • C07D309/02—Heterocyclic compounds containing six-membered rings having one oxygen atom as the only ring hetero atom, not condensed with other rings having no double bonds between ring members or between ring members and non-ring members
    • C07D309/08—Heterocyclic compounds containing six-membered rings having one oxygen atom as the only ring hetero atom, not condensed with other rings having no double bonds between ring members or between ring members and non-ring members with hetero atoms or with carbon atoms having three bonds to hetero atoms with at the most one bond to halogen, e.g. ester or nitrile radicals, directly attached to ring carbon atoms
    • C07D309/10—Oxygen atoms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/13—Amines
    • A61K31/135—Amines having aromatic rings, e.g. ketamine, nortriptyline
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P13/00—Drugs for disorders of the urinary system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P13/00—Drugs for disorders of the urinary system
    • A61P13/02—Drugs for disorders of the urinary system of urine or of the urinary tract, e.g. urine acidifiers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A61P25/04—Centrally acting analgesics, e.g. opioids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A61P25/24—Antidepressants
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07C—ACYCLIC OR CARBOCYCLIC COMPOUNDS
    • C07C215/00—Compounds containing amino and hydroxy groups bound to the same carbon skeleton
    • C07C215/46—Compounds containing amino and hydroxy groups bound to the same carbon skeleton having hydroxy groups bound to carbon atoms of at least one six-membered aromatic ring and amino groups bound to acyclic carbon atoms or to carbon atoms of rings other than six-membered aromatic rings of the same carbon skeleton
    • C07C215/48—Compounds containing amino and hydroxy groups bound to the same carbon skeleton having hydroxy groups bound to carbon atoms of at least one six-membered aromatic ring and amino groups bound to acyclic carbon atoms or to carbon atoms of rings other than six-membered aromatic rings of the same carbon skeleton with amino groups linked to the six-membered aromatic ring, or to the condensed ring system containing that ring, by carbon chains not further substituted by hydroxy groups
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07C—ACYCLIC OR CARBOCYCLIC COMPOUNDS
    • C07C215/00—Compounds containing amino and hydroxy groups bound to the same carbon skeleton
    • C07C215/46—Compounds containing amino and hydroxy groups bound to the same carbon skeleton having hydroxy groups bound to carbon atoms of at least one six-membered aromatic ring and amino groups bound to acyclic carbon atoms or to carbon atoms of rings other than six-membered aromatic rings of the same carbon skeleton
    • C07C215/64—Compounds containing amino and hydroxy groups bound to the same carbon skeleton having hydroxy groups bound to carbon atoms of at least one six-membered aromatic ring and amino groups bound to acyclic carbon atoms or to carbon atoms of rings other than six-membered aromatic rings of the same carbon skeleton with rings other than six-membered aromatic rings being part of the carbon skeleton
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07C—ACYCLIC OR CARBOCYCLIC COMPOUNDS
    • C07C217/00—Compounds containing amino and etherified hydroxy groups bound to the same carbon skeleton
    • C07C217/54—Compounds containing amino and etherified hydroxy groups bound to the same carbon skeleton having etherified hydroxy groups bound to carbon atoms of at least one six-membered aromatic ring and amino groups bound to acyclic carbon atoms or to carbon atoms of rings other than six-membered aromatic rings of the same carbon skeleton
    • C07C217/74—Compounds containing amino and etherified hydroxy groups bound to the same carbon skeleton having etherified hydroxy groups bound to carbon atoms of at least one six-membered aromatic ring and amino groups bound to acyclic carbon atoms or to carbon atoms of rings other than six-membered aromatic rings of the same carbon skeleton with rings other than six-membered aromatic rings being part of the carbon skeleton
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07C—ACYCLIC OR CARBOCYCLIC COMPOUNDS
    • C07C291/00—Compounds containing carbon and nitrogen and having functional groups not covered by groups C07C201/00 - C07C281/00
    • C07C291/02—Compounds containing carbon and nitrogen and having functional groups not covered by groups C07C201/00 - C07C281/00 containing nitrogen-oxide bonds
    • C07C291/04—Compounds containing carbon and nitrogen and having functional groups not covered by groups C07C201/00 - C07C281/00 containing nitrogen-oxide bonds containing amino-oxide bonds
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07C—ACYCLIC OR CARBOCYCLIC COMPOUNDS
    • C07C305/00—Esters of sulfuric acids
    • C07C305/22—Esters of sulfuric acids having oxygen atoms of sulfate groups bound to carbon atoms of six-membered aromatic rings
    • C07C305/24—Esters of sulfuric acids having oxygen atoms of sulfate groups bound to carbon atoms of six-membered aromatic rings of non-condensed six-membered aromatic rings
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07C—ACYCLIC OR CARBOCYCLIC COMPOUNDS
    • C07C2601/00—Systems containing only non-condensed rings
    • C07C2601/12—Systems containing only non-condensed rings with a six-membered ring
    • C07C2601/14—The ring being saturated

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  • Pain & Pain Management (AREA)
  • Urology & Nephrology (AREA)
  • Epidemiology (AREA)
  • Psychiatry (AREA)
  • Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
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  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)

Description

WO 2004/009067 PCT/EP2003/007720 1-PHENYL-2-DIMETHYLAMINOMETHYLCYCLOHEXANE COMPOUNDS FOR THERAPY OF DEPRESSIVE SYMPTOMS, PAIN AND INCONTINENCE The invention relates to metabolites of [2-(3 5 methoxyphenyl)-cyclohexylmethyl]-dimethylamine as free bases and/or in the form of physiologically acceptable salts, corresponding medicaments and the use of [2-(3 methoxyphenyl)-cyclohexylmethyl]-dimethylamine and its metabolites for the preparation of a medicament for 10 treatment of depressions and methods for treatment of depressions. Depression is an affectivity disorder with which a depressive syndrome occupies the foreground, depressive 15 meaning associated with depression or of sad mood. The antidepressants used for therapy are also important adjuvants for pain therapy (R. van Schayck et al. 1998, MMP, 10, 304-313; Jung et al. 1997, J. Gen. Intern. Med. 12, 384-389; Onghena and Van Houdenhove 1992, 20 Pain, 49, 205-219; Feuerstein 1997, Diagnostik und Therapie, 3, 213-225; Rowbotham 1997, The Pain Medicine Journal Club Journal, 3, 119-122), in particular in cases of chronic states of pain, since the lasting pain load can lead to a-depressive mood in the patient. This is 25 particularly often the case with cancer pain patients (Berard 1996, Int. Med. J., 3, 257-259). Since there has hitherto been no painkiller with a clinically relevant antidepressant action component, antidepressants must be added to the administration of analgesics as additional 30 medication. Since chronic pain patients often require a large number of various medicaments, the additional administration of the antidepressant leads to a further stress on the organism. For this reason and to improve WO 2004/009067 PCT/EP2003/007720 2 compliance, an antidepressant action component already present in an analgesic substance would be of particular advantage. 5 The basis of the antidepressant action is the inhibition of the reuptake of noradrenaline and serotonin. Opioids having a moderate inhibition of the uptake, such as e.g. tramadol, have been known for a relatively long time and are employed therapeutically as potent analgesics having a 10 low addiction and dependency potential (Raffa et al. 1992, Journal of Pharmacology and experimental Therapeutics, 260, 278-285; Raffa and Friderichs 1996, Pain Review, 3, 249 271). However, the uptake-inhibiting component is not potent enough to be able to initiate a clinically relevant 15 antidepressant effect. In addition to the actual antidepressant action, inhibition of the reuptake of noradrenaline and serotonin also leads to an independent analgesic action, in that descending pain 20 inhibition pathways are activated at the level of the spinal marrow. In combination with opiates, which also inhibit transmission of pain at the spinal marrow level, this leads to a mutual potentiation of the pain inhibition mechanisms and therefore to a particularly effective 25 analgesia. An opioid substance having a relatively potent NA and/or 5HT uptake-inhibiting component which displays an antidepressant activity (e.g. demonstrated in a suitable 30 behaviour model in animal studies) would therefore be particularly favourable in this indication, in particular WO 2004/009067 PCT/EP2003/007720 3 treatment of depressions, precisely also in combination with pain therapy. The object of the present invention was therefore to 5 discover substances, in particular opiod substances, which are suitable for treatment of depressions, in particular those which combine this activity with analgesic activity. It has now been found, surprisingly, that 2-(3 10 methoxyphenyl)-cyclohexylmethyl)-dimethylamine and also its metabolites, and in this context in particular 3-(2 dimethylaminomethyl-cyclohexyl)-phenol, have a therapeutically relevant antidepressant action component. 15 The invention accordingly provides the use of m 3-(2-dimethylaminomethyl-cyclohexyl)-phenol, 0 (lR,2R)-3-(2-dimethylaminomethyl-cyclohexyl) phenol, 20 * [2-(3-methoxyphenyl)-cyclohexylmethyl] dimethylamine, 0 (lR,2R)-[2-(3-methoxyphenyl)-cyclohexylmethyl] dimethylamine, m sulfuric acid mono-[3-(2-dimethylaminomethyl 25 cyclohexyl)-phenyl] ester, m sulfuric acid mono-(lR,2R)-[3-(2 dimethylaminomethyl-cyclohexyl)-phenyl] ester, M 3-(2-methylaminomethyl-cyclohexyl)-phenol, a (lR,2R)-3-(2-methylaminomethyl-cyclohexyl)-phenol, 30 m 3-(2-dimethylaminomethyl-cyclohexyl)-phenol N oxide, WO 2004/009067 PCT/EP2003/007720 4 0 (1R,2R)-3-(2-dimethylaminomethyl-cyclohexyl) phenol N-oxide, m 6-[3-(2-dimethylaminomethyl-cyclohexyl)-phenoxy] 3,4,5-trihydroxy-tetrahydropyran-2-carboxylic 5 acid, 0 6-[(lR,2R)-3-(2-dimethylaminomethyl-cyclohexyl) phenoxy]-3,4,5-trihydroxy-tetrahydropyran-2 carboxylic acid, m 4-(2-dimethylaminomethyl-cyclohexyl)-catechol, 10 M (lR,2R)-4-(2-dimethylaminomethyl-cyclohexyl) catechol, a 3-(2-aminomethyl-cyclohexyl)-phenol, 0 (1R,2R)-3-(2-aminomethyl-cyclohexyl)-phenol, m 4-(2-dimethylaminomethyl-cyclohexyl)-benzene-1,2 15 diol, M (1R,2R)-4-(2-dimethylaminomethyl-cyclohexyl) benzene-1,2-diol, N C-[2-(3-methoxy-phenyl)-cyclohexyl]-methylamine, M (1R,2R)-C-[2-(3-methoxy-phenyl)-cyclohexyl] 20 methylamine, 0 [2-(3-methoxy-phenyl)-cyclohexylmethyl]-methyl amine, 0 (lR,2R)-[2-(3-methoxy-phenyl)-cyclohexylmethyl] methyl-amine, 25 M [2-(3-methoxy-phenyl)-cyclohexylmethyl]-dimethyl amine; N-oxide or E (1R,2R)-[2-(3-methoxy-phenyl)-cyclohexylmethyl] dimethyl-amine; N-oxide; 30 optionally in the form of their racemates, their pure stereoisomers, in particular enantiomers or diastereomers, or in the form of mixtures of the WO 2004/009067 PCT/EP2003/007720 5 stereoisomers, in particular the enantiomers or diastereomers, in any desired mixture ratio; in the form shown or in the form of their acids or their bases or in the form of their salts, in 5 particular the physiologically acceptable salts, or in the form of their solvates, in particular the hydrates; for the preparation of a medicament for treatment of 10 depressions. In this context it is particularly preferable if the compounds used are in the form of R,R, preferably 1R,2R stereoisomers. 15 The term salt is to be understood as meaning any form of the active compound according to the invention in which this assumes an ionic form or is charged and coupled with a counter-ion (a cation or anion) or is in solution. This is 20 also to be understood as meaning complexes of the active compound with other molecules and ions, in particular complexes which are complexed via ionic interactions. In particular, this is understood as meaning (and this is also a preferred embodiment of this invention) physiologically 25 acceptable salts, in particular physiologically acceptable salts with cations or bases and physiologically acceptable salts with anions or acids or also a salt formed with a physiologically acceptable acid or a physiologically acceptable cation. 30 The preferred salt of the compounds used is the hydrochloride.
WO 2004/009067 PCT/EP2003/007720 6 Physiologically acceptable is to be understood as meaning that the substance, in particular the salt as such, is acceptable when used in humans or mammals, that is to say, 5 for example, does not have a non-physiological (e.g. toxic) action. In the context of this invention, the term of physiologically acceptable salt with anions or acids is 10 understood as meaning at least one of the compounds according to the invention - usually protonated, for example on the nitrogen - as the cation with at least one anion, which are physiologically acceptable - especially when used in humans and/or mammals. In particular, in the 15 context of this invention by this there is understood the salt formed with a physiologically acceptable acid, namely salts of the particular active compound with inorganic or organic acids which are physiologically acceptable especially when used in humans and/or mammals. Examples of 20 physiologically acceptable salts of particular acids are salts of: hydrochloric acid, hydrobromic acid, sulfuric acid, methanesulfonic acid, formic acid, acetic acid, oxalic acid, succinic acid, malic acid, tartaric acid, mandelic acid, fumaric acid, lactic acid, citric acid, 25 glutamic acid, 1,1-dioxo-1,2-dihydrolb6-benzo[d]isothiazol 3-one (saccharic acid), monomethylsebacic acid, 5-oxo proline, hexane-1-sulfonic acid, nicotinic acid, 2-, 3- or 4-aminobenzoic acid, 2,4,6-trimethyl-benzoic acid, a liponic acid, acetylglycine, acetylsalicylic acid, hippuric 30 acid and/or aspartic acid. The hydrochloride salt is particularly preferred.
WO 2004/009067 PCT/EP2003/007720 7 In the context of this invention, the term of salt formed with a physiologically acceptable acid is understood as meaning salts of the particular active compound with inorganic or organic acids which are physiologically 5 acceptable - especially when used in humans and/or mammals. The hydrochloride is particularly preferred. Examples of physiologically acceptable acids are: hydrochloric acid, hydrobromic acid, sulfuric acid, methanesulfonic acid, formic acid, acetic acid, oxalic acid, succinic acid, 10 tartaric acid, mandelic acid, fumaric acid, lactic acid, citric acid, glutamic acid, 1,1-dioxo-1,2-dihydroLA 6 _ benzo[d]isothiazol-3-one (saccharic acid), monomethylsebacic acid, 5-oxo-proline, hexane-l-sulfonic acid, nicotinic acid, 2-, 3- or 4-aminobenzoic acid, 2,4,6 15 trimethyl-benzoic acid, a-liponic acid, acetylglycine, acetylsalicylic acid, hippuric acid and/or aspartic acid. In the context of this invention, the term of physiologically acceptable salt with cations or bases is 20 understood as meaning salts of at least one of the compounds according to the invention - usually of a (deprotonated) acid - as the anion with at least one preferably inorganic cation which are physiologically acceptable - especially when used in humans and/or mammals. 25 The salts of the alkali metals and alkaline earth metals and also with NH4 are particularly preferred, but especially (mono-) or (di-)sodium, (mono-) or (di-)potassium, magnesium or calcium salts. 30 In the context of this invention, the term of salt formed with a physiologically acceptable cation is understood as meaning salts of at least one of the particular compounds WO 2004/009067 PCT/EP2003/007720 8 as the anion with at least one inorganic cation which is physiologically acceptable - especially when used in humans and/or mammals. The salts of the alkali metals and alkaline earth metals and also NH 4 ' are particularly 5 preferred, but especially (mono-) or (di-)sodium, (mono-) or (di-)potassium, magnesium or calcium salts. According to the present investigations, the substances used, and in particular (1R,2R)-3-(2-dimethylaminomethyl 10 cyclohexyl)-phenol, are potent analgesics and antidepressants, that is to say have an additional and clinically relevant antidepressant action component. In particular, (1R,2R)-3-(2-dimethylaminomethyl-cyclohexyl) phenol can be employed in cases of moderate to severe acute 15 and chronic pain and renders possible treatment of the depressive concomitant symptoms with chronic states of pain. It therefore leads to a significant improvement in the treatment of chronic pain, since antidepressants hitherto had to be added as additional medicaments to those 20 of pain therapy. (1R,2R)-3-(2-Dimethylaminomethyl cyclohexyl)-phenol and the other substances used according to the invention can therefore also be used as genuine antidepressants independently of their analgesic action. 25 The invention also provides metabolites, in particular of [2-(3-methoxyphenyl)-cyclohexylmethyl]-dimethylamine and 3 (2-dimethylaminomethyl-cyclohexyl)-phenol chosen from " sulfuric acid mono-[3-(2-dimethylaminomethyl 30 cyclohexyl)-phenyl] ester, " sulfuric acid mono-(1R,2R)-[3-(2 dimethylaminomethyl-cyclohexyl)-phenyl] ester, -- WO 2004/009067 PCT/EP2003/007720 9 m 3-(2-methylaminomethyl-cyclohexyl)-phenol, 0 (1R,2R)-3-(2-methylaminomethyl-cyclohexyl)-phenol, 0 3-(2-dimethylaminomethyl-cyclohexyl)-phenol
N
oxide, 5 m (1R,2R)-3-(2-dimethylaminomethyl-cyclohexyl) phenol N-oxide, 0 6-[3-(2-dimethylaminomethyl-cyclohexyl)-phenoxy] 3,4,5-trihydroxy-tetrahydropyran-2-carboxylic acid, 10 m 6-[(1R,2R)-3-(2-dimethylaminomethyl-cyclohexyl) phenoxy]-3,4,5-trihydroxy-tetrahydropyran-2 carboxylic acid, 0 4-(2-dimethylaminomethyl-cyclohexyl)-catechol, 0 (1R,2R)-4-(2-Dimethylaminomethyl-cyclohexyl) 15 catechol, 0 3-(2-aminomethyl-cyclohexyl)-phenol, 0 (1R,2R)-3-(2-aminomethyl-cyclohexyl)-phenol, m 4-(2-dimethylaminomethyl-cyclohexyl)-benzene-1,2 diol, 20 m (lR,2R)-4-(2-dimethylaminomethyl-cyclohexyl) benzene-1,2-diol, m C-[2-(3-methoxy-phenyl)-cyclohexyl]-methylamine, 0 (lR,2R)-C-[2-(3-methoxy-phenyl)-cyclohexyl] methylamine, 25 0 [2-(3-methoxy-phenyl)-cyclohexylmethyl]-methyl amine, * (1R,2R)-[2-(3-methoxy-phenyl)-cyclohexylmethyl] methyl-amine, * [2-(3-methoxy-phenyl)-cyclohexylmethyl]-dimethyl 30 amine; N-oxide or m (1R,2R)-[2-(3-methoxy-phenyl)-cyclohexylmethyl] dimethyl-amine N-oxide; -WO 2004/009067 PCT/EP2003/007720 10 optionally in the form of their racemates, their pure stereoisomers, in particular enantiomers or diastereomers, or in the form of mixtures of the 5 stereoisomers, in particular the enantiomers or diastereomers, in any desired mixture ratio; in the form shown or in the form of their acids or their bases or in the form of their salts, in particular the physiologically acceptable salts, or in 10 the form of their solvates, in particular the hydrates. Metabolites according to the invention which are in the form of R,R, preferably 1R,2R stereoisomers are 15 particularly preferred. The metabolites according to the invention are physiologically acceptable. The invention therefore also provides a medicament comprising as the active compound at 20 least one metabolite according to the invention and optionally additives and auxiliary substances. In particular, the invention accordingly provides a medicament comprising as the active compound at least one compound chosen from 25 " sulfuric acid mono-[3-(2-dimethylaminomethyl cyclohexyl)-phenyl] ester, " sulfuric acid mono-(lR,2R)-[3-(2 dimethylaminomethyl-cyclohexyl)-phenyl] ester, 30 = 3-(2-methylaminomethyl-cyclohexyl)-phenol, " (lR,2R)-3-(2-methylaminomethyl-cyclohexyl)-phenol, WO 2004/009067 PCT/EP2003/007720 11 0 3-(2-dimethylaminomethyl-cyclohexyl)-phenol N oxide, 0 (1R,2R)-3-(2-dimethylaminomethyl-cyclohexyl) phenol N-oxide, 5 0 6-[3-(2-dimethylaminomethyl-cyclohexyl)-phenoxy] 3,4,5-trihydroxy-tetrahydropyran-2-carboxylic acid, m 6-[(lR,2R)-3-(2-dimethylaminomethyl-cyclohexyl) phenoxy]-3,4,5-trihydroxy-tetrahydropyran-2 10 carboxylic acid, m 4-(2-dimethylaminomethyl-cyclohexyl)-catechol, 0 (lR,2R)-4-(2-Dimethylaminomethyl-cyclohexyl) catechol, m 3-(2-aminomethyl-cyclohexyl)-phenol, 15 m (lR,2R)-3-(2-aminomethyl-cyclohexyl)-phenol, m 4-(2-dimethylaminomethyl-cyclohexyl)-benzene-1,2 diol, m (1R,2R)-4-(2-dimethylaminomethyl-cyclohexyl) benzene-1,2-diol, 20 0 C-[2-(3-methoxy-phenyl)-cyclohexyl]-methylamine, 0 (lR,2R)-C-[2-(3-methoxy-phenyl)-cyclohexyll methylamine, m [2-(3-methoxy-phenyl)-cyclohexylmethyl]-methyl amine, 25 0 (1R,2R)-[2-(3-methoxy-phenyl)-cyclohexylmethyl] methyl-amine, 0 [2-(3-methoxy-phenyl)-cyclohexylmethyl]-dimethyl amine; N-oxide or 0 (1R,2R)-[2-(3-methoxy-phenyl)-cyclohexylmethyll 30 dimethyl-amine N-oxide; WO 2004/009067 PCT/EP2003/007720 12 optionally in the form of their racemates, their pure stereoisomers, in particular enantiomers or diastereomers, or in the form of mixtures of the stereoisomers, in particular the enantiomers or 5 diastereomers, in any desired mixture ratio; in the form shown or in the form of their acids or their bases or in the form of their salts, in particular the physiologically acceptable salts, or in the form of their solvates, in particular the 10 hydrates; and optionally additives and/or auxiliary substances. It is particularly preferable if the compounds contained 15 therein are in the form of R,R, preferably 1R,2R stereoisomers. Suitable additives and/or auxiliary substances in the context of this invention are all the substances known to 20 the expert from the prior art for achieving galenical formulations. The choice of these auxiliary substances and the amounts thereof to be employed depend on whether the medicament is to be administered orally, intravenously, intraperitoneally, intradermally, intramuscularly, 25 intranasally, buccally or locally. Formulations in the form of tablets, chewable tablets, coated tablets, capsules, granules, drops, juices or syrups are suitable for oral administration, and solutions, suspensions, easily reconstitutable dry formulations and sprays are suitable 30 for parenteral, topical and inhalatory administration. Suppositories for use in the rectum are a further possibility. The use in a depot in dissolved form, a WO 2004/009067 PCT/EP2003/007720 13 carrier film or a patch, optionally with the addition of agents which promote penetration through the skin, are examples of suitable forms for percutaneous administration. Examples of auxiliary substances and additives for the oral 5 administration forms are disintegrating agents, lubricants, binders, fillers, mould release agents, optionally solvents, flavourings, sugars, in particular carrier agents, diluents, dyestuffs, antioxidants etc. For suppositories, inter alia, waxes and fatty acid esters can 10 be used, and for compositions for parental administration carrier substances, preservatives, suspension auxiliaries etc. can be used. The amounts of active compound to be administered to patients vary as a function of the weight of the patient, the mode of administration and the severity 15 of the disease. The compounds used according to the invention can be released in a delayed manner from formulation forms which can be used orally, rectally or percutaneously. Corresponding sustained-release formulations, in particular in the form of a "once daily" 20 preparation which has to be taken only once a day, are particularly preferred for the indication according to the invention. Medicaments which comprise at least 0.05 to 90.0 % of the 25 active compound, in particular low active dosages, in order to avoid side effects or analgesic actions, are preferred. 0.1 to 5,000 mg/kg, in particular 1 to 500 mg/kg, preferably 2 to 250 mg/kg of body weight of a least one compound used according to the invention are conventionally 30 administered. However, the administration of 0.01 5 mg/kg, preferably 0.03 to 2 mg/kg, in particular 0.05 to 1 mg/kg, is also preferred and conventional.
WO 2004/009067 PCT/EP2003/007720 14 Auxiliary substances can be, for example: water, ethanol, 2-propanol, glycerol, ethylene glycol, propylene glycol, polyethylene glycol, polypropylene glycol, glucose, 5 fructose, lactose, sucrose, dextrose, molasses, starch, modified starch, gelatine, sorbitol, inositol, mannitol, microcrystalline cellulose, methylcellulose, carboxymethylcellulose, cellulose acetate, shellac, cetyl alcohol, polyvinylpyrrolidone, paraffins, waxes, naturally 10 occurring and synthetic gums, gum acacia, alginates, dextran, saturated and unsaturated fatty acids, stearic acid, magnesium stearate, zinc stearate, glyceryl stearate, sodium lauryl sulfate, edible oils, sesame oil, coconut oil, groundnut oil, soya bean oil, lecithin, sodium 15 lactate, polyoxyethylene and -propylene fatty acid esters, sorbitan fatty acid esters, sorbic acid, benzoic acid, citric acid, ascorbic acid, tannic acid, sodium chloride, potassium chloride, magnesium chloride, calcium chloride, magnesium oxide, zinc oxide, silicon dioxide, titanium 20 oxide, titanium dioxide, magnesium sulfate, zinc sulfate, calcium sulfate, potash, calcium phosphate, dicalcium phosphate, potassium bromide, potassium iodide, talc, kaolin, pectin, crospovidone, agar and bentonite. 25 The medicaments and pharmaceutical compositions according to the invention are prepared with the aid of means, devices, methods and processes which are well-known in the prior art of pharmaceutical formulation, such as are described, for example, in "Remington's Pharmaceutical 30 Sciences", ed. A. R. Gennaro, 17th ed., Mack Publishing Company, Easton, Pa. (1985), in particular in part 8, chapter 76 to 93.
WO 2004/009067 PCT/EP2003/007720 15 Thus e.g. for a solid formulation, such as a tablet, the active compound of the medicament, i.e. a compound of the general structure I or one of its pharmaceutically 5 acceptable salts, can be granulated with a pharmaceutical carrier, e.g. conventional tablet constituents, such as maize starch, lactose, sucrose, sorbitol, talc, magnesium stearate, dicalcium phosphate or pharmaceutically acceptable gums, and pharmaceutical diluents, such as e.g. 10 water, in order to form a solid composition which comprises a compound according to the invention or a pharmaceutically acceptable salt thereof in homogeneous distribution. Homogeneous distribution is understood here as meaning that the active compound is uniformly distributed over the 15 entire composition, so that this can easily be divided into unit dose forms, such as tablets, pills or capsules, having the same activity. The solid composition is then divided into unit does forms. The tablets or pills of the medicament according to the invention or of the 20 compositions according to the invention can also be coated or compounded in another manner in order to provide a dose form with delayed release. Suitable coating compositions are, inter alia, polymeric acids and mixtures of polymeric acids with materials such as e.g. shellac, cetyl alcohol 25 and/or cellulose acetate. Although the medicaments according to the invention show only few side effects, it may be of advantage - should this be necessary at all - for example to avoid certain forms of 30 dependency, also to use morphine antagonists, in particular naloxone, naltrexone and/or levallorphan, in addition to the compounds used.
WO 2004/009067 PCT/EP2003/007720 16 Since the compounds according to the invention - as stated above - have an analgesic action, the invention also provides the use of a compound according to the invention 5 or of a metabolit according to the invention for the preparation of a medicament for treatment of pain, in particular acute, visceral, chronic or neuropathic pain or cancer pain. 10 Since the compounds according to the invention moreover also show an activity in cases of urinary incontinence, the inventiona also provides the use of a compound according to the invention or of a metabolite according to the invention for the preparation of a medicament for treatment of an 15 increased urge to urinate or urinary incontinence. The invention furthermore also relates to a method for treatment of depression, in which the compounds used according to the invention are used. 20 The invention likewise also relates to a method for treatment of pain, in particular acute, visceral, chronic or neuropathic pain or cancer pain, in which the compounds or metabolites according to the invention are used. 25 The invention likewise also relates to a method for treatment of an increased urge to urinate or urinary incontinence, in which the compounds or metabolites according to the invention are used. 30 2-(3-Methoxyphenyl)-cyclohexylmethyl)-dimethylamine and (1R,2R)-[:2-(3-methoxyphenyl)-cyclohexylmethyl)- WO 2004/009067 PCT/EP2003/007720 17 dimethylamine] and their preparation are known from DE 195 25 137 Al Example 8 and US 5,733,936 Example 8, where the absolute stereochemistry of the compound (-6) prepared according to Example 8 is certainly correctly (LR,2R) and 5 not (1R,2S). 3-(2-Dimethylaminomethyl-cyclohexyl)-phenol and(lR,2R)-3-(2-dimethylaminomethyl-cyclohexyl)-phenol and their preparation are also known from DE 195 25 137 Al Example 10 and US 5,733,936, Example 10, where the absolute stereochemistry of the compound (-7) prepared according to 10 Example 10 is certainly correctly (1R,2R) and not (1R,2S). The compounds which, and the preparation of which, are not yet known from DE 195 25 137 Al or US 5,733,936 were prepared in accordance with the examples. 15 The following examples are intended to explain the invention without the subject matter of the invention being limited thereto. 20 Examples Generally, the purification and the separation of enantiomers in all the processes mentioned as an example is carried out at the various stages with column 25 chromatography, and predominantly HPLC. Example 1: Preparation of (lR,2R)-[2-(3-methoxyphenyl) cyclohexylmethyl]-methylamine, hydrochloride 30 [2-(3-Methoxyphenyl)-cyclohexylmethyl]-methylamine, and (lR,2R)-[2-(3-methoxyphenyl)-cyclohexylmethyl]-methylamine, WO 2004/009067 PCT/EP2003/007720 18 in particular the hydrochloride salt thereof, are prepared as follows: 5.67 g (22.9 mmol) (lR,2R)-[2-(3-methoxyphenyl) 5 cyclohexylmethyl]-dimethylamine as the free base were heated in 389.64 ml toluene with 3.16 ml (25.2 mmol) phenyl chloroformate for 3 h. After cooling and washing, the organic residue was concentrated and stirred at 110 *C with 192.53 ml ethylene glycol and a total of 45.84 ml 5 N NaOH 10 for a total of 8.5 h, with occasional stirring. (lR,2R) [2-(3-Methoxyphenyl)-cyclohexylmethyl]-methylamine was formed. This was worked up and precipitated as the hydrochloride with TMCS. 15 Example 2: Preparation of (1R,2R)-3-(2-methylaminomethyl cyclohexyl)-phenol, hydrochloride 3.55 g (15.2 mmol) of the hydrochloride salt of the (lR,2R)-[2-(3-methoxy-phenyl)-cyclohexylmethyl]-methyl 20 amines according to Example 1 were stirred under reflux in 4.59 ml (47-48 %) aqueous HBr for 7.5 h and the mixture was cooled overnight. (1R,2R)-3-(2-Methylaminomethyl cyclohexyl)-phenol is formed. This was worked up and precipitated as the hydrochloride with TMCS. 25 Example 3: Preparation of sulfuric acid mono-(lR,2R)-[3-(2 dimethylaminomethyl-cyclohexyl)-phenyl] ester Sulfuric acid mono-[3-(2-dimethylaminomethyl-cyclohexyl) 30 phenyl] ester or sulfuric acid mono-(lR,2R)-[3-(2 dimethylaminomethyl-cyclohexyl)-phenyl] ester was prepared as follows: WO 2004/009067 PCT/EP2003/007720 19 (1R,2R)-3-(2-Dimethylaminomethyl-cyclohexyl)-phenol; hydrochloride was treated with dicyclohexylcarbodiimide (DCC) in H 2
SO
4 . Sulfuric acid mono-(lR,2R)-[3-(2 5 dimethylaminomethyl-cyclohexyl)-phenyl] ester was formed. Example 4: Preparation of 6-[(lR,2R)-3-(2 dimethylaminomethyl-cyclohexyl)-phenoxy]-3,4,5-trihydroxy tetrahydropyran-2-carboxylic acid 10 6-[3-(2-Dimethylaminomethyl-cyclohexyl)-phenoxy]-3,4,5 trihydroxy-tetrahydropyran-2-carboxylic acid or 6-[(1R,2R) 3-(2-dimethylaminomethyl-cyclohexyl)-phenoxy]-3,4,5 trihydroxy-tetrahydropyran-2-carboxylic acid was prepared 15 as follows: (1R,2R)-3-(2-Dimethylaminomethyl-cyclohexyl)-phenol; hydrochloride was treated with 3,4,5-tri-O-acetyl-1-a bromo-D-glucoronic acid methyl ester with 1. LiOH and 2. 20 HOAc. 6-[(lR,2R)-3-(2-Dimethylaminomethyl-cyclohexyl) phenoxy]-3,4,5-trihydroxy-tetrahydropyran-2-carboxylic acid was formed. Purification was carried out via a Lobar Lichoprep RP128 column MeOH:H20 system with subsequent HPLC separation. 25 Example 5: Preparation of [2-(3-methoxy-phenyl) cyclohexylmethyl]-dimethyl-amine; N-oxide [2-(3-Methoxy-phenyl)-cyclohexylmethyl]-dimethyl-amine;
N
30 oxide or (1R,2R)-[2-(3-methoxy-phenyl)-cyclohexylmethyl] dimethyl-amine; N-oxide was prepared as follows: WO 2004/009067 PCT/EP2003/007720 20 (lR,2R)-[2-(3-Methoxy-phenyl)-cyclohexylmethyl]-dimethyl amine; hydrochloride was dissolved, and treated with H 2 0 2 at room temperature. (1R,2R)-[2-(3-Methoxy-phenyl) cyclohexylmethyl]-dimethyl-amine; N-oxide was formed. 5 Example 6: Preparation of (lR,2R) -3- (2-dimethylaminomethyl cychlohexyl)-phenol N-oxide 3-(2-Dimethylaminomethyl-cychlohexyl)-phenol N-oxide or 10 (lR,2R)-3-(2-dimethylaminomethyl-cychlohexyl)-phenol N oxide was prepared as follows: (lR,2R)-3-(2-Dimethylaminomethyl-cychlohexyl)-phenol; hydrochloride was dissolved, and treated with H 2 0 2 at room 15 temperature. (lR,2R)-3-(2-Dimethylaminomethyl cychlohexyl)-phenol N-oxide was formed. Example 7: Preparation of 4-(2-dimethylaminomethyl cyclohexyl)-catechol or 4-(2-dimethylaminomethyl 20 cyclohexyl)-benzene-1,2-diol. 4-(2-Dimethylaminomethyl-cyclohexyl)-catechol or 4-(2 dimethylaminomethyl-cyclohexyl)-benzene-1,2-diol was prepared in accordance with the following reaction 25 equation: WO 2004/009067 PCT/EP2003/007720 21 O 0 Method 1: Buli J Method 2: Grignard N aqueous 48% HBr solution at -5
*
C 0 0 N I) H2, Pd/C catalyst, MeOH, HCl salt or II) H2, Pd/C catalyst, EtOH, base aqueous OH O 'N, 48% HBr OH solution at 25 *C N N In this, in addition, Method 1 BuLi designates the synthesis via BuLi reagents which is well-known to the expert, and Method 2 Grignard designates the synthesis via 5 Mg reagents which is well-known to the expert.
WO 2004/009067 PCT/EP2003/007720 22 Example 8: Preparation of C-[2-(3-methoxy-phenyl) cyclohexyl] -methylamine. 5 The preparation of C-[2-(3-methoxy-phenyl)-cyclohexyl] methylamine was carried out in accordance with the following reaction equation: 00 Bna polyformaldehyde Bn2NH2Cl B2 M~ - ~NBn 2 MgBr 2N HO Tetrahydrofuran NBn 2 0 0 " NBn 2 NBn 2 H2, Pd-C catalyst, EtOH 0
NH
2 WO 2004/009067 PCT/EP2003/007720 23 Example 9: Preparation of (lR,2R)-3-(2-aminomethyl cyclohexyl) -phenol. 3- (2-Aminomethyl-cyclohexyl) -phenol or (lR,2R) -3- (2 5 aminomethyl-cyclohexyl)-phenol was prepared in accordance with the following reaction equation: Bn Ij 0 0 polyformaldehyde O Bn 2
NH
2 Cl NBn 2 MgBr SHO Tetrahydrofuran Nn2 0 0 NBn 2 NBn 2 column chromatography to give the desired 1,6 olefin di-isobutyl-aluminium hydride (DiBAH) OH OH
H
2 , NBn 2 Pd-C catalyst, NH 2 base, EtOH WO 2004/009067 PCT/EP2003/007720 24 Example 10 In vitro isolation of the metabolites: [2-(3-Methoxyphenyl)-cyclohexylmethyl]-dimethylamine; hydrochloride and in another example (lR,2R)-3-(2 5 dimethylaminomethyl-cyclohexyl)-phenol; hydrochloride was dissolved in TRIS/HCl buffer pH 7.4. MgCl and, where appropriate, the other necessary cofactors, known from the literature, for cytochrome P450 (CytP450) were then added and the batch was incubated with CytP450 3A4 (N 10 demethylation) and/or CytP450 2D6 (0-demethylation) at 37 *C. The batch was then separated via HPLC and the metabolites in the fractions were identified via NMR and then isolated from the fractions. 15 Example 11 In vivo isolation of the metabolites: [2-(3-Methoxyphenyl)-cyclohexylmethyl]-dimethylamine; hydrochloride and in a further example (lR,2R)-3-(2 dimethylaminomethyl-cyclohexyl)phenol; hydrochloride were 20 injected into a mammal. Blood was taken from the mammal and, after the corpuscular constituents had been separated off, this was separated via HPLC and the metabolites in the fractions were identified via NMR and then isolated from the fractions. 25 Example 12 p-Opioid receptor affinity and NA and 5HT uptake-inhibiting components: In addition to the binding to the p-opioid receptor, which 30 is decisive for an opiod substance, the NA and 5HT uptake inhibiting components were also investigated for two antidepressants which are used clinically, fluoxetine and WO 2004/009067 PCT/EP2003/007720 25 desipramine. The results of these standard tests, the procedure of which is adequately known in the literature, are summarized in Table 1: 5 Table 1: Uptake inhibition and opioid receptor binding (1R,2R) -3- (lR,2R) -3- Fluoxetine Desipramine (2-Dimethyl- (2-Methyl aminomethyl - aminomethyl cyclohexyl) - cyclohexyl) phenol; phenol; hydro- hydro chloride chloride Ki values (pM) p-Opioid 0.038 (rat) 0.91 (human) inactive inactive receptor NA uptake 0.16 0.56 0.53 0.0011 inhibition 5HT uptake 0.05 9.41 0.026 1.44 inhibition The 5HT reuptake inhibition precisely of (1R,2R)-3-(2 dimethylaminomethyl-cyclohexyl) -phenol is of the same order 10 of magnitude as the p-opioid receptor binding of the substance. The substance thus has an exactly balanced ratio of p-opioid component and uptake inhibition and therefore also has the potential for a particularly effective pain inhibition. The uptake inhibition is of the 15 order of magnitude of antidepressants used clinically and thus leads to an independent antidepressant action component, the substance having a relatively potent inhibiting action on the noradrenaline and, in particular, serotonin reuptake. 20 WO 2004/009067 PCT/EP2003/007720 26 Example 13 Tail suspension test: The tail suspension test detects antidepressant and anxiolytic activity and follows the method of Porsolt et 5 al. (Porsolt R. D., Bertin A., Jalfre M., Behaviourial despair in mice: a primary screening test for antidepressants. Arch. Int. Pharmacodyn. Ther., 229, 327 336, 1977) and St6ru at al. (St6ru L., Chermat R., Thierry B, Simon P. The Tail Suspension Test: a new method for 10 screening antidepressants in mice. Psychopharmacology, 85, 367-370, 1985). Rodents left hanging by the tail rapidly become immobile. Antidepressants reduce the duration of the immobility, while tranquilizers prolong the duration of the immobility. The behaviour of the animals was observed 15 for 6 minutes, preferably with a computerized apparatus (Itemac-TST) developed by St6ru et al. (1985) (see above). Several mice were investigated in parallel and the duration of immobility determined. This parameter is analogous to that in the behavioural despair test (St6ru L., Chermat R., 20 Thierry B., Mico J. A., Lenegre A., St6ru M., Simon P. Porsolt R. D., The automated Tail Suspension Test: a computerized device which differentiates psychotropic drugs. Prog. Neuropsychopharmacol. Exp. Psychiatry, 11, 659-671, 1987). 10-20 mice were investigated per group. 25 Morphine, (1R,2R)-3-(2-dimethylaminomethyl-cyclohexyl) phenol; hydrochloride and desipramine were administered i.p. 30 minutes before the test and naloxone i.v.. This behavioural model is capable of demonstrating the 30 antidepressant action of the uptake inhibition component in the simultaneous presence of an opioid action. In this behavioural model, antidepressants, as also in other WO 2004/009067 PCT/EP2003/007720 27 behavioural models, lead to a shortening of the immobility phase, while opioids such as morphine prolong the immobility phase. If both action components are present the two effects overlap, so that only a slight change in 5 motility results. This was eliminated by the opiate component being blocked by pretreatment with naloxone. After the pretreatment with naloxone, the stimulating action of (-1R,2R)-3-(2-dimethylaminomethyl-cyclohexyl) phenol, which was only slight without pretreatment, 10 manifested itself clearly. The substance is therefore very suitable, especially in combination with a pain therapy. The results of these investigations together with reference substances are summarized in Table 2.
WO 2004/009067 PCT/EP2003/007720 28 Table 2: Action of (lR,2R)-3-(2-dimethylaminomethyl cyclohexyl)-phenol, imipramine and morphine in the tail suspension test on mice (10 - 20 animals/group) Substance Dose Duration of (mg/kg i.p.) immobility % change compared with the solvent control (1R,2R)-3-(2- 4.64 +6 % Dimethylaminomethyl- 10.0 +12 % cyclohexyl)-phenol; 21.5 +9 % hydrochloride 31.6 -13 % (1R,2R)-3-(2- 21.5 -90 % Dimethylaminomethyl- 31.6 -85 % cyclohexyl)-phenol; hydrochloride + 1.0 mg/kg i.v. naloxone Naloxone 1.0 mg/kg -15 % i.v. Morphine 4.64 +90% 10.0 +145 % 21.5 +169 % Imipramine 31.6 -61 % 5 Tab. 2 shows that (1R,2R)-3-(2-dimethylaminomethyl cyclohexyl)-phenol; hydrochloride causes a marked decrease in the duration of immobility, such as was also found with imipramine, only after pretreatment with naloxone. As 10 shown for morphine, opioids lead to a prolonging of the duration of immobility. This explains why (lR,2R)-3-(2- WO 2004/009067 PCT/EP2003/007720 29 dimethylaminomethyl-cyclohexyl)-phenol without naloxone pretreatment causes, as the net effect of uptake inhibition and opioid action, only a slight change in the duration of immobility compared with the solvent control. 5 According to the present findings, (lR,2R)-3-(2 dimethylaminomethyl-cyclohexyl)-phenol surprisingly is the first opiod analgesic to have a relevant and evidently also clinically useful antidepressant action component. 10 Example 14: Parenteral administration form 1 g (lR,2R)-3-(2-dimethylaminomethyl-cyclohexyl)-phenol; hydrochloride is dissolved in 1 1 of water for injection 15 purposes at room temperature and the solution is then adjusted to isotonic conditions by addition of NaCl.

Claims (9)

1. Use of 5 M 3-(2-dimethylaminomethyl-cyclohexyl)-phenol, M (1R,2R)-3-(2-dimethylaminomethyl-cyclohexyl) phenol, 0 [2-(3-methoxyphenyl)-cyclohexylmethyll dimethylamine, 10 m (lR,2R)-[2-(3-methoxyphenyl)-cyclohexylmethyl] dimethylamine, m sulfuric acid mono-[3-(2-dimethylaminomethyl cyclohexyl)-phenyl] ester, 0 sulfuric acid mono-(1R,2R)-[3-(2 15 dimethylaminomethyl-cyclohexyl)-phenyl] ester, 0 3-(2-methylaminomethyl-cyclohexyl)-phenol, E (1R,2R)-3-(2-methylaminomethyl-cyclohexyl)-phenol, m 3-(2-dimethylaminomethyl-cyclohexyl)-phenol N oxide, 20 0 (1R,2R)-3-(2-dimethylaminomethyl-cyclohexyl) phenol N-oxide, m 6-[3-(2-dimethylaminomethyl-cyclohexyl)-phenoxy] 3,4,5-trihydroxy-tetrahydropyran-2-carboxylic acid, 25 0 6-[(1R,2R)-3-(2-dimethylaminomethyl-cyclohexyl) phenoxy]-3,4,5-trihydroxy-tetrahydropyran-2 carboxylic acid, 0 4-(2-dimethylaminomethyl-cyclohexyl)-catechol, 0 (1R,2R)-4-(2-dimethylaminomethyl-cyclohexyl) 30 catechol, n 3-(2-aminomethyl-cyclohexyl)-phenol, 0 (lR,2R)-3-(2-aminomethyl-cyclohexyl)-phenol, WO 2004/009067 PCT/EP2003/007720 31 = 4-(2-dimethylaminomethyl-cyclohexyl)-benzene-1,2 diol, M (1R,2R)-4-(2-dimethylaminomethyl-cyclohexyl) benzene-1,2-diol, 5 * C-[2-(3-methoxy-phenyl)-cyclohexyl]-methylamine, 0 (1R,2R)-C-[2-(3-methoxy-phenyl)-cyclohexyl] methylamine, 0 [2-(3-methoxy-phenyl)-cyclohexylmethyl]-methyl amine, 10 0 (lR,2R)-[2-(3-methoxy-phenyl)-cyclohexylmethyl] methyl-amine, 0 [2-(3-methoxy-phenyl)-cyclohexylmethyl]-dimethyl amine; N-oxide or 0 (1R,2R)-[2-(3-methoxy-phenyl)-cyclohexylmethyl] 15 dimethyl-amine; N-oxide; optionally in the form of their racemates, their pure stereoisomers, in particular enantiomers or diastereomers, or in the form of mixtures of the 20 stereoisomers, in particular the enantiomers or diastereomers, in any desired mixture ratio; in the form shown or in the form of their acids or their bases or in the form of their salts, in particular the physiologically acceptable salts, or in 25 the form of their solvates, in particular the hydrates; for the preparation of a medicament for treatment of depressions. 30 32
2. Use according to claim 1, characterized in that the compounds used are in the form of R,R, preferably I R,2R stereoisomers.
3. Metabolites of 3-(2-dimethylaminomethyl-cyclohexyl)-phenol chosen from 5 * sulfiric acid mono-(1R,2R)-[3-(2-dimethylaminomethyl-cyclohexyl) phenyl]ester, * (1R,2R)-3-(2-methylaminomethyl-cyclohexyl)-phenol, " (1R,2R)-3-(2-dimethylaminomethyl-cyclohexyl)-phenol N-oxide, " 6-[(lR,2R)-3-(2-dimethylaminomethyl-eyclohexyl)-phenoxy]-3,4,5 1o trihydroxy-tetrahydropyran-2-carboxylic acid, " (1R,2R)-4-(2-Dimethylaminomethyl-cyclohexyl)-catechol, * (1R-2R)-3-(2-aminomethyl-cyclohexyl)-phenol, * (1R,2R)-4-(2-dimethylaminomethyl-cyclohexyl)-benzene-1,2-diol, (2304121 1):KZA 33 * (1R,2R)-C-[2-(3-methoxy-phenyl)-cyclohexyl]-miethylamine, * (1R,2R)-[2-(3-methoxy-phenyl)-cyclohexylmethyl]-methyl-amine, or * (1R,2R)-[2-(3-methoxy-phenyl)-cyclohexylmethyl]-dimethyl-amine N-oxide; in the form shown or in the form of their acids or their bases or in the form of 5 their salts, in particular the physiologically acceptable salts, or in the form of their solvates, in particular the hydrates.
4. Medicament comprising as the active compound at least one compound according to claim 3 and optionally additives and/or auxiliary substances. (|2304 121 1)|KZA 34
5. Use of a compound according to claim 3 for the preparation of a medicament for treatment of pain, in particular acute, visceral, chronic or neuropathic pain or cancer pain.
6. Use of a compound according to claim 3 for the preparation of a s medicament for the treatment of an increased urge to urinate or urinary incontinence.
7. A method for the treatment of depression comprising administering to a patient in need thereof = 3- (2-dimethylaminomethyl-cyclohexyl) -phenol, " (iR, 2R) -3- (2-dimethylaminomethyl-cyclohexyl) phenol, " [2- (3 -methoxyphenyl) -cyclohexylmethyl] t0 dimethylamine, * (IR, 2R) - [2- (3-methoxyphenyl) -cyclohexylmethyl] dimethylamine, sulfuric acid mono- [3- (2-dimethylaminomethyl cyclohexyl) -phenyll ester, * sulfuric acid mono-(1R,2R)-[3-(2 ditnethylaminomethyl-cyclohexyl) -phenyl] ester, 3- (2 -methyl aminomethyl -cyclohexyl) -phenol, is ' * (lR, 2R) -3- (2-methylaminomethyl-cyclohexyl) -phenol, = 3- (2 -dimethylaminomethyl -cyclohexyl) -phenol M oxide, * (1R, 28) -3- (2-dimethylaminomethyl- cyclohexyl) phenol N-oxide, " 6- {3 - (2 -dimethylaminomethyl-cyclohexyl) -phenoxy] 3,4, 5-trihydroxy-tetrahydropyran-2-carboxylic acid, 20 2 6- [(R, 2R) -3- (2-dimethylaminomethyl-cyclohexyl) phenoxy] -3,4,5-trihydroxy-tetrahydropyran-2 carboxylic acid, " 4- (2--dimethylaminomethyl -cyclohexyl) -catechol, " (lR, 2R) -4- (2-dimethylaminomethyl-cyclohexyl) catechol, * 3- (2 -aminomethyl -cyclohexyl) -phenol, " (IR, 2R) -3- (2-aminomethyl-cyclohexyl) -phenol, (2304121 I)KZA 35 * 4 - (2-dimethylaminomethyl -cyclohexyl) -benzene -1, 2 (iR, 2R) -4- (2-dimethylaminomethyl-cyclohexyl) benzene-1, 2-diol, * C- [2- (3-methoxy-phenyl) -cyclohexyl] -methylamine, * (1R, 2R) -C- [2- (3-methoxy--phenyl) -cyclohexyl methylamine, * [2- (3-methoxy-phenyl) -cyclohexylmethyl] -methyl amine, (1R, 2R) - [2- (3-methoxy-phenyl) -cyclohexylmethyl] methyl -amine, * (2- (3-methoxy-phenyl) -cyclohexylmethyl] -dimethyl amine; N-oxide or N (1R, 2R) - (2- (3-methoxy-phenyl) -cyclohexylmethyl] dimethyl-amine; N-oxide; 10 optionally in the form of their racemates, their pure stereoisomers, in particular enantiomers or diastereomers, or in the forn of mixtures of the stereoisomers, in particular the enantiomers or diastereomers, in any desired mixture ratio; in the form shown or in'the form of their acids or their bases or in the form of their salts, in particular is the physiologically acceptable salts, or in the form of their solvates, in particular the hydrates.
8. A method for the treatment of pain, in particular acute, visceral, chronic or neuropathic pain or cancer pain comprising administering to a patient in need thereof a compound according to claim 3 or a medicament according to claim 4, 20
9. A method for the treatment of an increased urge to urinate or urinary incontinence comprising administering to a patient in need thereof a compound according to claim 3 or a medicament according to claim 4. Dated 24 September, 2009 Grnenthal GmbH 25 Patent Attorneys for the ApplicantlNominated Person SPRUSON & FERGUSON (2304121 1):KZA
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