The antischizophrenic activity of phenothiazine drugs and their tendency to elicit extrapyramidal symptoms are thought to involve blockade of synaptic dopamine receptors in the brain. Space filling molecular models show how favorable Van der Waal's interactions between the side chain amino of phenothiazines and the 2-substituent on ring A can promote a conformation mimicking dopamine. These Van der Waal's attractive forces can explain (i) the greater potency of drugs with trifluoromethyl rather than chlorine as a 2-substituent; (ii) the enhanced activity of phenothiazines with piperazine instead of alkylamino side chains; (iii) the increased potency associated with hydroxyethylpiperazines as contrasted to piperazine side chains ; (iv) the greater potency of cis rather than trans thioxanthenes; and (v) the crucial location of the ring A substituent at carbon no. 2. Potential energy calculations support the observations with molecular models and suggest an active conformation for the phenothiazines.An abundance of recent research suggests that a major mechanism whereby antischizophrenic phenothiazine drugs exert their therapeutic actions and extrapyramidal side effects involves a blockade of synaptic receptor sites for dopamine in the brain (1, 2). The activity of a dopamine-sensitive adenylate cyclase correlates with dopamine receptor activity (3). Relative potencies of several phenothiazine and related drugs as inhibitors of the dopamine-sensitive adenylate cyclase parallel their antischizophrenic potency (4-6). Earlier we proposed a molecular model wherein dopamine could be superimposed upon a portion of the chlorpromazine molecule (7). While explaining some structure-activity characteristics of phenothiazines, this model did not deal with important features such as the greater potencies of phenothiazines with piperazine rather than alkylamino side chains, nor did it explain the greater potency of trifluoromethyl than of chlorine ring substituents. Moreover, it provided no explanation for the mechanism whereby the A ring substituent caused the side chain to tilt toward the A ring, nor did it explain why the A ring substituent must be located in the number 2 position.In the present study, Corey-Pauling-Koltun molecular models and computer calculations support a model in which phenothiazines assume a conformation that mimics that of dopamine, explaining the role of trifluoromethyl, piperazine, and hydrox-yethvlpiperazine groups as well as the mechanism whereby A ring substituents influence the side chain.
MATERIALS AND METHODSMolecular models of promazine, chlorpromazine, triflupromazine, prochlorperazine, trifluoperazine, thiethylperazine, 1899 perphenazine, and fluphenazine were constructed with CoreyPauling-Koltun kits (Ealing Corp.; Cambridge, Mass.). To confirm the apparent influence of Van der Waal's forces on the side chain conformation, we performed potential energy calculations on the following three compounds with differing ring substituents but the same side chain: promazine, chlorpromazine, an...