Prediction and Classification of the Uptake and Disposition of Antidepressants and New CNS-Active Drugs in the Human Brain using the ANDROMEDA by Prosilico Software and Brainavailability-Matrix

Background Passive blood-brain barrier permeability (BBB Pe), fraction bound to brain tissue (fb,brain) and efflux by transport proteins MDR-1 and BCRP are essential determinants for the brain uptake and disposition of drugs. Methods The main objective of the study was to use the software ANDROMEDA by Prosilico to predict passive BBB Pe- and fb,brain-classes and MDR-1- and BCRP-specificities for various classes of antidepressants and for CNS-active small drugs marketed during 2020 and 2021, and then to position them according to a new 2-dimensional Brainavailability-Matrix (8 passive BBB Pe x 4 fb,brain classes, where class 11 has highest and 84 lowest values/brainavailability). Predicted estimates were used, except for cases where measured values were available. Results and Conclusion Results for 53 drugs show that adequate CNS uptake and disposition are achieved for compounds placed in the zones for low, moderate and high brainavailability, despite efflux. They also show that high brainavailability and efflux are common for CNS-active drugs and that modern CNS-active drugs generally have lower brainavailability than older antidepressive drugs. Furthermore, they demonstrate that ANDROMEDA by Prosilico and the new Brainavailability-Matrix are applicable for prediction, optimization and positioning of CNS uptake and disposition of drugs and drug candidates in man. ### Competing Interest Statement Urban Fagerholm, Ola Spjuth and Sven Hellberg declare shares in Prosilico AB, a Swedish company that develops solutions for human clinical ADME/PK predictions.