Pharmaceutical Composition Comprising (1r,4r)-6'-fluoro-N,N-dimethyl-4-phenyl-4',9'-dihydro-3'H-spiro[cyclohexane-1,1'-pyrano[3,4,b]indol]-4-amine and Antidepressants

Abstract

The invention relates to a pharmaceutical composition comprising a first pharmacologically active ingredient selected from (1r,4r)-6′-fluoro-N,N-dimethyl-4-phenyl-4′,9′-dihydro-3′H-spiro[cyclohexane-1,1′-pyrano[3,4,b]indol]-4-amine and the physiologically acceptable salts thereof, and a second pharmacologically active ingredient which is an antidepressant.

1 . A pharmaceutical composition comprising:
 a) a first pharmacologically active ingredient selected from (1r,4r)-6′-fluoro-N,N-dimethyl-4-phenyl-4′,9′-dihydro-3′H-spiro[cyclohexane-1,1′-pyrano-[3,4,b]indol]-4-amine and the physiologically acceptable salts thereof, and   b) a second pharmacologically active ingredient which is an antidepressant.   
     
     
         2 . The pharmaceutical composition according to  claim 1 , wherein the first pharmacologically active ingredient is (1r,4r)-6′-fluoro-N,N-dimethyl-4-phenyl-4′,9′-dihydro-3′H-spiro[cyclohexane-1,1′-pyrano[3,4,b]indol]-4-amine. 
     
     
         3 . The pharmaceutical composition according to  claim 1 , wherein the second pharmacologically active ingredient is a selective serotonin reuptake inhibitor. 
     
     
         4 . The pharmaceutical composition according to  claim 3 , wherein the selective serotonin reuptake inhibitor is selected from the group consisting of zimeldine, fluoxetine, citalopram, paroxetine, sertraline, alaproclate, fluvoxamine, etoperidone, escitalopram and the physiologically acceptable salts thereof. 
     
     
         5 . The pharmaceutical composition according to  claim 1 , wherein the second pharmacologically active ingredient is a non-selective monoamine reuptake inhibitor. 
     
     
         6 . The pharmaceutical composition according to  claim 5 , wherein the non-selective monoamine reuptake inhibitor is selected from the group consisting of desipramine, imipramine, imipramine oxide, clomipramine, opipramol, trimipramine, lofepramine, dibenzepin, amitryptyline, nortriptyline, protriptyline, doxepin, iprindole, melitracen, butriptylene, dosulepin, amoxapine, dimetacrine, amineptine, maprotiline, quinupramine and the physiologically acceptable salts thereof. 
     
     
         7 . The pharmaceutical composition according to  claim 1 , wherein the second pharmacologically active ingredient is selected from the group consisting of oxitriptan, tryptophan, mianserin, nomifensine, trazodone, nefazodone, minaprine, bifemelane, viloxazine, oxaflozane, mirtazapine, bupropion, medifoxamine, tianeptine, pivagabine, venlafaxine, milnacipran, reboxetine, gepirone, duloxetine, agomelatine, desvenlafaxine, vilazodone and the physiologically acceptable salts thereof, as well as  Hyperici herba.    
     
     
         8 . The pharmaceutical composition according to  claim 1 , which contains the first and the second pharmacologically active ingredient in such a weight ratio that they will exert a synergistic therapeutic effect upon administration to a patient. 
     
     
         9 . The pharmaceutical composition according to  claim 1 , wherein the relative weight ratio of the first pharmacologically active ingredient to the second pharmacologically active ingredient is within the range of from 1:1 to 1:1,000,000. 
     
     
         10 . The pharmaceutical composition according to  claim 1  for use in the prevention or treatment of pain, anxiety or a mood disorder. 
     
     
         11 . The pharmaceutical composition according to  claim 10 , wherein the pain is:
 peripheral, central or muscle skeletal pain; and/or   acute, subacute or chronic pain; and/or   moderate to severe pain; and/or   neuropathic or psychogenic or nociceptive or mixed pain; and/or   low back pain, visceral pain or headache; and/or   post-operative, cancer or inflammatory pain.   
     
     
         12 . A pharmaceutical dosage form comprising the pharmaceutical composition according to  claim 1 . 
     
     
         13 . The pharmaceutical dosage form according to  claim 12 , which contains the first pharmacologically active ingredient in a dose of from 10 to 1,200 μg. 
     
     
         14 . The pharmaceutical dosage form according to  claim 12 , which contains the second pharmacologically active ingredient in a dose of from 1 mg to 1,000 mg. 
     
     
         15 . A kit comprising a first pharmaceutical dosage form comprising the first pharmacologically active ingredient as defined in  claim 1 , and a second pharmaceutical dosage form comprising the second pharmacologically active ingredient as defined in  claim 1 .