Aminoglutethimide

Aminoglutethimide (AG), sold under the brand names Elipten, Cytadren, and Orimeten among others, is a medication which has been used in the treatment of seizures, Cushing's syndrome, breast cancer, and prostate cancer, among other indications. It has also been used by bodybuilders, athletes, and other men for muscle-building and performance- and physique-enhancing purposes. AG is taken by mouth three or four times per day. Side effects of AG include lethargy, somnolence, dizziness, headache, appetite loss, skin rash, hypertension, liver damage, and adrenal insufficiency, among others. AG is both an anticonvulsant and a steroidogenesis inhibitor. In terms of the latter property, it inhibits enzymes such as cholesterol side-chain cleavage enzyme (CYP11A1, P450scc) and aromatase (CYP19A1), thereby inhibiting the conversion of cholesterol into steroid hormones and blocking the production of androgens, estrogens, and glucocorticoids, among other endogenous steroids. As such, AG is an aromatase inhibitor and adrenal steroidogenesis inhibitor, including both an androgen synthesis inhibitor and a corticosteroid synthesis inhibitor. AG was introduced for medical use, as an anticonvulsant, in 1960. It was withdrawn in 1966 due to toxicity. Its steroidogenesis-inhibiting properties were discovered serendipitously and it was subsequently repurposed for use in the treatment of Cushing's syndrome, breast cancer, and prostate cancer from 1969 and thereafter. However, although used in the past, it has mostly been superseded by newer agents with better efficacy and lower toxicity such as ketoconazole, abiraterone acetate, and other aromatase inhibitors. It remains marketed only in a few countries. AG is used as an anticonvulsant in the treatment of petit mal epilepsy and as a steroidogenesis inhibitor in the treatment of Cushing's syndrome, postmenopausal breast cancer, and prostate cancer. It is also used to treat secondary hyperaldosteronism, edema, adrenocortical carcinoma, and ectopic adrenocorticotropic hormone (ACTH) producing tumors.