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JNJ-18038683 is a potent and selective small molecule antagonist of the serotonin 7 (5-hydroxytryptamine type 7, 5-HT7) receptor, developed by Janssen Research & Development (a Johnson & Johnson company). It was investigated primarily as an adjunctive oral treatment for bipolar disorder, with the aim to improve cognition and reduce residual depressive symptoms in stable patients. The drug has also been studied for major depressive disorder but development for this indication was discontinued after Phase II trials. Mechanistically, it binds selectively to the 5‑HT7 receptor and with lower affinity to the 5‑HT6 receptor; antagonism at these receptors is hypothesized to confer antidepressant and pro-cognitive effects[1][3][6]. Clinical studies have shown that while it can reduce REM sleep and affect circadian rhythms in preclinical models, efficacy on cognitive impairment in bipolar disorder was not demonstrated[8].
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