SUMMARY Large library docking can reveal unexpected chemotypes that complement the structures of biological targets. Seeking new agonists for the cannabinoid-1 receptor (CB1R), we docked 74 million tangible molecules, prioritizing 46 high ranking ones for de novo synthesis and testing. Nine were active by radioligand competition, a 20% hit-rate. Structure-based optimization of one of the most potent of these (K i = 0.7 µM) led to ‘4042 , a 1.9 nM ligand and a full CB1R agonist. A cryo-EM structure of the purified enantiomer of ‘4042 ( ‘1350 ) in complex with CB1R-G i1 confirmed its docked pose. The new agonist was strongly analgesic, with generally a 5-10-fold therapeutic window over sedation and catalepsy and no observable conditioned place preference. These findings suggest that new cannabinoid chemotypes may disentangle characteristic cannabinoid side-effects from their analgesia, supporting the further development of cannabinoids as pain therapeutics.

Structure-based discovery of cannabinoid-1 receptor agonists with reduced side effects