A series of novel 5-trans-hydroxyadamantan-2-yl-5, 6, 7, 8-tetrahydropyrazolo [4, 3-c] azepin- 4 (1H)-ones that inhibit 11beta-hydroxysteroid dehydrogenase type 1 are described. We discovered these 7-membered cyclic amide derivatives by introducing a distinctive linker through pharmacophore analysis of known ligands included in X-ray co-crystal structures. Further optimization using docking studies led to highly potent inhibitors 15b and 27, ...