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Medicines > classes : Antidepressant or [[:Category:Antithyroid_agents|Antithyroid agent]] & routes: Oral

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generic:
Duloxetine (1) · Methimazole (thiamazole) (1) · Sertraline (1)
brand:
Cymbalta, Drizalma Sprinkle, Irenka, Yentreve (1) · Tapazole; outside US Mercazole (1) · Zoloft (1)
classes: (Click arrow to add another value)
mechanism:
Serotonin–norepinephrine reuptake inhibition (balanced) (1) · TrkB/BDNF'"`UNIQ--ref-00000084-QINU`"' '"`UNIQ--vote-00000085-QINU`"' (1) · '"`UNIQ--vote-00000ECD-QINU`"' Agranulocytosis is the most-feared adverse effect (~0.3%, usually first 90 days of treatment; warn patients to seek urgent CBC for fever or severe sore throat). Hepatotoxicity is class-recognized but more often associated with PTU'"`UNIQ--ref-00000ECE-QINU`"'. (1)
uses:
None (1) · Depression, anxiety, neuropathic pain, fibromyalgia, chronic musculoskeletal pain (1) · '"`UNIQ--vote-00000ECF-QINU`"', '"`UNIQ--vote-00000ED0-QINU`"', '"`UNIQ--vote-00000ED1-QINU`"', '"`UNIQ--vote-00000ED2-QINU`"' (1)
starting dose:
None (1) · 10-40 mg PO daily depending on hyperthyroidism severity; titrate by clinical and biochemical response (target TSH/free T4) (1) · 25 mg (1)
preparations:
None (1) · 25 mg, 50 mg, 100 mg tablets; oral concentrate 20 mg/mL (1) · 5, 10 mg tablets (1)
fda max:
None (1) · 200 mg/d (1) · 60 mg/d typical (1)
routes: (Click arrow to add another value)
onset:
Anxiolysis classically 3-4 weeks, continuing improvement to 8-12 weeks (1) · Biochemical improvement within 2-4 weeks; full euthyroid state 6-12 weeks (1) · Mood: 2–4 weeks. Pain: often within 1–2 weeks. (1)
duration:
24 hours (1) · Chronic daily dosing (1) · Long (1)
halflife:
~12 hours (1) · ~26 h (sertraline; range 13-45 h, longer in females); ~62-104 h (N-desmethylsertraline, weakly active) (1) · ~4-6 hours (plasma); intrathyroidal accumulation gives a much longer functional duration'"`UNIQ--ref-00000ED3-QINU`"' (1)
bioavailability:
Absolute bioavailability not precisely characterized; food modestly increases exposure (1) · ~50% (highly variable) (1) · ~93% (oral)'"`UNIQ--ref-00000ED4-QINU`"' (1)
pregnancy:
None (1) · Category C (1) · Category C'"`UNIQ--ref-0000008F-QINU`"' (1)
legal:
Rx-only (1) · Rx-only in US (1) · [[USLegal:Prescription only|Rx-only]] in US (1)

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