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Medicines > classes : Antidepressant or Research material or None

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generic:
brand:
None (135) · (none, never marketed) (1) · Anafranil (1) · Aurorix (1) · Cymbalta, Drizalma Sprinkle, Irenka, Yentreve (1) · Edronax (1) · Fetzima (1) · ketalar (1) · Laudanum, Dropizol (1) · Lithobid (1) · Ludiomil (1) · Marplan (1) · Nardil (1) · Norpramin (1) · Nuedexta (1) · O-DSMT (1) · Parnate (1) · Savella (1) · Serzone (1) · Stablon (1) · Surmontil (1) · Tofranil (1) · Ultracet, Tramacet (1) · Valdoxan (1) · Vivactil (1) · Zoloft (1)
classes: (Click arrow to add another value)
mechanism:
5-HT2A agonist (26) · Monoamine releasing agent (9) · GABAA positive allosteric modulator (8) · CB1/CB2 agonist (7) · Dopamine/norepinephrine reuptake inhibitor (5) · Potent 5-HT2A agonist (5) · LSD analogue; 5-HT2A agonist (4) · Prodrug of LSD; 5-HT2A agonist (4) · Irreversible non-selective MAO inhibitor (3) · Selective norepinephrine reuptake inhibitor (3) · Serotonin and norepinephrine reuptake inhibitor (3) · Serotonin/norepinephrine/dopamine releasing agent (3) · Cathinone analogue; monoamine reuptake inhibitor (2) · Dopamine and norepinephrine reuptake inhibitor (2) · NMDA antagonist (2) · Prodrug of GHB (2) · Serotonin–norepinephrine reuptake inhibitor (2)
uses:
None (154) · Antimanic, Antidepressive, Antisuicide (1) · Depression, anxiety, neuropathic pain, fibromyalgia, chronic musculoskeletal pain (1) · No approved medical problem. Encountered as a designer/research benzodiazepine and, increasingly, as an adulterant in illicit opioid supplies. (1) · Pain, cough, disquiet (1) · '"`UNIQ--vote-0000152F-QINU`"' (1) · '"`UNIQ--vote-00001582-QINU`"' (1)
starting dose:
None (156) · 1 capsule (20/10 mg dextromethorphan/quinidine) PO once daily × 7 days, then 1 capsule BID (1) · 2 tablets (75 mg tramadol / 650 mg acetaminophen) PO every 4-6 hours as needed; maximum 8 tablets/day for ≤5 days (1) · 25 mg (1) · No medical dose. Active recreational doses reported in the 0.5–1.5 mg range (similar potency to alprazolam). (1)
preparations:
None (156) · 20 mg dextromethorphan HBr / 10 mg quinidine sulfate capsules (1) · 25 mg, 50 mg, 100 mg tablets; oral concentrate 20 mg/mL (1) · Illicit tablets ("bars"), powders, blotter, occasionally solutions. No pharmaceutical product exists. (1) · Tramadol/acetaminophen 37.5/325 mg tablets (1)
fda max:
None (156) · 1 capsule BID (40 mg DXM / 20 mg quinidine per day) (1) · 200 mg/d (1) · 8 tablets/d (300 mg tramadol / 2600 mg acetaminophen); 5-day duration limit per label (1) · N/A (never approved) (1)
routes:
None (155) · intranasal; rectal and IV reported. (1) · Oral (5) · sublingual (1)
onset:
None (155) · 30-60 minutes (1) · Anxiolysis classically 3-4 weeks, continuing improvement to 8-12 weeks (1) · Mood: 2–4 weeks. Pain: often within 1–2 weeks. (1) · PBA episode reduction within 1-2 weeks (1) · ~20–40 min PO; faster sublingual/intranasal. (1)
duration:
None (155) · 12 hours (1) · 4-6 hours (1) · 6–10 h subjective; full pharmacologic effect considerably longer. (1) · Chronic daily dosing (1) · Long (1)
halflife:
None (155) · Dextromethorphan substantially prolonged by quinidine's CYP2D6 inhibition (typical extensive metabolizers see ~10× higher AUC); quinidine ~6-8 hours'"`UNIQ--ref-00001583-QINU`"' (1) · Estimated ~12–17 h (some sources cite up to ~21 h); active metabolites prolong effect. (1) · Tramadol ~5-7 hours (M1 metabolite ~9 hours); acetaminophen 1-3 hours'"`UNIQ--ref-00001530-QINU`"' (1) · ~12 hours (1) · ~26 h (sertraline; range 13-45 h, longer in females); ~62-104 h (N-desmethylsertraline, weakly active) (1)
bioavailability:
None (155) · Absolute bioavailability not precisely characterized; food modestly increases exposure (1) · Increased substantially via CYP2D6 inhibition'"`UNIQ--ref-00001584-QINU`"' (1) · Not formally characterized in humans. (1) · Tramadol ~75% (oral); acetaminophen 85-98%'"`UNIQ--ref-00001531-QINU`"' (1) · ~50% (highly variable) (1)
pregnancy:
None (155) · Avoid. Benzodiazepines are associated with neonatal sedation, floppy-infant syndrome, and withdrawal; teratogenic signal weak but non-zero. Designer benzo with no safety data, assume worst-case. (1) · Avoid; neonatal opioid withdrawal documented.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Category C (1) · Category C'"`UNIQ--ref-0000008F-QINU`"' (1) · Limited data; quinidine has been used in pregnancy as antiarrhythmic.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)
legal:
None (156) · Rx-only (1) · Rx-only in US (1) · [[USLegal:Prescription only|Rx-only]] in US. Caution with QT-prolonging medicines (quinidine itself is class IA antiarrhythmic, and the dose here, though sub-antiarrhythmic, still contributes to QT)'"`UNIQ--ref-00001585-QINU`"' (1) · [[USLegal:Schedule IV|Schedule IV controlled substance]] in US (tramadol was reclassified from non-controlled to Schedule IV in 2014 after recognition of dependence risk) (1)

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