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Medicines > classes : Antidepressant or Selective norepinephrine reuptake inhibitor (NRI) with 5HT1A partial agonism & routes: oral

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generic:
None (1) · Duloxetine (1) · Sertraline (1)
brand:
Cymbalta, Drizalma Sprinkle, Irenka, Yentreve (1) · Qelbree (1) · Zoloft (1)
classes: (Click arrow to add another value)
mechanism:
Selective NET inhibitor (no significant DAT activity, distinguishes from amphetamine/methylphenidate). Also: 5HT1A receptor partial agonism, 5HT2B and 5HT7 receptor antagonism. The serotonergic actions may underlie better tolerability and possibly different efficacy spectrum than atomoxetine. (1) · Serotonin–norepinephrine reuptake inhibition (balanced) (1) · TrkB/BDNF'"`UNIQ--ref-00000084-QINU`"' '"`UNIQ--vote-00000085-QINU`"' (1)
uses:
None (1) · ADHD in children (6+), adolescents, and adults (FDA-approved 2021 for pediatric, 2022 for adult) (1) · Depression, anxiety, neuropathic pain, fibromyalgia, chronic musculoskeletal pain (1)
starting dose:
None (1) · 25 mg (1) · Pediatric 6-11: 100 mg PO daily, titrate weekly to max 400 mg. Adolescent 12-17: 200 mg, max 400 mg. Adult: 200 mg, max 600 mg. (1)
preparations:
None (1) · 100 mg, 150 mg, 200 mg extended-release capsules (can be sprinkled on food) (1) · 25 mg, 50 mg, 100 mg tablets; oral concentrate 20 mg/mL (1)
fda max:
None (1) · 200 mg/d (1) · 400 mg/d (pediatric); 600 mg/d (adult) (1)
routes: (Click arrow to add another value)
onset:
ADHD symptom improvement reported within 1-2 weeks (faster than atomoxetine which takes 4-6 weeks) (1) · Anxiolysis classically 3-4 weeks, continuing improvement to 8-12 weeks (1) · Mood: 2–4 weeks. Pain: often within 1–2 weeks. (1)
duration:
Chronic daily dosing (1) · 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) · ~7 hours (1)
bioavailability:
Absolute bioavailability not precisely characterized; food modestly increases exposure (1) · Adequate oral bioavailability with extended-release formulation (1) · ~50% (highly variable) (1)
pregnancy:
Category C (1) · Category C'"`UNIQ--ref-0000008F-QINU`"' (1) · Limited data (1)
legal:
Rx, '''not a controlled substance''' (no DEA scheduling) (1) · Rx-only (1) · Rx-only in US (1)

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