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Drilldown: Medicines

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Medicines > classes : Antidepressant or wake-promoting agent & routes: Oral

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generic:
None (2) · Duloxetine (1) · Sertraline (1)
brand:
Cymbalta, Drizalma Sprinkle, Irenka, Yentreve (1) · Sunosi (1) · Wakix (1) · Zoloft (1)
classes: (Click arrow to add another value)
mechanism:
None (1) · Selective dopamine and norepinephrine reuptake inhibitor (DAT and NET inhibition). Unlike amphetamine, does not significantly release monoamines, pure reuptake inhibition. (1) · Serotonin–norepinephrine reuptake inhibition (balanced) (1) · TrkB/BDNF'"`UNIQ--ref-00000084-QINU`"' '"`UNIQ--vote-00000085-QINU`"' (1)
uses:
None (1) · Depression, anxiety, neuropathic pain, fibromyalgia, chronic musculoskeletal pain (1) · Excessive daytime sleepiness in adults with narcolepsy or obstructive sleep apnea (OSA) (1) · Excessive daytime sleepiness or cataplexy in adults with narcolepsy (FDA-approved August 2019) (1)
starting dose:
None (1) · 25 mg (1) · Narcolepsy: 75 mg PO once daily upon awakening, titrate every 3 days. OSA: 37.5 mg PO once daily, titrate. (1) · Week 1: 8.9 mg PO once daily in the morning. Week 2: 17.8 mg. Week 3+: 35.6 mg (max). Titrate as needed. (1)
preparations:
None (1) · 25 mg, 50 mg, 100 mg tablets; oral concentrate 20 mg/mL (1) · 4.45 mg, 17.8 mg tablets (1) · 75 mg, 150 mg tablets (1)
fda max:
None (1) · 150 mg/d (1) · 200 mg/d (1) · 35.6 mg/d (1)
routes: (Click arrow to add another value)
onset:
Anxiolysis classically 3-4 weeks, continuing improvement to 8-12 weeks (1) · Mood: 2–4 weeks. Pain: often within 1–2 weeks. (1) · Wake-promoting effect over weeks of titration (1) · ~30-60 min (1)
duration:
Chronic daily dosing (1) · Daily morning dosing (1) · Long (1) · ~9 hours (1)
halflife:
~12 hours (1) · ~20 hours (1) · ~26 h (sertraline; range 13-45 h, longer in females); ~62-104 h (N-desmethylsertraline, weakly active) (1) · ~7.1 hours (1)
bioavailability:
Absolute bioavailability not precisely characterized; food modestly increases exposure (1) · Not formally established; oral once-daily adequate (1) · ~50% (highly variable) (1) · ~95% (1)
pregnancy:
Category C (1) · Category C'"`UNIQ--ref-0000008F-QINU`"' (1) · Limited data; pitolisant may reduce hormonal contraceptive efficacy (1) · Limited data; pregnancy exposure registry available (1)
legal:
Rx, '''not a controlled substance''' (unique among wake-promoting agents) (1) · Rx, Schedule IV (US) (1) · Rx-only (1) · Rx-only in US (1)

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