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Medicines > classes : Classic Psychedelic or [[:Category:Antioxidants|Antioxidant]] or dissociative

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generic:
brand:
None (86) · Delysid (historical, Sandoz, withdrawn 1965) (1) · DXM (1) · DXO (1) · Generic; huge OTC presence (1) · Generic; many OTC formulations (1) · Spravato (1)
classes: (Click arrow to add another value)
mechanism:
5-HT2A agonist (26) · Potent 5-HT2A agonist (5) · LSD analogue; 5-HT2A agonist (4) · Prodrug of LSD; 5-HT2A agonist (4) · None (3) · NMDA antagonist (3) · Contains LSA (2) · Contains mescaline (2) · NMDA antagonist; sigma receptor agonist (2)
uses:
None (89) · Treatment-resistant depression (TRD) in adults, as adjunct to oral antidepressant (FDA-approved March 2019). Depressive symptoms in adults with MDD with acute suicidal ideation or behavior (FDA-approved Aug 2020). (1) · '"`UNIQ--vote-000012CE-QINU`"', '"`UNIQ--vote-000012CF-QINU`"', '"`UNIQ--vote-000012D0-QINU`"' (1) · '"`UNIQ--vote-000012E5-QINU`"', '"`UNIQ--vote-000012E6-QINU`"', '"`UNIQ--vote-000012E7-QINU`"', '"`UNIQ--vote-000012E8-QINU`"' (1)
starting dose:
None (89) · General supplementation 75-90 mg/d (RDA); scurvy treatment 100-1000 mg/d for several weeks; megadose claims unsupported (1) · Induction (TRD): 56 mg intranasal twice weekly × 4 weeks. Maintenance: 56-84 mg once weekly × 4 weeks, then 56-84 mg every 1-2 weeks. For acute suicidality: 84 mg twice weekly × 4 weeks. Administered under medical supervision in REMS-certified site. (1) · Replacement: 15-30 mg (22.5-45 IU) daily; NASH: 800 IU daily; AREDS-2: 400 IU daily (in combination formula) (1)
preparations:
None (89) · 100, 200, 400 IU softgels and capsules; many proprietary OTC blends; combined formulations (AREDS-2) (1) · 100, 250, 500, 1000 mg tablets, chewables, gummies, effervescent; IV (specialty) (1) · 28 mg/device (each dose uses 2 devices) (1)
fda max:
None (89) · 84 mg per session (1) · UL 1000 mg (~1500 IU natural)/d in adults; routinely exceeded in older AREDS-1 trials (1) · UL 2000 mg/d in adults (1)
routes:
None (88) · Intranasal (under direct medical supervision) (1) · IV (1) · Oral (3)
onset:
None (88) · 30–60 minutes (1) · Days for symptom improvement in scurvy (1) · Days to weeks for tissue saturation (1) · Within hours of first administration (1)
duration:
None (88) · 8–12 hours (1) · Acute effect ~24 hours; cumulative effect builds with repeated dosing (1) · Hours (1) · Weeks (fat-soluble) (1)
halflife:
None (88) · 3–5 hours (1) · ~10-20 days (steady-state body pool); single dose plasma ~2 hours (1) · ~3-4 days plasma; adipose tissue stores last months (1) · ~7-12 hours (1)
bioavailability:
None (88) · 70–90% (oral) (1) · High with fat-containing meal; reduced in malabsorption (1) · ~48% intranasal (1) · ~70-90% at typical doses; saturable at high doses (>500 mg) (1)
pregnancy:
None (88) · Avoid; may cause fetal harm (1) · Not established (1) · Safe at replacement doses; high-dose use generally avoided.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Safe at routine doses; routinely supplemented in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)
legal:
None (88) · OTC in US (2) · Rx, Schedule III (US). REMS program required. (1) · Schedule I (United States) (1)

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