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Medicines > classes : Classic Psychedelic or [[:Category:Benzisoxazoles|Benzisoxazole]] or dissociative

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generic:
brand:
None (86) · Delysid (historical, Sandoz, withdrawn 1965) (1) · DXM (1) · DXO (1) · Risperdal (oral), Risperdal M-Tab (ODT), Risperdal Consta (biweekly IM LAI), Perseris (monthly SC LAI), Uzedy (monthly/bimonthly SC LAI), Rykindo (biweekly IM LAI) (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) · NMDA antagonist (3) · None (2) · 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-0000001C-QINU`"', '"`UNIQ--vote-0000001D-QINU`"', '"`UNIQ--vote-0000001E-QINU`"', '"`UNIQ--vote-0000001F-QINU`"', '"`UNIQ--vote-00000020-QINU`"' (1)
starting dose:
None (89) · 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) · Schizophrenia / mania: 1 mg PO BID, titrate to 4-8 mg/day. Pediatric autism irritability: 0.25-0.5 mg/day, weight-titrated. Consta LAI: 25 mg IM every 2 weeks after oral overlap (1)
preparations:
None (89) · 28 mg/device (each dose uses 2 devices) (1) · Tablets 0.25, 0.5, 1, 2, 3, 4 mg; M-Tab ODT 0.5, 1, 2, 3, 4 mg; oral solution 1 mg/mL; Consta LAI 12.5, 25, 37.5, 50 mg; Perseris SC LAI 90, 120 mg monthly (1)
fda max:
None (89) · 16 mg/day (schizophrenia, adult); 6 mg/day (bipolar maintenance, autism irritability) (1) · 84 mg per session (1)
routes:
None (88) · intramuscular (LAI) (1) · Intranasal (under direct medical supervision) (1) · Oral (2) · subcutaneous (LAI) (1)
onset:
None (88) · 30–60 minutes (1) · Neuroleptic effect emerges over days to weeks (1) · Within hours of first administration (1)
duration:
None (88) · 24 hours (oral); 2-4 weeks (LAI formulations) (1) · 8–12 hours (1) · Acute effect ~24 hours; cumulative effect builds with repeated dosing (1)
halflife:
None (88) · 3–5 hours (1) · Risperidone 3-20 hours; '''9-hydroxy-risperidone (paliperidone) ~20-24 hours''' is the major active metabolite and is separately marketed as a parent compound (Invega)'"`UNIQ--ref-00000021-QINU`"' (1) · ~7-12 hours (1)
bioavailability:
None (88) · 70–90% (oral) (1) · ~48% intranasal (1) · ~70% (oral)'"`UNIQ--ref-00000022-QINU`"' (1)
pregnancy:
None (88) · Avoid; may cause fetal harm (1) · Not established (1) · Signal for neonatal extrapyramidal symptoms and withdrawal with third-trimester exposure.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)
legal:
None (88) · Rx, Schedule III (US). REMS program required. (1) · Schedule I (United States) (1) · [[USLegal:Prescription only|Rx-only]] in US. Carries the atypical-neuroleptic '''Boxed Warning''' for increased mortality in elderly patients with dementia-related psychosis'"`UNIQ--ref-00000023-QINU`"' (1)

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