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Medicines > classes : Classic Psychedelic or Dissociative or [[:Category:Disaccharides|Non-absorbable disaccharide]]

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generic:
brand:
None (86) · Delysid (historical, Sandoz, withdrawn 1965) (1) · DXM (1) · DXO (1) · Kristalose, Constulose, Generlac, Enulose (1) · Spravato (1)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-00000F5C-QINU`"', '"`UNIQ--vote-00000F5D-QINU`"' (1)
starting dose:
None (89) · Constipation: 15-30 mL PO daily (titrate to 1-2 soft stools/day); hepatic encephalopathy: 20-30 g (30-45 mL) PO/PR every 1-2 hours acutely until soft stools, then BID-QID to target 2-3 soft stools/day (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)
preparations:
None (89) · 10 g/15 mL solution (Constulose); 10 g, 20 g powder packets (Kristalose) (1) · 28 mg/device (each dose uses 2 devices) (1)
fda max:
None (89) · 84 mg per session (1) · Indication-specific; HE may require high-volume dosing (1)
routes:
None (88) · especially in acute HE) (1) · Intranasal (under direct medical supervision) (1) · Oral (2) · rectal (enema (1)
onset:
None (88) · 30–60 minutes (1) · Constipation: 24-48 hours; HE: ammonia reduction within hours of stool production (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)
halflife:
None (88) · 3–5 hours (1) · Not meaningfully described — lactulose is not significantly absorbed (1) · ~7-12 hours (1)
bioavailability:
None (88) · 70–90% (oral) (1) · <3% systemic absorption (the basis of the safety and mechanism)'"`UNIQ--ref-00000F5E-QINU`"' (1) · ~48% intranasal (1)
pregnancy:
None (88) · Avoid; may cause fetal harm (1) · Generally considered safe (minimal systemic absorption).<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Not established (1)
legal:
None (88) · Rx, Schedule III (US). REMS program required. (1) · Schedule I (United States) (1) · [[USLegal:Prescription only|Rx-only]] in US (1)

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