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Drilldown: Medicines

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Medicines > classes : Classic Psychedelic or Dissociative or atypical)]]

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generic:
brand:
None (86) · Contrave (US), Mysimba (EU) (1) · Delysid (historical, Sandoz, withdrawn 1965) (1) · DXM (1) · DXO (1) · Spravato (1)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-00001567-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) · Week 1: 1 tablet (8/90 mg) PO morning; week 2: 1 tablet AM + 1 PM; week 3: 2 AM + 1 PM; week 4 onward: 2 AM + 2 PM (32 mg naltrexone / 360 mg bupropion/d) (1)
preparations:
None (89) · 28 mg/device (each dose uses 2 devices) (1) · 8 mg naltrexone / 90 mg bupropion ER tablets (titration-pack design) (1)
fda max:
None (89) · 32 mg naltrexone / 360 mg bupropion per day (1) · 84 mg per session (1)
routes:
None (88) · Intranasal (under direct medical supervision) (1) · Oral (2)
onset:
None (88) · 30–60 minutes (1) · Modest appetite suppression within weeks; weight loss over months (1) · Within hours of first administration (1)
duration:
None (88) · 12 hours (BID dosing required) (1) · 8–12 hours (1) · Acute effect ~24 hours; cumulative effect builds with repeated dosing (1)
halflife:
None (88) · 3–5 hours (1) · Naltrexone ~4 hours (6β-naltrexol metabolite ~13 hours); bupropion ~21 hours'"`UNIQ--ref-00001568-QINU`"' (1) · ~7-12 hours (1)
bioavailability:
None (88) · 70–90% (oral) (1) · Naltrexone ~5% (oral, extensive first-pass to 6β-naltrexol); bupropion ER ~87%'"`UNIQ--ref-00001569-QINU`"' (1) · ~48% intranasal (1)
pregnancy:
None (88) · Avoid; may cause fetal harm (1) · Contraindicated in pregnancy (FDA label).<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 (89) · Rx, Schedule III (US). REMS program required. (1) · Schedule I (United States) (1)

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