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Medicines > classes : Dissociative or Stimulant or [[:Category:Dissociatives|Dissociative]]

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generic:
brand:
None (59) · Benzedrex (1) · DXM (1) · DXO (1) · Sernyl (human, withdrawn 1965); Sernylan (veterinary, withdrawn 1978) (1) · Spravato (1)
classes: (Click arrow to add another value)
mechanism:
Monoamine releasing agent (8) · Dopamine/norepinephrine reuptake inhibitor (5) · NMDA antagonist (3) · None (2) · Cathinone analogue; monoamine reuptake inhibitor (2) · Dopamine and norepinephrine reuptake inhibitor (2) · NMDA antagonist; sigma receptor agonist (2) · Norepinephrine–dopamine reuptake inhibitor (2)
uses:
None (62) · 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-00000063-QINU`"', '"`UNIQ--vote-00000064-QINU`"' (1)
starting dose:
None (62) · 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) · No current medical indication. Historical anesthetic dose 0.25 mg/kg IV (Sernyl). (1)
preparations:
None (62) · 28 mg/device (each dose uses 2 devices) (1) · Historical: Sernyl 25 mg tablets, 10 mg/mL injection (human); Sernylan 100 mg/mL injection (veterinary). Illicit: white crystalline powder, oily liquid, "dipped" cigarettes ("wet"), tablets. (1)
fda max:
None (62) · 84 mg per session (1) · N/A (no current medical indication) (1)
routes:
None (62) · IM (1) · insufflated (1) · Intranasal (under direct medical supervision) (1) · IV (1) · Oral (1) · smoked (1)
onset:
None (62) · Smoked 2-5 min; insufflated 5-15 min; oral 30-60 min; IV / IM ~5-15 min (1) · Within hours of first administration (1)
duration:
None (62) · 4-8 hours typical; longer at high doses; residual cognitive and perceptual effects up to 48 hours (1) · Acute effect ~24 hours; cumulative effect builds with repeated dosing (1)
halflife:
None (62) · Highly variable, 7-46 hours (mean ~21 h); lipophilic deposition in fat with delayed re-release contributes to wide range'"`UNIQ--ref-00000065-QINU`"' (1) · ~7-12 hours (1)
bioavailability:
None (62) · ~48% intranasal (1) · ~72% oral; ~85% smoked'"`UNIQ--ref-00000066-QINU`"' (1)
pregnancy:
None (63) · Avoid; may cause fetal harm (1)
legal:
None (62) · Rx, Schedule III (US). REMS program required. (1) · [[USLegal:DEA Schedule II|Schedule II]] controlled substance in US (rescheduled from Schedule III in 1978). No accepted medical use. UN Convention on Psychotropic Substances Schedule II internationally.'"`UNIQ--ref-00000067-QINU`"' (1)

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