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Medicines > classes : Dissociative or Stimulant or [[:Category:Eugeroics|Eugeroic]]

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generic:
brand:
None (59) · Benzedrex (1) · DXM (1) · DXO (1) · Provigil (Teva/Cephalon); Alertec (Canada); Modavigil (Australia) (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 (63) · 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)
starting dose:
None (63) · 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 (62) · 28 mg/device (each dose uses 2 devices) (1) · Tablets: 100 mg, 200 mg (scored). [[Armodafinil]] (Nuvigil), the R-enantiomer of modafinil, is available separately as 50 mg, 150 mg, 200 mg, and 250 mg tablets. (1)
fda max:
None (62) · 400 mg/day.'"`UNIQ--ref-0000006C-QINU`"' (1) · 84 mg per session (1)
routes:
None (62) · Intranasal (under direct medical supervision) (1) · Oral (1)
onset:
None (62) · Peak plasma concentration in 2-4 hours after oral administration. Clinically perceptible wakefulness-promoting effects typically begin within 1-2 hours of dosing.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Within hours of first administration (1)
duration:
None (62) · Acute effect ~24 hours; cumulative effect builds with repeated dosing (1) · Effective duration approximately 12-15 hours at the 200 mg dose, consistent with the elimination half-life. A single morning dose generally sustains wakefulness throughout the day without substantially disrupting nighttime sleep onset when taken early.'"`UNIQ--ref-0000006D-QINU`"' (1)
halflife:
None (63) · ~7-12 hours (1)
bioavailability:
None (62) · Oral bioavailability is not precisely established in the label but absorption is rapid and essentially complete. Food delays peak plasma concentration by approximately one hour but does not reduce the extent of absorption.'"`UNIQ--ref-0000006F-QINU`"' (1) · ~48% intranasal (1)
pregnancy:
None (63) · Avoid; may cause fetal harm (1)
legal:
None (63) · Rx, Schedule III (US). REMS program required. (1)

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