Drilldown: Medicines

None · Codeine · 1,4-Butanediol · 1B-LSD · 1cP-LSD · 1P-LSD · 1V-LSD · 2-AI · 2-FA · 2-FDCK · 2-FMA · 25B-NBOH · 25B-NBOMe · 25C-NBOH · 25C-NBOMe · 25I-NBOH · 25I-NBOMe · 25N-NBOMe · 2C-B · 2C-B-FLY

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Dayvigo (1) · Nuplazid (1)

Dual orexin receptor antagonist (DORA) (1) · Selective 5HT2A inverse agonist (with weaker 5HT2C inverse agonism) (1)

Competitive antagonist at OX1R and OX2R. Faster receptor association/dissociation kinetics than suvorexant (~16 sec dissociation vs ~57 sec) hypothesized to support sleep onset, with sufficient duration for maintenance. (1) · Selective inverse agonist at 5HT2A receptors with weaker activity at 5HT2C. Has no significant dopamine D2 affinity, unique among approved antipsychotics. Inverse agonism (rather than antagonism) reduces constitutive 5HT2A receptor activity below baseline. (1)

Hallucinations and delusions associated with Parkinson's disease psychosis (PDP). Investigational for psychosis in other dementias and as augmentation for depression. (1) · Insomnia (sleep onset and/or maintenance) in adults (FDA-approved Dec 2019) (1)

34 mg PO once daily (1) · 5 mg PO at bedtime; may increase to 10 mg if inadequate (1)

10 mg, 34 mg capsules/tablets (1) · 5 mg, 10 mg tablets (1)

None · Indication-specific · 40 mg/d · 10 mg/d · 20 mg/d · 80 mg/d · 10 mg/d (adults) · 100 mg/d · 4 g/d · 400 mg/d · 40 mg/d typical; up to 240 mg/d for Zollinger-Ellison · 5 mg/d · 50 mg/d · 600 mg/d · No fixed ceiling; titrate to clinical effect and tolerability with CDC opioid prescribing guidance constraints on morphine-milligram-equivalent (MME) totals · No fixed maximum; titrated to TSH target · TID per eye · Titrated to glucose; no fixed ceiling · Titrated to glucose; no fixed maximum · '''20 mg/day in adults >60 years''' per FDA's 2011-2012 QT-prolongation warning; 40 mg/day in adults ≤60

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Oral (2)

Benefit over weeks of dosing (1) · ~30 min (1)

Daily dosing (1) · ~7-8 hours (1)

~17-19 hours (longer than daridorexant) (1) · ~57 hours (parent), ~200 h (active metabolite) (1)

Not characterized; oral dosing once daily (1) · ~44% (1)

Limited data; avoid (2)

Rx, Schedule IV (US) (1) · Rx. FDA black-box warning for increased mortality in elderly patients with dementia-related psychosis (class warning shared with all antipsychotics) (1)