Drilldown: Medicines

2C-B (1) · Atropa belladonna (1) · Banisteriopsis caapi (1) · Black Drink (1) · Brugmansia (1) · Chocolate (1) · Dexmethylphenidate (1) · Duloxetine (1) · Guarana (1) · Haloperidol (1) · Hyoscyamus niger (1) · Kola (1) · Lamotrigine (1) · Lithium (1) · LSD (1) · Mandragora officinarum (1) · Mescal Bean (1) · Methylphenidate (1) · Modafinil (1) · Naltrexone (1) · Sertraline (1) · Yerba mate (1)

''Brugmansia'' spp., Angel's trumpet, ''borrachero'', ''toé'' (1) · ''Cola nitida'', ''Cola acuminata'' (1) · ''Ilex paraguariensis'' (1) · ''Ilex vomitoria'' (1) · ''Paullinia cupana'' (1) · ''Sophora secundiflora''. Texas mountain laurel, frijolillo (1) · ''Theobroma cacao'' (1) · Cymbalta, Drizalma Sprinkle, Irenka, Yentreve (1) · Deadly nightshade (1) · Delysid (historical, Sandoz, withdrawn 1965) (1) · Focalin, Focalin XR (1) · Haldol, Serenace, Haldol Decanoate (1) · Henbane, black henbane (1) · Lamictal (IR), Lamictal XR, Lamictal ODT (1) · Lithobid (extended-release); Eskalith (discontinued in US); Carbolith (Canada); Priadel (UK); Camcolit (UK) (1) · Mandrake (1) · Nexus, Eroxan (historical, late-1980s through mid-1990s) (1) · Provigil (Teva/Cephalon); Alertec (Canada); Modavigil (Australia) (1) · ReVia (oral, 50 mg tablets), Depade (oral, generic), Vivitrol (extended-release IM injection 380 mg monthly); Contrave (naltrexone + bupropion ER tablets for weight management) (1) · Ritalin, Ritalin LA, Concerta, Metadate CD, Daytrana, Quillivant XR (1) · The ayahuasca vine, ''yagé'', ''caapi'', ''mariri'' (1) · Zoloft (1)

2C-x series (1) · Antidepressant (2) · Antiemetic (1) · Anxiolytic (2) · Caffeine plant (5) · Classic Psychedelic (1) · CNS stimulant (1) · Daimonica (4) · Ergoline (1) · Excitantia (5) · Lysergamide (1) · MAOI (1) · NDRI (2) · Phantastica (2) · Phenethylamine (1) · Plant Medicine (11) · Psychedelic (1) · Psychostimulant (2) · SNRI (1) · SSRI (1) · Tropane alkaloid plant (4) · Typical antipsychotic (1) · [[:Category:Anticonvulsants|Anticonvulsant]] (1) · [[:Category:Antimanic medicines|Antimanic]] (1) · [[:Category:AUD medicines|Alcohol use disorder medicine]] (1) · [[:Category:Eugeroics|Eugeroic]] (1) · [[:Category:Mood stabilizers|Mood stabilizer]] (2) · [[:Category:Opioid antagonists|Opioid antagonist (mu and kappa)]] (1) · [[:Category:OUD medicines|Opioid use disorder medicine]] (1) · [[:Category:Psychostimulants|Psychostimulant]] (atypical) (1) · [[:Category:Sodium channel blockers|Sodium channel blocker]] (1)

None (4) · 5-HT2A partial agonist (2) · Active alkaloid is cytisine, a nicotinic acetylcholine receptor agonist. NOT a classical 5-HT2A psychedelic. (1) · Caffeine (1.5–2%) + theobromine + kolanin (a glycoside). (1) · Caffeine (highest of the ''Ilex'' genus) plus saponins that produce ritual vomiting at high doses. (1) · Caffeine (sometimes called 'mateine' historically, though chemically identical), theobromine, theophylline, plus polyphenols. (1) · Contains the β-carboline alkaloids harmine, harmaline, and tetrahydroharmine, reversible monoamine oxidase inhibitors (RIMAs) that allow oral DMT to reach the brain. (1) · High-affinity D2 receptor antagonist (1) · Highest natural caffeine content of any plant (2–7% by dry weight, ~2–4× coffee). Caffeine is bound to tannins, producing a slower release than pure coffee caffeine. (1) · Norepinephrine–dopamine reuptake inhibition (DAT, NET) (1) · Norepinephrine–dopamine reuptake inhibition (DAT, NET), d-threo enantiomer of methylphenidate (1) · Primary alkaloid is theobromine (3,7-dimethylxanthine), with minor caffeine. Also contains phenethylamine, anandamide (an endogenous cannabinoid), tryptophan (serotonin precursor), and flavanols. The combined effect is mild stimulation + mood elevation. (1) · Serotonin–norepinephrine reuptake inhibition (balanced) (1) · TrkB/BDNF'"`UNIQ--ref-00000084-QINU`"' '"`UNIQ--vote-00000085-QINU`"' (1) · Tropane alkaloids: hyoscyamine (dominant; the racemic form is atropine), scopolamine. Competitive muscarinic antagonism. (1) · Tropane alkaloids: hyoscyamine, scopolamine, atropine, apoatropine. (1) · Tropane alkaloids: hyoscyamine, scopolamine, in higher seed concentrations than belladonna or datura. (1) · Tropane alkaloids: scopolamine (dominant), hyoscyamine, atropine. Competitive antagonism at muscarinic acetylcholine receptors. (1)

None (6) · ADHD, narcolepsy (1) · Depression, anxiety, neuropathic pain, fibromyalgia, chronic musculoskeletal pain (1) · Schizophrenia, acute psychosis, agitation, delirium, Tourette syndrome, severe nausea (1) · '"`UNIQ--vote-00000006-QINU`"' (2) · '"`UNIQ--vote-00000008-QINU`"', '"`UNIQ--vote-00000009-QINU`"' (4) · '"`UNIQ--vote-00000021-QINU`"', '"`UNIQ--vote-00000022-QINU`"', '"`UNIQ--vote-00000023-QINU`"', '"`UNIQ--vote-00000024-QINU`"' (1) · '"`UNIQ--vote-00000065-QINU`"' (1) · '"`UNIQ--vote-000000AD-QINU`"', '"`UNIQ--vote-000000AE-QINU`"' (1) · '"`UNIQ--vote-00000150-QINU`"', '"`UNIQ--vote-00000151-QINU`"' (1) · '"`UNIQ--vote-000003A0-QINU`"', '"`UNIQ--vote-000003A1-QINU`"' (1) · '"`UNIQ--vote-0000069B-QINU`"', '"`UNIQ--vote-0000069C-QINU`"' (1) · '"`UNIQ--vote-0000081E-QINU`"' (1)

None · ~10 units SC at the same time daily, or 0.1-0.2 units/kg/d; titrate by fasting glucose · '''5 mg PO at bedtime for women, 5-10 mg for men''' (per FDA's 2013 sex-specific dose reduction for women due to slower clearance). Ambien CR 6.25 mg women / 6.25-12.5 mg men. Intermezzo SL 1.75 mg women / 3.5 mg men · 0.25 mg · 0.4 mg PO daily (general prevention); 0.8-1 mg/d in pregnancy; 4 mg/d for women with prior NTD-affected pregnancy; 1 mg/d during methotrexate therapy · 0.4 mg PO once daily, 30 minutes after the same meal each day · 0.5 mg PO once daily · 0.5-1 mg PO/IV once or twice daily; titrate to clinical response. Approximate equipotency: bumetanide 1 mg ≈ furosemide 40 mg ≈ torsemide 20 mg · 0.5-2 mg/kg/d divided or single morning dose for acute conditions; lowest effective dose for chronic conditions, with planned taper · 0.5-3 mg PO 30-60 minutes before bedtime. Some patients respond to micro-doses (0.3 mg) without additional benefit at higher doses. For circadian phase shifting, timing relative to dim-light melatonin onset matters more than absolute dose · 0.5–1 oz (10–30 g) ground for psychoactive effect; far smaller for culinary use · 0.75 mg SC weekly'"`UNIQ--ref-00000053-QINU`"' · 1 capsule (20/10 mg dextromethorphan/quinidine) PO once daily × 7 days, then 1 capsule BID · 1 drop in affected eye(s) TID (monotherapy); BID with timolol (Cosopt) · 1 drop in the affected eye(s) once daily in the evening · 1 drop in the affected eye(s) once daily in the evening (Lumigan); Latisse applied to upper lash line at bedtime · 1 g PO QID on an empty stomach (1 hour before meals and at bedtime); 1 g BID for maintenance · 1 mg at bedtime (PTSD nightmares); 1 mg BID–TID (HTN) · 1 mg PO at bedtime to limit first-dose syncope; titrate weekly to 5-10 mg · 1 mg PO once daily

Other values:

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None (6) · 25 mg, 50 mg, 100 mg tablets; oral concentrate 20 mg/mL (1) · Bark/woody stem decocted with a DMT-source plant (''Psychotria viridis'', ''Diplopterys cabrerana'') to make ayahuasca (1) · Bright red seeds, traditionally ingested or smoked. Highly toxic, narrow margin between active and lethal (1) · Dried leaves and twigs, infused in a gourd (''mate'') and drunk through a metal straw (''bombilla'') (1) · Fermented and roasted seeds, ground. Mexican tradition: drunk with chili, cornmeal, achiote. European tradition: with sugar and milk (1) · Flowers or leaves infused or smoked. Highly variable potency; narrow toxic margin (1) · Fresh nuts chewed; also dried and powdered (1) · IR tablets 25, 100, 150, 200 mg; chewable dispersible tablets 2, 5, 25 mg; ODT 25, 50, 100, 200 mg; XR tablets 25, 50, 100, 200, 250, 300 mg (1) · Leaves and seeds, traditionally smoked or infused. Possibly the original Pythia oracle plant (1) · Leaves, berries, root. Historically: belladonna cigarettes ("Asthmador") OTC in US until the 1970s (1) · Lithium carbonate: immediate-release capsules (150 mg, 300 mg, 600 mg) and tablets (300 mg); extended-release tablets (300 mg, 450 mg). Lithium citrate: oral solution (8 mEq/5 mL, equivalent to 300 mg lithium carbonate per 5 mL) for patients unable to swallow tablets. (1) · Oral tablets 50 mg (ReVia, Depade, generics); Vivitrol extended-release IM suspension 380 mg single-dose vial; Contrave (naltrexone 8 mg + bupropion 90 mg ER tablets); compounded 1, 2, 3, 4.5 mg tablets/capsules for LDN (1) · Roasted seeds ground to powder, mixed with water; commercial syrups and energy drinks (1) · Root, traditionally carved into ''mannikens'' or infused into wine (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) · Toasted leaves and twigs decocted to a near-black concentrate (1)

None (17) · 200 mg/d (1) · 400 mg/day (bipolar monotherapy); 700 mg/day (epilepsy with enzyme-inducing comedication) (1) · 400 mg/day.'"`UNIQ--ref-0000006C-QINU`"' (1) · 50 mg/day oral; 380 mg/4 weeks IM (Vivitrol); 32 mg + 360 mg naltrexone/bupropion daily (Contrave maximum after titration) (1) · No defined absolute maximum; dosing is guided by serum level monitoring. Levels above 1.5 mEq/L carry increasing toxicity risk. Levels consistently above 1.2 mEq/L are generally not maintained in clinical practice.'"`UNIQ--ref-00000052-QINU`"' (1)

None · Oral · IV · topical · IM · intranasal · rectal · Subcutaneous · Topical ophthalmic · ophthalmic · intramuscular · intravenous · transdermal · vaginal · Subcutaneous (abdomen · sublingual · thigh · Inhaled · SC · intra-articular

Other values:

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None (11) · 20–60 min (oral) (1) · 30–60 min (1) · 30–60 minutes (1) · 45-75 min (oral) (1) · Antiepileptic effect within days at therapeutic level; mood-stabilizing effect emerges over weeks (1) · Antimanic effects begin within 5-7 days of reaching therapeutic serum levels, with full response often requiring 2-3 weeks. For acute mania, a neuroleptic is typically added for rapid sedation while lithium takes effect.'"`UNIQ--ref-00000053-QINU`"' (1) · Anxiolysis classically 3-4 weeks, continuing improvement to 8-12 weeks (1) · Mood: 2–4 weeks. Pain: often within 1–2 weeks. (1) · Oral peak plasma 1 hour; therapeutic opioid blockade within hours of first dose. IM Vivitrol: peak plasma 2-3 days; therapeutic blockade through the dosing interval. (1) · 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) · PO 1–2 h; IM 30–60 min; IV 5–20 min (1)

None (12) · 12–24 h (oral); decanoate IM 3–4 weeks (1) · 24 hours (often divided BID at higher doses) (1) · 4-8 h (1) · 8–12 hours (1) · Chronic daily 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) · IR 3–5 h; LA/SR 6–8 h; Concerta 10–12 h; Daytrana ~9 h wear time (1) · IR 4–6 h; XR 8–12 h (1) · Long (1) · Oral mu-blockade clinically meaningful for 24-72 hours; IM Vivitrol blockade through 4 weeks. (1)

None (12) · 14–26 h (oral); ~3 weeks (decanoate) (1) · 2.2 h (IR parent); ~3 h (XR parent) (1) · 2–3 h (parent compound) (1) · 3–5 hours (1) · Approximately 18-24 hours after acute administration; may extend to 36-48 hours with chronic dosing as tissue compartments equilibrate. Serum trough levels should be drawn 12 hours after the last dose for accurate interpretation.'"`UNIQ--ref-00000055-QINU`"' (1) · Naltrexone parent ~4 hours (oral); 6-beta-naltrexol (active metabolite) ~13 hours. Vivitrol depot terminal half-life 5-10 days with sustained release from microspheres maintaining blockade for the 4-week dosing interval.'"`UNIQ--ref-0000004F-QINU`"' (1) · Not well characterized (1) · ~12 hours (1) · ~25-33 hours alone; ~15 hours with enzyme inducers; '''≥60 hours with valproate''' (UGT inhibition)'"`UNIQ--ref-00000025-QINU`"' (1) · ~26 h (sertraline; range 13-45 h, longer in females); ~62-104 h (N-desmethylsertraline, weakly active) (1)

None (12) · 70–90% (oral) (1) · Absolute bioavailability not precisely characterized; food modestly increases exposure (1) · Not well characterized (1) · 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) · ~22–25% (1) · ~30% (high first-pass) (1) · ~5-40% (oral, highly variable due to extensive first-pass metabolism; mean ~5-10% for parent naltrexone with the majority of pharmacologic effect coming from 6-beta-naltrexol). IM Vivitrol bypasses first-pass entirely.'"`UNIQ--ref-00000050-QINU`"' (1) · ~50% (highly variable) (1) · ~60–70% (oral) (1) · ~98% (oral)'"`UNIQ--ref-00000026-QINU`"' (1)

None (14) · '''Among the safest mood stabilizers in pregnancy''' with reassuring monotherapy registry data, in sharp contrast to valproate. Estrogen-containing contraceptives accelerate lamotrigine metabolism, requiring dose adjustments at start and stop of contraception'"`UNIQ--ref-00000027-QINU`"' (1) · Category C (3) · Category C'"`UNIQ--ref-0000008F-QINU`"' (1) · Not established (2) · Pregnancy categories were retired by FDA in 2015. Limited reproductive data with small observational signal for cardiac malformations; risk-benefit decision, with many patients deferring ADHD treatment during pregnancy. See pregnancy_details for the full discussion. (1)

None (12) · Not a controlled substance in the United States, European Union, United Kingdom, Canada, or Australia. Prescription-only in all of these jurisdictions due to the narrow therapeutic index and the need for serum monitoring. No abuse potential has been identified. (1) · Plant unrestricted; pharmaceutical atropine Rx-only (1) · Rx-only (2) · Rx-only in US (1) · Schedule I (United States) (1) · Schedule II (2) · [[USLegal:DEA Schedule I|Schedule I]] (United States) (1) · [[USLegal:Prescription only|Rx-only]] in US. Carries the FDA '''Boxed Warning for serious skin reactions''' including Stevens-Johnson syndrome and toxic epidermal necrolysis, with the risk concentrated in the first 2-8 weeks of therapy and elevated by rapid titration'"`UNIQ--ref-00000028-QINU`"' (1)