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Avanir Pharmaceuticals, Inc. Message Board

  • get648 get648 Nov 20, 2013 12:12 PM Flag

    Nuedexta story - just read and smile...

    goog for

    Can Cough Medicine treat Depression? November 12, 2013

    Nuedexta is mentioned at page 2

    Sentiment: Strong Buy

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    • wow depression

    • Thx for the heads up.

      The reference at the bottom of that artcle looks interesting as well:

      Mechanism of action of dextromethorphan/quinidine: comparison with ketamine
      Stephen M. Stahl


      ISSUE:Reports of rapid-onset but short-duration antidepressant effects in patients with treatment-resistant mood disorders after intravenous administration of ketamine have prompted efforts to find an agent with ketamine's properties that can be administered orally in repeated doses in order to sustain that action. One candidate for this is dextromethorphan, and here the pharmacologic mechanism of action is compared and contrasted with that of ketamine.

    • "Despite the details of that case, I began prescribing Nuedexta for my patients following IV ketamine, due to the lack of other options. I have prescribed it to about 40 patients thus far, and almost all of them have tolerated it very well, particularly as it lacks the acute dissociative effects that are linked to ketamine treatment. Many have been able to continue on Nuedexta either alone or in combination with other oral medications without further ketamine infusions, while others have been able to greatly extend the time interval between maintenance ketamine infusions, often up to 2 to 3 months."

      Sentiment: Strong Buy

    • "An initial study on the effects of Nuedexta without ketamine in treatment-resistant depression has recently begun at the Mount Sinai School of Medicine in New York, NY. Alongside other ketamine-like drugs in development, Nuedexta offers hope that the legacy of ketamine will spawn a new generation of more rapidly effective and well-tolerated treatment options. "

      Sentiment: Strong Buy

    • Great article. Thanks for posting!

    • Can Cough Medicine Treat Depression?
      By Steven P. Levine, MD | November 12, 2013

      One of the most promising recent developments in psychiatry has been intravenous (IV) ketamine infusion for the rapid treatment of severe treatment-resistant depression. But even though multiple studies have demonstrated and replicated the safety and efficacy of the off-label use of the 50-year-old anesthetic, their findings remain limited to acute treatment.
      Longer-term maintenance studies on ketamine are not being done, based in part upon the premise that a medication with a similar mechanism to ketamine will emerge as a more widespread antidepressant. Those drugs are currently in development, and if all goes well, they may be available to us within the next few years.
      In the meantime, some clinicians have begun to treat severe treatment-resistant depression patients with IV ketamine without evidence-based guidance for maintaining long-term dramatic responses. The rough solution to that problem is to continue what has worked by infusing IV ketamine on a less frequent maintenance basis while weighing the unknown risks of ongoing infrequent exposure to the drug against the risks of recurrence of depressive symptoms. An additional solution is to find another off-label yet orally available medication with a similar mechanism to ketamine that may be sufficient to maintain response.

      Sentiment: Strong Buy

      • 1 Reply to greatdayforinvestments
      • Part 2
        Several drugs that fit the profile have been studied, either directly following ketamine or on their own. Each of those medications — which include riluzole, scopolamine, amantadine, and memantine — has an unrelated indication approved by the US Food and Drug Administration (FDA) and, like ketamine, promotes activity at the N-methyl-D-aspartate (NMDA) receptor. However, clinical studies on the drugs’ effects in depression have been limited and the results have been somewhat disappointing, which is why I considered another medicine that brings my story full circle.
        A few years ago, I met with a patient for a second-opinion consultation. She was on the unfortunately common path of having tried multiple treatments for long-standing depression and anxiety that either failed or had intolerable side effects. However, there was an interesting wrinkle in the case, as the patient had found that over-the-counter cough medicines with cough suppressant dextromethorphan helped her mood and anxiety better than anything else. So, she asked me, “Why can’t I just keeping taking DayQuil?”
        At the time, I advised against it because she required relatively high and frequent doses to achieve the effect that, over time, could be toxic. However, it made me curious about the mechanism of dextromethorphan that might account for the patient’s observations. Investigating that mechanism led me to a literature search of similar drugs and their safety and efficacy in depression. It turned out that there were several, including the aforementioned medicines; but when I read the ketamine studies, I knew there was something of value to further explore.

        Sentiment: Strong Buy

    • greatdayforinvestments greatdayforinvestments Nov 20, 2013 12:20 PM Flag

      Great find! NUEDEXTA mentioned in the article...

      Sentiment: Strong Buy