Improvement of depressive symptoms, after a suicide attempt, with dextromethorphan/bupropion combination treatment in a patient with treatment‐resistant depression and psychiatric comorbidities

Pedraz-Petrozzi, Bruno; Deuschle, Michael; Gilles, Maria

doi:10.1002/ccr3.7045

Cited by 4 publications

(3 citation statements)

References 14 publications

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“…The alignment of these findings with the literature set the efficacy profile of aminoketone antidepressants on a high profile for indication in MDD. This finding aligns with the perspective of literature on AXS-50 on the reduction of MDD symptomatology [71]. The high heterogeneity means low predictive values as the results cannot be used to ascertain conclusions on decreasing MADRS scores in MDD [65], [71].…”

Section: Certainty Of Evidencesupporting

confidence: 83%

“…This finding aligns with the perspective of literature on AXS-50 on the reduction of MDD symptomatology [71]. The high heterogeneity means low predictive values as the results cannot be used to ascertain conclusions on decreasing MADRS scores in MDD [65], [71]. Despite the high heterogeneity, improved symptomatology was evident within 2 weeks of AXS-50 treatment.…”

Section: Certainty Of Evidencesupporting

confidence: 81%

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A Comparative Efficacy of Antidepressants in the Treatment of Major Depressive Disorder: A Systematic Review and Meta-Analysis

Alnaher,

Alramahi,

Arida

et al. 2023

CJMS

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Study background & objective: Major Depressive Disorder (MDD) affects about 280, 000, 000 people globally, with a higher incidence among females than males. The increasing incidence implicates health burdens and clinical dilemmas regarding the low efficacy of the existing antidepressants. Methods: A literature search was performed on electronic databases, PubMed, the Cochrane Library of Randomized Trials, Scopus, and ProQuest, for studies reporting the efficacy of an SNRI (Desvenlafaxine 50 mg/d), a serotonin modulator (Vortioxetine 10-20 mg/d), and an aminoketone antidepressant (Bupropion). Study selection focused on randomized controlled trials (RCTs) and observational studies. All statistical analyses and visualization were performed using the Review Manager (RevMan) software and Python programming. The random effects model, ANOVA test, and Cohen’s d were used for statistical analyses. Results: The present meta-analysis involved 17 studies, including 11, 533 participants. The results aligned with previous studies and accounts provided by literature regarding the efficacy of antidepressants used to manage MDD. Five studies, including 2, 377 MDD patients, reported a statistically significant outcome, that Desvenlafaxine 50 mg/d reduced MDD’s severity than placebo (OR: 0.52, 95% CI [0.44, 0.62], P < 0.00001, I2 = 0%). Three studies involving 742 MDD patients reported the efficacy of dextromethorphan-bupropion (AXS-50). The reduction of MADRS scores in the treatment group was statistically insignificant, with high variability, favouring the placebo (OR of 1.85 [95% CI: 0.93, 3.70], p = 0.08, I2 = 79%). Additionally, Vortioxetine 10-20 mg/d produced adverse effects, headache, vomiting, nausea, diarrhea, dizziness, nasopharyngitis, somnolence, and suicidal ideation among 6, 669 MDD patients reported by the 9 studies. The finding was statistically significant but with a high variability OR: 15.25, 95% CI [12.55, 18.52], P < 0.00001, I2 = 98%). Discussion: A preliminary analysis of evidence collected following Desvenlafaxine, AXS-50, and Vortioxetine administration yielded compelling evidence on the efficacy of antidepressants in MDD treatment. Desvenlafaxine and AXS-50 reported reduced severity and symptomatology in MDD, respectively. On the other hand, Vortioxetine implicated adverse effects, which are common with most antidepressants. Conclusion: Despite adverse effects like headache, vomiting, nausea, diarrhea, dizziness, nasopharyngitis, somnolence, and suicidal ideation, antidepressants used to treat MDD yield clinically satisfying outcomes like decreased severity of depression and relief from symptoms. Clinicians should monitor patients to take care of any adverse effects resulting from the treatments.

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Section: Certainty Of Evidencesupporting

confidence: 83%

Section: Certainty Of Evidencesupporting

confidence: 81%

A Comparative Efficacy of Antidepressants in the Treatment of Major Depressive Disorder: A Systematic Review and Meta-Analysis

Alnaher,

Alramahi,

Arida

et al. 2023

CJMS

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“…Bupropion inhibits the reuptake of both NA and DA, as well as CYP2D6 enzymes, increasing the bioavailability of dextromethorphan. This drug combination was approved only in the USA in August 2022 for the treatment of MDD in adults (currently, is only used off-label in Europe [152]). In clinical trials, this combination was generally well tolerated, and was not associated with a signal for increased psychotomimetic effects or weight gain [153].…”

Section: Antidepressant Breakthroughs: Advancements In Pharmacotherap...mentioning

confidence: 99%

Advancements Exploring Major Depressive Disorder: Insights on Oxidative Stress, Serotonin Metabolism, BDNF, HPA Axis Dysfunction, and Pharmacotherapy Advances

Correia,

Vale

2024

IJTM

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Major depressive disorder (MDD), a prevalent mental illness, is marked by a complex mixture of biological factors. This review focuses on the roles of oxidative stress, tryptophan-serotonin metabolism, brain-derived neurotrophic factor (BDNF), and the hypothalamic–pituitary–adrenal (HPA) axis in MDD’s pathophysiology. Oxidative stress, defined as an imbalance between pro-oxidants and antioxidants, is closely linked to MDD’s neurobiological changes. The tryptophan (TRP)-/serotonin (5-HT) metabolic pathway is also known to be crucial in mood regulation, with its dysregulation being a central aspect of MDD. Additionally, BDNF, key for neuronal growth and plasticity, often shows alterations in MDD patients, supporting its role in the disorder’s progression. Furthermore, the HPA axis, which manages stress response, is frequently disrupted in MDD, further contributing to its complex pathology. In addition to exploring these biological mechanisms, this review also explores the pharmacotherapy of MDD, including new advances. These advancements in treatment strategies are crucial for managing MDD effectively. Understanding these mechanisms and the latest pharmacological interventions is essential for developing more effective treatments for MDD.

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Multiple drugs

2023

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Improvement of depressive symptoms, after a suicide attempt, with dextromethorphan/bupropion combination treatment in a patient with treatment‐resistant depression and psychiatric comorbidities

Cited by 4 publications

References 14 publications

A Comparative Efficacy of Antidepressants in the Treatment of Major Depressive Disorder: A Systematic Review and Meta-Analysis

A Comparative Efficacy of Antidepressants in the Treatment of Major Depressive Disorder: A Systematic Review and Meta-Analysis

Advancements Exploring Major Depressive Disorder: Insights on Oxidative Stress, Serotonin Metabolism, BDNF, HPA Axis Dysfunction, and Pharmacotherapy Advances

Multiple drugs

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