Dan V Iosifescu

2 papers in the library · publishing 2017-2023

Papers

Combinations of dextromethorphan for the treatment of mood disorders - a review of the evidence.

Expert review of neurotherapeutics March 1, 2023 Zamfira Parincu, Dan V Iosifescu

Major depressive disorder (MDD) is a leading cause of disability, but many patients do not improve with standard monoamine-targeting drugs, and benefits typically take 4-6 weeks. Combinations of dextromethorphan, an oral NMDA receptor antagonist, may offer faster relief. A systematic search of US Clinical Trials, PubMed, press releases, and poster presentations identified two case reports and eight clinical trials on dextromethorphan for MDD or treatment-resistant depression (TRD), plus additional studies in bipolar disorder. Clinical studies show that dextromethorphan combined with quinidine or bupropion effectively reduces depressive symptoms in MDD. However, results in adults with TRD or bipolar depression were mixed. The dextromethorphan-bupropion combination appears well-tolerated, safe, and efficacious for MDD, but more studies on TRD and bipolar depression are needed.

DOI: 10.1080/14737175.2023.2192402 Full text Depression Bipolar disorder Bupropion Dextromethorphan +1

Dextromethorphan/quinidine pharmacotherapy in patients with treatment resistant depression: A proof of concept clinical trial.

Journal of affective disorders August 15, 2017 James W Murrough, Elizabeth Wade, Sehrish Sayed et al.

A combination of dextromethorphan and quinidine, given at up to 45/10 mg twice daily for 10 weeks, reduced depression scores in patients with treatment-resistant depression. Twenty patients with unipolar treatment-resistant depression enrolled; six discontinued early. Depression scores on the Montgomery-Asberg Depression Rating Scale dropped by an average of 13 points, and on the Quick Inventory of Depressive Symptomatology by nearly 6 points. Response and remission rates were 45% and 35%, respectively. No treatment-emergent suicidal thoughts, psychosis, or dissociation occurred. The open-label, proof-of-concept design limits conclusions, but results suggest the combination is tolerable and warrants larger placebo-controlled trials.

DOI: 10.1016/j.jad.2017.04.072 Full text Depression Antidepressant Dextromethorphan Glutamate +2