[HN Gopher] Dextromethorphan-Bupropion in Major Depressive Disor... ___________________________________________________________________ Dextromethorphan-Bupropion in Major Depressive Disorder: Controlled Trial Author : bookofjoe Score : 21 points Date : 2022-09-28 22:07 UTC (53 minutes ago) (HTM) web link (pubmed.ncbi.nlm.nih.gov) (TXT) w3m dump (pubmed.ncbi.nlm.nih.gov) | mpalczewski wrote: | TLDR: Have some cough syrup with your Bupropion (anti-depressant) | for increased efficacy. | genewitch wrote: | Guaifenesin, another ingredient in most cough syrups, is also | used in muscle relaxants. | | Who knew that "more tussin" would be the answer? | schwartzworld wrote: | Guaifenesin also makes you puke if you have too much. | xen2xen1 wrote: | Just had a problem finding regular Nyquil last night, now I get | why they changed it so much. | sallystarace wrote: | Dextromethorphan tolerance builds so rapidly. I have found the | withdrawal to be hell after taking it legitimately for a cold | longer than I realized. I have tried SSRIs and found that they | also have a synergetic effect with Bupropion (good medicine). | SSRIs also make me drowsy, but at least they can be sustainably | taken daily for months. | PaulHoule wrote: | See https://www.erowid.org/chemicals/dxm/faq/ | PragmaticPulp wrote: | Not the same. The Bupropion significantly changes the | metabolism of Dextromethorphan when administered as a combo. | | It's nothing like taking high doses of DXM alone for | recreational purposes. | bergenty wrote: | DXM is a fantastic dissociative. There's a reason so many rappers | with really bad childhoods use it so much. | skyyler wrote: | Is this a potshot directed at someone in particular? I wasn't | aware that DXM was popular with rappers. | Mandatum wrote: | Google "lean". They made it popular in the 90s. | PragmaticPulp wrote: | The combination is known as AXS-05 in studies and will be | marketed as Auvelity. | | Interesting combo. Buproprion is an antidepressant by itself, but | it also inhibits the enzymes that break Dextromethorphan down in | the body. Taking the two drugs together is not equivalent to | taking the same dose of Dextromethorphan alone because Bupropion | induces a very different exposure to DXM and its metabolites. | Ignore anyone who tries to compare this to recreational DXM | consumption because they're quite different. | | Dextromethorphan gets a lot of attention for being an NMDA | antagonist, but fewer people know that it has quite strong | affinity for the serotonin transporter (the primary affinity of | SSRIs). It also has potentially significant affinity for the | sigma-1 receptor, the norepinephrine transporter, and several | other receptors that have been noted to be potentially useful for | depression modulation. | | In other words, this feels a little bit like a shotgun approach | to poking a wide array of receptors that may or may not be | helpful in modulating depressive disorders. I'd take some of the | narratives about this being an "NMDA drug like ketamine" with a | huuuge grain of salt. | | People have been trying this combination for several years in DIY | fashion (not recommended, but info is out there) since the | original study came out. I've seen some reports of good results, | other reports of weird side effects that interfered with daily | activities. I wouldn't rush to characterize this as a miracle | drug or a first-line treatment, but it does seem to help certain | patients who haven't seen much benefit from previous drugs. | | Also worth noting that other studies haven't been as | overwhelmingly positive as this one. Axsome Therapeutics (company | researching the drug) stumbled a few years ago when their own | trial failed to show statistical significance for Bupropion+DXM | over Bupropion alone. Later studies seem to have been more | positive though. | forbiddenvoid wrote: | Thank you for explaining the interaction that makes this work. | I was very confused for a bit trying to understand how mixing a | cough suppressant with an anti-depressant would change the | chemistry to the extent highlighted in the study. | braingenious wrote: | I'm always happy to see this. | | I know a therapist that's interested in ketamine/psilocybin | therapy and when she asked me about these types of drugs, I | immediately told her that DXM is hands down obviously going to | have clinical use. | nnlsoccer wrote: | Unable to access the full paper at the moment, but curious if | they addressed the fact that Bupropion can take 6-8wks before | symptoms such as depressed mood or anhedonia are affected. Were | these bupropion naive patients? From the abstract, this was only | a 6wk study - which means that the bupropion may not yet have | been working at maximal efficacy for those in the bupropion group | during the study period and therefore of course the AXS would | show a benefit when compared to only bupropion ___________________________________________________________________ (page generated 2022-09-28 23:00 UTC)