Deudextromethorphan/quinidine

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Deudextromethorphan/quinidine
Combination of
Deudextromethorphan Sigma-1 receptor agonist, NMDA receptor antagonist, serotonin–norepinephrine reuptake inhibitor
Quinidine Antiarrhythmic agent, CYP2D6 inhibitor
Clinical data
Other namesAVP-786; CTP-786; d-DM/Q; d6-DM/Q; d-DXM/Q; d6-DXM/Q
Routes of
administration 		By mouth

Deudextromethorphan/quinidine (d-DXM/Q; developmental code names AVP-786, CTP-786) is a combination of deudextromethorphan (d-DXM; deuterated (d6) dextromethorphan (DXM)) and quinidine (Q) which is under development by Avanir Pharmaceuticals for the treatment of a variety of neurological and psychiatric indications. [1] [2] The pharmacological profile of d-DXM/Q is similar to that of dextromethorphan/quinidine (DXM/Q). [2] DXM and d-DXM act as σ1 receptor agonists, NMDA receptor antagonists, and serotonin–norepinephrine reuptake inhibitors, among other actions, while quinidine is an antiarrhythmic agent acting as a CYP2D6 inhibitor. [2] Quinidine inhibits the metabolism of DXM and d-DXM into dextrorphan (DXO), which has a different pharmacological profile from DXM. [2] Deuteration of DXM hinders its metabolism by CYP2D6 into DXO, thereby allowing for lower doses of quinidine in the combination. [2] This in turn allows for lower potential for drug interactions and cardiac adverse effects caused by quinidine. [2] As of September 2020, d-DXM/Q is in phase 3 clinical trials for agitation, phase 2/3 trials for schizophrenia, and phase 2 trials for brain injuries, impulse control disorders, major depressive disorder, and neurodegenerative disorders. [1]

References

  1. 1 2 "Deudextromethorphan - Avanir Pharmaceuticals - AdisInsight".
  2. 1 2 3 4 5 6 Ahmed M, Malik M, Teselink J, Lanctôt KL, Herrmann N (July 2019). "Current Agents in Development for Treating Behavioral and Psychological Symptoms Associated with Dementia". Drugs Aging. 36 (7): 589–605. doi:10.1007/s40266-019-00668-7. PMID   30957198. S2CID   102348513.



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