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Dextromethorphan-bupropion (Auvelity) for the Treatment of Major Depressive Disorder

Brian McCarthy,Hannah Bunn,Morgan Santalucia,Charlotte Wilmouth,Andrew Muzyk,Colin M. Smith 대한정신약물학회 2023 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.21 No.4
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  KCI
  
  스콜라
Depression is a significant cause of morbidity and mortality globally. Although various pharmacologic options exist for depression, treatments are limited by delayed or incomplete therapeutic response, low rates of remission, and adverse effects necessitating effective, fast-acting, and better tolerated alternatives. The purpose of this review is to describe the safety and efficacy of dextromethorphan-bupropion (Auvelity), a Food and Drug Administration approved treatment for major depressive disorder in adults. Dextromethorphan modulates glutamate signaling through uncompetitive antagonism of N-methyl-D-aspartate receptors and sigma-1 agonism, while bupropion increases the bioavailability of dextromethorphan by CYP2D6 inhibition. In a phase 3 trial with dextromethorphan-bupropion 45−105 mg for patients with major depressive disorder saw significant reductions in their Montgomery-Åsberg Depression Rating Scale total scores compared to placebo. A phase 2 trial comparing dextromethorphan-bupropion 45−105 mg to bupropion monotherapy led to significant reduction in Montgomery-Åsberg Depression Rating Scale score. Changes in Montgomery-Åsberg Depression Rating Scale with dextromethorphan-bupropion were seen within two weeks in both clinical trials. Remission and response rates were significantly higher with dextromethorphan-bupropion in both studies. The medication was well-tolerated in both trials, with the most common adverse events being rated as mild-to-moderate. Two long-term, open-label studies with dextromethorphan-bupropion saw large reductions in Montgomery-Åsberg Depression Rating Scale scores that were maintained through 12 and 15 months of treatment. In both long-term studies, remission rates approached 70%, while response rates were greater than 80%. These data suggest that dextromethorphan-bupropion is an effective, fast-acting, and well tolerated option for depression treatment and produced remission in a large percentage of patients.
2
Sport Facility Feasibility Study: Assessment, Value and Demand

( Mark Lyberger ),( Brian H. Yim ),( Laurence M. Mccarthy ) 아시아스포츠융합과학회 2020 Asia Pacific Journal of Applied Sport Sciences Vol.1 No.1
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PURPOSE A sport managemnt organization proposed to build an indoor sport facility in a town close to a major urban area. The potential investors and stakeholders required that feasibility studies be conducted before an investment decision was made. METHOD The case examined the proposed facility through a feasibility study and a market analysis to understand the market, potential demand, possible growth opportunities and to determine if a project was worthy of investment. CONCLUSION Included in the study are the key components and data analysis which led to a positive investment report.
3
Affinity for self antigen selects T<sub>reg</sub> cells with distinct functional properties

Wyss, Lena,Stadinski, Brian D,King, Carolyn G,Schallenberg, Sonja,McCarthy, Nicholas I,Lee, Jun Young,Kretschmer, Karsten,Terracciano, Luigi M,Anderson, Graham,Surh, Charles D,Huseby, Eric S,Palmer, E Nature Publishing Group, a division of Macmillan P 2016 NATURE IMMUNOLOGY Vol.17 No.9
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<P>The manner in which regulatory T cells (T-reg cells) control lymphocyte homeostasis is not fully understood. We identified two T-reg cell populations with differing degrees of self-reactivity and distinct regulatory functions. We found that GITR(hi)PD-1(hi)CD25(hi) (Triple(hi)) T-reg cells were highly self-reactive and controlled lympho-proliferation in peripheral lymph nodes. GITR(lo)PD-1(lo)CD25(lo) (Triple(lo)) T-reg cells were less self-reactive and limited the development of colitis by promoting the conversion of CD4(+) T-conv cells into induced T-reg cells (iT(reg) cells). Although Foxp3-deficient (Scurfy) mice lacked T-reg cells, they contained Triple(hi)-like and Triple(lo)-like CD4(+) T cells with distinct pathological properties. Scurfy Triple(hi)CD4(+) T cells infiltrated the skin, whereas Scurfy. Triple(lo)CD4(+) T cells induced colitis and wasting disease. These findings indicate that the affinity of the T cell antigen receptor for self antigen drives the differentiation of T-reg cells into distinct subsets with non-overlapping regulatory activities.</P>