The FDA has approved the first non-antipsychotic medication for treating agitation associated with Alzheimer's disease, marking a significant shift in pharmacologic management for this behavioral symptom.
The FDA has approved the first non-antipsychotic medication for the treatment of agitation associated with Alzheimer's disease, offering a new prescribing option for this behavioral symptom.
The FDA has approved Auvelity (dextromethorphan/bupropion) for the treatment of agitation associated with Alzheimer's disease, expanding its indication beyond major depressive disorder.
FDA approval of Auvelity (dextromethorphan-bupropion) as the first non-antipsychotic treatment for agitation associated with Alzheimer's disease, offering a new pharmacologic option with a different safety profile than typical antipsychotics.
The FDA has approved a new treatment for agitation associated with Alzheimer's disease, marking a significant development in managing behavioral symptoms of dementia.
Clinical Pearls
Bite-sized clinical takeaways from today's literature (sources from Apr 28 – May 01)
- Prescribe Auvelity (dextromethorphan/bupropion) as a non-antipsychotic alternative for agitation in Alzheimer's disease to avoid antipsychotic black box warnings regarding mortality in elderly dementia patients.
- Monitor for QT prolongation and seizure risk when prescribing Auvelity to elderly patients with dementia, given the bupropion component's pro-convulsant potential.
- Be aware that AXS-05 (amantadine/dexmethylphenidate) has also received FDA approval for agitation in Alzheimer's disease, providing another non-antipsychotic pharmacologic option.
- Exercise extreme caution with investigational antipsychotics like evenamide following recent clinical holds due to patient deaths, prioritizing established safety profiles in schizophrenia trials.
- Consider repurposing GLP-1 agonists like semaglutide for patients with comorbid alcohol use disorder and obesity, as recent data suggests it may reduce heavy drinking days.
- Evaluate theta-burst TMS as a non-pharmacologic intervention for autistic children with intellectual disability who exhibit significant social communication and language deficits.
- Implement routine depresitation protocols for psychotropics in dementia patients, as 50% continue use one year after initiation despite limited long-term efficacy data.
- Utilize Auvelity's dual mechanism of NMDA antagonism and CYP2D6 inhibition to target glutamatergic dysfunction in dementia-related agitation where traditional antipsychotics have failed or are contraindicated.
- Screen for seizure risk factors before initiating bupropion-containing formulations like Auvelity, particularly in older adults with potential metabolic or neurological vulnerabilities.
- Recognize that the approval of non-antipsychotics for dementia agitation marks a paradigm shift away from first-line antipsychotic use, necessitating updated prescribing guidelines for behavioral symptoms.
Policy & Regulation 2
The FDA has approved Axsome's Auvelity (dextromethorphan/bupropion) for the treatment of agitation associated with Alzheimer's disease, providing a new pharmacologic option for this behavioral symptom.
FDA granted approval to Axsome's first non-antipsychotic treatment for agitation associated with Alzheimer's disease, marking a significant shift in pharmacologic management for this behavioral symptom.
Diagnosis & Treatment 3
The FDA has approved Axsome's Auvelity (dextromethorphan/bupropion) as the first non-antipsychotic treatment for agitation associated with Alzheimer's disease, offering a new pharmacologic option for this indication.
A randomized trial published in the BMJ demonstrates that a five-day course of theta-burst transcranial magnetic stimulation significantly improves social communication and language in autistic children with intellectual disability, offering a non-pharmacologic treatment option.
A study reveals that 50% of older patients with dementia continue psychotropic medication use one year after initiation, highlighting significant long-term prescribing persistence in this vulnerable population.
Drug Development 1
MapLight Therapeutics has completed enrollment in two Phase 2 clinical trials evaluating its investigational compounds for schizophrenia and autism spectrum disorder.
Substance Use 1
A small trial suggests semaglutide reduces heavy drinking days in patients with alcohol use disorder and obesity, highlighting a potential repurposing opportunity for GLP-1 agonists in substance use treatment.