Subject : A survey to assess the usage pattern of FDC of Dextromethorphan and Bupropion in the management of depression in India
Major depressive disorder (MDD) is a debilitating disease that is characterized by at least one discrete depressive episode lasting at least 2 weeks and involving clear-cut changes in mood, interests and pleasure, changes in cognition and vegetative symptoms. Depression is a common mental health disorder that can affect both the mental and physical health. The number of incident cases of depression worldwide increased from 172 million in 1990 to 258 million in 2017, representing an increase of 49.86%. In 2017, 197•3 million people had mental disorders in India, including 45•7 million with depressive disorders and 44•9 million with anxiety disorders.
Treatment options for management of depression can be broadly be divided into antidepressants, electroconvulsive therapy (ECT) and psychosocial interventions. In general, because of the side effect and safety profile, selective serotonin reuptake inhibitors (SSRIs) are considered to be the first line antidepressants. Other preferred options include tricyclic antidepressants, mirtazapine, bupropion, and venlafaxine
Dextromethorphan-bupropion combination tablet represents a novel rapid-acting oral treatment option for depression in adults. Dextromethorphan’s primary potential for MDD treatment is theorized to be due to its uncompetitive antagonism of the ionotropic glutamate receptor NMDA in the central nervous system. NMDA inhibition leads to downstream activation of AMPA, a suspected target for enhancing neuronal plasticity and by association improved antidepressant effect. Bupropion is also a potent inhibitor of CYP2D6, and thereby inhibits the metabolism of dextromethorphan.
In a phase 3 trial with dextromethorphan-bupropion 45−105 mg for patients with major depressive disorder saw significant reductions in their MADRS total scores compared to placebo. A phase 2 trial comparing dextromethorphan-bupropion 45−105 mg to bupropion monotherapy led to significant reduction in MADRS score. Changes in MADRS with dextromethorphan-bupropion were seen within two weeks in both clinical trials. Clinical 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. This survey is conducted to assess the usage pattern of FDC of Dextromethorphan and Bupropion in the management of depression in India.
As you will be spending some extra time to give your feedback on the questionnaire based on your clinical experience, we offer to pay you by cheque a professional fee of Rs {{$contractAmount}}, on receiving the completed Survey Questionnaire Form from you.
We trust you and we are partners in promoting safe and effective drug therapy. In that spirit we hope you will consent to participate in this study. If you do, please sign and return the enclosed reply along with your visiting card for accuracy of records.
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