Dolorac Nasal Solution (doxepin nasal spray) / Winston Pharma - LARVOL DELTA

Intranasal delivery of doxepin: enhancing brain targeting efficiency utilizing nanostructured lipid carriers for a biopharmaceutics drug disposition classification system class-I drug. (PubMed, Pharm Dev Technol) - "High-drug targeting efficiency (DTE = 284.3%) and direct transport percentage (DTP = 64.8%) suggested direct penetration of NLCs in the brain via olfactory and trigeminal pathways. In conclusion, the study highlights the potential of NLCs to improve the bioavailability of doxepin through nose-to-brain delivery and thereby potentially enable the treatment of neurological disorders."

Journal • CNS Disorders

[VIRTUAL] Trial of a Mu-Opioid Antagonist for Treatment- Refractory PTSD-Associated Nightmares (APA 2021) - "Nightmares in PTSD have been managed with SSRIs, SNRIs, anticonvulsants, prazosin, clonidine, topiramate, atypical antipsychotics, trazodone, and vilazodone...He reported past trials of escitalopram, vilazodone, bupropion, cariprazine, vortioxetine, lurasidone, and intranasal ketamine over the course of ten years. Past trials of prazosin, mirtazapine, and trazodone failed to treat his sleep disturbance. He completed a course of ECT, during which time treatment was initiated with duloxetine 60mg once daily and depressive symptoms resolved...Quetiapine, gabapentin, and doxepin were prescribed to improve sleep quality, while clonidine and topiramate were given to treat nightmares, but the sleep disturbance continued unabated...Sleep quality finally improved only with chlorpromazine 100- 200mg nightly... A limited evidence base makes it difficult to draw firm conclusions as to the utility of MOAs in the treatment of PTSD. Since small studies show success with MOAs for PTSD,..."

CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Post-traumatic Stress Disorder • Psychiatry • Sleep Disorder