Post-market safety profile and suicide/self-injury risk signals of dextromethorphan/bupropion: a real-world pharmacovigilance study.

Background: Dextromethorphan/bupropion (D/B) is an innovative pharmacological treatment for major depressive disorder. Nevertheless, the current evidence regarding the safety profile of D/B is predominantly derived from clinical trials, thus hindering the timely updating of adverse event (AE) data f...

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Publicado en:European Journal of Clinical Pharmacology Vol. 81; no. 7; pp. 1029 - 1042
Autores principales: Yuan, Lingjing, He, Jianping, Li, Xiangyu
Formato: research tables/charts Journal Article
Publicado: Springer Nature Jul2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2025
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        atl: Post-market safety profile and suicide/self-injury risk signals of dextromethorphan/bupropion: a real-world pharmacovigilance study.
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          Yuan, Lingjing
          He, Jianping
          Li, Xiangyu
        affil: https://ror.org/0269fty31 Shaoxing Second Hospital, Shaoxing, Zhejiang, China
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        subj:
          Suicide Psychosocial Factors
          Self-Injurious Behavior Chemically Induced
          Self-Injurious Behavior Epidemiology
          Dextromethorphan Adverse Effects
          Bupropion Adverse Effects
          Product Surveillance
          United States Food and Drug Administration
          Adverse Drug Event
          Data Mining
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          Funding Source
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          Female
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          Middle Age
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          Aged, 80 and Over
          Descriptive Statistics
          Confidence Intervals
          Odds Ratio
          Mental Disorders
          Nervous System Diseases
          Age Factors
          Age of Onset
          Drug Labeling
          Panic Disorder
          Ketamine Adverse Effects
          Drug Combinations
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          Child: 6-12 years
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
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      ab: Background: Dextromethorphan/bupropion (D/B) is an innovative pharmacological treatment for major depressive disorder. Nevertheless, the current evidence regarding the safety profile of D/B is predominantly derived from clinical trials, thus hindering the timely updating of adverse event (AE) data for this medication. Therefore, this study conducted data mining and analysis of AE signals (especially for suicide/self-injury) associated with D/B using the Food and Drug Administration Adverse Event Reporting System (FAERS) database. Methods: This study used the disproportionality method to systematically evaluate the associations between D/B and potential AEs and compared these AEs with AEs related to bupropion and esketamine by using data from the FAERS collected between the third quarter of 2022 and the second quarter of 2024. Results: A total of 2451 AE reports identifying D/B as the "primary suspect" were collected. From these reports, 81 preferred terms and 24 system organ classifications were identified, with a predominant focus on psychiatric disorders (22.07%) and nervous system disorders (18.77%). These AEs were mostly found in individuals aged 18–44 years. The median time to onset for D/B-related AEs was determined to be 2 days. Nearly 20 novel AEs identified during the labelling process were detected, such as a sensation of inebriation and panic attacks. Importantly, the risk signals for suicide/self-injury associated with D/B were significantly lower than those associated with bupropion and esketamine. However, these signals cannot be ignored in view of their serious consequences. Conclusion: Psychiatric and nervous system disorders, such as suicidal/self-injurious behaviours, require careful monitoring in clinical applications. It is imperative to conduct traditional pharmacoepidemiological research to evaluate whether D/B is linked to an increased risk of dissociative disorders in the future. Moreover, health care professionals should remain vigilant for AE signals not listed in package inserts.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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