Qelbree

[deleted1100659]

Anyone have experience with this? Havent been able to get a drug rep to provide samples yet or anything so I have no experience with it

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[Stagg737]

Haven't used it but we have plenty of brochures for it in our clinic. Basically sounds like a new Strattera with some slight serotonergic effects that may or may not be clinically relevant. Probably won't be using it anytime soon unless someone is treatment resistant and I've got access to samples.

 

[clausewitz2]

Not gonna lie, thought this was an obscure Breton cheese at first. I wonder about the clinical experience with it as an AD in Europe.

 

[calvnandhobbs68]

Yeah I don't understand the point of it personally. I'd like the clinical trials to be thrown into a meta-analysis compare head to head against stimulants and Strattera. I mean just from the receptor binding profile, it's like a really weak version of Strattera? Which is borne out by the dosing (100-400mg). Even Strattera is seemingly more serotonergic than it based on the binding profile and Strattera isn't really serotonergic at all....

New Insights into the Mechanism of Action of Viloxazine: Serotonin and Norepinephrine Modulating Properties - PMC

Viloxazine was historically described as a norepinephrine reuptake inhibitor (NRI). Since NRIs have previously demonstrated efficacy in attention deficit/hyperactivity disorder (ADHD), viloxazine underwent contemporary investigation in the treatment ...

www.ncbi.nlm.nih.gov

I have the sense it's just a marketing ploy to try to get a new expensive ADHD drug out there. Just like all the crap I got the other day about "Azstarys"...another ADHD dexmethylphenidate formulation seeking a reason to exist lol

 

[Merovinge]

Yeah I don't understand the point of it personally. I'd like the clinical trials to be thrown into a meta-analysis compare head to head against stimulants and Strattera. I mean just from the receptor binding profile, it's like a really weak version of Strattera? Which is borne out by the dosing (100-400mg). Even Strattera is seemingly more serotonergic than it based on the binding profile and Strattera isn't really serotonergic at all....

New Insights into the Mechanism of Action of Viloxazine: Serotonin and Norepinephrine Modulating Properties - PMC

Viloxazine was historically described as a norepinephrine reuptake inhibitor (NRI). Since NRIs have previously demonstrated efficacy in attention deficit/hyperactivity disorder (ADHD), viloxazine underwent contemporary investigation in the treatment ...

www.ncbi.nlm.nih.gov

I have the sense it's just a marketing ploy to try to get a new expensive ADHD drug out there. Just like all the crap I got the other day about "Azstarys"...another ADHD dexmethylphenidate formulation seeking a reason to exist lol

ADHD is one of the few disorders we treat where: A) effect size of meds is large B) meds are better than therapy C) long-term data supports treatment concretely improving lives. No surprise its a routinely targeted "me too" place for pharma companies, they would be fools not to.

Separately, completely agree that I have seen nothing about Qelbree that looks to be meaningful.

 

[clozareal]

I have yet to use this. It seems to be a faster form of Strattera and has been studied for the past 5 decades, so the safety data is there. It has an orphan drug designation from the FDA for narcolepsy. It has also been studied for nocturnal enuresis and depression but it didn't gain approval for either. The effect size seems to be moderate from the RCTs of about 0.547 for the lower dose and 0.623 for the higher one which about the same when compared with Strattera's reported effect sizes of about 0.6-0.7 in children and much lower than the stimulant effect sizes of 0.9-1.7 in children (although Strattera's effect size in adults is comparable to methylphenidates).

The biggest difference from Strattera is that Qelbree separated from placebo by week 1, more quickly than Strattera which separated at week 3. The RCT had some problematic analysis though since they used post hoc analysis to do crossover mapping for some of their outcome measures to the CGI.

For me, it'll take some more replication studies before I'd try it before Strattera or the host of other options for ADHD. It's only been tested in children so I wouldn't use it in adults yet.

 

[liquidshadow22]

i barely see any success with strattera. most people hate the side effects and give up on it after a week. most people get angry on it, irritable, more depressed and stop it.

 

[Jules A]

i barely see any success with strattera. most people hate the side effects and give up on it after a week. most people get angry on it, irritable, more depressed and stop it.

I start low, increasing as indicated and it has been well tolerated overall with decent results in those not simply angling for a stimulant.

 

[Merovinge]

i barely see any success with strattera. most people hate the side effects and give up on it after a week. most people get angry on it, irritable, more depressed and stop it.

In CAP or adults? Evidence base and effects in the CAP space are very well established when people understand that effects are not going to be present day 1 (as opposed to the stimulants).