Treatment of agitation associated with Alzheimer's disease with a combination of bupropion and dextromethorphan
Disclosed herein is a method of safely treating a nervous system condition with a combination of dextromethorphan and bupropion. This method is intended for patients having a neurological condition or a psychiatric condition, such as major depressive disorder, and a CYP2D6 poor metabolizer genotype or a CYP2D6 poor metabolizer phenotype.
1 . A method of treating agitation associated with Alzheimer's disease in a human patient having agitation associated with Alzheimer's disease comprising: 1) orally administering a first dosage form once daily for one week to the human patient, then administering the first dosage form twice daily to the human patient for one week; and 2) then orally administering a second dosage form twice daily to the human patient for at least one week; wherein the human patient has mild or moderate hepatic impairment;
wherein the first dosage form comprises about 30 mg of dextromethorphan hydrobromide, or a molar equivalent amount of another salt form of dextromethorphan or the free base form of dextromethorphan, about 105 mg of bupropion hydrochloride, or a molar equivalent amount of another salt form of bupropion or the free base form of bupropion, and a polymer;
wherein the second dosage form comprises about 45 mg of dextromethorphan hydrobromide, or a molar equivalent amount of another salt form of dextromethorphan or the free base form of dextromethorphan, and about 105 mg of bupropion hydrochloride, or a molar equivalent amount of another salt form of bupropion or the free base form of bupropion; and
wherein the first and second dosage forms are bilayertablets, wherein the bupropion and the dextromethorphan in each of the tablets are in separate layers.
2 . The method of claim 1 , wherein the first or second dosage form further comprises colloidal silicon dioxide.
3 . The method of claim 1 , wherein the first or second dosage form further comprises crospovidone.
4 . The method of claim 1 , wherein the first or second dosage form further comprises glyceryl monocaprylocaprate.
5 . The method of claim 1 , wherein the first or second dosage form further comprises L-cysteine hydrochloride monohydrate.
6 . The method of claim 1 , wherein the first or second dosage form further comprises magnesium stearate.
7 . The method of claim 1 , wherein the first or second dosage form further comprises microcrystalline cellulose.
8 . The method of claim 1 , wherein the first or second dosage form further comprises polyvinyl alcohol.
9 . The method of claim 1 , wherein the first or second dosage form further comprises sodium lauryl sulfate.
10 . The method of claim 1 , wherein the first or second dosage form further comprises stearic acid.
11 . The method of claim 1 , wherein the first or second dosage form further comprises titanium dioxide.
12 . The method of claim 1 , wherein the polymer is a carbomer homopolymer.
13 . The method of claim 1 , wherein the first or second dosage form further comprises: carbomer homopolymer, colloidal silicon dioxide, crospovidone, glyceryl monocaprylocaprate, L-cysteine hydrochloride monohydrate, magnesium stearate, microcrystalline cellulose, polyvinyl alcohol, red iron oxide, sodium lauryl sulfate, stearic acid, talc, titanium dioxide, or yellow iron oxide, or a combination thereof.
14 . The method of claim 1 , wherein the first or second dosage form comprises about 105 mg of bupropion hydrochloride.
15 . The method of claim 1 , wherein the first dosage form comprises about 30 mg of dextromethorphan hydrobromide.
16 . The method of claim 14 , wherein the first dosage form comprises about 30 mg of dextromethorphan hydrobromide.
17 . The method of claim 1 , wherein the second dosage form comprises about 45 mg of dextromethorphan hydrobromide.
18 . The method of claim 14 , wherein the second dosage form comprises about 45 mg of dextromethorphan hydrobromide.
19 . The method of claim 1 , wherein the dextromethorphan is formulated for immediate release.
20 . The method of claim 19 , wherein the bupropion is formulated for extended release.