Zulresso vs. Drizalma Sprinkle

Zulresso (brexanolone) Injection and Drizalma Sprinkle (duloxetine delayed-release capsules) are antidepressants used to treat depression.

Zulresso is specifically used to treat postpartum depression (PPD) in adults. Zulresso is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the Zulresso REMS.

Drizalma Sprinkle is also used to treat generalized anxiety disorder in adults and pediatric patients ages 7 years to 17 years old, diabetic peripheral neuropathic pain in adults, and chronic musculoskeletal pain in adults.

Zulresso and Drizalma Sprinkle are different types of antidepressants. Zulresso is a neuroactive steroid gamma-aminobutyric acid (GABA) A receptor positive modulator and Drizalma Sprinkle is a selective serotonin and norepinephrine reuptake inhibitor (SNRI).

Side effects of Zulresso and Drizalma Sprinkle that are similar include drowsiness and dry mouth.

Side effects of Zulresso that are different from Drizalma Sprinkle include sleepiness, loss of consciousness, flushing, and hot flushes.

Side effects of Drizalma Sprinkle that are different from Zulresso include nausea, constipation, decreased appetite, and increased sweating.

Both Zulresso and Drizalma Sprinkle may interact with other antidepressants.

Zulresso may also interact with CNS depressants (e.g., opioids, benzodiazepines).

Drizalma Sprinkle may also interact with monoamine oxidase inhibitors (MAOIs), triptans, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, St. John's wort, cimetidine, ciprofloxacin, enoxacin, nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, warfarin, quinidine, phenothiazines, type 1C antiarrhythmics, aluminum-and magnesium-containing antacids, famotidine, proton pump inhibitors (PPIs), theophylline, caffeine, centrally acting CNS drugs, highly plasma protein binding drugs, and alcohol.

Common side effects of Zulresso include:

• nausea
• diarrhea
• dry mouth
• constipation
• vomiting
• gas
• dizziness
• abnormal dreams
• itching, and
• decreased sexual desire

Antidepressants such as Zulresso increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term studies. Tell your doctor if you experience any thoughts of suicide while taking Zulresso.

Common side effects of Drizalma Sprinkle include:

• nausea,
• dry mouth,
• drowsiness,
• constipation,
• decreased appetite, and
• increased sweating

Zulresso (vortioxetine) tablets are an antidepressant indicated for the treatment of major depressive disorder (MDD).

Drizalma Sprinkle (duloxetine delayed-release capsules) is a serotonin and norepinephrine reuptake inhibitor (SNRI) indicated for major depressive disorder in adults, generalized anxiety disorder in adults and pediatric patients ages 7 years to 17 years old, diabetic peripheral neuropathic pain in adults, and chronic musculoskeletal pain in adults.

Zulresso may interact with monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), triptans, buspirone, tramadol, tryptophan products, NSAIDs, aspirin, warfarin, bupropion, fluoxetine, paroxetine, quinidine, rifampicin, carbamazepine, and phenytoin. Tell your doctor all medications and supplements you use.

Drizalma Sprinkle may interact with monoamine oxidase inhibitors (MAOIs), triptans, tricyclic antidepressants, other SNRIs or SSRIs, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, St. John's wort, cimetidine, ciprofloxacin, enoxacin, nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, warfarin, quinidine, phenothiazines, type 1C antiarrhythmics, aluminum-and magnesium-containing antacids, famotidine, proton pump inhibitors (PPIs), theophylline, caffeine, centrally acting CNS drugs, highly plasma protein binding drugs, and alcohol. Tell your doctor all medications and supplements you use. Tell your doctor if you are pregnant or plan to become pregnant before using Drizalma Sprinkle; third trimester use may increase risk of symptoms of poor adaptation (respiratory distress, temperature instability, feeding difficulty, low muscle tone, tremor, irritability) in newborns. There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to antidepressants during pregnancy. Drizalma Sprinkle passes into breast milk but its effects on nursing infants are unknown. Consult your doctor before breastfeeding.

The recommended starting dose of Zulresso is 10 mg administered orally once daily without regard to meals. Dosage should then be increased to 20 mg/day, as tolerated.

The dose of Drizalma Sprinkle is 60 mg daily for most conditions.