Curation and Extraction of Drug-Related Entities from Reddit Platform

Automated Drug Combination Extraction (DCE) from large-scale biomedical literature is crucial for advancing precision medicine and pharmacological research. However, existing relation extraction methods primarily focus on binary interactions and struggle to model variable-length n-ary drug combinations, where complex compatibility logic and distributed evidence need to be considered. To address these limitations, we propose RexDrug, an end-to-end reasoning-enhanced relation extraction framework for n-ary drug combination extraction based on large language models. RexDrug adopts a two-stage training strategy. First, a multi-agent collaborative mechanism is utilized to automatically generate high-quality expert-like reasoning traces for supervised fine-tuning. Second, reinforcement learning with a multi-dimensional reward function specifically tailored for DCE is applied to further refine reasoning quality and extraction accuracy. Extensive experiments on the DrugComb dataset show that RexDrug consistently outperforms state-of-the-art baselines for n-ary extraction. Additional evaluation on the DDI13 corpus confirms its generalizability to binary drugdrug interaction tasks. Human expert assessment and automatic reasoning metrics further indicates that RexDrug produces coherent medical reasoning while accurately identifying complex therapeutic regimens. These results establish RexDrug as a scalable and reliable solution for complex biomedical relation extraction from unstructured text. The source code and data are available at https://github.com/DUTIR-BioNLP/RexDrug

Treatment-resistant depression (TRD) is a severe form of major depressive disorder in which patients do not achieve remission despite multiple adequate treatment trials. Evidence across pharmacologic options for TRD remains limited, and trials often do not fully capture patient-reported tolerability. Large-scale online peer-support narratives therefore offer a complementary lens on how patients describe and evaluate medications in real-world use. In this study, we curated a corpus of 5,059 Reddit posts explicitly referencing TRD from 3,480 subscribers across 28 mental health-related subreddits from 2010 to 2025. Of these, 3,839 posts mentioned at least one medication, yielding 23,399 mentions of 81 generic-name medications after lexicon-based normalization of brand names, misspellings, and colloquialisms. We developed an aspect-based sentiment classifier by fine-tuning DeBERTa-v3 on the SMM4H 2023 therapy-sentiment Twitter corpus with large language model based data augmentation, achieving a micro-F1 score of 0.800 on the shared-task test set. Applying this classifier to Reddit, we quantified sentiment toward individual medications across three categories: positive, neutral, and negative, and tracked patterns by drug, subscriber, subreddit, and year. Overall, 72.1% of medication mentions were neutral, 14.8% negative, and 13.1% positive. Conventional antidepressants, especially SSRIs and SNRIs, showed consistently higher negative than positive proportions, whereas ketamine and esketamine showed comparatively more favorable sentiment profiles. These findings show that normalized medication extraction combined with aspect-based sentiment analysis can help characterize patient-perceived treatment experiences in TRD-related Reddit discourse, complementing clinical evidence with large-scale patient-generated perspectives.

Patients increasingly seek medication information online, yet safety knowledge for psychiatric drugs is split between regulatory adverse-event records, which are authoritative but abstract, and patient narratives, which are experience-near but unvalidated. Integrating them without conflating evidence and anecdote is especially consequential in psychiatry, where poorly contextualised information can amplify fear, nocebo responses, and non-adherence. Here we develop a provenance-aware, knowledge-graph-based multi-agent framework unifying 466,525 Reddit posts, 60,782 WebMD reviews, and twenty years of U.S. FDA Adverse Event Reporting System records for nine antidepressants. A large-language-model entity-recognition pipeline benchmarked against physician annotations reached highest F1 scores of 0.969 for medications and 0.973 for conditions. The two community platforms were far more concordant with each other (overlap up to a Jaccard similarity of 0.905) than with regulatory reports, indicating that patient-generated data form a partly independent safety signal. For sertraline, many adverse events appeared in community sources hundreds of days before the corresponding FDA date. A Neo4j knowledge graph grounded in ATC-N, ICD-10, and MedDRA vocabularies preserves provenance, keeping every claim traceable and regulatory facts distinct from patient experience. These results establish source-aware integration as a route to more auditable psychiatric medication information, with usefulness and patient benefit to be tested prospectively.