From the Research
Auvelity, a combination of dextromethorphan and bupropion, is typically initiated at one tablet (45 mg dextromethorphan/105 mg bupropion) once daily for the first three days of treatment for major depressive disorder, and then increased to one tablet twice daily, taken at least 8 hours apart, providing a total daily dose of 90 mg dextromethorphan and 210 mg bupropion, as supported by the most recent study 1. The dosing of dextromethorphan in Auvelity is crucial for its efficacy in treating major depressive disorder.
- The medication works through a dual mechanism: dextromethorphan acts as an NMDA receptor antagonist and sigma-1 receptor agonist, while bupropion inhibits the reuptake of dopamine and norepinephrine and also prevents the metabolism of dextromethorphan, allowing it to reach therapeutic levels in the brain 2.
- Patients should take Auvelity with food if possible to reduce gastrointestinal side effects.
- The gradual titration helps minimize side effects while establishing therapeutic levels.
- Patients should be monitored for improvement in depressive symptoms, which typically begins within 1-2 weeks, though full effects may take several weeks to develop, as seen in clinical trials 3, 4. The efficacy and safety of Auvelity have been established in several studies, including a phase 3 trial and a phase 2 trial, which demonstrated significant reductions in depressive symptoms and high remission rates 1, 2.
- The most common adverse events associated with Auvelity are dizziness, nausea, dry mouth, decreased appetite, and anxiety, but it is not associated with psychotomimetic effects, weight gain, or sexual dysfunction 2.
- Real-world treatment patterns have shown that Auvelity is often used as an add-on therapy to other antidepressants, and it has been effective in treating patients with major depressive disorder who have failed to respond to other treatments 3.