Auvelity

What is Auvelity?

Auvelity is a combination antidepressant medicine used to treat major depressive disorder (MDD) in adults. Auvelity contains dextromethorphan, an NMDA receptor antagonist, and bupropion, a norepinephrine-dopamine reuptake inhibitor (NDRI). 

Auvelity works by targeting multiple brain pathways involved in depression. Dextromethorphan works by blocking NMDA receptors, increasing the levels of glutamate, a chemical messenger (neurotransmitter),  to improve mood and brain connectivity. While bupropion helps dextromethorphan last longer in the body and increases dopamine and norepinephrine levels to improve depression symptoms.

Auvelity’s usual dose is 1 tablet taken once daily for 3 days, followed by 1 tablet twice daily, separated by at least 8 hours.  Tablets should be swallowed whole and not crushed or chewed.

Auvelity is a rapid-acting antidepressant that started working as early as 1 week, and patients’ depression symptoms continued to improve over time when compared to placebo in a 6-week clinical study for MDD (Study 1, NCT04019704).

Auvelity became an FDA-approved medicine on August 18, 2022, for adults with major depressive disorder (MDD).

How does Auvelity work?

Auvelity’s active ingredient, dextromethorphan, works as a N-methyl D-aspartate (NMDA) receptor antagonist and is also an agonist at the sigma-1 receptors. This helps to improve depressive symptoms by increasing glutamate levels, changing glutamate signalling, and regulating other neurotransmitters.

The second active ingredient, bupropion, helps dextromethorphan work more effectively by slowing how quickly it’s broken down in the body. It does this by blocking an enzyme called CYP2D6, allowing dextromethorphan to stay active longer. As a norepinephrine-dopamine reuptake inhibitor, bupropion also helps improve mood by increasing levels of dopamine and norepinephrine in the brain.

What is the cost of Auvelity?

The cost of prescription drugs varies depending on your insurance plan and which pharmacy you use. Refer to our price guide page for more information about the cost of Auvelity.

You may also be eligible for an Auvelity savings card or an Auvelity coupon. Ask your doctor or pharmacist if you qualify.

Auvelity side effects

Common Auvelity side effects

The most common Auvelity side effects include:

• dizziness
• diarrhea
• dry mouth
• excessive sweating
• headache
• feeling sleepy
• sexual function problems

Serious Auvelity side effects

Also, see Warnings.

Auvelity may cause serious side effects, including:

Seizures. There is a risk of seizures during treatment with this medicine. The risk is higher in people who:

• take higher doses of this medicine
• have certain medical problems
• take it with certain other medicines

Do not take Auvelity with other medicines unless your healthcare provider tells you to.
If you have a seizure during treatment, stop taking this medicine and call your healthcare provider right away. Do not take this medicine again if you have a seizure.

Increases in blood pressure (hypertension). Some people may get high blood pressure during treatment. Your healthcare provider should check your blood pressure before you start taking and during treatment.

Manic episodes. Manic episodes may happen in people with bipolar disorder who take Auvelity. Symptoms may include:

• greatly increased energy
• racing thoughts
• unusually grand ideas
• talking more or faster than usual
• severe trouble sleeping
• reckless behavior
• excessive happiness or irritability

Unusual thoughts or behaviors. One of the ingredients in Auvelity (bupropion), can cause unusual thoughts or behaviors, including delusions (believing you are someone else), hallucinations (seeing or hearing things that are not there), paranoia (feeling that people are against you), or feeling confused. If this happens to you, call your healthcare provider.

Eye problems (angle-closure glaucoma). Auvelity may cause a type of eye problem called angle-closure glaucoma in people with certain other eye conditions. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are. Call your healthcare provider if you have eye pain, changes in your vision, or swelling or redness in or around the eye.

Dizziness. this medicine may cause dizziness, increasing your fall risk.

Serotonin syndrome. A potentially life-threatening problem called serotonin syndrome can happen when you take Auvelity with certain other medicines. Call your healthcare provider or go to the nearest hospital emergency room right away if you have any of the following signs and symptoms of serotonin syndrome:

• agitation
• seeing or hearing things that are not there (hallucinations)
• confusion
• coma
• fast heartbeat
• changes in blood pressure
• dizziness
• sweating
• flushing
• high body temperature (hyperthermia)
• shaking (tremors), stiff muscles, or muscle twitching
• loss of coordination
• seizures
• nausea, vomiting, diarrhea