Auvelity (Dextromethorphan-Bupropion) for Major Depressive Disorder
At Philadelphia Integrative Psychiatry, we pride ourselves on our expertise in the latest mental health treatments and our commitment to providing the most up-to-date care for our patients. Our focus on cutting-edge research ensures that we are well-equipped to discuss and recommend innovative treatments like Auvelity for Major Depressive Disorder (MDD).
In our continuous effort to offer evidence-based care, we have closely examined the efficacy and safety of Auvelity (dextromethorphan-bupropion), a novel medication approved for treating MDD in adults. This medication stands out due to its unique mechanism of action, combining dextromethorphan and bupropion to target multiple neurotransmitter systems, potentially offering benefits for patients who have not found success with other treatments. Sources such as clinical trials and reputable medical journals underscore its rapid onset of action and its distinct approach compared to traditional antidepressants.
For patients considering Auvelity, it's important to weigh the potential benefits against the possible side effects. Clinical studies highlight its effectiveness in improving mood symptoms in adults with MDD, with some patients experiencing benefits as early as one week after starting treatment. However, discussing any concerns about side effects or interactions with a healthcare provider is crucial for making an informed decision.
Dosing Instructions
Initial Dosing: Take one tablet once a day for the first three days.
Subsequent Dosing: After three days, increase to two tablets daily, spaced at least 8 hours apart.
Maximum Dose: Do not exceed two tablets within 24 hours.
Administration: Tablets can be taken with or without food and should be swallowed whole without breaking, crushing, or chewing.
Potential Side Effects
Dizziness
Headache
Somnolence (sleepiness)
Diarrhea
Dry mouth
Sweating
Contraindications
Patients with a history of seizures or bipolar disorder should use Auvelity with caution.
Regular monitoring of blood pressure is recommended due to the potential for increases.
Special consideration is needed for patients with renal or hepatic impairment, cardiac issues, and for elderly patients.
Medications to Avoid with Auvelity
MAO Inhibitors: Avoid use within 14 days of MAO inhibitors due to the risk of hypertensive crisis.
CYP2D6 Substrates: Bupropion, a component of Auvelity, can inhibit CYP2D6, potentially increasing the levels of medications metabolized by this enzyme. Some common examples are listed at the bottom of this post.
At Philadelphia Integrative Psychiatry, our holistic approach to treatment encompasses innovative options like Auvelity within a broader strategy that includes therapy, lifestyle adjustments, and nutrition. This comprehensive care model allows us to treat the whole person, not just the symptoms, aligning with our philosophy of personalized, patient-centered care.
For further reading on Auvelity and its application in treating Major Depressive Disorder, please consult the following journal article: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9577655/].
Here are the brand names of some mental health medications that are metabolized by CYP2D6:
Fluoxetine - Prozac
Paroxetine - Paxil
Venlafaxine - Effexor
Desipramine - Norpramin
Nortriptyline - Pamelor
Amitriptyline - Elavil
Haloperidol - Haldol
Risperidone - Risperdal
Duloxetine - Cymbalta
Thioridazine - Mellaril
Perphenazine - Trilafon
Doxepin - Sinequan
Imipramine - Tofranil
Clomipramine - Anafranil
Aripiprazole - Abilify
Atomoxetine - Strattera
Please note that this list is not exhaustive and there may be other mental health (as well as non-mental health) medications metabolized by CYP2D6. Additionally, the brand names may vary by country and over time.
Citations:
[1] https://www.omicsonline.org/open-access/psychotropic-medications-metabolized-by-cytochromes-p450-cyp2d6-enzyme-and-relevant-drug-interactions-2167-065X-1000162.php?aid=79609
[2] https://go.drugbank.com/categories/DBCAT002623
[3] https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2773579
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6901912/
[5] https://www.sciencedirect.com/science/article/abs/pii/S0165178117313306
