Dr. Chris Aiken and Kellie Newsome discuss controversies around Auvelity, a fast-acting antidepressant, examining side effects, addictive potential, and generic components. They explore the combination of dextromethorphan and bupropion, generic substitution risks, treatment options for resistant depression, and concerns about long-term efficacy and medication use.
Auvelity offers fast relief for depression, but watch out for side effects like dizziness and dry mouth.
Combining dextromethorphan with bupropion can be cost-effective and provide rapid relief from depression.
Deep dives
Side Effects of Oveleti
Oveleti, a combination of bupropion and dextromethorphan, works fast and boosts antidepressant efficacy. However, it also comes with side effects like sleepiness, somnolence, nausea, dizziness, headache, and dry mouth. Although no cases of psychosis, dissociation, serotonin syndrome, or addictive behaviors were reported, there is a possibility of experiencing mania on this drug.
Controversies: Abuse Potential and Generic Component
Oveleti and dextromethorphan are not classified as controlled substances, but dextromethorphan has a history of misuse. While the clinical trials did not show evidence of abuse, it is important to note the potential for abuse when combined with bupropion, as their interaction could push the drug into the abusable range. Additionally, there are potential generic substitutions for Oveleti, using separately prescribed dextromethorphan and bupropion, which can provide the same beneficial effects at a lower cost.
Combining Dextromethorphan with Other Antidepressants
Although it may be tempting to combine dextromethorphan with other antidepressants like duloxetine or fluoxetine, caution is advised. These medications, being serotonin medications, can potentially cause serotonin syndrome when combined with dextromethorphan, which itself is an unknown serotonin reuptake inhibitor. The combination of dextromethorphan and bupropion is ideal for patients in need of rapid relief from depression, especially those who are hospitalized.
Auvelity, a new rapid acting medication for depression, is a branded combination of two generic drugs. We look at its side effects, addictive potential, and whether you can just use the generic components.
Chris Aiken, MD, and Kellie Newsome, PMHNP have disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.
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