| Common Brands | Auvelity |
|---|---|
|
Drug Class |
Antidepressant |
|
Controlled Substance Classification |
Not a controlled medication |
|
Generic Status |
No Lower-cost generic available |
|
Availability |
Prescription only |
Auvelity is an oral prescription drug mainly for the treatment of patients with major depressive disorder (MDD) in adults. The manufacturer is Axovant Gene Therapies, and the medication is the first FDA-approved drug for the treatment of depression that brings together dextromethorphan and bupropion.
The medication Auvelity has indicated some promise in major depression treatment, particularly for patients who did not respond well to antidepressants like selective serotonin reuptake inhibitors (SSRIs) and other medicines such as serotonin-norepinephrine reuptake inhibitors (SNRIs).
As mentioned before, Auvelity is administered orally once daily with or without food. The tablet form of the drug may be taken as directed by the health care professional.
Initiation Dose: The usual recommended dosing is one 45 mg tablet once daily.
Dose Tapering: In some cases, after a week of treatment, the dosing may be escalated to a single 90 mg tablet per day, depending on the response of the patient to the treatment.
Maximum Dosage: The maximum recommended dose is 90 mg once daily.
It is necessary not to take more than the prescribed dose and to strictly follow the dosing schedule so that side effects will be kept at bay. Skipping or suddenly stopping Auvelity could result in re-emergence of depression symptoms.
Auvelity works through the combined effects of dextromethorphan and bupropion.
In action, dextromethorphan acts on the NMDA receptor in the brain involved in regulating the glutamate neurotransmitter system. Modulating the glutamatergic system has its neuroprotective effect and is believed to enhance mood, improve cognitive function, and neuroplasticity that may improve symptoms in depression.
Bupropion works by inhibiting the reuptake of dopamine and norepinephrine, two neurotransmitters that are often found to be imbalanced in individuals with depression. By increasing the availability of these neurotransmitters in the brain, bupropion helps regulate mood and energy levels, which are typically impaired in people suffering from depression.
Like all drugs, Auvelity has side effects. Most and most serious include:
Common Side Effects:
Headache: A frequently occurring side effect, especially in the initial stages of treatment.
Fatigue: Some individuals may become more easily fatigued when initiating treatment.
Insomnia: Sleeping difficulty is also common, though this can be resolved over time.
Serious Side Effects:
Severe Allergic Reactions: Although not very common, severe allergic reactions can occur with some aspect of rash, itchiness, or swelling.
Risk of Seizure: Bupropion, part of Auvelity, has been identified as a drug that lowers the seizure threshold, resulting in seizure increasing. Patients diagnosed with seizure disorders, or the history of eating disorder, or alcohol/substance abuse should avoid taking Auvelity.
Serotonin Syndrome: A potentially life-threatening condition characterized by agitation, hallucinations, fever, and muscle stiffness has been reported, but only rarely, when used in combination with other serotonergic medications.
Suicidal Thoughts: As the above statements mention, there is an increased risk of suicidal thoughts or actions in young adults and children. Monitor patients closely, especially during the initial times of treatment or when a dose change is made.
Seizures: Because of the possibility of seizures, Auvelity should not be used in patients with a history of seizure, eating disorders (such as bulimia or anorexia nervosa), or patients undergoing abrupt alcohol withdrawal.
Alcohol Use: Alcohol must be used cautiously during treatment with Auvelity as it can induce seizures. Patients must avoid alcohol as much as possible with this medication.
Pregnancy and Breastfeeding: Safety of Auvelity during pregnancy and breastfeeding has not yet been established. Women who are pregnant, plan to become pregnant, or breastfeed need to have a talk with their physician before using the drugs.
Other Drugs: Patients should provide information on other drugs or medications that they may be taking over the counter, herbs, and supplements, as some of the drug interactions predispose to side effects.
Monoamine Oxidase Inhibitors (MAOIs): Combining Auvelity with MAOIs (e.g., phenelzine, tranylcypromine) can cause serious side effects like high blood pressure, serotonin syndrome, or other severe reactions, so the combination should be avoided.
Serotonergic Drugs: Using Auvelity with other serotonergic medications (e.g., SSRIs, SNRIs, or triptans) increases the risk of serotonin syndrome, which can cause symptoms like confusion, fever, and rapid heart rate.
Alcohol and CNS Depressants: Taking Auvelity with alcohol or other central nervous system depressants (e.g., benzodiazepines) can increase sedation and impair motor functions, leading to drowsiness, dizziness, and difficulty concentrating.
Bupropion-containing Medications: Combining Auvelity with other bupropion-containing medications (e.g., Wellbutrin) increases the risk of side effects, such as seizures, as bupropion can lower the seizure threshold.
Initial Dose: Dose the patient at 45 mg/day.
One Week Later: If not intolerable, increase to 90 mg/day based on patient response.
Maximum Dose: The maximum recommended dose is 90 mg once daily.
Auvelity is strictly a prescription-only medication. Only a licensed healthcare provider can prescribe Auvelity based on the medical history of the patient, all his symptoms, and any other drugs he might be taking.
Auvelity is a prescription medication approved for the treatment of major depressive disorder (MDD) in adults. It combines two active ingredients: dextromethorphan and bupropion.
Auvelity works by affecting neurotransmitters in the brain, particularly by modulating the activity of glutamate, which is thought to play a role in mood regulation. Dextromethorphan is an NMDA receptor antagonist, while bupropion is a norepinephrine and dopamine reuptake inhibitor.
Common side effects may include:
Auvelity is taken orally, typically in tablet form. The prescribed dosage and schedule will be determined by your healthcare provider.
The usual starting dose is 1 tablet taken once daily in the morning. Your doctor may adjust the dosage based on your response and tolerability.
You should always disclose all medications you’re taking to your healthcare provider, as Auvelity can interact with other drugs, particularly those that affect serotonin levels, and those that increase the risk of seizures.
Auvelity is not classified as a controlled substance and is generally considered non-addictive, but individual responses can vary. Discuss any concerns with your doctor.
Auvelity should not be taken by individuals with a history of seizures, eating disorders, or hypersensitivity to bupropion or dextromethorphan.
Some patients may start to notice an improvement in symptoms within the first week, but it may take several weeks (up to 6-8 weeks) for the full effects to be realized.
It’s essential to consult with your healthcare provider before stopping Auvelity to prevent withdrawal symptoms or a potential worsening of depression.
The safety of Auvelity in pregnancy or while breastfeeding is not well-established. Discuss with your healthcare provider for tailored advice based on your situation.
Weight changes can occur with any antidepressant, but Auvelity has not been specifically associated with significant weight gain in clinical studies. Individual reactions may vary.
Auvelity can cause dizziness or drowsiness, so you should assess how the medication affects you before driving or operating heavy machinery.
While Auvelity is not primarily a serotonin modulator, it’s essential to be cautious when taken with other serotonergic medications, as it could theoretically contribute to serotonin syndrome.
The long-term effects of Auvelity are still being studied, but as with any medication, it’s important to have regular consultations with your healthcare provider to monitor any potential issues.
While intended to improve mood, some individuals may experience mood changes, including agitation or increased anxiety. Report these symptoms to your doctor.
Coverage for Auvelity can vary depending on your insurance plan. Check with your insurance provider to confirm whether it’s covered and any associated costs.
If you miss a dose, take it as soon as you remember. If it’s close to the time of your next dose, skip the missed dose and return to your regular schedule. Do not double the dose.
For more information, consult your healthcare provider, or refer to the official medication guide and reputable medical websites for detailed information about Auvelity.
If you experience severe side effects such as seizures, severe dizziness, or any signs of serious allergic reactions, seek immediate medical attention.
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