thoughtscape NP Psychiatry · Patient education
Dextromethorphan-Bupropion
Auvelity • two medicines in one prescription tablet
Scheduled treatment for adult depression or Alzheimer's-related agitation. Each use has its own starting schedule.
Draft for review · Clinical content has not been revalidated for this website.
The diagram's author-requested alpha1D action still awaits functional verification; no benefit is inferred.
What it is used for
For adult major depression or Alzheimer's-related agitation. Not an as-needed calming medicine, dementia cure, or treatment for children.
Uses of either ingredient alone, or dextromethorphan-quinidine, do not automatically apply to Auvelity.
How it works
Dextromethorphan acts at NMDA and sigma-1 sites. Bupropion affects norepinephrine and dopamine and slows dextromethorphan breakdown.
The full therapeutic mechanism is uncertain. Cough medicine plus separate bupropion is not an equivalent.
What to expect over time
STARTING
Follow your indication-specific plan. Kidney function, interactions, or drug processing may require once-daily treatment.
EARLY WEEKS
Dizziness may precede benefit. Track mood, sleep, and function; report worsening without waiting for the next visit.
AT REVIEW
For agitation, track frequency, severity, and safety with a caregiver. Sleepiness is not the same as improvement.
Taking your medication
Take only the prescribed dose. Once-daily doses are taken in the morning. Never exceed 2 tablets in 24 hours; some people must stay at one.
Take with or without food; swallow whole. Do not crush, chew, or split. If a dose is missed, skip it and take the next at its usual time. Never double.
Do not drive until effects are clear. Limit or avoid alcohol, but get medical help before stopping heavy alcohol or sedative use abruptly.
When to get help
Call 911: seizure, collapse, severe breathing trouble, or immediate self-harm danger. After a seizure, stop Auvelity and never restart it.
Urgent care: fever with confusion, shaking, or stiffness; severe headache or chest pain; eye pain/vision changes; swelling or blistering rash.
Call promptly: suicidal thoughts, worse mood, unusually high energy with little sleep, hallucinations, marked dizziness, confusion, or unsteadiness.
Early side effects
Dizziness, sleepiness, dry mouth, sweating, headache, or bowel upset can occur. Food may ease nausea. Prevent falls and keep up dental care.
Other effects to discuss
Blood pressure, sleep, sexual function, or appetite can change. Report persistent or disruptive effects; do not change treatment on your own.
What to keep track of
Check blood pressure before and during treatment; review mood, falls and medicines. Kidney or sodium tests may be needed; routine Auvelity levels are not. Tell testing staff: unexpected amphetamine screens need a specific confirmatory test.
Before you start
Discuss seizures, any history of anorexia, or bulimia, bipolar disorder, suicide risk, head injury, glaucoma, high blood pressure, heart disease, low sodium, kidney/liver problems, diabetes, falls and all medicines. Seizure disorder, current, or past anorexia/bulimia, abrupt alcohol/sedative withdrawal, and ingredient allergy can rule out this treatment. Check pregnancy plans and breastfeeding before starting.
Medicines & interactions
MAOIs and switching
Allow at least 14 days between Auvelity and an MAOI in either direction. Linezolid and IV methylene blue also need coordinated care; never combine them on your own.
Duplicate or serotonin medicines
Check cough products containing dextromethorphan, other bupropion, antidepressants, tramadol, triptans, and supplements. Combining certain medicines can cause seizures or serotonin toxicity.
Metabolism and other medicines
Some medicines require once-daily Auvelity or an alternative. It can raise levels of some drugs and reduce activation of others. Review digoxin, levodopa, amantadine, and seizure-risk medicines.
Alcohol, nicotine, and stimulants
Discuss alcohol or sedative withdrawal safely. Review nicotine medicines, stimulants, appetite products, and recreational drugs; blood pressure or seizure risk may increase.
Everyday tips
Use reminders and a written schedule. Check the tablet strength and instructions whenever a prescription changes.
Track mood, sleep, and function. Report new suicidal thoughts or unusual behavior, especially after a dose change.
For agitation, assess pain, infection, medicines, and environmental triggers with the care team; medication is only part of care.
Keep follow-ups and refill early. Review every new medicine with the pharmacist before starting or stopping it.
Your questions, answered
Can I stop it or split it to taper?
Agree on an individual stopping plan. There is no standard labeled taper, and tablets must not be split. A seizure is different: stop and never restart; get emergency help.
What about pregnancy?
Auvelity is not recommended. Contact your prescriber right away if pregnant or possibly pregnant: the label directs stopping it and arranging alternative treatment. Plan alternatives before pregnancy.
Can I breastfeed?
Do not breastfeed during treatment or for 5 days after the final dose. Discuss a feeding and treatment plan with your care team.
What if I take too much?
Call Poison Help at 1-800-222-1222 or go to an emergency department immediately, even if you feel well. Call 911 for a seizure, collapse, or breathing trouble.
Storage & safety
Keep in its original bottle at room temperature, secured away from children and pets. Never share. Ask a pharmacy about take-back disposal.
About this information
For general information only; not a substitute for individualized medical advice. This sheet does not cover every risk or interaction. Ask your prescriber or pharmacist before changing how you take this medication.
Sources
Educational inclusion does not mean this medication or its indications are treated at this practice. Review the guide for your exact product with your prescriber or pharmacist.