Medication Side-Effects for Auvelity

General Information

Manufacturer: Axsome Therapeutics

Medical Name: Auvelity (Dextromethorphan hydrobromide and bupropion hydrochloride)

Purpose: Auvelity a prescription oral medicine used to treat major depressive disorder (MDD) in adults.

Side Effect	Likelihood
Dizziness	16%
Nausea	13%
Headache	8%
Diarrhea	7%
Drowsiness (Somnolence)	7%
Dry mouth	6%
Sexual dysfunction (e.g., erectile dysfunction, decreased libido)	6%
Excessive sweating (Hyperhidrosis)	5%

Other side effects that occurred in at least 2% of patients and more frequently than placebo include

Side Effect	Occurence
Anxiety	4%
Constipation	4%
Decreased appetite	4%
Insomnia	4%
Joint pain (Arthralgia)	3%
Fatigue	3%
Tingling sensation (Paresthesia)	3%
Blurred vision	3%

Side Effect	Description
Suicidal thoughts and behaviors	There is a Boxed Warning for an increased risk of suicidal thoughts and behaviors, especially in young adults under the age of 25.
Seizures	The risk of seizures is higher in patients with a history of seizure disorders, eating disorders (bulimia or anorexia nervosa), or those who abruptly stop using alcohol or certain medications like benzodiazepines.
High blood pressure (Hypertension)	Blood pressure should be monitored before and during treatment with Auvelity.
Manic episodes	Auvelity may trigger manic episodes in individuals with bipolar disorder.
Serotonin syndrome	A potentially life-threatening condition when taken with certain other medicines (e.g., SSRIs, MAOIs).
Severe allergic reactions	Symptoms can include rash, itching, hives, and swelling of the face, lips, tongue, or throat.
Psychosis and other neuropsychiatric reactions	Includes delusions, hallucinations, paranoia, and confusion.

Auvelity is not suitable for patients with certain preconditions. These include:
- a history of seizures or conditions that increase seizure risk, such as severe head injury or brain tumor.
- Individuals with a current or past diagnosis of bulimia or anorexia nervosa should also avoid Auvelity due to a higher seizure risk associated with bupropion.
Other contraindications include abrupt discontinuation of alcohol, benzodiazepines, barbiturates, or antiepileptic drugs, as this can increase the risk of seizures. Auvelity should not be used with or within 14 days of stopping monoamine oxidase inhibitors (MAOIs) due to the potential for serious interactions like hypertensive crisis and serotonin syndrome. This includes reversible MAOIs such as linezolid or intravenous methylene blue.
Patients with a known allergy or hypersensitivity to bupropion, dextromethorphan, or any other ingredient in Auvelity should not use the medication. Severe liver impairment and severe kidney impairment (eGFR 15 to 29 mL/min/1.73 m²) are also contraindications. Additionally, individuals with untreated anatomically narrow angles should not use Auvelity.
Auvelity is generally not advised during pregnancy or breastfeeding due to potential risks to the baby. A screening for bipolar disorder is recommended before starting treatment, as Auvelity may trigger mania or hypomania.