Dextromethorphan–bupropion

Auvelity treats major depression in adults and agitation associated with Alzheimer dementia. It is scheduled treatment, not an as-needed calming medicine. It does not cure dementia.

Dextromethorphan acts at NMDA and sigma-1 sites. Bupropion affects norepinephrine and dopamine and slows dextromethorphan breakdown, allowing it to remain active longer.

Sleep, energy, or appetite may change before mood improves. Benefit usually builds over several weeks; some conditions need a longer trial at a useful dose.

Track the symptoms you are treating and how you manage daily activities. Keep follow-up appointments. Schedule an earlier appointment if your mood gets worse.

• Swallow tablets whole, with or without food. Do not split, crush, or chew.
• Follow the prescribed schedule; when twice daily, doses are separated by at least eight hours.
• If you miss a dose, skip it. Do not double or exceed the prescribed daily amount.
• Do not recreate the combination using cough medicine and separate bupropion.

• Dizziness or sleepiness
• Nausea, diarrhea, or constipation
• Dry mouth, sweating, or headache
• Sexual side effects or changes in appetite

Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.

Antidepressants can increase suicidal thoughts in people under 25. Watch for changes in mood or behavior at any age, especially when starting treatment or changing a dose.

Tell your provider about emotional numbness, unusual agitation, or a reduced need for sleep with increased energy. These changes may call for a treatment adjustment.

Have blood pressure checked. For agitation, track frequency, severity, and safety with a caregiver. Review falls, confusion, and possible medical triggers.

For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.

Do not take with a seizure disorder, current or past anorexia or bulimia, or during abrupt withdrawal from alcohol, benzodiazepines, barbiturates, or antiseizure medicines. Discuss bipolar symptoms, head injury, glaucoma, and kidney or liver disease.

Pregnancy is not recommended during treatment. If pregnant or possibly pregnant, contact your provider promptly for stopping and alternative-treatment instructions. Do not breastfeed during treatment or for five days afterward.

Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.

Do not combine with other bupropion-containing medicines or unreviewed dextromethorphan preparations. Other serotonergic medicines can add serotonin-syndrome risk.

MAOIs require at least a 14-day gap in either direction. Strong CYP2D6 inhibitors and other interacting medicines may require a different schedule.

Limit or avoid alcohol; consult with your provider before abruptly stopping heavy alcohol or sedative use.

A regular dose time and refill reminder can help prevent missed doses.

Bring a few specific observations to appointments: sleep, motivation, anxiety, and activities that have become easier or harder.

Keep medication in its labeled container, away from excess heat and moisture and out of reach of children and pets. Do not share it. Ask a pharmacy about disposal of unused medication.