What makes Auvelity different from other antidepressants?

Drugs.com

Official answer

by Drugs.com

Auvelity is a combination oral tablet for depression containing dextromethorphan and bupropion that works differently from other antidepressants because it has a direct effect on the N-methyl-D-aspartate (NMDA) receptor as well as possibly other traditional neurotransmitter effects. It also works much faster than traditional antidepressants, and it does appear to be more effective.

Dextromethorphan, more commonly known for its traditional role as a cough suppressant, works by blocking the NMDA receptor. NMDA receptors are located on nerve cells, mostly at excitatory synapses, and research has shown that they can become overstimulated when glutamate levels are high. This is the basis for the glutamate hypothesis of depression. Glutamate is an excitatory neurotransmitter that is important for memory, cognition, and mood. It gets released during excitement or stress, but in some people, this system can be turned on for hours, days, or months at a time. When levels of glutamate are high all the time, they overstimulate the NMDA receptor which results in two main effects:

  • The NMDA receptor loses its responsiveness and needs more and more glutamate to get activated
  • All this extra glutamate cascades over and is toxic, damaging nerves, synapses, and supporting cells.

    • Usually, the body has a way of removing extra glutamate and recycling it, but this process can become ineffective if levels of glutamate remain high for prolonged periods. Previous studies have shown that antagonists of the NMDA receptor have antidepressant effects. For example, infusions of low-dose ketamine, which is an NMDA receptor antagonist, are associated with significant decreases in depression symptoms.

    Bupropion has traditionally been thought to work on noradrenergic and dopaminergic pathways in the brain, although the exact way it works is unknown. In Auvelity, perhaps its main role is that it boosts concentrations of dextromethorphan in the blood by competitively inhibiting cytochrome P450 2D6, an enzyme in the liver that breaks it down.

    Trials have also shown that Auvelity works faster than other antidepressants, with rapid symptom improvement being noted in as early as 1 week. In addition, more people experienced symptom remission by week 2 than those taking placebo. Continued effects were seen at week 6. Symptom improvement was based on the overall change in a depression symptom scale that evaluated: sadness, inner tension, reduced sleep and appetite, difficulty concentrating or doing daily activities, lack of interest, lack of energy/motivation and ability to feel, pessimism, and thoughts of suicide.

    Related medical questions

    Disclaimer

    Every effort has been made to ensure that the information provided by Drugslib.com is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Drugslib.com information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Drugslib.com does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Drugslib.com's drug information does not endorse drugs, diagnose patients or recommend therapy. Drugslib.com's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.

    The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugslib.com does not assume any responsibility for any aspect of healthcare administered with the aid of information Drugslib.com provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

    Popular Keywords