Profiling the combination of bupropion and dextromethorphan as a treatment option for major depressive disorder.

A review of the neurobiology of major depressive disorder and the pharmacology, efficacy, safety, and tolerability of dextromethorphan hydrobromide combined with bupropion hydrochloride (Auvelity®) for adults. The combination is an approved alternative for MDD, usable as a first-line therapy, as a second option after failed remission with a serotonin-targeting agent, and for treatment-resistant depression. Clinicians' familiarity with both drugs may increase acceptability, and further research into other indications, including addiction disorders, may yield additional benefits. The review is based on observational studies, clinical trials, and other secondary studies from systematic literature searches.

Study at a glance

Abstract

Major Depressive Disorder (MDD) is a common mental health disorder marked by sadness, hopelessness, and anhedonia. Various therapies exist, but their effectiveness is limited. Dextromethorphan hydrobromide combined with bupropion hydrochloride (Auvelity®) is a recently approved alternative for treating this condition in adults. This review summarizes the neurobiology of major depression and delves into the pharmacology, efficacy, safety, and tolerability of dextromethorphan plus bupropion in adult patients. It is based on observational studies, clinical trials, and other secondary studies obtained through systematic literature searches. The combination of bupropion and dextromethorphan as a new pharmacotherapy for mental health is an interesting addition to the treatment options that can be used for MDD. The combination can be used in a range of scenarios, including as a first line therapy, as a second option when a patient has failed to achieve remission with a serotonin targeting agent, and for treatment resistant depression. Further research for other indications, including addiction disorders, may provide exciting results. Although a new combination, clinicians will be very familiar with both agents, increasing their acceptability. This pharmacotherapy also may bring increased impetus for discovering other combinations that may have beneficial synergistic effects.