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Spravato vs. Auvelity

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Spravato

(esketamine)

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Auvelity

(dextromethorphan / bupropion)

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Summary for Spravato

Prescription only

Spravato (esketamine) is used for adults with treatment-resistant depression (TRD). It also treats adults who have depression with suicidal thoughts or behavior. As an NMDA antagonist, it works in the brain to regulate mood. Spravato (esketamine) is a nasal spray that you must use at a treatment center. At first, you take it twice a week for 4 weeks. After that, people with treatment-resistant depression can take it once a week. Side effects include feeling sleepy and dissociated (disconnected from your thoughts or feelings). Side effects can be serious, so you must join the Spravato REMS program to get treatment.

Indications for Spravato

Pros and Cons for Spravato

Pros

  • Generally only need to take 1 or 2 times each week
  • Available through a REMS program that helps makes sure the medication is used safely
  • Can be used by itself for people with treatment-resistant depression who've already tried 2 oral antidepressants

Cons

  • Can't give the medication to yourself at home (must go to a treatment center to take)
  • Requires 2 to 3 sprays in each nostril for each dose
  • Serious risks of sleepiness; slowed breathing; and feeling disconnected with your thoughts, feelings, and sense of self

Common Side Effects for Spravato

  • Dissociation (disconnected from your thoughts, feelings, or sense of self, 41%)
  • Dizziness (29%)
  • Nausea (28%)
  • Sleepiness (23%)
  • Vertigo (feeling like the room is spinning, 23%)
  • Headache (20%)
  • Changes in taste (19%)
  • Numbness (18%)
  • Anxiety (13%)
  • Feeling sluggish (11%)
  • Higher blood pressure (10%)

Warnings for Spravato

  • Sleepiness, slowed breathing, and dissociation
  • Potential for misuse and dependence
  • Must enroll in the Spravato REMS program to get treated
  • Suicidal thoughts and behaviors in young adults
  • Higher blood pressure
  • Problems with your mental abilities (e.g., thinking, concentrating, remembering)
  • Bladder problems
  • Harm to an unborn baby

Summary for Auvelity

Prescription only

Auvelity (dextromethorphan / bupropion) is a newer antidepressant that's taken by mouth. It can work faster than some other antidepressants, but it's not a good choice for people with a history of seizures, eating disorders, severe kidney or liver problems, or alcohol abuse.

Indications for Auvelity

  • Depression

Pros and Cons for Auvelity

Pros

  • Works faster to treat depression symptoms compared to other antidepressants
  • Can be taken with or without food
  • Works well to improve depression symptoms in adults
  • Conveniently combines two medications into one tablet

Cons

  • Not recommended while pregnant or breastfeeding
  • Not studied in children
  • Brand only, so might be expensive
  • Can interact with many medications

Common Side Effects for Auvelity

  • Dizziness (16%)
  • Nausea (13%)
  • Headache (8%)
  • Diarrhea (7%)
  • Drowsiness (7%)
  • Dry mouth (6%)
  • Sexual problems (e.g., erectile dysfunction, low sex drive; 6%)
  • Sweating a lot (5%)

Warnings for Auvelity

  • Suicidal thoughts or behavior
  • Seizures
  • High blood pressure
  • Changes in thoughts, mood, or behavior
  • Serotonin syndrome
  • Harm to unborn babies

Prices with our coupons for Spravato vs. Auvelity

Price Card Drug Icon
Spravato1 nasal spray / three 28mg nasal sprays of 84mg
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Price Card Drug Icon
Auvelity60 tablets / 45mg/105mg
$1,199.00$1,503.95
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