Auvelity vs. Wellbutrin XL: How These Treatments for Depression Compare
Key takeaways:
Auvelity (dextromethorphan/bupropion) and Wellbutrin XL (bupropion) are antidepressants. They’re both effective at treating depression, but Auvelity may start working faster.
Common side effects of Auvelity and Wellbutrin XL include headache, nausea, and trouble sleeping. More serious side effects include suicidal thoughts or behaviors, seizures, and increased blood pressure.
GoodRx can help you save over 60% off the average retail price of generic Wellbutrin XL at certain pharmacies. And, if you’re eligible, a manufacturer savings card can help you access brand-name Wellbutrin XL for as little as $5 a month and Auvelity for as little as $10 per month.
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Table of contents
Depression is a common mental health condition that affects over 280 million people worldwide. If you have depression, it can have a big impact on your daily life. But there are many ways to treat the condition, including therapy, medication, and alternative methods like yoga.
Auvelity and Wellbutrin XL are two antidepressants that share a common ingredient: bupropion. But Auvelity also contains an ingredient called dextromethorphan. And they have a few other important differences you should know about.
What is Auvelity?
Auvelity (dextromethorphan/bupropion) is a prescription-only medication that’s FDA-approved to treat depression in adults. It’s an extended-release (ER) tablet that combines two medications: dextromethorphan and bupropion.
Pay as little as $10 on your prescription
Auvelity® (dextromethorphan HBr and bupropion HCI) patients can pay as little as $10 for a 30- or
90-day supply of AUVELITY. Terms and conditions apply.
Prescribing Information | Please see Important Safety Information and Medication Guide, including Boxed Warning
AUVELITY, AXSOME, and its logos are trademarks or registered trademarks of Axsome Therapeutics, Inc. or its affiliates. Other trademarks are property of their respective owners. ©2024 Axsome Therapeutics, Inc. All rights reserved.
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How does Auvelity work for depression?
Experts think that the dextromethorphan component of Auvelity works by blocking areas in the brain called N-methyl-D-aspartate (NMDA) receptors. Dextromethorphan also activates other areas in the brain called sigma-1 receptors. Together, these actions raise the levels of several chemicals in the brain that are thought to regulate mood. These chemicals include glutamate and serotonin.
The other ingredient in Auvelity — bupropion -— helps boost the effectiveness of dextromethorphan. It blocks the enzyme (protein) that breaks down dextromethorphan, allowing the medication to stay in the body longer. Additionally, bupropion increases levels of mood-boosting chemicals like norepinephrine and dopamine.
What is Wellbutrin XL?
The active ingredient in Wellbutrin XL (bupropion) is available in a few different forms:
Immediate-release (IR) tablets
Sustained-release (SR) tablets (Wellbutrin SR)
Extended-release (ER or XL) tablets (Wellbutrin XL, Forfivo XL)
It’s also available as Aplenzin (bupropion hydrobromide). The other forms of bupropion listed above contain bupropion hydrochloride. Hydrobromide and hydrochloride, two types of salts, are inactive ingredients that don’t affect how well the bupropion products work.
These bupropion products are FDA approved to treat depression. The XL forms are also approved to prevent seasonal affective disorder.
How does Wellbutrin XL work to treat depression?
In Auvelity, one of bupropion’s major functions is to boost the effects of dextromethorphan. But when used on its own, like in Wellbutrin XL, experts think that bupropion works mainly by increasing levels of norepinephrine and dopamine in the brain. Increasing these chemicals is thought to help treat depression symptoms.
What are the dosages for Auvelity and Wellbutrin XL?
Auvelity tablets are available in one dose. One tablet contains 45 mg of dextromethorphan and 105 mg of bupropion. The usual starting dosage is 1 tablet once a day in the morning for the first 3 days. Afterward, the usual dosage is 1 tablet by mouth twice a day. These doses should be separated by at least 8 hours.
Wellbutrin XL is available as 150 mg and 300 mg tablets. The usual starting dosage of Wellbutrin XL is 150 mg once daily in the morning. After 4 days, your healthcare provider may increase your dosage to 300 mg once daily in the morning.
Auvelity and Wellbutrin XL can be taken with or without food. You should swallow the tablets whole. This means you shouldn’t split, crush, or chew them.
How effective are Auvelity and Wellbutrin XL for treating depression?
Auvelity and Wellbutrin XL are both effective at treating depression. But when Auvelity was compared to Wellbutrin SR in a study, Auvelity was better at improving depression symptoms. This effect was seen as early as 2 weeks into treatment and continued for the entire study (6 weeks).
One potential advantage to Auvelity is how quickly it starts to work. Auvelity may be effective in as little as 1 week. Whereas, with other antidepressants — like Wellbutrin XL — it may take many weeks to see a significant improvement in depression symptoms.
What are the known side effects of Auvelity and Wellbutrin XL?
In the chart below, we compare some of the more common Auvelity and Wellbutrin XL side effects. Keep in mind that the Wellbutrin XL side effects listed below are based on studies of Wellbutrin SR 300 mg as a treatment for depression.
Side effect | Wellbutrin XL 300 mg | |
Dizziness | 16% | 7% |
Nausea | 13% | 13% |
Headache | 8% | 26% |
Diarrhea | 7% | Less than placebo |
Drowsiness | 7% | Same as placebo |
Dry Mouth | 6% | 17% |
Tremor | Not reported | 6% |
Increased sweating | 5% | 6% |
Constipation | 4% | 10% |
Trouble sleeping | 4% | 11% |
Anxiety | 4% | 5% |
Lowered or no appetite | 4% | 5% |
Sexual problems | 6% | Not reported |
What are the serious side effects of Auvelity and Wellbutrin XL?
Auvelity and Wellbutrin XL can also cause some rare but serious side effects. These include:
Seizures
New episodes of mania (high levels of energy), especially in people with bipolar disorder or risk factors for bipolar disorder
Severe psychiatric symptoms like hallucinations and paranoia
Increased blood pressure
A serious vision problem called angle-closure glaucoma
Serotonin syndrome with Auvelity (when combined with other medications that increase serotonin)
Additionally, all antidepressants have a boxed warning for suicidal thoughts and behaviors. (A boxed warning is the most serious warning the FDA can assign to a medication.) Increased suicidal thoughts and behaviors may be more likely in people younger than 25 years old. And they’re more likely to occur soon after starting therapy with these medications, or after a dose increase.
If you experience worsening or new symptoms of depression, or sudden changes in mood or behavior, contact your healthcare provider immediately. You can also call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.
If you’re pregnant or planning on becoming pregnant, taking Auvelity isn’t recommended. Animal studies have shown a link between Auvelity and harm to unborn fetuses. Though there isn’t much research on taking Wellbutrin XL during pregnancy, it’s usually not recommended. There are other antidepressants, including citalopram (Celexa) and sertraline (Zoloft), that are considered first-choice options in this scenario.
What interactions do Auvelity and Wellbutrin XL have?
Auvelity and Wellbutrin XL have possible interactions with other medications and substances. These include:
Medications that affect serotonin levels, like triptans and other antidepressants
Medications that increase the risk for seizures, like tramadol (Ultram) and diphenhydramine (Benadryl)
Medications that raise dopamine levels in the brain, like carbidopa/levodopa (Sinemet) and amantadine (Gocovri, Osmolex ER)
Alcohol
If you take any of the medications or substances listed above, your healthcare provider may adjust your dosage of Auvelity or Wellbutrin XL or recommend avoiding them altogether. But don’t make any changes to your medication regimen without talking to your provider first.
Keep in mind: This isn’t a complete list of possible Auvelity and Wellbutrin XL interactions. Before you start taking one of these medications, give your provider and pharmacist an updated list of all the medications and supplements you take, so they can check for possible interactions.
You can also read more about Auvelity and Wellbutrin XL interactions on GoodRx Health.
How to save on Auvelity and Wellbutrin XL
There are many ways to save on Auvelity and Wellbutrin XL. Both are available as brand-name medications. But you can also find Wellbutrin XL as a lower-cost generic. Depending on which medication you choose, you can:
Save with GoodRx. GoodRx can help you save over 60% off the average retail price of the generic version of Wellbutrin XL. For example, the price for 30 tablets of generic Wellbutrin XL 300 mg is as low as $9.76 at certain pharmacies with a free GoodRx coupon.
Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $5 for a 30-day supply of brand-name Wellbutrin XL and as little as $10 for a 30-day supply of Auvelity, using a savings card from the manufacturer
Can you take Auvelity and Wellbutrin XL together for depression?
No, you shouldn’t take Auvelity and Wellbutrin XL together, since both medications contain bupropion. Taking too much bupropion can lead to side effects.
The bottom line
Auvelity and Wellbutrin XL are two extended-release (ER) antidepressants that contain the ingredient bupropion. But Auvelity also contains dextromethorphan. Auvelity is usually taken twice a day and Wellbutrin XL is taken once a day.
Both medications are effective at treating depression symptoms, but Auvelity may work more quickly than Wellbutrin XL. Some common side effects of both medications include nausea, headaches, and trouble sleeping. More serious side effects include suicidal thoughts or behavior, seizures, and high blood pressure.
Why trust our experts?
References
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Huecker, M. R., et al. (2022). Bupropion. StatPearls.
Jun, C., et al. (2014). Disturbance of the glutamatergic system in mood disorders. Experimental Neurobiology.
Khabir, Y., et al. (2022). Rapid-acting oral drug (auvelity) for major depressive disorder. Annals of Medicine & Surgery.
NCS HealthCare of KY, LLC. (2022). Bupropion hydrochloride XL [package insert].
Stahl, S. M., et al. (2004). A review of the neuropharmacology of bupropion, a dual norepinephrine and dopamine reuptake inhibitor. The Primary Care Companion to the Journal of Clinical Psychiatry.
Tabuteau, H., et al. (2022). Effect of AXS-05 (dextromethorphan-bupropion) in major depressive disorder: a randomized double-blind controlled trial. TheAmerican Journal of Psychiatry.
World Health Organization. (2021). Depression.
For additional resources or to connect with mental health services in your area, call SAMHSA’s National Helpline at 1-800-662-4357. For immediate assistance, call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.
