Auvelity vs. Wellbutrin: Effectiveness for Depression?

Medically reviewed by Carmen Pope, BPharm. Last updated on Sep 12, 2023.

Official Answer by Drugs.com

Both Auvelity and Wellbutrin are effective for depression but a small RCT (n=80) reported that Auvelity worked significantly better than Wellbutrin and took less time to start working. 43 people prescribed Auvelity experienced an overall decrease in their Montgomery-Åsberg Depression Rating Scale (MADRS) score of 13.7 points after 6 weeks compared to a decrease of 8.8 points in the 37 people prescribed bupropion (least-squares mean difference=-4.9; 95% CI=-3.1, -6.8).

At week 2 and every time point thereafter, significantly larger changes in the MADRS score and remission rates were reported with Auvelity than bupropion (-12.5 vs. -7.8, least-squares mean difference=-4.7; 95% CI=-0.6, -8.8).
In addition, 60.5% of people taking Auvelity had at least a 50% decrease in their MADRAS score at week 6 compared with only 40.5% prescribed bupropion (least-squares mean difference=19.9%, 95% CI=-1.6, 41).
Most other outcomes favored Auvelity.
The most common side effects associated with Auvelity were dizziness, nausea, dry mouth, decreased appetite, and anxiety. It was not associated with psychotomimetic effects (hallucinations or delusions), weight gain, or sexual dysfunction.

Auvelity is a combination extended-release tablet containing dextromethorphan 45mg and bupropion 105mg, and Wellbutrin XL tablets contain 150mg of bupropion. The addition of dextromethorphan to Auvelity means that it also has a direct effect on the N-methyl-D-aspartate (NMDA) receptor because dextromethorphan is an NMDA receptor antagonist. 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. Previous studies have shown that NMDA receptor antagonists can have antidepressant effects. In Auvelity, the bupropion component has a similar antidepressant effect to that experienced by people taking Wellbutrin, but , it also boosts concentrations of dextromethorphan in the blood by competitively inhibiting cytochrome P450 2D6, an enzyme in the liver that breaks it down.

Auvelity is usually given twice a day after an initial titration period and Wellbutrin XL is usually given once a day.

What's the difference between Wellbutrin XL and SR?

Wellbutrin XL is an extended release tablet which releases more slowly than the Wellbutrin SR tablet which is released faster. Wellbutrin SR is only used for major depressive disorder (MDD), whereas Wellbutrin XL can be used for both MDD and seasonal affective disorder (SAD) Continue reading

Does Auvelity work better than Wellbutrin?

Auvelity worked significantly better than Wellbutrin (bupropion) at relieving symptoms of depression in a small randomized double-blind, parallel trial that lasted for 6 weeks. It also had a faster onset of effect, with improvement in the Montgomery-Åsberg Depression Rating Scale (MADRS) score being observed as early as week 1 and differences being statistically significant by week 2. Continue reading

What makes Auvelity different from other antidepressants?

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. Continue reading

Auvelity vs. Wellbutrin: Effectiveness for Depression?

Related questions

Read next

What's the difference between Wellbutrin XL and SR?

Does Auvelity work better than Wellbutrin?

What makes Auvelity different from other antidepressants?

See also:

Aimovig

Botox

Vraylar

Nurtec ODT

Emgality

Inderal

Ajovy

Vyepti

Botox Cosmetic

Fremanezumab

Related medical questions

Drug information

Related support groups