Key points
- The label lists two approved uses: major depressive disorder in adults, and agitation associated with dementia due to Alzheimer's disease.
- Its boxed warning covers suicidal thoughts and behaviors in children, teens and young adults.
- Bupropion can cause seizures, so the label rules it out for people with a seizure disorder or a current or past diagnosis of bulimia or anorexia.
- It can raise blood pressure, and many cough and cold products also contain dextromethorphan.
- Do not stop it suddenly or on your own: MedlinePlus says to talk with your doctor first.
What this combination is
Auvelity is a single extended-release tablet with two active ingredients. Dextromethorphan is also found in many cough medicines, and bupropion is an antidepressant sold on its own. You can read about it separately on our bupropion page.
This page sums up the FDA label and MedlinePlus. It is general information, and it is written for readers thinking about depression care. Our list of medicines covers others.
What it is approved for
The current FDA label lists two approved uses. The first is major depressive disorder (MDD) in adults. The second is agitation associated with dementia due to Alzheimer's disease, and the label adds that it is not meant as an as-needed treatment for that agitation.
It is not approved for children or teens. This page describes only the label's approved uses. Our psychiatrist's care described on this page is for depression. For questions about a family member with dementia, please talk with their own doctor.
How it is thought to work
The two ingredients do different jobs. The label says bupropion raises dextromethorphan levels by blocking an enzyme, CYP2D6, that normally breaks dextromethorphan down. Dextromethorphan acts on NMDA receptors, which respond to the brain chemical glutamate, and on sigma-1 receptors.
Even so, the label says the way dextromethorphan works in depression is unclear. The way bupropion works in depression is also unclear, and may relate to norepinephrine and dopamine. Unlike many antidepressants, bupropion does not block serotonin reuptake.
What taking it can be like
MedlinePlus says to swallow the tablets whole, without splitting, chewing or crushing them, and that they can be taken with or without food. Before and during treatment, the label calls for checking blood pressure, screening for a history of bipolar disorder, mania or hypomania, and making sure you are not taking anything else with bupropion or dextromethorphan.
That last check matters in ordinary life. MedlinePlus warns that many cough and cold products contain dextromethorphan, and that doubling up could cause severe side effects. Check with your pharmacist before picking up a cold remedy.
The National Institute of Mental Health (NIMH) notes that medicines affect people in different ways. Dizziness is a common effect here, so the label advises taking care to avoid falls and being careful with machinery. The label also says this medicine can cause false positive urine test results for amphetamines. It is not a controlled substance, according to the label, though the label notes cases of dextromethorphan abuse and says people with a history of drug abuse should be observed closely for misuse.
Boxed warning and who should not take it
The boxed warning is about suicidal thoughts and behaviors. Antidepressants increased this risk in children, teens and young adults in short-term studies. Everyone taking an antidepressant should be closely watched for worsening depression and new suicidal thoughts.
If you are in crisis or thinking about harming yourself, call or text 988, or call 911. Locascio Wellness does not provide emergency services. You can also see our crisis resources.
The label says this medicine must not be used by people:
- With a seizure disorder.
- With a current or past diagnosis of bulimia or anorexia nervosa.
- Who are abruptly stopping alcohol, benzodiazepines, barbiturates or antiepileptic medicines.
- Taking an MAOI, or within 14 days of stopping either an MAOI or this medicine.
- With a known allergy to bupropion, dextromethorphan or other ingredients.
Side effects and other warnings
In depression studies, the most common side effects in the label were dizziness, headache, diarrhea, sleepiness, dry mouth, sexual side effects and heavy sweating. In the Alzheimer's agitation studies they were dizziness and indigestion.
MedlinePlus says not to stop it without talking to your doctor, because stopping suddenly may bring serious effects such as mood changes, agitation, irritability, dizziness and shock-like sensations. Tell your prescriber if you are pregnant, plan to become pregnant or are breastfeeding, because the label has specific warnings about each.
Other serious risks named in the label include seizures, which are dose-related and can be made more likely by other medicines; raised blood pressure and hypertension; mania or hypomania; psychosis and other neuropsychiatric reactions, such as delusions, hallucinations, paranoia and confusion; angle-closure glaucoma; serotonin syndrome, with more risk alongside SSRIs or tricyclic antidepressants; and low sodium. The label also says to avoid it with severe liver impairment.
Can it be managed online in Pennsylvania and New York
The label does not require a clinic setting to take it, but it does call for blood pressure checks. A video visit can cover your history and other medicines, while a blood pressure reading has to come from a home cuff or a local visit. Ask about how that would work.
A licensed psychiatrist on our team, a Doctor of Osteopathic Medicine (DO), treats depression by secure video for people physically located in Pennsylvania or New York during each visit. Whether it is an option for you is a decision for you and your prescriber. Ask us whether our psychiatrist can help. See online depression treatment, psychiatry in New York or send us a medication question.
Our therapists do not prescribe. Their depression therapy is by video in Pennsylvania, West Virginia, Arizona, Colorado and Florida, not New York, so New York readers can get psychiatry here but not therapy here. Asking these questions early is a strong and practical thing to do.
Common questions
Is Auvelity the same as taking cough medicine with bupropion?
No, and you should not try to recreate it. Auvelity is a specific FDA-approved extended-release tablet. MedlinePlus warns against taking more than one product containing bupropion or dextromethorphan at a time, including many cough and cold products, because too much can cause severe side effects. Ask your pharmacist or prescriber before using any cold remedy.
Why does a past eating disorder matter with this medicine?
The label rules this medicine out for anyone with a current or past diagnosis of bulimia or anorexia nervosa. It explains that a higher rate of seizures was seen in such patients taking immediate-release bupropion. Tell your prescriber about this history even if it was many years ago, since it affects whether this medicine can be considered.
Is Auvelity a controlled substance?
The label says dextromethorphan and bupropion are not controlled substances. It also says the combination has not been systematically studied for abuse, tolerance or physical dependence, and that cases of dextromethorphan abuse have been reported, so prescribers should watch closely for misuse in people with a history of drug abuse.
Can your psychiatrist prescribe Auvelity online?
We cannot say a visit will lead to any particular medicine. Our psychiatrist treats depression by secure video for people physically located in Pennsylvania or New York during each visit. Whether it is an option for you is a decision for you and your prescriber. Ask us whether our psychiatrist can help, and about fees and insurance.
Sources
Published by Locascio Wellness. Published November 5, 2026. Clinically reviewed by Kenneth M. Levy, DO, Psychiatrist (Pennsylvania license OS007464L). This page is general information, not medical advice or a diagnosis.