Farmakoterapia w Psychiatrii i Neurologii

Abstract

1/2024 vol. 40
Review article

A combination of dextromethorphan with bupropion as a treatment for major depressive disorder

  1. Faculty of Medicine, Poznan University of Medical Sciences, Poland; Wydział Lekarski, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu, Polska
  2. University Clinical Hospital in Poznań, Poland; Uniwersytecki Szpital Kliniczny w Poznaniu, Polska
Farmakoterapia w Psychiatrii i Neurologii 2024, 40 (1), 25–30
Online publish date: 2024/08/01
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Objectives.

This review aims to collect information on the effectiveness of the combination of bupropion and dextromethorphan as a treatment for major depressive disorder.

Literature review.

Major depressive disorder is a global health concern. Available antidepressants primarily target monoaminergic pathways. They often have limited efficacy and unwanted side effects. Recent research emphasizes understanding antidepressant mechanisms at the receptor and molecular levels. The main focus is on neurogenesis and neuroplasticity, which has been proven to be influenced by glutamatergic transmission. In 2022 Food and Drug Administration approved Auvelity, which combines dextromethorphan, an NMDA receptor antagonist with bupropion, a norepinephrine-dopamine reuptake inhibitor. As a CYP2D6 inhibitor, bupropion prolongs the half-life of dextromethorphan. This beneficial interaction allows dextromethorphan to maintain therapeutic concentrations throughout the day. Clinical studies have shown that it is effective in treating major depressive disorder in adults and has few side effects compared to other pharmacological treatments.

Conclusions.

The combination of dextromethorphan and bupropion is an effective treatment for depression with few side effects and a rapid onset of action.

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