Wait a Minute...Cough Syrup or Antidepressant?? (Auvelity)
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- Опубликовано: 8 фев 2025
- Auvelity (dextromethorphan/bupropion), FDA-approved for Major Depressive Disorder. "Wellbutrin-DM??" Everything you need to know.
Join me for an overview of this novel antidepressant and for a discussion of NMDA receptors, their antagonists, and the implications for neuronal proliferation (neuroplasticity).
At 15:02 I misspeak and say "bupropion" when I meant _dextromethorphan._
Thanks for covering this medication!
From a neuroplasticity and cognition standpoint - for long term treatment in atypical ptsd presenting without significant anxiety - would you prefer DXM & Bupropion vs Fluoxetine/Vortioxetine & Bupropion?
First of all, let me say that I have very limited experience when it comes to prescribing this newer medication, but also I am definitely no expert when it comes to atypical cases of PTSD. PTSD is an anxiety disorder, so I would be loathe to call any syndrome without that core diagnostic feature (even one following a traumatic event, with some symptom-overlap) "PTSD," but at the end of the day, it's all just semantics; it doesn't matter what we call the syndrome, what matters are the target symptoms, and without knowing yours, it would be impossible for me to opine intelligently about what might work better for you.
However, all other things being equal, just theoretically, I would expect an NMDA antagonist, or any agent that improves neuroplasticity via the actions of glutamate, to be superior to a serotonergic agent, although both mechanisms, and all 3 of the agents you mention are known to increase brain-derived neurotrophic factor (BDNF) and promote dendritic branching and spine maturation. I couldn't find any head-to-head studies, however.
Thanks for your question!
Can be used with SSRI ??
Yes, in reasonable doses. Always confer with your prescriber, and be sure to disclose all medications you are taking, including over-the-counter preparations. The main concern would be avoiding serotonin syndrome.