Auvelity: the “newest latest and greatest” FDA approved medication for depression
Remember our discussion about serotonin based medications and their lack of efficacy in treating depression in most patients? Remember our discussion about the fact that new medications that come to market do not necessarily have to work BETTER, they just have to work AS GOOD to get FDA approval? Remember the toxic waste dump we have discovered about Alzheimer’s medications and their lack of efficacy?
Well kids……here is the newest drug on the market that will have pharma reps running rampant and delivering coffee and lunch and discount cards to my office soon: Auvelity. I don’t know the price range for this new drug, but if I had to guess, it will run $400 per month. https://www.multivu.com/players/English/9034852-axsome-therapeutics-announces-fda-approval-auvelity/
This is a fun new drug to poke apart. First off, this is not a creation of any new drug. This drug mixes two drugs already ON the market: Wellbutrin, which is a NDRA or norepinephrine dopamine reuptake inhibitor, and Dextromethorphan, which is a COLD MEDICATION. Mixing cold medication with Wellbutrin…..is this like the sizzurp purple drink that was a club drink a few years back? When they mixed cold medication with Red Bull or alcohol? I digress.
OK back on track here. So Wellbutrin comes in 3 versions: HCL, SR, and XL. I prefer XL for many reasons, but this newly hatched drug uses HCL extended release (so I am not sure if it is SR or XL) but it comes in a LOWER dose than we normally use. Normal Wellbutrin doses are SR/XL 150-300 at therapeutic dose, and this is 105mg dosing. So it is SUB-dosing compared to therapeutic doses of Wellbutrin currently on the market. Also note: Wellbutrin is off patent and generic so it is cheap. Repurpose a cheap drug into something new and sell it for hundreds of dollars at subtherapeutic dosing. Whyyyyyyyyyyy.
But oh it gets better. Dextromethorphan? It is also known as DMX. It is a cold medication used to help clear the snot out of your sinuses and lungs. It is found in cold medications like Robitussin and Sucrets lozenges. Those are doses of around 7mg. There are MULTIPLE WARNINGS about DMX. There are warnings of overdose, people abuse this drug to get the hallucinogenic effects of it, and some locations limit how much you can purchase at one time to prevent abuse. It is a “behind the counter” over the counter cold medicine in places much like Sudafed is to prevent using it to make meth. The mg strength of DMX in this new drug? Children should not take more than 30 mg per day and adults should not take more than 60mg per day. This new drug has 45mg.
What is the angle of Auvelity here? Repurposed drugs in the hope they work AS GOOD as other meds for depression. BUT. With a BOATLOAD of dangerous drug interactions. First off, if you have a cold and take Auvelity, you better steer clear of cold meds with DMX in it or you could easily overdose on it. Second, the drug class that DMX comes from is a known stimulant, sedative, and dissociative agent. It just depends on the dose. It is a known serotonin reuptake inhibitor (oh hey, there is that serotonin again! So we made a drug that works “just” like taking a Prozac with Wellbutrin?)
Side effects of this new drug? WHEW they are UGLY!!!
https://www.drugs.com/auvelity.html
WHY would ANY provider start this med on a patient? The risks are so extensive, the comorbid health conditions are contraindicated for use, and what is this pregnancy registry thing? Why do we not have one of those for covid vaccines but we do for a depression drug made with cough syrup?
Oh and if you are on meds such as the above…..you cannot take Auvelity either.
I can tell you how many prescriptions I will write for Auvelity. ZERO.