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this post was submitted on 23 Jul 2024
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chapotraphouse
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The closest OTC thing to that is DXM (yeah, the cough syrup drug). Auvelity is a new prescription antidepressant that is a combined formulation of DXM and Bupropion. Unfortunately it is crazy expensive and unlikely to be covered by insurance, so a lot of people just try using DXM this way without the Bupropion.
I've seen a lot of success stories using this method, many also claim it's a great anxiolytic. But tread carefully, always do your own extensive research when using an OTC med for chronic off label use if you don't have access to a doctor. Like most antidepressant drugs, DXM has withdrawal symptoms. Nowhere near as bad as opioids, but definitely worse than a heavy caffeine habit. It's also very addictive to a small subset of people, so exercise extreme caution there as well.
Some psychiatrists are prescribing buproprion and DXM under separate scripts but in the same dosages as Auvelity to achieve the exact same outcome.
DXM will still work on its own, without bupropion, but it won't be nearly as effective as an antidepressant.
Yeah it's hard to say how effective DXM is on its own, I'm not sure whether there's much research on it if any. But it's worth noting because it's definitely an SNRI. I know some people who don't tolerate Bupropion very well, in those cases it might be worth trying.
It's only an SNRI in its pro drug form, which is DXM. The reason it is prescribed with Wellbutrin is because it prevents your body from turning DXM into DXO, which is a powerful disassociative.
Additionally the half-life of DXM doesn't make it a very effective SNRI without changing the body's metabolism. The Wellbutrin is the component that changes metabolism.
I've done a lot of personal research with both DXM and it's active metabolite. And have some undergraduate education in pharmacology. I really don't recommend it.