Initiating dextromethorphan-bupropion extended release in patients with major depressive disorder: Delphi panel expert consensus recommendations.

Publication/Presentation Date

6-1-2026

Abstract

OBJECTIVE: To establish consensus recommendations for initiating dextromethorphan-bupropion extended release (45 mg/105 mg) (AUVELITY) for the treatment of major depressive disorder (MDD) in adults.

METHODS: US-based healthcare providers (HCPs,

RESULTS: The panel reached consensus on 27 final recommendations with a mean overall agreement score of 3.8. Key consensus recommendations (abbreviated here) included: (1) dextromethorphan-bupropion is recommended as a first-line treatment for MDD, including with co-occurring symptoms of anxiety; (2) HCPs should individualize treatment decisions that prioritize safety considerations noted in the Prescribing Information; (3) dextromethorphan-bupropion is recommended for patients with inadequate response, residual symptoms, and/or intolerable side effects associated with prior MDD treatment(s); (4) when switching from (or adding to current) medication, the potential for a drug interaction should be considered, consistent with the dextromethorphan-bupropion label; and (5) switching from ketamine or esketamine should be done with caution, and with an awareness of the short-to-intermediate elimination half-lives of these drugs.

CONCLUSION: These consensus panel recommendations provide real-world guidance for initiating MDD treatment with dextromethorphan-bupropion extended release and address any perceived barriers for scenarios of interest.

Volume

42

Issue

6

First Page

1243

Last Page

1256

ISSN

1473-4877

Disciplines

Medicine and Health Sciences

PubMedID

42454904

Department(s)

Department of Medicine

Document Type

Article

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