Auvelity Side Effects: What They Are and How to Manage Them

Starting a new antidepressant can feel like moving into a new apartment: you’re hopeful, you’re nervous, and you’re
pretty sure you’ll discover something weird in the first week. If you’ve been prescribed Auvelity
(dextromethorphan-bupropion), you’re not alone in wondering: What side effects might pop up, and what can I do
about them?

This guide breaks down the most common Auvelity side effects, the “call your clinician ASAP” ones,
and the practical, real-life tricks that can make the first few weeks a lot smoother. It’s educationalnot a
substitute for medical careso use it as a map, not a DIY prescription pad.

What Auvelity is (and why side effects can feel “two-in-one”)

Auvelity is a prescription medication approved to treat major depressive disorder (MDD) in adults.
It combines two active ingredients:

• Dextromethorphan (yes, the same ingredient found in some cough medicinesthough in Auvelity it’s
  used for brain signaling, not a cold).
• Bupropion, an antidepressant that also changes how your body processes dextromethorphan.

Because it’s a combo, side effects can come from either componentor from how they work together. The bupropion
piece can be a bit “activating” for some people (more energy, lighter sleep), while dextromethorphan can be more
“brain-signal” focused and may contribute to dizziness, stomach upset, or sleepiness in some folks. Translation:
your experience can be unique, but it’s usually predictable enough to plan for.

The most common Auvelity side effects (and how to outsmart them)

In clinical trials, the most common side effects included dizziness, headache, diarrhea, sleepiness
(somnolence), dry mouth, sexual dysfunction, and increased sweating. Nausea, anxiety, constipation,
decreased appetite, and insomnia also showed up for some people.

1) Dizziness

What it’s like: Lightheadedness, feeling “off balance,” or the classic “why does the hallway feel
slightly longer than yesterday?”

• Try this: Stand up slowly, especially from bed or the couch. Hydrate consistently.
• Safety move: Be extra careful on stairs, in the shower, or when driving until you know how
  you react.
• Call your prescriber if: dizziness is severe, causes falls, or doesn’t improve over time.

2) Nausea (and other stomach drama)

What it’s like: Mild queasiness, reduced appetite, or a stomach that’s suddenly “picky.”

• Try this: Take it with a small snack (unless your prescriber told you otherwise). Eat smaller,
  more frequent meals. Ginger tea or peppermint can help some people.
• Keep it practical: Avoid greasy, heavy meals right around dosing if nausea is your main issue.
• Call your prescriber if: nausea is persistent, severe, or comes with dehydration.

3) Headache

What it’s like: Pressure-y headaches, often early on as your body adjusts.

• Try this: Hydration + regular meals + consistent sleep timing.
• Medication note: Ask your clinician/pharmacist what pain relievers are okay for you,
  especially if you have other medical conditions or take other meds.
• Call your prescriber if: headaches are intense, new/worsening, or paired with vision changes.

4) Diarrhea (or constipation)

What it’s like: Your digestive system temporarily acts like it’s in a group chat with your brain.

• For diarrhea: Hydrate, consider bland foods for a day or two, and avoid excess caffeine.
• For constipation: Add fiber slowly, drink water, and keep gentle movement in your day.
• Call your prescriber if: symptoms are severe, persistent, or you notice signs of dehydration.

5) Sleepiness (somnolence) or insomnia

What it’s like: Some people feel more drowsy; others feel more wired. Your brain may pick one…
or audition both in the same week.

• Try this: Keep a steady bedtime and wake time. Limit caffeine late in the day. Reduce screen
  brightness before bed.
• Timing matters: Auvelity is typically taken in the morning at first; if you move to twice
  daily, doses are separated by at least 8 hours. If sleep is a problem, ask your prescriber whether adjusting
  timing could help.
• Call your prescriber if: insomnia is persistent, you feel unusually activated, or your sleep
  is falling apart.

6) Dry mouth

What it’s like: Your mouth becomes the Sahara, and suddenly you understand why people carry
water bottles like they’re emotional support items.

• Try this: Sip water, chew sugar-free gum, or use sugar-free lozenges.
• Dental tip: Dry mouth can raise cavity risk, so keep up with brushing/flossing.

7) Increased sweating (hyperhidrosis)

What it’s like: You’re not nervousyou’re just… glossy.

• Try this: Breathable clothing, a small fan at night, and staying hydrated.
• Call your prescriber if: sweating is severe, sudden, or paired with fever/confusion/rigidity
  (more on that below).

8) Sexual side effects

What it’s like: Lower libido, delayed orgasm, or erectile difficulties (in people who have
erections). Not everyone gets this, but it can be frustrating and very real.

• Try this: Give it timesome sexual side effects improve as your body adjusts. Track patterns.
• Don’t suffer in silence: Tell your prescriber. Options might include dose timing changes,
  switching meds, or adding strategies to reduce the impact.

9) Anxiety, restlessness, or feeling “amped”

What it’s like: A jittery edge, more worry than usual, or a “can’t sit still” vibe.

• Try this: Reduce caffeine, add a short daily walk, and use simple breathing routines.
• Track it: Note when it happens (after dosing? evenings?). Patterns help your prescriber help
  you.
• Call your prescriber if: anxiety is intense, worsening, or comes with big mood changes.

Side effects that deserve faster attention

Most side effects are mild-to-moderate and improve with time. But some are higher-stakes and should be treated as
“don’t wait and see” situations.

High blood pressure (hypertension)

Auvelity can raise blood pressure in some people, so clinicians typically check your blood pressure before
starting and monitor during treatment.

• Be extra cautious if: you already have high blood pressure, heart disease, or you use nicotine
  or high amounts of caffeine.
• Call your prescriber promptly if: you notice pounding headaches, chest discomfort, or
  consistently high readings (if you monitor at home).

Seizures

Auvelity contains bupropion, which can increase seizure risk in a dose-related way. This is one reason it has
specific contraindications (for example, people with seizure disorders or certain eating disorders should not take
it).

• Risk increases with: taking more than prescribed, combining with other bupropion products, or
  using certain other medications that lower seizure threshold.
• Emergency rule: if a seizure occurs, seek urgent medical care.

Serotonin syndrome

Because Auvelity includes dextromethorphan, combining it with certain antidepressants (like SSRIs or tricyclics)
or other serotonergic drugs can raise the risk of serotonin syndrome, a potentially life-threatening
reaction.

• Get urgent help if you develop: sudden confusion, agitation, fever, heavy sweating, fast
  heartbeat, muscle stiffness/tremor, or coordination problemsespecially after a medication change or a new
  combination.
• Prevention tip: Always tell your prescriber about every medication and supplement you take,
  including cough/cold products.

Mania or hypomania (especially with bipolar disorder risk)

Antidepressants can sometimes trigger manic or hypomanic episodes in people who have bipolar disorder or certain
risk factors (like a strong family history).

• Call your prescriber if you notice: unusually elevated mood, racing thoughts, risky
  decision-making, much less need for sleep, or markedly increased energy that feels out of character.

Psychosis or unusual thoughts/behavior changes

Both bupropion and high doses of dextromethorphan (in general) have been associated with serious neuropsychiatric
effects in some cases. If you notice hallucinations, paranoia, or severe confusion, contact your clinician urgently.

Angle-closure glaucoma (rare, but important)

Some antidepressants have been linked to angle-closure glaucoma in people with anatomically narrow angles that
weren’t treated. Eye pain, vision changes, or swelling/redness around the eye should be treated as urgent.

Pregnancy warning

Auvelity has specific pregnancy-related warnings, including potential fetal harm based on animal data. If you are
pregnant, might be pregnant, or are planning pregnancy, this is a must-discuss topic with your clinician.

Interactions and “hidden” side-effect boosters

A big chunk of side-effect prevention is simply avoiding accidental stackinglike taking Auvelity and then grabbing
an over-the-counter cough medicine that also contains dextromethorphan. (It happens. Pharmacies are bright,
you’re tired, and packaging is basically designed to confuse the human brain.)

Common interaction situations to flag for your prescriber/pharmacist

• MAOIs (and certain antibiotics like linezolid or IV methylene blue): contraindicated due to
  serious interaction risk.
• Other serotonergic meds (some antidepressants, certain migraine meds, some pain meds):
  combination can raise serotonin syndrome risk.
• Other bupropion products: raises seizure risk.
• Other dextromethorphan products (many cough/cold meds): can raise side-effect risk.
• Strong CYP2D6 inhibitors: may require once-daily dosing and closer monitoring.
• Strong CYP2B6 inducers: may reduce effectiveness and are generally avoided with Auvelity.

A practical “side-effect toolkit” for weeks 1–6

Side effects tend to cluster early. The goal isn’t to “tough it out”it’s to manage them intelligently so you can
actually stay on the medication long enough to see whether it helps your depression.

Build a two-minute daily tracker (seriouslytwo minutes)

• Rate dizziness, nausea, sleep, anxiety from 0–10.
• Note dose times and caffeine intake.
• Write one sentence: “Today felt better/same/worse because…”

Bring this to follow-ups. Clinicians love data. Your future self also loves data, especially when your brain tries
to rewrite history like it’s editing a movie trailer.

Food and hydration: the boring advice that works

• If nausea hits, take doses with a small snack (if appropriate for you) and keep meals simpler.
• For diarrhea, focus on fluids + electrolytes and avoid “surprise” high-fiber meals until things settle.
• For constipation, add fiber gradually and keep moving daily (a short walk counts).

Sleep protection plan

• Cut caffeine earlier than you think you need to.
• Keep a wind-down routine (dim lights, no doom-scrolling in bed).
• If twice-daily dosing affects sleep, ask your prescriber whether timing adjustments are appropriatedon’t
  freestyle it.

Dry mouth and sweating: small fixes, big relief

• Dry mouth: sugar-free gum/lozenges, water, and good oral hygiene.
• Sweating: breathable clothing, shower timing, extra hydration, and talk to your clinician if severe.

Mood changes: take them seriously, not personally

If you feel more anxious, irritable, or unusually energizedespecially early in treatmenttell your prescriber.
Sometimes it’s a temporary adjustment. Sometimes it’s a signal to tweak the plan. Either way, it’s information,
not a character flaw.

When do side effects usually improve?

Many people notice that milder side effects ease as the body adaptsoften over the first couple of weeks. Others
may take longer. If side effects are getting worse instead of better, or interfering with daily life, it’s worth a
check-in rather than waiting it out.

Special situations to know about

If you’re under 18

Auvelity is approved for MDD in adults. If you’re a teen and you’ve heard about it, talk with a qualified
clinician about what treatments are appropriate for your age and medical history. Also, antidepressants carry an
increased risk of suicidal thoughts/behaviors in people 24 and under, so monitoring and support matterespecially
early in treatment or after dose changes.

If you or someone you know feels unsafe or in immediate danger, contact local emergency services right away. In
the U.S., you can also call or text 988 for the Suicide & Crisis Lifeline.

Kidney issues and metabolism differences

Some people need dose adjustments with moderate kidney impairment or if they are known CYP2D6 poor metabolizers,
and certain interacting medications can change dosing recommendations. This is exactly why “bring your full med
list” is not optionalit’s the whole game.

Pregnancy planning

If pregnancy is possible now or in the near future, discuss risks and alternatives with a clinician before you
startor as soon as possible if you’re already taking it.

Quick FAQ

Can I stop Auvelity suddenly?

Don’t stop or change how you take it without talking to your prescriber unless you’re dealing with a serious
reaction that requires urgent care. Stopping abruptly can worsen symptoms or create unpleasant rebound effects for
some people.

What if side effects are annoying but not dangerous?

Annoying still counts. If nausea, insomnia, dizziness, or anxiety makes it hard to function, your prescriber may
adjust timing, dose progression, or consider alternatives. The goal is treatment you can actually live with.

Experiences : What people often noticeand what tends to help

Everyone’s response to Auvelity is different, but there are some patterns people commonly describeespecially in
the first month. Think of this as a “what you might notice” section, not a guarantee. It’s also a reminder that if
you experience something intense or scary, you should reach out for medical help rather than trying to power
through it solo.

Week 1 often feels like the adjustment week. Some people describe mild dizziness that shows up
within a few hours after a dosealmost like standing up too fast, except you didn’t. The most helpful strategies
tend to be very unglamorous: drinking enough water, standing up slowly, and avoiding risky “I can totally sprint up
the stairs in socks” decisions until the dizziness calms down. People who track symptoms sometimes notice it’s
strongest on days when they’re under-slept or dehydrated, which is both annoying and empowering (because those are
fixable variables).

Nausea can be a cameo side effect. It may appear early and then fade as your body adapts. People
often report doing better when they take the medication with a small snacklike toast, yogurt, or something
boring-but-stablerather than an empty stomach. Smaller meals and avoiding greasy food right around dosing can also
help. One surprisingly common “experience tip” is to plan your first few days with fewer big social commitments, so
you can learn how your body reacts without also trying to be the life of the party.

Sleep can go either direction. Some people feel sleepier; others feel more alert or restless.
People who feel keyed up often describe their brain being “on” at bedtimelike it’s trying to solve problems from
three years ago with the urgency of a breaking news alert. The coping tools that get mentioned most are: pulling
caffeine earlier in the day, setting a consistent bedtime, and asking the prescriber about dose timing if insomnia
becomes persistent. People also report that a simple pre-sleep routine (dim lights, no intense scrolling, a calm
podcast) can make the difference between “I guess I’ll sleep” and “I guess I’ll stare at the ceiling and think
about taxes.”

Dry mouth and sweating are more “day-to-day” side effects. People often cope by keeping water
nearby, using sugar-free gum, and choosing breathable clothing. For dry mouth specifically, many find it improves
with time, but they also emphasize keeping up with dental carebecause dry mouth can be sneaky and irritating,
especially if it leads to bad breath or sore gums. For sweating, the most useful experience-based advice is to
treat hydration like a real job: keep a water bottle, add electrolytes if you sweat a lot, and talk to your
prescriber if sweating is intense or paired with other concerning symptoms.

Emotional and mental changes are the most important to track. Some people describe feeling a bit
more anxious, irritable, or restless early on. Others feel “lighter” or more motivated as depression symptoms
improve. Because antidepressants can affect mood and energy in complex ways, many people find it helpful to involve
a trusted personparent, partner, close friendwho can notice changes from the outside. If you notice agitation,
unusual behavior changes, or severe mood shifts, that’s not a “wait it out” moment; it’s a “call the prescriber”
moment. And if you ever feel unsafe, urgent help is the right move.

The overall theme from real-world stories is this: side effects are often manageable when you
treat them early, track them simply, and communicate clearly. You don’t win points for suffering quietly. The win
is finding a treatment plan that supports your mental health and lets you live your life.