Auvelity (dextromethorphan HBr and bupropion HCl)

[Nitro802]

I would be curious to hear about experiences with this drug or separate generic combo. Approved in US in August 2022 for the treatment of major depressive disorder. Apparently the bupropion makes the DXM long lasting.

The Bateman Horne center in Utah prescribes dextromethorphan 15mg twice a day.

Jarred Younger has also looked at it
https://www.healthrising.org/blog/2021/03/02/dextromethorphan-fibromyalgia-neuroinflammation-study/

From wiki

"Dextromethorphan acts as an NMDA receptor antagonist, σ1 receptor agonist, and serotonin–norepinephrine reuptake inhibitor, among other actions, while bupropion acts as a norepinephrine–dopamine reuptake inhibitor and nicotinic acetylcholine receptor negative allosteric modulator.[1][13] Bupropion is also a potent inhibitor of CYP2D6, and thereby inhibits the metabolism of dextromethorphan.[13] Dextromethorphan/bupropion has less activity as an NMDA receptor antagonist than dextromethorphan alone.[11] This is because bupropion is a potent CYP2D6 inhibitor and prevents the bioactivation of dextromethorphan into dextrorphan, a much more potent NMDA receptor antagonist and weaker serotonin reuptake inhibitor than dextromethorphan itself.[11] The mechanism of action of dextromethorphan/bupropion in the treatment of depression is unknown, although the preceding pharmacological actions are assumed to be involved.

 

[deleder2k]

Has anyone tried DXM? Not sold OTC here in Norway. Alcohol helps me a lot, in particular against muscle/leg pain. ChatGPT suggested that it could due to the facts that ethanol is a strong NMDA inhibitor. ChatGPT suggested DXM and even ketamine too!

 

[Utsikt]

ChatGPT suggested DXM and even ketamine too!

I don’t think we should rely on LLMs for biology or medicine..

 

[deleder2k]

I don’t think we should rely on LLMs for biology or medicine..

Everyone should of course be skeptical and they should consult with their doctor. That is a given. ChatGPT’s «point» is that alcohol is a very potent NMDA inhibitor. DXM and ketamine are two other drugs with the same effect. Dxm tablets are sold OTC in many countries, so I reckon that the side effect profile is OK.

 

[Utsikt]

ChatGPT’s «point» is that alcohol is a very potent NMDA inhibitor.

ChatGPT doesn’t have any points, ever. It guesses at which letter you want to see after the previous one.

So my point was that LLMs are unreliable for information so something isn’t anything just because an LLM says it is so.

 

[deleder2k]

ChatGPT doesn’t have any points, ever. It guesses at which letter you want to see after the previous one.

So my point was that LLMs are unreliable for information so something isn’t anything just because an LLM says it is so.

I know that. That is why one should check whether what it says are sound, including sources. Great if we could stick to the question.

from Perplexity:

Ethanol (alcohol) is a potent inhibitor of NMDA receptors, a key finding supported by extensive research. Acute exposure to ethanol reduces NMDA receptor activity in a concentration-dependent manner, with effects observed at levels as low as 5–50 mM-a range associated with human intoxication. For example, 50 mM ethanol inhibits NMDA-activated ion currents by ~61% in hippocampal neurons, significantly more than its effects on other glutamate receptors like AMPA or kainate receptors.

The following sources were used to conclude that alcohol (ethanol) is a potent NMDA receptor inhibitor:
- PMC article: “Ethanol Inhibition of Constitutively Open N-Methyl-d-Aspartate Receptors” (PMC3251024)
- Marquette University PDF: “Effects of Ethanol on GluN1/GluN2A and GluN1/GluN2B NMDA Receptors”
- NCBI Bookshelf: “The NMDA Receptor and Alcohol Addiction”
- PubMed: “Ethanol and the NMDA receptor”
- ScienceDirect: “Ethanol-induced inhibition of NMDA receptor channels”
- PMC article: “Alcohol and NMDA receptor: current research and future direction”
- ScienceDirect: “Ethanol and the NMDA receptor”
- Wiley Online Library: “Acute Effects of Ethanol on Glutamate Receptors”
These sources provide experimental and review evidence that ethanol acutely and potently inhibits NMDA receptor function in a concentration-dependent and selective manner.

 

[Utsikt]

I know that. That is why one should check whether what it says are sound, including sources. Great if we could stick to the question.

You might want to avoid another LLM reference then..

 

[deleder2k]

I think that the use of AI can propel us forward. Statements and conclusions should of course be checked out, but if we exclude the use of AI to improve our understanding of the disease and also discuss possible treatments as patients, then I believe we lose out. That it is it from me. If anyone have more on whether dxm allieviates ME symptoms please feel free to go on topic!

 

[Utsikt]

if we exclude the use of AI to improve our understanding of the disease and also discuss possible treatments as patients, then I believe we lose out.

You’d also run the risk of grave mistakes and in general wasting your time on hallucinations.

If anyone have more on whether dxm allieviates ME symptoms please feel free to go on topic!

I was talking about LLMs specifically because the majority of your post was «ChatGPT said X».

As for your question, the answer is probably that we have no way of knowing, and that the likelihood in general is vanishingly small.