What is the New Form of Wellbutrin? Meet Auvelity and Aplenzin
For decades, Wellbutrin (bupropion hydrochloride) has been a mainstay in treating depression. However, the landscape has evolved with newer formulations that offer different mechanisms and benefits. While the original brand-name Wellbutrin is largely discontinued, its active ingredient, bupropion, is now available in different extended-release forms under new brand names and as generics.
Auvelity: A Combination Therapy with a Novel Mechanism
One of the most significant recent developments is the FDA approval of Auvelity (dextromethorphan/bupropion) in 2022 for major depressive disorder in adults. Auvelity combines dextromethorphan (DXM), known as a cough suppressant, with bupropion. Dextromethorphan primarily acts as an NMDA receptor antagonist and sigma-1 receptor agonist, affecting glutamatergic neurotransmission. Bupropion in this combination increases DXM's availability by inhibiting its breakdown, allowing for a therapeutic effect. Clinical trials suggest Auvelity may have a rapid onset of action, with some improvement seen within one to two weeks, potentially faster than traditional antidepressants.
Aplenzin: The Different Salt Form of Bupropion
Another bupropion formulation is Aplenzin, an extended-release tablet containing bupropion hydrobromide, approved in 2008. Unlike Wellbutrin XL, which uses bupropion hydrochloride, Aplenzin uses bupropion hydrobromide. This difference allows for a simpler, once-daily dosing, even at higher strengths. Aplenzin is a brand-name-only product, which typically makes it more expensive than generic bupropion hydrochloride options.
The Status of Wellbutrin Brand and its Generics
The brand-name Wellbutrin (bupropion hydrochloride) is largely discontinued. Doctors prescribing "Wellbutrin" usually mean a generic bupropion product, available in immediate-release (IR), sustained-release (SR), and extended-release (XL) forms. Generic bupropion XL is the most common, but Aplenzin and Auvelity offer distinct alternatives.
Comparing the Newest Bupropion Formulations
To highlight the key differences, here is a comparison table of the most relevant bupropion-based medications:
Feature | Auvelity (dextromethorphan/bupropion) | Aplenzin (bupropion hydrobromide) | Wellbutrin XL (Generic bupropion HCl) |
---|---|---|---|
Active Ingredient(s) | Dextromethorphan + Bupropion | Bupropion | Bupropion |
Salt Form | Dextromethorphan HBr + Bupropion HCl | Bupropion HBr | Bupropion HCl |
Mechanism of Action | NMDA receptor antagonism + NDRI | Norepinephrine/Dopamine Reuptake Inhibitor (NDRI) | Norepinephrine/Dopamine Reuptake Inhibitor (NDRI) |
FDA Approval | August 2022 | April 2008 | Original Wellbutrin approved 1985; generics widely available |
Onset of Effect | Can be as fast as 1-2 weeks | Typically 4-6 weeks, similar to other bupropion products | Typically 4-6 weeks |
Availability | Brand-name only | Brand-name only | Available in lower-cost generic forms |
Dosage | Twice daily | Once daily (up to 522mg in a single tablet) | Once daily |
Exploring the Clinical Significance of New Formulations
The newer bupropion formulations offer more tailored options for patients and healthcare providers.
Auvelity is particularly valuable for adults with Major Depressive Disorder (MDD), especially those who haven't responded well to other treatments or need faster relief. Its dual action on glutamatergic and monoaminergic systems provides a new therapeutic strategy. The ASCEND trial showed Auvelity had superior efficacy and higher remission rates compared to standard bupropion.
Aplenzin provides an alternative within the bupropion class. Patients requiring a higher bupropion dose but preferring once-daily dosing may benefit from Aplenzin's hydrobromide salt formulation, which allows for a 522 mg tablet. While its mechanism is the same NDRI as traditional bupropion, this dosing flexibility can improve patient adherence.
Generic bupropion hydrochloride (SR and XL) remains a crucial and cost-effective treatment option. However, variations in manufacturing for some generics have been noted, underscoring the importance of consistency and communication with healthcare providers.
Conclusion
The question "What is the new form of Wellbutrin?" highlights the ongoing evolution of bupropion-based treatments. The options extend beyond just SR and XL generics to include the novel combination therapy Auvelity, offering a rapid onset and unique mechanism, and Aplenzin, a bupropion hydrobromide formulation with improved high-dose, once-daily convenience. Generic bupropion hydrochloride remains a readily available choice. Understanding these differences is essential for choosing the most suitable treatment based on individual needs, clinical history, potential side effects, desired speed of effect, and cost.