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What is the new form of Wellbutrin? Comparing Auvelity, Aplenzin, and Generic Bupropion

3 min read

Over 280 million people worldwide are affected by depression, making new treatment options a welcome development. In recent years, several newer versions of bupropion, the active ingredient in the brand-name antidepressant Wellbutrin, have been introduced, addressing the question: What is the new form of Wellbutrin? The most notable additions are the combination drug Auvelity and the alternative salt form Aplenzin, each offering a distinct approach to treating major depressive disorder.

Quick Summary

The "new" forms of Wellbutrin include Auvelity, a combination of dextromethorphan and bupropion with a rapid onset, and Aplenzin, an extended-release bupropion hydrobromide formulation. These differ from standard generic bupropion (wellbutrin sr or wellbutrin xl) in their active ingredients, salt form, mechanism, onset of action, and cost.

Key Points

  • Auvelity is a Combination Drug: The most recent new form is Auvelity, which combines bupropion with dextromethorphan for a novel antidepressant mechanism and faster onset of effect.

  • Aplenzin is a Different Salt Form: Aplenzin uses bupropion hydrobromide (HBr) instead of the traditional bupropion hydrochloride (HCl) found in Wellbutrin, allowing for a single, once-daily high-dose tablet.

  • Faster Onset with Auvelity: Clinical trials have shown that Auvelity can begin working in as little as one to two weeks, a quicker response time than traditional bupropion formulations.

  • Generic Bupropion is Widely Available: The brand-name Wellbutrin has been largely discontinued, but generic bupropion hydrochloride is widely available in immediate-release, sustained-release, and extended-release forms.

  • Cost and Availability Differ: Both Auvelity and Aplenzin are brand-name-only medications, while Wellbutrin generics are lower-cost alternatives.

  • Mechanisms are Distinct: While bupropion acts as a norepinephrine and dopamine reuptake inhibitor (NDRI), Auvelity's dextromethorphan component also acts as an NMDA receptor antagonist, offering a dual mode of action.

In This Article

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.

Frequently Asked Questions

Auvelity contains two active ingredients, bupropion and dextromethorphan, while Wellbutrin (and its generic forms) contains only bupropion. This combination gives Auvelity a dual mechanism of action and a potentially faster onset of effect compared to Wellbutrin.

Aplenzin uses a different salt form of bupropion, known as bupropion hydrobromide (HBr), whereas Wellbutrin uses bupropion hydrochloride (HCl). This chemical difference allows Aplenzin to be formulated as a single, high-dose, once-daily tablet, which is not available in other bupropion forms.

The original brand-name Wellbutrin has been largely discontinued. However, generic bupropion is widely available in sustained-release (SR) and extended-release (XL) versions that are considered therapeutically equivalent.

Yes, in clinical trials, Auvelity showed a significantly faster onset of antidepressant effect, with noticeable improvements sometimes occurring within one to two weeks, whereas traditional bupropion typically takes several weeks to reach full effect.

Auvelity and Aplenzin are both brand-name-only medications, which tend to be more expensive. Generic bupropion is a much lower-cost alternative, making it a more accessible option for many patients.

Since they all contain bupropion, some side effects like insomnia and dry mouth are common to all. However, Auvelity's unique combination can result in a different side effect profile, such as dizziness, nausea, and headache. Aplenzin's side effect profile is very similar to standard bupropion, though the high-dose option changes considerations.

The salt form can affect the tablet's properties, such as its extended-release profile and the amount of active ingredient that can be included in a single tablet. In Aplenzin's case, the hydrobromide salt allows for a once-daily, high-dose tablet that was not possible with the hydrochloride salt.

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Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice.