Huge improvements with new med Auvelity

In r/covidlonghaulers, the OP (u/Presentlava, self-described 6-year long COVID with symptoms including headache, widespread pain, MCAS, mild POTS, small fiber neuropathy, brain fog, PEM) reported a 'huge improvement' after adding the recently approved Auvelity (dextromethorphan 105mg + bupropion 45mg) on top of prior LDA, bupropion, Xolair, and ketotifen, explaining that bupropion inhibits the enzyme that metabolizes dextromethorphan, thereby enhancing its NMDA antagonistic effect. Commenters were cautious: u/Central_Perk20 warned that Auvelity carries QT prolongation risk and requires ECG monitoring if used with drugs like ivabradine, noting that even 15mg of dextromethorphan caused them to crash; u/[deleted] said three years of continuous use helped treatment-resistant depression but 'did nothing for long COVID'; u/WlLDLlGHT and others felt the improvements were mostly temporary. Factually, Auvelity is indeed the first NMDA antagonist/σ1 agonist combination approved by the FDA in 2022 for major depressive disorder and in 2024 for agitation associated with Alzheimer's disease. On a speculative level, benefits from off-label self-treatment with Auvelity in long COVID patients are individual anecdotal reports with no RCT support.

Checked ✔ Verified: Auvelity (dextromethorphan/bupropion) FDA