Comparison

Ketamine vs Auvelity

Auvelity is an FDA-approved oral antidepressant that also acts on NMDA receptors. It offers a take-home alternative to ketamine but with smaller effect sizes in published trials.

Written by: Ira ZootMedical review status: Not yet clinically reviewed.Last updated: June 4, 2026Evidence: Educational synthesis - not medical advice

This page has been written and edited by the publisher. It has not been reviewed by a licensed clinician.

Quick answer

Bottom line

Auvelity offers a take-home glutamatergic option for less severe depression. Ketamine remains the stronger choice for treatment-resistant cases.

This page compares Ketamine and Auvelity (dextromethorphan-bupropion) across the same fixed dimensions - mechanism, evidence, onset, duration, side effects, access, suitability, and limits. It does not name a winner and does not recommend either option for you.

Related on Ketalux

Ketamine

Auvelity (dextromethorphan-bupropion)

Mechanism

Direct NMDA antagonism via IV/IM/intranasal/sublingual ketamine.

Oral dextromethorphan (NMDA antagonist, sigma-1 agonist) plus bupropion (raises dextromethorphan levels and adds noradrenergic/dopaminergic effects).

Evidence

Decades of trial data in TRD across modalities.

FDA approval based on GEMINI trial in major depressive disorder; smaller evidence base.

Onset

Hours to days.

About 1 week.

Duration

Days to weeks per session.

Ongoing while taken daily.

Side effects

Transient dissociation, BP, nausea.

Dizziness, headache, dry mouth, hyperhidrosis; seizure risk from bupropion component.

Access

Specialty clinics.

Standard pharmacy; commercial insurance widely covers.

Best for

Severe TRD, rapid relief, patients open to clinic-based treatment.

MDD patients wanting a daily oral option with novel mechanism, faster than SSRIs.

Limits

Cost, access.

Smaller effect size, daily medication burden, drug interactions.

Disclaimer

This comparison is educational and general. It is not a recommendation. Treatment choice depends on your individual history, diagnosis, prior response, preferences, and access - discuss with a qualified clinician.

About the author

Ira Zoot

Publisher and editor of Ketalux, based in Chicago, Illinois. Ira is a ketamine therapy patient, not a clinician. This is editorial review, not medical review: Ira is not a licensed clinician and does not provide diagnosis or medical care. Ketalux does not accept compensation from providers in exchange for favorable editorial coverage, evidence ratings, recommendations, patient referrals, or organic provider ranking. Read the full publisher disclosure →

Educational use only. The content on this page is provided for general educational purposes and does not constitute medical advice, diagnosis, or treatment. Ketamine and related therapies carry risks and are appropriate only under qualified medical supervision. Always consult a licensed healthcare professional about your individual situation. Information may change as research evolves.