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.
Medically reviewed by: Pending medical review(draft)Last updated: June 4, 2026Evidence: Educational synthesis - not medical advice
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.
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.