Auvelity Side Effects: What's Common, What Goes Away and When to Call

Dizziness is the most common side effect of Auvelity, followed by nausea, headache and sleepiness. Most are mild, but seizures, high blood pressure and mood changes need a call.

By withClaro Editorial · Medically reviewed by Dr. Jason Tan, Consultant Psychiatrist · 2026-11-09 · 11 min read

Auvelity Side Effects: What's Common, What Goes Away and When to Call

Key takeaways

In the main trial, 16% of people on Auvelity had dizziness, against 6% on placebo.
Nausea, headache, diarrhea, sleepiness, dry mouth, sweating and sexual side effects were also more common than on placebo.
The depression trials found no weight gain and no ketamine-like effects. Some people on Reddit still describe feeling a little high in the first days.
Seizures, a rise in blood pressure, signs of mania and serotonin syndrome with SSRIs are the serious risks to know before starting.
In 100 Reddit threads, anxiety or restlessness was the side effect people named most. Some said their side effects eased within weeks, others that one effect stayed.

The most common Auvelity side effects are dizziness, nausea, headache, diarrhea, sleepiness and dry mouth. In the trial behind the FDA label, they were all more common than on placebo, and few people stopped because of them. Rarer risks, like seizures and raised blood pressure, come from the bupropion in Auvelity.

Psychiatric pharmacist Roberta Dume went through the Auvelity trials in a January 2023 episode of HelixTalk. It is the podcast of Rosalind Franklin University College of Pharmacy. She works on an inpatient psychiatric unit at the North Chicago VA. We checked her claims about side effects against the label and the trials. We also added what people on Reddit say about their own first weeks.

What are the most common Auvelity side effects?

Auvelity combines dextromethorphan, the cough medicine ingredient, with bupropion, the drug in Wellbutrin. The FDA label reports a six-week trial where 162 people took Auvelity and 164 took placebo. Each common side effect showed up more often on Auvelity, and the gap was widest for dizziness.

Side effect	Auvelity	Placebo
Dizziness	16%	6%
Nausea	13%	9%
Headache	8%	4%
Diarrhea	7%	3%
Sleepiness	7%	3%
Dry mouth	6%	2%
Sexual side effects	6%	0%
Sweating	5%	0%
Anxiety	4%	1%
Trouble sleeping	4%	2%

Dume called dizziness, nausea, headache, diarrhea, dry mouth and sweating the hallmark side effects of dextromethorphan, one of the two ingredients. Few people stopped because of them. According to the label, 4% of people on Auvelity and none on placebo stopped because of side effects. Anxiety was the most common reason. If one of these effects starts in your first days, note the day and how long it lasts after each dose. Many of them overlap with plain bupropion, covered in what Wellbutrin side effects look like.

Does Auvelity make you sleepy or keep you awake?

It can do either. In the label's trial, sleepiness affected 7% of people on Auvelity against 3% on placebo, and trouble sleeping affected 4% against 2%. The two effects pull in opposite directions, and which one you get varies from person to person.

Dume's explanation is that the two ingredients act differently:

So when you dose bupropion alone, it's typically an activating medication. I ask my patients to take it in the mornings. So the insomnia component could be commonly due to the bupropion.

She thinks the sleepy side may come from dextromethorphan. That is her reading, and the label does not give a cause. The label says to start with one tablet in the morning. A second dose comes on day 4, at least 8 hours apart. On Reddit, some people who felt very sleepy changed when they took it. One person on r/AuvelityMed wrote:

After a week, I started moving the dose earlier to see if the sleepiness was any better, and it was.

If your sleep changes, write down when you took each dose and how you slept. Ask your prescriber about the timing before you move it.

Why does Auvelity make you feel high or drunk?

Feeling dizzy, spacey or a little drunk in the first days comes up often on r/AuvelityMed. Dizziness was also the most common side effect in the label's trial. Some people say this feeling eased within the first week or two. It is not the kind of high the trials looked for. GEMINI, the 2022 depression trial of 327 adults that led to approval, found no psychotomimetic effects, meaning no ketamine-like changes in perception. Dume made the same point:

There were no psychotomimetic effects that were seen, like when you think of a medication like ketamine

One person on r/AuvelityMed wrote:

First week on 1 a night I felt dizziness, kind of a slight high and was just generally tired. All that left after the 1st week

For another person, it took a little longer. One person on r/AuvelityMed wrote:

On one a day, it took about five days of feeling pretty high, but then after two weeks I was feeling myself.

The label is clear that high doses are another matter. Dextromethorphan overdose can cause psychosis, stupor and coma, and bupropion can cause hallucinations or confusion. Don't drive until you know how Auvelity affects you. Call your prescriber if you notice confusion or hallucinations.

Which side effects do people on r/AuvelityMed mention most?

Anxiety, tiredness and nausea came up most often

We read 100 recent threads on r/AuvelityMed and r/antidepressants, comments included. Between the posts and the replies, 271 people wrote about their own time on Auvelity. Of them, 221 named at least one side effect. Anxiety or restlessness led the list, ahead of tiredness and nausea.

Side effect	People
Anxiety, jitters or restlessness	52
Tiredness or sleepiness	47
Nausea or stomach upset	44
Dizziness	39
Lower sex drive or trouble with orgasm	37
Trouble sleeping	31
Brain fog	30
Less appetite	24
Sweating	21
Headache	20

One person can appear in several rows. People who have a hard start are more likely to post, so threads like these lean toward the difficult cases. Only 3 people mentioned weight gain or a bigger appetite, and 5 said they noticed none.

Of the 78 people who said how long their side effects lasted, 32 said they eased within the first 8 weeks. Another 44 said theirs had not eased yet at the time they posted. One person on r/AuvelityMed wrote:

i had awesome nausea the first couple of nights after taking it and that went away after a week. i've never felt spaced out or wonky.

For others, one effect stayed. One person on r/AuvelityMed wrote:

I've been on it for months and the sweating never stopped for me but I don't get nauseous like I used to.

Of the 82 people who named something that helped, 27 mentioned a lower or slower dose. Another 15 said it passed with time. Moving the dose to another time of day came up for 13. Of the 24 people who said whether they talked to their prescriber, 18 said the talk led to a change. That meant a different dose, a different drug or an added medicine. If a side effect is still there after the first few weeks, bring it up. A dose or timing change is a decision to make with your prescriber, not alone.

Does Auvelity cause weight gain or sexual side effects?

Weight gain is unlikely, and sexual side effects affect a minority. GEMINI, a 2022 trial, and ASCEND, a 2022 trial that compared Auvelity with bupropion alone, both found no weight gain. The maker's page says people on Auvelity lost about half a pound on average over six weeks. People on placebo gained about a pound.

Less appetite is more likely than more. The label lists decreased appetite in 4% on Auvelity against 1% on placebo. If your appetite stays low after the first weeks, or your clothes start to fit differently, mention it at your next appointment.

Sexual side effects depend on how they are measured. GEMINI found no increase on its sexual function questionnaire. But in the label, 6% of people on Auvelity reported a sexual side effect, against none on placebo. The maker's page adds that these effects tend to be underreported.

So the risk is not zero. If you notice a change in desire or orgasm, note when it started and whether it followed a dose increase. For more on how bupropion compares, see sexual side effects on Wellbutrin.

Which serious side effects can Auvelity cause?

The serious risks are rare, and most come from bupropion. Auvelity has the same boxed warning as other antidepressants about suicidal thoughts in children and young adults. Its label also warns about seizures, raised blood pressure, mania, psychosis, serotonin syndrome and an eye problem called angle-closure glaucoma.

Seizure risk rises with the bupropion dose, so Auvelity is not for people with a seizure disorder. After a seizure, the label says to stop Auvelity and not restart it. The label also rules it out for people with bulimia or anorexia, now or in the past. It does the same for anyone suddenly stopping alcohol, benzodiazepines, barbiturates or seizure medication. Dume listed the same groups:

those who have a known epilepsy or seizure history, even certain eating disorders like bulimia or anorexia nervosa

Blood pressure can go up, so the label says to check it before starting and from time to time after. Antidepressants can trigger mania or hypomania in people with bipolar disorder, which is why prescribers screen for it first. Serotonin syndrome is more likely when Auvelity is taken with an SSRI or a tricyclic antidepressant. MAOIs must not be combined with it at all.

Bupropion also blocks the liver enzyme CYP2D6. That can raise levels of other drugs that use it, and make some drugs that need it to activate work less well. Before you start, give your prescriber a full list of your medicines, including cough remedies. For the bupropion side of this, see how Wellbutrin interacts with other drugs.

Was the pharmacist right about side effects of Auvelity?

Mostly yes. Dume's account of the common side effects, sleep, seizures, blood pressure, mania, serotonin syndrome and drug interactions matches the label. She oversimplified in two places: sexual side effects and why people stopped.

What Dume said	What the research found	Does it hold up?
The hallmark side effects are dizziness, nausea, headache, diarrhea, dry mouth and sweating	All were more common than on placebo. Dizziness 16% against 6%	Yes, but sexual side effects (6% against 0%) are missing from her list
People stopped Auvelity more often than placebo, mostly because of those effects	4% stopped for side effects against 0%, and anxiety was the most common reason	Partly
No weight gain	Both trials found no weight gain	Yes
No sexual dysfunction	No increase on the questionnaire in GEMINI, 2022, but 6% reported it against 0% on placebo	Partly
No psychotomimetic effects, unlike ketamine	GEMINI found none	Yes, in the depression trials
Trouble sleeping likely comes from bupropion, sleepiness possibly from dextromethorphan	Both are more common than on placebo, and the label gives no cause	Plausible, not tested
Anxiety was more common in the phase 2 trial	Anxiety was among the most common side effects in ASCEND, 2022	Yes
Seizure risk depends on dose, and people with seizures, bulimia or anorexia should avoid it	Listed as contraindications, with seizure risk called dose-related	Yes
Seizure risk is higher in people who suddenly stop heavy drinking	Abrupt stop of alcohol is a contraindication	Yes
Blood pressure may rise, especially at first	The label says to check it before starting and regularly after	Yes
Undiagnosed bipolar disorder can lead to mania, hypomania or psychosis	Warnings for mania and psychosis are in the label	Yes
Serotonin syndrome mainly happens with SSRIs or other serotonergic drugs	The label names SSRIs and tricyclics	Yes
Bupropion in Auvelity blocks CYP2D6, so it interacts with some antidepressants, antipsychotics and opioids	The label says it raises levels of CYP2D6 substrates and can make prodrugs that need CYP2D6 work less well	Yes

The table can read as a list of mistakes, but most rows hold. Before you start, raise the rows that apply to you, such as seizures, blood pressure or other medicines.

When should you call your prescriber about side effects on Auvelity?

Most early side effects of antidepressants ease within the first weeks, while a few tend to last and are worth raising.

Side effects that often pass include nausea, an upset stomach, headache, sleep changes and feeling restless. If sexual side effects, weight change or feeling emotionally flat appear, they tend to stay while you take the medication. A change of dose or medication often helps with these, so mention them instead of putting up with them.

Call 911 or 988 now if you feel you might act on thoughts of suicide, or you have a seizure, a very high temperature with stiff muscles, or swelling of the face or throat.

Call your prescriber the same day, or get urgent care, if you notice:

new or worse thoughts of suicide or self-harm, especially early on, after a dose change, or in people under 25
agitation, heavy sweating, fever, muscle twitching or confusion, which can be signs of serotonin syndrome
unusual bleeding or bruising, black or tarry stools, or vomiting blood
a sudden burst of energy, little need for sleep, racing thoughts or unusual risk-taking, especially if you or a close relative has bipolar disorder
headache, confusion, weakness or unsteadiness, especially if you are older (a sign of low sodium)
eye pain, changes in vision, or swelling or redness in or around the eye
fainting, or a fast or irregular heartbeat

Hormonal changes across the menstrual cycle, pregnancy and menopause can change how a medication feels. Any side effect that bothers you is reason enough to bring it up.

Medical review
Medically reviewed by Dr. Jason Tan, Consultant Psychiatrist, on 27 October 2026, this section only. Next review: 27 October 2027.

For the side effects that can wait, a few notes make the appointment shorter and more useful. It helps to bring:

Which side effect you have, and the day it started.
Whether you take one tablet or two, and at what times.
Whether it peaks a few hours after a dose or lasts all day.
Your blood pressure readings, if you check them.
Other medicines you take, including cough remedies and anything for sleep.
What you have already tried, such as taking it with food.

If you're having thoughts of harming yourself, contact emergency services or a crisis line straight away. In the US, call or text 988. In the UK, call Samaritans on 116 123. Elsewhere, find a crisis line near you.

Keeping track of the first weeks on Auvelity

The first weeks on Auvelity are when side effects are most likely to change, and memory blurs them fast. A short daily note on dizziness, sleep, anxiety and mood shows whether things are easing. Note the dose and time too, since many effects follow the dose.

The withClaro app lets you log mood, energy, sleep and appetite each day. It links side effects to your dose and turns the record into a report for your prescriber.

Download on the App Store Side effects on Auvelity tend to show up in the first days, and some fade while others stay. The withClaro app lets you log mood, energy, sleep and appetite each day, track side effects against your dose and share a report with your doctor.

Frequently asked questions

Is anxiety a side effect of Auvelity?

Yes. In the label's trial, 4% of people on Auvelity had anxiety against 1% on placebo. If you feel more anxious or restless after starting, note when it began and tell your prescriber.

How long does it take to get used to Auvelity?

On Reddit, some people said the dizziness and spacey feeling eased within the first week or two. Some effects, like sweating or sexual changes, can last longer. Note which effects fade and which stay, and raise the ones that stay.

Does Auvelity cause hair loss?

Hair loss is not in the label's table of common side effects from the main trial. But the label does list hair loss (alopecia) among postmarketing reports for bupropion. If you notice more shedding than usual, note when it started and mention it at your next appointment.

Does Auvelity cause high blood pressure?

It can raise blood pressure, because of the bupropion in it. If you have high blood pressure, ask how often to check it.

Can you take Auvelity with an SSRI?

Only if your prescriber decides it is safe, because the combination raises the risk of serotonin syndrome. Tell your prescriber about every antidepressant you take before starting Auvelity.

Does Auvelity affect appetite?

It can lower it a little, and a bigger appetite is less likely. If your appetite has not come back after the first weeks, tell your prescriber.

Related articles

Sources

Claro articles are for self-monitoring and educational purposes only. They are not a medical device, therapist, or diagnostic tool, and do not replace care from your prescribing clinician. If you are in crisis, contact your care team, emergency services, the Samaritans (UK: 116 123), or the Crisis Text Line (US: text HOME to 741741).

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