Auvelity vs Spravato

Auvelity (dextromethorphan and bupropion) is indicated for the treatment of major depressive disorder (MDD) in adults. Regulatory review documents for Auvelity highlight that in its 6-week controlled trials, there was a statistically superior improvement in MADRS total score change from baseline to Week 6 compared to placebo.

Spravato (esketamine) is indicated for adults with treatment-resistant Major Depressive Disorder (TRD) who have not responded to at least two different treatments with antidepressants in the current moderate to severe depressive episode, and for the rapid reduction of depressive symptoms in adult patients with a moderate acute short-term treatment, co-administered with oral antidepressant therapy. Regulatory review documents for Spravato note a MADRS total score change from baseline (LS mean treatment difference) for esketamine + SOC vs placebo + SOC of -3.8.

It is crucial to note that these drugs were studied in separate trials with different designs, populations, and timepoints. Auvelity was reviewed for MDD, while Spravato was reviewed for TRD. The endpoints, comparator arms, and study durations also differed between the respective trials. Therefore, the figures presented are not head-to-head comparisons, and neither drug is presented as superior to the other.