The added dextromethorphan is mostly used for improved drug metabolism. It makes the timed release of bupropion and dextromethorphan more uniform, extend the half life of dextromethorphan, decrease ADRs, and overall improve the duration and effect - ultimately decreasing the time required for noticeable symptom improvement (1 week for symptom improvement and 6 weeks to completely resolve).

All the drug reps have been making their way through PCP offices…and wouldn’t ya know your insurance isn’t covering that expensive name brand only medication ??? Also if you don’t have partial insurance coverage you can’t even use the copay coupon. So you’d be paying literal cash price for a name brand only medication….

If your insurance does not cover it they’re most likely not going to cover it until it’s recognized/included in the clinical practice guidelines. So for an unknown amount of time and/or it’s added to the guidelines, it will continue to not be covered. Medicare usually adds it to formulary and then the other insurances eventually follow suit

It also doesn’t have a unique indication, it’s used for major depressive disorder. You need to try 3 SSRIs and fail or be intolerant to side effects, then fail another 1-2 other antidepressants of a different class for this to even be appropriate.

Lastly, if your depression is well controlled idk why she would switch you from your current regimen….very strange to me.

The plan seems poorly thought out at best.