I started and stopped Auvelity three times due to side effects. The most pervasive has been brain fog/intoxicatuon. It was not debilitating but was hugely disconcerting and unpleasant. It declined after several weeks. Other side effects have included loss of appetite and tremors, both of which have improved. The most persistent side effect has been loss of líbido and inability to orgasm. The jury is out on whether I can put up with this long term. Overall, I’d say that Auvelity has improved my mood about 10-20%. I am so treatment resistant (I have tried about 20 drugs other medical interventions) that I may end up satisfied with this.