Dextromethorphan-bupropion combination in depression with dual diagnosis: Insights from a case series.
Mahak Aggarwal, Jawahar Singh, Khushpreet Kaur, Mohit Thakur, Rohit Guleria
Indian Journal of Psychiatry February 1, 2026 DOI: 10.4103/indianjpsychiatry_979_25 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 3 |
| Population | Male patients with alcohol or opioid dependence and depression |
| Intervention | dextromethorphan-bupropion |
| Topics | Addiction Depression |
| Keywords | Anhedonia Antidepressants Dextromethorphan-bupropion |
| Key findings | Dextromethorphan-bupropion led to substantial improvement in depressive symptoms and functioning in three male patients with dual-diagnosis depression after multiple failed antidepressant trials. |
Abstract
Major depressive disorder and co-morbid substance use disorder represent a challenging dual diagnosis, characterized by persistent anhedonia, high relapse rates, and poor response to conventional antidepressants. The dextromethorphan-bupropion combination with synergistic glutamatergic and dopaminergic mechanisms provides a new treatment option. We present three male patients with alcohol or opioid dependence and depression who showed substantial improvement in depressive symptoms and functioning with dextromethorphan-bupropion after multiple failed antidepressant trials. These findings highlight the clinical implications of dextromethorphan-bupropion in dual-diagnosis depression and warrant further controlled studies to establish efficacy and safety.