This medication contains bupropion, the same active ingredient as some antidepressant medications (Aplenzin, Forfivo, Wellbutrin). A small number of children, teenagers, and young adults (up to 24 years of age) who took antidepressants (‘mood elevators’) such as bupropion during clinical studies became suicidal (thinking about harming or killing oneself or planning or trying to do so). Children, teenagers, and young adults who take antidepressants to treat depression or other mental illnesses may be more likely to become suicidal than children, teenagers, and young adults who do not take antidepressants to treat these conditions. The combination of dextromethorphan and bupropion is not approved for use in children under 18 years of age.

You should know that your mental health may change in unexpected ways when you take the combination of dextromethorphan and bupropion even if you are an adult over 24 years of age. You may become suicidal, especially at the beginning of your treatment and any time that your dose is increased or decreased. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: new or worsening depression; thinking about harming or killing yourself, or planning or trying to do so; extreme worry; agitation; anxiety or panic attacks; difficulty falling asleep or staying asleep; aggressive, angry, or violent behavior; irritability; acting without thinking; severe restlessness; abnormal thoughts or sensations; feeling that people are against you; hallucinations (seeing things or hearing voices that do not exist); feeling confused; frenzied abnormal excitement; or any other sudden or unusual changes in behavior. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own.

No matter what your age, before you take an antidepressant, you, your parent, or your caregiver should talk to your doctor about the risks and benefits of treating your condition with an antidepressant or with other treatments. You should also talk about the risks and benefits of not treating your condition. You should know that having depression or another mental illness greatly increases the risk that you will become suicidal. This risk is higher if you or anyone in your family has or has ever had bipolar disorder (mood that changes from depressed to abnormally excited) or mania (frenzied, abnormally excited mood) or has thought about or attempted suicide. Talk to your doctor about your condition, symptoms, and personal and family medical history. You and your doctor will decide what type of treatment is right for you.

Your healthcare provider will want to see you often while you are taking the combination of dextromethorphan and bupropion, especially at the beginning of your treatment. Be sure to keep all appointments for office visits with your doctor.

Your doctor or pharmacist will give you the manufacturer’s patient information sheet (Medication Guide) when you begin treatment with the combination of dextromethorphan and bupropion and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (https://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer’s website to obtain the Medication Guide.