Posted by Bekka H. on February 4, 2002, at 3:14:12
In reply to Intense biological depression on Wellbutrin, posted by pedr on February 3, 2002, at 6:49:28
Hello, Pete!
I had the same problem on Wellbutrin. I was feeling suicidal on it and I had to stop. My negative thoughts were relentless and obsessional, like an endless tape or broken record. The odd thing is, I had taken Wellbutrin about 5 or 6 years ago, and I didn't have that problem, but I had it this past year when I tried it. This was quite a shock and disappointment to me because, in the past, it was the only antidepressant I could tolerate, and it gave me energy and drive, both of which were numbed on all the other antidepressants. For some reason, my body just can't tolerate it now. I have a thought, and I wonder whether you've checked with your doctor about this. . .I don't know too much about Reboxetine since it's not available in the U.S., but after reading your post, it occurred to me that Reboxetine and Wellbutrin might compete for some of the same liver enzymes and, therefore, might be rendering each other less effective. Do you know about the cytochrome P450 enzymes? Nearly every drug requires some metabolism by the cytochrome P450 enzymes. The problem is, some drugs are substrates of the enzymes, some drugs are inhibitors of the enzymes and some drugs are inducers of the enzymes. If you take one drug that inhibits an enzyme (let's call it enzyme IID6, for example), and you take a second drug that is a substrate of IID6, then that second drug won't be properly broken down because the first drug inhibited the enzyme that was needed for the second drug's metabolism. As I said, I don't know much about reboxetine, but I do know that Wellbutrin metabolites affect some of the cytochrome P450 enzymes. If I'm not mistaken, I believe that hydroxy-bupropion, the major metabolite of Wellbutrin, inhibitis cytochrome P450 IID6.
Another thing to consider is the half-lives of the various drugs. Bupropion itself has a fairly short half life of about 14 hours or so; however, its metabolites have half lives of 2-3 days, so I wonder how that might be interacting with reboxetine. I wish I knew more about reboxetine so I could help you. Also, I wonder how you would be responding to Wellbutrin if you weren't on reboxetine. How long have you been on reboxetine? Have you ever taken Wellbutrin without reboxetine and, if so, did you have the same reaction?
poster:Bekka H.
thread:92694
URL: http://www.dr-bob.org/babble/20020131/msgs/92800.html