Posted by King Vultan on May 17, 2004, at 8:01:10
In reply to Zoloft, then Serzone, then Wellbutrin, need help., posted by hawaiistaci on May 17, 2004, at 2:29:48
Be careful here because one of the metabolites of Serzone, mCPP, is cleared by the CYP-450 2D6 enzyme, and Wellbutrin is a powerful inhibitor of this enzyme. What this means is that at the dosages of Wellbutrin you are talking about, the 2D6 enzyme is going to get tied up to such an extent that the levels of mCPP in your bloodstream may rise to much higher levels than they would otherwise--this may be on the order of of two to five times normal. Because mCPP is pharmacologically active, it is important to at least be aware of this, and it may be more prudent to start at a lower level of Serzone than you would otherwise.
You might want to consider adding back an SSRI to see if it might help with your anxiety if the Wellbutrin seems to be controlling the depression. I would suggest Paxil, but there are horrendous CYP-450 interactions between Wellbutrin and Paxil, and IMO these two drugs should not be combined. I'm not aware of any interactions between Lexapro/Celexa and Wellbutrin, though.
Todd
poster:King Vultan
thread:347664
URL: http://www.dr-bob.org/babble/20040515/msgs/347721.html