Posted by mtdewcmu on April 14, 2011, at 17:11:33
In reply to Re: Pristiq + Wellbutrin anyone? » Bob, posted by SLS on April 13, 2011, at 18:18:49
> > Seems like 900mg of bupropion is super high compared to what is FDA approved these days, right?
>
> Yes. The original clinical trials for major depression used the higher dosages. When it was discovered that people with bulimia suffered seizures, the drug company decided to withdraw the medication temporarily. The dosage recommendations were refined to dosages that were about half of that originally approved for.What was it like at 900mg? It's a strange tale that it was originally intended to be used at such high doses, but now suddenly 300mg is good enough, just because it doesn't cause seizures. Maybe we are missing out on what are supposed to be the true effects.
> > Wellbutrin is a strange med
>
> For sure. I don't think its efficacy is produced by acting as a dopamine reuptake inhibitor. Preskhorn differs on this point, though.
>
> http://www.preskorn.com/columns/0001.html
>My understanding (no reference handy) is that bupropion is a DRI, and hydroxybupropion, the metabolite, is an NRI. Hydroxybupropion accumulates over the first week or so until there is more of it than bupropion. Unfortunately, there is no way to separate out just bupropion. I have been taking WB for over a year and I see no reason to doubt that it's in fact a DRI. It's just that it gets overwhelmed by NE as the metabolites accumulate. Over at erowid.org there are stories by people claiming to have gotten high from WB. They take large doses in a short time period, so it would mostly affect DA.
I stopped it for a few days and when I restarted it, the effects were best the first day. I could concentrate pretty well on work that day.
> Sometimes, I think it is fruitless to try to guess at the clinical result of a specific drug treatment. There is much data, but little understanding.
>I absolutely agree. Psychiatry is voodoo. It's a lot like the days when all diseases were explained in terms of the four humors, blood, phlegm, yellow bile, and black bile. The treatment for almost everything was bloodletting. Not too different than treating all mental illness by jacking up serotonin and hoping for the best. Of course, there are proven (if not understood) treatments for psychosis, ADHD, and bipolar mania. But any treatment for MDD is basically a shot in the dark.
I think you ought to give Wellbutrin another shot. The effects may be different if you are mixing it with different other drugs. Especially if the other drug reduces anxiety.
poster:mtdewcmu
thread:982583
URL: http://www.dr-bob.org/babble/20110406/msgs/982830.html