Posted by Gabriel14 on March 10, 2021, at 23:27:35
In reply to Re: Guidance on blood tests results for bupropion?, posted by linkadge on March 9, 2021, at 16:50:53
> Interesting.
>
> There is only one antidepressant I know of (nortriptyline) for which a therapeutic blood level has been established.
>
> The fact that you have lower bupropion, but higher hydroxybupropion indicates to me that you may be a faster metabolizer of bupropion. However, from what I understand, a significant degree of wellbutrin's antidepressant effect is from the metabolites. So a lower level of bupropion may not be detrimental. Personally, I would go based on therapeutic responses. Do you feel your depression is being adequately treated? If not, have you considered a higher dose? If not, have you tried other agents (i.e. SSRIs) which may augment it? For example, even a low dose of escitalopram may augment it. Zoloft may be an option too, however it can increase blood levels of bupropion (to keep in mind).
>
> Linkadge
Thanks, Linkadge. That's an interesting point on the lower bupropion levels perhaps having to do with it being metabolized fast.However, my hydroxybupropion levels are also below the reference range - not as dramatically so as the bupropion, but below nevertheless. So it seems like there's a potential issue here no matter how you cut it.
As far as my response, I've been on Wellbutrin for over a decade, and overall the experience has been positive, but I do feel like the effectiveness varies from batch to batch, even with the brand name.
That's actually why I had this test done; I felt like my most recent batch of Wellbutrin has been a dud, and it convinced me that maybe it was a good idea, going forward, to start tracking its levels in my blood shortly after I start each new batch.
poster:Gabriel14
thread:1114047
URL: http://www.dr-bob.org/babble/20210120/msgs/1114058.html