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Re: Some TCA/Wellbutrin Questions - Concerns Althea8869

Posted by zeugma on February 27, 2004, at 16:17:33

In reply to Some TCA/Wellbutrin Questions - Concerns, posted by Althea8869 on February 27, 2004, at 11:07:23

> Im curious about others experience and thoughts on the following:
> Currently on Wellbutrin @300mg - doing nothing for me, Remeron was a bust, so was prozac, celexa & lexapro. Im thinking of either augmenting wellbutrin (with lithium, lamictal, pindolol or buspirone)
> OR
> Trying a TCA(desipramine, nortriptyline or clomipramine seem clinically the most popular), which I have never done. Can a TCA be added safely to Wellbutrin? Also, If I have failed on Remeron, does this mean its more likely I will fail on a TCA given there is some similarity in their actions on the brain.
>
> Any thoughts on this from those that have been down this road would be so greatly appreciated.
> Thanks in advance.

Augmentation is a good idea when the main drug is working, but things aren't quite there yet. Augmenting a drug that's a "bust" doesn't sound like a good idea; why not get rid of the Wellbutrin, if it's really useless for you?

And TCA's and WB do not mix at all. WB, like many other of the newer AD's, blocks the crucial metabolic pathways that process the TCA's, leading to a potentially quite dangerous buildup of TCA in the blood.

Remeron, in my opinion, is not a good probe to see if your depression is TCA-sensitive. True, it's sedating, as are many TCA's. But I'll put it this way: I don't believe Remeron would have been discovered to be an 'antidepressant' if people hadn't been looking real hard to see such an effect. The TCA's on the other hand were discovered to be antidepressants before anyone had really known there were such things. A drug that is powerful enough to be discovered by serendipity is a different proposition from a drug developed in its wake by a pharmaceutical company that has a major financial stake in developing a drug with a fresh patent.


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