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Re: Nortrip/Wellbutrin Combo

Posted by JohnL on December 17, 1999, at 3:16:21

In reply to Re: Narrow windows ... & Nortrip/Wellbutrin Combo?, posted by JohnL on December 13, 1999, at 16:53:50

> Hi again Bob. No experience here with the two combined. However I did read an abstract describing the combination used successfully for refractory depression. It seems like it should be a great combination. JohnL

OK, so this got my interest. I am now taking Nortrip+Wellbutrin and we'll see how it goes. Prozac+whatever was useless on my anhedonia/melancholia after a year of trying. I saw another abstract that showed that patients experiencing melancholia while on SSRIs responded when switched to Nortrip, Wellbutrin, or ECT. Clearly it seems the melancholic subtype requires a different approach than other forms of depression. Lots of research and anecdotal evidence seems to support TCAs or Wellbutrin or both over SSRIs for melancholic depression. If the measuring criteria is 50% reduction of Hamilton depression score, all antidepressants are equally effective. But if the criteria is changed to a more stringent requirement of 10 points or less on the Hamilton score, TCAs blow SSRIs in the weeds.

This is the route my psychiatrist has always wanted me to take, but I couldn't because of severe tinnitus on Wellbutrin. What I have discovered is that Wellbutrin does not produce tinnitus since the Remeron was removed. Something about that combo caused severe tinnitus. Strange. I am taking 50mg of Lamictal too, which seems to be a factor in quieting the tinnitus. And I plan on continuing Prozac, perhaps 20mg every three days or so, just because.

So, Nortrip+Wellbutrin it is, with a sprinkle of Lamictal and Prozac in the background for tinnitus control. So far the only side effects are dry mouth and insomnia. Nortrip has always seemed quite sedating to me, but Wellbutrin overcomes that strongly enough to cause insomnia. Hope that passes. In theory this seems like an excellent combo for melancholia in a sexually active patient. We'll see. So far so good. Thanks for starting this thread. I was in need of more ideas after abandoning Remeron. :) JohnL




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