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Re: Long time no see... » Ame Sans Vie

Posted by sb417 on August 5, 2004, at 23:02:17

In reply to Long time no see..., posted by Ame Sans Vie on August 5, 2004, at 11:25:17

Hi Michael. Welcome back. Regarding your question about Wellbutrin and amphetamine. . . First, let me say that I've read quite a few of your posts, and it appears as if you are able to tolerate "polypharmacy" a lot better than some of us, so you might do very well on a Wellbutrin + Amphetamine combination. I do know that Wellbutrin's parent compound, bupropion, mildly inhibits cytochrome P450 2D6, and Wellbutrin's major metabolite, hydroxybupropion, is a substrate of 2D6. Amphetamines are also 2D6 substrates. If you have a "good version" of 2D6 (i.e., if you don't have a genetic polymorphism which causes a deficient version of 2D6), then the mild inhibition caused by bupropion might not interfere with the metabolism of the drugs and you might not have a problem. The fact that you were able to combine Prozac with your other medications seems to indicate that you can tolerate combinations that I couldn't tolerate. I also want to mention, however, that I have known other people (besides myself) who cannot combine Wellbutrin with amphetamine. Some people just get too agitated or sick feeling, and I know of one fatality. I'm sorry to mention that fatality, but I think it's important for people to realize how highly variable and individual our reactions are. The person who died was a student who was on Wellbutrin. She took Adderall to cram for final exams and went into cardiac arrest. Again, because you seem to be able to tolerate other multi-drug combinations well, you might not have any problem at all. Perhaps you can start really, really slowly, with minute doses and see how you feel. Keep in mind that, even if you don't have a liver enzyme problem, Wellbutrin can be very activating, so you may want to cut it in tiny pieces for the first week or so. Good luck, and let us know how you're doing.


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