Posted by King Vultan on November 4, 2004, at 11:05:05
In reply to Re: Wellbutrin + Paxil? » KaraS, posted by SLS on November 4, 2004, at 6:17:19
I perhaps do worry too much about these CYP-450 interactions, but I have read anecdotes in which people were taking, for instance, Prozac + desipramine, and were in near overdose states of the tricyclic without understanding what was going on. Obviously, there isn't nearly the concern when dealing with non-tricyclics, but since I've been on Wellbutrin combined with various drugs myself, I've done a lot of research on it.
The truth is that the best info on Wellbutrin's ability to inhibit other 2D6 metabolized drugs comes right with it in the prescribing info. "In a study of 15 male subjects (ages 19 to 35 years) who were extensive metabolizers of the CYP2D6 enzyme, daily doses of bupropion given at 150 mg twice daily followed by a single 50 mg dose of desipramine increased the Cmax, AUC, and t 1/2 of desipramine by an average of two-, five-, and two-fold respectively." So it would appear that 300 mg/day of Wellbutrin can easily double (or more, also considering the AUC--area underneath the curve) the blood plasma level of drugs that are mainly metabolized by 2D6. How much does this matter if that drug is an SSRI? I don't know, probably not that much, but one would think that side effects would at least tend to increase somewhat, and it is something to be aware of.
Todd
poster:King Vultan
thread:411372
URL: http://www.dr-bob.org/babble/20041103/msgs/411633.html