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Re: looking for NON-SSRI -AD suggestions

Posted by Lucie Lu on June 27, 2008, at 21:59:41

In reply to looking for NON-SSRI -AD suggestions, posted by B2chica on June 26, 2008, at 12:28:58

B2c, I replied on the other board but not so much about the meds. Racer listed the A/D options although other meds might have some A/D properties. Tricyclics and MAOIs could be problematic or dangerous given what else you are taking, so wellbutrin is probably the best if it works for you. SSRIs are not recommmended if hypomania or bipolar present so I'm a little surprised your pdoc would have you try lex. Are you going off it because it didn't work or because it worked but caused rapid mood fluctuations? I've been on wellbutrin for a long time, couldn't take SSRIs same reason. WB alone worked well most of the time but occasionally I'd need stronger downside protection so added the mood stabilizer lamotrigine (lamictal). That combo has worked very well for me and very tolerable in terms of side effects. Many posters have commented on the variability in wellbutrin formulations and I've had the same experience. For me, the XL lasts too long in my system and increases my insomnia so I've settled on the SR, 200 mgs in the am and 100 mgs early afternoon. It's less convenient than the one-a-day formulation but for me is worth it. My daughter has had a similar experience, she gets headaches >200 mgs if on the XL but not on the SR. Not sure if there are also differences in generic vs brand but the formulation itself has mattered. There is a useful explanatory section on wikipedia under bupropion, section dosage and administration, may clear up some of the name confusion and options.

Also, anytime I decrease dosage of any psych med my body is used to, I do it VERY VERY slowly - even when the pdoc and pharm company say you can stop abruptly with no ill effects! Some people are *exquisitely* sensitive to changes in neurotransmitter levels and can have intensely negative reactions in response, e.g. sudden increase in depression, sluggishness, irritability, etc. to changes in meds. So be on the lookout if this potentially describes you too.

Finally, many of us are on multiple meds and NO ONE really knows for sure how a given mixture will affect an individual! I have had a different response to the same med depending upon the exact mix of other meds I'm taking at the time. I only raise that issue because in the context of wellbutrin, that is another variable in addition to formulation. So WB may yet work for you as an A/D over the longer term.

Hope this helps!




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poster:Lucie Lu thread:836564