Posted by Tony P on March 28, 2018, at 1:46:24
In reply to Re: What is a good Norepinephrine increaser?, posted by SLS on March 4, 2018, at 1:07:59
As the Wikipedia article describes, bupropion (Wellbutrin) is a DNRI, but over time the principal metabolite, hydroxybupropion, which has a longer half-life, builds up to 16-20 times the concentration of bupropion itself. Unfortunately (for us anhedonics anyway), hydroxybupropion is ONLY an NE agonist.
This accounts for my experience 2 years ago when I started bupropion (added to Lexapro). For about two weeks, on only 37.5 mg/day, I was a new man, outgoing, depression lifted, doing chores that I had neglected for years. Then I lost the magic, and dosage increases didn't seem to help. I've tried a 10 day holiday from the bupropion, but that doesn't seem to be long enough to reset whatever-it-is, and at 10 days I can feel the depression closing in (& my housemates notice too).
So, to return to the question, in my experience bupropion is a powerful NE increaser. I'm very sensitive to it, though; some years back I was on the customary 300 mg/day, and had to take benzos, zopiclone and other remedies such as Kava & muscle relaxants to tolerate it -- and my family still thought I had gone mad!
Much better, IMO, for an NE boost is Cymbalta. I found it both effective and very low on side effects. I have read that it gives 5x the NE boost that Effexor does (Effexor drives me up the wall with anxiety; YMMV). It seems to have got a very bad press; the BC govt. drug plan does not support it. Maybe it only works well for a subset of people, and does poorly on the averages.
Depression is an altered state of consciousness - SLS
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Escitalopram
Bupropion XR
Diazepam 5 mg tid - weaning
Robaxin - non-prescribed
Kava - non-Rx, prn
poster:Tony P
thread:1097121
URL: http://www.dr-bob.org/babble/20180212/msgs/1097781.html