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Re: Does Wellbutrin plays the role of adjunct to SRIs? SLS

Posted by undopaminergic on January 17, 2023, at 9:45:30

In reply to Re: Does Wellbutrin plays the role of adjunct to SRIs? undopaminergic, posted by SLS on January 16, 2023, at 8:30:57

> Hey, UD

Hey SLS!

> > I tried bupropion (Wellbutrin, Zyban, Voxra) at very high doses, chasing (at least an inkling of) a stimulant effect. It was ineffective. I would be interested in trying it again in combinations with other agents.
> >
> > -undopaminergic
> Unless you have already had persistenly bad experiences (not start-up side-effects), the drugs that I would favor to combine with bupropion are venlafaxine (Effexor) or desvenlafaxine (Pristiq). My guess is that Effexor gets more people well than Pristiq, but I don't know now how large is the difference in response rate between the two.
> I guess it makes sense to try Pristiq first. It is the active metabolite of Effexor. I think once you establish equalibrium, desvenlafaxine becomes the predominant compound in the blood stream.
> I know someone who has remained in total remission for about 15 years with a combination of Pristiq 100 mg/day and bupropion sustained release (Wellbutrin SR) 300 mg/day. She has never shown medication breakthrough or diminishing returns, despite multiple episodes of severe stress. With Pristiq, she was taking pure desvenlafaxine.
> I think some people are absolutely worse off when exposing their brains to the parent compound, Effexor, than the daughter compound, Pristiq. However, in other cases, it, might be necessary to have the parent compound, venlafaxine, in the brain along with desvenlafaxine. If this is not the cased, one might find Pristiq more tolerable than Effexor with respect to side-effects, including start-up anxiety or brain-fog.
> - Scott

I don't know why I've never tried venlafaxine. I guess there was always something else to try that seemed more exciting.

They (Wyeth) gave up on getting desvenlafaxine approved in Europe, so it's not available to me.

I'm also a bit wary about giving it a full trial due to the withdrawal syndrome. But maybe I shouldn't worry, as I've always been able to quit any drug cold-turkey.





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