Posted by Optimist on October 8, 2004, at 10:09:57
In reply to Selegiline vs. Wellbutrin -- my perspective » Optimist, posted by Ame Sans Vie on October 6, 2004, at 14:40:19
> > Congratulations on your success! It seems like your meds are more on the stimulant side of things, combined with some benzos.
>
> Thanks! :-)
>
> Yeah, it wasn't till fairly recently I realized the unfathomable advantages of catecholaminergic enhancement in my disorders -- hence my meds being "more on the stimulant side of things".
>
> > Have you tried wellbutrin in the past, and if you have how does it compare to the selegiline?
>
> My experience with Wellbutrin (actually Zyban, but they're both bupropion HCl) is limited, but I can say that the short time (two months) I spent taking Zyban was quite comparable to my recent trial of desipramine (Norpramin). Zyban is equivalent to 150mg Wellbutrin SR, if I recall correctly. It gave me the same bad dry mouth as desipramine and, also like desipramine, raised my blood pressure a bit. Neither of them, however, increased my anxiety levels. In all fairness though, I was taking 8mg/day Klonopin, 400mg/day Ultram (tramadol -- an atypical narcotic analgesic with properties similar to Effexor), and various hypnotics at different times (i.e., Halcion [triazolam], Restoril [temazepam], Ambien [zolpidem], Somnote [chloral hydrate], Placidyl [ethchlorvynol], Nembutal [pentobarbital]) at the same time as the Zyban; during my desipramine trial (300mg/day for two months) I was additionally taking between 8-12mg/day Klonopin, a bit of Xanax XR here and there, 60-90mg/day Adderall, barbiturate hypnotics (Seconal [secobarbital], and Tuinal [secobarbital 50%/amobarbital 50%]), and either 60-120mg Delsym (dextromethorphan polistirex) or 60-120mg Dexalone (dextromethorphan HBr). I'm pretty convinced that the similarities I found between these two meds are strongly linked to their relatively potent norepinephrine reuptake effects, though I know some would blame the desipramine dry mouth on anticholinergia, I never experienced this adverse effect on more powerful anticholinergics such as Elavil (amitriptyline) or Flexeril (cyclobenzaprine). I believe Wellbutrin/Zyban has about half the affinity for the dopamine transporter as for the norepinephrine transporter, but someone please correct me if I'm wrong.
>
> As for the effects on my mental condition, 150mg bupropion HCl didn't help a bit, and I wouldn't dare increase the dose due to a lack of desire to be prescribed artificial saliva. Libido and sexual function were slightly enhanced, but that effect is ten-fold with selegiline HCl... for myself, anyway. :-D
>
> > I was asking my pdoc about trying selegiline a year ago but she wasn't too hot on the idea. I'm currently taking wellbutrin 300mg per day, plus 5mg of Adderall XR twice a day. It seems to be working well, but the selegiline has always intrigued me.
>
> Yeah, selegiline had intrigued me for quite some time before I finally decided to take the plunge with oral Eldepryl, seeing as how EmSam (the transdermal selegiline patch) doesn't seem to be appearing on the horizon anytime terribly soon.
>
> By the way, I feel it quite important to note that I take my Eldepryl in a rather odd, but quite effective way: I always take it with food, as the literature asserts that this increases drug absorption three- to four-fold, however, I take 2.5mg of each dose sublingually, swallowing the remainder. I began taking it this way three weeks ago when my psychiatrist recommended it at my one-week checkup (we're being cautious and making sure to meet at least biweekly due to the combination of the MAO inhibitor and amphetamines) and the effect increased dramatically. I also open up my capsules of DLPA and simply swallow the crystalline powder inside, which seems to provide a more pronounced effect.
>
> Any more questions, feel perfectly free to ask away! I've tried nearly every traditional psych med as well as a bunch of off-the-wall stuff, so if you're curious about other dopaminergics (e.g., Mirapex [pramipexole], Symmetrel [amantadine], Sinemet [levodopa/carbidopa]) or any other drug/alternative therapies, I can provide you with my experiences and personal opinions.
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> Glad to hear you're doing well on your current combo, though! :-) Mind if I ask how long it took you to arrive at your current plan? Just curious.
>
> All the best to you,
>
> ~Michael
> SAD, GAD, PD, OCD, agoraphobia, dysthymia, MDD, ADD, AvPD
>
Hi Michael, I forgot to reply on how long it took me to arrive at my current plan. I haven't been on antidepressants very long. I tried effexor for to 2 weeks, 3 years ago, but couldn't handle the sexual side effects and apathy at the beginning. I think I was at a point where I thought those types of side effects weren't worth the trouble of being on an antidepressant. I may have been in a bit of denial as well. I tend to feel a more of an apathetic depression as well, and it seemed the effexor was compounding those effects although I know I didn't give it enough time to give a proper evaluation anyways.A year ago, I was in a rough state of mind, and decided to get a psychiatrist. She put me on moclobemide (Manerix), in July and I was ramped up to 1200mg quite quickly. Even at that high a dose I didn't experience any side effects. Zilch. Which I thought was a little funny. Gradually I tended to feel better, but I usually tend to feel better in September/October anyways so it was a tough call whether it was the AD that was working or seasonal pattern to my depression. In the beginning of nov. the floor came out from under me, so my pdoc decided to switch me to wellbutrin 300mg. She added lamictal in dec. at 100mg. I added some St. John's Wort at the end of Feb and shortly after started feeling much better. I also bought a light box at that time.
In the beginning of march I took myself off the lamictal and wellbutrin on my own. The lamictal was making me feel like a zombie. I felt like there was a continual fog in my head, and since I was in university at the time I decided that I couldn't handle that side effect anymore. My depression started to lift quite remarkably at that time but in march/april it usually tends to lift anyways. Again part of a seasonal pattern I think. I'm still trying to figure out if it's really there. I tend to get depressed in the winter and summer for 8 months of the year, and feel better during spring and fall for 4 months of the year. I went off the SJW at the beginning of spring as well.
So in July again of this year I had been having problems with depression again. It had been creeping up for a couple months, so I decided to go back on the St. John's Wort and Wellbutrin. I started feeling much better shortly afterwards.
The last week my pdoc put me on the Adderall, since I was complaining of some loss of motivation/energy which I had been having problems for continuously. I also have been unemployed for 4 months and was started to get desperate to get my life going in the right direction. Even though my depression had abated I felt like I needed an extra kick in the pants to get things started.
I have experimented with 5-HTP and tyrosine as well the last couple months. I've used it more for PRN type situations (as needed) to give me a little extra effects from time to time. Since I've been paying everything out of pocket it gets expensive though so I haven't explored that avenue as much as I've liked.
I know this was a little long, but that's generally the overview of my AD experimentation. It hasn't been very long. I find it a bit therapeutic telling about myself as I think it gives me more perspective about myself and my own inner workings. We'll see this november if my improvement is from my AD combo or whether it is the seasonal pattern. I'm crossing my fingers.
Brian
poster:Optimist
thread:399488
URL: http://www.dr-bob.org/babble/20041007/msgs/400336.html