chipmunk Posted March 30, 2009 Share Posted March 30, 2009 I have been on Wellbutrin in the past but thought it was not working for anxiety and my lack of patience (symptoms of depression for me). Doc switched me to Prozac 10 mg but that interacted with the ADD meds so psych switched me to Celexa 40 mg which is great for the depression but very sedating and I have NO sex drive. I thought I would try Wellbutrin again but due to a suicidal episode in January (had gone off ALL ADs for the four months prior - bad idea in retrospect ) I am nervous about it not being effective. I have two little girls that I need to be here for, but I also have a marriage that is in trouble and we need to be connecting through sex more than every 3 months. Are there other drugs that work like Wellbutrin (non-sedating, low risk of sexual side effects) that I could try? TIA! Link to comment Share on other sites More sharing options...
Teddy Posted March 30, 2009 Share Posted March 30, 2009 You could try Cymbalta. I think it's a norepinephrine reuptake inhibitor like Wellbutrin. Also Effexor. Check out crazymeds.us (or is it .com?) to see. Look at the drugs that are grouped with Wellbutrin and read the pages to find out if there are sexual side effects. I used to take Wellbutrin and now take Cymbalta because Wellbutrin made me a litle irritable. I have no sexual side effects with Cymbalta. I do have a toddler and an infant so THAT causes sexual side effects but the Cymbalta doesn't as far as I can tell! Link to comment Share on other sites More sharing options...
null0trooper Posted April 1, 2009 Share Posted April 1, 2009 You could try Cymbalta. I think it's a norepinephrine reuptake inhibitor like Wellbutrin. It combines norepinephrine reuptake inhibition with serotonin reuptake inhibition, so it usually doesn't cause the sexual effects of an SSRI. However, for it can still cause the anxiety/irritation/agitation that every other NRI is capable of. You won't know untill you try it. The bottom line is that there are no effective psych meds - including placebo - that do not carry a risk of side effects. They cause changes in the body in a way that has multiple effects. Before changing meds again, first you should discuss which potential side effects you can live with (and to what degree) and which you can't, and how much improvement you'll settle for. Link to comment Share on other sites More sharing options...
AnneMarie Posted April 1, 2009 Share Posted April 1, 2009 Mirapex is used off label for depression sometimes. It works on dopamine which is the neurotransmitter Wellbutrin hits. Mirapex is a parkinsons med. It is hit or miss as an AD, and the hit tends to be more like Wellbutrin light from what I gather. Anyway, it's out there. Link to comment Share on other sites More sharing options...
null0trooper Posted April 1, 2009 Share Posted April 1, 2009 Mirapex is used off label for depression sometimes. It works on dopamine which is the neurotransmitter Wellbutrin hits. Mirapex is a parkinsons med. It is hit or miss as an AD, and the hit tends to be more like Wellbutrin light from what I gather. Anyway, it's out there. Wellbutrin is by far more of a selective noradrenaline reuptake inhibitor than a dopamine reuptake inhibitor. Even then, the effect may be entirely a result of the noradrenaline transporter also picking up a significant fraction of dopamine as well. Mirapex is a dopamine receptor agonist, not a reuptake inhibitor, so it's just not going to work like Wellbutrin, Strattera, Norpramin, or Vivactil (and a couple of other oddball TCAs.) Link to comment Share on other sites More sharing options...
AnneMarie Posted April 1, 2009 Share Posted April 1, 2009 Mirapex is used off label for depression sometimes. It works on dopamine which is the neurotransmitter Wellbutrin hits. Mirapex is a parkinsons med. It is hit or miss as an AD, and the hit tends to be more like Wellbutrin light from what I gather. Anyway, it's out there. Wellbutrin is by far more of a selective noradrenaline reuptake inhibitor than a dopamine reuptake inhibitor. Even then, the effect may be entirely a result of the noradrenaline transporter also picking up a significant fraction of dopamine as well. Mirapex is a dopamine receptor agonist, not a reuptake inhibitor, so it's just not going to work like Wellbutrin, Strattera, Norpramin, or Vivactil (and a couple of other oddball TCAs.) I'd always heard that Wellbutrin primarily works on dopamine and norepinephrine secondarily. Please explain. Interested in info on Mirapex works. Heh, I take it and don't understand much about it. Link to comment Share on other sites More sharing options...
null0trooper Posted April 1, 2009 Share Posted April 1, 2009 I'd always heard that Wellbutrin primarily works on dopamine and norepinephrine secondarily. Please explain. I'd have to go searching to pull numbers, but bupropion (it may be through one of its metabolites) has a strong affinity for binding to the noradrenaline transporter (NAT.) However, while I think it's been shown to have little or no binding to the dopamine transporter (DAT), administering bupropion has been shown to increase dopamine transmission. Other studies have suggested that NAT can also transport dopamine, so that may be part of the dopamine reuptake being halted. Or not. Bupropion is one of the meds that the manufacturer won't claim to know quite how it does what it does. Still it's one of the few meds in production that touches dopamine reuptake, so when a research project needs a DRI med for comparison that's what they use. Interested in info on Mirapex works. Heh, I take it and don't understand much about it. The receptor binding mechanism is probably a big factor in making it usable for RLS and EPS without sending folks with bipolar and schizophrenia batshit from excess dopamine. Unfortunately, it's no good for ADHD, and hit-or-miss at best for depression (it's sure to help someone, but otherwise not so good, or amineptine would never have made it to market) Link to comment Share on other sites More sharing options...
AnneMarie Posted April 1, 2009 Share Posted April 1, 2009 Thanks, Null0Trooper. Link to comment Share on other sites More sharing options...
chipmunk Posted April 1, 2009 Author Share Posted April 1, 2009 Psych wants me to try Lexapro but said it will likely have the same side effects as Celexa and Prozac. The Celexa made me horribly drowsy as well so it just wasn't good. I will ask about Cymbalta if the Lexapro doesn't work out. Thanks! Link to comment Share on other sites More sharing options...
ghost_train Posted April 3, 2009 Share Posted April 3, 2009 It seems like both Celexa and Wellbutrin are effective for you. So I'm surprised you're not on both. See...from what I understand, when someone on an SSRI complains of sexual side effects, Wellbutrin is often added to help with those, because it tends to increase libido. (My p-doc chose to put me on it because I had anhedonia when I presented for depression.) And then on the other hand, an SSRI is often added to Wellbutrin to counter anxiety that might be secondary to Wellbutrin itself. (This was the case for me when I pulled out of my major depressive episode....suddenly, I was manifesting crucial OCD.) This might be worth addressing with your doctor, anyhow, if you think it has any chance of working. You could possibly start on a higher dose of Wellbutrin, and a lower dose of SSRI, then adjust accordingly once the side effects wear off. God, I hope things improve for you. Not wanting to have sex more than every three months sounds awful. *hug* Edit: Also, because Wellbutrin is stimulating, it would probably counter the fatigue. In fact, when I started on Paxil, I took it at bedtime, and took Wellbutrin in the morning. The fatigue actually wore off after a month, and now I love Paxil. :-D Link to comment Share on other sites More sharing options...
chipmunk Posted May 12, 2009 Author Share Posted May 12, 2009 I am also on meds for ADD, so maybe that is why he is leery of the Wellbutrin? I have an appt with him tomorrow and I will ask him about all of this. He is really hard to get into, so I do most of the consulting over the phone. He is really good at finessing the med "cocktails" though so that is why I stick with him. The Lexapro is working pretty well, I still have some sexual side effects but not as bad. My Vyvanse isn't working as well as I would like it to, so who knows, we may be switching everything tomorrow. We'll see. Link to comment Share on other sites More sharing options...
chipmunk Posted June 5, 2009 Author Share Posted June 5, 2009 I forgot to ask him about the Wellbutrin. He switched me from Vyvanse to Adderall. I like the flexible dosing with the Adderall but I don't think it's working as well as it should - I always seem to hit the side effect ceiling before I can get the full brain effect. Because of that switch, I elected to stay on the Lexapro for now, just so we wouldn't be switching everything at once. Next appt I will ask about switching that or adding Wellbutrin. Link to comment Share on other sites More sharing options...
ghost_train Posted June 24, 2009 Share Posted June 24, 2009 Because of that switch, I elected to stay on the Lexapro for now, just so we wouldn't be switching everything at once. Next appt I will ask about switching that or adding Wellbutrin. Yay! If you do add the Wellbutrin back, I'm curious to know what happens. Have they tried Ritalin / Concerta on you? Best of luck. :-) Link to comment Share on other sites More sharing options...
Mayteana Posted June 24, 2009 Share Posted June 24, 2009 Many people take both stimulants for ADD and Wellbutrin. It may be too stimulating, but it's worth a shot. Case in point: me. I take Adderall and Wellbutrin. Yes, a stimulant + Wellbutrin might be too much - but if you stay on the Lexapro (since it's working for you) you might find that combo to be just what you need. ~ May Link to comment Share on other sites More sharing options...
ghost_train Posted June 26, 2009 Share Posted June 26, 2009 Case in point: me. I take Adderall and Wellbutrin. Yes, a stimulant + Wellbutrin might be too much - but if you stay on the Lexapro (since it's working for you) you might find that combo to be just what you need. I'm another person who gets gawked at every time a medical professional looks at my charts. To add to that, I'm adding Cymbalta and phasing out Paxil. Whee! I kind of wanted to glare daggers at the last pharmacist I saw when she self-righteously rolled her eyes at my medications. plz dun invite speculation as to whether you were ever good enough to get into med school. Link to comment Share on other sites More sharing options...
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