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Why no Wellbutrin in Australia?


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It seems that outside North America bupoprion is only used and approved for smoking cessation. It is quite expensive; too. I once asked my gDoc about it and he said it is not an effective AD, so it is not approved or marketed for depression. Yet, so many American doctors use it and so many patients seem to do well on it.

I took it a few times to stop smoking. We get a 3 month NHS subsidised course once a year. It was more effective than any other AD I've ever taken. It seemed to work so instantly and powerfully. Why is there this huge difference between NA and the rest of the world?

Also, why is the stuff so damn expensive? It has been off patent a long time, hasn't it? For the full dose, 450mg/day, it costs AU$174/mo. By our standards here, that is very costly and usually only very new meds cost that much and usually the NHS foots most of the bill. 

Ive thought about ordering from a Canadian pharmacy, which would be much cheaper and they say they accepted AU scripts.

one of the reasons it's so terrible we can't access WB is that it is fairly unique in the way it works. It worked great for me, but there's nothing I can try that works the same way..

Has anyone else outside NA struggled to get this med?

Edited by mcjimjam
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On 5/3/2017 at 6:13 PM, mcjimjam said:

 Why is there this huge difference between NA and the rest of the world?

From my understanding, and from what I have read a few places, this has something to do with a potential side effect of taking Wellbutrin--seizures......I will try to find the link for you about this.....

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From what I've seen, the max dosage of Wellbutrin for smoking cessation is lower than the max dose used for depression.

Here in U.S., the maximum dose can be up to 450mg for depression......The dosage for smoking cessation is a maximum of 300mg.

The higher the dose, the greater the risk for seizures.

Edited by CrazyRedhead
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That would make sense.....I don't know why they won't do it.

Is off-label prescribing allowed in Australia?.........If so, perhaps you could find a private doc to prescribe it off-label for depression if it seems to work well for you, although probably a private doctor will cost you more.

Just as a side note, my own pdoc has a personal policy of not prescribing more than 300mg per day for depression, although there are some pdocs here who will go up to 450mg.

Edited by CrazyRedhead
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6 minutes ago, CrazyRedhead said:

That would make sense.....I don't know why they won't do it.

Is off-label prescribing allowed in Australia?.........If so, perhaps you could find a private doc to prescribe it off-label for depression if it seems to work well for you, although probably a private doctor will cost you more.

Off label prescribing is allowed, for sure and any doctor can do it but the problem is the cost of this drug here as a private prescription (off NHS) It costs more than my Abilify with no available generic. If I take it again, for longer than three months I will order online from Canada.

 

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I talked to a pdoc once who said they never use it because of the risk of psychosis. They also said the evidence wasn't strong enough for it to be on the PBS and sometimes in the US drugs take off because they are marketed aggressively to doctors and also marketed directly to consumers, which is illegal in Australia. It sucks if you're one of the few it does work for because off-label is bloody expensive. I'm having similar issues with modafinil. 

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2 hours ago, bluelikejazz said:

I talked to a pdoc once who said they never use it because of the risk of psychosis. They also said the evidence wasn't strong enough for it to be on the PBS and sometimes in the US drugs take off because they are marketed aggressively to doctors and also marketed directly to consumers, which is illegal in Australia. It sucks if you're one of the few it does work for because off-label is bloody expensive. I'm having similar issues with modafinil. 

 I find some doxtors, especially gp's, will bend the rules and write an authority PBS script even though you don't meet the criteria. I do that with both Lamictal and Abilify. 

Perhaps you could get a private script for modafinil and use a Canadian online pharmacy. They get you to mail them the script and localise it somehow and post you the pills. A lot of meds are quite reasonably priced so long as there is a generic.

Edited by mcjimjam
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My doctors have been willing to do that if it's a fudging of criteria, e.g script says BP when I clearly have MDD. The modafinil situation is different because it is only listed for narcolepsy and the criteria would require appropriate evidence from a sleep specialist. I did extensive research into buying it (legally) from India but the pharmaceutical companies involved had been in trouble for contamination etc so I decided not to risk it. 

I hadn't considered a canadian pharmacy - I'll check that out. 

edit - nope. It's schedule F in Canada and seized at the border. Only available for Canadians if they have narcolepsy. 

Edited by bluelikejazz
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It is so fucking unfair. I was in a situation years ago when modafinil could have really helped. I had a sleep phase/circadian rhythm disorder that was particularly severe. I have ADHD so traditional stims don't keep me awake at clinical doses. That sleep disorder was my first health problem from 13 years old. I would go so long with barely any sleep I was hallucinating constantly and couldn't function properly. At the time they thought all my MI was caused by it. Whenever I'm depressed I go back to the fucked sleep cycle. My old pdoc said I should go to a sleep specialist and possibly get modafinil. Have you had any of the required tests?

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