# Anyone take bupropion with an SSRI?? apathy thread spinoff



## instil (Aug 19, 2005)

read it..its not that long, mostly an excerpt from somewhere :b 
I often read that while single meds dont always do the job for people, they sometimes find that combo that works for them. Prozac has almost fully knocked out my depression, but now im just indifferent towards everything and it sucks just as bad. I was reading that 'apathy' thread, then followed a link within that post to a study where they were trying to find a solution for ssri-induced apathy. This part (specifically whats in bold) was interesting to me:


> How this revving up of the serotonin system may contribute to apathy is not clear; however, Barnhart et al., (2004), Hoehn-Saric et al. (1990, 1991), Levy, et al. (1998), and Marangell et al. (2002) suggest two possible explanations for AAS. _antidepressant apathy syndrome if you havent read it_
> 
> Direct Effect
> Serotonin directly affects frontal lobe projections that modulate initiative, curiosity, inhibition, and ability to focus. According to this view, as serotonin receptors are bombarded with increasing amounts of serotonin, these frontal lobe functions devolve into lack of motivation, disinterest, disinhibition, and poor attention.
> ...


Later in the article, treatment possibilities include: 
*lowering your SSRI dosage
*adding a norepinephrine enhancing antidepressant, or dopamine enhancing antidepressant
*switch from SSRI's to another class of AD

Leading me to my question, does anyone take a combination of an SSRI plus a med that acts primarily on dopamine, ie:bupropion/Wellbutrin (that being the only one i know that works in that way) ???? Whats your experience, or has anyone else found their solution after a similar experience to mine (and many others, who dont care enough to post,haha)


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## arthur56 (Jul 31, 2005)

I an very doubtful that buspar helps any more than placebo affect, but it was promoted for augmenting antidepressants


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## instil (Aug 19, 2005)

arthur56 said:


> I an very doubtful that buspar helps any more than placebo affect, but it was promoted for augmenting antidepressants


well buspirone is something different the Wellbutrin (bupropion). 
isnt buspar for anxiety, wellbutrin for depression?


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## korey (Apr 25, 2006)

I think Noca currently takes Lexapro (a potent SSRI) along with one of the time-released versions of Wellbutrin (a dopamine and norepinephrine reuptake inhibitor). Maybe he'll be able to give us some feedback about this.

I currently take Celexa (which is almost chemically the same as Lexapro), and I do feel that I have been experiencing the "lack of motivation, disinterest, disinhibition, and poor attention" caused by Celexa's serotonergic effects on me. I asked my psychiatrist about adding on some Wellbutrin to my Celexa on my appointment yesterday, but he opted for doubling my Celexa just to see if it would have any positive effect on my situation. My guess is that it will make me even more unmotivated, disinterested, disinhibited, and inattentive; but we'll have to wait and see. (I'm almost certain that I will again ask for Wellbutrin on my next appointment, though :b)


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## instil (Aug 19, 2005)

i need to try _something_, because being in this mindset is going to be as destructive as being in a deep depression. Still not spending time with friends, still laying around all the time, and not doing the things that need to be done like housework, taking care of my appearance, paying my bills. The only thing that has changed in the past 2 months is instead of just obsessing in my head about how im not living life and wanting to die, i just dont care.
Lack of motivation and disinterest are extreme understatements.


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## korey (Apr 25, 2006)

I know what you mean. :sigh


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## Noca (Jun 24, 2005)

I take Wellbutrin with Lexapro if which is an SSRI. It helps with the sexual side effects and gives an energy boost.


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## instil (Aug 19, 2005)

you cant be the only one Noca, but thanks for your input.

Yea, not only would I be grateful if it got rid of some of this apathy, but if it brought back my sex drive, even a little, that would be cool too. 

Not wanting sex all the time is actually kind of freeing (thats not a word, i dont think) Im able to pay attention while im working,and listen when people talk... since my eyes arent all over the place.


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## Noca (Jun 24, 2005)

I still get sexual side effects 60% of the time.


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## mask (Sep 18, 2006)

instil said:


> i need to try _something_, because being in this mindset is going to be as destructive as being in a deep depression. Still not spending time with friends, still laying around all the time, and not doing the things that need to be done like housework, taking care of my appearance, paying my bills. The only thing that has changed in the past 2 months is instead of just obsessing in my head about how im not living life and wanting to die, i just dont care.
> Lack of motivation and disinterest are extreme understatements.


I'm exactly in your position....I've just started wellbutrin, but it's too soon to say....although people sometime claim an immediate energy boost that I haven't experienced. Another possibility is amisulpride, a dopaminergic, selective dopamine reuptake inhibitor, originally used just as antipsicotic but now more and more used to treat dysthymia, chronic depression. apparently works great at the doses of 50 mg the only problem is that in about 15% percent of the patients produce an increase of prolactin, an hormon that influence also sexuality....other dopaminergic are many meds used to treat parkinson like selegiline....for the moement just used in reasearch to treat depression...but if you find an enlighted doc....


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## VoxPop (Nov 9, 2003)

I take Wellbutrin SR and Paxil.


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## instil (Aug 19, 2005)

mask said:


> I'm exactly in your position....I've just started wellbutrin, but it's too soon to say....although people sometime claim an immediate energy boost that I haven't experienced. Another possibility is amisulpride, a dopaminergic, selective dopamine reuptake inhibitor, originally used just as antipsicotic but now more and more used to treat dysthymia, chronic depression. apparently works great at the doses of 50 mg the only problem is that in about 15% percent of the patients produce an increase of prolactin, an hormon that influence also sexuality....other dopaminergic are many meds used to treat parkinson like selegiline....for the moement just used in reasearch to treat depression...but if you find an enlighted doc....


cool, thanks for commenting. Hey, did i convert a lurker to a poster?...i see thats your first post.
but yea, so you know what its like, im just indifferent towards everything like 'eh', no matter what happens or doesnt happen during my day. Please check in with me once in a while and let me know how its going, feel free to PM me.


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## mask (Sep 18, 2006)

instil said:


> mask said:
> 
> 
> > I'm exactly in your position....I've just started wellbutrin, but it's too soon to say....although people sometime claim an immediate energy boost that I haven't experienced. Another possibility is amisulpride, a dopaminergic, selective dopamine reuptake inhibitor, originally used just as antipsicotic but now more and more used to treat dysthymia, chronic depression. apparently works great at the doses of 50 mg the only problem is that in about 15% percent of the patients produce an increase of prolactin, an hormon that influence also sexuality....other dopaminergic are many meds used to treat parkinson like selegiline....for the moement just used in reasearch to treat depression...but if you find an enlighted doc....
> ...


I ended up just introducing some keywords in google and I got straight in your topic (I think they were dopamine, motivation....) I've never suffered of social anxiety, I suffer of depression....so I am afraid not a lurker.....;-) I use much the forum 'crazy meds talks'....it'just about medicines' discussions, I reccomend you a visit...I've opened a topic there about dopamine and motivation in the wellbutrin section


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## instil (Aug 19, 2005)

Bwhaha. he was searching for some scientific essays on the subject, and out of all the trillions of things on the internet, from all corners of the world....he gets MY post on SAS. ive checked that site out before i believe, by the way.
Again, let me know how you are making out with the treatment you are trying.


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## Ricky (Sep 23, 2006)

*Celexa....*

Hi!! i was on Celexa, even 60mg/day, flat me even more..
depending on your Dx (diagnostic) it works or not for you.

if I were U would drop it slowly and try something else.

U can e-mail me and chat over it in detail, Ricky


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## D.B. Cooper (Jul 21, 2006)

1. You will not ever be scripted a drug that primarily works on dopamine for depression except maybe emsam. Most dopamine reuptake drugs are either A.) schedule II controlled substances like amphetamines or B.) used for parkinsons. 

2. Its much easier to learn to deal with the apathy than add another med and possibly compounding other problems. I've done all sorts of cocktails and learned this the hard way. Theres a cost to be paid for that emotional buffer you get in anti-depressants, nothing is free.

The amount of dopamine action you get in wellbutrin even in high doses probably isnt even comparable to the blockading effect of caffeine. Its very very weak.


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## D.B. Cooper (Jul 21, 2006)

After thinking about this maybe you should try one of the supplements DLPA or L-Tyrosine, in theory they both convert to dopamine. Maybe add a little caffeine in the mix to kick start them.

I've never been a big beliver in supplements (besides omega 3) as most seem to be just a bunch of crap but these two do work to varying degrees.


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