3 ms·

Only slightly related, but can anyone ELI5 why Bupropion XL is not the universal first line treatment for depression and is hardly used at all in Europe? It ha

by elil17 1mo ago

Only slightly related, but can anyone ELI5 why Bupropion XL is not the universal first line treatment for depression and is hardly used at all in Europe? It has fewer side effects vs. SSRIs, can be safely used as a long term medication (which many people do with SSRIs even though it can have negative effects), and doesn't have the same horrible withdrawal symptoms (although you still need to taper).

LoganDark 1mo ago
My doctor tried me on Bupropion for ADHD and I think it caused my BorderlinePD to get much worse, so definitely YMMV.
hapless 1mo ago
Anxiety is a common comorbidity in depression patients and buprioprion can dramatically raise anxiety levels It is a second-line treatment for a reason. Great when it works. Harmful when it does not.
- petesergeant 1mo ago
  Just want to underscore that this is the right answer.
- haswell 1mo ago
  Yeah, this is exactly why I couldn’t stay on it. I already deal with GAD and OCD, and whatever benefits it had for the depression were directly counteracted by the return of acute anxiety. It was truly hellish. Feeling like I had this energy that I needed to use, while also feeling so anxious that I didn’t want to leave the apartment. I know it works really well for some people but I was definitely not one of them.
  - bcjdjsndon 1mo ago
    [flagged]
- elil17 1mo ago
  Thank you, that answer makes a lot of sense.
herbst 1mo ago
It has a long and scary list of side effects, good if it works for you
- esperent 1mo ago
  They all do and my reading has always been that bupronion has less scary side effects than e.g. escalitopram.
  - Schlagbohrer 1mo ago
    There's a medicine named escalate-o-pram?
    - kijashdkujdfhas 1mo ago
      Probably a misspelling of escitalopram, aka Lexapro.
attemptone 1mo ago
Doctor gave it to me and I reacted paradoxically to it. Worse depression and even more peculiar I picked up smoking again. I never felt such an urge to smoke in my life. Over the years I've been looking for an explanation for that reaction but wasnt able to find anything
Trasmatta 1mo ago
Or Auvelity, which is a newer one that mixes Bupropion and DXM.

by elil17 1mo ago

LoganDark 1mo ago

My doctor tried me on Bupropion for ADHD and I think it caused my BorderlinePD to get much worse, so definitely YMMV.

hapless 1mo ago

Anxiety is a common comorbidity in depression patients and buprioprion can dramatically raise anxiety levels It is a second-line treatment for a reason. Great when it works. Harmful when it does not.

petesergeant 1mo ago
Just want to underscore that this is the right answer.
haswell 1mo ago
Yeah, this is exactly why I couldn’t stay on it. I already deal with GAD and OCD, and whatever benefits it had for the depression were directly counteracted by the return of acute anxiety. It was truly hellish. Feeling like I had this energy that I needed to use, while also feeling so anxious that I didn’t want to leave the apartment. I know it works really well for some people but I was definitely not one of them.
- bcjdjsndon 1mo ago
  [flagged]
elil17 1mo ago
Thank you, that answer makes a lot of sense.

herbst 1mo ago

It has a long and scary list of side effects, good if it works for you

esperent 1mo ago
They all do and my reading has always been that bupronion has less scary side effects than e.g. escalitopram.
- Schlagbohrer 1mo ago
  There's a medicine named escalate-o-pram?
  - kijashdkujdfhas 1mo ago
    Probably a misspelling of escitalopram, aka Lexapro.

attemptone 1mo ago

Doctor gave it to me and I reacted paradoxically to it. Worse depression and even more peculiar I picked up smoking again. I never felt such an urge to smoke in my life. Over the years I've been looking for an explanation for that reaction but wasnt able to find anything

Trasmatta 1mo ago

Or Auvelity, which is a newer one that mixes Bupropion and DXM.