Mental Health Any clinical trial links for bupropion/Wellbutrin/Zyban??

JohnBoy2000

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First off, my doc is a real old dude that will be retired shortly.
He's had an absolute myriad of health conditions himself, so basically, he's going on whatever he learned in college about 40 years ago, and does absolutely nothing in the way of staying updated with modern medicine and publications.

He had, as he told me, three or four patients to whom he prescribed bupropion previously.

I don't know if it was the generic version or brand, but in any case, they reported back to him with side effects of insomnia and supposedly, extreme nightmares.
He discontinued prescribing it from there forth.

Now - I've gone through several first line treatments, serotonergics, anti-psychotic adjuncts, and given bupropions activity on a different set of receptors entirely, it's something I'd be relatively keen on trying.

It's marketed in my country as Zyban, the smoking cessation agent.

I know there has been dispute between the efficacy of the brand Zyban versus generics - which is, from what I can see, amply supported by a plethora of anecdotal evidence, so maybe that was in part the cause of the mixed feedback my doc received regarding his scripting of this med.

But anyways - my job now, to convince him that this could potentially be a very effective medicine, despite one or two falters in prescribing it thus far.

I need to support that with written information that goes beyond a few copy and pasted anecdotal reports.

That being said, after much googling, I failed to happen across much in the way of substantive clinical trial reports delineating the efficacy of said drug on a widespread basis.

You guys seemed to, in the past, have been much more adept at retrieving this type of information; maybe there's a knack to internet researching that I just haven't got the hang of yet.

In any case - quite a long winded way of saying - can anyone link me to officially concluded and drawn up reports or articles that could assist me in swaying the opinion of my out of date GP, into scripting this a-typical drug??


PS - as an afterthought that maybe you guys can help me on; it's known to suppress appetite also.
That being said, a mood elevation would incite a return in appetite (which is currently very poor) - so perhaps this would balance out?
Makes sense from a lay mans application of general logic, but does it translate that way in the world of pharmacological reality?
 
Wellbutrin can cause insomnia, and I'd imagine (less often) nightmares. Even so, it sounds strange to me that he stopped prescribing the drug altogether because of only four negative cases. I would think that psychiatrists are supposed to use algorithms, clinical studies, and the experiences of the majority of other psychiatrists when they decide upon a medication. I mean, if they tried twenty patients on it, and all or many of those patients reported such symptoms, that might be a decent lesson to use it more judiciously. But three or four patients??

And furthermore because Wellbutrin is pretty unique in how it works, when it comes to antidepressants. I mean it's not like the SSRIs, which there are at least five that I can think of off the top of my head. It's a really good medication to keep in mind for lethargic depression, bipolar depression, ADHD, and to an extent, stimulant addiction. And it doesn't really have abuse potential.

The issue with generic bupropion vs name-brand, was a real issue, but I'm under the impression that that problem has been fixed.

It's never good for the patient to seek a specific medication. You can find just about anything on the internet. Be honest with your doctor, don't ask for the drug you want, and things will turn out better, almost surely.

Again, strange that he wouldn't be aware of those trials.

As your question is phrased, we can't help you do research to help you get a drug. I'm sorry, but that strays too far into against the rules.

There are plenty of substances that boost mood and reduce appetite (stimulants0. If you have a poor appetite, I could see why he wouldn't want to add Wellbutrin--it decreases appetite. So no, your question is way too reductive.

I'm going to leave this open for the time being because you're not asking for recreational drugs and have legitimate concerns that we may be able to offer a few thoughts on. But if those goes too far into "How do I get this drug?" I will close this.
 
i find it hard to believe that you can get a prescription for zyban in your country but not for wellbutrin or wellbutrin xr, but if that is the case, they are quite effective ssni's, and i would highly recommend them. though there is research that suggests that in patients with manic tendencies this medication may cause restlessness and insomnia. i am a manic and have not had any of these problems when prescribed them.

the only difference between the marketing of zyban and wellbutrin is the dosage. if it is truly packaged Zyban, then it passes all the quality controls of manufacturing of Wellbutrin as set forth by and monitored by the FDA of the USA. so it is the same thing, usually though 50 mg, and not XR, you would want to start at the 150 range of wellbutrin XR, and never exceed a maximum of 300mg wellbutrin XR, as the side effects do outweight the treatment benifits at higher dosages than that and are not prescribed, as serious damage can result.

best of luck.
 
Why he wouldn't prescribe Bupropion i don't know because out of all the Anti-Depressants on the market today it probably has the least number of side effects and in Canada is definitely in the top 5 prescribed anti-depressants today. Sure it can cause insomnia and anxiety (though this usually goes away or atleast subsides in most people) as it is a Dopamine Norepinephrine reuptake inhibitor but i found it to only cause very mild insomnia. Also unlike SSRI's and SNRI's it neither causes physical addiction or sexual dysfunction which are 2 big pluses. The only other newish Anti-Depressant i have taken is Effexor and in the whole 6 weeks i was on it i didn't have a fucking orgasm even with a gorgeous woman never mind by myself :! . So fuck that shit right off. Wellbutrin actually increases alot of peoples sex drive so hey there's another plus :). It also makes me more alert and just generally lifts my mood plus it's the only Anti-Depressant that works well on Seasonal Affective Disorder which is why i usually end up on it every winter as SAD makes my Bipolar Depression far worse. Besides the Tricyclic Anti-depressants Trimipramine and Amitriptyline (of which Trimipramine seemed to work best) Bupropion is the only other anti-Depressant that works for me and does not cause mania or horrible side effects.

There are tons of studies out there on Bupropion so why your doctor seems hesitant to prescribe it is beyond me. Just print off abunch of studies about it and give it to him.
 
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