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Suggest A SSRI Drug Other Than Wellbutrin For Bipolar Disorder

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Posted on Sat, 3 May 2014
Question: I was diagnosed with Bipolar II this summer, right before I attempted suicide. I (luckily) have been on Lamictal since the 10th grade (I am a college sophomore) * I reduced my Lamictal dosage before I attempted suicide... My previous doctor just thought that since I have Bi-Polar in my family, I was someone who was not Bi-Polar, but who responded to Lamictal (and Wellbutrin) better than SSRI's because of that. (I tried Zoloft and Prozac for 2 weeks each: both resulted in sexual side effects and felt somewhat numbing) THIS IS MY CURRENT SITUATION: I am currently on a trial run of Lexapro. My main difficulty now is finding a way to treat my Anxiety. I also have difficulty with focus, but after trial runs with amphetamines, I have confirmed that my attention issues are very much intertwined with Anxiety, not a separate phenomena (i.e. they are related to "racing thoughts") I have felt no effect (then again, I've only been on it for 4 days) BUT I have already noticed sexual side effects. I am not a sexual person, but one day I might be and I don't want this issue (sexual side effects don't go away like many others)... Some say that taking Wellbutrin might help...well I am taking 300mg, so I doubt that. OKAY SO HERES THE QUESTION: I worry that Wellbutrin may have all along been increasing/maintaining my anxiety. When I took Wellbutrin alone, I felt nothing, except slightly more functional but still miserable. Furthermore I have had headaches recently and while this may be due to my recent Lamictal increase, it may have to do with the fact that Wellbutrin (according to my doctor, who is really competent) might somehow "increase" certain effects...not sure how that works, but we're gonna try and reduce the Wellbutrin soon. SO, SHOULD I JUST STOP NOW WITH THE LEXAPRO, REDUCE THE WELLBUTRIN AND SEE WHAT HAPPENS. OR EVEN IF I DO STOP LEXAPRO AND REDUCE WELLBUTRIN XL, IF I *STILL FEEL ANXIETY...IS THERE SOME OTHER NON SSRI DRUG THAT WILL HELP (THAT IS NOT A "TAKE_AS_NEED" TYPE DRUG (i.e benzo's) Please get in touch! Feeling a bit desperate here. Thanks!
doctor
Answered by Dr. Dr.Saatiish Jhuntrraa (54 minutes later)
Brief Answer: Consider MAO inhibitors Detailed Answer: Hello Thanks for choosing wwwhealthcaremagic.com Yes, MAO inhibitors may be the right choice. They should be started after you completely stop Wellbutrin and a washout period of 2 weeks. There are restrictions of some foods containing tyramine when on MAO inhibitors. but these can be extremely effective. Another choice can be Mirtazapine. Both have almost no sexual side effects Dr Saatiish Jhuntrraa
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Dr.Saatiish Jhuntrraa (2 days later)
But, Buspirone is not an MAOI inhibitor, in fact it specifically says do not take with MAO inhibitors? And I'm not going off of Wellbutrin completely, only a little. My psychiatrist told me to stay on Wellbutrin for now and then go on Buspirone. I Really don't mean to sound rude, but it says that you are a Sexologist...this is a purely psychiatric question. Please get back to me Thank you
doctor
Answered by Dr. Dr.Saatiish Jhuntrraa (29 minutes later)
Brief Answer: I again stand by the advice given last time. Detailed Answer: Hello I have never mentioned Buspirone as an alternative to you. I know Buspirone is not MAO inhibitor but is a 5 HT1A partial agonist and you should not combine these two medicines.usually. Kindly read my profile. I am a psychiatrist with 29 years of experience and In India, degree in psychiatry is required for sexology. I shall be very glad that you should follow a very competent colleague of mine. but the issue you raised was sexual side effects due to psychotropic medicines. Buspirone also raises levels of serotonin in brain so has almost similar sexual side effects. There are a few medicines only that are effective for anxiety disorder without sexual side effects. I still repeat what I said in my earlier reply. Most other medicines will have side effects like reduced libido and delayed or no discharge. I shall be glad to clarify any further doubts . Dr Saatiish Jhuntrraa
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Dr.Saatiish Jhuntrraa (37 hours later)
I wasn't attacking your credentials I was just curious. Anyways, one last question. But according to my research Buspirone is actually used to counter the sexual side effects of SSRI's (not that I'm taking anyone anymore)
doctor
Answered by Dr. Dr.Saatiish Jhuntrraa (4 hours later)
Brief Answer: Buspirone can worsen Sexual side effects of SSRI Detailed Answer: Hello I am sorry to say your research is not correct. SSRI have two SE's- reduced libido and delayed ejaculation. It helps in neither. On the contrary, it can worsen the situation. Dr Saatiish Jhuntrraa
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Raju A.T
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Dr. Dr.Saatiish Jhuntrraa

Sexologist

Practicing since :1983

Answered : 1525 Questions

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Suggest A SSRI Drug Other Than Wellbutrin For Bipolar Disorder

Brief Answer: Consider MAO inhibitors Detailed Answer: Hello Thanks for choosing wwwhealthcaremagic.com Yes, MAO inhibitors may be the right choice. They should be started after you completely stop Wellbutrin and a washout period of 2 weeks. There are restrictions of some foods containing tyramine when on MAO inhibitors. but these can be extremely effective. Another choice can be Mirtazapine. Both have almost no sexual side effects Dr Saatiish Jhuntrraa