Actually, Wellbutrin is a norepinephrine reuptake inhibitor as an atypical antidepressant and marketed under the name Zyban as a smoking cessation aid. Wellbutrin is really in a class of its own and not to be confused with SSRIs like Celexa or Prozac. If Prozac made you anxious, you would probably respond very well to Celexa (also marketed as Lexapro) and visa versa. This is because the mode of action related to your particular genetic structure. Celexa, like Wellbutrin, has anti-anxiety properties.
Do not confuse the NRI with the SNRIs such as Cymbalta, Effexor XR and Pristique. These also work on keeping the norepinephrine and serotonin present longer in the brain chemistry.These are also called dual reuptake inhibitors. Unlike the SSRIs, if you respond well to one SNRI, you are likely to do well with each of them which is great news as Cymbalta is currently the most expensive anti-depressant on the market in the US followed by Pristique and then Effexor XR. Effexor (non extended release is available in generic form.
Now here is the exciting news. The NRI (Wellbutrin) is often used as a piggyback drug with your effective SSRI (in your case, again, if prozac wasn't working, you would probably do very well with Celexa) both Celexa and Wellbutrin, anxiety is decreased. Additionally, the addition of Wellbutrin increases the efficacy of the Celexa often negating some of the side effects and making it a more effective anti-depressant. There is no wonder though really. The NRI and SSRI predates the SNRI or dual reuptake inhibitors, exactly what the combination of an NRI and an SSRI becomes at a fraction of the cost!
Don't you just love how the drug companies love to make a buck by combining existing medications whose patents have run out and raising the price to nearly $900 per month for one drug?
Be patient my friend and keep asking questions. It might take some time to find the right combination of meds but it will be well worth it! Anytime I can help, do not hesitate to reach out.
Finally, just to clarify what is often misunderstood, while Lithium Salts were the first effective mood stabilizer, Lamictal is the first mood stabilizer on the market that has the FDA's approval for on-label use as a mood stabilizer in the treatment of bipolar disorder. It is very effective at the optimum dosage of 200 mg. However, it is very important that your doctor start you off at the lowest dosage, 25 mg, and work up to 200 mg over a 5-6 week period. Otherwise you risk responding with a life threatening rash and will never be able to take Lamictal again. If you go off Lamictal and wish to start taking it again, it is necessary to titrate up your dosage once again. Other popular mood stabilizers, although I do not find them to be as effective, are depakote and topamax. Again, these can be used in combination with Lamictal which is also sold in the US under the generic name, Lamotrigine. (Yea, generic,... lower co-pay)
God Speed and Best Wishes,
ptk