[ShoelessTroy]

I have Bipolar II Disorder and OCD. I'm just trying to find out any information about taking Wellbutrin and Luvox together

Thanks, T

[CamW]

BarefootHellenicCityWhosePeoleHaveACondomNamedAfterThem - I have seen this combination as the antidepressant part of a BPII regimen. It is not a common combination, but it should work (at least in some people).

SSRIs (like Luvox™ - fluvoxamine) are common augmented with another antidepressant with a different mechanism of action (MoA), like Wellbutrin SR™ (bupropion). Bupropion is a DNRI: dopamine-norepinephrine-reuptake inhibitor, which is really a misnomer, as significant dopamine-reuptake blockade only occur at dosages much higher than is used clinically. Also, Wellbutrin "regulates the turnover of norepinephrine", rather than by increasing synaptic concentrations of norepinephrine through reuptake blockade.

So then, what is Wellbutrin's mechanism of action? ...... I dunno ...... Personally, I think it has something to do with intraneuronal (nerve cell) regulation of calcium ion influx from outside the cell, as well as the release of bound up calcium ions from the endoplasmic reticulum (and I thought I'd never have to deal with that intracellular structure after graduation) ..... "the organelle with the musical name". The above is my own thinking out loud and I have no (well, a little) scientific proof of this

Uh, ..... where was I? ..... oh, yeah .... A second antidepressant, with a different MoA, is often added to an antidepressant that only partially resolves one's depressive symptoms. Quite often Wellbutrin, Remeron™ (mirtazapine), or Edronax™-CDN / Vestra™-US (reboxetine) is added to a partially effective SSRI.

I believe that your doc chose Wellbutrin and Luvox because, historically these agents have low "manic-switch" rates in people who are in the depressive phase of the disorder. Manic-switch is when an antidepressant (TCAs and MAOIs are the worst offenders) causes a manic episode someone with bipolar disorder. One explanation of this is that the antidepressant relieves the depression that was masking the manic behavior. This is not correct for a number of reasons.

Also, since World War II there has been a dramatic rise in the percentage of the population who suffer bipolar disorder. The rise is too great to be explained by better detection. One theory that I find quite compelling is the fact that the first antidepressants were marketed less than ten years after the end of WWII.

The tricyclic antidepressants (TCAs) and the monoamine oxidase inhibitors (MAOIs) were the first inorganic antidepressants available (outside of ECT, of course). These drugs are notorious for causing manic-switch in those people diagnosed with major depression who really suffered from bipolar disorder. Some researchers think that TCAs and MAOIs may cause someone who has a familial predisposition toward bipolar disorder to advance to full-blown bipolar disorder. That is, the TCAs/MAOIs act as the trigger (stressor) that tips someone over the edge from non-bipolar to bipolar, and may be the cause of the great increase in the number of people living with bipolar disorder.

Whoa! Off on a tangent ..... again. If you have any specific questions, I can try to answer them for you.

I hope that this is of some help. - Cam

[ShoelessTroy]

Good Lord! I wasn't expecting that but thanks for the reply.I'll need to read it about six more times in order to grasp it all.

Thanks again, T

[CamW]

ShoelessTroy - If there is anthing you'd like me to clarify, or any question you may, feel free to ask.

- am