I'm really very ADHD and ASD, n I got finally got mental health relief on bupropion, after going through a fair gamut of serotonin affecting medications. It affects dopamine and noradrenaline (norepinephrine).
It only helps me truly at 600mg, which I started taking accidentally, and that's double the UK max, which used to be 600mg but was reduced as there's a mildly higher statistical likelihood of seizures as side-effect with that dose. Afair USA max is 450mg.
If I take any less, the depression causing emotional dysregulation and intrusive/automatic thoughts (hypermentalisations) come back (n I'm an utter mess at baseline), though it's said/known that ND folk can more often have hypo or hyper reaction to certain chemicals.
I read it can have an amplifying affect on other drugs in one's system, so could be a causal part of serotonin syndrome if another medication is being taken, but I can't find that paper again, which in part regarded someone who started it for smoking cessation and found, apparently, that it worked in combination with some serotonin based med to lift them out of depression, though pinch of salt on the causality and reality of all that.
It's also for ADHD, but it doesn't (really) help my attention or memory, though my psychiatrist noted that having space in the mind from not having bad thoughts certainly helps better attention..
Alternatively, as someone with severe ADHD, bupropion at the lowest dose gave me a psychotic episode where I started hearing things. Felt like I’d been dosed with schizophrenia pills. The razor blades told me to give them a look see. I threw them behind my fridge to keep them away. I went to my mom’s house, crawled in bed and cried for 24 hours straight. I’ve never had anything remotely like that before or since. This was nearly twenty years ago. Absolute worst day of my life.
My daughter had a pharmacogenetic screening test a few years ago and I’m not sure what this means exactly, but they give you a number with 1 being baseline expected response (this was awhile ago) and bupropion was a 9.
I’m extremely cautious about any sort of medication for me and my children because of this episode.
This is all very unsettling to read. Not only because of what happened to you, but because I had a terrifying experience with bupropion almost a year ago.
I’ve told myself I must have been at fault. I’m forgetful, I must have taken too much. I must have already been in a bad state. Whatever.
I quite literally almost died. I didn’t put anyone else at risk; nothing like it. But I went into a horrifying dark mental state and couldn’t imagine ever exiting it.
I tapered off and it took months to feel some semblance of normality again. I look back on it with a sense of fear. I genuinely lost my mind. I’ve taken psychedelics and even quite a lot of them at times and know the feeling of losing my ego and having a loss of control, but never have I felt so utterly disconnected and void.
I’ve wondered ever since how much this affects other people. Or how often it’s reported. I never told a soul until very recently.
For the short time I was on Wellbutrin/bupropion I would have micro blackouts multiple time periods per day and couldn't recall what I did or where I was. Not for me. Sertraline on the other hand (SSRI) is a godsend.
Bupropion + SSRI is a fairly common combination for treating depression! Back in the day I think people used to start on an SSRI alone and then would add bupropion if they needed an extra kick, but it may be more common now to start with the bupropion (not sure).
And re. serotonin syndrome, I can anecdotally say that I accidentally gave myself mild SS by mixing imipramine, ondansetron, and NyQuil. I suspect that also being on bupropion at the time is what put me over the edge, but it's hard to say; even without the bupropion it may have been a nasty combo. Live and learn!
Bupropin has been wonderful for my ADHD and probably saved my life. I'm at the US max (450) and I still get those occasional intrusive thoughts -- I've learned to just ignore them and they don't really affect me, but it is weird that they pop up. Flying has been the one time it's been actually bad.
You mentioned that those went away after increasing dosage? I've been on the fence about going up since I'd need to take anti-seizure meds.
Do you have any issues sleeping? This has been the one (major) side effect, that I can't as easily get good reliable sleep. I wake up at 7am every day, cannot sleep in, and have trouble falling asleep (which was typical prior, but I'd be able to get around this by staying up til exhaustion and then sleeping in to get my full 8 -- now I have to get to sleep by 11 but find it very hard to fall asleep).
Are you me? I had the same experience but I'm at 450mg + adderrall.
It's basically a miracle. Not sure if the newer non-stimulant adhd meds work in combination with buproprion if you don't want a stimulant or can't take one or get one.
I will probably drop down the buproprion now.. I suspect that buproprion is basically just less effective Adderall.. however, the generic buproprions really have bad quality control. I think there's a big scandal there brewing like before.
Buproprion inhibits cypd2, which means drugs like DXM have much stronger serotonin effects. I combine these 2 drugs for treatment of major depressive disorder (the latter is easily available on Amazon, the former is prescribed to me)
"Strikingly, up to 80% of individuals diagnosed with ASD are male, suggesting sex-specific neurodevelopment underlies this condition."
There's also a suggestion that women have more social pressure/conditioning to act a certain way and thus are more efficient at an early age at "masking" symptoms of ASD and less likely to get an opportunity to be tested. Maybe there can be multiple suggestions though (yes, rtfad).
80% is indeed a striking imbalance though, I had no idea it was this high, and I don't know if social conditioning alone is enough to explain it. Not to mention that according to this study itself, when considering ASD-like behaviours, "an estrogenic fatty acid alleviated these features and reversed detrimental neurodevelopmental gene expression." So it seems to really be something based in the biology.
There’s a growing consensus that this number is way, way off, considering just how good women tend to be at masking compared to men.
I’ve met many women with the same story that didn’t even know they were autistic until they heard someone explain “masking” behavior as an autistic coping mechanism, and they said: “wait, isn’t that what everybody does?” They then go to a doctor to help them understand, etc.
Lots of actresses have it, some of them are public about it.
I’m surprised to see that 80% number cited without bold caveats mentioning the limitations.
Historically most clinical studies up until around the 2000’s were done with a large percentage of participants being white men, often times there were NO WOMEN in the study.
A lot of rework is being done, which is great to see, but that’s going to take a long time before we have a true understanding of the variations between sexes caused by nature and/or nurture.
Females are often under-diagnosed with ADHD as well, the going theory being that males are more often hyperactive type and females inattentive (people can also have both characteristics). The boy running around the class being disruptive is more likely noticed than the girl always looking out the windown.
If you're part of any group (or set of groups), you're either less or more of an individual, depending on how you look at it, both of which can be viewed normatively as good or bad.
