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LittleJem

Visionary
Jul 3, 2019
2,644
Am trying to decide which SSRI to augment buproprion - whether lexapro or prozac. The question in my mind is that Fluoxetine is metabolised by CYP2D6 and buproprion inhibits CY2D6. Can anyone please explain to me why it is important that fluoextine is metabolised? Does it matter if it is not metabolised? Does it just mean that there will be higher levels of fluoextine in my blood stream/body? Fluoextine has boosted the efficacy of buproprion in rats and there are reports on reddit of fluoxetine/buproprion being prescribed together. I'm not keen on Lexapro/escitalopram as the withdrawal effects sound rougher than fluoextine and it also can give lethargy and weight gain. I've had somnolence from an SSRI before which sucked. Prozac in the past has been helpful and I had no bad side effects and no withdrawals when it stopped helping me.

I could wait for 8 weeks on this dose of buproprion at 300 mg and see how it is, but my depression has been dangerous for a long time, so might be better off adding an SSRI asap so everything can kick in together. I'm not going to discuss this with a psychiatrist as my psychiatrist has given me the go ahead to take buproprion but will not advise on it as it is not prescribed in the UK for depression. This is because GSK did not apply for a license in the UK (imagine all the people suffering that could have been helped by buproprion if GSK had pursued the license). She also does not know about things such as the MHTHR gene mutation, so basically as a sufferer I have found I do more research than the psychiatrists. She is the nicest psychiatrist I ever met though - I have never met a nice one before.

Thank you if anyone scientific or medically informed can help with this query. Basically it looks like lexapro is the better option, but am trying to see if I can get away with prozac. And it helped the rats!!! So maybe it will help me.
 
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