Learning from the "bupropion effect"?

[Numby]

As some of you know, I have been on bupropion for about 7 weeks now and experienced a complete reversal of symptoms in weeks two and three. On November 18 (end of week three), I was back to baseline, no changes in weeks four and five. I then increased dose from 150 to 300mg on December 2 (end of week 5) and am now experiencing another "wave" of reversal (increase in libido, lubrication, arousal, genital sensitivity, etc.). I am not experiencing other side effects except for positive effects like feeling more "alive"/active and being less phlegmatic. Since I know that a couple of people on this forum have reported a similar effect of bupropion, I am wondering whether we can possibly learn something from the "bupropion effect" in order to understand what may cause or reverse PSSD symptoms.

Although I have read several studies on SSRI, PSSD, fluoxetine and bupropion, I am not a professional; neither do I have any knowledge of chemistry, pharmacology or biology. However, maybe there is someone on this forum who has more knowledge in these areas and thinks that having a look at what bupropion does would help? Or maybe someone has already tried to understand potential relationships between bupropion and (temporary) PSSD reversal?

The following questions came up when reading literature on bupropion and fluoxetine/SSRIs in general:

• Is there a connection between the SSRI that caused PSSD in the first place and the effectiveness of bupropion (i.e. everybody who took SSRI xy has a positive effect under bupropion and everybody else doesn't)?
• How many people on this forum have actually tried bupropion for a long enough period with a reasonable dose and what exactly was their experience?
• What is it that bupropion temporarily activates/increases/changes that causes the complete reversal of symptoms in some people? Is there anything known about a temporary effect of bupropion on anything (I couldn't find anything)?
• Why is this effect temporary although other (side) effects as well as the antidepressant effect aren't?
• Is it possible that norepinephrine and dopamine reuptake inhibition is the only reason for this effect? Then again: Why is it temporary?
• Does bupropion have a different effect on nitric oxide than SSRIs? I read that there is a synergetic effect between NO inhibitors and bupropion.
• What effect does bupropion have on nACh receptors that SSRIs don't have? As far as I read, SSRIs inhibit nAC, so what is it that bupropion does?

I want to apologize beforehand in case these thought/questions sound stupid... As I said, I am not a professional, but I am still trying to understand what is going on inside me (and others who are affected).

[Bunny]

Just to add my own two cents with this drug: I have taken bupropion XL on and off (300mg every day for a week once a month, every month) from 2011-2015. While on the dosage, I would experience modest improvement in all areas affected by PSSD -- desire, drive, sensitivity, sexual imagination, lubrication, orgasm, etc. I HAVE had complete "recoveries" -- most only lasting one day before returning to baseline, but for one week in 2012 I experienced a full, weeklong remission of all PSSD symptoms. I only stopped when the drug stopped having any effect whatsoever, though it might be time to go back on it. (I live in a very rural area where there almost no psych doctors, and all of them have extremely long wait lists, so it'll be quite a while before I have access to a prescription.) I'm curious to know as well why bupropion can yield such dramatic benefits, and why they only seem to be temporary.

[Kk88]

Hi numby, good Post - thanks. Afraid I Can’t offer any clever insight but would like to agree that we need to look more into the mechanisms of these things that help even just for ‘waves’. I had a wave (just one day) of full recovery on SJW. Surely looking at how these things affect us can at least help us understand a bit more. Fingers crossed for an expert to help...

[jaiho]

It basically comes down to tolerance.
You're feeling the acute effects of the drug rather than the long term therapeutic side of it.
Tolerance is inevitable when it comes to dopamine reuptake inhibitors. Bupropion does not impact depression by this mechanism, it's too weak to do so.
Theres some speculation that Bupropion interacts with VMAT2, but i haven't read enough into it.

Have you tried waiting a full 6-8 weeks after a dose change to see what happens?

[Numby]

@Bunny: Thank you for sharing your experience. I had read about your "cycling strategy" but wasn't sure if you are still on bupropion. It would be interesting to know if it had an effect on you after your two-year break. On the other hand, it is sad that the effect seems to fade out after some time. BTW: It was your post that made me try the 300mg.

@jaiho: Thanks for the information. I didn't know about VMAT2 and I'll try to find some information on that. Basically, I fear very much that bupropion will worsen my condition in the long run. So I am undecided, but I'll probably keep taking it to see what happens when I take the 300mg dose for a couple of weeks or months. My psychiatrist proposed that I try flibanserin but here again, I fear the serotonin-action... And I would have to wait a couple of weeks or months after discuntinuing bupropion to be on the save side.

Is there anybody else that tried bupropion? Please share your experience. Maybe we can "learn" something from it.

[fasttrack1982]

I have had PSSD for 4 years with no changes, and i've been on wellbutrin for three of those years. Wellbutrin has been a life saver for me in that it is the one thing that has helped my depression and anxiety, but it has not had a noticeable effect on my PSSD.

[hgwxx7]

I feel exactly the same situation whenever I start sertraline from long pause. Week 2-3 is peak. Then returns to baseline.
After a little research, I have come to an information that sertraline is not only a seratonin reuptake inhibitor, but also dopamin reuptake inhibitor.
I guess it is about receptor counts which reduces after some time (3 weeks.)