Posted by SLS on March 19, 2012, at 6:33:28
In reply to Re: Viibryd (vilazodone) - What is the Verdict? » SLS, posted by phidippus on March 18, 2012, at 19:59:05
> I take Latuda, a potent dopamine antagonist. Won't it negate some of the effects of the Wellbutrin?
Gosh. That's a good question for which I don't know the answer. I guess it's no secret that I don't tend to rely on theoretical thinking to exclude treatment alternatives like this one. I would, on the other hand, use theory to exclude treatment alternatives with when safety and side effects are concerned. On the other hand, I am more likely to incorporate theory when choosing drugs to include as an alternative.
Theoretically, one might argue that a neuroleptic and Wellbutrin might act on different regions and circuits in the brain. They would thus not act antagonistically so as to "cancel each other out". Empirically, it should be noted that the addition of Wellbutrin can make worse OCD and tics. It can also produce irritability and agitation. In your case, I would be wary of the potential for Wellbutrin to worsen OCD. If you opt to try Wellbutrin, it is probably a good idea to abort the trial early if this occurs.
Regarding dosages, I tend to see augmentation and adjunctive treatments as combinations of full therapeutic dosages of the component drugs. Of course, serotonin syndrome is a risk when SRI drugs are combined. I don't know of any statistics or clinical impressions as to how often this occurs, though. It is done. Even the addition of lithium to an SRI can produce serotonin toxicity. However, with the latter combination, I think the potential benefit is worth the relatively small risk.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1012278
URL: http://www.dr-bob.org/babble/20120316/msgs/1013434.html