7/7/2023 0 Comments 450 to 300 wellbutrin insomniaIt lowers the seizure threshold in a dose-dependent fashion. Bupropion interacts with TCAs, some SSRIs (e.g., fluoxetine, paroxetine, sertraline ), antipsychotics, antiarrhythmics, selegiline (Eldepryl), amantadine (Symmetrel), and metoprolol (Toprol-XL). In addition, mirtazapine enhances the neurotransmission of serotonin and norepinephrine by blocking B-2 adrenergic receptors. Trazodone (Desyrel, brand no longer available in the United States), nefazodone (Serzone, brand no longer available in the United States), and mirtazapine (Remeron) selectively block the 5-HT2A and 5-HT2C serotonin receptors. 8īupropion (Wellbutrin) inhibits the presynaptic reuptake of norepinephrine and dopamine. Predictors of a positive response to treatment include a lower baseline severity, a higher education level, a higher income, private insurance, a higher level of mental and physical functioning, and a shorter episode of depression. 7 Cultural and medical factors influence the likelihood of patient improvement with antidepressant medications. The number needed to harm (i.e., cause side effects severe enough to terminate treatment) is from 5 to 11 for TCAs, and 21 to 94 for SSRIs. 8 The number needed to treat (NNT) to achieve one responder is 4 for tricyclic antidepressants (TCAs), and 6 for selective serotonin reuptake inhibitors (SSRIs). 8 One half of patients who respond to treatment do so only after eight or more weeks. Only one third of depressed patients who are treated with a single antidepressant achieve remission (i.e., complete resolution of symptoms) after three months. Whereas approximately one half of primary care patients with depression respond partially to medications, 7 residual depressive symptoms persist in most patients.
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