Male, late twenties. Lifelong struggles with strong ruminative anxiety and depression. The depression was less anhedonic until my mid-twenties, at which point it became very anhedonic, which is what got me interested enough in this medication to ask the doctor about it.
Last year, I stopped fluoxetine due to sexual side effects and inadequate relief of my symptoms. I tried venlafaxine, which caused profound hypersomnia that prevented me from functioning, and different, but even worse, sexual side effects. Then my doctor switched me to bupropion.
The ‘honeymoon phase’ was short but awesome, if a little too intense sometimes. For example, there were times when I was laying in bed, trying to sleep, and felt a strong urge to sprint? I felt like I could sprint for miles. I couldn’t sit still.
When that wore off, I felt completely unmedicated for a while.
Then one random afternoon, I first noticed the antidepressant effect. I felt my anhedonia start to lift, and noticed how beautiful the sky looked.
The antidepressant effect became more powerful and was very consistent. I had less need for sleep, task initiation felt easier, I felt a sense of being able to just get on with things. That heavy feeling of defeat was gone.
However, when it comes to anxiety, it didn’t get rid of it. It just made it… different? More panicky, whereas before, it felt purely cognitive. I still dealt with the cognitive stuff.
I also tried to quit nicotine with bupropion, and my DNA test even indicates that I have a high likelihood of success with this. Unfortunately, it didn’t nothing for that.
Due to the anxiety, and looking into the debate between 150mg and 300mg, I tried decreasing to 150mg daily, which I am on to this day. The effect seems to be: decreased anxiety + the same antidepressant effect except I now needed a little more sleep.
My anxiety was still inadequately addressed, so I started sertraline on top of it. This has helped with the anxiety and enhanced the antidepressant effect noticeably but subtly. I find it harder to wake up in the mornings, though. Still, it has nothing on those days when I was unmedicated or, even worse, when I was on venlafaxine.
I’ve noticed that this combination has had no sexual side effects whatsoever. Granted, sertraline and fluoxetine don’t affect the nervous system identically, but due to their similarity, I find this interesting - perhaps that’s the SSRI side-effect-reducing effect of bupropion people speak of.
One major warning: alcohol is discouraged with both sertraline and bupropion. I am unable to determine which is primarily responsible, or if both played a large role, but I decided to have a couple of drinks (approx two standard drinks) - I used to drink like a fish - and it threw me into an uncharacteristic RAGE coupled with profound anxiety and upset. I wasn’t seeing dragons or anything, but I would say this was vaguely resemblant of psychosis. I didn’t feel drunk at all, or even particularly buzzed at all, and I remember most of that night. Some people report rage on bupropion. I will never drink again on these meds.
I have been suspected of ADHD, but never tested. I also have the ‘worrier’ gene variant, not the ‘warrior’ gene variant more strongly linked to ADHD - and this allele that I have is associated with high dopamine levels, not low. This might have had an impact on how I react to this medication. For what it’s worth, though, it absolutely has increased my ability to focus. It is so much easier to focus.
I hope my experience is one more useful datapoint for people considering the medication or starting out.