Medication and Therapy

Beware of Grapefruits and Pomelos in Drug Interactions

Grapefruits and pomelos may cause accumulation of the drugs that have to be cleared (metabolized) through the liver enzyme CYP450 3A4. Many psychotropics and antidepressants used by psychiatrists to treat conditions including depression, bipolar disorder, and anxiety are metabolized through CYP450 3A4. This means you have to be very careful if you are used to [...]

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Abilify in Bipolar Disorder: Doctors say, “We Need More (Good) Data!”

Medical researchers are asking for better data on aripiprazole (brand name, Abilify) based on the latest PLoS publication, “Aripiprazole in the Maintenance Treatment of Bipolar Disorder: A Critical Review of the Evidence and Its Dissemination into the Scientific Literature”. Basically the title is translated as, “objectively looking at Abilify’s use long term in bipolar disorder.” [...]

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Antidepressant-Suicide-Risk Paradox

Here’s a great question asked on Quora: “If antidepressants are supposed to make you less depressed, why would they carry an increased suicide risk?” Supportive of the answer regarding an increased motivation that has been created by the antidepressant in the system, another supporting observation to the “activating the motivation necessary to carry out suicide [...]

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Antidepressants and Liver Enzymes

On Quora there was a question about the effects of antidepressants on liver enzymes that metabolize/clear out medications, also known as cytochrome P450 (CYP450). These are the ones that cause you problems when you mix drugs, based on the effect of the drugs on its ability to work. Think of drugs as acting like “gas [...]

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Wellbutrin and Anorgasmia: Bupropion Can Cause Sexual Dysfunction

Most of the patient experience with bupropion (Wellbutrin, Zyban) has been an increase in libido, and this side effect has caused physicians to use this drug as a way to manage sexual dysfunction caused by serotonin-receptor based antidepressants (SSRI, SNRI). However, a reader wrote in about her experience with sexual dysfunction on bupropion. I’m looking [...]

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What does it feel like to have depression?

On Quora someone asked what it feels like to be depressed, and there was an anonymous answer that provided a good description of symptoms as it applies to real life. Without rehashing the good responses, I’ll provide some of the “old scripts” that I’ve lived with personally when I suffered from clinical depression in the [...]

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Wellbutrin in Sexual Dysfunctions in Women

Recently 2 studies came out looking at the use of bupropion (brand name Wellbutrin) in female sexual dysfunction, including dysfunction that was caused by SSRI-antidepressant therapy. In this first study (below for scientific citation and abstract), 232 women who were diagnosed with “hypoactive sexual desire disorder” (HSDD) were treated for 12 weeks with either bupropion [...]

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Moving Beyond Blue

Therese Borchard at Beliefnet’s Beyond Blue interviewed me in October 2007. She asked many insightful questions including, “how do you think you know when or if you can go off your meds?” and “What did you do when you relapsed?” I had no idea that my answers were interpreted as controversial based on the comments [...]

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