I'm really very ADHD and ASD, n I got finally got mental health relief on bupropion, after going through a fair gamut of serotonin affecting medications. It affects dopamine and noradrenaline (norepinephrine).
It only helps me truly at 600mg, which I started taking accidentally, and that's double the UK max, which used to be 600mg but was reduced as there's a mildly higher statistical likelihood of seizures as side-effect with that dose. Afair USA max is 450mg.
If I take any less, the depression causing emotional dysregulation and intrusive/automatic thoughts (hypermentalisations) come back (n I'm an utter mess at baseline), though it's said/known that ND folk can more often have hypo or hyper reaction to certain chemicals.
I read it can have an amplifying affect on other drugs in one's system, so could be a causal part of serotonin syndrome if another medication is being taken, but I can't find that paper again, which in part regarded someone who started it for smoking cessation and found, apparently, that it worked in combination with some serotonin based med to lift them out of depression, though pinch of salt on the causality and reality of all that.
It's also for ADHD, but it doesn't (really) help my attention or memory, though my psychiatrist noted that having space in the mind from not having bad thoughts certainly helps better attention..
Bupropion + SSRI is a fairly common combination for treating depression! Back in the day I think people used to start on an SSRI alone and then would add bupropion if they needed an extra kick, but it may be more common now to start with the bupropion (not sure).
And re. serotonin syndrome, I can anecdotally say that I accidentally gave myself mild SS by mixing imipramine, ondansetron, and NyQuil. I suspect that also being on bupropion at the time is what put me over the edge, but it's hard to say; even without the bupropion it may have been a nasty combo. Live and learn!
Bupropin has been wonderful for my ADHD and probably saved my life. I'm at the US max (450) and I still get those occasional intrusive thoughts -- I've learned to just ignore them and they don't really affect me, but it is weird that they pop up. Flying has been the one time it's been actually bad.
You mentioned that those went away after increasing dosage? I've been on the fence about going up since I'd need to take anti-seizure meds.
Do you have any issues sleeping? This has been the one (major) side effect, that I can't as easily get good reliable sleep. I wake up at 7am every day, cannot sleep in, and have trouble falling asleep (which was typical prior, but I'd be able to get around this by staying up til exhaustion and then sleeping in to get my full 8 -- now I have to get to sleep by 11 but find it very hard to fall asleep).
Are you me? I had the same experience but I'm at 450mg + adderrall.
It's basically a miracle. Not sure if the newer non-stimulant adhd meds work in combination with buproprion if you don't want a stimulant or can't take one or get one.
I will probably drop down the buproprion now.. I suspect that buproprion is basically just less effective Adderall.. however, the generic buproprions really have bad quality control. I think there's a big scandal there brewing like before.
Buproprion inhibits cypd2, which means drugs like DXM have much stronger serotonin effects. I combine these 2 drugs for treatment of major depressive disorder (the latter is easily available on Amazon, the former is prescribed to me)
Alternatively, as someone with severe ADHD, bupropion at the lowest dose gave me a psychotic episode where I started hearing things. Felt like I’d been dosed with schizophrenia pills. The razor blades told me to give them a look see. I threw them behind my fridge to keep them away. I went to my mom’s house, crawled in bed and cried for 24 hours straight. I’ve never had anything remotely like that before or since. This was nearly twenty years ago. Absolute worst day of my life.
My daughter had a pharmacogenetic screening test a few years ago and I’m not sure what this means exactly, but they give you a number with 1 being baseline expected response (this was awhile ago) and bupropion was a 9.
I’m extremely cautious about any sort of medication for me and my children because of this episode.