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Combinations - bupropion (Wellbutrin) and cannabis: frightening experiences

Discussion in 'Antidepressants' started by 5ht-Lover, Jan 14, 2011.

  1. 5ht-Lover

    5ht-Lover Newbie

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    I have been on bupropion SR, indicated for depression, for about 2 months. He's currently on 300mg daily (split into two 150mg pills). SWIM seemed particularly sensitive to this substance when he first started, showing some hypomanic tendencies and anxiety, but he was grateful for having some energy and motivation to help counter his depression. Things seemed to level out after a couple of weeks and SWIM continued to take the bupropion without problem.

    I was smoking cannabis avidly at the time, especially to provide relief from bupropion's initial side effects. He had been self-medicating for a good while and was very comfortable and functional while high. He had a moderately-high tolerance and could smoke a chronic-filled blunt all by himself and think nothing of it...sometimes he enjoyed getting high to an extent that many people seemed uncomfortable with. He'd had very few negative experiences and enjoyed the light psychedelia.

    About a month into the bupropion therapy, SWIM's attitude towards cannabis started to change. The first thing he noticed was that bupropion seemed to give THC more of a "punch"...it seemed more psychedelic and focused, and was prone to cause anxiety and paranoia at moderately-high doses. SWIM began to cut back on his smoking but still was inclined to experiment with this chemical combination further. He noticed that derealization, an infrequent but usually pleasant effect of weed, was now more prevalent and not quite as comfortable. Several times when he was listening to music in bed with his eyes closed, he'd begin heavily body-tripping. He'd also see ambiguous hints of CEVs. All these things were primarily noticeable in higher doses. Weed had definitely become weirder but not altogether worse; more interesting than anything.

    It was also more tiresome, however, and SWIM lost much of his interest in smoking at this point, though he still did it fairly regularly with his friends for the purpose of socialization. It wasn't nearly as much as he'd consumed before though, and he lost most of his tolerance to THC. Soon the effects on him were so strong that he only smoked 2-3 hits on average.

    Then SWIM made the mistake of getting together with some friends and smoking a good-sized blunt with them, probably taking 6-7 hits. The night that followed was the worst of his life. He was higher than he could've ever imagined being on cannabinoids, and this was someone who'd experimented with high-dose JWH-018. His heart started heavily thudding in his chest. He had an unpleasant, "buzzy" body load. He felt very dissociated to the point where he thought that maybe he'd smoked PCP or something; feelings of depersonalization and derealization were incredibly strong...he was *gone*. The body load seemed to intensify and he started feeling painful electrical sensations throughout. SWIM knew that bupropion lowered one's seizure threshold and he worried that he was going to seize (which had never happened, and he had no family history of seizures). Eventually, though, he decided that while these were strange effects, he'd heard of plenty of people who thought they were going to die from a THC OD when really they had nothing to fear. Thus he decided to just wait it out, which took about an hour and a half. After that he seemed fine.

    SWIM abstained from cannabis for a while and then used it very cautiously, initially taking no more than one hit, which he tolerated fine. Soon he moved up to two hits and got blazed, but everything seemed fine. Then one night he took three hits, and the same frightening experience as before occurred. This time he called 911 and told them that he might seize, explaining about the apparent bupropion-cannabis interaction. The ambulance technicians seemed to think that he wouldn't seize after talking with him. He was driven to the hospital and hooked up to an EKG which revealed his heart rate to be 150. He was given a strong benzo (lorazepam-I say that this is some good shit) and eventually he settled down. Blood, urine, and STD tests all came back negative. He was not told exactly what had happened (probably because they didn't know) and was simply advised to never smoke marijuana again (get rid of the illicit drug, not the one that actually puts you at the risk for seizures, typical.)

    I have smoked once (a cautious amount) since then with no adverse reaction, but he's uncertain about both the pot and the bupropion, thinking that he should stop smoking for a good while and discontinue the bupropion entirely. He would also like to know what exactly was happening to him those two nights.
     
  2. TheFakeBass

    TheFakeBass Palladium Member

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    Re: bupropion (Wellbutrin) and cannabis: SWIM's frightening experiences

    Perhaps it is true that bupropion is more likely than cannabis to raise people's seizure thresholds.

    BUT:
    You say that SWIM's bupropion has been helping with his depression. Is cannabis helping SWIM's depression? Your remark "get rid of the illicit drug, not the one that actually puts you at the risk for seizures, typical" was funny, but bupropion hasn't actually GIVEN SWIM a seizure. You say that SWIM's bupropion anxiety levelled off after a couple of weeks, and it was smoking cannabis that gave SWIM this horrible panic attack.

    You say that I have lost interest in cannabis.

    So why is it that you want SWIM to discontinue his bupropion entirely?

    My guess as to what happened to I am that I got unpleasantly high and then started panicking about having a seizure.

    Most bupropion seizures happen right after increasing the dose, and/or within hours of taking it. Also, at 300mg/day or below, the risk of seizures from bupropion is not appreciably higher than the risk of seizures from most antidepressants.

    It seems to me that I am at no risk from the bupropion, which is actually helping him; cannabis, on the other hand, has become unpleasant for him.

    I could stop the bupropion and then maybe cannabis will be fun for him again, but it might not happen that way. Lots of people who love cannabis begin to get unpleasant effects from it after a while without taking any other drugs. And besides, the depression might come back.

    If I feel so strongly about being able to enjoy high-dose cannabis that he is willing to stop his effective antidepressant, just to have a chance at enjoying high-dose cannabis again, then SWIM might as well do that.

    If not, I think you know what I think I should do: stay on the bupropion if it's not causing SWIM any other problems, and not smoke more cannabis than he can tolerate.


    On an unrelated note, your friend I should not let his real name be used on this forum. Instead of "SWIM", say something ridiculous like "my grandma's pet's food bowl" or something like that to protect SWIM's identity.
     
  3. psyche

    psyche Palladium Member

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    Re: bupropion (Wellbutrin) and cannabis: SWIM's frightening experiences

    Cannabis mixes well with almost everything, but Erowid has listed wellbutrin as the only contraindication to cannabis use, meaning the combination could be dangerous.

    Edit: That didn't come out right. What I meant was that cannabis isn't considered physically dangerous to combine with any other drug as far as I know, unlike depressants, stimulants and dissociatives, which can make up fatal combinations. Cannabinoids have such a high LD50 because the brainstem, which controls breathing and heart rate is virtually absent of cannabinoid receptors.
     
    Last edited: Jan 15, 2011
  4. TheFakeBass

    TheFakeBass Palladium Member

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    Re: bupropion (Wellbutrin) and cannabis: SWIM's frightening experiences

    Where does it say that? I've never read anything like that on Erowid or on any other site.
     
  5. psyche

    psyche Palladium Member

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    Re: bupropion (Wellbutrin) and cannabis: SWIM's frightening experiences

    It's apparently been removed. It was on the Basics under the contraindications a few years back when I first started looking into drugs. Caught my eye because I've never read anything like that anywhere else.

    Anyhow, wellbutrin potentiates cannabis Very much, not necessarily in a desired way. Here's one example from erowid:

    http://www.erowid.org/experiences/exp.php?ID=14393
     
    Last edited: Jan 14, 2011
  6. 5ht-Lover

    5ht-Lover Newbie

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    Re: bupropion (Wellbutrin) and cannabis: SWIM's frightening experiences

    Alright then, I wrote me a story about his gerbil. In this story, the gerbil had been pumped full of Lexapro (40mg) daily for several months, but nevertheless fared very poorly on his forced-swim tests, and in fact became more lethargic and could not longer fuck his favorite female gerbil. Luckily for the gerbil, he was discontinued from this horrible drug over a month's worth of tapering, which in retrospect was perhaps too quickly. The gerbil didn't respond well to the tapering and showed signs of agitation and frequent brain/body zaps. These passed gradually and the gerbil showed signs of normality again.

    However, my friend's gerbil's veterinarian believes that the gerbil's visit to the ER could largely be attributed to the recurrence of these chemical withdrawals, though the heart rate could be attributed to both chemicals (THC and bupropion) present in his system. The gerbil certainly didn't exhibit the traits of a panic attack and in fact seemed pretty calm, all things considered. My friend also wants to know since when 3 hits is considered to be a high dose, and also wants to mention that the bupropion seems to have little impact on the actual mood of gerbils, merely providing a stimulating effect that makes gerbils exhibit more efficient behavior. This particular gerbil seems to only respond positively to THC.

    My friend is angry that he was sternly warned and reprimanded about chemical dependency issues when giving his gerbil THC, which his gerbil had little trouble discontinuing when required...yet wasn't informed in the slightest about the *severe* dependency issues SSRIs cause. The more my friend reads about antidepressants, the more disillusioned and bitter about them he's become. He's still not exactly sure how to proceed, however.
     
  7. C.D.rose

    C.D.rose Palladium Member Donating Member

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    Re: bupropion (Wellbutrin) and cannabis: SWIM's frightening experiences

    Hmm, there are two conflicting statements here, no? This one from another thread:

    *emphasis mine*

    Is there maybe a discrepancy between how useful bupropion really is for your friend, and that he would nonetheless like to get rid if it in order to be able to indulge in cannabis the way he used to? I guess he'd really have to make his own choice there, though, for me, the choice would be crystal-clear.

    As for SSRI discontinuation vs. cannabis discontinuation: some have it like this, some have it like that. There are people who want to stop cannabis but can't because of severe discontinuation syndrome, and there are those just go off of an SSRI like that. It all depends on the individual. I'd agree though, psychiatrists do not give a decent warning on what is likely to happen if one stops an SSRI too abruptly.
     
  8. TheFakeBass

    TheFakeBass Palladium Member

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    Re: bupropion (Wellbutrin) and cannabis: SWIM's frightening experiences

    I've never heard of SSRI withdrawal returning long after the fact, but if that is the case, then the answer should be obvious: wait a while longer for the withdrawals to cease completely.

    That's not the impression I got from reading your original post. Fast heart rate, depersonalization and derealization, unpleasant body feeling... you used such words as "frightening" and "worried" in your original post. I'm not sure in what sense you say the gerbil "seemed pretty calm"--I've had A LOT of panic attacks and I generally act outwardly more mellow than usual when I'm having one.

    3 hits is considered to be a high dose when the gerbil's tolerance has gone down, either from not smoking as much or from taking bupropion or from some combination of the two. 3 hits is considered to be a high dose when it produces effects too intense or unpleasant to handle. 3 hits is a high dose for many people even who aren't on any other drugs.

    C.D.Rose said it better than I could: That's not what many readers would read in your original post.

    If your hamster is depressed and only responds positively to THC, then I can't imagine how the gerbil WOULDN'T have trouble discontinuing it--though I don't disbelieve that the gerbil's depressive symptoms might not rebound beyond baseline upon stopping it.

    Like I said in my first post, if the only bad thing bupropion is doing to the gerbil is making high-dose THC harder to handle, I don't see that much reason to be disillusioned or bitter about it. And for the record, there ARE other types of antidepressants besides SRIs and bupropion. My hamster was somewhat disillusioned and bitter after SSRIs had intolerable side effects and it couldn't tell if bupropion was doing anything or not. My hamster is now on mirtazapine and it works pretty well with very little in the way of side effects--my hamster can't trip on hallucinogens because of it, but the hamster is willing to pay that price.

    My opinion stands: The gerbil can discontinue the THC and (from what I've read) continue taking the bupropion without problem, the gerbil can continue smoking THC at doses that don't cause problems with the bupropion, or the gerbil can stop the bupropion and hope that THC becomes easier to handle and hope that its depression doesn't come back.

    Also, I should mention that antidepressants often increase energy and motivation before they start to elevate mood. At two months, the bupropion should be working by now, but I think the hamster should consider the possibility (and I say "possibility", not "fact") that the cannabis use and dependence (insofar as it depends on cannabis to elevate its mood) is contributing to rather than combating its depression.
     
    Last edited: Jan 15, 2011
  9. 5ht-Lover

    5ht-Lover Newbie

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    Re: bupropion (Wellbutrin) and cannabis: SWIM's frightening experiences

    Yeah, well I guess that alerts you to how long that ended up working out for. SWIM's gerbil can barely identify with those two or so weeks that were probably, as you had suggested, instances of acute hypomania more than anything. Now the gerbil has re-developed increased feelings of irritability and edginess that he hadn't felt in months prior to taking bupropion (and still has a diminished appetite). Bupropion gets the gerbil up and out of the cage and going in the morning, and allows him to focus his mind away from his negative mood throughout much of the day, so that he may be productive. While these are undoubtedly positive things and a step in the right direction, the overall effects profile is basically that of any stimulant. SWIM hopes that TheFakeBass's comments about the mood-lifting effects coming later is correct.

    I did misjudge the amount of time his gerbil's been on bupropion though; it would be closer to 3 months now.

    All SWIM desires for his gerbil at this point is for him to be living a healthy and fulfilling life. As stated previously, he has absolutely no desire to "indulge the way he used to". THC, up until this point, had been the one thing that allowed his gerbil some relief without fucking with him. I would simply like to be able to give his gerbil one hit without worrying about him having a seizure or a heart attack.

    SWIM's gerbil has had a fair number of experiences with a fast heart rate and depersonalization/derealization while feeling fine; euphoric even. This gerbil, as it was said, is familiar and usually comfortable with these high-dose effects. What was frightening in this were the painful body shocks. I wasn't aware of all a panic attack could encompass and was especially ignorant of its somatic symptoms. So yes, my guess now would be that his gerbil probably indeed have one.

    After being told by the vet that his gerbil wasn't having the onset of a seizure, I do think that continuing the bupropion would be appropiate, but he also recognizes that his gerbil is in desperate need of a seditive/anxiolytic to counter some of the speedy effects. I have actually had his eye on remeron for a while, and called the vet earlier today to inquire about it.
     
  10. psyche

    psyche Palladium Member

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    Re: bupropion (Wellbutrin) and cannabis: SWIM's frightening experiences

    For the record, bupropion isn't an SSRI, but dopamine and norepinephrine reuptake inhibitor.
     
  11. C.D.rose

    C.D.rose Palladium Member Donating Member

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    Re: bupropion (Wellbutrin) and cannabis: SWIM's frightening experiences

    You're right of course Psyche, my comment was addressed at the above statement by 5HT though.

    Well, my impression was that your friend was quite happy with bupropion. If that's not the case, then that's a different thing after all, though it doesn't change much about what has been said about the existing alternatives, namely to drop either it or to drop cannabis (or to not drop either of them, but that seems to be not a really sustainable option). But you already said your friend thinks he will continue bupropion, I thin that is a good idea as a first step!

    The point is really that cannabis may make it (much) more difficult for your friend to lead a "healthy and fulfilling life". I totally understand he feels the need to get relief, but maybe he has to force himself to think more long-term for the moment. I'm sure he can do that. Cannabis, particularly when self-administered, just isn't a good antidepressant. I'm not saying it isn't one, but it comes with lots of downsides and drawbacks. Even if it sounds lame, I would suggest the following: laying off the cannabis for a while, exercising, continuing to pursue treatment with a doctor and with a psychologist (does your friend still regularly see one?). You mentioned above that, the more your friend reads about antidepressants, the more he's opposed to them. Unfortunately, reading will not tell him how they will work in his individual case. Indeed, there are people who don't get much or anything out of them, but seeing your friend's experiences so far, I think it may be more a thing of finding the right one, or the right combination. Once he is on a stable set-up that enables him to lead a normal life, he can reconsider going back to smoking cannabis, maybe occasionally, but until then, I would think it will rather not serve him well.

    Mirtazapine plus bupropion is a strong, and quite effective combination indeed. If your friend's doctor thinks it's a good idea to try it, I would think so too. Again, though - and please don't think I have a problem with people smoking cannabis, that's not the point - smoking cannabis simultaneously is very probably a bad idea for your friend, seeing his current situation. He's young, he can still smoke cannabis for the rest of his life, why not take a break from it to see how it'll work out?
     
    Last edited: Jan 15, 2011
  12. Meremoth

    Meremoth Newbie

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    Re: bupropion (Wellbutrin) and cannabis: SWIM's frightening experiences

    Wellbutrin seemed to completely block the euphoria I receive from smoking cannabis. It was either 75 or 150 mg, I can't quite remember, but I smoked afterwards and I felt all the peripheral effects of cannabis with no euphoria, no matter how much I smoked, and it was good bud and I have a low tolerance. Anyone else have a similar experience?

    Also, has anyone who had the same problem tried a very low dose of Wellbutrin + cannabis with any success?

    Meremoth added 18 Minutes and 56 Seconds later...

    According to wikipedia, bupropion is considered a weak reuptake inhibitor, which is why I thought it was strange it would completely block cannabis induced euphoria for me.

    Does anyone know how adderall compares to bupropion as far as reuptake inhibition is concerned?

    Sorry for concurrent posts, but apparently I'm not able to edit my above post? If there is a way that I'm somehow completely missing, please enlighten me and correct my ignorance

    Meremoth added 10 Minutes and 0 Seconds later...

    Automerge for the win.

    If anyone is interested, I found an interesting article on the subject matter at hand:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3620032/

    Meremoth added 37 Minutes and 6 Seconds later...

    Also, anyone who had bupropion inhibit the good effects of cannabis, how long after taking bupropion do you have to wait before you can achieve the desirable effects of cannabis?
     
    Last edited: Oct 31, 2014
  13. beez69

    beez69 Newbie

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    Re: bupropion (Wellbutrin) and cannabis: SWIM's frightening experiences

    I was feeling a bit down and too a 300 mg extended release one evening. I had not used Wellbutrin in several months. I felt a bit of a boost but nothing special. Maybe felt a little aroused later so queued up some porn. No big deal, just normal feeling.

    Anyway much later had a couple of puffs of weed before bed to help me sleep. Not much, was not a fresh full bowl, just a bit to top up some smoked a while ago. Not a heavy user.
    Started to feel quite good and horny and felt like fingering my butt and it was some of the best anal play I've ever had - I can get off quite hard with some prostate stimulation but this was different, I was enjoying the thrusting sensations too and managed to hit my ass in just the right spot while I wa cumming and it was amazing. Repeated that once more before turning out the lights to sleep.

    Felt good the next morning. Ground up a pill and plugged 50 mg. felt a stimulating buzz. Took a shower and the water felt great, as did another round of anal masturbation. A little over stimulated but manageable.

    As a quick pick me up with some sexual twists to it, seems like a good combo for me.