Wellbutrin/buproprion on NHS

[DancingLady]

There are a few older threads about this, but I wondered if anyone has been prescribed this on the nhs for depression? I'm currently on 20mg fluoxetine and have been on several other SSRIs over the past decade. Have been reading up on Wellbutrin - a friend in the US recommends it. I don't feel the fluoxetine is helping a great deal - maybe after 2 years the efficacy is wearing off. My mh has really deteriorated over the past couple of months (no surprise) and GP won't increase my dose. Any advice about getting a prescription for Wellbutrin much appreciated.

You wont get it on the NHS as it isnt licensed. They are not allowed to prescribe it. You might get a private psychiatrist to prescribe it but you would have to pay yourself for both the medication and consultations and honestly I've never found one willing to do it. You'd be better to try another class of AD rather than chase after Wellbutrin. SSRIs are only one class, try SNRIs or Tricyclic ADs.

For some reason it's only usually prescribed as a short term smoking cessation treatment here. Some tertiary and even secondary NHS services will prescribe it off label for depression but that's very rare and usually when other treatments have not been effective and there is reason to think this one will.

It's a shame. In other health systems it is the go to anti depressant and given that it doesn't cause the weight gain and reduced libido the antidepressants preferred by the NHS often do it's bonkers that we cannot usually access it here.

A private psych is more likely to prescribe it, though they still may not wish to.

Thanks both. That's so frustrating. I'll look at other options and types of meds.

It is frustrating but I've found that the more you ask, the more they will dig their heels in. I've had success with Tricyclics as I can't take SSRIs.

I would be concerned that your GP will not allow you to try it above 20mg, when you have been taking it for quite a while and the response isn't great.

Unless that can justify that on, say, physical health grounds, that it isn't suitable for you at a higher dose, then it would look like your GP is simply failing to treat you.

What I think I read for bupropion, (can't guarantee accuracy), is that it was intended by the company to get licensed in the UK. However, things got messed up because the original formulation caused too many seizures. That issue was fixed, (lower doses used), and it's now no more risky than SSRIs for seizures. But no UK licence.

I've done this to death, including reaching out to multiple private psychiatrists, all of which said no.

It's simply not available legitimately in the UK unless you are very lucky indeed.

I want it as SSRIs have killed my sex life - all of them.

For the sexual dysfunction issue, there are other possible options such as Mirtazapine, Vortioxetine, and Moclobemide, which may not be as bad as SSRIs. Depends on individual response of course.

What annoys me about the lack of availability, is that there isn't any other antidepressant that really does the same job (that I know) as bupropion, as a norepinephrine and dopamine reuptake inhibitor.

So this is something that could actually help to relieve depression in some people, whether by itself, or combined with SSRIs, as it's having a wider action. I guess that's a bit obvious that an antidepressant could help some people with depression, but I mean, it's lack of availability wouldn't be so bad if the NHS already was using equivalent medicines that hit the same neurotransmitters, but dopamine boosting antidepressants are a bit of a rarity.

Why they can't just draft a policy that encourages / routinely allows, the off label use in this case I don't know.

I am prescribed Wellbutrin (Bupropion / Zyban) on the NHS in conjunction with Vortioxetine to overcome sexual side effects. GP will no prescribe it but a psychiatrist can / will.
It is very effective at an initial dose of 75mg increased to 150mg/day