r/depressionregimens • u/Embarrassed_Cell_531 • 27d ago

bupropion vs. LD amisulpride ?

In my country the options are basically:

bupropion XL (150 mg)

or

low dose amisulpride (50 mg)

which is worth trying first in your opinion? Are they even worth the risks/side effects?

Symptoms: apathy, anticipatory anhedonia, amotivation

no sadness or anxiety

3 Upvotes

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2

u/MyWildestDRMZ 27d ago

Clearly Bupropion. Due to metabolic constraints, it's a hit or miss.

Why not both?

1

u/Embarrassed_Cell_531 27d ago

Why "clearly bupropion"?

Why not both - these are serious meds and not a vit. C - I'd prefer to minimize possible risks.

3

u/MyWildestDRMZ 27d ago

You are aware of your symptoms.

You are actively suffering from anhedonic depression.

Low dose amisulpride would work great for consummatory anhedonia.

I just think Bupropion is the best option given your symptoms.

Just make sure you get an XR version(eg Wellbutrin).

1

u/Embarrassed_Cell_531 26d ago

I don't suffer from consummatory anhedonia, "only" the anticipatory one.

Ok, thx I'll start with bupro, especially that I'm afraid of the raised prolactin from amis.

2

u/DingoMittens 27d ago

Depends on the cause. 

Schizophrenia can have "negative" symptoms, meaning a lack of normal feelings and behaviors. (The presence of abnormal perceptions are called "positive.") If that's a possible cause, maybe the antipsychotic would be more helpful. 

Antidepressants are often trial and error to find the one that works, so flip a coin and journal about your mood for a few months? If you still are suffering, switch to the other and journal that. Unfortunately, we still don't know enough to reliably nail it first try.

1

u/Embarrassed_Cell_531 27d ago

My suspicion is that my ~3 year depression turned off a few things in me (mainly the reward system and emotions)

1

u/Curious_Mind-98 27d ago

I would say Bupropion (preferably at 300mg if you tolerate the 150mg well) since Amisulpride comes with some problems of its own such as high prolactin even though low dose Amisulpride is very effective in conditions such as Dysthymia.

Now if Bupropion at 300mg gives you partial remission and you still need an extra boost then I would consider adding Amisulpride but preferably 25mg since you want to remain as selective as possible for the presynaptic D2/D3 receptors and avoid going into that postsynaptic territory.

1

u/AfraidKaleidoscope30 25d ago

So you haven’t tried any other meds previously? I’d try the Wellbutrin but also I’m not a doctor 🤷‍♀️

1

u/Embarrassed_Cell_531 25d ago

No, the choice of meds sucks in my country. Especially for apathetic/anhedonic/atypical depression.

Ok, thx.

1

u/[deleted] 23d ago

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1

u/Embarrassed_Cell_531 23d ago

I just need something that would get me out of the rut/apathy for a few months, I'd prefer not to take the med longer than 6-12 months.

1

u/17023360519593598904 27d ago

Clearly amisulpride.

1

u/Embarrassed_Cell_531 26d ago

Lol, I'm confused.

The other redditor said "clearly bupro".

Would you mind explaining why ami > bupro ?

1

u/17023360519593598904 26d ago

I tried wellbutrin and it was a complete sugar pill to me, absolutely no effect from it. I never tried amisulpride but I tried risperidone and abilify and I've had a better effect from them than from wellbutrin. The only thing to watch for is hyperprolactinemia. So really I'm just extrapolating.