Buprenorphine and antidepressants

[teakabeagle]

I have had RLS for 50 years and depression right along with it. Wellbutrin has worked well, but I still get periods of severe depression on it. Since discontinuing the Pramipexole 3 months ago, the depression has been very severe. Not sure if was stopping the Pramipexole or starting the Bup.

has anyone gotten great control of RLS and been able to take any antidepressant other than Wellbutrin(buproprion) without RLS breakthrough? Has anyone tried TMS, ketamine or esketamine or even ECT with RLS and depression?

It has been so frustrating yo have great control of the RLS, but to not be enjoying it because of severe depression. Going to work or doing anything else is such a struggle and EXHAUSTING!

[SueJohnson]

Have you tried trazodone?

[teakabeagle in reply to SueJohnson]

Tea adobe should not be taken with Buprenorphine. It can cause heart rhythm irregularities.

[SueJohnson in reply to teakabeagle]

I assume you meant trazodone. Yes that can happen but it is rare unless one has a heart condition. Wellbutrin with buprenorphine can cause seizures. That is why these drugs have to be prescribed so one's doctor can check for these things and properly advise one. I certainly am not qualified to know all the interactions.

[RCHD in reply to teakabeagle]

Must be a misspelling

[707twitcher]

I have a similar situation, but I hadn't been taking wellbutrin previously. From what I've learned here and elsewhere, the pramipexole stoppage is a major cause of depression. When your body stops getting the dopamine boost from pramipexole, it causes DAWS (Dopamine Agonist Withdrawal Syndrome). This can last for months, or even years. The two antidepressants that seem not to trigger RLS for most people (not all) are Trazodone and Bupropion (Wellbutrin). Given the additional stress from the DA withdrawal, I would imagine you shoud increase the Wellbutrin dosage, or try Trazodone. Obviously under the direction of your doctor. I just started Bupropion yesterday; stopped pramipexole about 6 weeks ago.

[teakabeagle in reply to 707twitcher]

I am already at the max dosage of Buproprion. Trazadone should not be taken with Buprenorphine as it can cause heart rhythm irregularities. The worsening depression is the only symptom I’ve had from the Pramipexole withdrawal; alternatively it could be the Buprenorphine driving the depression.

I am wondering if I can take an SSRI, which worked great in the past but set off the RLS now that I’ve got the control with Buprenorphine. Could the RLS breakthrough?

[BooBoobearlove in reply to 707twitcher]

Hi; hope this can help anybody out there: I currently take 100 mg of Tramadol every night and have very little or no RLS! Hope this helps someone; have a great day

[RiversW in reply to 707twitcher]

Mr. Twitcher

I am assuming the same would hold true for any dopamine agonist. Don’t you think? I have recently stopped Neupro and I am struggling with depression as well. And as teakabeagle said it is ashame to finally be free of dopamine agonists and not to be able to enjoy the freedom. I try very hard to keep myself busy but frankly I have to fight the urge to get under the covers.

[707twitcher in reply to RiversW]

Mr. Old Man River (I couldn’t resist 😂),

Yes - DAWS is a problem for any DA. I found that my depression started getting better after about two months. I couldn’t take Bupropion because it aggravated my RLS. Hopefully your depression starts improving soon 🤞.

[RiversW in reply to 707twitcher]

I am glad you didn't resist.

I hope mine does as well, but I am happy for you. Truly!

[keiralee in reply to 707twitcher]

Hi , I know a long time has elapsed but wandered how you were getting on with Wellbutrin/buprepoionI am suffering from depression I think attributable to Buprenorphine. I have been taking the Wellbutrin for 7 days and it has killed my appetite. I wasn't eating much before but now I cannot eat hardly at all. Does it take time to help . How did you get on withbit ?

[707twitcher in reply to keiralee]

I only tried bupropion, not Wellbutrin. The bupropion seemed to make my RLS worse, so I stopped it after a few days. I find cannabis to be the best anti-depressant for me.

[keiralee in reply to 707twitcher]

Thanks for your help

[teakabeagle in reply to keiralee]

I ultimately had 40 TMS treatment that was very helpful. I was able to decrease the Buproprion to 300 mg., as the results with the TMS likely won’t last forever. I’m 5 months out and the depression is still controlled.

[keiralee in reply to teakabeagle]

Thanks for replying

[707twitcher]

my doctor said depression from buprenorphine is highly unlikely. DAWS makes sense - stopping all the dopamine has to have an effect on one’s mood. What is your current dose of bupropion? My doctor is afraid of too large of a dose because it’s apparently difficult to wean off of it. But maybe for a couple months your doctor might think it’s ok to bump it? I don’t know about SSIs. I suppose switching buprenorphine for a different opioid and going to Trazodone would be another option . It’s no fun dealing with all these drug interactions, is it?

[Drls]

hello I am taking buprenorphine and have had periods of deep depression since being on it. I am 62 and this feeling is different to anything I have experienced before. I was not withdrawing from DAs when I went on it. I have concluded that for me personally the buprenorphine is causing this particular level of depression. I am just passing on this information since I think buprenorphine - which is after all an opioid - can have side effects for some people.

[Typicallygaslit in reply to Drls]

Yes it totally can. I suffer from depression because of it too, and have heard others on here say the same. Doctors don’t know this stuff. The worst thing one can do in this situation is add more serotonin to the mix. There is risk for serotonin syndrome but you can also have low level serotonin toxicity which is what I think I have.

[teakabeagle in reply to Drls]

I agree, but since I had withdrawn form PRmi- have no idea which one , or probably both are the culprit.

[brotherinarms]

Hi teakbeagle. You know wellbutrin(bupropion) is not the same as buprenorphine so maybe check that out I’ve had bad RLS for 20 odd years somewhat modified over the years by 10 to 15 mg of OxyContin at night . Two years ago I got prescribed Neupro patch (rotigotine) put on every 24 hrs and the combination changed my life as regards sleep and energy. If I watch the dietary triggers I wish you all the best

[SueJohnson in reply to brotherinarms]

Just be aware of the signs of augmentation which are when you have to keep increasing your dose to get relief, or when your symptoms occur earlier in the day or there is a shorter period of rest or inactivity before symptoms start or when they move to other parts of your body (arms, trunk or face) or when the intensity of your symptoms worsen. At that point you will have to come off it because your symptoms will keep getting worse.

[teakabeagle]

year I know Buproprion ( an antidepressant) and Buprenorphine( a partial opioid agonist) are not the same thing. I take both of them. I have excellent relief of the RLS with the Buprenorphine, but not good control of the depression with Buproprion. I’ve had breakthrough depression with any antidepressant I’ve been on. Buproprion is the only one that hasn’t aggravated the RLS.