Discussions that mention bupropion

Lymphomas board


Lymphpre,

With all due respect, this is a support board, and speaking so ill of GPs and psychiatrists the way you audaciously do is both rude and counterproductive. Especially considering doctor-patient relationships play a HUGE role for people who have an illness. Name-calling doesn't get anyone anywhere.

pinkmada, I sense you must be having a very difficult time. I take it you are on chemo?

Anyway, when your GP was talking about other "classes" of antidepressants, I will diverge slightly from lymphpre and say that she was very unlikely talking about MAOIs or tricyclic antidepressants. The former are a very old class with lots of side-effects and are rarely used anymore. The latter are only used now as tranquilizers as they can have serious cardioelectrophysiological side effects. (*edit: I see that the GP DID in fact prescribe a TCA which is VERY surprising to me given the many more safe options available! Simon, I apologize, you were correct!) She was likely speaking of the SNRIs (serotonin-norepinephrine reuptake inhibitors) such as venlafaxine (or Effexor), or...shoot...I forget the class...but an example in the class is called bupropion or Wellbutrin...and there is a final one and...shoot again, I forget the name of its class, but it is called mirtazipine or Remeron. Those three drugs are relatively new agents used for the treatment of depression which are NOT SSRIs.

As you know mentally fighting to stay positive is a huge part of getting through an illness. Depression is something which is definitely not just "in your head", and can seriously hinder the aforesaid process. Though I don't agree with lymphpre's comments about GPs and shrinks, I DO agree that it would likely be best for you to be seen by a psychiatrist who is not just experienced in the pharmacological treatment of depression, but also psychotherapy.
Hey again,

Yeah, it does sound like your doctor doesn't listen to you, and for sure that is not exactly going to help with your perception of her abilities. I can't believe she said "it would be too much trouble to contact your onc". Man! But I hope that doesn't soil your perception of all family docs, 'cause many of them are good. One thing is, doctors who are doing locums don't know you as well, and since they are transient, don't ever GET to know you well and develop a therapeutic relationship.

There is a huge discrepancy between what a doctor thinks (knows) is a good doctor and what a patient does. From a doctor's point of view, a good doctor is obviously someone who has very good clinical accumen in the realm of diagnosis and therapeutics. The icing on the cake would be a good bedside manner, but unfortunately with older docs, this is often not the case. Then you go to a patient's point of view (and there has been studies on this): showing that a patient is much more likely to view a doctor as a "good doctor" if they feel like the person's bedside manner is good, regardless of their clinical accumen.

To clarify, many doctors know of an eccentric older physician (lets' call him Dr. X) they work with who is one of the most brilliant people they've ever met, and if they ever got sick, would want Dr. X looking after them; HOWEVER, because Dr. X's bedside manner is atrocious, patients (who are not aware of what makes a good clinician from the knowledge and clinical accumen point of view) will uniformly say they hate Dr. X and don't trust him. The converse is true as well: there are plenty of doctors out there who are really nice and easy to get along with, but don't have the best clinical skills. Patients often trust anything this doctor says, and when another doctor gives a dissenting opinion, they are less likely to listen, even if doctor II is correct.

What am I trying to get at? Well, the optimal doctor would be someone who not only has a razor sharp clinical accumen, but also has amazing bedside manner. Wouldn't that be great eh?!

Soooooooooooooooooooooooo, in Canada, I don't think we have the bnf or whatever...we have something called CPS. While it is the "bible" so to speak of drugs, physicians often nowadays use things internet search engines first of all because it is way faster, and second of all because search engines help to find the medical databases (like Micromedex) that clinicians around the world use. The CPS (or bnf) is a great resource, yes, but the 'net can hook you up with electronic versions of that resource which saves a lot of time.

Finally, I mentioned a few medications like bupropion, mirtazipine and venlafaxine--did your doctor mention any of those?