For those of you who have taken wellbutrin for an extended period of time (>3 months) did you notice any persistent brain fog /lapses in memory?
Wellbutrin (and its main metabolites) are non-competitive Nicotinic acetylcholine receptor (nAChR) antagonists so they target the same receptor that nicotine agonizes, hence it is also prescribed as a smoking cessation aid. But nACh is important for memory, which is why some people use nicotine as a nootropic. Since wellbutrin is a non-competitive nAChR antagonist, this means no amount of agonist can acheive maximum response in the receptor. So basically, my idea of taking nicotine gum while on wellbutrin won't work since it would block most of the effect of the nicotine.
So the only possibility is that you would have to endure a period of time until/if the nACh are upregulated. To reformulate my question, how long does it take for upregulation to occur, if it happens at all?
I tell people if they really fucking care about dealing with their illness, they have to lead the charge for their own treatment. Being dependent on medical practitioners will lead to your undoing. I will promise you that. Too many people have made the mistake to put too much trust into practitioners. The world is not that perfect.
Pharms are not evil but we must eliminate dangerous bias. There are an exponentially increasing amount of concerns regarding the ineffectiveness of popular antidepressants which include effexor, wellbutron, Zoloft, and Prozac. These are very dangerous and if used at all can only be used short term or the adverse effects become more devastating. This will eventually become widely accepted when we realize more outpatient studies need to be realized instead of having practitioners make the mistake that inpatient studies are highly reliable.
If you are not going to learn the neuropharmacology for yourself as a patient seeking to improve and become aware, you have failed at treating your illness. There is a fine line between medical practice and medical research.
We do not live in a world good enough to trust a one sided dependency on the practitioners. I have suffered as well as everyone else I know from making this mistake.
Now what you choose to do, including the mistakes you are willing to make are up to you. If you want to put complete faith in a doctor and be miserable, that's on you. This is 2016, healthcare is not going to be this good for a long time. You as the patient are also responsible for this.
And I also agree that people should learn about medications and how it affects their body. Blindly following anyone's advice is not ideal.
Now, as for the drug combinations you mentioned, Selegiline and Moclobemide are both used to treat depression. The reason they are not popular is that both of them are MAOI's which have many lethal interactions with other drugs and even certain foods (basically any food that is high in tyramine needs to be avoided. But this rules out a huge list of foods). Arguably MAOIs are more dangerous than most other anti depressants, maybe even so than tricyclic anti depressants. So they are used as a last resort, when other drugs like SSRI's haven't worked.
As for up regulation, there is no way to absolutely say for sure, I cannot report any adaptation on my part while on the medication on and off for almost 2 years. Once off Wellbutrin, always noticed a change in cognition within a week (less blunted, easier to recall facts and memories).