2024-04-29

Bupropion Review

I've been on Bupropion for about three weeks now. Unlike all other psychiatric meds I've tried up until now, whose effects are sort of vague (and perhaps too weak? Never tried dose increases), Bupropion actually feels like a psychiatric med. It's put me in what is an undeniably different state of consciousness. It's not as extreme as alcohol or THC, nor comparable with either of those, but is definitely a substance with a perceptible effect on how "existing" feels like.

Good:

I find certain activities a lot more fun. Reading, writing, drawing, exercising – all now immensely satisfying. So is music and podcasts.

If I do feel myself sinking into a "don't know what to do with myself" rut (e.g. mindless jumping between internet tabs, unsure of what to watch, playing a video game just for the sake of occupying myself), I just… stop and go do something else.

Similarly, I feel no sense of "obligation" to continue activities or stick to plans. A noticeable increase in impulsive behavior (not in a bad way, though). It's very easy for me to rapidly "switch gears".

No urges to drink alcohol or smoke cannabis to relieve boredom. In fact, "boredom" as a feeling is pretty much absent now.

No suicidal thoughts. At all. Even in low moments, my thoughts turn towards "what can I do to fix things" instead of the irrational impulse to just give up and escape from it all.

I feel generally energized and highly motivated. A marked increase in self-confidence, too.

Unhelpful:

Ever since I dropped my last SNRI, my anxiety returned. Not in full force, but strong enough to be a concern. I again find it difficult to just be outside or talk to people without freezing and/or constantly having thoughts run through my head. Combined with the increased self-confidence, this is a very weird and uncomfortable feeling, one that I struggle to put it into words. My best attempt would be: "Feeling okay with myself, but I still get frightened by eye contact and the like." Doesn't sound too bad, I know, but the cognitive dissonance is palpable and very distressing.

Body dysmorphia has not gone away.

Constant intrusive thoughts and periods of "racing thoughts" have not gone away. If anything, I suspect they've gotten worse.

Bad:

Insomnia! This is a big one. I just can't fall asleep. Even if I do fall asleep, I wake up after 4-6 hours, and go to almost full wakefulness in just a couple of minutes. I still feel tired throughout the day, just not sleepy.

And speaking of sleep, dreams are a problem. I tend to experience a lot of very odd dreams now, and frequent nightmares (e.g., just last night I was forced by nameless & faceless authority to collect sharp metal shrapnel while being mocked by people around me).

Another peculiar side effect is what I can only call "waking dreams": During nights when I struggle to fall asleep, I may enter that weird twilight zone between wakefulness and sleep, and then just get stuck there. And then, in that state, I start dreaming. This is bizarre and something I never encountered before. The experience is very hard to describe; despite the fact I'm dreaming, I am still fully aware that I'm just lying in my bed. The dreams themselves are semi-lucid, in that some part of me understands that I am dreaming, but I still can't actually influence the dream in any way. A very distressing experience, especially when combined with the nightmares.

Despite the fact that the normal urge to drink/smoke to just "kill time" is gone, it is replaced with an urge to drink… just because drinking is fun. And in the evenings in particular, this is combined with an urge to drink to make sleeping easier. Even in my worst days of heaviest drinking, when I would down half a bottle of hard liquor a day, I never really felt like I couldn't stop. However, on Bupropion, my inhibition is almost completely gone.

And speaking of drinking, the process of sobering up is a hundred times worse. While sobering up was never really fun, now it's combined with a sort of dazed and soulcrushing sense of dread.

I'm not sure if it's an effect of going off SSRIs/SNRIs, but I now suffer from premature ejaculation. I never had this problem before, even in previous attempts to be weened off SSRIs/SNRIs. Even after discontinuing Escitalopram (which made me unable to cum unless I'm beating my meat for 30+ minutes) my sexual function returned to normal within just a week or two. I have been off any other med for three+ weeks now, and instead of returning to normal, I cum in just 60 seconds. I do hope it's a side effect of Bupropion, and not some long-term syndrome caused by playing around with the neurotransmitters in my central nervous system.

Ever since I started taking Bupropion, I found it very difficult to enjoy social interactions. It used to be that just sitting around and chatting was one of the few things I actually enjoyed in life. Now everything's reversed – I love doing alone activities, while talking to others feels like a chore. I just have no patience for others. I also suspect a reduced capacity for empathy, as there is some sort of "veil" now between me and others that simply wasn't there before.

And speaking of having no patience, another very obvious and very annoying side effect is extreme irritability. Shit just annoys me now. Every petty little thing makes me so irritated. I can't even talk to my mom without some comment or phrase of her making me so annoyed that I wish for nothing more than to hang up in her face right there and then. But then I calm myself down, and in less than I minute I look back and think "what the fuck was that?"

Final Thoughts:

The entire thing feels like a medicinally-induced hypomania. Kinda fun in its own way, sure, but not something I would stick with for the rest of my life. Some periods of calm and relaxation (and sleep!) are necessary.

So yeah. Great for deep depression, not so great for anxiety and personality disorders with obsessive-compulsive elements.

I'll talk to my shrink tomorrow. It's been a cool experiment, but this is not for me. I want to go back and try some more SSRIs.