Originally Posted by hiptothat

I don't think Wellbutrin and Sinemet are contraindicated together, but there may need to be dosage adjustments. Wellbutrin targets both dopamine and norepinephrine neurotransmitters, so it can raise the level of dopamine in the brain in theory enough that the sinemet dosage may need to be lowered to avoid dopaminergic side effects, like hallucination. It makes sense to me that a Parkinson's pt. would benefit from Wellbutrin because of the target pathways, although I am not a psychiatrist and have no experience with monitoring pts on these drugs. My Neuro said that sometimes the older psych drugs benefit the depression associated with Parkinson's better than the SSRI's which mainly target serotonin. He also said that increasing the dose of Selegeline could help with depression by gaining both MAO-A and B inhibition rather than the B that is targeted with lower dosages. But then you have to watch the tyramine/Hypertension risk with the wine, aged cheese etc. So complicated!

Interestingly, I struggled with depression about 10-12 yrs prior to my PD dx and found that Wellbutrin was the only treatment that helped me. In retrospect, it probably was raising the dopamine levels in my brain that was making less and less of it. SSRI's like Prozac made me feel awful, since raising serotonin gave me too much of what I had plenty of.

It really feels like brain chemistry is the last frontier of medicine, doesn't it?
So much trial and error...