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To help provide useful advice for people dealing with mental health problems in the effective altruism community I've written up my experience trying Wellbutrin / Bupropion to treat mild depression. It starts:

This isn't professional medical advice, it's just my experience and amateur knowledge. I'm an economist not a doctor.

Summary

  • I wasn't sure whether I should try antidepressants because I was only mildly depressed, but I gave Bupropion XL a go.
  • It was easy to get, cheap, and I think it enhanced my life a lot.
  • Studies suggest this is a pretty common experience, and Bupropion is likely the best antidepressant for some groups of people to try first.
  • So if you're ever depressed and live in or can visit the USA, or another country that prescribes it, maybe you should consider taking it too.
  • Note that you should be willing to stop taking it quickly if the experiment indicates it's not helping you, or is causing worrying side effects.
  • I note some kinds of people for whom it's probably not the best antidepressant to try first, and link to further research on the topic.

My experience in more detail

A lot of people suffer from depression or low mood and take antidepressants, or wonder whether they should take anti-depressants...

Continue reading...

Happy pills

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I have now been taking bupropion for a little bit over two weeks. I'm unsure if it will continue to work as well as it does now. But if it does, I think starting to take bupropion will be in the top five most important things I have ever done, in terms of increasing my overall well-being and productivity. So thank you very much for writing this article. Without it, I likely would never have tried it.

if it does, I think starting to take bupropion will be in the top five most important things I have ever done, in terms of increasing my overall well-being and productivity

 

I'm really curious about the other four!

I only saw this now. I am usually on LessWrong. Here is the list:

  • General Nutrition
  • Sleep hygiene
  • Regular Sport
  • Meditation
  • Tulpamancy

Now I would probably also take methylphenidate. It's even more useful than bupropion.

To anyone who is curious about Bupropion based on this post: Rob mentions this in the post, but I just want to emphasize again - this is likely not a suitable antidepressant if you are prone to anxiety. SSRIs or other antidepressants like Clomipramine are better in that case.

I took bupropion from about February to November 2021.

After a pretty rough transition I found it to be a quite effective antidepressant, but it gave me very bad insomnia which I needed to take sleeping pills to overcome (this kind of sucked as it meant I had to be very careful to take all my meds at the right time of day, and couldn't increase the dose). I'm also quite confident that it made me more anxious.

That said, I would still definitely recommend it over SSRIs or mirtazapine, both of which have very common and serious side effects that I think are worse than bupropion's for most people.

I'm considering trying bupropion again when I move to the US in 2022, since there is a shorter-half-life version available there that is not available in the UK.

Was chatting with Gwern about this. An excerpt of their thoughts (published with permission):

Wellbutrin/Buproprion is a weird one. Comes up often on SSC and elsewhere as surprisingly effective and side-effect free, but also with a very wide variance and messy mechanism (even for antidepressants) so anecdotes differ dramatically.
With antidepressants, you're usually talking multi-week onset and washout periods, so blinded self-experiments would take something like half a year for decent sample sizes. It's not that easy to get if you aren't willing to go through a doctor (ie no easy ordering online from a DNM or clearnet site, like modafinil)...
Finally, as far as I can tell, my personal problems have more to do with anxiety than depression, and anti-anxiety is not what buproprion is generally described as best for, so my own benefit is probably less than usual. I thought about it a little but decided it was too weird and hard to get, and self-experiments would take too long.

Thanks so much for writing this! I'm commenting so that more recent readers can see it. Wellbutrin/Bupropion can really be life-enhancing with very limited (to none) side effects.

I appreciate this!

Nice. I love ideas with the shape of "Consider trying this thing because the costs are low, even if you're not sure if it will help or pretty sure it won't."

The main confounder I worry about is that I changed what I spent most of my time doing at work around that time, and I think that also improved my life.

Given confounders like this, it'd be great to see someone run a Gwern-style controlled trial on their Wellbutrin use. The value of information would probably be quite high.

It'd be sorta tricky to do given the on- and off-ramping effects of the drug, so perhaps should only be undertaken by someone with sufficient slack to accommodate.

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