Posted by King Vultan on July 14, 2004, at 14:54:09
In reply to Zoloft VS. Wellbutrin, posted by Luddy on July 14, 2004, at 13:17:29
I've been on both more than once and also suffered the ear ringing in the early going with Wellbutrin. It did go away after a while, or it at least diminished drastically. I did read an anecdote in another forum from a person fixated on the notion that a high dosage of Wellbutrin had given them permanent tinnitus, but I question this. I have minor tinnitus in my left ear from something that apparently happened to me as a kid and never noticed it until I became involved in the high end audio hobby about ten years ago and started paying more attention to what I was hearing. I suggest that the aforementioned Wellbutrin patient may have always had a low level of tinnitus, and was unaware of it until the higher level of tinnitus on Wellbutrin sensitized them to the whole issue, perhaps resulting in an obsessive fixation. That's just a suggestion to be considered, though.
In any event, the more relevant issue here is Wellbutrin vs. Zoloft, and these are really quite different antidepressants. Wellbutrin is a combined norepinephrine/dopamine reuptake inhibitor, while Zoloft is an SSRI (it targets serotonin); it also happens to have a very low level and probably irrelevant effect on dopamine. Wellbutrin is an activating med known for its lack of sexual side effects; it can even be pro-sexual in some cases. It is also known as one of the antidepressants that tends to have a minimal or negative effect on appetite for many people.
Zoloft, OTOH, is known for its sexual side effects (loss of libido and problems with delayed and/or absent orgasm), and this is really a characteristic of the whole SSRI class. I find it rather activating myself, especially at first, but Wellbutrin would likely be considered more so, and Zoloft definitely would have more of tendency to induce weight gain. Out of the ten or so drugs I've tried, this is the one that had the most noticeable effect on increasing my own appetite. There is a huge YMMV you need to keep in mind with that, however, because people really do seem to exhibit large individual differences in the way they react to these SSRIs.
So my suggestion is that if you really are doing well on the Wellbutrin except for the tinnitus--which appears to be more or less just a nuisance at this time--I would suggest calling your doctor and clarifying your position. The Zoloft is from a different antidepressant class and while it's a good drug IMO, it really is quite different in its effects. You may want to consider sticking with the Wellbutrin to give it more of a trial.
Todd
poster:King Vultan
thread:366110
URL: http://www.dr-bob.org/babble/20040714/msgs/366139.html