I agree -- Wellbutrin is so very different from an SSRI, that it makes
no sense to imply any kind of comparison/equivalency between the two.  It
is pretty obvious that there is an attempt to defer/delay use of the more
expensive medication.  It is ALMOST like requiring that someone
try aspirin before tylenol!!!  Those are also quite different,
even though they have some overlapping applications.

For example, what if you were considering an anti-depressant for a
middle aged, sexually active, healthy (normal/moderate blood
pressure/no seizures) man who likely needs an 'activating' type
antidepressant?  It really might make sense to consider
Wellbutrin for someone like that, simply to avoid the spectre
of increasing the chance for impotency.  I'd also continue
being aware of the SSRI abstinence syndromes -- which are
REAL and VERY uncomfortable.  I wonder if there are any
known Wellbutrin abstinence syndromes?

To SOME people, the issue of 'sexual performance' is so important
that it makes little sense to risk problems in the areas that
SOME people take very seriously.  If I had a girlfriend, and
needed an anti-depressant, I certainly wouldn't want to be
prescribed Zoloft (in my case, I do happen to know that it totally
disables me.)  If I wasn't concerned about that aspect of sexuality,
then the SSRI might be a good choice.

However, it would be VERY WRONG to risk disappointment in someone
who takes their sexual performance very seriously, especially
when the reason for that risk is because of an insurance company
who'd would rather risk the patient's sense of wellbeing.

John

John