I'm 41 and developed psoriasis/psa 1.5 years ago after strep. i have a hard time keeping up with work and kids. my next step is enbrel (etanercept). is it reasonable to ask for bupropion (mild tnf inhibitor) 1st?

Replace deficiencies: Before you use medications try replacing nutritional deficiencies. People with "autoimmune" disease often are low in vitamin d3. It's easy to get a blood level to know how much to replace. Until then you can take a supplement on your own and try taking 2000-4000 units/day. Also try taking 2-3 grams/day of fish oil. Lastly, make sure to get a reasonable amount of sun exposure.

No: Buproprion is an antidepressant and is not effective for the treatment of psoriasis and psoriatic arthritis. Enbre, on the other hand, is extremely effective in most cases.

Talk to your doctor: There have been many articles on tnf reduction with bupropion, and its use for psoriasis and crohn's disease, but it is not approved for this, and your doctor may not be comfortable with prescribing it in the absence of depression. However, bupropion is relatively low in side effects, although it can cause seizures in some people, especially in higher doses. Discuss it with dermatologist and pcp.