Posted by JohnX2 on March 3, 2002, at 18:31:05
In reply to Re: Wellbutrin after one week » JohnX2, posted by mike21 on March 3, 2002, at 8:04:56
Mike,Wellbutrin is a very interesting medicine.
I have been very fascinated by it and Ohh so much
would like to have it be a part of my dosing regimine.
I found that at 150 mg, it more or less relieved my
Major Depression symptoms and really "got me off my Ass".
My depression symptoms are primarily lack of drive, interest,
etc. Unfortunately I was not diagnosed as bipolar at the
time and so the medicine did not do what I wanted it to
do at the higher doses when it REALLY kicked in. Felt
a lot like amphetamines.Anyways, Wellbutrin (buproprion hcl) is actually what is
called a "pro-drug". The parent compound bupropion hcl has
a very short "1/2 life" - the time for 1/2 of the medicine
to clear from the body and doesn't do much. However there
are a few very psycho-active metabolites that get created
by bupropion hcl on its 1st pass through
the liver. The most actives are Hydroxybupropion,
Threohydroxybupropion,and Erythrohydroxybupropion.
These metabolites have longer 1/2 lifes (upto like
20 hours for hydroxybupropion) and accumulate to
high degrees in the body. The degree to which they
accumulate can have a profound impact on the
thereapeutic window, i.e. the dosing window that
works for YOUR BODY. This can be affected by how
YOUR liver and body works.Anyways, I found a really good article discussing
Wellbutrin and some myths regarding its dopamine
mode of action and also how the metabolites build
up in the body. So I really feel you should tinker
with smaller doses.Here is the website if you are interested
(written by a researcher on Wellbutrin):
http://www.preskorn.com/columns/0001.htmlSorry to present such technical detail.
Just for your own education if you are interested.Best Wishes,
John> John,
>
> I didn't think you were being too short. Nothing wrong with being to-the-point.
>
> I read in a book that the therapeutic dose range is 225-450mg. Obviously not the case. I think there is a conventional wisdom that says you need to treat strongly your depression,anxiety,etc. and I think that can do more harm than good. My doctor didn't even recommend ramping up the dose. I started with one 150 and then immediately started with 2x150 the next day. To further complicate matters, as I mentioned in another thread, remeron was also prescribed. As an alpha-2 antagonist I expect it was further increasing the norepinephrine levels, but the sedative effect was masking it somewhat. I discontinued the remeron after 4 days.
>
> Obviously a lower dose is needed here. I will request the 100mg tabs and the inderal as well.
>
> Thanks for all your input,
>
> Mike
>
> >
> > Hi Mike,
> >
> > Sorry I was being so short with you. I got
> > shut out from the pharmacy to pick up my mood
> > stabilizer and I'm really skimping. Feeling a bit
> > hot tempered today, maybe I should take a beta-
> > blocker! ;)
> >
> > Anyways, here's one thing I don't understand about
> > Wellbutrin, it's the only medicine I was put on that
> > the doctor pushed to the therapeutic dose more or
> > less immediately. 4 days at 150 mg and then 300 mg.
> > Every other medicine I got to taper up very slowly.
> > Doesn't this seem odd? No wonder a lot of people complain
> > of start up anxiety! Mind you I just happened to get lucky
> > and have no real side effects except for after the medicine
> > kicked in I thought I was superman and felt that there were
> > conspiracies going on by my work and family (this was before
> > I was dx'd as bipolar) ;).
> >
> > Anyways, I think a lot of people find relief at doses
> > lower than 300 mg and for you starting this high might just
> > be too strong. Also there is a 100 mg SR tab that you can
> > start with that should be a good option to ween you onto
> > the medicine.
> >
> > As far as the beta blockers go (Inderal being the gold
> > standard), they do slow down a hyperactive locus coerulus
> > like you and I were discussing in another thread. So do
> > alpha-2 agonists. Its just that the medical community are
> > much more standardized at prescribing the beta blockers.
> > I personally took Inderal a few times. One time I was on this
> > crazy combo of medicines including Remeron and my heart was
> > racing at like 120 beats per second and I felt really anxious
> > and I took Inderal and I felt fine minutes later. Slept like
> > a baby.
> >
> > Hope this info helps.
> >
> > Best wishes,
> > John
> >
> >
> >
> > >
> > > Mike,
> > >
> > > Based on neuropysiology, if you are having
> > > hand tremors, then a beta-blocker is THE
> > > anti-dote. Period. End of story. Call your doctor and ask
> > > about it. It will help your sleep if you
> > > take it at night before sleep.
> > >
> > > Good Luck,
> > > John
> > >
> > >
> > >
> > >
> > >
> > >
> > >
> > > > >
> > > > > You can take a beta blocker like Inderal if you
> > > > > are in a bind.
> > > > >
> > > > > Another pbabble poster was having similar problems
> > > > > and took Inderal on/off. Eventually the problem
> > > > > wore off and his anxiety eased.
> > > > >
> > > > > -John
> > > > >
> > > > >
> > > > I was thinking beta blockers were used more for panic attacks. I don't know if this qualifies, although it could develop into that if it gets worse. I guess it's an option to keep in mind.
> > > >
> > > > Mike
poster:JohnX2
thread:96089
URL: http://www.dr-bob.org/babble/20020301/msgs/96223.html