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Re: Dopaminergic Drug/Supp to Aug SSRI-Not Wellbutrin

Posted by SLS on August 17, 2004, at 7:04:16

In reply to Re: Dopaminergic Drug/Supp to Aug SSRI-Not Wellbutrin, posted by KaraS on August 17, 2004, at 6:03:56

> I have read different things about the action of Wellbutrin. I had heard originally that it was dopaminergic but later started reading that it's action is more on norepinephrine and has a much smaller effect on dopamine. Is this the general consensus here?

I don't know. Generally, I have not considered Wellbutrin to be a directly acting dopaminergic drug. Although there is far from being a consensus on how it works, there was a period of time several years ago when the focus was on norepinephrine. Promoting NE activity probably does represent an important net effect.

Bromocriptine, Dexedrine, and nomifensine all produced significant, albeit transient antidepressant effects for me. All three are direct acting pro-dopaminergic drugs, with additional NE promoting effects to be found in the latter two. Wellbutrin consistently worsens my depression. If pro-dopaminergic activity was sufficient to improve my condition, the selective DA agonist bromocriptine would provide support for this and tend to call into question the significance of the DA properties of Wellbutrin.

On the other hand, Sheldon H. Preskorn, MD on his website, presents a thoughtful argument for why he believes that both NE and DA reuptake inhibition are significant contributors to its clinical effect.

http://www.preskorn.com/columns/0001.html

What might make for a more complete appraisal of the physiological effects of Wellbutrin would be to provide information as to where in the brain these effects dominate and the drug concentrates. Function is dependent on not only what happens, but where it happens. A little dopamine here, and you chase yourself around in circles; a little dopamine there, and you chase members of the opposite sex in straight lines.


- Scott

 

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