Posted by SLS on July 12, 2005, at 18:37:28
In reply to Question for Scott (if you have time) » SLS, posted by TamaraJ on July 12, 2005, at 16:11:55
> I noticed that Wellbutrin and Zoloft appear to be equal in terms of Dopamine reuptake or inhibition.
Actually, thinking simplistically, it is not surprising that you should get nausea from combining two pro-dopaminergic drugs. Nausea can occur for any number of reasons, but dopaminergic activation in certain areas of the brain does. Actually, I think that's why people have nausea attacks over the first few days of starting Effexor, a drug with a "weak" dopamine reuptake property. I once tried nomifensine (Merital), the most potent dopamine reuptake inhibitor antidepressant ever marketed in the U.S. I did not suffer any nausea with this drug. So much for being simplistic.
> I also read in a couple of places that Wellbutrin actually only has a mild effect on dopamine and norepiphedrine.
I don't know what the heck Wellbutrin does. Sheldon Preskorn, MD, is very adamant that Wellbutrin is a potent enough DA/NE reuptake inhibitor such that it explains its mechanism of action. Currently, I don't agree with him. I cannot offer an alternative, though.
> Yet, Nortriptyline seems to be quite a potent or at least be a significant inhibitor of norepiphedrine.
It is. It also tickles serotonin a wee bit.
> So, the question I have is that is Nortriptyline less activating than Wellbutrin because of its other mechanisms,
I don't find Wellbutrin to be activating at all. But that's just me and my enigmatic brain chemistry. It might be that its metabolite is the source for the activation and anxiety that Wellbutrin is known to frequently produce. So the question becomes: is Wellbutrin the active antidepressant compound or is it the metabolite or both? Is the metabolite the source of the amphetamine like effects? Can a Wellbutrin-like compound be synthesized that doesn't produce this metabolite and perhaps avoid the unwanted side effects? I don't know. I'm just thinking out loud.
Wellbutrin makes me feel worse.
Nortriptyline makes me feel better.
Nortriptyline has been associated with successful treatment of melancholic depression. However, I don't think Wellbutrin has been scrutinized in this area. It might be just as good, but I think I would opt for a TCA for melancholia with psychomotor retardation.
I doubt I threw any light on the subject. Just a ramble. Sorry.
- Scott
poster:SLS
thread:525731
URL: http://www.dr-bob.org/babble/20050708/msgs/526850.html