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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by terra miller on February 17, 2001, at 22:22:08
Does anybody know what the Dopamine does that the Wellbutrin SR effects? I understand its effect on Serotonin and Norepinephrine. But I don't understand this dopamine thing. This is naive, but I'm not wanting to develop Parkinson's down the road. Can anyone educate me about Wellbutrin SR and why it targets so many neuroreceptor sites? Thanks so much.
terra
Posted by JohnX on February 18, 2001, at 18:43:09
In reply to Wellbutrin SR Dopamine/Parkinson's, posted by terra miller on February 17, 2001, at 22:22:08
> Does anybody know what the Dopamine does that the Wellbutrin SR effects? I understand its effect on Serotonin and Norepinephrine. But I don't understand this dopamine thing. This is naive, but I'm not wanting to develop Parkinson's down the road. Can anyone educate me about Wellbutrin SR and why it targets so many neuroreceptor sites? Thanks so much.
>
> terraTerra,
I wouldn't worry about getting Parkinson's from
Wellbutrin. Did you read this somewhere?
In fact researchers did some studies to see
if Wellbutrin may help Parkinson patients but
the results showed no effect + or -.Wellbutrin (Bupropion) is really what is called
a pro-drug. That means that the parent compound
Bupropion really doesn't have much affect; it
is an extremely weak re-uptake inhibitor at
any site. The liver breaks Bupropion into
metabolites which do most of the work. The
mechanism of action of Bupropion is not well understand. However, the last report that I
read indicated that the metabolite
hydroxy-bupropion likely does most of its work
through norepinephrine re-uptake and a possible
genomic mechanism that reduces the production
of norepinephrine and dopamine in some areas
of the brain (but this is reversable upon
termination of the medication). Most of the
action is not in the area of the brain that would
interfere with the substantia-niagra (hope I spelled it right) where parkinson's is caused.For responders at therapeutic doses, the report indicated that bupropion nor its metabolites had
much action on dopamine reuptake either. The
genomic mechanism may somehow be involved in
the increased sensitization of dopamine in the
limbic part of the brain (the reward center).Serotonin is hardly touched by Wellbutrin. That's
why it is safe to use it in conjunction with
SSRI's (normally not safe to combine SSRI's).BTW, SSRI's are more likely to induce Parkinson's
like symptoms, although the chances are rare.
There are serotonin neurons in the substantia-
niagra that will decrease dopamine
in response to an increase in serotonin.
However,the dopamine neurons have a feedback
mechanism that generally allows them to adjust to
this push/pull effect.-John
Posted by terra miller on February 19, 2001, at 9:02:23
In reply to Re: Wellbutrin SR Dopamine/Parkinson's, posted by JohnX on February 18, 2001, at 18:43:09
John,
Fire-up! What an informative reply. Thanks so much.
I gleaned more information that explained what's going on with me.... I don't respond to SSRI's well, so I'm thinking that since Wellbutrin SR is weak on it's serotonin action that might explain why it seems to be working better with me than my trials of SSRI's previously. That explains a lot.
I really am feeling that I am on the right track now. I am very thankful for the input on the Dopamine.
Thanks. Terra.
Posted by JohnX on February 19, 2001, at 18:19:02
In reply to Re: Wellbutrin SR Dopamine/Parkinson's, posted by terra miller on February 19, 2001, at 9:02:23
> John,
>
> Fire-up! What an informative reply. Thanks so much.
>
> I gleaned more information that explained what's going on with me.... I don't respond to SSRI's well, so I'm thinking that since Wellbutrin SR is weak on it's serotonin action that might explain why it seems to be working better with me than my trials of SSRI's previously. That explains a lot.
>
> I really am feeling that I am on the right track now. I am very thankful for the input on the Dopamine.
>
> Thanks. Terra.Terra,
I hope it goes well for you. Wellbutrin is a good
alternative to SSRI's. It has some advantages
like fewer sexual side effects. Also, it tends
to work well for people who are anergic (lack of
energy) & have lack of motivation or interest.You also may try Effexor if Wellbutrin doesn't
pan out. Effexor works on serotonin like the
SSRI's but at higher doses it also works on norepinephrine. Generally norepinephrine and
dopamine are more associated with anergia, lack
of motivation, etc. The SSRI's can help in these
areas too but they generally are more targeted to
symptoms of anxiety,panic,ocd. Both groups of
meds have the same response rate for depression.
But some people definately tend to do better with
the SSRI alternatives.Good Luck,
John
Posted by terra miller on February 19, 2001, at 20:52:42
In reply to Re: Wellbutrin SR Dopamine/Parkinson's, posted by JohnX on February 19, 2001, at 18:19:02
John,
*laughing* My brain is SO backwards. (Picture pdoc rolling eyes in bewilderment!) We're trying to treat anxiety from PTSD. The SSRI's are totally unhelpful (send me into MAJOR depression), serzone was great (until I started swelling up from it?!), and I could never get rid of the shakes from Effexor even after gutting it out 5 weeks. So, I'm really hoping this med works.
Does Wellbutrin cause weight gain? (I'm hoping it's just the GirlScout cookies.) But I don't think so. (grrrrr.)
Terra.
> Terra,
>
> I hope it goes well for you. Wellbutrin is a good
> alternative to SSRI's. It has some advantages
> like fewer sexual side effects. Also, it tends
> to work well for people who are anergic (lack of
> energy) & have lack of motivation or interest.
>
> You also may try Effexor if Wellbutrin doesn't
> pan out. Effexor works on serotonin like the
> SSRI's but at higher doses it also works on norepinephrine. Generally norepinephrine and
> dopamine are more associated with anergia, lack
> of motivation, etc. The SSRI's can help in these
> areas too but they generally are more targeted to
> symptoms of anxiety,panic,ocd. Both groups of
> meds have the same response rate for depression.
> But some people definately tend to do better with
> the SSRI alternatives.
>
> Good Luck,
> John
Posted by Lorraine on February 19, 2001, at 21:27:23
In reply to Re: Wellbutrin SR/etc/weight gain? » JohnX, posted by terra miller on February 19, 2001, at 20:52:42
> John,
>
> *laughing* My brain is SO backwards. (Picture pdoc rolling eyes in bewilderment!) We're trying to treat anxiety from PTSD. The SSRI's are totally unhelpful (send me into MAJOR depression), serzone was great (until I started swelling up from it?!), and I could never get rid of the shakes from Effexor even after gutting it out 5 weeks. So, I'm really hoping this med works.
>
> Does Wellbutrin cause weight gain? (I'm hoping it's just the GirlScout cookies.) But I don't think so. (grrrrr.)
>
> Terra.
> > Terra,
> >
> > I hope it goes well for you. Wellbutrin is a good
> > alternative to SSRI's. It has some advantages
> > like fewer sexual side effects. Also, it tends
> > to work well for people who are anergic (lack of
> > energy) & have lack of motivation or interest.
> >
> > You also may try Effexor if Wellbutrin doesn't
> > pan out. Effexor works on serotonin like the
> > SSRI's but at higher doses it also works on norepinephrine. Generally norepinephrine and
> > dopamine are more associated with anergia, lack
> > of motivation, etc. The SSRI's can help in these
> > areas too but they generally are more targeted to
> > symptoms of anxiety,panic,ocd. Both groups of
> > meds have the same response rate for depression.
> > But some people definately tend to do better with
> > the SSRI alternatives.
> >
> > Good Luck,
> > JohnMy experience with Wellbutrin and my understanding of it is that it does not cause weight gain. It's a puppy upper.
Posted by allisonm on February 19, 2001, at 22:11:48
In reply to Re: Wellbutrin SR/etc/weight gain?, posted by Lorraine on February 19, 2001, at 21:27:23
I have lost a good amount of weight on WB SR.
Posted by JohnX on February 20, 2001, at 2:01:01
In reply to Re: Wellbutrin SR/etc/weight gain? » JohnX, posted by terra miller on February 19, 2001, at 20:52:42
Terra,I *think* my 1st submission of this was lost,
so excuse me if I entered this twice.Yeah, I found that Wellbutrin releaved anxiety.
Some people find it agitating.
I also found that Effexor caused the most anxiety
of all the meds and Effexor is indicated to treat
GAD (Generalized Anxiety Disorder).
So I laugh too ;). My 1st psychiatrist thought
I might have PTSD. I think I'm backwards also.PTSD is a somewhat complex treatment. Research
into the biological underpinnings has not garnered
as much attention as other disorders in the past.
But there is a lot of momentum gaining in this
area.Many psychotropic meds have shown to be effective
at treating PTSD, but generally no one medication
has shown much greater efficacy than another.
The SSRI's are generally the 1st line treatment
since they are most likely to help with anxiety.
Its not atypical for PTSD patients to get a
different response profile to meds than most others. The biology of PTSD patients tends to
show paradoxical differences to those with other
disorders. For example, most typical patients
with depression show abnormally high levels of
the hormone cortisol (released during stress),
whereas PTSD depressed patients will show
abnormally low levels. A lot of this has to do
with how the traumatic episode(s) leading to
PTSD have caused interference in the body's
normal response to stress.There are medications in the pipeline called
CRF-antagonists that normalize the stress response
system that will likely be an excellent 1st line
treatment for both PTSD and many other disorders.And yes, I did lose weight on Wellbutrin too. ;)
-John
> John,
>
> *laughing* My brain is SO backwards. (Picture pdoc rolling eyes in bewilderment!) We're trying to treat anxiety from PTSD. The SSRI's are totally unhelpful (send me into MAJOR depression), serzone was great (until I started swelling up from it?!), and I could never get rid of the shakes from Effexor even after gutting it out 5 weeks. So, I'm really hoping this med works.
>
> Does Wellbutrin cause weight gain? (I'm hoping it's just the GirlScout cookies.) But I don't think so. (grrrrr.)
>
> Terra.
> > Terra,
> >
> > I hope it goes well for you. Wellbutrin is a good
> > alternative to SSRI's. It has some advantages
> > like fewer sexual side effects. Also, it tends
> > to work well for people who are anergic (lack of
> > energy) & have lack of motivation or interest.
> >
> > You also may try Effexor if Wellbutrin doesn't
> > pan out. Effexor works on serotonin like the
> > SSRI's but at higher doses it also works on norepinephrine. Generally norepinephrine and
> > dopamine are more associated with anergia, lack
> > of motivation, etc. The SSRI's can help in these
> > areas too but they generally are more targeted to
> > symptoms of anxiety,panic,ocd. Both groups of
> > meds have the same response rate for depression.
> > But some people definately tend to do better with
> > the SSRI alternatives.
> >
> > Good Luck,
> > John
Posted by Shell on February 20, 2001, at 22:10:43
In reply to Re: Wellbutrin SR/etc/weight gain?, posted by JohnX on February 20, 2001, at 2:01:01
I've lost 10 pounds since the first of the year while taking Wellbutrin...though it could be the Concerta too.
Posted by michael on February 20, 2001, at 23:14:23
In reply to Re: Wellbutrin SR/etc/weight gain?, posted by Shell on February 20, 2001, at 22:10:43
Shell,
Can I ask you the doses you're taking?
Additionally, do you notice any difference in your response to the concerta - with the wellbutrin vs. alone (ie. w/o the wellbutrin)?
In other words, dose the wellbutrin lower the dose of concerta you need for a positive response?
I was thinking about asking my pdoc about the possibility of adding concerta to wellbutrin... and wondering if there's a synergistic (not sure if that's a word...) effect?
[I had some positive effects from each seperately]
Thanks.
> I've lost 10 pounds since the first of the year while taking Wellbutrin...though it could be the Concerta too.
Posted by terra miller on February 21, 2001, at 18:00:18
In reply to Re: Wellbutrin SR/etc/weight gain? » Shell, posted by michael on February 20, 2001, at 23:14:23
Ummm, what's concerta? :-)
Thanks. Terra.> Shell,
>
> Can I ask you the doses you're taking?
>
> Additionally, do you notice any difference in your response to the concerta - with the wellbutrin vs. alone (ie. w/o the wellbutrin)?
>
> In other words, dose the wellbutrin lower the dose of concerta you need for a positive response?
>
> I was thinking about asking my pdoc about the possibility of adding concerta to wellbutrin... and wondering if there's a synergistic (not sure if that's a word...) effect?
>
> [I had some positive effects from each seperately]
>
> Thanks.
>
>
>
>
>
> > I've lost 10 pounds since the first of the year while taking Wellbutrin...though it could be the Concerta too.
Posted by michael on February 21, 2001, at 18:58:32
In reply to Re: Wellbutrin SR/etc/weight gain? » michael, posted by terra miller on February 21, 2001, at 18:00:18
It's an extended release / sustained release / etc. type of ritalin. It's supposed to last 12 hours, I believe.
I've seen a number of people mention (here & elsewhere) that it does seem to be effective longer than other extended release forms of ritalin - don't recall for certain, but I THINK in the 9-12 hour range?
However, they say it seems to take an hour & a half to kick in after taking the dose... (this is all hearsay - no personal experience on my part)
> Ummm, what's concerta? :-)
> Thanks. Terra.
>
>
>
> > Shell,
> >
> > Can I ask you the doses you're taking?
> >
> > Additionally, do you notice any difference in your response to the concerta - with the wellbutrin vs. alone (ie. w/o the wellbutrin)?
> >
> > In other words, dose the wellbutrin lower the dose of concerta you need for a positive response?
> >
> > I was thinking about asking my pdoc about the possibility of adding concerta to wellbutrin... and wondering if there's a synergistic (not sure if that's a word...) effect?
> >
> > [I had some positive effects from each seperately]
> >
> > Thanks.
> >
> >
> >
> >
> >
> > > I've lost 10 pounds since the first of the year while taking Wellbutrin...though it could be the Concerta too.
Posted by Shell on February 23, 2001, at 11:38:10
In reply to Re: Wellbutrin SR/etc/weight gain? » Shell, posted by michael on February 20, 2001, at 23:14:23
> Shell,
>
> Can I ask you the doses you're taking?I'm taking 300 mg Wellbutrin, 54 mg Concerta
> Additionally, do you notice any difference in your response to the concerta - with the wellbutrin vs. alone (ie. w/o the wellbutrin)?
>I'm not really sure. I started the Wellbutrin about three weeks before the Concerta, so I think it was probably just kicking in when I added the Concerta. I've never taken the Concerta without the Wellbutrin.
> In other words, dose the wellbutrin lower the dose of concerta you need for a positive response?
I think it should, though I really don't know.
> I was thinking about asking my pdoc about the possibility of adding concerta to wellbutrin... and wondering if there's a synergistic (not sure if that's a word...) effect?I think there probably is; it would make sense. Since I have never taken either one separately, I am just guessing.
> [I had some positive effects from each seperately]
>
> Thanks.
>I wish I could be more helpful. I've always taken both together, so I really don't have much of an idea how they would work separately.
Posted by Shell on February 23, 2001, at 11:52:01
In reply to Re: Wellbutrin SR/etc/weight gain?, posted by michael on February 21, 2001, at 18:58:32
> It's an extended release / sustained release / etc. type of ritalin. It's supposed to last 12 hours, I believe.
>
> I've seen a number of people mention (here & elsewhere) that it does seem to be effective longer than other extended release forms of ritalin - don't recall for certain, but I THINK in the 9-12 hour range?
>
> However, they say it seems to take an hour & a half to kick in after taking the dose... (this is all hearsay - no personal experience on my part)
>
> > Ummm, what's concerta? :-)
> > Thanks. Terra.
> >I've noticed it takes at least an hour, more like an hour and a half to start to take effect, though I think it is designed to release a small amount immediately. It does seem to wear off about 12 hours after it is taken...which would give about 10 1/2 hours of coverage.
If you are like me, even twelve hours is too short. If I take it when I get up at 5:30, it is worn off before I get home from work. I seem to "need" it more in the evening and my husband doesn't like to deal with me after it has worn off, so I split the dose.
I usually take 36 mg in the morning (sometimes at 6:00 am, sometimes I might wait until as late as 9:00 am) and then 18 mg around noon or so. I try to time the second dose so that I will be asleep before it wears off. If it is a Friday or Saturday and I think I'll be up late, I might take that second dose as late as 2:00 pm.
I find it doesn't affect sleep at all. Even if I take it fairly late in the day and go to bed while it is still working, I can still go right to sleep. That might just be me...I sleep a lot!
This is the end of the thread.
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