![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 10 to 34 of 40. Go back in thread:
Posted by Ritch on March 3, 2002, at 21:59:34
In reply to Re: Wellbutrin increases or decreases dopamine?, posted by JohnX2 on March 3, 2002, at 18:04:20
>
> Look, Wellbutrin is not the most well understood medicine in
> the world , but it is probably the MOST misquoted medicine in
> the world. Without looking at ANY of the clinical data on its
> mode of action, at SOLELY looking at behavioral tests of animal
> models and subsequent follow ups in human trials, there is every
> bit of evidence that Wellbutrin affects the dopamine system in
> responders to the medicine. In the animal models, when they look
> into the dopaminergic system, they often look for behaviours that
> are consistent with the administrations of dopaminergic medicines
> like amphetamines, which Wellbutrin passes the test.
> Also in human trials, Wellbutrin has been shown to be affective
> in disorders such as ADHD which are known to be dysruptions in the
> dopaminergic system. Also many responders to Wellbutrin report getting
> an amphetamine like feeling on the medicine.
>
> Now as far as clinical data. Many people base their opinions of the medicine
> on the parent compound bupropion hcl which has LITTLE IF ANY clinical value
> in the medicine what so ever. Wellbutrin (bupropion hcl) is what is known
> as a pro-drug, its metabolites (the thing the 1st pass of the liver breaks
> it down to, do almost all of the work). So looking strictly at binding assays, concentrations of, etc of bupropion
> hcl is of value, but gives a SERIOUS misconception of what is seriously going on. What has been discovered is that the active metabolites
> primarily hydroxy-bupropion and threohydroxybupropion accumulate at levels in
> the body so potent to make the dopamine reuptake properties substantial.
> It may be true that through some genomic mechanism the release of
> dopamine is diminished, possibly through a feedback mechanism. But this
> is even seen with norepineprine reuptake inhibitors, decreased firing,
> yet more noradrenaline in the synpatic cleft from the reuptake inhibition.
>
> Here is the best article I have read to date with
> a clear and concise summary of research findings
> on Wellbutrin (bupropion hcl) and myths/misconceptions
> regarding its dopaminergic mode of action:
>
> http://www.preskorn.com/columns/0001.html
>
> Best wishes,
> John
Hi John,Very good stuff indeed. I am still on WB with other meds and my personal experience with taking the med seem to correlate with your talk about the active metabolites, etc. I like the "straight" bupropion right after a dose in the morning with some strong coffee. What I do *not* like is all the pharmacological "baggage" that hangs around late in the day culminating in irritability or in difficulty sleeping. That highlights something I really miss about taking Adderall. It gets to "work" quickly and leaves your body when it is time to sleep. A lot of people are out there taking a lot of "unintended" medications that are active metabolites with very different modes of action than what is "showcased".
Mitch
Posted by Jason911 on March 3, 2002, at 22:21:46
In reply to Re: Wellbutrin increases or decreases dopamine?, posted by JohnX2 on March 3, 2002, at 18:04:20
I have read that same article as you John and I have to admit it is a little hard to follow. Anyway, I think the ADHD and dopamine/mice reaction tests are due mainly to increases of NE. I'm not sure, and I probably am wrong but this is what I tend to believe. I believe that it could act on a part of the brain whose method of action mimicks that of dopamine, but I believe that if the problem is dopamine, why can't docs put people on another more well-known dopaminergic drug other than Wellbutrin. I guess there aren't any. All I know is that the bupropion did nothing for my depressed mood or concentration. Adderall did nothing for my concentration. So, I'd have to think that both Wellbutrin and Adderall act similar, somewhat; that they activate the CNS in some people. Me, though? NOTHING. I guess I'm just wierd. Hope the Jumex is the answer for me, I'll know in a couple of weeks. BTW, the Klonopin has been working wonders for me and my anxiety. It seems to have improved my mood a little as well. Still have the concentration probs and a little mental "fogginess." -Jason911 PS - It seems to me that the only medical answer right now for dopamine-related depression, the only answer, is Wellbutrin or stimulants. I don't like that one bit. Remember, AndrewB? Of the meds that helped his depression, 3 are no longer available in the US. What the hell??? And I believe that dopamine is one of the major reasons for depression in people. It's just that the pharmacies are just in their "baby years" in finding cures for depression - what affects mood more powerfully than serotonin? Hardly anything.... but.. dopamine-defecient sufferers are pretty much limited to what we can do. I am hoping the selegiline will be the answer for us.
>
> Look, Wellbutrin is not the most well understood medicine in
> the world , but it is probably the MOST misquoted medicine in
> the world. Without looking at ANY of the clinical data on its
> mode of action, at SOLELY looking at behavioral tests of animal
> models and subsequent follow ups in human trials, there is every
> bit of evidence that Wellbutrin affects the dopamine system in
> responders to the medicine. In the animal models, when they look
> into the dopaminergic system, they often look for behaviours that
> are consistent with the administrations of dopaminergic medicines
> like amphetamines, which Wellbutrin passes the test.
> Also in human trials, Wellbutrin has been shown to be affective
> in disorders such as ADHD which are known to be dysruptions in the
> dopaminergic system. Also many responders to Wellbutrin report getting
> an amphetamine like feeling on the medicine.
>
> Now as far as clinical data. Many people base their opinions of the medicine
> on the parent compound bupropion hcl which has LITTLE IF ANY clinical value
> in the medicine what so ever. Wellbutrin (bupropion hcl) is what is known
> as a pro-drug, its metabolites (the thing the 1st pass of the liver breaks
> it down to, do almost all of the work). So looking strictly at binding assays, concentrations of, etc of bupropion
> hcl is of value, but gives a SERIOUS misconception of what is seriously going on. What has been discovered is that the active metabolites
> primarily hydroxy-bupropion and threohydroxybupropion accumulate at levels in
> the body so potent to make the dopamine reuptake properties substantial.
> It may be true that through some genomic mechanism the release of
> dopamine is diminished, possibly through a feedback mechanism. But this
> is even seen with norepineprine reuptake inhibitors, decreased firing,
> yet more noradrenaline in the synpatic cleft from the reuptake inhibition.
>
> Here is the best article I have read to date with
> a clear and concise summary of research findings
> on Wellbutrin (bupropion hcl) and myths/misconceptions
> regarding its dopaminergic mode of action:
>
> http://www.preskorn.com/columns/0001.html
>
> Best wishes,
> John
>
>
>
>
> > My pdoc has also recommended wellbutrin for my social phobia/apathy. I am also on neurontin for mild anxiety. He thinks I need more dopamine. He says that is why I smoke cigarettes. I read wellbutrin actually decreases the dopamine and that is why it has a low incidence of inducing mania.
> >
> > Does anyone know whether wellbutrin helped with dopamine or not?
> >
> > Jill
Posted by Jason911 on March 3, 2002, at 22:29:13
In reply to Re: Wellbutrin increases or decreases dopamine?, posted by germanium on March 3, 2002, at 20:31:50
I am absolutely jumping for joy about your success story!!!!! I knew that the selegiline with phenylalanine would do it!!! For us people who wouldn't respond to SSRI's, etc. (which I know would have been me)... I am so happy and can't wait till my selegiline arrives in the mail. THERE IS A CURE FOR TREATMENT_RESISTENT DEPRESSION PEOPLE!!!! Thank you , thank you Lord. -Jason911 Best of yluck to you and I'm glad you've found a solution!!!!
> Jason very well said. I myself have taken effexor, Wellbutrin & every other antidepressant available tricyclics worked ok but were way overboard on side effect to the point that I couldn't tolerate for long wellbutrin seemed not much more than caffiene too me by itself or in combo with effexor the effect wore off rather quickly & not haveing an addictive personallity I went in search of something else that would do the same or better than the previously mentioned combo but not wear off as that had done so quickly which brought me to Selegiline. It has made a tremendous difference for me especially augmented with Phenylalanine. SSRI's seemed to help initially butt robbed me of any desire to perform at work & stunted the emotions & drive very much. Selegiline for me has no side effects worth noting except more energy than I know what to do with at times.I do not recomend this for everybody as evrybody is different & reacts different.But may help a lot of anergic depressives out of there holes & get them back up & running again Also may help with social phobias
Posted by Jason911 on March 3, 2002, at 22:32:31
In reply to Re: Wellbutrin increases or decreases dopamine?, posted by germanium on March 3, 2002, at 20:52:06
Well said. -Jason911
Posted by Jill K. on March 3, 2002, at 22:33:50
In reply to Re: Wellbutrin increases or decreases dopamine?, posted by JohnX2 on March 3, 2002, at 18:04:20
Hello John,
Thanks for the info. Still some questions.
> Look, Wellbutrin is not the most well understood medicine in
> the world , but it is probably the MOST misquoted medicine in
> the world. Without looking at ANY of the clinical data on its
> mode of action, at SOLELY looking at behavioral tests of animal
> models and subsequent follow ups in human trials, there is every
> bit of evidence that Wellbutrin affects the dopamine system in
> responders to the medicine. In the animal models, when they look
> into the dopaminergic system, they often look for behaviours that
> are consistent with the administrations of dopaminergic medicines
> like amphetamines, which Wellbutrin passes the test.
> Also in human trials, Wellbutrin has been shown to be affective
> in disorders such as ADHD which are known to be dysruptions in the
> dopaminergic system. Also many responders to Wellbutrin report getting
> an amphetamine like feeling on the medicine.Desipramine is also very effective for ADHD, and it effects norepinephrine, not dopamine. Many people on desipramine also report an amphetamine like feeling. So I am not sure if this correlates with wellbutrin increasing dopamine.
> Now as far as clinical data. Many people base their opinions of the medicine
> on the parent compound bupropion hcl which has LITTLE IF ANY clinical value
> in the medicine what so ever. Wellbutrin (bupropion hcl) is what is known
> as a pro-drug, its metabolites (the thing the 1st pass of the liver breaks
> it down to, do almost all of the work). So looking strictly at binding assays, concentrations of, etc of bupropion
> hcl is of value, but gives a SERIOUS misconception of what is seriously going on. What has been discovered is that the active metabolites
> primarily hydroxy-bupropion and threohydroxybupropion accumulate at levels in
> the body so potent to make the dopamine reuptake properties substantial.
> It may be true that through some genomic mechanism the release of
> dopamine is diminished, possibly through a feedback mechanism. But this
> is even seen with norepineprine reuptake inhibitors, decreased firing,
> yet more noradrenaline in the synpatic cleft from the reuptake inhibition.
>
> Here is the best article I have read to date with
> a clear and concise summary of research findings
> on Wellbutrin (bupropion hcl) and myths/misconceptions
> regarding its dopaminergic mode of action:
>
> http://www.preskorn.com/columns/0001.html
>Dr Preskorn mentions that the metabolites of wellbutrin are much higher than the wellbutrin in the blood stream. He also shows a table that demonstrates that wellbutrin blocks dopamine and norepinephrine reuptake weakly. He then states that because the metabolites concentrations are so high, dopamine and norepinephrine reuptake inhibition occurs. He *did not* show the reuptake values for the metabolites though. Most metabolites, like desipramine (from imipramine) and norfluoxetine (from fluoxetine) are *norepinephrine* blockers, not dopamine.
> Best wishes,
> John
>Thanks. I hope to figure this out some day.
Jill
Posted by Jason911 on March 3, 2002, at 22:43:12
In reply to Re: Wellbutrin increases or decreases dopamine? » JohnX2, posted by Ritch on March 3, 2002, at 21:59:34
I don't see Wellbutrin as anything but an "upper" similar to coffee in the morning. And the effects like insomnia are not uncommon. Probably due to the high levels of NE keeping you uneasy and unable to sleep. Like germanium said, if you suffer from depression (since you respond to the stimulation effect meds) try low-dose selegiline (5-10mg) and supplement with around 600mg/phenylalanine (presurser to PEA) daily. Phenylalaine is cheap. GNC sells 30 100mg tabs for $10. Selegiline via mail-order is cheap (Jumex - same as US Eldepryl but ALOT cheaper) $47 with s&h inc. gives you 50 5mg tabs! 50 Days worth! And as for sleeping and being more eased and more social I'd augment 2-3mg Klonopin a day. You'll have no problem getting to sleep. I'd guess you'd do well with the Klonopin at 1mg in the morning, 1mg at noon, and 2mg - 2 hours before bedtime. Hope this helps -Jason911
>
> Hi John,
>
> Very good stuff indeed. I am still on WB with other meds and my personal experience with taking the med seem to correlate with your talk about the active metabolites, etc. I like the "straight" bupropion right after a dose in the morning with some strong coffee. What I do *not* like is all the pharmacological "baggage" that hangs around late in the day culminating in irritability or in difficulty sleeping. That highlights something I really miss about taking Adderall. It gets to "work" quickly and leaves your body when it is time to sleep. A lot of people are out there taking a lot of "unintended" medications that are active metabolites with very different modes of action than what is "showcased".
>
> Mitch
Posted by Jason911 on March 3, 2002, at 23:08:36
In reply to OH MY GOD!!!!!!!!! » germanium, posted by Jason911 on March 3, 2002, at 22:29:13
Low dose selegiline WON'T cure your depression for those of us whose problems are related to something other than serotonin deficiency. SSRI non-responders (who aren't bipolar) are probably deficient elsewhere. We all know that MAOI's are the most effective way to keep those neurotranmitters flowing through our brains. But they come with potentially life-threatening side-effects. MAO-B selective selegiline is part of the magic duo that can cure us depressed people! It's selegiline (Jumex/Eledepryl) with Phenylalanine (PEA-pre) that does the trick. The selegiline opens the door to higher levels of dopamine and PEA (which is rapidly absorbed by MAO) and your brain won't be forced to counteract the new "correct" balance by changing this and that because of the MAO inhibition. Selegiline+Phenylalanine for depression people!!!!! PEA- makes you feel good ~~~ Smoking (which lowers your MAO-B by 40% and therefore increases dopamine at the synapse) makes you feel good. Selegline+PEA is the answer but no one will listen. Not even the top pdocs in the nation. It's all because of money and greed and publicity folks... it's up to us to decide what's good for us and what we should put in our bodies. Do your research first!!!! Don't get caught up in the latest SSRI fads. Sure some people feel good on those meds. So will people WITHOUT depression. Plus side-effects are a bitch. The truth is out there and it's up to us (the sufferers) to find our cures, and thanks to Psycho-Babble our job has been made much easier for us. For those people whose problem is serotonin, there are SSRI's (unfortunately for them ~ side-effects). But for those who are thinkning they suffer from depression/anxiety or something else.. I'd say see a pdoc first.. but then come back to us for further advise before going on what could potentially be a long and miserable journey through the wide world of meds (most of which are crap in one way or another). -Jason911
Posted by Jason911 on March 3, 2002, at 23:12:48
In reply to Re: Wellbutrin increases or decreases dopamine? » JohnX2, posted by Jill K. on March 3, 2002, at 22:33:50
Like I said before.. ADHD response is probably due to the NE and not neccesarily DA. I've always thought this. Give Jumex+Phenylalnine a try. -Jason911
Posted by Jason911 on March 3, 2002, at 23:14:58
In reply to Jill .... your on the right track!!! read: » Jill K., posted by Jason911 on March 3, 2002, at 23:12:48
Posted by JohnX2 on March 3, 2002, at 23:36:19
In reply to Wellbutrin increases or decreases dopamine?, posted by Jill K. on March 3, 2002, at 2:41:40
Hi Jill,This thread is going down hill really fast.
I think what's really the issue here is trust
between you and your psychiatrist.Your psychiatrist has probably treated thousands
of patiets and has studied extensively biology,
chemisty, etc. Spent zillions of years in schooling.Pschobabble is a good place to exchage experieces
and information.Everyone here means well.
I'm not a psychiatrist. I'm a psychiatric patient.
I'm 29, and I have a degree in electrical engineering
specialing in microchip design.I have been on 20+ different medications, and have
spent a lot of time reading information on the internet
and have tried all the fads, etc. Jason is
a bright fellow too and has had some good luck and
back luck with the medications he's been on just like
the rest of us and I know he'll be really
successful given his intelligence and will get
into a fine college and have a great
career.So I think if you don't trust your psychiatrist's
advice, this is something you need to evaluate
seriously. Maybe you want to shop around and get
advice from other psychiatrists. They aren't all
perfect, they are human just like the rest of us,
I have been through 4 and liked 2. Sometimes you
click and sometimes you don't.Please take care and best of luck with your medicines.
-John
> My pdoc has also recommended wellbutrin for my social phobia/apathy. I am also on neurontin for mild anxiety. He thinks I need more dopamine. He says that is why I smoke cigarettes. I read wellbutrin actually decreases the dopamine and that is why it has a low incidence of inducing mania.
>
> Does anyone know whether wellbutrin helped with dopamine or not?
>
> Jill
Posted by JohnX2 on March 4, 2002, at 0:34:48
In reply to Re: Wellbutrin increases or decreases dopamine? » JohnX2, posted by Jill K. on March 3, 2002, at 22:33:50
Jill,
I don't know what Desipramine does.
But I'll give you 2 more examples.Almost EVERY atypical antipsychotic that
blocks the serotonin 5ht-2 receptor has absoltutely NO
affinity for the dopamine reuptake pump yet
substantially INCREASES dopamine
in the (pre)frontal cortex of the brain.
Why, because there are a lot of indirect mechanisms
of action that occur in this complex machine
we call the brain. In the frontal cortex it has
been widely shown that the serotonin 5ht2 receptor
is negatively coupled to dopamine release (i.e.
it is a gate keeper for dopamine release). This
is also true in other areas of the brain.Example 2, Nicotine has absolutely no affinity
for the dopamine reuptake pump, etc, yet increases
concentrations of dopamine via an indirect mechanism
in the limbic (feel good) portion of the brain.There are a lot of indirect routes to increase
dopamine conductance.Best regards,
John> Desipramine is also very effective for ADHD, and it effects norepinephrine, not dopamine. Many people on desipramine also report an amphetamine like feeling. So I am not sure if this correlates with wellbutrin increasing dopamine.
>
Posted by JohnX2 on March 4, 2002, at 3:41:09
In reply to Re: Wellbutrin increases or decreases dopamine? » JohnX2, posted by Jason911 on March 3, 2002, at 22:21:46
> I have read that same article as you John and I have to admit it is a little hard to follow.
Hi Jason,
Why is the article a little hard to follow?
What part did you not understand that I can
explain? May a lack of formal higher education
in mathematics/biology/chemistry impede your
understanding in any way? I would have a hard
time imbibing the article when I was in high
school. I guess understanding the complex working
of neurology and psychopharmacology at the age of
17 may be quite a daunting task. If there is anything
I can help explain, please let me know. God knows
I have difficulties debugging microchips with
25-50 million transistors much less understanding
the most complex computers on planet earth, the
human brain.Regards,
John
Posted by Jill K. on March 4, 2002, at 6:56:47
In reply to Re: trust between you and your psychiatrist » Jill K., posted by JohnX2 on March 3, 2002, at 23:36:19
Dear John,
I am new to this site, and am not use to posting. I was thinking about my post to you all last night. I wrote it quickly before going to bed.
Your insights and explainations are great! When I spoke about desipramine, I really meant it as a question, not fact. I have no idea how this meds work .... I am simply guessing. You have a much better working knowledge of these meds and disease than I ever will. So let me rephase my post.
I have read desipramine(a tricyclic) is also very effective for ADHD. I think it effects norepinephrine mostly and not dopamine, although who really knows. Could it be possible that ADHD could be a dysfunction in norepinephrine?
Once again, my post came across wrong. I am just in so much pain from this anxiety and depression. I am very desperate to get better. I need all the help I can get. I am sorry about the prior post. Please keep posting.
Jill
Posted by Ritch on March 4, 2002, at 10:30:46
In reply to Re: Wellbutrin increases or decreases dopamine? » Ritch, posted by Jason911 on March 3, 2002, at 22:43:12
Jason,
Thanks for the reply. I have brought up selegiline to my pdoc before and MAOI's of *any* kind will not be prescribed, period. In my case I was trying to find something for my ADHD probs that wouldn't make me as anxious as Wellbutrin or pstims (and also not as likely to aggravate bipolar mood cycling as much as TCA's). I *have* to have a script for selegiline here to take it however because of the potential for random urine tests at work. When it metabolizes there is going to be some unchanged methamphetamine excreted by my kidneys that a test will pick up. If I drop a box on my toe at work I am going to be SOL. Maybe my pdoc would reconsider the transdermal version?
Mitch
> I don't see Wellbutrin as anything but an "upper" similar to coffee in the morning. And the effects like insomnia are not uncommon. Probably due to the high levels of NE keeping you uneasy and unable to sleep. Like germanium said, if you suffer from depression (since you respond to the stimulation effect meds) try low-dose selegiline (5-10mg) and supplement with around 600mg/phenylalanine (presurser to PEA) daily. Phenylalaine is cheap. GNC sells 30 100mg tabs for $10. Selegiline via mail-order is cheap (Jumex - same as US Eldepryl but ALOT cheaper) $47 with s&h inc. gives you 50 5mg tabs! 50 Days worth! And as for sleeping and being more eased and more social I'd augment 2-3mg Klonopin a day. You'll have no problem getting to sleep. I'd guess you'd do well with the Klonopin at 1mg in the morning, 1mg at noon, and 2mg - 2 hours before bedtime. Hope this helps -Jason911
>
>
>
> >
> > Hi John,
> >
> > Very good stuff indeed. I am still on WB with other meds and my personal experience with taking the med seem to correlate with your talk about the active metabolites, etc. I like the "straight" bupropion right after a dose in the morning with some strong coffee. What I do *not* like is all the pharmacological "baggage" that hangs around late in the day culminating in irritability or in difficulty sleeping. That highlights something I really miss about taking Adderall. It gets to "work" quickly and leaves your body when it is time to sleep. A lot of people are out there taking a lot of "unintended" medications that are active metabolites with very different modes of action than what is "showcased".
> >
> > Mitch
Posted by Jason911 on March 4, 2002, at 10:47:34
In reply to Re: Wellbutrin increases or decreases dopamine? » Jason911, posted by Ritch on March 4, 2002, at 10:30:46
At 5mg/day with the Phenylalanine the amphetamine will NOT show up on your drug scren. Nothing to worry about. Any more question? Just ask. -Jason911
> Jason,
>
> Thanks for the reply. I have brought up selegiline to my pdoc before and MAOI's of *any* kind will not be prescribed, period. In my case I was trying to find something for my ADHD probs that wouldn't make me as anxious as Wellbutrin or pstims (and also not as likely to aggravate bipolar mood cycling as much as TCA's). I *have* to have a script for selegiline here to take it however because of the potential for random urine tests at work. When it metabolizes there is going to be some unchanged methamphetamine excreted by my kidneys that a test will pick up. If I drop a box on my toe at work I am going to be SOL. Maybe my pdoc would reconsider the transdermal version?
>
> Mitch
>
>
>
> > I don't see Wellbutrin as anything but an "upper" similar to coffee in the morning. And the effects like insomnia are not uncommon. Probably due to the high levels of NE keeping you uneasy and unable to sleep. Like germanium said, if you suffer from depression (since you respond to the stimulation effect meds) try low-dose selegiline (5-10mg) and supplement with around 600mg/phenylalanine (presurser to PEA) daily. Phenylalaine is cheap. GNC sells 30 100mg tabs for $10. Selegiline via mail-order is cheap (Jumex - same as US Eldepryl but ALOT cheaper) $47 with s&h inc. gives you 50 5mg tabs! 50 Days worth! And as for sleeping and being more eased and more social I'd augment 2-3mg Klonopin a day. You'll have no problem getting to sleep. I'd guess you'd do well with the Klonopin at 1mg in the morning, 1mg at noon, and 2mg - 2 hours before bedtime. Hope this helps -Jason911
> >
> >
> >
> > >
> > > Hi John,
> > >
> > > Very good stuff indeed. I am still on WB with other meds and my personal experience with taking the med seem to correlate with your talk about the active metabolites, etc. I like the "straight" bupropion right after a dose in the morning with some strong coffee. What I do *not* like is all the pharmacological "baggage" that hangs around late in the day culminating in irritability or in difficulty sleeping. That highlights something I really miss about taking Adderall. It gets to "work" quickly and leaves your body when it is time to sleep. A lot of people are out there taking a lot of "unintended" medications that are active metabolites with very different modes of action than what is "showcased".
> > >
> > > Mitch
Posted by Jason911 on March 4, 2002, at 12:08:01
In reply to John I need your help! » JohnX2, posted by Jill K. on March 4, 2002, at 6:56:47
Here:
> I have read desipramine(a tricyclic) is also very effective for ADHD. I think it effects norepinephrine mostly and not dopamine, although who really knows. Could it be possible that ADHD could be a dysfunction in norepinephrine?I think it could be either DA or NE problems in persons with ADHD. I really do.
>
> Once again, my post came across wrong. I am just in so much pain from this anxiety and depression. I am very desperate to get better. I need all the help I can get. I am sorry about the prior post. Please keep posting.For your anxiety, I am a big supporter of Klonopin (brand name not generic: clonazepam). I think it would work wonders for your anxiety (like me and many others) and calm you right down; relax you.. make you more at ease and therefore more sociable. Your depression, like I said before, could be helped (I really believe strongly in this) by selegiline+phenylalanine. 5mg selegiline and 500mg phenylalanine daily to start. The Klonopin you'll have to get from your doctor. Just tell your doctor that you are suffering from anxiety attacks and want to give Klonopin a try. The selegiline (Jumex-the cheapest) is a different story. You can click on my post name at the top of the page and send me an e-mail and I can get right back to you if you have any other questions. -Jason911
>
> Jill
Posted by Jason911 on March 4, 2002, at 12:14:43
In reply to Re: Wellbutrin increases or decreases dopamine? » Jason911, posted by Ritch on March 4, 2002, at 10:30:46
The reason why your doc won't prescribe MAOI's like Nardil is because you are bipolar and could induce a manic state. Have you given lithium a try? -Jason911
> Jason,
>
> Thanks for the reply. I have brought up selegiline to my pdoc before and MAOI's of *any* kind will not be prescribed, period. In my case I was trying to find something for my ADHD probs that wouldn't make me as anxious as Wellbutrin or pstims (and also not as likely to aggravate bipolar mood cycling as much as TCA's). I *have* to have a script for selegiline here to take it however because of the potential for random urine tests at work. When it metabolizes there is going to be some unchanged methamphetamine excreted by my kidneys that a test will pick up. If I drop a box on my toe at work I am going to be SOL. Maybe my pdoc would reconsider the transdermal version?
>
> Mitch
>
>
>
> > I don't see Wellbutrin as anything but an "upper" similar to coffee in the morning. And the effects like insomnia are not uncommon. Probably due to the high levels of NE keeping you uneasy and unable to sleep. Like germanium said, if you suffer from depression (since you respond to the stimulation effect meds) try low-dose selegiline (5-10mg) and supplement with around 600mg/phenylalanine (presurser to PEA) daily. Phenylalaine is cheap. GNC sells 30 100mg tabs for $10. Selegiline via mail-order is cheap (Jumex - same as US Eldepryl but ALOT cheaper) $47 with s&h inc. gives you 50 5mg tabs! 50 Days worth! And as for sleeping and being more eased and more social I'd augment 2-3mg Klonopin a day. You'll have no problem getting to sleep. I'd guess you'd do well with the Klonopin at 1mg in the morning, 1mg at noon, and 2mg - 2 hours before bedtime. Hope this helps -Jason911
> >
> >
> >
> > >
> > > Hi John,
> > >
> > > Very good stuff indeed. I am still on WB with other meds and my personal experience with taking the med seem to correlate with your talk about the active metabolites, etc. I like the "straight" bupropion right after a dose in the morning with some strong coffee. What I do *not* like is all the pharmacological "baggage" that hangs around late in the day culminating in irritability or in difficulty sleeping. That highlights something I really miss about taking Adderall. It gets to "work" quickly and leaves your body when it is time to sleep. A lot of people are out there taking a lot of "unintended" medications that are active metabolites with very different modes of action than what is "showcased".
> > >
> > > Mitch
Posted by christophrejmc on March 4, 2002, at 12:42:08
In reply to MAOI-Bipolar » Ritch, posted by Jason911 on March 4, 2002, at 12:14:43
Ritch,
MAOIs are supposedly the ADs least likely to induce mania (save for Wellbutrin, maybe). Is your doctor MAOI-phobic, or is he worried about a [hypo]manic switch? Have you had similar problems before with antidepressants? Also, are you sure that your work screens for amphetamine? I didn't think this was a standard test (because many things can cause false positives)...
-Chris
> The reason why your doc won't prescribe MAOI's like Nardil is because you are bipolar and could induce a manic state. Have you given lithium a try? -Jason911
Posted by Jason911 on March 4, 2002, at 12:52:21
In reply to Re: MAOI-Bipolar, posted by christophrejmc on March 4, 2002, at 12:42:08
Hey, you've got it backwards. Wellbutrin has been touted as being less likely to induce mania. My friend, people who are bipolar and go on MAOI's.. well it can be an absolute disaster. Where did you hear that MAOI's wouldn't produce mania in BP's?? I'm sorry but that is absolutely not the truth. This is why his doc would not put him on an MAOI and on Wellbutrin instead.. but on the otherhand there are MAOI-haters out in the med world. Good riddance to them all. MAOI+BP = Mania potenital!!! Even though, I'd recommmend selegiline+phenylalanine. You know the regimen I'd recommend. I'm sure you've read my other posts. And for those on Nardil and don't like it. Try 50mg selegiline daily. Should get same effect but no side-effects (maybe insomnia .. but hey there's always Klonopin!!)-Jason911
> Ritch,
>
> MAOIs are supposedly the ADs least likely to induce mania (save for Wellbutrin, maybe). Is your doctor MAOI-phobic, or is he worried about a [hypo]manic switch? Have you had similar problems before with antidepressants? Also, are you sure that your work screens for amphetamine? I didn't think this was a standard test (because many things can cause false positives)...
>
> -Chris
>
> > The reason why your doc won't prescribe MAOI's like Nardil is because you are bipolar and could induce a manic state. Have you given lithium a try? -Jason911
Posted by christophrejmc on March 4, 2002, at 15:51:17
In reply to Re: MAOI-Bipolar » christophrejmc, posted by Jason911 on March 4, 2002, at 12:52:21
> Hey, you've got it backwards. Wellbutrin has been touted as being less likely to induce mania.
When did I say otherwise?
> My friend, people who are bipolar and go on MAOI's.. well it can be an absolute disaster. Where did you hear that MAOI's wouldn't produce mania in BP's??
Several sources. I can dig up references if needed... Wellbutrin and perhaps a few other newer antidepressants (and Lamictal) have taken their place, but it was once commonplace to use MAOIs (especially Parnate) to treat the depressive phase of bipolar depression.
> MAOI+BP = Mania potenital!!!
What do you base this on?
> Even though, I'd recommmend selegiline+phenylalanine.
I hope this combo works well for you, but you should know that selegiline+precursor loading hasn't been very well studied (and the studies that exist weren't large enough to prove much).
> You know the regimen I'd recommend. I'm sure you've read my other posts. And for those on Nardil and don't like it. Try 50mg selegiline daily. Should get same effect but no side-effects (maybe insomnia .. but hey there's always Klonopin!!)-Jason911
I'm pretty sure that high-dose selegiline has its fair share of side-effects; but you're right, they are most likely quite different than Nardil's. Incidentally, all MAOIs have some neuroprotective properties. I'm planning on trying selegiline next as I'm tired of Nardil's side-effects -- I'll start at MAO-B selective doses and I might try the PEA combo. I'll let you know how it goes.
-Chris
Posted by JohnX2 on March 4, 2002, at 17:48:28
In reply to John I need your help! » JohnX2, posted by Jill K. on March 4, 2002, at 6:56:47
Hi Jill,Hey, *don't worry about your posts*, I was getting
a little hot under the collar yesterday.It was a disservice/rude to you for the thread to lose
some of its focus on helping discuss good treatment options
for you.I know the severe torment of pain and depression
first hand like a lot of people reading this, and
we all want you to pull through this.So, I'm going to start a new Jill K. thread down
below as a do-over to concentrate on helping YOU
help US best understand your history so maybe
we can give you some better suggestions to talk
about with your pdoc.Hang in there.
-John
> Dear John,
>
> I am new to this site, and am not use to posting. I was thinking about my post to you all last night. I wrote it quickly before going to bed.
>
> Your insights and explainations are great! When I spoke about desipramine, I really meant it as a question, not fact. I have no idea how this meds work .... I am simply guessing. You have a much better working knowledge of these meds and disease than I ever will. So let me rephase my post.
>
> I have read desipramine(a tricyclic) is also very effective for ADHD. I think it effects norepinephrine mostly and not dopamine, although who really knows. Could it be possible that ADHD could be a dysfunction in norepinephrine?
>
> Once again, my post came across wrong. I am just in so much pain from this anxiety and depression. I am very desperate to get better. I need all the help I can get. I am sorry about the prior post. Please keep posting.
>
> Jill
Posted by Jason911 on March 4, 2002, at 18:20:25
In reply to Re: MAOI-Bipolar, posted by christophrejmc on March 4, 2002, at 15:51:17
I guess I stand corrected. I just have always heard that MAOI's induce mania in BP's. Oh well. I'm not the expert on that anyway. But I feel strongly that the seleg-PEA combo will work very well and will (should) be used more often in the future. Me and you will basically be doing the same thing (except I'll be taking the Klonopin as well) and I wish you the best of luck and, yes, tell me how it goes as I will you... (my selegiline arrives in 1.5 weeks!) God Bless -Jason911
Posted by Jason911 on March 4, 2002, at 18:25:02
In reply to Re: John I need your help! - New Jill K. Thread » Jill K., posted by JohnX2 on March 4, 2002, at 17:48:28
Jill,
I still say you should try:
Daily:
5mg selegiline (Jumex/Eldepryl/Deprenyl)-morning
500mg phenylalanine -noon
2mg Klonopin -2 hours before bedI really think this is your answer, but John may have some other options for you. I wish you the best. -Jason911
>
> Hi Jill,
>
> Hey, *don't worry about your posts*, I was getting
> a little hot under the collar yesterday.
>
> It was a disservice/rude to you for the thread to lose
> some of its focus on helping discuss good treatment options
> for you.
>
> I know the severe torment of pain and depression
> first hand like a lot of people reading this, and
> we all want you to pull through this.
>
> So, I'm going to start a new Jill K. thread down
> below as a do-over to concentrate on helping YOU
> help US best understand your history so maybe
> we can give you some better suggestions to talk
> about with your pdoc.
>
> Hang in there.
>
> -John
>
>
>
>
> > Dear John,
> >
> > I am new to this site, and am not use to posting. I was thinking about my post to you all last night. I wrote it quickly before going to bed.
> >
> > Your insights and explainations are great! When I spoke about desipramine, I really meant it as a question, not fact. I have no idea how this meds work .... I am simply guessing. You have a much better working knowledge of these meds and disease than I ever will. So let me rephase my post.
> >
> > I have read desipramine(a tricyclic) is also very effective for ADHD. I think it effects norepinephrine mostly and not dopamine, although who really knows. Could it be possible that ADHD could be a dysfunction in norepinephrine?
> >
> > Once again, my post came across wrong. I am just in so much pain from this anxiety and depression. I am very desperate to get better. I need all the help I can get. I am sorry about the prior post. Please keep posting.
> >
> > Jill
Posted by JohnX2 on March 4, 2002, at 18:40:14
In reply to Re: John I need your help! - New Jill K. Thread » JohnX2, posted by Jason911 on March 4, 2002, at 18:25:02
As I mature I learn new things.
As I learn new things I find there are more
things that I don't know than I do know.Best Wishes,
John> Jill,
>
> I still say you should try:
>
> Daily:
> 5mg selegiline (Jumex/Eldepryl/Deprenyl)-morning
> 500mg phenylalanine -noon
> 2mg Klonopin -2 hours before bed
>
> I really think this is your answer, but John may have some other options for you. I wish you the best. -Jason911
>
> >
> > Hi Jill,
> >
> > Hey, *don't worry about your posts*, I was getting
> > a little hot under the collar yesterday.
> >
> > It was a disservice/rude to you for the thread to lose
> > some of its focus on helping discuss good treatment options
> > for you.
> >
> > I know the severe torment of pain and depression
> > first hand like a lot of people reading this, and
> > we all want you to pull through this.
> >
> > So, I'm going to start a new Jill K. thread down
> > below as a do-over to concentrate on helping YOU
> > help US best understand your history so maybe
> > we can give you some better suggestions to talk
> > about with your pdoc.
> >
> > Hang in there.
> >
> > -John
> >
> >
> >
> >
> > > Dear John,
> > >
> > > I am new to this site, and am not use to posting. I was thinking about my post to you all last night. I wrote it quickly before going to bed.
> > >
> > > Your insights and explainations are great! When I spoke about desipramine, I really meant it as a question, not fact. I have no idea how this meds work .... I am simply guessing. You have a much better working knowledge of these meds and disease than I ever will. So let me rephase my post.
> > >
> > > I have read desipramine(a tricyclic) is also very effective for ADHD. I think it effects norepinephrine mostly and not dopamine, although who really knows. Could it be possible that ADHD could be a dysfunction in norepinephrine?
> > >
> > > Once again, my post came across wrong. I am just in so much pain from this anxiety and depression. I am very desperate to get better. I need all the help I can get. I am sorry about the prior post. Please keep posting.
> > >
> > > Jill
Posted by christophrejmc on March 4, 2002, at 19:22:08
In reply to Re: John I need your help! - New Jill K. Thread » Jason911, posted by JohnX2 on March 4, 2002, at 18:40:14
>
> As I mature I learn new things.
> As I learn new things I find there are more
> things that I don't know than I do know.
>
> Best Wishes,
> John
>Would it be out of line to hug you?
-chris :)
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