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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Joe Schmoe on November 16, 2010, at 6:58:47
I have read Wellbutrin raises both dopamine and norepinephrine activity.
I am just curious which of those is responsible for the common rage/irritability/short temper effects, or whether it is some combination of both.
Kind of an academic question for me since it appears pure dopamine reuptake inhibitors are not legal here in the U.S. :(
Or are they? I have read that Europe has some pure dopamine AD agents not available here, but on the other hand, aren't stimulants basically dopamine activity increasers?
As someone with anxiety I have never even considered stimulants as a treatment for depression.
Posted by Conundrum on November 16, 2010, at 10:00:57
In reply to Why does Wellbutrin cause rage/irritability?, posted by Joe Schmoe on November 16, 2010, at 6:58:47
It seems to be very common to wellbutrin. Like you said there are no pure DRIs so its hard to say whether the dopamine is having this effect or not. Some times some drugs just make some people grumpy. lol. Vague I know. People get angry on alcohol or cocaine. Some get angry on wellbutrin. THe thing about wellbutrin is besides its effects as a DNRI it works on nitric oxide pathways and nicotinergic receptors. It does many things and it would be impossible to pin down what is causing what. So it would be best to try something else and not analyze why wellbutrin failed. If you try an NRI and have the same response then it could just be you don't need more norepinephrine.
> I have read Wellbutrin raises both dopamine and norepinephrine activity.
>
> I am just curious which of those is responsible for the common rage/irritability/short temper effects, or whether it is some combination of both.
>
> Kind of an academic question for me since it appears pure dopamine reuptake inhibitors are not legal here in the U.S. :(
>
> Or are they? I have read that Europe has some pure dopamine AD agents not available here, but on the other hand, aren't stimulants basically dopamine activity increasers?
>
> As someone with anxiety I have never even considered stimulants as a treatment for depression.
Posted by Lam22 on September 18, 2011, at 10:21:32
In reply to Re: Why does Wellbutrin cause rage/irritability? » Joe Schmoe, posted by Conundrum on November 16, 2010, at 10:00:57
I have the same issue at high dosage.. High dosages seem to do nothing more than making me angry. I take about 90mg at that helps some without having rage. Everything above 90mg just makes me more angry but not less depressed
Posted by Raza on February 14, 2012, at 18:05:19
In reply to Why does Wellbutrin cause rage/irritability?, posted by Joe Schmoe on November 16, 2010, at 6:58:47
Norepinephrine is definitely responsible for this. Short temper, impatience and conflict-exploring social attitude are highly characteristic of it.
However, from personal experience with dopaminergic drugs that are as close to not affecting (nor)epinephrine as they come, I do think dopamine contributes to a lesser degree. Dopamine release is pleasant, but its excessive, continuous presence can contribute to feelings of tension, impatience and agitability when you're not actively engaging activities that suit the mood (working focusedly towards some goal, in dopamine's case).
Still, if you're looking for a stimulant that doesn't cause these side effects, something that affects dopamine without affecting norepinephrine would almost certainly be an improvement over something that affects both. Augmenting wellbutrin with a full norepinephrine antagonist might also alleviate its unpleasant side.
Posted by Raza on February 14, 2012, at 18:18:57
In reply to Why does Wellbutrin cause rage/irritability?, posted by Joe Schmoe on November 16, 2010, at 6:58:47
Norepinephrine is definitely responsible for this. Short temper, impatience and conflict-exploring social attitude are highly characteristic of it.
However, from personal experience with dopaminergic drugs that are as close to not affecting (nor)epinephrine as they come, I do think dopamine contributes to a lesser degree. Dopamine release is pleasant, but its excessive, continuous presence can contribute to feelings of tension, impatience and agitability when you're not actively engaging activities that suit the mood (working focusedly towards some goal, in dopamine's case).
Still, if you're looking for a stimulant that doesn't cause these side effects, something that affects dopamine without affecting norepinephrine would almost certainly be an improvement over something that affects both. Augmenting wellbutrin with a full norepinephrine antagonist might also alleviate its unpleasant side.
Posted by joe schmoe on February 14, 2012, at 20:02:21
In reply to Re: Why does Wellbutrin cause rage/irritability?, posted by Raza on February 14, 2012, at 18:18:57
> Norepinephrine is definitely responsible for this. Short temper, impatience and conflict-exploring social attitude are highly characteristic of it.
>
> However, from personal experience with dopaminergic drugs that are as close to not affecting (nor)epinephrine as they come, I do think dopamine contributes to a lesser degree. Dopamine release is pleasant, but its excessive, continuous presence can contribute to feelings of tension, impatience and agitability when you're not actively engaging activities that suit the mood (working focusedly towards some goal, in dopamine's case).
>
> Still, if you're looking for a stimulant that doesn't cause these side effects, something that affects dopamine without affecting norepinephrine would almost certainly be an improvement over something that affects both. Augmenting wellbutrin with a full norepinephrine antagonist might also alleviate its unpleasant side.
That's very interesting. I'm not sure what to make of it though, since a friend of mine takes an SNRI (Effexor) and she says it greatly decreases irritability. Why would two drugs, which both are norepinephrine reuptake inhibitors, have opposite effects? The difference between them is Effexor also boosts serotonin while Wellbutrin boosts dopamine. That is why I assumed dopamine is the cause of the irritability.
Posted by Conundrum on February 14, 2012, at 20:51:51
In reply to Re: Why does Wellbutrin cause rage/irritability?, posted by joe schmoe on February 14, 2012, at 20:02:21
Because effexor is probably 30x stronger as a serotonin reuptake inhibitor, which curbs irritability in the long run. It prevents the norepinephrines effects from going out of control. Wellbutrin probably does not increase serotonin to that degree.
YMMV
> > Norepinephrine is definitely responsible for this. Short temper, impatience and conflict-exploring social attitude are highly characteristic of it.
> >
> > However, from personal experience with dopaminergic drugs that are as close to not affecting (nor)epinephrine as they come, I do think dopamine contributes to a lesser degree. Dopamine release is pleasant, but its excessive, continuous presence can contribute to feelings of tension, impatience and agitability when you're not actively engaging activities that suit the mood (working focusedly towards some goal, in dopamine's case).
> >
> > Still, if you're looking for a stimulant that doesn't cause these side effects, something that affects dopamine without affecting norepinephrine would almost certainly be an improvement over something that affects both. Augmenting wellbutrin with a full norepinephrine antagonist might also alleviate its unpleasant side.
>
>
> That's very interesting. I'm not sure what to make of it though, since a friend of mine takes an SNRI (Effexor) and she says it greatly decreases irritability. Why would two drugs, which both are norepinephrine reuptake inhibitors, have opposite effects? The difference between them is Effexor also boosts serotonin while Wellbutrin boosts dopamine. That is why I assumed dopamine is the cause of the irritability.
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