Posted by Larry Hoover on June 6, 2003, at 12:43:35
In reply to ? about med chemistry/biology - need help!, posted by Snoozy on June 6, 2003, at 11:09:29
> I hope someone will be able to help me out or point me to a good resource to learn this stuff.
>
> Can anyone explain anything about how Wellbutrin works (or is supposed to work)?This was published in 1995:
"The mechanism of action of bupropion appears to have an unusual, not fully understood, noradrenergic link. The bupropion metabolite hydroxybupropion probably plays a critical role in bupropion's antidepressant activity, which appears to be predominantly associated with long-term noradrenergic effects. The mild central nervous system activating effects of bupropion appear to be due to weak dopaminergic mechanisms. There is some evidence that dopamine may contribute to bupropion's antidepressant properties. Antidepressant effects of bupropion are not serotonergically mediated."And yet, in 2001, a study was published showing substantially enhanced serotonin activity with bupropion treatment, through down-regulation of NE activity.
What I conclude is, they still don't know how this drug, or other drugs work. I like the black box theory. You put new stuff (drugs) in the black box (brain), and new stuff comes out (possible remission of depression, side-effects, and so on). No mechanism required. Pure observation.
> Second question: I know there's a theory that a lot of meds the body just adjusts to and they're not as effective.
That's one theory of what we sometimes call "poop out". I think your body will quite naturally try to decrease the effect of any stimulus it receives. It doesn't matter what the stimulus is, your body will try to do things which make "the next time" you experience the stimulus less effective. The first time seems never to be re-experienced. If you extrapolate that process, you get something like poop-out.
>Can this go so far as to cause (grrrr- I can't think of the word I want to use) what I'll just call an opposite reaction?
Are you thinking of "paradoxical reaction"? Like taking a stimulant to calm hyperactivity? Or taking a sedating antihistamine and getting a buzz?
>For example, a drug that originally caused a side effect of insomnia would eventually cause hypersomnia.
There's another way to look at that altogether, as short-term or acute effects, compared with long-term or chronic effects. I think anything's possible, when we're thinking in terms of individual experience. Only when you look at groups of people do you consider likelihood. For the individual with an unusual side-effect, his/her incidence rate is 100%.
> Any information would be very appreciated. I need relief of my idiocy!You're not an idiot. Please. You're asking good questions. And those are questions which will help settle things in your mind, which is a very important aspect of self-care.
I've purposely not gotten into major discussions about your questions, not because I don't want to answer, but because there are so many variables to consider, each of which may or may not have any bearing on your experience.
I'm happy to bounce ideas back and forth with you, but I am going off-line for a short period.
Lar
poster:Larry Hoover
thread:231897
URL: http://www.dr-bob.org/babble/20030604/msgs/231914.html