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Re: An update

Posted by dave45 on June 23, 2006, at 14:58:43

In reply to Re: An update » dave45, posted by puravida on June 23, 2006, at 11:34:39

As for wellbutrin, it's mechanism of action is complex and poorly understood. It breaks down into about five or six different metabolites, all of which seem to have different pharmacodynamic actions. It does promote dopamine release, but you are correct in that it also increases the reuptake of dopamine. Many people believe wellbutrin's effects come from more from its noradrenergic effects. This would make sense to me, as the feeling i got from wellbutrin was similar to what i experienced on remeron, both of which have strong pro-noradrenergic action. For me, wellbutrin helped a little intially (not alot) but then made me frist very angry, then absolutely crayz with anxiety. A different kind of anxiety then I usually experienced, more of a "death is upon me" kind of feeling. For me, very bad.
As far as dopamenergic drugs go, there are direct dopamine agonists, things that are usually used to treat parkinson's, that have some efficacy in depression. The most popular of these is mirapex. That is somewhat preferential for the d3 receptors. There is also dostinex (cabergoline) and one other brocriptomine or something similar. Those are preferential fro the d2 receptors. Other dopamenergixc drugs which are used as adjuncts in depression are stimulants, such as dexedrine or adderal. There are the MAOIs such as parnate and nardil, which increaser the amounts of all three neurotransimtters. There are also reversible MAOIS that tend to deaminate the enzyme MAO B more then MAO A. Mao B is the enzyme that mostly break downs dopamine, whereas MAO A breaks down serotonin, and if your problem is dopamine related these might benefit you without the side effects of the MAOIS. Examples of this are moclobemide or deprenyl, which is currently available in patch form under the name emsam. Of course all this you should discuss with your doctor before making any changes. Hope this helps. Good luck.


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