Posted by ed_uk2010 on January 25, 2015, at 16:57:32
In reply to Re: feeling like im out of options ED_UK, posted by hello123 on January 25, 2015, at 16:24:31
> Ed,i actually felt the opposite effect of what most experience from Wellbutrin. bad effects on motivation and libido.
Wellbutrin's mechanism of action is not well understood.... it's not like nortriptyline or desipramine though, that much is clear.
>every other med with a strong action on NE like Wellbutrin, Effexor and Fetzima.Effexor is a weak norepinephrine reuptake inhibitor but a potent serotonin reuptake inhibitor. Wellbutrin isn't a potent NRI either, it's a weak NRI, a very weak DRI and has other poorly understood actions, for example at nicotinic receptors. Neither drug is particularly similar to tricyclic antidepressants.
It could be that you'd find the tricyclic NRIs such as nortriptyline intolerable, but you won't know unless you try... You might respond well.
>i figured it was from the Norepinephrine...
It certainly could have been, but it's not definitely the case. I think you need to be cautious if you try nortriptyline or desipramine. Start with a very low dose if you choose to try one. Strattera was not effective against depression in clinical trials, I wouldn't particularly recommend it for this purpose when NRIs proven to be effective against depression are available. Tricyclics are dangerous in overdose which is one reasons that some pdocs may not wish to prescribe.
Desipramine is a potent and relatively selective NRI. Nortriptyline has more additional effects - it might be better if you suffer from anxiety or trouble sleeping. Nortriptyline possibly has slightly more evidence to support its use in severe depression... on the other hand it may cause more dry mouth and initial drowsiness (which tends to wear off quite quickly).
poster:ed_uk2010
thread:1075467
URL: http://www.dr-bob.org/babble/20150102/msgs/1075564.html