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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Lynne on December 3, 2000, at 9:41:11
I am having good results with Wellbutrin in treating my depression. But... I am allergic to it! So I have to stop taking it. Does anyone know if there is another drug or combination of drugs that would effect the brain in the same way as Wellbutrin? After five years of trying different AD's the one that works I can't take!!!! Any information will be greatly appreciated.Oh, one more thing Meridia helped also but I can't afford it.
Thanks,
Lynne
Posted by JohnB on December 3, 2000, at 12:06:47
In reply to Any other drugs or combos like Wellbutrin?, posted by Lynne on December 3, 2000, at 9:41:11
Does anyone know if there is another drug or combination of drugs that would effect the brain in the same way as Wellbutrin?
1. Reboxetine+Stimulant
2. Reboxetine+MirapexBoth combos would give the NE plus Dopamine boost that Well gives.
Posted by Lynne on December 3, 2000, at 16:12:18
In reply to Re: Any other drugs or combos like Wellbutrin?, posted by JohnB on December 3, 2000, at 12:06:47
> Does anyone know if there is another drug or combination of drugs that would effect the brain in the same way as Wellbutrin?
>
> 1. Reboxetine+Stimulant
> 2. Reboxetine+Mirapex
>
> Both combos would give the NE plus Dopamine boost that Well gives.
Thanks JohnB for the info. How do I get ReboxetineI live in the US? Is Mirapex a Stimulant? I already have Adderall,Dexedrine.Thanks ,
Lynne
Posted by JohnB on December 5, 2000, at 3:04:43
In reply to Re: Any other drugs or combos like Wellbutrin?, posted by Lynne on December 3, 2000, at 16:12:18
If you have Adderal or Dex, then you could try a trial of Rebox, start low -2mg.
Posted by JackD on December 5, 2000, at 21:52:00
In reply to Any other drugs or combos like Wellbutrin?, posted by Lynne on December 3, 2000, at 9:41:11
Wellbutrin's mechanism in the brain is very poorly understood. I'm sorry, but I don't think there are any drugs that mimic it's effects.
Although Wellbutrin does cause the reuptake of Norepinephrine, Seratonin, and Dopamine (listed in order of reuptake, from highest to lowest), it does so only at doses much higher than the 300mg/day recommended therapeutic dosage.
There's much more to Wellbutrin's metabolism in the body than meets the eye. If you go to rxlist.com, you can read a little about it.
I myself have responded incredibly well to Wellbutrin, and no combination of Reboxetine/Stimulant, Remeron/Stimulant, or other combination felt quite the same, although some did work in helping the depression.
Ok, what I'm trying to say is I'm sure another combo will help, maybe even as much as the Wellbutrin, but I don't think any other will feel the same.
Posted by JohnB on December 6, 2000, at 4:17:01
In reply to Re: Any other drugs or combos like Wellbutrin?, posted by JackD on December 5, 2000, at 21:52:00
>Ok, what I'm trying to say is I'm sure another combo will help, maybe even as much as the Wellbutrin, but I don't think any other will feel the same.Jack,
But Lynne begins by saying that she can't take Wellbutrin. So isn't the point to help Lynne find a something that in your words "will help, maybe even as much as Wellbutrin"?Also, Wellbutrin is a norpinephrine and dopamine reuptake inhibitor, and has no significant serotonergic component to its mechanism of action. That's why it usually has less sexual dysfunction side-effects.
_______________________________"Bupropion (Wellbutrin) is the prototypical agent of the norepinephrine and dopamine reuptake inhibitors"
"Bupropion lacks a significant serotonergic component to its mechanism of action."
source:
Stephan M. Stahl, "Essential Psychopharmacology, Neuroscientific Basis and Practical Applications, 2nd edition, Cambridge University Press, published 2000,
page 241.
______________________________Lynne,
It's always a good idea to double and triple check anything you read on this board before proceeding, and try to seek out the help of a good psychopharmacologist. --JB
Posted by JackD on December 7, 2000, at 1:29:54
In reply to Re: Any other drugs or combos like Wellbutrin? » JackD, posted by JohnB on December 6, 2000, at 4:17:01
You could very well be right. But, from my literature, and experience, Wellbutrin's method of action has very little to do with it's reuptake of neurotransmitters. It's chemistry is quite complex. If you read back to an older post on this site, you can read an interesting theory. (http://www.dr-bob.org/babble/20000508/msgs/33406.html)
That's just a theory you say? Let me remind you that even the information on Glaxo-Wellcome's page or any other source for that matter is all highly theoretical when it comes to antidepressants.
Also, if you read about several case studies on www.biopsychiatry.com (I know, this site is a little bit eccentric, but their information and references are right on point), you'll see that Wellbutrin only causes significant reuptake of norepinephrine, seratonin, and dopamine at extremely high doses ( >900mg/day). Also, there has been a lot of evidence that suggests that two or more of Wellbutrin's metabolites, and not bupropion itself, is what is responsible for its antidepressant action.
Seratonin reuptake IS inhibited. True, it does not contribute to it's action, but I believe neither are the very mild NE and Dopamine reuptake inhibition.
My purpose was to inform Lynne as accurately as possible about Wellbutrin, and not to let her get her hopes up too high about the suggested combos of stimulants. I think she should not necessarily limit her next antidepressant trial to stimulant combos of NE + Dopamine reuptake.
P.S. John, I'm not here to tell anyone who's right or wrong, I'm just spewing out information for Lynne or anyone reading to absorb and interpret. My information could very well be wrong. But, the more you read about a drug, from all angles and perspectives, the closer you'll come to finding your answer. It is a given that all info be taken with a grain of salt.
Posted by Lynne on December 8, 2000, at 21:00:22
In reply to Re: Any other drugs or combos like Wellbutrin?, posted by JackD on December 7, 2000, at 1:29:54
> You could very well be right. But, from my literature, and experience, Wellbutrin's method of action has very little to do with it's reuptake of neurotransmitters. It's chemistry is quite complex. If you read back to an older post on this site, you can read an interesting theory. (http://www.dr-bob.org/babble/20000508/msgs/33406.html)
>
> That's just a theory you say? Let me remind you that even the information on Glaxo-Wellcome's page or any other source for that matter is all highly theoretical when it comes to antidepressants.
>
> Also, if you read about several case studies on www.biopsychiatry.com (I know, this site is a little bit eccentric, but their information and references are right on point), you'll see that Wellbutrin only causes significant reuptake of norepinephrine, seratonin, and dopamine at extremely high doses ( >900mg/day). Also, there has been a lot of evidence that suggests that two or more of Wellbutrin's metabolites, and not bupropion itself, is what is responsible for its antidepressant action.
>
> Seratonin reuptake IS inhibited. True, it does not contribute to it's action, but I believe neither are the very mild NE and Dopamine reuptake inhibition.
>
> My purpose was to inform Lynne as accurately as possible about Wellbutrin, and not to let her get her hopes up too high about the suggested combos of stimulants. I think she should not necessarily limit her next antidepressant trial to stimulant combos of NE + Dopamine reuptake.
>
> P.S. John, I'm not here to tell anyone who's right or wrong, I'm just spewing out information for Lynne or anyone reading to absorb and interpret. My information could very well be wrong. But, the more you read about a drug, from all angles and perspectives, the closer you'll come to finding your answer. It is a given that all info be taken with a grain of salt.
Posted by JohnB on December 8, 2000, at 21:54:34
In reply to Re: Any other drugs or combos like Wellbutrin?, posted by JackD on December 7, 2000, at 1:29:54
> there has been a lot of evidence that suggests that two or more of Wellbutrin's metabolites, and not bupropion itself, is what is responsible for its antidepressant action.
___________________________Wellbutrin is metabolized into an active metabolite, which is not only a more powerful NE reuptake blocker than Wellbutrin itself, but is also concentrated in the brain. Wellbutrin's hydroxylated active metabolite is the actual mediator of AD activity via NE and Dopamine reuptake blockade. --JB
This is the end of the thread.
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