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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Laney on March 22, 2011, at 10:13:03
I really liked how the Nortriptyline worked. I just wasn't willing to pack on the weight and crave sweets like I did. Not to mention severe dry mouth and severe constipation.
Thanks!
Laney
Posted by Christ_empowered on March 22, 2011, at 11:39:30
In reply to Does Wellbutrin work anything like Nortriptyline?, posted by Laney on March 22, 2011, at 10:13:03
I'm not a doctor or anything, but..here goes:
Wellbutrin is kind of unique. Chemically, its related to Tenuate, which is a relatively mild diet pill that used to be popular. Unlike most TCAs, with Wellbutrin you're getting norepinephrine and dopamine reuptake inhibition. Wellbutrin tends to be stimulating; over-simulation can be treated with low dose antipsychotics or benzos. Adding wellbutrin to an ssri reduces the ssri "blahs" and also helps to minimize agitation from the Wellbutrin (this according to my former shrink).
Wellbutrin can cause a bit of weight loss. Wellbutrin may be less likely to cause drug-induced mania than TCA or SSRI drugs.
Posted by Phillipa on March 22, 2011, at 12:50:23
In reply to Re: Does Wellbutrin work anything like Nortriptyline?, posted by Christ_empowered on March 22, 2011, at 11:39:30
Laney CE knows meds. Seriously!!!! And how are you doing Christ Empowered? Phillipa
Posted by mtdewcmu on March 22, 2011, at 15:24:03
In reply to Does Wellbutrin work anything like Nortriptyline?, posted by Laney on March 22, 2011, at 10:13:03
> I really liked how the Nortriptyline worked. I just wasn't willing to pack on the weight and crave sweets like I did. Not to mention severe dry mouth and severe constipation.
>
> Thanks!
>
> LaneyI can't tell you if WB will work. But it shouldn't give you those specific side effects.
Weight gain and munchies are usually related to antihistamines and drugs that block 5-ht2c. Dry mouth and constipation are caused by anticholinergics. Newer antidepressants were designed specifically to eliminate those side effects. Some people claim to gain weight on SSRIs, but I have not heard that about WB.
Posted by linkadge on March 22, 2011, at 16:15:21
In reply to Re: Does Wellbutrin work anything like Nortriptyline?, posted by mtdewcmu on March 22, 2011, at 15:24:03
Nortriptyline probably results in a higher NE reuptake inhibiton at clincal doses. I remember a study showing that even at 450mg, wellbutrin only results in a low (10-15%) occupancy of the norepinephrine / dopamine transporters.
That doesn't mean that nortriptyline is more stimulating since, as mentioned, it has antihistamine / antiserotonin effects.
Linkadge
Posted by Phillipa on March 22, 2011, at 21:07:56
In reply to Re: Does Wellbutrin work anything like Nortriptyline?, posted by linkadge on March 22, 2011, at 16:15:21
If Laney responded to paxil for 13 years why would serotonin now be a problem? Phillipa
Posted by desolationrower on March 23, 2011, at 4:22:23
In reply to Does Wellbutrin work anything like Nortriptyline?, posted by Laney on March 22, 2011, at 10:13:03
bupropion:
more bonersnotriptaliyne:
more drymouth
more complete absence of dysphoriaboth had that 'fire under your ass' feel
-d/r
Posted by linkadge on March 23, 2011, at 11:40:39
In reply to Re: Does Wellbutrin work anything like Nortriptyline? » linkadge, posted by Phillipa on March 22, 2011, at 21:07:56
Not sure what you mean.
Posted by mtdewcmu on April 1, 2011, at 23:20:37
In reply to Does Wellbutrin work anything like Nortriptyline?, posted by Laney on March 22, 2011, at 10:13:03
Actually, I think Wellbutrin does have slight anticholinergic side effects. But probably nothing like a TCA.
Posted by desolationrower on April 2, 2011, at 0:17:14
In reply to Anticholinergic side effects, posted by mtdewcmu on April 1, 2011, at 23:20:37
> Actually, I think Wellbutrin does have slight anticholinergic side effects. But probably nothing like a TCA.
The word you want is "pseudoanticholinergic" side effects
-d/r
Posted by mtdewcmu on April 2, 2011, at 1:00:07
In reply to Re: Anticholinergic side effects » mtdewcmu, posted by desolationrower on April 2, 2011, at 0:17:14
> > Actually, I think Wellbutrin does have slight anticholinergic side effects. But probably nothing like a TCA.
>
> The word you want is "pseudoanticholinergic" side effects
>
> -d/rI don't think so. I checked a professional source and it mentioned anticholinergic side effects.
Posted by desolationrower on April 2, 2011, at 14:54:22
In reply to Re: Anticholinergic side effects, posted by mtdewcmu on April 2, 2011, at 1:00:07
> > > Actually, I think Wellbutrin does have slight anticholinergic side effects. But probably nothing like a TCA.
> >
> > The word you want is "pseudoanticholinergic" side effects
> >
> > -d/r
>
> I don't think so. I checked a professional source and it mentioned anticholinergic side effects.there is some activity of metabolites at some nicotinic receptors, but i really doubt that has something to do with 'cholinergic' side effects like dry mouth, heart rate, problems urinating, etc. cholinergic effects are usually more related to muscarinic receptors.
Thats going to be true for any drug that increases sympathetic tone, because of how the two systems balance. The importance of knowing which is which is that pseudoanticholinergic are unavoidable (without doing something like a cholinergic drug too) whereas anticholinergic are just the result of choosing a dirty drug.
-d/r
Posted by mtdewcmu on April 2, 2011, at 17:41:35
In reply to Re: Anticholinergic side effects, posted by desolationrower on April 2, 2011, at 14:54:22
> there is some activity of metabolites at some nicotinic receptors, but i really doubt that has something to do with 'cholinergic' side effects like dry mouth, heart rate, problems urinating, etc. cholinergic effects are usually more related to muscarinic receptors.
>Goodman and Gillman lists the inhibition constant for bupropion at DAT as 526nM, and at muscarinic receptors as 40,000nM. So, bupropion would not appear to be a very potent antimuscarinic. But the numbers for active metabolites are curiously absent, even though the exposure is greater. The hard numbers that would settle this one way or the other are strangely hard to find.
This is the end of the thread.
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