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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by olivia12 on September 14, 2010, at 19:23:35
Anyone have any input re: an antidepressant that has few side effects and works on this neurotransmitter? I recently switched from Wellbutrin to Effexor and while I think both of these drugs work well for me and with almost no side effects, I am suddenly finding that I long for a glass of wine and a cigarette (quit both years ago). Anyone tried Abilify? Thanks:)
Posted by Conundrum on September 14, 2010, at 19:42:41
In reply to Dopamine, posted by olivia12 on September 14, 2010, at 19:23:35
Keep the wellbutrin, it blocks nicotinergic receptors. It also activates neurons in the nucleus accumben shell. This is where reward is believed to reside. Now that the drug is stop you crave something to activate that part of the brain(hypothetically, i'm not a doctor). If you can tolerate wellbutrin then it would not hurt to stay on it. I believe selegiline would also increase dopamine in the nucleus accumben shell. Abilify will not,it only increases dopamine in the prefrontal cortex, in fact at higher doses it will inhibit dopamine release in nucleus accumbens shell.
Posted by olivia12 on September 14, 2010, at 19:54:22
In reply to Re: Dopamine » olivia12, posted by Conundrum on September 14, 2010, at 19:42:41
And so Effexor is lacking in what way? I really like it besides this. I find I have more energy than I did with Wellbutrin. I so appreciate the feedback and I will go back on the Wellbutrin--you seem to know what you are talking about (over my head though). Abilify is something that a friend takes and likes it...I continue to be amazed at the wealth of knowledge on this site. Thank you:)
Posted by olivia12 on September 14, 2010, at 19:57:18
In reply to Re: Dopamine » olivia12, posted by Conundrum on September 14, 2010, at 19:42:41
Wow, if you are not published already, you need to be. What a waste if you do not share what you know beyond this site:)
Posted by Conundrum on September 14, 2010, at 20:23:25
In reply to Re: Dopamine, posted by olivia12 on September 14, 2010, at 19:57:18
Pssh I'm just really good with google and have too free time :). Effexor can increase dopamine as well and possibly a little bit in the nucleus accumbens shell. Effexor goes serotonin>norepinephrine>dopamine in that order. Wellbutrin is dopamine>norepinephine. It also blocks nicotinergic receptors which is why you might now want a cigarette. The boost of norepinephrine from effexor will also increase your energy. They might work really well for you in a combo. Don't take my advice though ask your doctor. This is all theoretical. Just curious as to why you switched from wellbutrin if it was working?
Abilify could help but I wouldn't want to take an antipsychotic if I didn't need to. Its also expensive as hell.
Posted by olivia12 on September 14, 2010, at 20:33:17
In reply to Re: Dopamine » olivia12, posted by Conundrum on September 14, 2010, at 20:23:25
Well, despite the extra time on your hands, you have given me more info than any doc I've seen:) You underestimate yourself. I don't know why I wanted to switch--just been on Wellbutrin for about 4-5 years and was looking for something new/improved. I will, however, go back to Wellbutrin--no side effects and I think this was the better drug for me. Thanks so much:)
Posted by Phillipa on September 15, 2010, at 0:02:09
In reply to Re: Dopamine, posted by olivia12 on September 14, 2010, at 20:33:17
Olivia if you have found a drug that works for you stay on it. You could end up like me had one that worked doc put me in a trial of another and none have worked since. Your're very lucky!!!! Phillipa
Posted by weatherfreak on September 15, 2010, at 5:16:12
In reply to Re: Dopamine » olivia12, posted by Phillipa on September 15, 2010, at 0:02:09
wellbutrin is a DNRI, maybe you're like me and respond well to dopamine related meds. NRI's are good too and so are meds that work on DAT (Dopamine Active Transport)
http://en.wikipedia.org/wiki/Dopamine_transporter
here's some info on NRI's and other meds
http://en.wikipedia.org/wiki/Norepinephrine_reuptake_inhibitor
Ritalin is good for dopamine, it worked great for my depression for a while.
Posted by olivia12 on September 15, 2010, at 20:55:45
In reply to Re: Dopamine, posted by weatherfreak on September 15, 2010, at 5:16:12
You are all so well read in this area and I appreciate the advice very much. While Wellbutrin seemed to just make my outlook a bit better, I felt it was not doing all that much. And so, at my physician's annual visit, I asked about something else--she suggested Effexor. Love the energy it gives me to keep up with 2 little kids and a crazy-busy job, I do not like how it makes me want to indulge in my former smoking and drinking habits. I almost feel manic on it. Anyone know of a good antidepressant that continues to curb that reckless Dopamine receptor? Love the Serotonin reuptake inhibitors, but the side effects are just not worth it for me. Thanks for all the great advice:)
Posted by Conundrum on September 15, 2010, at 21:41:20
In reply to Re: Dopamine, posted by olivia12 on September 15, 2010, at 20:55:45
SSRI + wellbutrin. If you feel manic it might be from the effexor and you might want to switch to something less stimulating.
Posted by linkadge on September 16, 2010, at 6:50:10
In reply to Re: Dopamine » olivia12, posted by Conundrum on September 15, 2010, at 21:41:20
I'm not sure that the actions of wellbutrin on dopamine are very clear cut.
Blocking the nicotinergic receptors will actually supress the release of dopamine in the nucleus accumbens.
Also, the DRI action of bupropion is so weak, even at high doses.
Posted by olivia12 on September 16, 2010, at 6:52:47
In reply to Re: Dopamine, posted by weatherfreak on September 15, 2010, at 5:16:12
Thank you for those links--great info:)
Posted by olivia12 on September 16, 2010, at 6:56:41
In reply to Re: Dopamine, posted by linkadge on September 16, 2010, at 6:50:10
Hmmm, it just occurred to me that maybe I just feel better, thus the urge to want to "celebrate" life;) Have a great day and thanks!
Posted by Conundrum on September 16, 2010, at 7:21:44
In reply to Re: Dopamine, posted by linkadge on September 16, 2010, at 6:50:10
http://www.ncbi.nlm.nih.gov/pubmed/1381923
http://onlinelibrary.wiley.com/doi/10.1111/j.1460-9568.2007.05546.x/abstract
This study shows it increase dopamine in the nucleus accumbens. Do you have any studies showing that this is not the case?
Posted by linkadge on September 16, 2010, at 8:57:11
In reply to Re: Dopamine, posted by Conundrum on September 16, 2010, at 7:21:44
Well, the first study you gave would equate to human doses of almost 2000mg of bupropion. The second study does not really give doses.
The following study suggests that the effect of bupropion on dopamine release is dependant on the dose (U shaped). Lower doses inhibiting it due to nicotinergic blockade, and higher doses facilitating it due to enhanced binding to the DAT transporter.
Posted by olivia12 on September 16, 2010, at 21:33:55
In reply to Re: Dopamine, posted by linkadge on September 16, 2010, at 8:57:11
I was just thinking dopamine because Wellbutrin and Zyban are about the same, right? From what I know (little), dopamine is inhibited by the above drugs. Beyond that, I have no business in this scholarly exchange between you two;)
This is the end of the thread.
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