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Re: MB-stimulant monotherapy

Posted by MB on July 18, 2000, at 20:10:46

In reply to MB-stimulant monotherapy, posted by Eddie Stefurak on July 17, 2000, at 19:59:26

The drug I'm on for depression is one I don't completely understand. Is Wellbutrin a stimulant *and* an antidepressant. What I mean is...does it's stimulating property mediate its antidepressant effect, or are they results of two different phenomena? It all gets confusing. Supposedly, unlike amphetamine, which both inhibits reuptake and stimulates release of neurotransmiters, bupropion only inhibits uptake of neurotransmitters. OK, that part I understand. But doesn't cocaine work the same way that bupropion does (inhibiting uptake of NE, 5HT, and DA)? Why is cocaine a stim, and Wellbutrin an antidepressant. Why is cocaine so horribly addictive, and Wellbutrin is not? Also, wellbutrin doesn't seem to lead to severe crashes like amphetamine and cocaine do.

MB

> MB-I don't know if my first message made it through, but I was adressing your questions about stimulant monotherapy for depression. Medically speaking monotherapy with stimulants may not be such a good idea. Generally, depressed patients are emotionally unstable with a lot of doubts and fears and worries going through his or her mind. Sure, a stimulant may reverse those symptoms for a little while but the side effects from the "crash" or when it wears off can just intensify depression in some people creating dysphoria if a high enough dose is used. this leaves them craving more in order to get that same excitment or security feeling that the drug created. In my opinion, you'd be hard pressed to find a person of descent health who will not abuse it and/or become somewhat psychologically dependent on it. Stimulants range in potency and duration. Some common ones are Dexedrine, Aderall, Ritalin, and Cylert which are used for ADD. There are various other ones like Phentermine which is used as a diet drug. Usually thes drugs are amphetamines which operate in the brain in a similar fashion to cocaine or methamphetamine, just not as intense. They boost norepinephrine and dopamine (neurotransmiters) in the brain which create central nervous system stimulation and pleasurable "reward" signals in the brain. This is why it us usually craved when it wears off. However, I would imagine that it could be used successfully in low doses along with SSRI antidepressants.
> thanks---feel free to write back. I'm new and full of info. and ?'s. I'm pre-medicine at University of Georgia looking to go into psychiatry


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