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Wellbutrin DA? and digression on ADHD

Posted by zeugma on August 17, 2004, at 14:15:50

In reply to Re: Dopaminergic Drug/Supp to Aug SSRI---SLS, posted by alesta on August 17, 2004, at 12:29:26

hi all. last week, when i started Ritalin, and had combined it with about 50 mg Provigil, I had mydriasis (enlarged pupils). The last time I had this side effect was on Wellbutrin, which makes me think all three drugs are dopaminergic. LSD also had this effect, and I think it also affects dopamine function, although I am less familiar with its pharmacology (I know it also functions as a serotonin agonist).

About DA and depression, I really shouldn't say, as I know for sure that I have ADHD, and that is a dopaminergic disorder beyond doubt. Attempts to correlate noradrenergic function to ADHD via genetics have been politically driven and unsuccessful, while abnormalities in dopaminergic function have been established for some years now. But there is a link, I am convinced, between ADHD severity and depression. I used to think that the ADHD caused depression as a secondary matter, i.e. by producing multiple failures in school, socially, etc., leading finally to a reactive depression. I don't believe this any more, because I think that abnormalities of DA expression strain the balance of the other amines, and that if, e.g. the dopamine transporter is overexpressed, leading to a chronically low level of synaptic dopamine, one is going to be in a constant state of hypoarousal that the brain is going to try to compensate for somehow, and this could well lead to other amines becoming hyperfunctional to the point where they themselves break down and depression results.

I think a similar thing may happen on long-term SSRI therapy, but in reverse. The hyperfunction of the serotonin system causes the dopamine system to break down to some extent. I think that it is unfortunate that so many with comorbid ADHD are treated with SSRI's, as they appear capable of creating ADHD-like symptoms in those without the disorder.Btw, someone made a suggestion a while ago that AD poop-out was so frequent on SSRI's because of a mild serotonin syndrome induced by unnecessarily high dosages. Recovery from depression requires all aminergic systems to function properly, and doctors have become so fixated on serotonin that they have been utilizing the pharmacopeia very unwisely, in my opinion. This is especially unfortunate given that the official catecholinergic alternative since the TCA's and MAOI's have fallen from favor is Wellbutrin. In my experience and in the experience of those I know, it is an extremely unpredictable drug, has an ambiguous effect on symptoms, and appears far more prone than any other AD to induce serious allergic reactions.


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poster:zeugma thread:378302
URL: http://www.dr-bob.org/babble/20040817/msgs/378763.html