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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 jealibeanz on May 30, 2006, at 19:43:06
Since they both work on NE and DA, how are they different? What are the advantages and disadvantages to each?
I've taken Wellbutrin before. It may have relieved depression, but definitely not anxiety. It also had unwanted side effects (apathy and weight gain). Would EMSAM be worth trying for my social anxiety, general anxiety, and depression/dysthymia/winter depression?
BTW, right now I'm taking Xanax, which helps the anxiety. I take Straterra for inattentive ADHD. I'm not sure if I actually have it, or the wandering thoughts are caused by anxiety and depression, but it does help me a little with concentration and energy. It also probably keeps me from sinking into a deep deep depression, which I would normally be in given my anxiety level before Xanax and major stress.
Posted by jealibeanz on May 31, 2006, at 8:41:57
In reply to Wellbutrin vs. EMSAM, posted by jealibeanz on May 30, 2006, at 19:43:06
Any thoughts?
Posted by Donna Louise on June 1, 2006, at 6:58:30
In reply to Re: Wellbutrin vs. EMSAM, posted by jealibeanz on May 31, 2006, at 8:41:57
I have taken wellbutrin, and quit and and tried agian and quit, about 4x's altogether with different sri's to help with energy and motivation. I just can't take wellbutrin. It caused me to be very jittery and rageful and more socially phobic. I do not have this experience with EMSAM. I don't know why but it is true that they work by different systems. Wellbutrin is an NE and DA reuptake inhibitor and EMSAM inhibits monoaminine oxidase which deanimates SE, NE and DA. That would be just one reason they are different. I could not use wellbutrin as a solitary medication even if I didn't have all the nasty stuff and the jury is out on whether EMSAM is going to be enough for the depression. It is helping everything else and the depression too although not as much as I would like. Maybe I "would like" too much..
Donna
Posted by jealibeanz on June 1, 2006, at 15:50:56
In reply to Re: Wellbutrin vs. EMSAM » jealibeanz, posted by Donna Louise on June 1, 2006, at 6:58:30
Is there an advantage to inhibiting vs. deamintaing neurotransmitters in different people? Does this produce different feelings in regard to the manipulation of SE, NE, and DA?
Posted by Donna Louise on June 1, 2006, at 21:26:36
In reply to Re: Wellbutrin vs. EMSAM, posted by jealibeanz on June 1, 2006, at 15:50:56
> Is there an advantage to inhibiting vs. deamintaing neurotransmitters in different people? Does this produce different feelings in regard to the manipulation of SE, NE, and DA?
Apparantly there is for me. I guess one way works best for some and the other way for others. I think, now it is just me thinking for the most part, that the global reuptake inhibition of monoamines causes too many side effects for me. If for example, only the specific htp-5 neurotransmitters that deal with feelings of well being were involved, then it would work fine for me. All these other subtypes that get involved too make me unwell. Like anhedonic, amotivated, non sexual, ect. Generally speaking, melancholic depression responds well to the reuptake and atypical depression to the deanimation. I hope someone else can tell us more about this.
Donna
Posted by jealibeanz on June 1, 2006, at 23:56:16
In reply to Re: Wellbutrin vs. EMSAM » jealibeanz, posted by Donna Louise on June 1, 2006, at 21:26:36
It's hard to figure out what type of depression I have. I think both actually.
Posted by Donna Louise on June 2, 2006, at 6:29:21
In reply to Re: Wellbutrin vs. EMSAM, posted by jealibeanz on June 1, 2006, at 23:56:16
I know what you mean. I think I started witht the melancholic type and ended up with the atypical type.I bet most people have features of both. And it is trial and error finding the med that works the best. Prozac and paxil both used to work well for me, the first two types I took and then that type stopped working for me.
Another thing about the difference between the two types of drugs is that the reuptake inhibitors work by preventing the releasing neuron to reabsorb transmittors from synapse. MAOI's work by not allowing the enzyme oxidase to remove the transmittors. So one acts on an enzyme and one acts on a nerve terminal. I think. Or "they " think. I don't know if the scientific community is even sure how they work exactly. I know I am not sure. But it is something like that and that may have make a difference in how they effect different people differently.Donna
Posted by jealibeanz on June 2, 2006, at 8:19:54
In reply to Re: Wellbutrin vs. EMSAM » jealibeanz, posted by Donna Louise on June 2, 2006, at 6:29:21
I can't even remember the difference between the two types of depression. Nobody has ever been remotelt specific about a diagnosis, the only have been GAD, depression, insomnia, ADD. I've never been intensely questioned. Basically I go in to the office, say I have something, and get some drugs.
One time my PA asked about mania, trying to rule out bipolar, that's the extent to any questioning I've received. I do like them at the office though. They're nice and they know me. Even if they do think I'm a hypochondriac, they continue to be respectful and courteous.
I've found that any mental health care professional "talks down" to me, and does not treat me like a real person. I actually just realized that yesterday when thinking about how I dislike all counselors, therapists, psychiatrists, or psychologists I've ever met. Maybe it's some sort of mannerism they develop to deal with the severely ill patients, but comes across as offensive with those of a higher functioning. Just a thought, I don't know.
Posted by jealibeanz on June 2, 2006, at 8:26:41
In reply to Re: Wellbutrin vs. EMSAM » jealibeanz, posted by Donna Louise on June 2, 2006, at 6:29:21
I know the theory is that depressed people don't have enough of certain neurotransmitters. Obviously this isn't measurable and what is sufficient for some people isn't enough for others. So, in theory, even if someone who is producing normal levels of chemical in their brain, but are depressed, does this mean they are one of the outliers who require higher levels than most people?
Does reuptake inhibition vs. deamination that this fact into account?
I still question whether to address the depression. I don't want to get the reaction that I've tried drugs which didn't work or weren't tolerable, so that means that I'm either not clinically depressed or have no hope for medication, so I should stop the drug seeking. I need to make an appointment to get Straterra and Xanax refills, but I'm so ashamed and hopeless about the chronic (not terrible at this point) depression that I might not even bother, and just stop all medications (and comfort, ease, school, and work)
Posted by Donna Louise on June 2, 2006, at 22:06:46
In reply to Re: Wellbutrin vs. EMSAM, posted by jealibeanz on June 2, 2006, at 8:26:41
> I know the theory is that depressed people don't have enough of certain neurotransmitters. Obviously this isn't measurable and what is sufficient for some people isn't enough for others. So, in theory, even if someone who is producing normal levels of chemical in their brain, but are depressed, does this mean they are one of the outliers who require higher levels than most people?
>.reuptake inhibition vs. deamination that this fact into account?
>
> I still question whether to address the depression. I don't want to get the reaction that I've tried drugs which didn't work or weren't tolerable, so that means that I'm either not clinically depressed or have no hope for medication, so I should stop the drug seeking. I need to make an appointment to get Straterra and Xanax refills, but I'm so ashamed and hopeless about the chronic (not terrible at this point) depression that I might not even bother, and just stop all medications (and comfort, ease, school, and work)I am sorry, I don't know how to answer your questions. I mean, I don't know the answers. But before you give up, I hope you have a good psychiatrist in your area. You don't mention having seen one of those. I would not trust any other type of dr. or PA to diagnose or treat a mental illness. Not that all psychiatrists can do that either, I am very lucky to have a good one that works with me and treats me like a team member in this quest for stable mental health. I hope you can get to one like mine for a proper diagnosis and hopefully a medication that will ease your symptoms.
donna
Posted by jealibeanz on June 3, 2006, at 0:52:45
In reply to Re: Wellbutrin vs. EMSAM » jealibeanz, posted by Donna Louise on June 2, 2006, at 22:06:46
I saw one who told me I didn't have anxiety or depression and sent me home empty handed. This was after I'd waited months to get in and already went through screening. He had no interest in treating me.
Posted by Donna Louise on June 3, 2006, at 6:09:08
In reply to Re: Wellbutrin vs. EMSAM, posted by jealibeanz on June 3, 2006, at 0:52:45
> I saw one who told me I didn't have anxiety or depression and sent me home empty handed. This was after I'd waited months to get in and already went through screening. He had no interest in treating me.
Well, that had to be disappointing to say the very least. Is he the only one in your area? I drive 1.5 hours one way to see mine who isn't covered by my insurance. There are none in my area, covered by my insurance that I would bother with. Some can do more damage than good. It is almost too scary but that is where being your own advocate comes in, as you are doing by reading pbabble and getting informed. I wish you the best of luck with this.
donna
Posted by jealibeanz on June 3, 2006, at 6:19:24
In reply to Re: Wellbutrin vs. EMSAM » jealibeanz, posted by Donna Louise on June 3, 2006, at 6:09:08
Yeah, he was the only in my area. I've moved recently though, so more are now available. I still may stick with my GP though, at least I'm comfortable with him. If he suggests a referral, then I'd go.
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