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-   -   Question regarding "Bupropion" (or "Wellbutrin") for Neuropathic pain (https://www.neurotalk.org/peripheral-neuropathy/147752-question-regarding-bupropion-wellbutrin-neuropathic-pain.html)

Apollo 04-12-2011 10:11 PM

I think that I will try the Wellbutrin XL (the once daily time-release version), and I read that 300 mg once per day seems to be the suggested dose. Does this dose level sound correct for neuropathic pain?

Mrs D?

mrsD 04-13-2011 07:23 AM

Most people start lower and titrate up. This way, the palpitations side effects seem to be less likely.

You may also find that you don't need the high dose. I think it is always a good idea with drugs that affect neurotransmitters to titrate up. (once there you may have to titrate down, if you decide to quit. Tapering off drugs that affected neurotransmitters is typically needed if you have been on them for months or years).

For example, TCAs which were the first antidepressants, work in very low doses. The Wellbutrin may be the same.

Apollo 04-13-2011 05:13 PM

Quote:

Originally Posted by mrsD (Post 761893)
Most people start lower and titrate up. This way, the palpitations side effects seem to be less likely.

You may also find that you don't need the high dose. I think it is always a good idea with drugs that affect neurotransmitters to titrate up. (once there you may have to titrate down, if you decide to quit. Tapering off drugs that affected neurotransmitters is typically needed if you have been on them for months or years).

For example, TCAs which were the first antidepressants, work in very low doses. The Wellbutrin may be the same.




Thank you for your thoughts, Mrs. D!

Based on what you said, what would be your suggested recommended dosage then, and is the one a day "XR" version available in your lower suggested dosage?

David

mrsD 04-13-2011 05:22 PM

100SR or -150 XL daily to start.

Wellbutrin goes up to 450 daily I think. You probably won't need that much.

In the old days, they used the immediate release 50mg.. etc.

But that was because of the "seizure warning"...which didn't turn out to be a significant thing in the field. So 100 SR or 150mgXL to start for a month may be a way to start.

norahs 04-21-2011 01:19 PM

Apollo
My personal experience with Wellbutrin........started taking it for depression, took a low dose to start (can't remember exactly what it was). Within 5 days or so I was becoming more and more depressed and by about day 8 I was suicial. I can confirm that it works well for weight lose, I couldn't eat at all while taking it. I quit taking once I realized what was happening to me. I realize I am probably not the "norm" but thought you should hear from someone that had a bad reaction.

Apollo 04-24-2011 10:06 PM

Quote:

Originally Posted by norahs (Post 764206)
Apollo
My personal experience with Wellbutrin........started taking it for depression, took a low dose to start (can't remember exactly what it was). Within 5 days or so I was becoming more and more depressed and by about day 8 I was suicial. I can confirm that it works well for weight lose, I couldn't eat at all while taking it. I quit taking once I realized what was happening to me. I realize I am probably not the "norm" but thought you should hear from someone that had a bad reaction.





... thank you for your feedback.

Mrs. D, why would Cymbalta cause sexual issues whereas Wellbutrin does not, when they are both "SNRI" type antidepressants?

mrsD 04-25-2011 03:48 AM

Wellbutrin works mostly on the dopamine system.

Cymbalta works on norepi and serotonin.

The serotonin actions are the ones that affect sexual functions.

When Wellbutrin was discovered, it took a long while to understand how it works. In fact the SSRIs like Prozac are still creating confusion! They are not as "simple" as serotonin affecting.

All the the drugs affecting neurotransmitters, are complex in fact and were allowed on the market LONG before they were understood. The general public became a huge experiment IMO.

Example: a new atypical antipsychotic: Abilify:
Quote:

Aripiprazole exhibits high affinity for dopamine D2 and D3, serotonin 5-HT1A and 5-HT2A receptors (Ki values of 0.34 nM, 0.8 nM, 1.7 nM, and 3.4 nM, respectively), moderate affinity for dopamine D4, serotonin 5-HT2C and 5-HT7, alpha1-adrenergic and histamine H1 receptors (Ki values of 44 nM, 15 nM, 39 nM, 57 nM, and 61 nM, respectively), and moderate affinity for the serotonin reuptake site (Ki=98 nM). Aripiprazole has no appreciable affinity for cholinergic muscarinic receptors (IC50 > 1000 nM). Aripiprazole functions as a partial agonist at the dopamine D2 and the serotonin 5-HT1A receptors, and as an antagonist at serotonin 5-HT2A receptor.
from http://www.rxlist.com/abilify-drug.htm
In general antipsychotics were labeled as reducing dopamine in the past. But you can see this one is really complex.

This is why when a person has been on a drug that impacts neurotransmitters for a long time, it is best to taper off. Many receptors "adjust" and change with the presence of these centrally acting drugs, and the person goes thru a withdrawal when the drug is removed. Often unpleasant.

Drugs are really quite complicated and both doctors and the public do not respect that factor at all.

Wellbutrin:
Quote:

Bupropion is a relatively weak inhibitor of the neuronal uptake of norepinephrine and dopamine, and does not inhibit monoamine oxidase or the re-uptake of serotonin. While the mechanism of action of bupropion, as with other antidepressants, is unknown, it is presumed that this action is mediated by noradrenergic and/or dopaminergic mechanisms.
from http://www.rxlist.com/wellbutrin-xl-drug.htm

Debbielynn88 04-21-2012 09:31 AM

Wellbutrin for periphral neuropathy
 
I was taking Wellbutrin for my PN and had great success almost immediately. But I did experience the heart issues and Dr told me to stop taking it, almost immediately the swelling and pain/burning came back - I want to start taking it again B/C I feel so terrible again.
Are there alternatives for me?
I tried the serotonin type meds but they make me feel terrible and I don't feel any relief.

I am soooo frustrated and sad.

echoes long ago 04-21-2012 03:15 PM

wellbutrin is the poor mans viagara.

i took 150 xl. i would use it again if i had to. Mrs.D is correct in my experience, use as little of something as you need to and still get the desired effect and take your time going up and down in dose.

bdickey 07-12-2012 03:22 PM

This is old, but my observation may help someone.

Wellbutrin did this for me...I could taste things fully for the first time in forever. It made a HUGE difference in how much I could taste. Without it, I can barely detect some flavors. They are "muffled" at best.

I lost my habit eating? It controlled urges. The things that I would impulsively do, I had more control over. That covered, snacks, and sunflower seeds (my drug of choice).

It's like the highways to the taste buds weren't clogged anymore, the nudges from impulses was manageable, and it has helped with mental acuity somewhat to, which is the big hope for me with it.

It's sometimes used for weight loss and stop smoking, I understand. I can see why that would work, lessen the urge to smoke as an "urge", same with weight loss.

bye.



Quote:

Originally Posted by Apollo (Post 758362)
Hi Gang:

Over the years, I have used Cymbalta with moderate success for Neuropathic pain (especially Small Fiber).

The only side effect that I have encountered is delayed orgasm, which is very frustrating.

I recently read online that "Bupropion" (or "Wellbutrin") was shown in a number of studies to be effective for neuropathic pain relief without the sexual side effects of Cymbalta.

It was also shown to be useful in weight loss as a nice side effect.

Can anyone who is knowledgable about this drug share their knowledge. Could this drug actually be an effective replacement for Cymbalta without the sexual side effects?

I know that it is not an "SNRI" like Cymbalta, so I was surprised to read that it may be effective for treating neuropathic pain as opposed to depression alone.

Many thanks!

David



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