Bupropion, aka Wellbutrin. I currently hold 3 weeks worth of it in my hot little paws. But ask yourself this question, if a man on the street talks with you for a half hour and sells you a snifter of cocaine, and if a man in an office with a PH.D. talks to you for a half hour and sells you 3 weeks worth of Bupropion, is there really any way to distinguish them? Yes I saw a psych today, but that's a whole nother story. I was kind of disturbed by how his conclusion was that I stop working with the therapists at school, and start taking his "medicine" called Bupropion. I was even more alarmed when I asked what the withdrawal strategy is and he told me, "You shouldn't worry about those things now. First try it out." So I went and looked up this odd antidepressant that I hadn't heard of before.
MentalHealth.com had a rather lengthy essay on the drug, in which they performed a placebo study on it. Also the loveable CrazyMeds.org had a nice description of people's experiences with it, and what it does here.
So what I learned is this. In the liver it gets metabolized twice, that is turns into something, and then that something turns into something else. Then each of those three metabolites themselves get metabolized again, for a total of 6 chemicals, all having an effect on the brain. Most of them are reuptake inhibitors, but they don't just inhibit the reuptake of serotonin. One does serotonin, another does the mysterious norepinephrin, and a third does... dopamine. Yes you heard me right: Bupropion produces a dopamine reuptake inhibitor in the brain. The basic strategy is by inhibiting all this reuptake, your brain soaks in inordanite amounts of these chemicals, thus enabling it to overcome the current deficiency in those chemicals.
But the dopamine thing has me worried. Among other things, crystal meth, and any amphetamine really, are nothing more than extremely strong dopamine reuptake inhibitors. Dopamine is the 'enabling' neurochemical. Its presence gives us motivation, inspiration, confidence and euphoria. Not a good combination usually when they're asking for volunteers to inspect the leopard cave, but otherwise very advantageous. The trouble is it's easy for the brain to forget how to produce dopamine itself, so crystal meth floods your brain with dopamine sending you into a feeling of incredible empowerment, and then leaves your brain stunned, causing a crash that's arguably not worth ten times the effects of the euphoria.
I'm fairly sure Wellbutrin, even in high dosages, isn't as strong as meth, or speed, or cocaine. Nevertheless it does worry me that byproducts of it inhibit the reuptake of dopamine. I'm all for messing with my brain chemistry to see if I can get over this disorganization of thought, but it really seems odd to tweak the dopamine levels.
Another concern about Bupropion is the irregular effect it has over time. With all those 6 byproducts churning out from the overworked liver, one will get to the brain, and then another, and their levels will rise and fall in a slapdash manner as the liver tries to deal with all that stuff. So people haven't exactly reported suffering from crashes of dopamine, serotonin, or norepinephrin, but as crazymeds.org says Bupropion doesn't really ever reach a "stable" zone, and can have unexpected spikes in neurochemicals even well on into the treatment.
Perhaps more worrying is that mentalhealth.com suggests that nobody really knows what happens if you take Bupropion for more than 6 weeks. Its advice was to consult your psychiatrist and make very sure you really wanna try taking it for longer. I say this with concern because the psychiatrist I talked to assessed me for half an hour, then gave me 3 weeks worth of Bupropion, and had me schedule an appointment to come back after those 3 weeks to see what it has done. Now it doesn't take a Ph.D. to realize that you should probably check back with the guy before half the maximum recommended drug period has elapsed. But apparantly it's fine... according to him at least. Meh, I could say some words about him. Short version is he was creepy. *shivers*
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