I'm that person that gets the weird/rare side effects, and I think I've hit the bizarre jackpot with this one, well except for the one years ago that made me lactate. I can't find any information on how Wellbutrin interacts with HRT/estrogen, and if I hadn't had a hysterectomy 20 years ago, I'd swear I was pregnant (and no, I haven't gained weight in general).
By l'appel du vide
Hello everyone, I hope everyone's December has been off to a good start. I am back, on the med merry-go-round and also sober from opiates.... Again (16 days as of now).
So I was taking wellbutrin as an add on to my Prozac, and it really didn't help and might have made me worse, losing dramatic amounts of weight, a lot of intrusive thoughts, very depressed (though that's probably just it not doing much for it. And getting off drugs.) so I'm now on the Rexulti starter pack.
I'm here seeking others experiences with abilify and rexulti, since they are both dopamine partial agonists and 5-ht1a partial agonists, amongst other things. I'm very nervous about taking an antipsychotic for depression, though... And just want to know of other's experiences starting these medications. How were the side effects? If you had any, did they eventually go away? Did you gain weight?
I appreciate anyone who shares their experience. I've asked about these meds before, but I'm so nervous about it I just want reassurance. A lot is changing around me. Thank you all so much, and I hope the holidays have been treating you well.
Hello, it has been awhile!
Well, my old psychiatrist retired and I am now stuck with a new one. A tele-med provider. Without really letting me know if they read my chart (they even made mistakes when asking what meds I was on now) they prescribed me topamax to take alongside my usual anxiety med due to (duh) increase in anxiety. They said the added benefit would be that I would be able to lose weight as well, since my previous meds made me...ahem, chunky. And I told them I have body issues.
Here's the thing. I did a little research about the weight loss and all studies said that it was beneficial to those who were bulimic or over eaters. I have history, and deal with restrictive eating. Making my appetite less would be a very stupid move in my opinion. My other concern is that there is a side effect where your eyes can suffer permanent damage. Not likely of course, but it is noted. I have a degenerative eye problem and I feel that it would be risky to take something that could make my eyesight worse. Of course there is the caveat that if I notice anything like that I can stop the med, but would my eyes regain the vision they "lost"?
I talked to a pharmacist today and they told me it would be very unlikely that I would have any visions problems other than blurriness and that most symptoms are dizziness, hard time focusing, etc the usual. They kind of glossed over the eating part too, saying to just talk to my provider. I have an appointment in a month, and with the Holidays coming up, I decided not to start taking the topamax so as not to ruin any festivities I hope to have with my family.
I guess I just needed to vent a bit because it doesn't seem like my new provider is listening to what I have to tell them...since they keep asking me things that are in my chart already! I miss my old psychiatrist a lot, and don't like this new tele-med set up. In any case, I would love to hear from others who have taken topamax for anxiety and how it worked for them. I know everyone is different, but I'd like to get some feedback nonetheless.
Abilify (Aripriprazole) is a partial agonist on dopamine receptors with 60% the activity of dopamine on receiving neurons and 75% activity of dopamine on firing neurons . Abilify is the only antipsychotic which can increase dopaminergic activity in the mesocortical pathway through dopamine partial agonism. Abilify is a 5HT1A partial agonist (68%), which causes dopamine levels to go up in the prefrontal cortex. Abilify is also a 5HT2A antagonist; which has antipsychotic and antimanic properties .
Here are the Four Dopaminergic Pathways and Abilify's Effect on them
1. Mesolimbic (Abilify decreases activity)
2. Mesocortical (Abilify increases activity)
3. Nigrostriatal (Abilify dampens down)
4. Tuberoinfundibular (Abilify does not cause prolactin release unlike dopamine antagonist antipsychotics. In fact, even low doses of Abilify can reduce prolactin release caused by dopamine blockers).
Abilify reduces neurotransmission in three of the four dopaminergic neuronal pathways.
Welbutrin (Bupropion) is a dopamine-norepinephrine reuptake inhibitor; its occupancy at dopamine transporter (DAT) is 23%; whereas over 75% causes euphoria (ex. cocaine). A dopamine reuptake inhibitor (DRI) is a class of drug which acts as a reuptake inhibitor of the monoamine neurotransmitter dopamine by blocking the action of the dopamine transporter (DAT). Reuptake inhibition is achieved when extracellular dopamine not absorbed by the postsynaptic neuron is blocked from re-entering the presynaptic neuron. This results in increased extracellular concentrations of dopamine and increase in dopaminergic neurotransmission.
I am currently taking Abilify 400 mg every 3 weeks (~ 20 mg / day) and 300 mg of Welbutrin.
I was complaining to my psychiatrist about the side effects of Abilify I was suffering from; depression (low mood), sexual dysfunction, anhedonia, from a condition called "Neuroleptic Induced Deficit Syndrome" . I complained that I had totally lost my motivation, drive, and initiative and was experiencing anhedonia (lack of pleasure), emotional suppression, etc. It is like living in a mental restraint "straigthjacket". So my psychiatrist added Welbutrin. Abilify dampens down dopaminergic activity in three of the four dopaminergic pathways; It is the only Antipsychotic that I know of that can increase mesocortical dopaminergic activity. Other partial agonists like Brexiprazole and Cariprazine might do this also, whereas a silent antagonist cannot. Welbutrin has treated my low mood; I am euthymic now, but I am still anhedonic from Abilify being so frequent for such a dose; I am taking the daily equivalent of 20 mg: 400 mg per 3 weeks. At lower doses Abilify has a more stimulating effect. The Welbutrin he added certainly helps; but is unfortunately not enough.
I am considering adding a dopamine full agonist such as Ropinirole, Rotigotine, Cabergoline and Pramipexole to my prescription meds. Some dopamine agonists are useful at treating depression resistant to SSRI-treatment. Dopamine agonists can be given to counteract the side effects of antipsychotics and serotonergic antidepressants. No doubt that dopamine antagonism has a negative effect on mood. In the mesolimbic pathway *(reward pathway)* Aripriprazole reduces dopaminergic activity; which reduces motivation - salience (liking, rewarding), which can be identified as a major source of anhedonia. Aripriprazole does not reduce dopamine transmission in the mesocortical pathway in people whose mesocortical pathway has .less than normal activity. The dopamine boost that Welbutrin provides keeps me stable; counterbalances some of the negative effects of Abilify. I just need more help in alleviating this zombified state of existence in which I am alienated from my own real self. and cannot enjoy the things I used to enjoy; food, drugs, sex. I live in anhedonia, a state of a loss of pleasure; due to the neurological inhibition caused by Abilify. Welbutrin works as a wakefullness promoting agent, a mild stimulant.