How Does Bupropion Disable Mania?

[AlphaMethylPhenyl]

Bupropion is technically labeled an NDRI, yet its the only medicine in its class that's officially indicated for depression. It also antagonizes at least one subset of the nicotinic acetylcholline receptor.

I've also personally heard from a highly regarded psychiatrist that Bupropion is exceptionally good at actually disabling mania in bipolar patients. For me, it is apparently only one of a very few select agents which can do so, meaning atypical anti-psychotics don't so well. What is up with this? I can't believe its because of the antagonistic action I mentioned. I have one other theory than a "hidden" mechanism of action, but was wondering if anyone knew why this is. And from a stimulant too, this is unheard of. Something is up with this cathinone.

 

[Epsilon Alpha]

Post question's in the Big and Banging thread unless you want to foster a large discussion.
Personally I have no idea what your psychiatrist is talking about unless it is indeed a "hidden MOA" as you said. IIRC ACh levels are inversely correlated with mania.

 

[AlphaMethylPhenyl]

Aight. I just wanted a fast answer.

 

[RobotRipping]

did u try double checking what ur psychiatrist said?That seems strange and goes against my personal experience with it as it made me restless and energetic and probably would have made me manic if i stayed on it longer. My girlfriend also had similar issues on it. I think it'd be more prone to giving mania than SSRI's even. But if we can dig up some info in this thread about it i'd certainly like to find out.

 

[sekio]

It seems to me administration of monoamine reuptake inhibitors would increase, not decrease manic behaviour.

Do other nicotinic-blockers like DXM, varencicline etc also block your manic behaviour? Because I thought (at least varencycline) NACh block was associated with erratic behaviour.

 

[AlphaMethylPhenyl]

DXM does not seem to make me manic, so perhaps that is the case.

I mean, Welbutrin can make me hyper, but it doesn't cross the line (so to speak). It seems to rev up my mind and build my ego for me, which would disallow any inadequacy leading to mania. Though basically every "pure" stimulant seems to do the former without leading to the latter. Welbutrin has powerful brakes on too high of an emotion, that I can tell. I can't remember where I read this, but I do remember seeing that it can decrease dopamine release, though maybe this is just long-term.

 

[allthegoodjwh's]

being manic bi-polar myself i find that wellbutrin along with any other sympathomimetic drug increases mania, i find myself having more energy and talking more as well as being more sporadic with my thought patterns and movements
wellbutrin doesn't make my mania nearly as bad as say cocaine or high high amphetamine doses, but it does have above placebo felt-effects
everyone reacts to drugs differently though, as some people are tweaking off xanax and dont say more than 4 words on stimulants
i dont know the exact nature of that phenomenon but is it possible that might be why people would have a paradoxal decrease in mania from a medicine who's pharmacology increases manic tenancies

 

[AlphaMethylPhenyl]

I agree that I have more energy on it, but I can definitely tell when I cross the manic line. Interestingly though I can't concentrate nearly as well on it as I can while manic or otherwise normal.

Its interesting though because with basically any other stimulant I will show at least some academic-cognitive improvement during an initial dose (so long as its not ridiculous).

Anecdotes:
http://treato.com/Wellbutrin,Cognitive+Problems/?a=s
http://www.everydayhealth.com/drugs/wellbutrin-for-bipolar-ii-disorder/review

I mean, so its definitely a viable approach. I'd imagine its rarely used just by itself, but when I was on 300mg it was perfect. I was rarely if ever manic on it.


Then this:
http://www.ncbi.nlm.nih.gov/pubmed/11893875

Countering that:
http://www.ncbi.nlm.nih.gov/pubmed/1487473
http://biopsychiatry.com/bupomania.htm
http://biopsychiatry.com/bupoman.htm

I haven't been able to find any verifiable information stating that Bupropion blocks dopamine release, just a few posters on the net ha.

...unless this is an indication: http://www.sciencedirect.com/science/article/pii/S0014299907004189

http://neuro.psychiatryonline.org/article.aspx?articleid=179809
"Compared with other antidepressants, it is the preferred choice in the treatment of bipolar depression because of its low propensity for switching into mania/hypomania (treatment-emergent affective switch).4–6 However, we report two patients with bipolar depression who switched to hypomania and mania while taking bupropion alone or as an adjunct to lithium, which speaks against the lesser switching potential of bupropion in bipolar depression."


What is DOPAC?
http://ukpmc.ac.uk/abstract/MED/2482026

 

[skillet]

I don't see anything suggesting it can prevent mania, just that it's maybe less likely than some other AD to cause it. Not saying it doesn't work for you, but it doesn't seem to be the general case.

Where did that psych get the idea from? Personal experience?

 

[AlphaMethylPhenyl]

I don't think anything totally prevents mania.

The ratings for use in bipolar disorder suggest that it can help with mania.

"MAOIs and bupropion may be associated with milder manic states than either tricyclic drugs or fluoxetine"

"A switch into mania is a potential risk associated with antidepressant drug use in bipolar affective disorder. Bupropion is believed to be associated with a decreased risk compared with other antidepressant therapies"

and the quote of my post above...

I'll ask him. He's been working in the field for over fifty years.

 

[Anoymator]

I actually experienced what was my first (what Id consider) manic episode on bupropion. I only lasted 3 weeks on the stuff as I got no sleep during those 3 weeks unless benzo induced and by the 3 week mark I started hearing voices and had this bizarre behaviour as if I wanted to take the world and then kill myself. Scary stuff so I stopped it immediately. I only did 200mgs IR, hardly a high dose.