Author Topic: Promising start with Bupropion (Wellbutrin)  (Read 15391 times)

OpiesDad

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Promising start with Bupropion (Wellbutrin)
« on: March 16, 2021, 10:14:22 PM »
Background: I've had secondary POIS for 2.5 years.  Symptoms are cognitive (memory, agitation), emotional, physiological (fatigue, joint/muscle aches, digestional, pressure headache, full body inflammation, racing heart, jumpiness, headache, temperature modulation issues -- freezing feet etc). Originally symptom onset was 1.5 days post O and peaking at 4 days. More recently boundaries are fuzzier, the symptoms are less pronounced but last for weeks and recur even long after O.

Past Treatment: So I've had some success on a regimen of Propranolol, sudafed (increases norepinephrine levels), hydroxyzine (H1 blocker that crosses blood brain barrier) and Pepcid (H2 blocker), and adderrall. I also had to go gluten free. This course has made life tolerable though I have bad brain fog and still feel generally impaired. I have been convinced that POIS is primarily a mast cell reaction.

New Treatment: My psychiatrist thought it would be worth trying Wellbutrin.  Main effect is a dopamine and norepinephrine reuptake inhibitors. Idea was I could sub out adderrall and perhaps the sudafed.

Results: Starting with 150 mg dosage.  I am 3 days in.  I have O'd twice and so far essentially no symptoms, besides perhaps a slight skin reaction that suggests I still may need the antihistamine.  I am still taking Propranolol. Generally, I have somewhat higher alertness levels and less fatigue.  I am aware that this could be placebo or a honeymoon period so remaining CAUTIOUSLY optimistic.

I am out of my depth here, but it suggests to me that POIS may for some reflect a norepinephrine deficiency.  I gather that after orgasm norepinephrine levels increase but then drop before returning to a baseline. People with norepinephrine deficiency have poor memory, low mood, fatigue etc. Makes you wonder whether POIS sufferers have a norepinephrine dump that takes longer to refill or remains low/empty.

I am also not ready to give up on the mast cell theory either and would not be surprised to find additional links.

In any event, for me this is an exciting development and I will keep you all posted.






 
« Last Edit: April 17, 2021, 03:07:56 AM by OpiesDad »

Quantum

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Re: Promising start with Bupropion (Wellbutrin)
« Reply #1 on: March 17, 2021, 07:06:07 AM »
Hi OD, I hope this relief will last.  Please keep us informed of your results in the coming months.

2 O's in 3 days?  you sure put your treatment to the test.  Some treatments may be partially efficient, and if O frequency exceeds their capacity to overcome POIS symptoms, you may miss the fact that they would have been of great help to you.   As I see it, we can find a way to control our symptoms, but there is no way yet to cure POIS, so moderation vs O frequency is always a good idea.  However, of course, you are the one who is the best placed to decide what is the best frequency for you,
You are 100% responsible for what you do with anything I post on this forum and of any consequence it could have for you.  Forum rule: ""Do not use POISCenter as a substitute for, or to give, medical advice" Read the remaining part at http://poiscenter.com/forums/index.php?topic=1.msg10259#msg10259

b_jim

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Re: Promising start with Bupropion (Wellbutrin)
« Reply #2 on: March 17, 2021, 07:19:02 AM »
Great job !
Taurine = Anti-Pois

Iwillbeatthis

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Re: Promising start with Bupropion (Wellbutrin)
« Reply #3 on: March 17, 2021, 07:43:40 AM »
I tried this before and it turned me into an alien literally... I felt awful and could barely even speak when I was with friends or family, it was by far the worst antidepressant I've tried the others didn't do anything like this. I'm guessing it's to do with some problems related to dopamine.

Just shows everyone's body is different, I'm glad it's working for you so far.

BoneBroth

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Re: Promising start with Bupropion (Wellbutrin)
« Reply #4 on: March 17, 2021, 09:33:07 AM »
OpiesDad, do you experience any of the following symptoms of  Small Intestinal Bacterial Overgrowth (SIBO):

Bloating
Abdominal pain
Nausea
Food intollerance
Difficult to digest fat
IBS/Chrons
Acid reflux
Constipation/diarrea
Yelloish poop
Coated tounge
Gas

OpiesDad

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Re: Promising start with Bupropion (Wellbutrin)
« Reply #5 on: March 17, 2021, 12:08:06 PM »
Quantum: I got carried away with testing.  Agree that moderation will be key, certainly won't find myself back in my old regimen of 4-5 Os a week. :)

BoneBroth: Not really.  Yes to Acid Reflux and yes to occasional bloating.

Iwillbeatthis: Yes.  I've also read that people have a few great weeks with it before a sort of crash.  Will be on the lookout.

OpiesDad

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Re: Promising start with Bupropion (Wellbutrin) [Update]
« Reply #6 on: April 02, 2021, 08:43:39 PM »
Update: Now using 300 mg wellbutrin daily, sudafed and propranolol (have taken hydroxyzine a few times when I felt rashy).

Okay guys, I am two weeks plus in to using wellbutrin.  I've O'd 4 or 5 times since and have had no cognitive symptoms.  None.  No buzzy head, no memory impairment, motivation is back, ability to concentrate and articulate is back.  I have easily had the best two weeks cognitively that I've had since this nightmare started 2.5 years ago. Physically also very solid though I would say my legs still feel weirdly heavy when I jog in the days after O, but generally body is good too, including gut which goes haywire in POIS.

Restating the theory --- POIS could be a norepinephrine deficiency, which somehow sometimes cascades into a mast cell reaction.  Wellbutrin is a Norepinephrine reuptake inhibitor (and dopamine reuptake inhibitor as well).  No impact on Serotonin. So by taking it, your norepinephrine and dopamine levels should rise.  Norepinephrine deficiencies are associated with many of the cognitive impairments we suffer (memory loss, lack of attention, headache, fatigue, low mood). It can rise and fall during stress events generally but during orgasm, norepinephrine spikes then drops before returning to a baseline.  On my theory, POIS sufferers don't refill after a drop and that gives rise to many of the symptoms.  Antidepressants also get prescribed commonly for fibromyalgia and other flare up arthritic conditions.

Every case is unique, so I have no idea if this treatment would work for you all.  But if you are okay with the idea of taking an anti depressant, if I were you I would 100% for certain talk to your doctor about giving this a trial run.  In my case I started feeling different in a good way the day after I took my first dose. Maybe even the day of. 

This is not placebo affect it's freaking real, I just hope it lasts.
« Last Edit: April 02, 2021, 08:46:57 PM by OpiesDad »

BoneBroth

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Re: Promising start with Bupropion (Wellbutrin)
« Reply #7 on: April 03, 2021, 04:19:54 AM »
Do you mean that if norepinephrine/dopamine is not beeing uptaked by the CNS (inhibited reuptaked) the levels in the blood will rise and thats where you want it to be?

OpiesDad

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Re: Promising start with Bupropion (Wellbutrin)
« Reply #8 on: April 04, 2021, 12:49:17 PM »
yes but in the brain, not blood.  In fact I still take propranolol so that epinephrine doesn't hit the heart (which seems to cause those weird POIS heart palpitations, sweating and the panic feeling). Mind you, I have no training and no aptitude for science, biology, neurology or medicine so all of this is based on a very rudimentary understanding. I just know that I feel much better these last two weeks than i have in 2.5 years and this is the only thing that has changed.

Laotzu1980

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Re: Promising start with Bupropion (Wellbutrin)
« Reply #9 on: April 05, 2021, 03:29:05 AM »
Opies, you mentioned you were only 3 days in to taking Wellbutrin but you had O'd twice with no symptoms. To me that suggests you may be able to use the drug as a prepack, only before O, or at least taking it in the 1-2 days before you O each week, instead of taking it every single day. It seems to have worked immediately for you, which is great news. You also mentioned some members have had a crash after a few weeks of using it, which you may be able to avoid by using it only as needed rather than daily. There may be some tolerance building up, or some reason others experience that change after a few weeks, that you may be able to avoid by not taking it so frequently.

Just a thought. Not sure how that drug works or if you are able to take it in that intermittent kind of way.
All the best, and keep us posted. I may give it a try too this week since you had such fast results.

OpiesDad

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Re: Promising start with Bupropion (Wellbutrin)
« Reply #10 on: April 05, 2021, 05:15:14 PM »
Yeah I don't know.  The psychiatrist explained that as an anti-depressant it usually takes 4 weeks before folks start reporting results, but that is not borne out by what folks on Reddit anecdotally report who all seemed to feel a change earlier. Perhaps it could be a pre-pack, but honestly my POIS was expanding beyond normal borders into something more chronic, trigered by something other than arousal/O, and the Wellbutrin has so far turned the ship around.  It is by the way also used off label for treatment of adhd and I have certainly had better motivation and ability to focus/do work in the 2.5 weeks.

Should mention that in the 2020 case study reporting an effective treatment of a single patient using TRT, the report mentions in the history that the patient had not had good results with Wellbutrin among other therapies, so it won't work for everyone I guess.

I will keep you all posted, had another O yesterday and today I feel cognitively and emotionally 100%, and body-wise 95% (slight runny nose, eyes feel a touch inflamed, legs a little heavy, stomach noises).

Please let us know if you give it a shot and results.

Laotzu1980

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Re: Promising start with Bupropion (Wellbutrin)
« Reply #11 on: April 06, 2021, 01:48:50 AM »
Fantastic. Great to hear it still works for you and helps in other areas. I had also read it takes up to 4 weeks to kick in, which is why I thought perhaps some other interaction with the drug is at play in POIS.
When the full effects do kick in in that 4 week period you may begin to feel those effects more strongly, so time will tell. Hopefully things remain the same for you.
Milnacipran had the same effect with Hurray, which normally takes time to kick in but he uses it only as a prepack before O and it works well for him so far.
I will definitely ask a doctor to test this drug next time.

Question:

A.) How many days had you taken it before you tested the O? E.g. you took a pill on Monday night, took another pill on Tuesday night, took another pill on Weds night, and O'd on that Weds night?

B.) On the day you had your first O with the Wellbutrin, approximately how many hours before did you take the pill?

C.) Did you take it with food the first night of the O, or on an empty stomach?

Pardon the detailed questions - I want to try and do exactly what you did. 🙂
« Last Edit: April 14, 2021, 09:24:12 PM by Laotzu1980 »

OpiesDad

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Re: Promising start with Bupropion (Wellbutrin)
« Reply #12 on: April 16, 2021, 12:37:00 AM »
Update: Wellbutrin is still working!  I have had no bad days and it's been just over a month. So  I had a crazy work fire drill the last 6 days (finished today just a few hours ago).  I worked 17 hour days (no joke and no exaggeration), doing a mentally demanding, high pressure, speaking intensive role, and at no point did I feel any of the POIS related symptoms creep in (which they used to during lack of sleep even when I was distant from an O).  No cognitive, emotional or physical deficits at all. 2 months ago, I guarantee I could not have accomplished this last week (though pre-POIS I definitely could). To me it feels like a miracle.  I've jerked off probably 7 times since starting and have not had a reaction I am easing off the sudafed and propranolol.  I do have some very light mast cell stuff, like after a shower my chest is extremely red, but it's nothing. I just hope this lasts.

Laotzu:
A) 3 days in I jerked off twice.  No symptoms.
B) Wellbutrin is a daily medication. Probably like 10 to 15 hours post pill.
C) Morning before any food.  Don;t think food impacts absorption.

Let me know if you have any other questions.

Laotzu1980

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Re: Promising start with Bupropion (Wellbutrin)
« Reply #13 on: April 16, 2021, 04:47:09 AM »
Wow. That's great news. You are extremely lucky, and let's hope it continues. Thank you for the reply, I was actually waiting to hear your results before seeing a doctor, but glad you waited to give it a proper test before reporting back. I am in a POIS episode now and it's hell. I wonder how severe your symptoms were pre-Wellbutrin. I cannot even function as a normal social being in this state. No way I could go to work in POIS, not even in a low-pressure position.

Thanks again, and wishing you continued success with it. 🙂


Iwillbeatthis

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Re: Promising start with Bupropion (Wellbutrin)
« Reply #15 on: April 16, 2021, 04:10:46 PM »
Bupropion is 100% dopamine reuptake and only 27% norepinephrine reuptake.

A simple way to test for noradrenaline deficiency is to try yohimbe or possibly yohimbine, I ordered some a few weeks ago from iherb but my order got cancelled for abusing their sign up offer lol. As well as raising norepinephrine it increases blood flow to the sexual organs.

I had low VMA and a high HVA/VMA ratio which indicated low norepinephrine and low conversion of dopamine to norepinephrine.

OpiesDad

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Re: Promising start with Bupropion (Wellbutrin)
« Reply #16 on: April 17, 2021, 03:07:23 AM »
ehhh. I had a bad day today -- sorry for the whipsaw and let down.

I O'd last night (first in like 10 days), and had symptoms as soon as I opened my eyes.  I took Wellbutrin first thing only (no propranolol). Extreme morning fatigue, head pressure, fogginess, desert dry mouth.  After a few hours still felt pretty shitty, so I added propranolol, sudafed and antihistamine and after an hour or two symptoms receded.  I was able to work and be effective enough, so though the morning was intense, I was functional. But I can tell you, I was a different person w anxiety, emotional turbulence, absolutely no working memory ... back to my POIS self which I hate.  If the tasks I was doing all week were on my plate today, I would have freaked the F out, whereas all week I never once doubted my competence was just as on point as I can possibly be. It's an incredible (and sad) transformation between yesterday and today.

Here's the kicker, so I've been very blocked up (constipated) for a few days because during this intense 17 hr a day week, my eating was irregular and shit. So late this afternoon I had the not so great idea of drinking some coffee.  I quit coffee 18 months ago after being a 6 cup/day guy for 20 years.  After POIS kicked in 3 years ago I eventually realized that caffeine while in POIS was an absolute killer for me causing wooziness and intense discomfort.  Anyways, I drank the coffee and sure enough the head feeling kicked in and I was as sick as I used to be 2 years ago. As I write this the symptoms are lifting but my legs and feet have the usual hot-cold sensations.

In any event, I have re-confirmation that caffeine is off limits; Wellbutrin may help but it ain't the silver bullet, or a Quantum wisely pointed out a month ago, something may work, but dont push it.  Well I pushed it.  Will keep you all posted.

[edit: just realized that I took Xyzal not my hydroxyzine antihistamine which was dumb since the latter has helped in the past and crosses the blood brain barrier.  Oh well.]
« Last Edit: April 17, 2021, 03:10:27 AM by OpiesDad »

Iwillbeatthis

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Re: Promising start with Bupropion (Wellbutrin)
« Reply #17 on: April 17, 2021, 04:37:21 AM »
You're not supposed to drink caffeine while on Bupropion btw

OpiesDad

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Re: Promising start with Bupropion (Wellbutrin)
« Reply #18 on: April 17, 2021, 02:23:57 PM »
I was not aware re caffeine and wellbutrin.  Luckily coffee is not my thing any longer.  Feel considerably better this morning.  Added Hydroxyzine last night and feel considerably better today.  I can live with one day POIS bouts.

hapl

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Re: Promising start with Bupropion (Wellbutrin)
« Reply #19 on: April 18, 2021, 01:00:56 AM »
Bupropion is 100% dopamine reuptake and only 27% norepinephrine reuptake.

A simple way to test for noradrenaline deficiency is to try yohimbe or possibly yohimbine, I ordered some a few weeks ago from iherb but my order got cancelled for abusing their sign up offer lol. As well as raising norepinephrine it increases blood flow to the sexual organs.

I had low VMA and a high HVA/VMA ratio which indicated low norepinephrine and low conversion of dopamine to norepinephrine.

So would Yohimbe yelp if it were a norepinephrine issue? I've definitely noticed that intense mental activity causes me similar symptoms as an O, just less severe. Less mentally engaged activity doesn't cause that. And POIS caused by an O has a ton of gut involvement, where mentally triggered doesn't do that as much for me.

Curious the involvement of norepinephrine vs dopamine and potential treatments.