bipolar disorder, Dr. Paul Markovitz  Q. Over the past seven years I have sought treatment for periods of extreme depression. Although, these periods were interrupted by periods of over-achieving activity, I was not diagnosed with BP until one year ago. During my treatment for depression I was prescribed SSRI anti-depressants. After I had finalized my plans for a killing spree while on Prozac, I thought it was a good idea to stop taking anti-depressants.

One thing that had always "worked" for me was smoking dope. Even though I would be intoxicated from smoking, I would feel alive, bright, and energetic. However, I continued to be plagued by depression and could not very well conduct my life while continuously high. Once, I was diagnosed and began to explore options for medications with my doctor, we settled on Wellbutrin 150mg/day and Depakote 1,500 mg/day. This regime has worked fairly well. A recent depressed episode has led to an increase in my Wellbutrin to 300 mg/day.

The difference between the Wellbutrin and the SSRI's is striking. The Wellbutrin provides me with the energy that I got from marijuana. I have read that marijuana is a dopamine uptake inhibitor and a norepinephrine uptake accelerator, while Wellbutrin is an uptake inhibitor for both.

My questions: Is there a medication that acts as a dopamine uptake inhibitor only? Could such a medication possibly alleviate some of the side-effects of Wellbutrin (insomnia/sweating/weight gain)?

  A. Wellbutrin is supposed to be a dopamine and noradrenaline reuptake inhibitor. That is why you sweat and have trouble sleeping (maybe). The weight gain is probably secondary to the Depakote, since just about everyone gains weight on Depakote.

A dopamine uptake inhibitor as you call it, is already in you in the form of Wellbutrin. Further increasing dopamine or noradrenaline uptake inhibition will potentially make the sweating and insomnia worse. I am glad the medications are helping you some. I have had some luck with Levsin XR for sweating in patients like yourself. You may want to ask your doctor about trying a smallish amount.