Citation: carboxyl. "Tremors and Anxious Feeling: An Experience with Bupropion & Yohimbe (exp38276)". Erowid.org. Sep 19, 2005. erowid.org/exp/38276
Bupropion and its metabolite, hydroxybupropion, mainly acts as norepinephrine re-uptake inhibitors, but bupropion also has a mild affinity for the dopamine re-uptake pump. At approximately 6 hours after ingesting the bupropion, 19 milligrams of yohimbine from standardized yohimbe extract was ingested with the intent of raising norepinephrine levels.
The effects from the yohimbine became apparent after approximately 45 minutes after ingestion. The onset was extremely rapid with peak effects occurring 2 - 5 minutes after the onset. At first, there was almost a stoned feeling with noticeable yet slight visual distortions, such as a “sparkle” to things. Cognitive abilities however were not noticeably impaired to any extent. Two minutes after the effects started, almost uncontrollable shaking occurred in all parts of the body from the arms and other extremities to jaw. Vision was noticeably blurred. By this point mental abilities had decreased significantly, higher thought and discussion was not possible, however I maintained consciousness throughout the episode.
At first, I thought I was experiencing a mild non-epileptic seizure furthered by the fact that bupropion lowers the seizure threshold. I am convinced however now that many of the noted effects were induced by epinephrine and norepinephrine freed from the synapse and also from binding to beta-adrenergic receptors. There are four receptor types on the sympathetic pathway, alpha-1, alpha-2, beta-1, and beta-2. The sympathetic pathway predominates in stressful situations. When norepinephrine and epinephrine bind to the beta-1 and beta-2 sites (norepinephrine binds only to beta-2) heart rate and blood pressure rise rapidly. This is why hypertension is treated with drugs called “beta blockers.”
Yohimbine binds to the alpha-2 receptors, leaving only alpha-1, beta-1, and beta-2 left to bind with the epinephrine and norepinephrine in the synapse. The heart rate increase was dramatic. The resting heart rate at the peak of the effects was 120 – 125 a two-fold increase over the normal resting heart rate of 58 – 60. It would have been great if I could have checked my blood pressure, but that simply was not possible.
With the alpha-2 receptor blocked by the yohimbine, and the beta receptors downregulated by the bupropion, I believe significant amounts of synaptic epinephrine and norepinephrine were released into the body resulting in the tremors and anxious feeling.
It should also be noted that yohimbine is a mild MAO inhibitor which also may have added to its effects.
10 hours after the onset of the yohimbine, I was almost back to baseline, but not quite. The alertness effects remained, being at 20 hours awake and not drowsy at all.
The Gist: Don’t take yohimbine with bupropion. There are some reports on the web that they positively reinforce each other, but extreme caution should be exercised with mixing they compounds.
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