Posted by medlib on July 5, 2001, at 20:04:47
In reply to Re: Friend trying to find right med combo, posted by Noa on July 5, 2001, at 18:25:45
> What do y'all mean about not ramping up--do you mean she would start at a higher dose right off the bat?
--Yeah, I started at 30mg., ramped to 60mg.
> I wonder what it is that is agitating about the Welbutrin--could it be the norepiniphrine effects? I was thinking that was a possibility given that she already has norepiniphrine activity from her asthma inhalers, and therefore might be sensitive to this in the wellbutrin.--It could be either the NE or dopamine effects. If any of the a/a meds contain ephedrin, they *could* have additive effects w. Well.'s NE action. If that's the case, results would be similar with a stimulant. If W.'s dopamine action is responsible for the agitation, a stim. such as Ritalin might be a good replacement for the W.
> The serotonin effects of the celexa seem to help her mood a lot, although she can't take too much of it, because of sensitivity to the increased muscle action effects from the serotonin.--Celexa is the "purest" and most potent ssri--no NE effect. All the others have varying amounts of action on NE receptors, though at much lower levels than their actions on seratonin.
> But medlib, your point about 225 wellbutrin is a good one. I think she was limited to 150 or 300--is that how the Wellbutrin SR comes?--That's true of the SR form; but, several I know take SR in the morning and an IR bolus in the afternoon.
The reason I mentioned Prozac is because your friend had done well on it in the past (as I did), and combining it with W. allows one to take a lower level of Prozac with little/no wt. gain. I've found it helpful to "add back" a low dose of P. to my med combo. Individual results vary so widely, though, reasoned prediction is almost useless; there sure are no "should work"s.
Although I'm *very* happy you've found something that works, I'm envious of your stable combo. Guess I'm with Tina right now--endless experimentation eventually gets to be a real drag.---medlib
poster:medlib
thread:68891
URL: http://www.dr-bob.org/babble/20010701/msgs/69109.html