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Re: Wellbutrin plus Effexor? (and Prozac too!)

Posted by Quinn on May 21, 2003, at 21:25:10

In reply to Re: Wellbutrin plus Effexor? (and Prozac too!) » Quinn, posted by Ritch on May 16, 2003, at 12:50:13

I've been back on Effexor XR 75mg. for almost a week now. It's definitely settled me down from the levels of anxiety I was experiencing the previous week (after I stopped the Effexor for a few days) and made me feel more calm, but I’m beginning to think I’m getting a little too relaxed.

Although I’ve been feeling better overall the past few days, I've also been feeling that my motivation has been somewhat lacking. Today I've been feeling especially tired and unable to concentrate. Is the Effexor causing this? Could the increased anxiety I was experiencing last week have been a withdrawal side effect from discontinuing the Effexor? I’m starting to think that was part of it. I’m also concerned about what part the Prozac is playing in all of this.

I’m very confused. I believe that the Effexor really has done a good job with calming my anxiety, if not easing my depression, and may be an important piece of the puzzle, but it does seem to be too sedating. I’m wondering if the 70mg. of Prozac I’m taking is adding to the sedation that the Effexor seems to be causing (and whether I need the Prozac, and at what dose, if I’m on Effexor/Wellbutrin). I’ve been concerned about continuing the Prozac ever since I started taking the Effexor, but my doc doesn’t seem to want to make an adjustment in the Prozac right now (I suppose there are enough moving parts here as it is). I also believe that the Wellbutrin SR has had a very positive effect on my depression (perhaps with an assist from Effexor or Prozac), but I’m not sure I want to make the jump from 300mg. to 400mg. that my doc is recommending given all the other meds I’m on.

I’m not sure where to go from here. My doc’s suggestion is to increase the Wellbutrin to 400mg. and cut the Effexor back to 37.5mg. While the easing back on the Effexor seems reasonable, I’m nervous about cutting the Effexor if it’s contributing to my positive response to the Wellbutrin (perhaps I should be easing off on the Prozac instead). Also, 400mg. of Wellbutrin SR seems high to me. I’ve only been taking the Wellbutrin for 2 1/2 weeks, and moved up to 300mg. pretty rapidly. My inclination is to go ahead with decreasing the Effexor to 37.5, and hold steady on the Wellbutrin for now, but my doc seems really anxious to get me up to 400mg. (his first thought was to increase the Wellbutrin and leave the Effexor at 75mg. – the cut to 37.5mg. of Effexor was pretty much my idea). Perhaps after the apparent misfire I had with the Effexor, he wants to find out as soon as possible whether the Wellbutrin is going to work.

Meanwhile, I've been basically nonfunctional at work today (just going through the motions). I’ve been like this for a most of the past 3 months as I’ve come off the Zyprexa and desipramine, ramped the Effexor up and then down, and most recently added the Wellbutrin (I was also on dextra amphetamine for a few weeks before starting the Wellbutrin and ramping down the Effexor). I’m really getting behind in my work and people are starting to notice. I don’t see myself doing much better until all these meds are sorted out, which looks like it will take awhile, perhaps another 3 months or longer at this rate. I’m worried that I won’t be able to hold things together that long.

Sorry for the rant. My primary concern is avoiding the hospitalization, job loss and career damage I went through circa 1986. If anyone has any thoughts or insights here, your input is greatly appreciated.

Q.


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URL: http://www.dr-bob.org/babble/20030520/msgs/228224.html