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Dysthymia and Wellbutrin XL

Posted by gladlock on April 22, 2004, at 13:41:52

Background: 28 year old male, been depressed since about age 16 or so. I tend to the dysthymic side - very pessimistic, life rarely feels good but I'm able to function. You could probably call it double depression since I get very down every once in a while. Don't have the manic swings to indicate bipolar, though my mood definitely swings up and down. Strong family history of depression (both sides) with some bipolar thrown in for good measure.

I've been on Zoloft, Wellbutrin SR, Wellbutrin SR+Remeron, Wellbutrin XL+Trazodone, and (currently) Wellbutrin XL only. Discontinued zoloft and trazodone due to sexual dysfunction. Wellbutrin SR+Remeron was good, but I discontinued due to Remeron-induced grogginess and Wellbutrin memory blips.

To the present day - I just stepped the Wellbutrin XL to 450mg/day on the advice of my psychiatrist. At 300mg/day I notice I'm more conversational and outgoing, but my mood isn't very improved. We're trying 450mg to see if I can get mood improvement without resorting to augmenting with another med. I've been at 450 for almost two weeks, which I know isn't necessarily enough time to fully evaluate. But from my experience with Wellbutrin, I don't expect it to elevate my mood enough to qualify as successful.

So here's my question: anyone else had success treating similar symptoms with Wellbutrin alone? My past experience with Wellbutrin+Remeron was good, but I'd like to avoid the grogginess of Remeron. My goal is improved mood with as few side effects as possible. Wellbutrin has almost no side effects for me other than "memory blips".

Secondly, is there anything other than Remeron that I might consider to augment the Wellbutrin? I won't consider anything that kills my sexual function - sorry, but at 28 I'm not ready to give it up. I seem to be very prone to sexual side effects, as I had them with Trazodone and it's not even supposed to do that. The 12 hour zombie state of Remeron is bad, but it seems like the only choice for something without sexual side effects. Any suggestions? I'd really like to find something that improves my mood without knocking me out, as it sucks to work 8 hrs and then come home, take a remeron, pass out and then do it all again the next day. Intrudes on having a non-work life at all :(

I'm thinking Wellbutrin+Remeron is what I'm going to have to go to. I was on 300mg WB SR+30mg Remeron before - anyone tried this combo with 45 or 60mg Remeron and found it to be less sedating? And is 450mg WB XL likely to be too much when used in combination with the Remeron? Of course I'll discuss this with my psychiatrist - just wanted some initial thoughts before I see him.

Sorry this turned into a treatise, but I would
really appreciate any input.




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