Posted by King Vultan on August 21, 2004, at 23:30:50
In reply to Fatigue even with Wellbutrin, posted by Marc R M on August 21, 2004, at 15:39:32
> I'm wondering if anyone else has experienced what I'm experiencing. I'm on 450 mg of Wellbutrin, 300 mg of Effexor XR, and 45 mg of Remeron, yet I still experience constant fatigue throughout the day.
>
> What makes matters worse is that I have a fairly "demanding" job and I have to "produce." Any suggestions?
Your combined dosages of these drugs are massive, and there are likely some severe CYP-450 interactions going on here. For instance, Wellbutrin is a powerful inhibitor of the 2D6 enzyme, which is involved in metabolizing the Effexor. My guess is that the blood plasma level of the Effexor has been increased by a factor of at least 3-5 times beyond what it would be taking 300 mg by itself. Since Effexor commonly induces lethargy and somnolence in overdose, I think there's a good chance that this is at least part of your problem. I would question your doctor about this issue, and if he seems ignorant of it, I think it would probably be in your best interest to find someone else.Todd
poster:King Vultan
thread:380461
URL: http://www.dr-bob.org/babble/20040821/msgs/380643.html