Posted by SLS on June 18, 2005, at 9:53:46
In reply to Re: Anyone TIRED on Wellbutrin XL? - ? for Scott » SLS, posted by TamaraJ on June 18, 2005, at 9:23:52
Hi Tamara.
How are you feeling right now?
> I started Wellbutrin SR about 3 weeks ago, to augment the 75mg of nortrityline I have been taking.
You might want to try moving up the dosage of nortriptyline to 100mg.
> Would I be better off changing the nort for a SSRI like Lexapro, or does the Wellbutrin/nort combo have the potential to be a good one?
Hmm. I wish I could answer this question for you. I know how much easier your decision-making process would be by having a definitive answer.
Do you think the Wellbutrin has helped at all?
> It seems to be ok so far, and I am only at 100mg of Wellbutrin (which, I know, is not the therapeutic does). I went up to 150mg for 5 or 6 days, but ended up with really bad heads (almost migraine-like). I am going to try 100mg a.m. and 100mg p.m. (early afternoon) to see if that is more tolerable. The 150mg all at once seems to affect me badly for some reason
:-(
I'm not a real big advocate of the XL once-a-day prescription. If I were taking Wellbutrin, I would take the SR version twice a day morning and evening.
Perhaps someone can provide some input as to the possibility that it is the nortriptyine that is acting as a catalyst to produce the headaches you get when you try to increase the dosage of Wellbutrin. It is conceiveable that you can take larger dosages of Wellbutrin in the absence of nortriptyline. I think I would proceed in the following sequence if I wanted to build a treatment around Wellbutrin:
1. Increase nortriptyline to 100mg; return to 75mg only if depression gets worse.
2. Switch to twice a day schedule of Wellbutrin of SR or XL: morning and evening.
3. Increase dosage of Wellbutrin gradually to 300mg.
4. If you cannot tolerate the higher dosages of Wellbutrin, discontinue nortriptyline. If tolerated, continue with the nortriptyline.
5. Attempt to increase the dosage of Wellbutrin to 300mg
6. Add to the Wellbutrin the SRI that you had the best response to in the past. These would include the SSRIs, Effexor, and Cymbalta. You can continue taking the nortriptyline.
If you prefer to stay with nortriptyline or cannot tolerate a higher dosage of Wellbutrin in its absence, you can discontinue the Wellbutrin, restart the nortriptyline if necessary and add Parnate, Effexor, or Cymbalta.
- Scott
poster:SLS
thread:473033
URL: http://www.dr-bob.org/babble/20050617/msgs/514867.html