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'Pulsing' Wellbutrin Dose

Posted by Chtorr281 on September 27, 2011, at 4:20:15

I'm curious if anyone here has experience with "pulsing" antidepressant dosage in order to keep it from pooping out. I'm currently taking Wellbutrin SR for chronic depression. Like all the different SSRIs I have tried, Wellbutrin worked very well for a few weeks then seemed to be way less effective. I started feeling emotionally flat and empty with periods of irritability and sadness. The emotional numbness or flatness was quite a bit worse with SSRIs though.

I seem to be able to get a positive response out of Wellbutrin again by pulsing the dose; I've tried different routines like 2 days off, 4 days on, etc. But what seems to work best is not taking it on Saturday, 300 mg on Sunday, and 150 mg the rest of the week. Strangely I feel best on Mondays and worst on Fridays. But if I keep taking it without interruption I get emotionally flat and irritable, and it does not improve.

Why would I feel the best the day after taking the higher dose? And worst after taking it continuously for a week?

I have tried different dosages and 300mg per day makes me feel much worse than 150mg. I've also tried going down to 75mg per day, but after a while even that had the same negative effects as when I continuously took the higher dosage with very few of the positive effects.

Do you think this has to do with building up tolerance or could it be something to do with circadian rhythms? When it is working its best and not causing anhedonia and irritation I sweat a lot when I sleep.

I have been on Zoloft, Paxil, Luvox, and Effexor, and they all had a short period where they were very effective, but then stopped working after a few weeks. Zoloft was the first one I ever tried and it probably worked the longest, for a couple of months, before I started feeling bland and irritable. Raising the dose made me exhausted all the time, more emotionally flat but with periods of extreme sadness or anger. I never tried "pulsing" the dose with any of the SSRIs.

I don't know if there is a better dosing strategy that I could be trying. Any ideas or experience in this area? My doctor claims that he has a few patients who do better by taking a med vacation for a day or two every so often, so he's not against my current strategy, but he also doesn't really have an explanation as to why just continually staying on a steady dose doesn't seem to work.

When taking no medications I have continuous atypical depression. Thanks for any ideas.





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