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Treatment Resistant Depression + Wellbutrin Add On

Posted by bonesintoronto on February 12, 2019, at 11:00:53

Hello Everyone.

I'm new to the forum and am hoping for some advice from people who have lived the experience. I just turned 60 years old, female. I have dx. of OCD and anxiety with post partum depression. Have been on an SSRI (currently on Prozac) since 2001 when my OCD became out of control. It helped me tremendously. Although I've suffered with OCD and social anxiety most of my life I didn't suffer with depression. When I hit menopause - about 5-6 years ago I started to experience major depression with suicidal thoughts. I've tried a number of SSRI's at various doses that didn't help. My psych doc (at time - just consult) suggested I augment with Lyrica - which I have been for past 2.5 years. It worked very well at first - improved mood, sleep and anxiety. Now effects are fizzling out. Memory is dreadful. Will have to keep increasing dose which I feel is making me more stupid. (I keep fearing that I have early dementia.) I recently added Wellbutrin XL 150 mg to augment my Prozac 20 mg. Only been on 4 days but I am totally wired. There have been improvements in my mood - feeling hints of my old self. Memory is amazing - remembering all the names of my clients again. LOL. Motivation improved. The trouble is I'm not sure I can live with this terrifically wired feeling and insomnia. Insomnia has been the worst of my depressive symptoms and a series of 'bad nights' exacerbates my OCD. I'm still working at a somewhat demanding job. I've read to "keep on plowing through" the side effects and they will subside after a couple of weeks. Not sure I can do it. Another night (4th) of 4 hours sleep and racing thoughts. Took clonazepam 0.5 last night and helped a little. Five hours sleep. I'm thinking that I can ask doc for clonazepam bid for next month until symptoms possibly subside?? But really do NOT want to take a sleep aid. Tried all of them and find that they don't help. Magnesium the best. Trazadone - hung over. Zopiclone - 4 hrs. sleep only. Clonazepam helps but developing tolerance, and don't want to get dependent. I can see the benefit of this augmentation with my depressed mood, but it is increasing anxiety and insomnia. Questions are: 1) Do you think if I switch to Wellbutrin IR from Wellbutrin XL and drop the last dose prior to sleep, that my mood would be maintained and sleep improved? 2) Do you think I should continue with Lyrica and Prozac - although I am obviously developing tolerance to Lyrica and is terrible for memory. 3) Any other suggestions for augmentation?
I'm wondering if 20 years of a seretonin enhancing med has caused my other neurotransmitters dopamine and norepinephrine to be 'out of wack' and hence the improvement in depression with Wellbutrin?

Thank you everyone. I realize this message is a little long, but a lot of needed details.




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