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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by jacquie on June 20, 2000, at 4:45:45
Hi Cam!
I finally started Wellbutrin SR 100mg 1x per day (after 7 days they want to increase to another 100 per day) It has been like pulling teeth to get to try this medication. I am curious because it has knocked me on my butt when I take it at night. I am so sleepy i have cut ativan in half down to .5mg and probably won't take it anymore since the Wellbutrin is making me so sleepy. Have not read of this side effect on babble everyone talks about increased energy and hyperactivity....I also had strange cramping yesterday, like ovarian area, both sides very strange...related? Thanks for listening, Cam. I hope you are well. Best, Jacquie
Posted by Cam W. on June 20, 2000, at 11:20:15
In reply to Wellbutrin SR...question for CAM, posted by jacquie on June 20, 2000, at 4:45:45
Jacquie - Every time that I lecture to G.P.s this always comes up in the discussion period. I don't know what the percentages are, but I'll bet that they are double-digit for that side effect. Most G.P.s have seen at least one person who does get drowsy from Wellbutrin. I really wonder if these people were taking too high of a dose of Wellbutrin and the dizziness that can occur put them to sleep (just a thought). I have not personally seen someone, who takes Wellbutrin, get drowsy, but I have heard of this first hand from many docs.
Ideosyncratic side effects do happen and sometimes the reasons behind them can be explained. In this case I do not have a good guess, except for the "too highdose/increased drowsiness" thing.
A always say that it better to take the fewest meds possible. If you can, stop your bedtime Ativan, but don't throw it away. The drowsiness side effect may be an initial start-up side effect and can completely disappear within a month. As your body readjusts or responds to the actions of the meds, the insomia may return. Tell your doc when you stop the Ativan, just to let him/her know that you have slightly altered the therapy. Also, tell the doc if you start taking the Ativan again. This just keeps the doc up-to-date with your ingoing treatment.
As for the cramping, Wellbutrin can dehydrate the body, to a minor extent and can cause constipation. Cramping can also occur (usually leg cramps or twitches) when using Wellbutrin. Maybe increase your water your water intake and see if that helps the cramping (ie a couple of extra 8oz glasses a day).
Hope this helps - Cam
Posted by jacquie on June 22, 2000, at 4:41:06
In reply to Wellbutrin SR...question for CAM, posted by jacquie on June 20, 2000, at 4:45:45
> Hi Cam!
> I finally started Wellbutrin SR 100mg 1x per day (after 7 days they want to increase to another 100 per day) It has been like pulling teeth to get to try this medication. I am curious because it has knocked me on my butt when I take it at night. I am so sleepy i have cut ativan in half down to .5mg and probably won't take it anymore since the Wellbutrin is making me so sleepy. Have not read of this side effect on babble everyone talks about increased energy and hyperactivity....I also had strange cramping yesterday, like ovarian area, both sides very strange...related? Thanks for listening, Cam. I hope you are well. Best, JacquieI have tried 2x to post and nothing happens. I wanted to thank you for your advice. I believe now the insomnia end has kicked unfortunately. Does this subside? I had this problem with Celexa and it was fierce. They don't want me hooked on Ativanor anything else, but it seem everything I have taken simply keeps me awake! Wellbutrin certainly keeps me focused I will say that. Thnak you for everything and I hope you are well.-jacquie
Posted by Cam W. on June 22, 2000, at 13:07:08
In reply to CAM, posted by jacquie on June 22, 2000, at 4:41:06
jacquie - The insomnia from Wellbutrin does subside within the first month. I find that I will still have trouble sleeping if I take my afternoon Wellbutrin after 4pm. (Remember, you should take Wellbutrin SR doses at least 8h apart, so you have to take your morning dose before 8am).
I don't know if the insomnia, in these instances, is due to effects of the Wellbutrin or is due to my anticipation of the 'potential' effects of the Wellbutrin.
Wellbutrin-mediated insomnia will "feel different" from Celexa-mediated insomnia. Each of these drugs acts at a number of neurotransmitters receptor sites. I heard someone describe the SSRI-induced insomnia to have a "heavier feel" to it (decreased cognition due too high of a dose?) than the Wellbutrin-induced insomnia (more of a "pins & needles'-type of feel).
Hope this makes some sense - Cam
Posted by jacquie on June 22, 2000, at 19:35:06
In reply to Re: Jacquie, posted by Cam W. on June 22, 2000, at 13:07:08
> Hey Cam- you always make sense! Thanks for the tips. The doc just increased me to 200mg per day starting on sunday. so, that's 1 tab 2x per day. she has me taking a dose at bedtime anf then i take a dose during the day 12 hours later she prefers, so that would be 9am. maybe that won't work, but i guess i won't know until i try. how many mg do you take??? have you been on it awhile? what do you like about it? I noticed one day I was incredibly focused on my work(a little irritable) but nonetheless focused incredibly so. so far that hasn't happened again. I know the dose of 100mg is very low, but I am a hyper sensitive to drugs so i am babied withthe dosage...better safe than sorry. Pleas e, if you have time, let me know your thoughts about wellbutrin. celexa took away compulsive thinking and social anxiety, will wellbutrin even touch that given it is affecting a different nuero thingy? Sorry, but the scientific part gets me every time. Mucho, much thank yous....
jacquie
>
> jacquie - The insomnia from Wellbutrin does subside within the first month. I find that I will still have trouble sleeping if I take my afternoon Wellbutrin after 4pm. (Remember, you should take Wellbutrin SR doses at least 8h apart, so you have to take your morning dose before 8am).
>
> I don't know if the insomnia, in these instances, is due to effects of the Wellbutrin or is due to my anticipation of the 'potential' effects of the Wellbutrin.
>
> Wellbutrin-mediated insomnia will "feel different" from Celexa-mediated insomnia. Each of these drugs acts at a number of neurotransmitters receptor sites. I heard someone describe the SSRI-induced insomnia to have a "heavier feel" to it (decreased cognition due too high of a dose?) than the Wellbutrin-induced insomnia (more of a "pins & needles'-type of feel).
>
> Hope this makes some sense - Cam
Posted by Vesper on June 23, 2000, at 0:00:17
In reply to Wellbutrin SR...question for CAM, posted by jacquie on June 20, 2000, at 4:45:45
I just started the same regimen. Wellbutrin SR 100mgx1, for 7 days, then increase to twice a day. I have been off klonopin for a couple of months. I have been prescribed ativan PRN. The wellbutrin makes me have "butterflies in the stomach" and keeps me awake. I'm trying to keep the ativan to a minimum to avoid the kind of physical addiction I had with klonopin. Maybe the stimulant effect you are describing is like what happens with ADD people--an opposite effect from the usual..?
Posted by Cam W. on June 23, 2000, at 10:27:16
In reply to Re: Cam, posted by jacquie on June 22, 2000, at 19:35:06
jacquie - Wellbutrin relives depressive symptoms differently than the SSRIs (like Celexa). I have been led to believe that OCD symptoms and social anxiety were problems with too little serotonin. Since Wellbutrin is not "supposed" to have very much serotonin action, I don't know how well Wellbutrin would work for compulsive thinking or social anxiety. This is not to say that it may not have some effect in these disorders, it is just that I have not seen Wellbutrin used very much for these conditions.This is my second trial of Wellbutrin. I had took it for about a year, then stopped. My remission from depression lasted a year or so. I started taking Wellbutrin again late summer or early fall (I'd have to check with my pharmacist). I am going to give it at least a year and now am toying with the idea of staying on it a little longer. I'll have to discuss this with my pdoc. What I like about Wellbutrin is that it does not "bog me down" like the SSRIs did. Also, my it does not inhibit my orgasm (I did not find this a problem with the SSRIs; I had arousal, but was a slow finisher and when/if I did finish, it was explosive). Currently, I am taking 150mg of the SR twice daily and seem to still be in remission from my depression. One thing that I did notice upon starting Wellbutrin is that after I was stablized on a 150mg twice daily dose, about 1 month into therapy I got really bitchy. I would look for things to chew people's heads off. This subsided within 2 weeks. Occationally, I still get irritable, but not like I used to.
Good luck with the therapy and tell me how the Wellbutrin affects compulsive thought and social anxiety. (Social anxiety for me is just that I hate making small talk with people that I do not know in crowd situations. I just find it a pain in the ass to try to carry on a meaningly conversation. I don't know if this is social anxiety or not, but I do get anxious before conventions and meetings, as well as just before speaking).
- Cam
Posted by Cam W. on June 23, 2000, at 10:43:12
In reply to Re: Wellbutrin SR...question for CAM, posted by Vesper on June 23, 2000, at 0:00:17
Vesper - Good to see you posting again, Vesper. Wellbutrin does have stimulant effects. It is structurally related to the diet pill diethylpropion (Tenuate™ in Canada), so it is activating. This is a side effect with most people, but I have a small proportion of people get really drowsy when taking Wellbutrin (especially in the 1st month). Whether this is because of taking too high of a dose or if it is an idiosyncratic effect, I don't know.
The supposed idiosyncratic effect of people with ADD to stimulants (ie amphetamines seem to slow down children with ADHD) has been discounted (or explained). It is not that children with ADHD are have "hyper" thinking, their thinking is actually slowed. They can't focus on the task at hand and flit from one project (and thought) to the next. The amphetamine (or other stimulant) actually speeds up the childs thought processes and allows him/her to 'attend' (focus on or pay attention) to the task at hand. So, in reality, an opposite effect to stimulants is not occuring.
Just though I'd add a couple of cents to the growing pile - Cam
Posted by noa on June 23, 2000, at 17:40:41
In reply to Re: Wellbutrin SR... » Vesper, posted by Cam W. on June 23, 2000, at 10:43:12
Cam, just to jump in on the ritalin/stimulant thing: my understanding is the old "paradoxical" effect idea has been discounted, as you say, and that in fact, lots of people get the same effects from the stimulants that ADD kids do. It supposedly activates cortical functioning, which in ADHD is supposed to be deficient, making it hard to focus, stay attentive, and use thought processes to inhibit impulses or think through multi-step problems, etc. As many of us know from our own experiences, some of these functions are deficient in depression, too, so in addition to potentiating the effects of some ADs, stimulants (and similarly, stimulating meds like wellbutrin) can be helpful for some depressions because they address these processes.
BTW, that non-ADD folks respond to stimulants has led to the general principle that a good response to ritalin, etc. should not be used as a criterion for the diagnosis of ADHD, although this principle is either unkown to or ignored by many pediatricians, I think.
Posted by jacquie on June 23, 2000, at 18:25:19
In reply to Re: Jacquie, posted by Cam W. on June 23, 2000, at 10:27:16
> Cam- thanks again for the info. Well the social anxiety issue is moe related to a sort of fear of people in public places....like huge grocery stores, malls and even on a smaller scale. Also it affects simply meeting people, getting panic like attacks. However, iwould oncur that meaningless conversation could easily cause anxiety. The Wellbutrin has made me bitchy, yes. definately. Where does that come from? I am up at 4am, which is either my depression or the drugs and this adds to being irritated. I am basically avoiding people at the moment...I just about chewed the head off a client today and felt like a total idiot for the rest of the day. Depression, or even underlying depression under meds really doesn't help one always see the world that clearily. I know that being irritable or angry or lashing out is a by product of my depression. We are upp;ing the dose on Sunday to 200mg like I said earlier. I hope this works becasue I don't really want an SSRI although there were many things i liked with Celexa, but definately no interest in sex, easily bruised, awake 3x per night at the same times every single night , but generally had a smile on my face. No more crying, nor obsessive thought....it's alnost enough to make you go back on. The weight gain thing was starting to happen, I hear with Wellbutrin itis the opposite. i should watch that one as I already have lost weight from trying and also from depression. When my depression gets severe I usually drop 15lbs., which I have. I will be okay though. Did you notice any lift in spirit with the Wellbutrin? What made you realize it was working? thanks, Cam.
> jacquie - Wellbutrin relives depressive symptoms differently than the SSRIs (like Celexa). I have been led to believe that OCD symptoms and social anxiety were problems with too little serotonin. Since Wellbutrin is not "supposed" to have very much serotonin action, I don't know how well Wellbutrin would work for compulsive thinking or social anxiety. This is not to say that it may not have some effect in these disorders, it is just that I have not seen Wellbutrin used very much for these conditions.
>
> This is my second trial of Wellbutrin. I had took it for about a year, then stopped. My remission from depression lasted a year or so. I started taking Wellbutrin again late summer or early fall (I'd have to check with my pharmacist). I am going to give it at least a year and now am toying with the idea of staying on it a little longer. I'll have to discuss this with my pdoc. What I like about Wellbutrin is that it does not "bog me down" like the SSRIs did. Also, my it does not inhibit my orgasm (I did not find this a problem with the SSRIs; I had arousal, but was a slow finisher and when/if I did finish, it was explosive). Currently, I am taking 150mg of the SR twice daily and seem to still be in remission from my depression. One thing that I did notice upon starting Wellbutrin is that after I was stablized on a 150mg twice daily dose, about 1 month into therapy I got really bitchy. I would look for things to chew people's heads off. This subsided within 2 weeks. Occationally, I still get irritable, but not like I used to.
>
> Good luck with the therapy and tell me how the Wellbutrin affects compulsive thought and social anxiety. (Social anxiety for me is just that I hate making small talk with people that I do not know in crowd situations. I just find it a pain in the ass to try to carry on a meaningly conversation. I don't know if this is social anxiety or not, but I do get anxious before conventions and meetings, as well as just before speaking).
>
> - Cam
Posted by Noa on June 24, 2000, at 10:39:59
In reply to Re: Wellbutrin SR...question for CAM, posted by Vesper on June 23, 2000, at 0:00:17
Vesper, you sound good.
Posted by ksvt on June 27, 2000, at 17:51:14
In reply to Re: Wellbutrin SR...question for CAM, posted by Cam W. on June 20, 2000, at 11:20:15
> Jacquie - Every time that I lecture to G.P.s this always comes up in the discussion period. I don't know what the percentages are, but I'll bet that they are double-digit for that side effect. Most G.P.s have seen at least one person who does get drowsy from Wellbutrin. I really wonder if these people were taking too high of a dose of Wellbutrin and the dizziness that can occur put them to sleep (just a thought). I have not personally seen someone, who takes Wellbutrin, get drowsy, but I have heard of this first hand from many docs.
>
> Ideosyncratic side effects do happen and sometimes the reasons behind them can be explained. In this case I do not have a good guess, except for the "too highdose/increased drowsiness" thing.
>
> A always say that it better to take the fewest meds possible. If you can, stop your bedtime Ativan, but don't throw it away. The drowsiness side effect may be an initial start-up side effect and can completely disappear within a month. As your body readjusts or responds to the actions of the meds, the insomia may return. Tell your doc when you stop the Ativan, just to let him/her know that you have slightly altered the therapy. Also, tell the doc if you start taking the Ativan again. This just keeps the doc up-to-date with your ingoing treatment.
>
> As for the cramping, Wellbutrin can dehydrate the body, to a minor extent and can cause constipation. Cramping can also occur (usually leg cramps or twitches) when using Wellbutrin. Maybe increase your water your water intake and see if that helps the cramping (ie a couple of extra 8oz glasses a day).
>
> Hope this helps - CamI too just started wellbutrin sr. I have been taking 100 mgs 4xday for a couple of years and its effectiveness diminished of late. I was switched to 150 mg of wellbutrin sr 2xday and 50 mg of zoloft which I have never taken before. I feel variously wired and washed out and my stomach has been pretty upset. Since I've taken so much wellbutrin without real side effects, I don't know whether what I'm experiencing is the zoloft or the wellbutrin sr. Is it possible to react to a drug differently on a timed release basis than you do otherwise? Also my sexual functioning has definitely diminished. I assume this to be the zoloft. Does anyone out there have any suggestions for a good drug to use to augment Wellbutrin that does not have this side effect?
This is the end of the thread.
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