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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by ksvt on July 29, 2000, at 16:28:12
I've been taking Wellbutrin for about 4 years or so, most of it at 100 mgs 4x daily. Altho, several people have posted remarks about suffering from anxiety or being too wound up on WB, that was really never an issue for me, at least not consistently. I did take a small amount of Klonopin to help me get to sleep, which always worked quite nicely. A couple of months ago, because I seemed to have really slid, I started augmenting WB with Zoloft. At the same time I, reduced the WB to 300 mgs of Wellbutrin SR. One real big problem with this combination was that I felt very wired alot of the time and started having difficulty getting to sleep and staying asleep. I first went back to regular WB and then eventually eliminated Zoloft. I am now just taking 100 mgs of Wellbutrin 3x daily which is only 75 % of what I've been taking for years. However, I still really struggle to sleep, and the klonopin, even in larger doses, seems much less effective. I am under alot of work related stress right now which may explain some of what's happened, but i don't think it explains all. Is it possible for this to be WB related even though this is a side effect that I never really suffered from at a higher dose. Lack of sleep is a real depression trigger for me. I've been able to ride this wave of little sleep because I have been so busy and since I am pretty wired right now, but I know I really need more than about 41/2 hours of sleep a night, even if that's enough for some people. Any ideas?
Posted by Nibor on July 29, 2000, at 16:44:32
In reply to Any Explanation For This Side Effect?, posted by ksvt on July 29, 2000, at 16:28:12
> I've been taking Wellbutrin for about 4 years or so, most of it at 100 mgs 4x daily. Altho, several people have posted remarks about suffering from anxiety or being too wound up on WB, that was really never an issue for me, at least not consistently. I did take a small amount of Klonopin to help me get to sleep, which always worked quite nicely. A couple of months ago, because I seemed to have really slid, I started augmenting WB with Zoloft. At the same time I, reduced the WB to 300 mgs of Wellbutrin SR. One real big problem with this combination was that I felt very wired alot of the time and started having difficulty getting to sleep and staying asleep. I first went back to regular WB and then eventually eliminated Zoloft. I am now just taking 100 mgs of Wellbutrin 3x daily which is only 75 % of what I've been taking for years. However, I still really struggle to sleep, and the klonopin, even in larger doses, seems much less effective. I am under alot of work related stress right now which may explain some of what's happened, but i don't think it explains all. Is it possible for this to be WB related even though this is a side effect that I never really suffered from at a higher dose. Lack of sleep is a real depression trigger for me. I've been able to ride this wave of little sleep because I have been so busy and since I am pretty wired right now, but I know I really need more than about 41/2 hours of sleep a night, even if that's enough for some people. Any ideas?
I don't know if this will help, because you say you eliminated the zoloft, but for what it's worth--I took zoloft for a couple of months. I couldn't sleep, it made me hyper almost like the diet pills they gave out in the '50s and '60s that were amphetamines. Things got better on paxil. It seems to have a more calming effect on me. Have you ever taken paxil?
Posted by ksvt on July 29, 2000, at 17:01:16
In reply to Re: Any Explanation For This Side Effect?, posted by Nibor on July 29, 2000, at 16:44:32
> > I've been taking Wellbutrin for about 4 years or so, most of it at 100 mgs 4x daily. Altho, several people have posted remarks about suffering from anxiety or being too wound up on WB, that was really never an issue for me, at least not consistently. I did take a small amount of Klonopin to help me get to sleep, which always worked quite nicely. A couple of months ago, because I seemed to have really slid, I started augmenting WB with Zoloft. At the same time I, reduced the WB to 300 mgs of Wellbutrin SR. One real big problem with this combination was that I felt very wired alot of the time and started having difficulty getting to sleep and staying asleep. I first went back to regular WB and then eventually eliminated Zoloft. I am now just taking 100 mgs of Wellbutrin 3x daily which is only 75 % of what I've been taking for years. However, I still really struggle to sleep, and the klonopin, even in larger doses, seems much less effective. I am under alot of work related stress right now which may explain some of what's happened, but i don't think it explains all. Is it possible for this to be WB related even though this is a side effect that I never really suffered from at a higher dose. Lack of sleep is a real depression trigger for me. I've been able to ride this wave of little sleep because I have been so busy and since I am pretty wired right now, but I know I really need more than about 41/2 hours of sleep a night, even if that's enough for some people. Any ideas?
>
> I don't know if this will help, because you say you eliminated the zoloft, but for what it's worth--I took zoloft for a couple of months. I couldn't sleep, it made me hyper almost like the diet pills they gave out in the '50s and '60s that were amphetamines. Things got better on paxil. It seems to have a more calming effect on me. Have you ever taken paxil?Nibor - I have never taken paxil, although I have taken prozac. The SSRIs don't seem to agree with me all that much and the accompanying sexual dysfunction is definitely a drawback. I'm not sure where I go from here - I've decided not to decide anything for a few weeks anyway unless I really crash first. What I can't figure out is why I'm still so hyper when I've supposedly removed the cause. I do feel pretty washed out several times a day, but it's like I get this big second wind as the evening progresses. I used to totally crash by 9:30 or 10:00 and now I'm having a tough time getting to sleep much before 1:00 am, and I frequently wake up between 5:00 and 5:30. I know there will be a heavy price to pay at some point.
Posted by SLS on July 29, 2000, at 18:24:13
In reply to Any Explanation For This Side Effect?, posted by ksvt on July 29, 2000, at 16:28:12
> I've been taking Wellbutrin for about 4 years or so, most of it at 100 mgs 4x daily. Altho, several people have posted remarks about suffering from anxiety or being too wound up on WB, that was really never an issue for me, at least not consistently. I did take a small amount of Klonopin to help me get to sleep, which always worked quite nicely. A couple of months ago, because I seemed to have really slid, I started augmenting WB with Zoloft. At the same time I, reduced the WB to 300 mgs of Wellbutrin SR. One real big problem with this combination was that I felt very wired alot of the time and started having difficulty getting to sleep and staying asleep. I first went back to regular WB and then eventually eliminated Zoloft. I am now just taking 100 mgs of Wellbutrin 3x daily which is only 75 % of what I've been taking for years. However, I still really struggle to sleep, and the klonopin, even in larger doses, seems much less effective. I am under alot of work related stress right now which may explain some of what's happened, but i don't think it explains all. Is it possible for this to be WB related even though this is a side effect that I never really suffered from at a higher dose. Lack of sleep is a real depression trigger for me. I've been able to ride this wave of little sleep because I have been so busy and since I am pretty wired right now, but I know I really need more than about 41/2 hours of sleep a night, even if that's enough for some people. Any ideas?
Perhaps using a sedating antidepressant at bedtime would help with sleep and augment the antidepressant properties of Wellbutrin. Trazodone, Serzone, or Remeron are possibilities. Also, Elavil and Sinequan.
- Scott
Posted by Julie Ann on July 30, 2000, at 0:14:40
In reply to Re: Any Explanation For This Side Effect?, posted by SLS on July 29, 2000, at 18:24:13
I've done a lot of dose changing within my 7 years on ADs. Changes can cause problems. If you go back to where you were before you started experimenting with dosages, at 100mg Wellbutrin, 4x per day, in my opinion, you will feel as you did before you made the changes -- that is, after some days -- your body will need to adjust back to the old dosage. This has been my experience in my many years of experimentation.
If you want to experiment with dosages, and you find you can't sleep, you may want to try Trazadone and Melatonin. These work well for me.
> > I've been taking Wellbutrin for about 4 years or so, most of it at 100 mgs 4x daily. Altho, several people have posted remarks about suffering from anxiety or being too wound up on WB, that was really never an issue for me, at least not consistently. I did take a small amount of Klonopin to help me get to sleep, which always worked quite nicely. A couple of months ago, because I seemed to have really slid, I started augmenting WB with Zoloft. At the same time I, reduced the WB to 300 mgs of Wellbutrin SR. One real big problem with this combination was that I felt very wired alot of the time and started having difficulty getting to sleep and staying asleep. I first went back to regular WB and then eventually eliminated Zoloft. I am now just taking 100 mgs of Wellbutrin 3x daily which is only 75 % of what I've been taking for years. However, I still really struggle to sleep, and the klonopin, even in larger doses, seems much less effective. I am under alot of work related stress right now which may explain some of what's happened, but i don't think it explains all. Is it possible for this to be WB related even though this is a side effect that I never really suffered from at a higher dose. Lack of sleep is a real depression trigger for me. I've been able to ride this wave of little sleep because I have been so busy and since I am pretty wired right now, but I know I really need more than about 41/2 hours of sleep a night, even if that's enough for some people. Any ideas?
>
>
> Perhaps using a sedating antidepressant at bedtime would help with sleep and augment the antidepressant properties of Wellbutrin. Trazodone, Serzone, or Remeron are possibilities. Also, Elavil and Sinequan.
>
>
> - Scott
Posted by Sigolene on July 30, 2000, at 1:20:15
In reply to Any Explanation For This Side Effect?, posted by ksvt on July 29, 2000, at 16:28:12
I had a similar problem with an other AD in the past, i.e after months incapacity of falling asleep. I finally found why. It was due to a lack of Potassium (K)because the AD was decreasing the rate of Potassium.
I've also heard same thing with someone who had anemia also due to AD.
You could check these parameters...
Sigolene.
Posted by paul on July 30, 2000, at 1:31:05
In reply to Any Explanation For This Side Effect?, posted by ksvt on July 29, 2000, at 16:28:12
i'd go back to your old dosage of wb and add serzone. trazodone would be another avenue. i'd advise against melatonin because of the bioactivity issues-you never know what you're getting with any mel supplement regardless of what the manufacturer says. i'm not a huge fan of the FDA but at least with an FDA-approved drug, 5 grains of aspirin is exactly that. without such standards, you never know what you're getting in an unregulated product. thats why i stopped taking it-that and the fact that if i have it right, mel is a serotonin precursor and can mess MAJORLY w/ad effectiveness. any experts welcomr to confirm/deny/correct my possibly very fawlty unnerstanding.
p(c(l))
Posted by JohnB on July 30, 2000, at 3:05:45
In reply to Any Explanation For This Side Effect?, posted by ksvt on July 29, 2000, at 16:28:12
I take Wellbutrin and low dose Remeron before bedtime does the trick.
Posted by caroline on July 30, 2000, at 3:31:36
In reply to Any Explanation For This Side Effect?, posted by ksvt on July 29, 2000, at 16:28:12
I've had a very similar 'wired' and largely sleepless experience on a different AD (Remeron 45mg). I added a Tricylcic AD, Anafranil and it worked. I can sleep 6-8hrs per night now. Anafranil is similar to trazadone in many respects, but I suspect trazadone may have fewer side effects. My advice is to try trazadone at night. My experience suggests it could work for you.
Best of luck!
Caroline
Posted by JohnL on July 30, 2000, at 4:38:32
In reply to Any Explanation For This Side Effect?, posted by ksvt on July 29, 2000, at 16:28:12
Remeron 7.5mg (half the minimum dose) or 15mg will work nicely. It will counter the WB insomnia and potentiate the anti-depressant effect simultaneously.
Some people like Trazodone. I hated it. It's a lot like Serzone.
Tricyclics are good for sleep too. But they come with dry mouth and constipation.
Overall, Remeron has been the best overall for me for a long time. I've tried them all. Your mileage could vary, but I would consider putting Remeron at the top of the list.
John
Posted by ksvt on July 30, 2000, at 21:05:20
In reply to Re: Any Explanation For This Side Effect?, posted by JohnL on July 30, 2000, at 4:38:32
> Remeron 7.5mg (half the minimum dose) or 15mg will work nicely. It will counter the WB insomnia and potentiate the anti-depressant effect simultaneously.
>
> Some people like Trazodone. I hated it. It's a lot like Serzone.
>
> Tricyclics are good for sleep too. But they come with dry mouth and constipation.
>
> Overall, Remeron has been the best overall for me for a long time. I've tried them all. Your mileage could vary, but I would consider putting Remeron at the top of the list.
> John
Several years ago when I started taking alot of meds I took trazadone. It did a good job of helping me get to sleep, but I generally woke up in the middle of the night. I think it also contributed to my pretty much feeling out of it much of the time. Klonopin worked much better, at least until recently. I'll ask my psychiatrist about remeron, altho it seems like alot of people on this site complain about dramatic weight gains. Do you think that's a risk at the lower dosages?
Posted by stjames on August 3, 2000, at 21:52:54
In reply to Any Explanation For This Side Effect?, posted by ksvt on July 29, 2000, at 16:28:12
Hmmm....
Seems to me when you augmented with zoloft you potentiated
something too much and got a side effect of being wired.
You have to be careful augmenting as on med often effects
the way another is metabolized, i.e. much higher levels
of both AD's in your blood, ect. Maybe just a 100 mg lowering of the WB
dose was not enough. How did you feel on this combo
otherwise ?Both these meds have to potential to cause the kind of side effects
you were having so taking both probably made this effect
pronounced in your case.james
Posted by ksvt on August 4, 2000, at 21:40:26
In reply to Re: Any Explanation For This Side Effect?, posted by stjames on August 3, 2000, at 21:52:54
> Hmmm....
>
> Seems to me when you augmented with zoloft you potentiated
> something too much and got a side effect of being wired.
> You have to be careful augmenting as on med often effects
> the way another is metabolized, i.e. much higher levels
> of both AD's in your blood, ect. Maybe just a 100 mg lowering of the WB
> dose was not enough. How did you feel on this combo
> otherwise ?
> james - I think I felt pretty good for the first several days and then got worn down by the fact that I wasn't sleeping. Intermittently I'd feel really wired and then really depressed. I'm trying to work myself beck to where I was biochemically before I tried to augment. It's taking awhile. I'm still awfully easily irritated and not sleeping particularly well altho I've started taking ambien to break out of my current sleeping (or non-sleeping) pattern. It's beyond me how people ever get these multiple meds in the right combinations and the right amounts. There are too many variables, particularly if you add environmental factors in as well. It makes me feel pretty gun-shy about rocking the boat, even when the boat's already rocky.
> Both these meds have to potential to cause the kind of side effects
> you were having so taking both probably made this effect
> pronounced in your case.
>
> james
Posted by JohnB on August 5, 2000, at 1:52:54
In reply to Re: Any Explanation For This Side Effect?, posted by ksvt on August 4, 2000, at 21:40:26
I found it interesting that in Dr. Jensen book, he states that Wellbutrin's molecular structure is similar to "diet pills".
Posted by Cam W. on August 5, 2000, at 6:23:39
In reply to Re: Any Explanation For This Side Effect?, posted by JohnB on August 5, 2000, at 1:52:54
> I found it interesting that in Dr. Jensen book, he states that Wellbutrin's molecular structure is similar to "diet pills".
John - Bupropion's structure is similar to diethylpropion (Tenuate™ - also called amfepramone). - Cam
Posted by JohnB on August 5, 2000, at 16:47:29
In reply to Re: Any Explanation For This Side Effect? » JohnB, posted by Cam W. on August 5, 2000, at 6:23:39
> > I found it interesting that in Dr. Jensen book, he states that Wellbutrin's molecular structure is similar to "diet pills".
>
> John - Bupropion's structure is similar to diethylpropion (Tenuate™ - also called amfepramone). - CamCam- Is Tenuate is a so called "diet pill" ? Sorry, but I haven't heard of it. But I guess I can now understand Well's ability to keep weight down, as well as the dreaded irritability factor.
This is the end of the thread.
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