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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Peter on July 10, 2001, at 3:02:22
Hello all. I've been on various combinations of meds for about 5 years. I used to take only paxil, but I found that it was contributing to mania and drug/alcohol cravings/abuse (my doctor told me that my dopamine was reduced as a result of my seratonin increase, causing cravings). I was soon afterwards diagnosed as bipolar and put on 875 mg depakote daily. I also have a history of panic and anxiety and was perscribed klonopin - I am now down to 1 mg daily (used to take up to 2mg). In spite of all these meds, something still seems not right. My social phobia still exists as well as obsessive thoughts (indecisiveness, dwelling over a small issue or decision obsessively), and mixed states of depression and generalized anxiety. I often just don't want to face the day and I sit at home, isolating, lacking motivation, and guilty that I'm not doing anything. My doctor just prescribed me Wellbutrin as an alternative anti-depressant; is anyone on these 3 drugs (dep., klon., Well.)? Does anyone have experience with the Wellbutrin helping with any of my above problems? I'd love to hear yes as the answer, but of course I would like to hear honest opinions. Thanks.
Posted by SalArmy4me on July 10, 2001, at 3:23:09
In reply to Depakote, Klonopin, Wellbutrin, posted by Peter on July 10, 2001, at 3:02:22
Wellbutrin appears effective in anxiety and depression, according to one report: Goldberg, Richard J. FAPA MD. Diagnostic Dilemmas Presented by Patients With Anxiety and Depression. American Journal of Medicine. 98(3):278-284, March 1995.
Though Wellbutrin wouldn't be my first choice for your case, it does have the best record for _not_ inducing mania in bipolars.
Posted by sl on July 10, 2001, at 11:10:12
In reply to Depakote, Klonopin, Wellbutrin, posted by Peter on July 10, 2001, at 3:02:22
I'm not Bipolar, I just have depression and anxiety, but I took Wellbutrin for 4-5 years with very good results. (I went off it cuz it started losing effectiveness after that long.) I will probably go back on it when I see a dr in a week, and I was contemplating asking to add Klonopin for the leftover anxiety and agitation.
Wellbutrin is very stimulating, I think that's where most people have problems with it. It could make you feel buzzy, give you headaches, twitchiness, agitated....BUT it can also make you feel normal, like it did for me. It was the first time I felt normal in my life. I had energy, motivation...I had a future. When I'm down there's no future, only past mistakes. That's why I'm going back on it. Even at reduced efficacy, it's better than what i'm on now.
Luck...
sl
Posted by v on July 12, 2001, at 8:41:02
In reply to Depakote, Klonopin, Wellbutrin, posted by Peter on July 10, 2001, at 3:02:22
wellbutrin was recently added to my cocktail (concerta/effexor/valium) as i have very similar symptoms regarding what you stated below... unfortunately the wellbutrin has not worked for me, although that doesn't mean it won't work for you...
i've become somewhat more agitated & EXTREMELY stupid... my cognitive function (more like dysfunction) is scary and it hasn't helped me in my inabilty to live, although i am, at times, somewhat more productive since i'm also more "stimulated"... i also still have the tendency to just sit there.. and sit there... and sit there... frozen in inactivity & indecision
i'm finding just writing this to be extremely difficult - hard to put my thought in order - and i'm used to being fairly literate at expressing myself... i can't tell you the number of posts i've tried to write lately, only to give up in disgust, embarrassment or just plain fear of reaching out...
sorry this is so long... obviously, i have my own post to write asking for help but i'm making myself send this since you've asked as well as the need to just start somewhere
i hope you get the relief you deserve... good luck
v> My social phobia still exists as well as obsessive thoughts (indecisiveness, dwelling over a small issue or decision obsessively), and mixed states of depression and generalized anxiety. I often just don't want to face the day and I sit at home, isolating, lacking motivation, and guilty that I'm not doing anything.
Posted by Mitch on July 12, 2001, at 9:30:53
In reply to Depakote, Klonopin, Wellbutrin, posted by Peter on July 10, 2001, at 3:02:22
Peter,
You have the same sort of troubles as I do-BPII and social anxiety. I have been on Depakote+Klonopin+Celexa (which didn't work too hot) but not Wellbutrin. I *did* try Wellbutrin last year but with +Neurontin+Klonopin. It worked fairly well, I was pretty depressed (very anergic and tired) and it helped with that. It did seem that the WB helped with the social anx. I could get out in my yard and work on the weekends when everybody else was without thinking much about it. The Klonopin seems to help more with talking situations with others, though. I found the WB more like a stimulant than an antidepressant. Which probably is why it tends to trigger less cycling. Let me know how this works out, OK? I may have to go back to Dep. (I can't tolerate higher doses of Neurontin-so it is only partially stabilizing my mood).
Mitch
I wonder if the Wellbutrin would counter the weight gain from the Dep.?
> Hello all. I've been on various combinations of meds for about 5 years. I used to take only paxil, but I found that it was contributing to mania and drug/alcohol cravings/abuse (my doctor told me that my dopamine was reduced as a result of my seratonin increase, causing cravings). I was soon afterwards diagnosed as bipolar and put on 875 mg depakote daily. I also have a history of panic and anxiety and was perscribed klonopin - I am now down to 1 mg daily (used to take up to 2mg). In spite of all these meds, something still seems not right. My social phobia still exists as well as obsessive thoughts (indecisiveness, dwelling over a small issue or decision obsessively), and mixed states of depression and generalized anxiety. I often just don't want to face the day and I sit at home, isolating, lacking motivation, and guilty that I'm not doing anything. My doctor just prescribed me Wellbutrin as an alternative anti-depressant; is anyone on these 3 drugs (dep., klon., Well.)? Does anyone have experience with the Wellbutrin helping with any of my above problems? I'd love to hear yes as the answer, but of course I would like to hear honest opinions. Thanks.
Posted by Peter on July 12, 2001, at 12:15:04
In reply to Re: Depakote, Klonopin, Wellbutrin, posted by v on July 12, 2001, at 8:41:02
> wellbutrin was recently added to my cocktail (concerta/effexor/valium) as i have very similar symptoms regarding what you stated below... unfortunately the wellbutrin has not worked for me, although that doesn't mean it won't work for you...
>
> i've become somewhat more agitated & EXTREMELY stupid... my cognitive function (more like dysfunction) is scary and it hasn't helped me in my inabilty to live, although i am, at times, somewhat more productive since i'm also more "stimulated"... i also still have the tendency to just sit there.. and sit there... and sit there... frozen in inactivity & indecision
>
> i'm finding just writing this to be extremely difficult - hard to put my thought in order - and i'm used to being fairly literate at expressing myself... i can't tell you the number of posts i've tried to write lately, only to give up in disgust, embarrassment or just plain fear of reaching out...
>
> sorry this is so long... obviously, i have my own post to write asking for help but i'm making myself send this since you've asked as well as the need to just start somewhere
>
> i hope you get the relief you deserve... good luck
> v
Thanks for your follow-up, v. I can relate to you on a number of counts. Firstly, the whole "frozen in inactivity and indecision" thing has been extremely prevalent with me. But it has not been so much the result of Wellbutrin as a problem I've had for years - I can just sit indoors and not be able to decide what I want to do and feel guilty for not knowing what to do and for the fact that I can't get myself to go outside. It just builds on itself until eventually I reach this paralyzed depressed state and I end up not doing anything. I'm wondering if it has been a direct result of Wellbutrin for you or has it been present in your life during the pre-Wellbutrin times? When did you start the Wellbutrin? I've heard from many that sometimes it takes a while for the side-effects to wear off and, when they do, it can be a very effective drug to counteract such symptoms as you describe. Also, what was your starting dose - some people experience alot more intense side-effects if they jump on at 300 mg instead of, let's say, gradually increasing from 100 mg. Finally, have you considered that maybe the combination of Wellbutrin with your other meds might be causing these bad effects (including the inability to put your thoughts in order) as opposed to the Wellbutrin itself? Have you spoken to your doc about it? Sorry for all these questions but I've been there; I appreciate your response to my last message, and I wish you the best of luck figuring things out and feeling better.
Posted by Peter on July 12, 2001, at 12:24:32
In reply to Re: Depakote, Klonopin, Wellbutrin » Peter, posted by Mitch on July 12, 2001, at 9:30:53
> Peter,
>
> You have the same sort of troubles as I do-BPII and social anxiety. I have been on Depakote+Klonopin+Celexa (which didn't work too hot) but not Wellbutrin. I *did* try Wellbutrin last year but with +Neurontin+Klonopin. It worked fairly well, I was pretty depressed (very anergic and tired) and it helped with that. It did seem that the WB helped with the social anx. I could get out in my yard and work on the weekends when everybody else was without thinking much about it. The Klonopin seems to help more with talking situations with others, though. I found the WB more like a stimulant than an antidepressant. Which probably is why it tends to trigger less cycling. Let me know how this works out, OK? I may have to go back to Dep. (I can't tolerate higher doses of Neurontin-so it is only partially stabilizing my mood).
>
> Mitch
>
> I wonder if the Wellbutrin would counter the weight gain from the Dep.?
> Hi Mitch - thanks for the follow-up. I'm encouraged to hear that Wellbutrin helped, instead of exacerbated, your social anxiety. I'm looking forward to baing able to go out more and do stuff without being so overly self-conscious. Also, I'm curious to know about the Wellbutrin counteracting Depakote weight gain. I've heard from so many people that they lost weight on Wellbutrin. Finally, I just wanted to ask you about klonopin. How long have you been taking it and what daily dose? The reason I ask is I have been on it for about 3 years. When I began it it did wonders for my social phobia - especially in talking situations like you said. But since then it began to make me more tired, spacey, and "inward," so I had to reduce the dose. I used to take up to 2 mg per day and now I only take .25 during the day to take the edge off without making me spacey and .5 at night to help me sleep. I'm curious if you've maintained the social-phobia benefits of klonopin and how?
Posted by Mitch on July 12, 2001, at 13:13:51
In reply to Re: Depakote, Klonopin, Wellbutrin, posted by Peter on July 12, 2001, at 12:24:32
> > Hi Mitch - thanks for the follow-up. I'm encouraged to hear that Wellbutrin helped, instead of exacerbated, your social anxiety. I'm looking forward to baing able to go out more and do stuff without being so overly self-conscious. Also, I'm curious to know about the Wellbutrin counteracting Depakote weight gain. I've heard from so many people that they lost weight on Wellbutrin. Finally, I just wanted to ask you about klonopin. How long have you been taking it and what daily dose? The reason I ask is I have been on it for about 3 years. When I began it it did wonders for my social phobia - especially in talking situations like you said. But since then it began to make me more tired, spacey, and "inward," so I had to reduce the dose. I used to take up to 2 mg per day and now I only take .25 during the day to take the edge off without making me spacey and .5 at night to help me sleep. I'm curious if you've maintained the social-phobia benefits of klonopin and how?
Peter,
I started off with 1.0 mg/day and I have been up to 1.5mg/day, and now *back* to 1.0mg/day off and on (mostly on) for the last three years like yourself. Yes, I did notice the pronounced pro-social effect it had right off when I started it, it is still with me I just don't notice the difference as much (because I am used to it). I have not had any full-blown panic attacks while I have been on it-so that's good enough reason for me to continue it.I think what is happenening to you (as far as being tired and unmotivated) is your Depakote dosage. I *never* got much of an AD effect from Dep. I *do* with Neurontin, however (at lower doses). 875mgs is actually quite a lot if you haven't ever had a full-blown manic episode. I have heard people bitch a lot here about 750mg. I never needed more than 500mg/day to keep hypomania away. This is just a hunch..but what if you could swap out some Depakote for some Neurontin instead and see if it helps (of course with the *same* Klonopin/Wellbutrin dose)?? I found 600/day of Neurontin really helped the SP and 300/day has an AD effect for me. However if I went 900mg+ I got tired and sleepy.
Depakote may be *potentiating* the *unwanted* side-effects of your Klonopin, so you may have went down with the Klonopin (to "wakeup") and your SP got worse.
My bottom line-get the Depakote dose down some, and perhaps the Klonopin back up a little. Try the Wellbutrin with it and see how it goes. I have heard that Wellbutrin can really kill your appetite (I noticed that too), while we know how HUNGRY you can get on dep. It might work ok.
good luck
Mitch
Posted by v on July 13, 2001, at 6:26:46
In reply to Re: Depakote, Klonopin, Wellbutrin, posted by Peter on July 12, 2001, at 12:15:04
hi peter...thank you for your reply
actually the whole frozen thing has been a major depressive symptom of mine off and on my whole life.. what i meant was that the wellbutrin doesn't seem to alleviate it... nor help much with getting me out of the house more than i have to
i started at 150mg and was supposed to go to 300mg after 4 days - that proved to be way too much too soon - particularly, i think, because of the other meds i'm already on... i've actually tried wellbutrin before... a number of years ago when it was relatively new but i took it by itself... it didn't seem to do much to me except i had "word finding" difficulty & said words wrong or used them inappropriately... it didn't agitate me then either but i'm sure that's a result of now taking it with concerta... and actually the agitation is better as time goes by - probably because i am more used to it and am adjusting so i'm sure what you said about side effects is somewhat true... i don't know if the cognitive effects will lessen though.. i have to be very vigilent to keep my mind focused... the problem with that, obviously, is that the more exhausting i find the world, the less inclined i am to participate in it
i was hoping for a better result this time, particularly as it doesn't carry the weight gain issue, and am considering tapering down on the effexor hoping that may be the "stupid" culprit in the cocktail - i believe i've seen both blamed for cognitive problems so maybe it's the combination...
i have also been trying to get pdoc to give me klonopin instead of the valium... hopefully he'll relent next time
so obviously i am not giving up on the wellbutrin yet... i think there is alot of tweaking i can do
BTW, how are you feeling?
this is your post... and i am as curious and hopeful about you as you seem to be about me.. :)blessings,
v
> Thanks for your follow-up, v. I can relate to you on a number of counts. Firstly, the whole "frozen in inactivity and indecision" thing has been extremely prevalent with me. But it has not been so much the result of Wellbutrin as a problem I've had for years - I can just sit indoors and not be able to decide what I want to do and feel guilty for not knowing what to do and for the fact that I can't get myself to go outside. It just builds on itself until eventually I reach this paralyzed depressed state and I end up not doing anything. I'm wondering if it has been a direct result of Wellbutrin for you or has it been present in your life during the pre-Wellbutrin times? When did you start the Wellbutrin? I've heard from many that sometimes it takes a while for the side-effects to wear off and, when they do, it can be a very effective drug to counteract such symptoms as you describe. Also, what was your starting dose - some people experience alot more intense side-effects if they jump on at 300 mg instead of, let's say, gradually increasing from 100 mg. Finally, have you considered that maybe the combination of Wellbutrin with your other meds might be causing these bad effects (including the inability to put your thoughts in order) as opposed to the Wellbutrin itself? Have you spoken to your doc about it? Sorry for all these questions but I've been there; I appreciate your response to my last message, and I wish you the best of luck figuring things out and feeling better.
This is the end of the thread.
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