Psycho-Babble Medication Thread 108296

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No immediate benefit from Wellbutrin?????

Posted by Anyuser on June 1, 2002, at 11:21:49

After a lot of thought and screwing around, I started Wellbutrin SR. I chose the drug after a lot of research on my own & my doctor (who is way into drugs) went along with that choice. I want to believe this drug will help my depression. I understand it will take weeks for the drug to kick in & I am willing to tough out the side effects.

At my first follow-up with my doctor after taking the drug for only two weeks, I told him that beginning the drug was very unpleasant, at first it seemed to worsen the dread and hypochondria the go along with my depression. That wore off after about five days & now the side effects are minimal, but as far as my depression goes I have good days and bad days which I figured was no more than I should expect after only two weeks.

Here's my issue: My doctor said my initial experience indicates that Wellbutrin is not the drug for me and that I should switch to Serzone. He said he can tell from a patient's immediate reaction to an antidepressant whether it will eventually alleviate depression. That advice is contrary to everything I've ever read on the subject, that is, intial side effects fade away and benefits kick in after a few weeks.

This has put me into something of a spin. I am not sure my doctor is giving me good advice, but he has shaken my confidence that I am doing the right thing in Wellbutrin.

Which should I abandon? My doctor or Wellbutrin? Has anybody ever heard of this idea that one's experience in the first days with an antidepressant indicates whether that drug will eventually be effective? I have something of an investment in getting ramped up on this drug and I am inclined to give it four weeks before trying something else. I am also thinking about finding a new doctor if I can't find some corroboration that he knows what he's talking about.

Any advice?

 

Re: No immediate benefit from Wellbutrin?????

Posted by deli on June 1, 2002, at 11:41:42

In reply to No immediate benefit from Wellbutrin?????, posted by Anyuser on June 1, 2002, at 11:21:49

Well I have never heard this from my pdoc. Is your dr a psychiatrist? You really need to be working with a psyc if your are going to be taking meds. General physicians just don't know enough about this meds. I have always been under the impression that you need to give it a good 4 to 6 weeks before you can see therapeutic effects. Otherwise, we would all be doing something else besides being glued to this newsgroup while waiting for our meds to work. I would suggest to get a second opinion from a board certified psychiatrist.
Good luck..
Deli

 

Re: No immediate benefit from Wellbutrin????? » Anyuser

Posted by JohnX2 on June 1, 2002, at 11:51:03

In reply to No immediate benefit from Wellbutrin?????, posted by Anyuser on June 1, 2002, at 11:21:49

> After a lot of thought and screwing around, I started Wellbutrin SR. I chose the drug after a lot of research on my own & my doctor (who is way into drugs) went along with that choice. I want to believe this drug will help my depression. I understand it will take weeks for the drug to kick in & I am willing to tough out the side effects.
>
> At my first follow-up with my doctor after taking the drug for only two weeks, I told him that beginning the drug was very unpleasant, at first it seemed to worsen the dread and hypochondria the go along with my depression. That wore off after about five days & now the side effects are minimal, but as far as my depression goes I have good days and bad days which I figured was no more than I should expect after only two weeks.
>
> Here's my issue: My doctor said my initial experience indicates that Wellbutrin is not the drug for me and that I should switch to Serzone. He said he can tell from a patient's immediate reaction to an antidepressant whether it will eventually alleviate depression. That advice is contrary to everything I've ever read on the subject, that is, intial side effects fade away and benefits kick in after a few weeks.
>
> This has put me into something of a spin. I am not sure my doctor is giving me good advice, but he has shaken my confidence that I am doing the right thing in Wellbutrin.
>
> Which should I abandon? My doctor or Wellbutrin? Has anybody ever heard of this idea that one's experience in the first days with an antidepressant indicates whether that drug will eventually be effective? I have something of an investment in getting ramped up on this drug and I am inclined to give it four weeks before trying something else. I am also thinking about finding a new doctor if I can't find some corroboration that he knows what he's talking about.
>
> Any advice?

As long as the Wellbutrin is not giving you more
racing thoughts of dread, or giving you more
motivatation to act on the dread
(Wellbutrin can be very activating from day1),
or cycling you into more dispair,
I wouldn't be too concerned. I guess this is
a judgement between you and your physician.

The main concern would be that the energizing
part of Wellbutrin may give you more motivation to
act on the dread before the AD effect really kicks
in.

If you and doctor are not worried about above,
I may give the Wellbutrin at least a 4 week trial
(some AD's take upto 8+ weeks).

Good Luck,
John

 

Re: No immediate benefit from Wellbutrin?????

Posted by katekite on June 1, 2002, at 11:55:40

In reply to No immediate benefit from Wellbutrin?????, posted by Anyuser on June 1, 2002, at 11:21:49

Well, he's wrong. Of course sometimes there is a predictive (hey this is great) response to wellbutrin or anything else, many times there's not. Even so, it still most likely takes 5 or 6 weeks for a drug to cause the upregulation/downregulation thought to be responsible for most alleviation of depression. Plus even if you have only a partial response to it after 6 weeks that is an important finding and information to carry around for later: worth waiting it out to find out.

As to switching docs, there seem to be a lot of benefits to this one: he is interested in drugs and he prescribed the first thing you asked for. So he is willing to work with you. That can be hard to find in itself.

Find out if he will work with you. Tell him you want to give it the 6 weeks you think it deserves before switching.

My pdoc is excellent: he says, "there's no way to predict response to any drug and drugs always need to be tried for at least 6 weeks to see what effects they have... I don't do that much here, its a crapshoot".

kate

 

Re: No immediate benefit from Wellbutrin????? » Anyuser

Posted by terra miller on June 1, 2002, at 20:17:41

In reply to No immediate benefit from Wellbutrin?????, posted by Anyuser on June 1, 2002, at 11:21:49

it took 6 weeks for me to notice affects, after a determined 4-6 weeks of somewhat miserable side-effects, which also calmed down at about the 6 week mark.

after 6 weeks what i noticed was energy- energy to get up in the morning (felt more like "jump out of bed") which really helped me move through my days well. this is helpful if your depression has you so that you can't get out of the bed in the morning and basically dread all through the day. but i didn't notice the peaceful calming affect until about 6 months. all of a sudden things were different; really different. and that has stayed.

i have also tried serzone and liked it a lot. but i think that you should give any AD a fighting chance to see if it is right for you. i do not know how you can tell in just 2 weeks. in 2 weeks all i felt was side-effects from adjusting to taking it.

terra

 

Thanks for the comments (nm)

Posted by Anyuser on June 2, 2002, at 12:23:01

In reply to No immediate benefit from Wellbutrin?????, posted by Anyuser on June 1, 2002, at 11:21:49


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