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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Simcha on December 18, 2003, at 0:27:54
Hi,
It's been a long time since I posted anything here. I've been in remission from MDD for about three years. Everything was going swimmingly with my mix of meds:
40mg Celexa (am)
200mg Wellbutrin SR (am)
600mg Neurontin (pm)Then for the past month or so depression has crept back into the picture. I slept the entire weekend. I called in sick on Monday because I woke up too late to make it to work and I was too depressed to go. I have not been eating regularly. (Just not hungry, this is not like me.)
It's the same old familiar depression. I went to work on Tuesday. It took all the energy I had. I went to my therapy appointment on Tuesday and my therapist told me to see my p-doc.
I called in sick today. I went to see the p-doc and now he's switching me to WellbutrinXL 300mg.
I'm going to Chicago on Saturday for a week to visit family. My p-doc is not thrilled that I'm going out of town while needing a med change. He said that I must see him on my return so that we can evaluate more.
This makes me so angry. I thought that I had this depression thing licked. I also thought that this was "The Holiday Blues." Well, it isn't so...
I have too much at stake. I'm a full-time grad student. I'm working full-time. I'm also dating someone. I'm used to being highly functional. I hate being back to my old self.
I'm feeling alone in this. I decided to come here because I know that some of you understand what this is like.
Has anyone else been stabilized for years only to see depression come back? I hate med changes. I feel like I'm starting over....
(Ok, I'm feeling sorry for myself and I'd like some support.)
Well, I start the new formulation of Wellbutrin tomorrow with the increased dosage. I hope it works and does not make me crazy. Other med changes in the beginning sent me for many loops. Again, I have too much at stake now to lose it...
Simcha :-(
Posted by zenhussy on December 18, 2003, at 0:52:25
In reply to Depressed, p-doc changed dosage, posted by Simcha on December 18, 2003, at 0:27:54
Welcome back Simcha,
Sorry things are as they are.
I'm very fragmented at the moment so I'll address the thing that jumped out at me from your post.
I was on 200 wb sr and 75 wb regular daily.
In October? November? Switched to 300 mg wb xl. Smooth. No major appetite problems like earlier changes of wb I went through.
Avoid caffeine if you don't already. Or at least lower it for beginning of switch.
Of all the wb I've been on over the years (I think I've taken every generic, patent, regular release, sustained release, and now eXtended reLief) this new one has felt the smoothest to me in my body and mind sense of the drug.
Hope this helps somewhat.
Take care and post away until you find what you need.
zenhussy
Posted by Simcha on December 18, 2003, at 1:17:08
In reply to Re: Depressed, p-doc changed dosage » Simcha, posted by zenhussy on December 18, 2003, at 0:52:25
Zenhussy,
Thanks for the response. It's good to be among friends who understand.
Thanks for sharing your experience with switching to XL. I hope that it goes as smoothly for me as it did for you. If it doesn't the psychiatrist mentioned something about switching Celexa 40mg for 20mg of Lexapro saying that it would be like a higher dose of Celexa.
The reason he upped the Wellbutrin was because of the lack of motivation and the inability to stay awake for long periods of time.
It seems like it makes sense. We'll see.
Posted by linkadge on December 18, 2003, at 9:26:52
In reply to Depressed, p-doc changed dosage, posted by Simcha on December 18, 2003, at 0:27:54
A full time grad student and have a full time job?? You may have experienced the post exam cortisol crash. This is when you are exposed to a high level of stress hormone for a while, and then it just dissapears (after exams) you can crash very quickly, and its very common.
Seems like you have a lot on your plate. You may be burning yourself out with the demands you are putting on yourself. A full time student and have a full time job ? This is insane, don't you think ??
Linkadge
Posted by Simcha on December 18, 2003, at 22:28:03
In reply to Re: Depressed, p-doc changed dosage, posted by linkadge on December 18, 2003, at 9:26:52
Linkadge,
Yeah, it's a bit nuts.. For the first time in my life I had three years free of depression. I guess I wanted to make up for lost time. I'll be re-evaluating my schedule.
Also,
I don't know if this is a placebo effect or a combination of real med action and two sick days... but I'm feeling a bit better today. I started the 300mg of the XL formulation. The only side effect I noticed was a heavy sweat at about 2pm. I took my dose at about 8am.
Simcha
> A full time grad student and have a full time job?? You may have experienced the post exam cortisol crash. This is when you are exposed to a high level of stress hormone for a while, and then it just dissapears (after exams) you can crash very quickly, and its very common.
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> Seems like you have a lot on your plate. You may be burning yourself out with the demands you are putting on yourself. A full time student and have a full time job ? This is insane, don't you think ??
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> Linkadge
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Posted by zenhussy on December 19, 2003, at 0:07:23
In reply to Re: Depressed, p-doc changed dosage » linkadge, posted by Simcha on December 18, 2003, at 22:28:03
> Yeah, it's a bit nuts.. For the first time in my life I had three years free of depression. I guess I wanted to make up for lost time. I'll be re-evaluating my schedule.
> Also,
> I don't know if this is a placebo effect or a combination of real med action and two sick days... but I'm feeling a bit better today. I started the 300mg of the XL formulation. The only side effect I noticed was a heavy sweat at about 2pm. I took my dose at about 8am.
> Simcha
Simcha,Now where in my head have I gotten the idea that you've mentioned the Bay Area as being the reason for full time work along with this grad school thing?
31-34 depression free. Sounds heavenly. What a crappy blow to have it come roaring back. I do so hope you and your pdoc are able to get the meds worked out for your travels. What do you have on hand to handle insomnia or anxiety if those are issues? I'd be making damn sure my pdoc had me loaded up with meds before going home to the family stead. I was without one med this past summer and my choice of replacement wasn't wise but it worked.
I understand the part about feeling like you're starting over as well. I'm just adding a mood stabilizer to my cocktail which is a whole new ball of wax for me to contend with. I felt like years of subtle ups or down with the wellbutrin or benzo tweaks were enough. Now I feel like some lab rat hopped up on goofballs.
I have always had some internal thermostat problem while on wellbutrin--any formulation, any manufacturer. I sweat heavily on this medication and have just learned to live with it somewhat. It isn't as bad as when I first started taking it. The times you mention seem to mirror the chart the pharm. reps give to the doctors to shove this stuff on us. I do recall about six hours sounding right for the 'coming on' of wellbutrin xl.
My 'I'm not a doctor but I'll play one on PB' opinion is that you could be nervous about upcoming travels home, the new meds and new dosages you're at, and the sick days all are playing into everything.
Keep breathing and yeah, you're amongst people who know what you're talking about. You don't have to stay here ya know. Your depression can lift and you can go back to not posting. We hope and pray for that for everyone on these boards. I mean who would want to deal with our diseases??
You take care and have safe travels. Post if you're able to when you return.
zh
p.s. please tell me you're not seeing a pdoc who went to school at 'the farm'.....
Posted by Simcha on December 19, 2003, at 7:55:24
In reply to Re: Depressed, p-doc changed dosage » Simcha, posted by zenhussy on December 19, 2003, at 0:07:23
Zenhussy,
> p.s. please tell me you're not seeing a pdoc who went to school at 'the farm'.....
Hmm... Not sure where 'the farm' is.... ;-)
I'm awake. I've been awake since 4am. I did not sleep very well last night. I guess that the increase in Wellbutrin may be part of it. Of course, my asthma is bad now too so my lungs hurt...
The only thing I have for sleep or anxiety is Neurontin. It seems to do the job. Or, rather it has until this increase in Wellbutrin. Perhaps this side effect will fade as my system adjusts. It was my first day on the new dosage.
I'm going to work today. I need to go. I need the money. You are right that I live in the Bay Area now and the loans don't cut it here. Work is a necessity. If I could get another job where I earn a bit more per hour I could cut back on hours.... Then again the economy here is really bad and I'm one of the lucky ones with a job.
Tonight I'll go to spend the night at the boyfriend's place up in Napa. I will drive to SFO in the morning and I'll be flying to Chicago (where I'm originally from) in the afternoon. I'll arrive in Chicago about 8pm their time (6pm my time). I hope that I'll be tired enough to sleep tonight. It's a a big day tomorrow...
I'll write when I get back.
Blessings,
Simcha
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