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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 ralphrogers on May 27, 2011, at 20:05:02
Hello fellows,
I was just wondering what could help smoothing off the edge that bupropion is giving me. It's been great, but the anxiety and feeling of being "on" all the time makes socializing specially discomforting (I sense that people feel anxious around me). And it's been depressing me over time.
I tried citalopram, but SSRIs always kill my feelings and I end up behaving like a vegetable. A carrot, most probably.
Hope you're all doing fine.
Ralph
Posted by ralphrogers on May 27, 2011, at 20:10:15
In reply to Bupropion plus what?, posted by ralphrogers on May 27, 2011, at 20:05:02
I thought about Mirtazapine, Buspar or maybe some other atypical AD. I wonder however whether some serotonergic agonism (any sort) wouldn't be required in order to balance bupropion.
Would you share some experience?
Thanks
Ralph
> Hello fellows,
>
> I was just wondering what could help smoothing off the edge that bupropion is giving me. It's been great, but the anxiety and feeling of being "on" all the time makes socializing specially discomforting (I sense that people feel anxious around me). And it's been depressing me over time.
>
> I tried citalopram, but SSRIs always kill my feelings and I end up behaving like a vegetable. A carrot, most probably.
>
> Hope you're all doing fine.
>
> Ralph
Posted by Christ_empowered on May 27, 2011, at 21:25:46
In reply to Re: Bupropion plus what?, posted by ralphrogers on May 27, 2011, at 20:10:15
I would think a tranquilizer--benzo or neuroleptic--would be the fastest and easiest way to go. I'm not a doc,though.
Posted by SLS on May 28, 2011, at 5:34:09
In reply to Bupropion plus what?, posted by ralphrogers on May 27, 2011, at 20:05:02
> Hello fellows,
>
> I was just wondering what could help smoothing off the edge that bupropion is giving me. It's been great, but the anxiety and feeling of being "on" all the time makes socializing specially discomforting (I sense that people feel anxious around me). And it's been depressing me over time.
>
> I tried citalopram, but SSRIs always kill my feelings and I end up behaving like a vegetable. A carrot, most probably.
>
> Hope you're all doing fine.
>
> Ralph
Buspar is an interesting choice. It might fit the bill very nicely.Are you happy with the antidepressant effect bupropion is providing you, or is there some residual depression? If depression is still a problem, Pristiq could help with both the anxiety and depression. If not, and you wish to stay away from benzodiazepines, some people prefer small dosages of Seroquel. It is impossible to guarantee anything except that the procedure to find an effective treatment involves trial-and-error. My guess is that determining the right antidepressant for an individual will be a more precise process involving assaying gene activity, possibly through using micrarrays, or perhaps using various substances as biological probes and PET scans.
You'll get there. Just keep at it.
- Scott
Posted by Peter Heuer on May 28, 2011, at 11:07:56
In reply to Bupropion plus what?, posted by ralphrogers on May 27, 2011, at 20:05:02
Hi Ralph,
I'm quite happy with my combo of bupropion and mirtazapine.
I'm also on pregabalin, buspirone and flupentixol.Best regards,
Peter HeuerWellbutrin XL 150 mg
Remeron 45 mg
Lyrica 100 mg
Buspar 20 mg
Fluanxol 1 mg
Posted by Phillipa on May 28, 2011, at 11:10:54
In reply to Re: Bupropion plus what?, posted by Peter Heuer on May 28, 2011, at 11:07:56
Any reason stimulant type ad's work well for some and others the anxiety is too much? Phillipa
Posted by ralphrogers on May 28, 2011, at 12:49:59
In reply to Re: Bupropion plus what? » ralphrogers, posted by SLS on May 28, 2011, at 5:34:09
Hi Scott,
Bupropion took me from a deep limbo state and brought me to a place where I could recognize myself again. I don't think that there are residual symptoms, but occasionally the anxiety it causes brings back some depressive feelings.
I'm concerned about something. Even though I use a microdose of bup (1/8 of a 150 mg SR pill), my face gets reddish (like vasodilation, not skin surface) and skin really dries out after some 30 mins I take it. Last night I had a tiny red spot in my chest skin that was itching. Sometimes I feel my scalp kind of tingling shortly after I take the drug. I'm really hoping this is no allergic/rash reaction. I wonder if it's dangerous to keep taking it if no major allergic reactions develop.
Depending on how this issue progresses I'll discuss some add on or a new drug with Dr.
Your comments about using additional tools for treatment are interesting. I do think drug selection could be much easier and quicker if additional details (maybe even holistic approach) of a patient condition were considered. I often think that maybe lots of people settle down with a poor drug combination or no drug at all because they can't bear enduring a long drug trial.
Thanks a lot and stay well
Ralph
> Buspar is an interesting choice. It might fit the bill very nicely.
>
> Are you happy with the antidepressant effect bupropion is providing you, or is there some residual depression? If depression is still a problem, Pristiq could help with both the anxiety and depression. If not, and you wish to stay away from benzodiazepines, some people prefer small dosages of Seroquel. It is impossible to guarantee anything except that the procedure to find an effective treatment involves trial-and-error. My guess is that determining the right antidepressant for an individual will be a more precise process involving assaying gene activity, possibly through using micrarrays, or perhaps using various substances as biological probes and PET scans.
>
> You'll get there. Just keep at it.
>
>
> - Scott
Posted by ralphrogers on May 28, 2011, at 12:57:18
In reply to Re: Bupropion plus what?, posted by Peter Heuer on May 28, 2011, at 11:07:56
Hi Peter,
I've heard good things about this bupropion - mirtazapine combo. It must be quite powerful.
I'm monitoring a possible rash issue with Bupropion. If it doesn't progress, I'll consider trying this.
Thank you
Ralph
> Hi Ralph,
>
> I'm quite happy with my combo of bupropion and mirtazapine.
> I'm also on pregabalin, buspirone and flupentixol.
>
> Best regards,
> Peter Heuer
>
> Wellbutrin XL 150 mg
> Remeron 45 mg
> Lyrica 100 mg
> Buspar 20 mg
> Fluanxol 1 mg
Posted by jono_in_adelaide on May 30, 2011, at 20:04:50
In reply to Bupropion plus what?, posted by ralphrogers on May 27, 2011, at 20:05:02
Two options - one would be to add an SSRI such as Zoloft, which would boost the antidepressant effect and also help anxiety, the other would be to add a straight anti anxiety med, for example Buspar, Valium or Atarax.
Benzos like Valium can be habit forming in long term use, so should probably not be a first choice, I'd go either the SSRI or a non habit forming anti anxiety compound like Buspar or Atarax.
This is the end of the thread.
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