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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by broken on January 12, 2005, at 15:29:47
Hiya,
I've posted here a few times, but very few. I usually can find alot of answers just by looking through older posts, and dont start a new thread.
In any event, my question is this, and the more answers the better. I see a Pdoc, no therapist at the moment. My question is, how do you really know if your meds are working. Stupid question, but I stopped using Wellbutrin earlier this week. I had been on 450mg a day, and the last time I had taken it, several years ago, it caused vivid dreams and/or nightmares. My Pdoc wanted me to give it a try, and I have for 6 months, but the dreams started again, and I can't handle them. I tossed the bottle. Haven't had any in roughly 60 hours now, and I cant tell a difference. It's like, I was taking a placebo or something, nothing has changed. So now, I assume that they haven't helped me a bit, and I wasted 6 months taking them. Then I feel guilty about telling the doc that this stuff did nothing for me. I'd almost rather quit seeing him at all, than say, "This med doesn't work either." I have been down that road alot. Paxil, Zoloft, Prozac, and now Wellbutrin, nothing has worked. I have seen some small results from the effexor I am taking (yes I've read about withdrawal, but dont care about that, if I see any results at all) but nothing else has even been noticeable. I'm stuck, I dont know what to say to him or what to do. Just give up on any hope of med treatment?
Thanks
Posted by mair on January 12, 2005, at 16:27:36
In reply to New here, and could use a bit of help (long), posted by broken on January 12, 2005, at 15:29:47
Hopefully Dr. Bob won't boot you over to the meds board, because I don't think your question is really medication specific. I've been through multiple drug trials, and for me, anyway, Wellbutrin is the first drug I took (after 4 or 5 others) that made a positive difference. But it wasn't overnight by any stretch; I almost wasn't aware that it was working until it suddenly occurred to me one day that I was working more effectively and productively, and not thinking about suicide as much. This may have happened even a couple of months after I started it. I probably kept with it in spite of being aware of specific benefits because for me, the side effects were either non existent or very tolerable and I wasn't falling apart otherwise. I will tell you, and I think others here would confirm this, that for a lot of us, no one drug is sufficient, and even a multi-drug cocktail will only go so far. The people who respond as if these drugs are miracle drugs are probably not hanging around this Board. So for the last several years, I've gone through multiple trials of other drugs to augment the Wellbutrin I take. Maybe no one drug is going to do the trick for you either.
My T is of the opinion that chronic major depression (my dx) requires a lifetime of symptom management. Drugs are a piece and for many of us, therapy is a tool as well. The use of medications is a loaded issue for me, probably minimally because I've tried so many with such unsatisfactory success. I really always hate the idea of trying something new because I don't want to experience yet another failure, and I don't want to feel that I haven't given a particular drug a real shot at working. Therapy actually helps me deal with some of the medication issues, maybe just because I see my T alot more frequently than I see my pdoc. My therapist has the time to review my history with me, and listen to all of my concerns about side effects. I've discovered that it's particularly helpful to have a session where we air out some of these issues before a meeting with my pdoc, because my T can help me formulate the questions I need to be asking my doc.
One thing that I did learn from coming to this Board is that there are tons of med alternatives. My first pdoc did a miserable job of letting me know that, so each drug failure produced this feeling on my part that I was running out of alternatives (and hope). The other thing I learned is that people are very idiosyncratic in the way they respond to medications so one person's miracle drug could be another one's poison. Lastly I've learned that you sort of have to plug along as best you can in the search for a better medical combination. I think finding the right one or ones is more art than science and really can take awhile.
In terms of quitting WB, and feeling the same, I'm not really sure what that means. I actually discovered with a few meds I took that I felt this real sense of euphoria after I went off them. It didn't mean that I was actually better off the drug. Inevitably I'd crash a few weeks later and be reminded of why I was taking the drugs to begin with.
One last thing about WB. Did you try it at smaller doses? The law of diminishing returns seems to apply to this drug. I take 400 mgs, and have taken less at different times. You might find that a lesser dose gives you much the same benefit without the same side effects, although if you really think it's not doing anything positive for you, that may just be academic.
Mair
Posted by broken on January 12, 2005, at 17:03:12
In reply to Re: New here, and could use a bit of help (long) » broken, posted by mair on January 12, 2005, at 16:27:36
Thanks so much for the reply. I really appreciate it. And yes, I was unsure of where to post this, but dealing with the situation was my main question, as opposed to specific medication.
If I remember correctly though, I started at 75mg, and brought up to 450mg. The problem with the dreams is going to determine my actions though. Long story, that I doubt anyone wants to hear, but bottom line is the dreams are very real to me. If it were good stuff, that would be great. If it were dreams about sex, I'd buy a lifetime supply lol.. but it's not. When I was young, my father had a massive heart attack. It's a very long story, suffice it to say it was in our home, and it wasn't a quiet instant death, it was a, it was long. I remember the details very well without the vivid dreams, but with them, it's something I cannot cope with.
I know drugs dont solve problems, they are another tool, but I'm just confused as to where to go next.
Posted by mair on January 12, 2005, at 17:23:35
In reply to Re: New here, and could use a bit of help (long) » mair, posted by broken on January 12, 2005, at 17:03:12
Were the dreams not a part of the landscape until you started taking WB? Did they kick in after you got to a particular level or right from the start?
What an awful thing to have to deal with.
Mair
Posted by broken on January 12, 2005, at 18:48:58
In reply to Re: New here, and could use a bit of help (long) » broken, posted by mair on January 12, 2005, at 17:23:35
> Were the dreams not a part of the landscape until you started taking WB? Did they kick in after you got to a particular level or right from the start?
>
> What an awful thing to have to deal with.
>
> Mair
They've been around off and on since that happened. The first time I was on Wellbutrin I quit taking it for the same reason. I'm talking about dreams that were so clear I would wake up trying to figure out what was real and what wasn't. The weird thing about it this time around was that it took so long before it happened again. I've been on the 450 dose for months now, without any problems, it just kicked in from out of nowhere.
I don't know how common that side effect is, but it was the reason I stopped taking the drug.The idea of trying to figure out what to say to my doc, and the frustration of not seeing improvement actually drives me into something I dont know how to explain. Not depression, it's more hyped up, out of control, and if I dont find a way to relax myself quickly at that point, I just go nuts. That's the only way I can explain it. Doesn't make much sense, but that's how it happens.
Posted by Dinah on January 12, 2005, at 18:52:47
In reply to Re: New here, and could use a bit of help (long) » mair, posted by broken on January 12, 2005, at 18:48:58
Are you sure that's not a Wellbutrin effect? Wellbutrin sent me spinning into an agitated hypomania that nearly killed me. It's a very "activating" drug.
Posted by broken on January 12, 2005, at 20:56:01
In reply to Re: New here, and could use a bit of help (long) » broken, posted by Dinah on January 12, 2005, at 18:52:47
> Are you sure that's not a Wellbutrin effect? Wellbutrin sent me spinning into an agitated hypomania that nearly killed me. It's a very "activating" drug.
No Dinah, I dont know. To be honest, I dont know much of anything right now. Hopefully I'll be learning. Thanks for the reply though
Posted by mair on January 12, 2005, at 21:14:27
In reply to Re: New here, and could use a bit of help (long), posted by broken on January 12, 2005, at 20:56:01
i don't know how long ago you stopped taking WB, but I've always been told that it didn't stick around in your system long enough to be continuing to produce effects after you've quit. Also, it does seem really strange that the dream stuff would arise months after you started taking the WB again. Have the dreams now gone away? Is it possible they were activated by something else altogether, like a life experience?
I can't remember what you said earlier. Do you have an appointment with a pdoc to figure some of this out?
Mair
Posted by broken on January 12, 2005, at 23:35:38
In reply to Re: New here, and could use a bit of help (long) » broken, posted by mair on January 12, 2005, at 21:14:27
> i don't know how long ago you stopped taking WB, but I've always been told that it didn't stick around in your system long enough to be continuing to produce effects after you've quit. Also, it does seem really strange that the dream stuff would arise months after you started taking the WB again. Have the dreams now gone away? Is it possible they were activated by something else altogether, like a life experience?
>
> I can't remember what you said earlier. Do you have an appointment with a pdoc to figure some of this out?
>
> Mair
>
>The dreams may have been triggered by something else entirely, but they were more vivid than normal. I feel pretty confident that the WB was responsible. I didnt have any dreams that I can remember the night after I stopped using the WB, certainly nothing like before.
Yes, I have an appointment to see my Pdoc Monday. It was scheduled for yesterday, but he had to leave town. Again I was just trying to straighten my head out before I saw him.
BTW, thanks again for the response and questions, makes me think about everything also.
Posted by mair on January 13, 2005, at 19:43:56
In reply to Re: New here, and could use a bit of help (long) » mair, posted by broken on January 12, 2005, at 23:35:38
Let me know how your appointment goes. I'd be curious as to what he says about the dreams-WB connection.
Good Luck
Mair
Posted by Broken on January 18, 2005, at 9:06:31
In reply to Re: New here, and could use a bit of help (long) » broken, posted by mair on January 13, 2005, at 19:43:56
> Let me know how your appointment goes. I'd be curious as to what he says about the dreams-WB connection.
>
> Good Luck
>
> MairMair, since you had asked, I wanted to reply about my appointment yesterday. As far as the WB, he said the dreams "were not unheard of while taking WB." Honestly, that was all the attention he gave it, other than scolding me for not tapering off and going cold turkey.
He also labled me as Treatment Resistant, and kept me on the Effexor as well as adding lamictal as a mood stabilizer. Those are the only two drugs I am taking now.
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