Psycho-Babble Medication Thread 10786

Shown: posts 1 to 25 of 33. This is the beginning of the thread.

 

Wellbutrin

Posted by Andrew on August 29, 1999, at 13:53:18

I've just been prescribed Wellbutrin by my doctor,
and after looking at the literature, I've discovered
he's got me on half the recommended starting dose.
I'm only on 75 mg/day, and by the fourth day you
are supposed to go to 300 mg/day.

Anyone know why my doc would prescribe a lower dosage?
I am on other meds, but nothing that interacts w/the
Wellbutrin that I know of.

 

Re: Wellbutrin

Posted by yardena on August 29, 1999, at 16:17:09

In reply to Wellbutrin, posted by Andrew on August 29, 1999, at 13:53:18

The drug manufacturers often recommend starting doses, but that doesn't mean they are right for everyone. I think it is best to be conservative when starting a new med, to get a sense of how your body reacts. Also, ALL medicines interact in some way, even if not listed officially as interacting. Your liver can only metabolize just so much at a time, so the effect of any one medicine on you can be amplified by others. Be patient, 4 days is just the beginning. Good Luck.

 

Re: Wellbutrin

Posted by Pat on August 29, 1999, at 18:05:43

In reply to Re: Wellbutrin, posted by yardena on August 29, 1999, at 16:17:09

My doc started me on 100mg of Wellbutrin SR a day, and he's leaving me that way for six weeks. I have had real bad experience with ad's and their awful side effects. This time, we're starting real, real slow and giving my body time to adjust. So far, it seems to be helping cause I've been on Wellbutrin for 2 1/2 weeks and that's longer than most other AD's I've been on. Let me know how you are doing with it.

 

Re: Wellbutrin

Posted by Barb on August 30, 1999, at 12:34:25

In reply to Re: Wellbutrin, posted by Pat on August 29, 1999, at 18:05:43

I cant imagine NOT starting on a lower dose and then increasing in a few days or even a week. It would seem safe to say that any AD use is not natural even though the need for them is related to a seemingly unnatural chemical imbalance. The side effects are a normal response to the body reacting to higher levels of serotonin, norepinephrine, dopamine, etc.

I have now been off Zoloft since 7/30 and on Wellbuttin for 4 weeks. I switched, after months of deliberation, for the very reason so many people are fed up with AD,s: WEIGHT GAIN. I hadn't gained as much as many, yet, but being a very active person with a regular exercise lifestyle, I was VERY disturbed to be steadily gaining at least 1.5 lbs each month while living a healthy, active life.

I am thrilled to report that I have adusted to the NEW set of side effects Wellbtrin presents, instead of the ones I experienced with Zoloft, and have LOST 12 POUNDS!!! That includes the weight in MUSCLE I surely have gained by getting back to some resistance training 2-3 days a week. My favorite sport these days is roller blading (UP hills, and down in a controlled, "slalom" fashion) as often as possible. (And do I have the bruises to prove it! I don't exactly avoid every risk, and I love the speed.)

I am not sure about long term use of Wellbutrin. I'd love to hear from DR. Bob or anyone who has personal experience on Wellbutrin for 9 mos or more.

> My doc started me on 100mg of Wellbutrin SR a day, and he's leaving me that way for six weeks. I have had real bad experience with ad's and their awful side effects. This time, we're starting real, real slow and giving my body time to adjust. So far, it seems to be helping cause I've been on Wellbutrin for 2 1/2 weeks and that's longer than most other AD's I've been on. Let me know how you are doing with it.

 

Re: Wellbutrin

Posted by randy on August 31, 1999, at 14:25:20

In reply to Re: Wellbutrin, posted by Barb on August 30, 1999, at 12:34:25

Hi, I have been on WB for a year and a half. It is the only AD that i can use without the side effects. Being bipolar ad's become almost required. I think starting realllly sllowwww is the best way on WB. Its most pronounced effect over the first week or two is a speeddy feeling.
So giving you time to adjust before increasing the dose makes good sense. The weight issue is very important to me due to the effects of mood stabilizers, which seem to always put weight on
you. The WB seems to balance that.


> I cant imagine NOT starting on a lower dose and then increasing in a few days or even a week. It would seem safe to say that any AD use is not natural even though the need for them is related to a seemingly unnatural chemical imbalance. The side effects are a normal response to the body reacting to higher levels of serotonin, norepinephrine, dopamine, etc.
>
> I have now been off Zoloft since 7/30 and on Wellbuttin for 4 weeks. I switched, after months of deliberation, for the very reason so many people are fed up with AD,s: WEIGHT GAIN. I hadn't gained as much as many, yet, but being a very active person with a regular exercise lifestyle, I was VERY disturbed to be steadily gaining at least 1.5 lbs each month while living a healthy, active life.
>
> I am thrilled to report that I have adusted to the NEW set of side effects Wellbtrin presents, instead of the ones I experienced with Zoloft, and have LOST 12 POUNDS!!! That includes the weight in MUSCLE I surely have gained by getting back to some resistance training 2-3 days a week. My favorite sport these days is roller blading (UP hills, and down in a controlled, "slalom" fashion) as often as possible. (And do I have the bruises to prove it! I don't exactly avoid every risk, and I love the speed.)
>
> I am not sure about long term use of Wellbutrin. I'd love to hear from DR. Bob or anyone who has personal experience on Wellbutrin for 9 mos or more.
>
> > My doc started me on 100mg of Wellbutrin SR a day, and he's leaving me that way for six weeks. I have had real bad experience with ad's and their awful side effects. This time, we're starting real, real slow and giving my body time to adjust. So far, it seems to be helping cause I've been on Wellbutrin for 2 1/2 weeks and that's longer than most other AD's I've been on. Let me know how you are doing with it.
>
>

 

Re: Wellbutrin

Posted by Pat on August 31, 1999, at 16:36:08

In reply to Re: Wellbutrin, posted by randy on August 31, 1999, at 14:25:20

>Hi Randy - thanks for sharing your info. I've been interested to hear from someone who's been on Wellbutrin for a while and had good luck with it. I am only taking 100 mg Wellbutrin SR per day now. What is your current dose? Did you have anxiety also, and if so, did Wellbutrin help that? Any input from anyone on this topic would be appreciated.

> ..

 

Re: Wellbutrin

Posted by randy on September 1, 1999, at 15:39:23

In reply to Re: Wellbutrin, posted by Pat on August 31, 1999, at 16:36:08

Hello Pat, I am on 225 mg of the plain old ordinary non sr WB. Anxiety?....HM.....
I think that kind of goes with the Bi-polar territory.
I will tell you one thing for sure. I am on 1800 mgs of Neurontin and that really keeps the anxiety at bay.. it was a pleasant ...shall i say side effect of Neurontin.
Wellbutrin may have actually made me a little anxious. cant say for sure. I know i did not like the sr formula at all. to much wallop at one time.


> >Hi Randy - thanks for sharing your info. I've been interested to hear from someone who's been on Wellbutrin for a while and had good luck with it. I am only taking 100 mg Wellbutrin SR per day now. What is your current dose? Did you have anxiety also, and if so, did Wellbutrin help that? Any input from anyone on this topic would be appreciated.
>
> > ..

 

Re: Wellbutrin

Posted by JohnL on September 1, 1999, at 17:16:20

In reply to Re: Wellbutrin, posted by randy on September 1, 1999, at 15:39:23

My psychiatrist says his experience with Wellbutrin has been spotty. But when it works it really works. When used in its marketing name Zyban for quitting smoking its dosage approach is more aggressive than what is being discussed here. It is started on day one at 200mg to quit smoking. Theoretically doses in the 300 to 400 range are more effective for depression, but if a less amount works that's awesome. Except for the severe tinnitus, I liked Wellbutrin a lot at 300 and was looking forward to going up to 400 except for that jet plane in my ears. Darn!

 

Re: Wellbutrin

Posted by Yardena on September 1, 1999, at 18:56:26

In reply to Re: Wellbutrin, posted by JohnL on September 1, 1999, at 17:16:20

I tried Wellbutrin for a short time a couple of years ago, but it cause tinnitus and intestinal discomfort. I also wasn't thrilled with 3x day dosing, so I am glad to hear they have put out an SR since then. I have a friend who has been on it a while and loves it. Frankly, I think it adds to his anxiety/OCD symptoms, and I have read that it can be kind of agitating for some people. But he had such a bad experience on Prozac (made him very manic and agitated) and then such a profound improvement in his depression on Wellbutrin, that he is reluctant to rock the boat.

 

Re: Wellbutrin-how long does it take??

Posted by LD on September 3, 1999, at 8:58:45

In reply to Re: Wellbutrin, posted by Yardena on September 1, 1999, at 18:56:26

Does anyone know how long it takes for the antidepressant effects of Wellbutrin to kick in? I have now been on full strength (300 mg/day)
for 5 weeks now, with no improvement in my depression. I also have panic disorder and lots of anxiety all the time.
The wellbutrin has increased my anxiety (I think) and have been taking a small amount of klonopin for that. Is this not the drug
for me? My doc and I were waiting it out to see if it improved (been through Serzone and Paxil). She said if this didnt work
we were going to try Celexa. I'm getting very frustrated.

Thanks, LMD

 

Experienced Wellbutrin Users Please Help

Posted by Pat on September 4, 1999, at 17:08:03

In reply to Re: Wellbutrin-how long does it take??, posted by LD on September 3, 1999, at 8:58:45

I think the small amount of Wellbutrin I'm on is helping my depression already (not yet a month), but I'm still having worse anxiety than I did when I started. What I want to know is did anyone have worsening anxiety for a month or more, and then had it get better? Will I always need a separate anxiety med with Wellbutrin? When the doc increases the dosage, will the anxiety increase as well? What have other users experienced?

 

Glad to hear it works for so many...

Posted by Bob (not Dr.) on September 4, 1999, at 23:33:20

In reply to Experienced Wellbutrin Users Please Help, posted by Pat on September 4, 1999, at 17:08:03

LD-- I have depression and panic disorder as well. Some time ago, I switched to Wellbutrin from Paxil as the Paxil had turned me into a complete zombie. To make it worse, I had some pretty severe withdrawal symptoms from the Paxil, so my doc had me start on the WB without letting the Paxil washout a bit. That small overlap of those two meds, in retrospect, was one of my clearest, sanest times in the last four years. WB's effect on my withdrawal symptoms took about 20 minutes on the two or three occasions I forgot to take a dose. I imagine whatever it was doing may be related to how it can help smokers quit....

Once the Paxil had washed out, tho, I started getting pretty psychotic. Thankfully, I had one part of me that could recognize when things were getting too hot--it would send me into these unprovoked, uncontrollable rages--and I could walk away from whatever situation I was in to defuse things. My doc put me on Perphenazine at a really small dosage. That worked to control the rage, but WB never did anything for my depression.

(In case you're wondering: yes, I have thought about trying Paxil and WB together intentionally. Given other factors in my life right now, plus how stable my current cocktail has me and how nasty each one of those were to me on their own, it's too much to risk right now.)

 

Re: Experienced Wellbutrin Users Please Help

Posted by fendel on September 5, 1999, at 22:59:50

In reply to Experienced Wellbutrin Users Please Help, posted by Pat on September 4, 1999, at 17:08:03

I've been on Wellbutrin for nearly four years now, currently taking 400 mg/day of Wellbutrin.

I felt a VERY fast response to it--about 12 hours from my first dose, which I think is unusual. It didn't help my anxiety, but my anxiety has been a spotty thing anyway--it comes and goes, mostly goes (luckily). I did have one panic attack after feeling stable on it for a while, but for the most part I've been calm, and for me the anxiety has not increased with the dosage.

But I have heard that Wellbutrin's not known for helping with anxiety.

 

Re: Experienced Wellbutrin Users & anxiety???

Posted by dj on September 9, 1999, at 10:28:58

In reply to Re: Experienced Wellbutrin Users Please Help, posted by fendel on September 5, 1999, at 22:59:50

> > It didn't help my anxiety, but my anxiety has been a spotty thing anyway--it comes and goes, mostly goes (luckily). I did have one panic attack after feeling stable on it for a while, but for the most part I've been calm, and for me the anxiety has not increased with the dosage.
>
> But I have heard that Wellbutrin's not known for helping with anxiety.

Anyone else have any experience on this front or anything to say about Wellbutrin & anxiety?

 

Re: Experienced Wellbutrin Users & anxiety???

Posted by Bob on September 9, 1999, at 23:24:35

In reply to Re: Experienced Wellbutrin Users & anxiety???, posted by dj on September 9, 1999, at 10:28:58

> Anyone else have any experience on this front or anything to say about Wellbutrin & anxiety?

Just a quick recap -- it worked great with mine. It was essential in helping me get off Paxil; I don't know how I would have managed to leave my bedroom without it. After the Paxil washed out, it still did a good job keeping my anxiety level down.

If it wasn't for those psychotic rages I started experiencing (before adding some perphenazine to
the mix), I might have stuck with it. So, while it did help my anxiety, I can't say that I had a very typical response to it.

Cheers,
Bob

 

Re: Glad to hear it works for so many...

Posted by dj on September 10, 1999, at 7:54:25

In reply to Glad to hear it works for so many..., posted by Bob (not Dr.) on September 4, 1999, at 23:33:20

Bob,

The Wellebutrin worked on your anxiety but not your depression but it also caused you to go into blind rages when used by itself. Anyone else have similar impact?

> LD-- I have depression and panic disorder as well. Some time ago, I switched to Wellbutrin from Paxil as the Paxil had turned me into a complete zombie.... That small overlap of those two meds, in retrospect, was one of my clearest, sanest times in the last four years.
> Once the Paxil had washed out, tho, I started getting pretty psychotic.... My doc put me on Perphenazine at a really small dosage. That worked to control the rage, but WB never did anything for my depression.

 

Still Need More Wellbutrin Info

Posted by Pat on September 10, 1999, at 10:01:04

In reply to Re: Glad to hear it works for so many..., posted by dj on September 10, 1999, at 7:54:25

Funny that it worked on Bob's anxiety, but not his depression. It is definitely working for my depression, but I still have to take ativan for anxiety every day. If I don't take the ativan, I start to feel anxious and edgy by the late afternoon. I've been on the Wellbutrin for a month now. It may increase the anxiety when the doc ups the dosage or (as I'm hoping), it may decrease the anxiety. I'd like to start getting off ativan. But if I feel good with a little bit of Wellbutrin and a little bit (2 - 2 1/2 mg) of ativan every day, would this be an ok long term solution?

 

Re: Experienced Wellbutrin Users Please Help

Posted by Jeff Silverstein on September 10, 1999, at 10:21:53

In reply to Experienced Wellbutrin Users Please Help, posted by Pat on September 4, 1999, at 17:08:03

I've taken Wellbutrin at various doses over a number of years. It is always mentioned as one of the few antidepressants that doesn't block panic attacks. (as did Imipramine and certain SSRIs) This is probably because its focus isn't on serotonin and it boosts dopamine and norepinephrine. It is, however considered a good choice for bipolars because it tends not to trigger manic swings. My experience has been that the higher the dosage, the more jittery. If you're sensitive to anxiety there's a point where it can trigger that. Benzodiazapines, like Ativan were the choice to smooth out the anxiety. At higher doses ((3-500mg) I found increased startle response and mild panicky feelings. However, if it's doing a really good job with the depression, and you're responding - the tranquilizer may be a good choice. People are hyper-afraid of tranqs because they fear addiction, and tend not to take as much as they need. Because of bad press we somehow feel that a tranquilizer is "bad" and should be avoided. Many anti-depressants have anxiety side effects, not just Wellbutrin - it all depends on your chemistry. If it's working well, Wellbutrin tends to be well tolerated because of low side effects - it's one of the very few antidepressants that has no sexual side effects for most - and the dopamine boost is said to even improve things in that department. I tolerated Wellbutrin well for years, usually with no more than .25 to 1mg of Ativan as needed - the more Wellbutrin, the more Ativan. Anxiety makes everything an emergency - make sure your doc is aware of what's going on. If a low dose of something quickly has intolerable side effects for you, he or she may not force it. You were wondering if the anxiety goes away - my experience is that there were times when it fluctuated, sometimes went away. But it's not a simple issue - for example the anxiety shows that the med is active - there were times when I found that a reduction in baseline anxiety meant the antidepressant fx were wearing off. Everybody's different. Some people get anxiety on rising - I found Wellbutrin anxiety kicked in late afternoon. I assume you're taking SR. A good choice might be cutting the tabs up and splitting the dosage over the day to reduce peaks - ask your doc. Good luck.

 

Re: Still Need More Wellbutrin Info

Posted by Jeff Silverstein on September 10, 1999, at 10:43:27

In reply to Still Need More Wellbutrin Info , posted by Pat on September 10, 1999, at 10:01:04

Pat, you sound like you're doing fine. We neurochemically-challenged have gotten it into our heads that if we take benzodiazapines we're going to end up like Marilyn Monroe - or addicted. The amounts of Ativan you're taking aren't "abuser" amounts and you're not washing them down with Vodka are you? You don't have to get off Ativan so fast - particularly if it's helping you tolerate an antidepressant which is helping your more major symptoms. But this is a common conflict - I'd fight myself when I needed the tranqulizer, and then I'd stay anxious. I used to have to tell myself "take the Ativan, stupid." Ivan Goldberg told me that these low dosages of Ativan are what he calls "pediatric" and it's far mor important to get the right antidepressant working. Of course he didn't want me taking Ativan if I didn't need it - but made sure I recognized that it was necessary when I did. I also have a theory that our increased self-hate, paranoia, and depressed thought may add to our beating ourselves up about taking the benzodiazapine - we've "picked" something "bad" to accuse ourselves of - and we've gotten into a double bind because if we took the Ativan appropriately, we wouldn't be so agitated about it.

 

Thanks Jeff

Posted by Pat on September 10, 1999, at 13:01:18

In reply to Re: Still Need More Wellbutrin Info , posted by Jeff Silverstein on September 10, 1999, at 10:43:27

Thanks for your posts, Jeff. I find your thoughts pretty comforting. I have had a lot of the same experiences that you have. My anxiety on the Wellbutrin also kicks in in late afternoon. I have also been at war with myself many times over taking the ativan. Sometimes I feel like a failure because I now have to take this addictive medicine (after having kicked all the drug abuse of my youth) just to keep myself from freaking out. But then I tell myself, like you, just take the ativan stupid. I only need 1/2 mg in the afternoon for anxiety, but I also take 1 to 1 1/2 mg at bedtime for insomnia. In a perfect world, Wellbutrin would handle the anxiety for me too. It is doing a really good job with the depression. I'm surprised at how much better I feel on a dose (only 100mg SR daily) my pdoc considers a "baby dose". I'm making a note to ask him on my next visit about splitting up the dose somehow to avoid the afternoon anxiety. Anyway, I'm "babbling". Thanks again.

 

Re: Experienced Wellbutrin Users Please Help

Posted by Jim on March 3, 2000, at 10:59:04

In reply to Experienced Wellbutrin Users Please Help, posted by Pat on September 4, 1999, at 17:08:03

> I think the small amount of Wellbutrin I'm on is helping my depression already (not yet a month), but I'm still having worse anxiety than I did when I started. What I want to know is did anyone have worsening anxiety for a month or more, and then had it get better? Will I always need a separate anxiety med with Wellbutrin? When the doc increases the dosage, will the anxiety increase as well? What have other users experienced?

I was on Wellbutrin(150 mg/day) for about 8 months last year. It worked fine, but I discontinued it without any trouble. After a 7 month layoff, I started back on it last week at 300 mg/day without starting at a lower dose as recommended. Now, 6 days after being back on it at 300 mg, I have experienced a couple nights of pretty bad insomnia with one moderate panic attack during my insomnia. I have had only one panic attack in my life and it was in a moment of severe stress a couple of years ago. This one was simply because I couldn't sleep. I want to believe that my error in not starting out at a lower dose, as recommended, caused this anxiety and panic, and not that I'm developing a panic disorder. I have discontinued Wellbutrin as a result. Has anyone experienced this or has anyone's physician commented on this? Please help.

 

Re: Experienced Wellbutrin Users Please Help

Posted by anne on March 3, 2000, at 14:05:57

In reply to Re: Experienced Wellbutrin Users Please Help, posted by Jim on March 3, 2000, at 10:59:04

for a little reassurance, it sounds like you are
having a reaction to the Wellbutrin. Unfortunately,
even if your body responded well to it the first
time that is not predictive of future responses.

However, you should not abruptly discontinue it,
either! Try taking 150 mg SR in the morning, every
other day for the next few days. If you are
feeling better, then you can decide whether to
discontinue use. I think it is very unlikely that you
are developing a concomitant anxiety disorder,
although not ruled out. Hope this helps, hang in
there.

 

Re: Experienced Wellbutrin Users Please Help

Posted by bob (hi folks, I'm back) on March 3, 2000, at 20:30:11

In reply to Re: Experienced Wellbutrin Users Please Help, posted by anne on March 3, 2000, at 14:05:57

Anne's advice about tapering off a med is good for just about any of the stuff we take.

I doubt, too, that Wellbutrin could GIVE you an anxiety disorder, but it may be helping an exisitng one express itself a bit more obviously. Depression and anxiety disorders go hand-in-hand for a lot of people, and at times the symptoms of one can mask any sign of the other.

I'm a good example of that. I started seeing my therapist due to some rather severe daily panic attacks. I've been observably depressed since I was 8, but I'd never really shown any signs of panic disorder until I was 34, just before I started treatment. By the time we decided I needed medication, we were back working on depression issues during our sessions. Over the next two years and something like 11 different combinations of meds, I'd present either more depressed or more panicked depending on which med wasn't working for me at the time. It all taught me not to take the panic disorder side of my condition lightly, and to thank my stars for finding klonopin when I did -- it's managed my panic wonderfully for 18 months or so now.

As for Wellbutrin -- I started right off at 300mgSR/d in reaction to severe withdrawal from Paxil. While both were in my system, things were fine. After the paxil washed out of me, tho, my Welbutrin demons started popping up. It lost its efficacy as an AD at 300/d, so I went up to 450. For me, it wasn't anxiety so much as it was irritability and, eventually, uncontrollable rages. Nothing a little perphenazine (an antipsychotic) couldn't handle, tho. Still didn't have any efficacy as an AD on its own or with Prozac for me, and these three together eventually put me in the ER due to a nasty interaction between the prozac and perphenazine ... but the story ends happily, because this chain of events brought klonopin into my mix.

16 months after that, I tried wellbutrin again, at 75mg (nonSR) 2xd to augment the nortriptyline I'm on now. All it did was bring back the irritability.

Oh, and my otherwise non-existent allergy to cats. Off wellbutrin, I'm fine. On wellbutrin ... contact with a cat will swell my eyes shut in ten minutes or less. And I've never shown any allergic reactions to anything else EVER. Weird science.

... maybe it's just me, but over the last year (or so) checking in on this board, it seems like wellbutrin triggers more love-it or hate-it reactions than any other med, with the possible exception of paxil.

cheers,
bob

 

Re: Glad to hear it works for so many...

Posted by micahael on March 4, 2000, at 14:52:18

In reply to Re: Glad to hear it works for so many..., posted by dj on September 10, 1999, at 7:54:25

> Bob,
>
> The Wellebutrin worked on your anxiety but not your depression but it also caused you to go into blind rages when used by itself. Anyone else have similar impact?
>
> > LD-- I have depression and panic disorder as well. Some time ago, I switched to Wellbutrin from Paxil as the Paxil had turned me into a complete zombie.... That small overlap of those two meds, in retrospect, was one of my clearest, sanest times in the last four years.
> > Once the Paxil had washed out, tho, I started getting pretty psychotic.... My doc put me on Perphenazine at a really small dosage. That worked to control the rage, but WB never did anything for my depression.

why did you not stay on the welllbutrin and start the paxil again?

why did you not stay on the wellbutrin and start the paxil again?

 

Re: Glad to hear it works for so many...

Posted by Noa on March 4, 2000, at 15:28:48

In reply to Re: Glad to hear it works for so many..., posted by micahael on March 4, 2000, at 14:52:18

Am I grasping at straws to want to try wellbutrin again? I was on it such a short time a few years ago, with some diarrhea. Now I think maybe I should try it again. Is this ludicrous? I am feeling frustrated with the effexor at this point. Each time I read about another medicine on the board, I think, well maybe that one will work for me. then I hear about them all pooping out on people and plateauing in their helpfullness. So getting of the effexor supermarket line just to get into another stuck line doesn't seem very appealing. But neither does staying in this line simply because I don't know where else to go. Today I had the fantasy, for the first tiem in years, of just going off of all my meds. I am pissed off that they aren't working. Don't worry, I won't actually go off my meds. My wish is that I could and be ok, but I know it ain't so.


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