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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by terra miller on February 26, 2001, at 21:23:46
Can somebody tell me or provide a link where I can research the differences/effects/side-effects of Wellbutrin (the plain old thing, compared to the SR version)?
I'm taking Well. SR now, but I seem to be metabolizing it faster than usual (pdoc's thoughts) and if 100mg twice a day doesn't work, he thinks 75mg might be the next option to try though it is not SR.
Thing is, Well. SR doesn't feel SR to me. I feel it the whole time. I can tell when it kicks in, when it peaks and when it is declining below acceptable levels. It's a total bell-curve.
I am stabilizing on the Well. SR and liking it, except for the hypothermia/sore hands and eye strain. (The eye strain side-effect is familiar from my time on serzone.)
Thanks for the input, again.
Terra
Posted by JohnX on March 2, 2001, at 4:23:11
In reply to Differences between Wellbutrin and Wellbutrin SR?, posted by terra miller on February 26, 2001, at 21:23:46
> Can somebody tell me or provide a link where I can research the differences/effects/side-effects of Wellbutrin (the plain old thing, compared to the SR version)?
>
> I'm taking Well. SR now, but I seem to be metabolizing it faster than usual (pdoc's thoughts) and if 100mg twice a day doesn't work, he thinks 75mg might be the next option to try though it is not SR.
>
> Thing is, Well. SR doesn't feel SR to me. I feel it the whole time. I can tell when it kicks in, when it peaks and when it is declining below acceptable levels. It's a total bell-curve.
>
> I am stabilizing on the Well. SR and liking it, except for the hypothermia/sore hands and eye strain. (The eye strain side-effect is familiar from my time on serzone.)
>
> Thanks for the input, again.
>
> TerraTerra,
I had the same eye-strain effect with Wellbutrin
SR.I'm not sure how the SR version works vs
the non-SR version. The reason the SR version was introduced was because the elimination time for the non-SR Wellbutrin was fast, thus requiring
multiple dosing during the day. The SR version was introduced to reduce the dosing schedule and
help to maintain a better steady state
level in the blood stream. In rare cases for
anorexics they found that the original Wellbutrin
may induce seizures due to spikes in the absorbtion in the blood. That was also a motive to design the SR version.I went to their website www.glaxowellcome.com,
but couldn't find the PDR for the non SR version.
Here is the PDR for the SR version:
http://www.glaxowellcome.com/pi/wellbusr.pdfMany times the clearance of a drug can be influenced by interactions with other medications that you may be taking? Are you taking anything else? This occurs because the amount of enzymes in the liver that metabolize the drugs can change.
I'm very curious as to what mechanism is used in
medications that are sustained released. I'll look into this and see if I can find out any more answers.-JohnX
Posted by terra miller on March 2, 2001, at 20:58:19
In reply to Re: Differences between Wellbutrin and Wellbutrin SR? » terra miller, posted by JohnX on March 2, 2001, at 4:23:11
> > Can somebody tell me or provide a link where I can research the differences/effects/side-effects of Wellbutrin (the plain old thing, compared to the SR version)?
> >
> > I'm taking Well. SR now, but I seem to be metabolizing it faster than usual (pdoc's thoughts) and if 100mg twice a day doesn't work, he thinks 75mg might be the next option to try though it is not SR.
> >
> > Thing is, Well. SR doesn't feel SR to me. I feel it the whole time. I can tell when it kicks in, when it peaks and when it is declining below acceptable levels. It's a total bell-curve.
> >
> > I am stabilizing on the Well. SR and liking it, except for the hypothermia/sore hands and eye strain. (The eye strain side-effect is familiar from my time on serzone.)
> >
> > Thanks for the input, again.
> >
> > Terra
>
> Terra,
>
> I had the same eye-strain effect with Wellbutrin
> SR.I am SO glad to not be alone! Sometimes you begin to think you're just nuts with the different side-effects. THANKS!
> Many times the clearance of a drug can be influenced by interactions with other medications that you may be taking? Are you taking anything else? This occurs because the amount of enzymes in the liver that metabolize the drugs can change.
Great question. I have ativan that I take as needed (1 mg) which lately is once a day. (That's the whole point for me to be on a longer acting med so that I don't have to be benzo-dependent; PTSD/anxiety stuff.) I have ambien for sleep induction (10mg, but sometimes I take 5mg but really I need 10mg). And I go through phases when I'm pumping the advil for headaches, but that hasn't been too bad the last couple of weeks. That's it. Fairly simple I think compared to some.>
> I'm very curious as to what mechanism is used in
> medications that are sustained released. I'll look into this and see if I can find out any more answers.
That would be interesting to know.Thanks for your thoughtful replies.
Terra
Posted by JohnX on March 6, 2001, at 1:31:53
In reply to Re: Differences between Wellbutrin and Wellbutrin SR? » JohnX, posted by terra miller on March 2, 2001, at 20:58:19
> > > Can somebody tell me or provide a link where I can research the differences/effects/side-effects of Wellbutrin (the plain old thing, compared to the SR version)?
> > >
> > > I'm taking Well. SR now, but I seem to be metabolizing it faster than usual (pdoc's thoughts) and if 100mg twice a day doesn't work, he thinks 75mg might be the next option to try though it is not SR.
> > >
> > > Thing is, Well. SR doesn't feel SR to me. I feel it the whole time. I can tell when it kicks in, when it peaks and when it is declining below acceptable levels. It's a total bell-curve.
> > >
> > > I am stabilizing on the Well. SR and liking it, except for the hypothermia/sore hands and eye strain. (The eye strain side-effect is familiar from my time on serzone.)
> > >
> > > Thanks for the input, again.
> > >
> > > Terra
> >
> > Terra,
> >
> > I had the same eye-strain effect with Wellbutrin
> > SR.
>
> I am SO glad to not be alone! Sometimes you begin to think you're just nuts with the different side-effects. THANKS!
>
>
> > Many times the clearance of a drug can be influenced by interactions with other medications that you may be taking? Are you taking anything else? This occurs because the amount of enzymes in the liver that metabolize the drugs can change.
>
>
> Great question. I have ativan that I take as needed (1 mg) which lately is once a day. (That's the whole point for me to be on a longer acting med so that I don't have to be benzo-dependent; PTSD/anxiety stuff.) I have ambien for sleep induction (10mg, but sometimes I take 5mg but really I need 10mg). And I go through phases when I'm pumping the advil for headaches, but that hasn't been too bad the last couple of weeks. That's it. Fairly simple I think compared to some.
>
> >
> > I'm very curious as to what mechanism is used in
> > medications that are sustained released. I'll look into this and see if I can find out any more answers.
>
>
> That would be interesting to know.
>
> Thanks for your thoughtful replies.
>
> TerraTerra,
I'm so glad that the Wellbutrin is working for you. Sound like you just need a little time and possibly some tweaking to reach a comfortable "zone". I wouldn't get too overfocused on the side-effects unless they are excruciating. My experience on anti-depressants is that if I litterally can't stand the side effects after 1 week then I probably should dump it. But, if the side effects are just marginally annoying (i.e. not as bad as being depressed), then they usually wear off after a few weeks.
As far as the Ambien and ativan go, they definately will relieve anxiety and insomnia but I'm sure your doctor has advised you to minimize their use. I do believe that these medications may create some mild interference with the workings of the wellbutrin and could explain the
up/down response, but it is nothing to get too excited about. That's why I would try to use them
as little as possible.
Headaches are also sometimes a problem with wellbutrin. Again, I had them transiently with the insomnia and they went away over time. Sometimes you just have to duke out the side effects if they are not too excruciating.There are a few natural things you can try that may help with the anxiety/insomnia/headache that
may not interfere with the wellbutrin as much and
are non habit forming, but check with your doctor
1st (anybody please feel free to spank me on these suggestions):top recommendation:
1) Flax-Seed-Oil (safe and good for you)
Go to a really good health food store and
buy a cold-compressed bottle. Quality is
extremely important. I use the Spectrum brand.
Take 1 to 2 Tbsp/day
(just suck it down and plug your nose) +
take a small dose of Vitamin E.
*Don't* over do it. Start slow to see how
your body responds.Flax Seed Oil is a really popular remody for
dry skin, anxiety, joint pain, and more. I
had really bad tendidnitis in my fingers and my
doctor had me take alleve. I found out that
flax seed oil was also a remedy for joint pain,
plus it helped relieve anxiety. The Omega-3 oil
in the supplement suppresses inflammitory
hormones and something called archidonic acid
which is usually the cause of headaches (its
what aspirin, etc target). It may take a few
days to a few weeks to notice. It also
increases brain levels of serotonin in a
somewhat natural way. People who eat good
diets with fish , nuts, and dark vegetables are
less likely to be omega-3 deficient. I eat
too much Wendy's and too little fish, so I
take a little flax-seed every day.You may also want to take a 1 a day vitamin.
*Not* the mega-vitamin stuff, just the kind
with the rda. Too much of a good thing is bad.
A good diet is most important above all.2) Valerian Root. This is listed on the
tips page as a natural non-addictive cure for
insomnia. Quality is important. Check with
your doctor 1st. I get a mixed response.3) This one is controversial, maybe I shouldn't
even mention it. It's called 5-htp
(5 hydroxy tryptophan). The brain almost
immediately converts it to serotonin. It has
successfully been used to treat mild insomnia,
anxiety, and depression. I found that it kicks
in after 1-2 hours and for me it most
definately relieves anxiety. Ironically, it
makes me a little depressed if I take it for
too many days. DEFINATELY check with your doc
on this one. DEFINATELY don't combine with
any serotonin drug. Their is potential for a
serious side effect called serotonin
syndrome. High quality is extremely
important (Trimedica is a good brand).
I would probably avoid this suggestion due
to its potential controversy. You must consult
with your physician for a green light.-John
Posted by terra miller on March 6, 2001, at 13:45:55
In reply to Re: Differences between Wellbutrin and Wellbutrin SR? » terra miller, posted by JohnX on March 6, 2001, at 1:31:53
> I'm so glad that the Wellbutrin is working for you. Sound like you just need a little time and possibly some tweaking to reach a comfortable "zone". I wouldn't get too overfocused on the side-effects unless they are excruciating.
if only i weren't so darn cold. it literally hurts. i've just switched over to the immediate response wellbutrin from the sustained release so that i could drop to the 75mg tabs.
i'm just burning this stuff up fast, even with the SR i was. one of the 75mg tabs lasts me four hours before the irritability sets in. i take the next one and it's night and day the difference. it really helps, but by the end of the day my body temperature is barely 97degrees and usually lower than that. i'm going to have to get off this (SIGH) if it doesn't stop.
>My experience on anti-depressants is that if I litterally can't stand the side effects after 1 week then I probably should dump it. But, if the side effects are just marginally annoying (i.e. not as bad as being depressed), then they usually wear off after a few weeks.
yep, that's what i think to. when it gets to the point when the sideeffects are unbearable, then that's when it's time to switch.
> There are a few natural things you can try that may help with the anxiety/insomnia/headache that
> may not interfere with the wellbutrin as much and
> are non habit forming, but check with your doctor
> 1st (anybody please feel free to spank me on these suggestions):
>
> top recommendation:
>
> 1) Flax-Seed-Oil (safe and good for you)
>
got it in the fridge right now; same brand. *s* and i typically eat a can of tuna a day (it's good for you...)>
> You may also want to take a 1 a day vitamin.
> *Not* the mega-vitamin stuff, just the kind
> with the rda. Too much of a good thing is bad.got that one covered too.
> 2) Valerian Root.yes, this is good stuff. it knocks me out too much, so i don't use it. but for other people it is very mellowing and sleep inducing.
>
> 3) This one is controversial, maybe I shouldn't
> even mention it. It's called 5-htp
> (5 hydroxy tryptophan).if only there weren't all that controversy and the, well, you probably know. in theory it sounds so good. i'm the type of person who gets the 1-in-100,000 sideeffects. it's totally annoying (not like i want it to be that way!), so i just stay clear of that.
good old chamomile tea, strong, i find helpful. also not doing anything to get all worked up right before bed, yet making sure to expend a lot of energy during the day so that i'm tired enough to go to sleep. those are other non-med. aids that are good. and i don't do caffeine anymore. etc.
i'm soooo cold.... (grrr)
Terra
Posted by JohnX on March 7, 2001, at 3:27:44
In reply to Re: Differences between Wellbutrin and Wellbutrin SR? » JohnX, posted by terra miller on March 6, 2001, at 13:45:55
> if only i weren't so darn cold. it literally hurts. i've just switched over to the immediate response wellbutrin from the sustained release so that i could drop to the 75mg tabs.
>
> i'm just burning this stuff up fast, even with the SR i was. one of the 75mg tabs lasts me four hours before the irritability sets in. i take the next one and it's night and day the difference. it really helps, but by the end of the day my body temperature is barely 97degrees and usually lower than that. i'm going to have to get off this (SIGH) if it doesn't stop.Terra,
Sounds like you are quite learned. I wonder why
your body temparature would be low? I've never
experienced that but I know anything is possible.
I have felt *extremely* hot while taking Paxil or
Serzone. In fact, Serzone is known to raise the body temperature a bit. BTW, Serzone was the #1
anxiety reliever for me, but it made me feel
really drugged out and it slowed down my reflexes.
Wellbutrin tends to improve alertness, but can
also create agitation.I don't remember why you dumped Serzone, maybe
a *low* dose added to the Wellbutrin would help
with your anxiety/irritability and the
temperature problem. The two meds are safe to
mix. Plus maybe it would help alleviate the need
for ativan/ambien. You can always turn up the
thermostat. ;)As always...Good luck,
John
Posted by terra miller on March 7, 2001, at 11:09:47
In reply to Re: Differences between Wellbutrin and Wellbutrin SR? » terra miller, posted by JohnX on March 7, 2001, at 3:27:44
> Sounds like you are quite learned. I wonder why
> your body temparature would be low? I've never
> experienced that but I know anything is possible.
it took me a week to find it, but i found it (i don't know where now because i've searched and searched!) but something like "cutaneous hypothermia"... anyway, it described it as lowering of body temperature below normal body temp. range- defined as 97.6 to 98.6 degrees. 1% side effect. there it was. a side effect of wellbutrin. i am NOT crazy! *s*
>Serzone was the #1
> anxiety reliever for me, but it made me feel
> really drugged out and it slowed down my reflexes.
i liked it the best as well, but i could only take it all at once at bedtime because it made me feel grogged during the day.
> Wellbutrin tends to improve alertness, but can
> also create agitation.
i am so incredibly productive on this stuff!! thankfully, the agitation subsided after 4 weeks. it was pretty tough going at first; talk about shakey!> I don't remember why you dumped Serzone
i couldn't get high enough. everytime i'd try i'd swell up and it was really painful. i could get to 300mg but if i moved up to 350 or 400 i'd swell and the lightning flashes (that's a "serzone" sideeffect) were pretty intense... the other reason why i took it at night so i could theoretically sleep through the side-effects. it worked for a few months until i needed to up it and i couldn't. so we started over.
maybe
> a *low* dose added to the Wellbutrin would help
> with your anxiety/irritability and the
> temperature problem. The two meds are safe to
> mix. Plus maybe it would help alleviate the need
> for ativan/ambien.
that's what i am thinking as well. the whole reason why i'm trying to get a longer term med to work is so that i don't have to take the ambien and ativan. i've actually started to sleep better with the wellbutrin (why i do not understand!... ha!... i think it's because i spend the day revved-up and highly functioning and by the time it's time to go to bed my physical body is wiped out while my brain is having a great time! *s*)thanks again for your helpful comments.
terra
p.s. any thoughts on the eye-strain? know anyway to combat that one?
Posted by JohnX on March 8, 2001, at 8:10:22
In reply to re: wellbutrin; serzone; cold temps eyestrain » JohnX, posted by terra miller on March 7, 2001, at 11:09:47
>
> that's what i am thinking as well. the whole reason why i'm trying to get a longer term med to work is so that i don't have to take the ambien and ativan. i've actually started to sleep better with the wellbutrin (why i do not understand!... ha!... i think it's because i spend the day revved-up and highly functioning and by the time it's time to go to bed my physical body is wiped out while my brain is having a great time! *s*)
>
> thanks again for your helpful comments.
>
> terra
>
> p.s. any thoughts on the eye-strain? know anyway to combat that one?Terra,
Unfortunately, I'm not too sure what to say about the eye strain. I bet it is just another side effect that will subside over time. For me the eye-strain was very transient, it only lasted about 3-4 days and it mainly affected me while reading things up close. My pdoc said he haid never seen that side effect. So, I was interested when you mentioned it. Anyways, have you been keeping up with your optomitrist appointmetns? Sometimes I wonder if the eyestrain sensitivity is related to the fact that I may be developing a little non-med related astigmatism. Currentlty I'm very near-sighted, but as of late I've noticed that my near vision isn't quite what it used to be even not on meds, but I'm around that age..
Anyways, I'll tell you that you are having better luck than me with the meds. I'm waiting for Ziprasidone to be released because it has the pluses of both Serzone and Buspar hopefully without the drowsiness/weight gain. Wellbutrin gives me spotty results, if I take it without a mood stabilizer, it sometime induces mania followed by a weird completely unemotional state. With the mood stabilizer added, it releaves depression but it still leaves me with a bit of anhedonia.
I thought about trying the wellbutrin/serzone combo because the serzone did such a good job of relieving my anxiety and tension headaches and the wellbutrin was better for energy/interest
and it seemed the bad side-effects may cancel
each other out. But i never tried.. If I told you
the number of meds I've tried, you'd be shocked. But my research has pinned my hopefully final anti-dote down to a few routes one of which can hopefully use Ziprasidone (a 5ht-2 antagonist).-John
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