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Dr. Bob is Robert Hsiung, MD,
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Posted by Roman on November 8, 2002, at 14:01:13
I started 20 mg Celexa about 6 weeks ago (10 mg for 2 weeks prior to that). 4 weeks ago I went to 40 mg and then to 60 mg about a week ago.
Although I feel the lowest-of-the-lows are not as bad as they used to be, I'm not getting significant relief from my depression. My anxiety is still hanging around as well.
I'm waiting for the AD to 'kick-in' as I've heard they can do--hasn't happened yet. Should I wait longer?
I'm thinking of talking to my doc about adding Wellbutrin in the hopes of furthering the antidepressant action of the meds and countering some of this terrible daytime fatigue. Any experience with this sort of thing to share? How much Celexa and how much Wellbutrin do you take? Any other suggestions?
Also, I was wondering if it's okay to take a single daily dose of Wellbutrin SR (100 or 150 mg) in the morning and skip the second dose; I'm concerned it will cause insomnia if I take it late in the day.
I guess I could try another AD such as Effexor or Zoloft and see what happens. I was able to tolerate Celexa (not so with Paxil), so I'm hoping it works instead of having to switch.
What do you think?
Thanks in advance.
-Roman
Posted by pelorojo on November 8, 2002, at 20:40:19
In reply to NEED ADVICE: Celexa Augmentation or Switch ADs?, posted by Roman on November 8, 2002, at 14:01:13
Hi Roman,
I've been taking Celexa and Wellbutrin for about the past year. I leveled off @ 50 mg Celexa, 400 mg Wellbutrin. I've since dropped to 40 mg Celexa, 300 mg Wellbutrin. (And just a week ago switched to Lexapro).
When I first went on the Celexa, I took it at night and didn't notice the daytime sleepiness. At about 9 months in, however, I got the daytime fatigue from the Celexa and some sexual side effects (which had gone away) returned. I dropped to 40 mg and that helped some. Then I switched to Lexapro. There's a lot of debate on here about Lex but I have noticed less daytime sleepiness.
Wellbutrin + Celexa worked for me for a long time (about 6 months). I've been tapering off of both, real slowly, as my symptoms have improved. I'm torn between suggesting it's worth a try to exhaust all options with the Celexa and being concerned that you haven't felt much improvement yet after this much time. It's not uncommon to go higher than 60 mg on the Celexa, you might try that in addition to the Wellbutrin augmentation.
Part of the issue is to figure out how long you can deal with the partial response. IMO, increasing dosage and augmenting are less drastic actions than switching. If you're coping with your symptoms well enough to give sufficient time to try these augmentation strategies, then it may be worth it. If your symptoms are overwhelming, then more drastic action such as switching AD's may be warranted.
That's just my $0.02. Best of luck.
Posted by Roman on November 8, 2002, at 23:05:24
In reply to Re: NEED ADVICE: Celexa Augmentation or Switch ADs? » Roman, posted by pelorojo on November 8, 2002, at 20:40:19
Thanks for all the info. Do you know off-hand what the maximum dose for Celexa is? I've read about 80 and 100 mg although the maximum suggested dose is 60 mg acccording to some sources.
I am not severely depressed, but definitely not comfortable. Is there any chance that a lower dose would be more effective, or doesn't it work that way? Since I can tolerate it, should I assume that I'm better off at 60 than say 40 mg? I always thought the higher doses were more effective for depression, but side-effects at those doses tend to cause more trouble.
-Roman
Posted by pelorojo on November 10, 2002, at 13:18:15
In reply to Re: NEED ADVICE: Celexa Augmentation or Switch ADs? » pelorojo, posted by Roman on November 8, 2002, at 23:05:24
> Thanks for all the info. Do you know off-hand what the maximum dose for Celexa is? I've read about 80 and 100 mg although the maximum suggested dose is 60 mg acccording to some sources.
>Generally the maximum dose is described as 60 mg but I've heard of as much as 100 mg. Your doctor should know -- they may need to do some sort of extra monitoring of you the higher your dose gets (true with some AD's, but maybe not Celexa - don't know)
> I am not severely depressed, but definitely not comfortable. Is there any chance that a lower dose would be more effective, or doesn't it work that way? Since I can tolerate it, should I assume that I'm better off at 60 than say 40 mg? I always thought the higher doses were more effective for depression, but side-effects at those doses tend to cause more trouble.
>There's a chance. Responses to AD's are highly individual and can often be counterintuitive. I'm taking Lexapro right now and I think 5 mg actually works better for me than 10. You really have to be sensitive to your feelings (hard to do when depressed) and, if you can, give each attempt at finding the right dose a "fair trial".
> -Roman
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Posted by Roman on November 10, 2002, at 13:42:00
In reply to Re: NEED ADVICE: Celexa Augmentation or Switch ADs?, posted by pelorojo on November 10, 2002, at 13:18:15
This is the end of the thread.
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