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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by platinumbride on December 30, 2003, at 0:52:48
I have been going through a bit of medication hell these past months which in addition to other stuff has made it seem stupid to get out of bed (though when forced to, I am generally glad I did, so I know that I do still have to ability to smile)
My doc (who I am about done with...good guy, but seems that we are not getting anywhere with the talk part of the therapy), put me on wellbutrin and keppra about 10 days ago.
I know we have to give these drugs their 6 week trials, but I don't have much faith in wellb for myself, based on previous experience with it. So I am considering an maoi, I guess, because it seems as if a lot of ppl here are having good experiences with them, so I figure, to hell with the "clean" drugs, I will try the dirty ones ha ha...
Has anyone else run the gamut from ssris to effexor and rememron and wellbutrin and found the older generation drugs to be a good move? Do you think I should give it the old 6 week try with the welb and the keppra?
Finally, what is the weight deal with maois? Are the tricyclics the ones that pack on the pounds? I'm not complaining of a minor weight problem here, so this has become a seriuos consideration.Thanks for sharing experiences.....
Posted by brussell on December 30, 2003, at 2:27:58
In reply to wellbutrin v. maois or any other thoughts?, posted by platinumbride on December 30, 2003, at 0:52:48
I don't know anything about Keppra, although I know Lamictal has a good reputation as a mood-stabilizer with some AD qualities.
As for the WB, you didn't mention your dose, but I would go up to 450mg/day (if possible) for a couple weeks before giving up on it. Welbutrin did nothing for me below 300mg/day, and I am curious if 450mg/day would have worked better.
I'm been taking Parnate for about four weeks, one of the two MAOIs commonly available. It has worked better than any AD I have ever used so far (although I still hope for more results) and has side effects similar to WB w/o anxiety (that is to say, almost none). Weight gain is not a problem in the literature, and hasn't been for me.
The other MAOI available is Nardil, which behaves quite differently. It tends to cause more side-effects, including weight gain, but it appears to work better as an AD for more people. I haven't taken it, although others on this board could tell you a lot about it.
As long as you observe the dietary restrictions, I consider MAOI's very "clean" drugs in the sense that they do their job without the really disturbing side effects I experienced with the SSRIs and Effexor. (Don't even ask me about Remeron...)
The biggest problems with MAOIs is that they interact badly with so many common medications, both prescription and over-the-counter. You must really educate yourself on this topic because most doctors do not know much about MAOIs. Wearing a MAOI med-alert bracelet wouldn't be a bad idea, either.
Virtually everyone who uses MAOIs these days has tried and failed with numerous current generation ADs. Many of these people (though not all, of course) get significant relief from these drugs.
Posted by cybercafe on December 30, 2003, at 3:44:44
In reply to Re: wellbutrin v. maois or any other thoughts?, posted by brussell on December 30, 2003, at 2:27:58
> I don't know anything about Keppra, although I know Lamictal has a good reputation as a mood-stabilizer with some AD qualities.
>
> As for the WB, you didn't mention your dose, but I would go up to 450mg/day (if possible) for a couple weeks before giving up on it. Welbutrin did nothing for me below 300mg/day, and I am curious if 450mg/day would have worked better.
>
> I'm been taking Parnate for about four weeks, one of the two MAOIs commonly available. It has worked better than any AD I have ever used so far (although I still hope for more results) and has side effects similar to WB w/o anxiety (that is to say, almost none). Weight gain is not a problem in the literature, and hasn't been for me.
>
> The other MAOI available is Nardil, which behaves quite differently. It tends to cause more side-effects, including weight gain, but it appears to work better as an AD for more people. I haven't taken it, although others on this board could tell you a lot about it.
>
> As long as you observe the dietary restrictions, I consider MAOI's very "clean" drugs in the sense that they do their job without the really disturbing side effects I experienced with the SSRIs and Effexor. (Don't even ask me about Remeron...)
>
> The biggest problems with MAOIs is that they interact badly with so many common medications, both prescription and over-the-counter. You must really educate yourself on this topic because most doctors do not know much about MAOIs. Wearing a MAOI med-alert bracelet wouldn't be a bad idea, either.
>
> Virtually everyone who uses MAOIs these days has tried and failed with numerous current generation ADs. Many of these people (though not all, of course) get significant relief from these drugs.
>
yep, parnate has almost given me my life back, no side effects, never really think about drug or food interactions (old cheese, alcohol mainly).....and i expect much more results in the coming weeks (mainly anti-anxiety i suppose, i think it kicks in later)
yes i have failed many drugs.... that worked POORLY and had WORSE side effects!
Posted by wsj on December 31, 2003, at 0:16:35
In reply to wellbutrin v. maois or any other thoughts?, posted by platinumbride on December 30, 2003, at 0:52:48
i have taken zoloft, paxil, wellbutrin, effexor, buspar, nuerontin, lexapro, remeron and others.
right now i'm at 50 days parnate. it has worked as good as all the above or better w/ a lot less side effects.best to ya!
wsj
Posted by watergirl on December 31, 2003, at 11:52:25
In reply to wellbutrin v. maois or any other thoughts?, posted by platinumbride on December 30, 2003, at 0:52:48
Anybody use this combo?? wellbutrin with Paxil.
Posted by watergirl on January 5, 2004, at 15:10:29
In reply to ***Wellbutrin + Paxil? Anyone????***, posted by watergirl on December 31, 2003, at 11:52:25
> Anybody use this combo?? Wellbutrin with Paxil.
Posted by jerseydevil on January 5, 2004, at 16:31:18
In reply to Re: ***Wellbutrin + Paxil? Anyone????***, posted by watergirl on January 5, 2004, at 15:10:29
I've been on Wellbutrin and Paxil together for a little over a year now, mostly because my pdoc wanted to get me on Wellburtrin and off of Paxil b/c the Paxil side effects were getting to me. When you are consciously aware that you haven't had a sex drive for over a year, the "sexual side effects" apply to you. I have been progressively weaning off of Paxil although we've need to fill in the void of the antianxiety component of Paxil. I'm on 400 mg/day of Wellbutrin and down to 5 mg of Paxil, but Effexor has replaced Paxil. I feel pretty good right now. I intend to continue to wean off of Paxil entirely (another six months should do it) and stay on the Wellbutrin and Effexor for awhile. Not everyone experiences the same side effects or withdrawl problems, but Paxil has not been my favorate drug.
Posted by sfmom on January 5, 2004, at 16:40:11
In reply to Re: ***Wellbutrin + Paxil? Anyone????***, posted by jerseydevil on January 5, 2004, at 16:31:18
I take 225 WB in the mornings and 2.5 Paxil before bed, with 1.5 of Klonopin throughout the day. I really like the WB, but my pdoc says I have to take a sedating ssri with it because of my anxiety and panic attacks. I started with 10mg of Paxil, but the side effects really sucked for me. I was constantly exhausted and had NO sex drive. Hum, maybe I should try Effexor too. . . I'm almost off the Paxil now, well at least I don't think I can break them into smaller pieces!
Posted by theo on January 7, 2004, at 11:22:06
In reply to Re: ***Wellbutrin + Paxil? Anyone????***, posted by jerseydevil on January 5, 2004, at 16:31:18
I don't know if you've come off Effexor before but it is condidered the number one worse AD to come off of accross the board. Paxil was nothing compaired to Effexor and I've read several studies on AD withdrawal and Effexor is ranked #1 worst for withdrawal. FYI
Posted by jerseydevil on January 7, 2004, at 16:22:45
In reply to Re: ***Wellbutrin + Paxil? Anyone????*** » jerseydevil, posted by theo on January 7, 2004, at 11:22:06
... and so I've read the reverse on this board, Paxil #1, Effexor #2. If I lose any level of the side effects I had with Paxil, I'll live with Effexor. While probably not recommended, people here have posted about going off of Effexor in one step and surviving. Don't try that with Paxil or (certain lawsuits say) it could kill you. If (I mean when) I am off Paxil, then I see how the new cocktail is working and post that too. Not every option is bad. But, thanks for your input. That is why I visit this site.
Posted by CraigD on January 8, 2004, at 15:27:32
In reply to Re: ***Wellbutrin + Paxil? Anyone????***, posted by sfmom on January 5, 2004, at 16:40:11
I'm curious, has the addition of WB helped to return any of your sex drive? My pdoc insists I try WB (again) before something more unconventional like amantadine or Periactin.
I remember stopping it before getting any benefit twice before when adding to SSRIs -- it made me kinda sad more than anything else.
Posted by sfmom on January 9, 2004, at 16:55:42
In reply to Re: Adding Wellbutrin? » sfmom, posted by CraigD on January 8, 2004, at 15:27:32
> I'm curious, has the addition of WB helped to return any of your sex drive? My pdoc insists I try WB (again) before something more unconventional like amantadine or Periactin.
>
> I remember stopping it before getting any benefit twice before when adding to SSRIs -- it made me kinda sad more than anything else.
It hasn't really helped yet with my sex drive. But I'm also on Paxil and Klonopin, which could be the reason for that. What really got my sex drive up more than anything else (although I couldn't reach orgasm) was Lexapro, but it didn't help with the depression, so my pdoc put me on Paxil instead. I'm really hoping that my sex drive will start to come back though. I miss it!I really like the WB though. It makes me feel better than anything else I've tried (which isn't too much) and it started making me feel better pretty quickly, although I've since had to up my dose twice and this week it seems to have become less effective again. I'm waiting to hear from my pdoc about upping my dose again. The only side effect that really bothers me is the insomnia. And after going to 225mg per day, I am actually smoking a lot less! In fact, I didn't have a cig today until about 2:30, which for me is unheard of.
Good luck if you decide to try it again. If it helps, for me the lower dose didn't do it, and I've heard of other people who got tired from a low dose and energized from a higher one.
Posted by Waterlily on January 11, 2004, at 20:24:42
In reply to Re: ***Wellbutrin + Paxil? Anyone????***, posted by jerseydevil on January 5, 2004, at 16:31:18
> I've been on Wellbutrin and Paxil together for a little over a year now, mostly because my pdoc wanted to get me on Wellburtrin and off of Paxil b/c the Paxil side effects were getting to me. When you are consciously aware that you haven't had a drive for over a year, the "sexual side effects" apply to you. I have been progressively weaning off of Paxil although we've need to fill in the void of the antianxiety component of Paxil. I'm on 400 mg/day of Wellbutrin and down to 5 mg of Paxil, but Effexor has replaced Paxil. I feel pretty good right now. I intend to continue to wean off of Paxil entirely (another six months should do it) and stay on the Wellbutrin and Effexor for awhile. Not everyone experiences the same side effects or withdrawl problems, but Paxil has not been my favorate .
If you find anything that works on anxiety when you use it with Wellbutrin (besides benzos, that is), let me know. I've tried Wellbutrin with imipramine (worked sort of - dry mouth didn't work with the orthodontic work going on), Paxil (killed already low libido, didn't do any good), Prozac (didn't do anything), Effexor (liked it, but it gave me insomnia BAD), Serzone (worked sort of, with no side effects), and now Luvox (so far it's not doing much except that it killed the breakthrough depression I had). I'm working on getting up to 200 mg of Luvox to see if it works any better than Serzone did. I'm not sure what else to try at this point.
Posted by watergirl on January 12, 2004, at 14:12:07
In reply to Re: Adding Wellbutrin? » CraigD, posted by sfmom on January 9, 2004, at 16:55:42
Posted by sfmom on January 12, 2004, at 16:39:17
In reply to Thanks for the input, VERY HELPFUL (nm), posted by watergirl on January 12, 2004, at 14:12:07
I'm on my third day off Paxil and just on WB and Klonopin and feel like crap. I have electrical shocks going through my whole body. Much more than this and I'm going to have to jump out a window. It sucks. I weaned off really slowly and was down to 5mg when I quit. My pdoc didn't even warn my that this could happen.
Does anyone know any way to mitigate these Paxil withdrawal symptoms? I've been taking extra Klonopin, vitamins and chinese herbs supposed to help with withdrawal but nothing seems to help except the periodic hot shower. How long does this crap last???
Also, as an update to the question about WB and sex drive, since I've stopped the Paxil I can actually have orgasms again! Yeah, finally!
This is the end of the thread.
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