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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Charm on August 9, 2004, at 14:20:46
Hello -
My pdoc believes that 300 mg effexor, 30 mg Adderall and 300 mg Wellbutrin is too much.
Before I was taking 300 mg of Effexor, 2.5 mg of Zyprexa and just recently started the 30 mg Adderall ( I also take 45mg buspar per day). I dropped the Zyprexa on my own because of sedative effects even at this low doseage.
She said that in order to add the Wellbutrin I had to drop the Effexor to 150mg. So, during my appointment today, she told me to decrease my Effexor to 150 mg and gave me a prescription for 150 mg Wellbutrin xl. She says that we can increase it to 300 mg of Wellbutrin next month.
Do you guys agree that there was a need to decrease the Effexor? She just seems to think its too much medicine.
Thanks!
Charm
Posted by linkadge on August 9, 2004, at 14:47:10
In reply to Am I taking too many meds? Need opinions, posted by Charm on August 9, 2004, at 14:20:46
I would think that 300mg of effexor, 300mg of wellbutrin and the stimulant you mentioned would probably be a bit in excess unless lower doses of the medications really didn't cut it.
There really is no "too much" if your depression simply isn't responding, but there can be definate drawbacks to overmedication. I would try a lower dose for a little while, then try increasing.
Linkadge
Posted by King Vultan on August 9, 2004, at 16:38:40
In reply to Am I taking too many meds? Need opinions, posted by Charm on August 9, 2004, at 14:20:46
> Hello -
>
> My pdoc believes that 300 mg effexor, 30 mg Adderall and 300 mg Wellbutrin is too much.
>
> Before I was taking 300 mg of Effexor, 2.5 mg of Zyprexa and just recently started the 30 mg Adderall ( I also take 45mg buspar per day). I dropped the Zyprexa on my own because of sedative effects even at this low doseage.
>
> She said that in order to add the Wellbutrin I had to drop the Effexor to 150mg. So, during my appointment today, she told me to decrease my Effexor to 150 mg and gave me a prescription for 150 mg Wellbutrin xl. She says that we can increase it to 300 mg of Wellbutrin next month.
>
> Do you guys agree that there was a need to decrease the Effexor? She just seems to think its too much medicine.
>
> Thanks!
>
> CharmYes, from the standpoint of enzyme interactions, the Wellbutrin is likely increasing the blood plasma level of the Effexor greatly, as Wellbutrin is a powerful 2D6 inhibitor, and Effexor is a 2D6 substrate. This will be exacerbated in your case because 300 mg/day represents full therapeutic dosages of each, and the increase in the Effexor blood plasma level is likely to be enormous. There has been at least one case of serotonin syndrome reported from the combination of these two drugs, very likely because of this enzyme thing. Your doctor appears to be informed and prudent, and I think the decision is a wise one.
Todd
Posted by Bill LL on August 10, 2004, at 9:52:09
In reply to Am I taking too many meds? Need opinions, posted by Charm on August 9, 2004, at 14:20:46
Charm- What is the reason for adding Wellbutrin? Is it to counteract tiredness? I never took Adderall, but I thought that it gave energy if the dose is high enough. Your dose is 30 mg but I don't know if that is a low or a high dose.
If tiredness is the main problem, I would think that Provigil might work better than Wellbutrin since Provigil might be less likely to cause jitteriness.
Posted by bethesdabob on August 11, 2004, at 13:01:57
In reply to Re: Am I taking too many meds? Need opinions, posted by King Vultan on August 9, 2004, at 16:38:40
I think that it's a good idea to cut back on meds, wish that it had been suggested to my wife, she died from a seizure disorder last December brought on I believe by the amount of medication that she was taking.
Her p-doc treated wife for her depression and epilepsy, at the time of her death my wife was taking 900 mgs. of trileptal, 450 mgs of effexor xr, 90 mgs. of remeron, 3 mgs of risperdal, 6 mgs of clonazepam, 10 mgs of ambien, 32 mgs. of atacand, and stadol NS and tylenol with codeine #3 for headache.
Posted by Charm on August 12, 2004, at 9:06:46
In reply to Re: Am I taking too many meds? Need opinions, posted by bethesdabob on August 11, 2004, at 13:01:57
> I think that it's a good idea to cut back on meds, wish that it had been suggested to my wife, she died from a seizure disorder last December brought on I believe by the amount of medication that she was taking.
>
> Her p-doc treated wife for her depression and epilepsy, at the time of her death my wife was taking 900 mgs. of trileptal, 450 mgs of effexor xr, 90 mgs. of remeron, 3 mgs of risperdal, 6 mgs of clonazepam, 10 mgs of ambien, 32 mgs. of atacand, and stadol NS and tylenol with codeine #3 for headache.
>
>I'm so sorry to hear about your wife. It's absolutely heartbreaking. Thanks for sharing it. It certainly makes me think twice about wanting to take more or higher amounts of medication.
Posted by bethesdabob on August 16, 2004, at 12:32:52
In reply to Re: Am I taking too many meds? Need opinions, posted by Charm on August 12, 2004, at 9:06:46
Appreciate your kind words, math was never my strong suit, said 450 mgs. of effexor xr correction 600 mgs. of effexor xr.
You never know how your body will react the more meds you put inside your system, in my wife's case she was an epileptic and had also once suffered with hepatitis so her liver did not work that well. The combination of all the stuff that she was taking I believe caused her to have a fatal seizure. Be careful
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