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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 Marc R M on August 21, 2004, at 15:39:32
I'm wondering if anyone else has experienced what I'm experiencing. I'm on 450 mg of Wellbutrin, 300 mg of Effexor XR, and 45 mg of Remeron, yet I still experience constant fatigue throughout the day.
What makes matters worse is that I have a fairly "demanding" job and I have to "produce." Any suggestions?
Posted by HappyGirl on August 21, 2004, at 16:54:09
In reply to Fatigue even with Wellbutrin, posted by Marc R M on August 21, 2004, at 15:39:32
Hi:
I never think that Wellbutrin is any contribution to 'constant-fatigue' you've been experiencing. WB is a sort stimulating effectiveness to make you 'perk-up,' rather than make you tired/fatigued. Rather, other 'two' anti-depressants, .... particularly 'Remeron' due to its sedative effectiveness. Also, Effexor 300 mg. seems 'mass' dosage, ... unless your depression is VERY severe.
H.G.
Posted by dazedandconfused on August 21, 2004, at 17:08:34
In reply to Fatigue even with Wellbutrin, posted by Marc R M on August 21, 2004, at 15:39:32
Yes, but I wasn't on Remeron. I'm with HG, I would venture a guess that is the cause.
I was on 60mg Celexa, 450mg Wellbutrin and 54 Concerta (Ritalin). I was still tired!!! You just never know w/ these dang meds.
FYI, I have no idea why, but I was more tired on the Wellbutrin XL vs. the XR. Have no idea why...
dazed
Posted by noelle on August 21, 2004, at 17:33:11
In reply to Re: Fatigue even with Wellbutrin, posted by dazedandconfused on August 21, 2004, at 17:08:34
Finally someone with my issue. Wellbutrin worked for me a while and then it started causing fatigue for me. I noticed that this is when I really needed an ssri instead
Posted by King Vultan on August 21, 2004, at 23:30:50
In reply to Fatigue even with Wellbutrin, posted by Marc R M on August 21, 2004, at 15:39:32
> I'm wondering if anyone else has experienced what I'm experiencing. I'm on 450 mg of Wellbutrin, 300 mg of Effexor XR, and 45 mg of Remeron, yet I still experience constant fatigue throughout the day.
>
> What makes matters worse is that I have a fairly "demanding" job and I have to "produce." Any suggestions?
Your combined dosages of these drugs are massive, and there are likely some severe CYP-450 interactions going on here. For instance, Wellbutrin is a powerful inhibitor of the 2D6 enzyme, which is involved in metabolizing the Effexor. My guess is that the blood plasma level of the Effexor has been increased by a factor of at least 3-5 times beyond what it would be taking 300 mg by itself. Since Effexor commonly induces lethargy and somnolence in overdose, I think there's a good chance that this is at least part of your problem. I would question your doctor about this issue, and if he seems ignorant of it, I think it would probably be in your best interest to find someone else.Todd
Posted by fuji on August 22, 2004, at 8:53:45
In reply to Fatigue even with Wellbutrin, posted by Marc R M on August 21, 2004, at 15:39:32
I added wellbutrin for some energy and it's like drinking coffee in that it makes me yawny and sleepy but I will give it a couple of more weeks and see what happens. Probably will go back to prozac and effexor. Now its efxr & wb.
Posted by waki on August 22, 2004, at 22:10:52
In reply to Fatigue even with Wellbutrin, posted by Marc R M on August 21, 2004, at 15:39:32
sit down with your p-doc and find out what each med does.
Work with him on turning up the volume on norepinephrine. I am 100% sure that for me, the Norepinephrine and the dopamine are my "superman phone booth".
You know how ole superman changes in the booth from clark kent to superman?
well this combo changes me from a couch potato back to a superior athlete.
I view myself as a high performance engine. I want to get all my measurables "dialed" in to be more efficient.
Even though my thyroid is normal, we may be cranking up the T 1 or T 2(I forget up).
About 25 years ago I used to be on anabolic steroids for strength and speed. Additionally I would cycle my thyroid to run my metabolisam like a blast furnace.
I practically forgot about this method, until my p-doc mentioned it. I then had fond memorys of being able to consume food and generate energy like a blast furnace.
Crank up that engine of yours bro! Work with the doc to stoke that ole pot belly stove of yours!
This is the end of the thread.
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