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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by 8833 on December 1, 2007, at 2:01:18
This is my first post, thank you for your patience.
I'm an adult who has always, since childhood, had low mood/mild depression/moodiness (big highs and big lows). However, for the first time ever, about 6 weeks ago I began to feel (very suddenly) that I was just in a black hole -- didn't want to talk to anyone, go to work, etc. for no apparent reason -- no problems at work, great family, etc.
I felt horrible. So I went to my GP. After talking with me, he prescribed Wellbutrin SR 150 mg once a day. I mentioned Wellbutrin to him because I actually did some research and saw that it had low risk of bad libido issues.
First week, I had headache, a little dizziness. However, since then, I have had more energy, been more open and talkative, less irritable, less likely to have big mood swings (for example, less likely to start crying spontaneously at a sad song on the radio) (which, before, happened all the time.). My wife says that I have been much easier to live with, less "walking on eggshells" around me. So it has been a great improvement.
I have a few questions:
1. Are the feelings I have described the effect of the AD? I have never taken one before, and I dont have anything to compare with Wellbutrin. Do other ADs give a really happy feeling, compared to WB, or is this what an AD feels like? Not to sound greedy -- I just wonder what else is out there, particularly one that doesn't hurt libido.
2. Would increase in dose to 100 mg twice a day increase the energy and improve all of those feelings I described, maybe even make it "happier"? Taking 150 mg, I have to take it midday, because it seems to "wear off" by dinner time if I take it at breakfast, and I feel a little tired, irritable -- would 100 mg twice a day help? (I wonder this especially since I see that the SR is usually given twice a day).
3. I took my blood pressure and it was about 139/70 instead its normal of around 120/70. Is this from WB? If so, can this effect go away as my body adjusts to taking it? If I were to have give up WB b/c of this, are there other ADs that would give similar effect without bad BP issues? I really dont want to think about giving up WB, it has really helped.
Thank you all very much for your attention and response.
Posted by Zyprexa on December 1, 2007, at 9:18:48
In reply to Wellbutrin- mood -blood pressure-dosage, posted by 8833 on December 1, 2007, at 2:01:18
Yes, probably wellbutrin. That is what it did to mine. No didn't go away. I take blood pressure med with it.
Posted by Racer on December 1, 2007, at 10:55:54
In reply to Wellbutrin- mood -blood pressure-dosage, posted by 8833 on December 1, 2007, at 2:01:18
That sounds like the Wellbutrin is working. Rather than increasing the dose of the SR, I'd suggest talking to your doctor about switching to the XL. Or, at least, asking why he/she went with SR instead of XL. That should improve the life of the action.
As for raising the dose, if it's working at 150mg, it's not necessary to raise the dose. There are generally windows of therapeutic action with anti-depressants -- increasing above that range is more likely to result in side effects, rather than increased effectiveness. Antidepressants aren't designed as "happy pills," they're just designed to bring you out of a depressive episode and back to normal levels of functioning.
As far as side effects go, for many people Wellbutrin has a very friendly side effect profile. Unfortunately, increased blood pressure can be one of those side effects. If the Wellbutrin is working for you -- and it sure sounds as though it is -- sticking with it and taking something to mitigate the increased blood pressure would make a lot of sense.
As far as other drugs that might help without the change to blood pressure, they'd come along with other side effects. With antidepressants, it's often the case that several drugs will all be effective for someone, but the side effect profile will make one of those drug the best choice. In fact, one reason for treatment-resistance in depression is an intolerance to side effects -- there's a drug which would work, but its side effect profile makes it impossible to take. (There are people here who will likely refute that opinion, so take it for what it's worth.)
Congratulations on getting a winner first time out, and good luck with continued success with it.
Posted by Phillipa on December 1, 2007, at 11:41:30
In reply to Re: Wellbutrin- mood -blood pressure-dosage, posted by Racer on December 1, 2007, at 10:55:54
Yes you have no idea how lucky you are to have a winner first time out and continued success with it. Phillipa
Posted by DStupid on December 1, 2007, at 12:57:51
In reply to Wellbutrin- mood -blood pressure-dosage, posted by 8833 on December 1, 2007, at 2:01:18
<< I took my blood pressure and it was about 139/70 instead its normal of around 120/70. Is this from WB? If so, can this effect go away as my body adjusts to taking it?>>
Likely from WB, and won't go away. Check your pulse, too. It's likely to be increased as well. I couldn't handle WB without a concomitant blood-pressure medication, and stopped it. Like you, I was also taking WB SR 150 mg. once daily. I've learned that picking a blood-pressure reducing medication is an art in and of itself. They come in 4 general categories and have sub-categories: beta blockers (selective and non-selective), ACE inhibitors, ARBs (differences in the strength of action), calcium channel blockers, and diuretics (thiazide-based, potassium-sparing, and loop). They're prescribed based on the patient's specific problem after a stress test. Also, there are medications which are prescribed for heart problems but are not the mainstay of cardiac therapy, such as alpha blockers.
Posted by stargazer2 on December 3, 2007, at 9:49:55
In reply to Wellbutrin- mood -blood pressure-dosage, posted by 8833 on December 1, 2007, at 2:01:18
You would have to monitor you BP a few times a day to get an accurate reading to verify that wellbutrin is causing an increase in your BP.
The two values you give, 139/70 and 120/70 are both within the normal range. The diastolic number (bottom) is really the more important of the two and yours remained the same. Daily and hourly fluctuations of BP is normal and until you analyze readings over the course of a few weeks, you can not be sure of Wellbutrin's effect on your BP.
If the systolic number (Top) goes up a few points and the bottom number stays constant, that is no cause for alarm.
If the bottom number goes above 85 and stays there over the course of a week or two that is significant. (ex. 120/85, 130/90, 124/88, 118/98)
It's really the two numbers together which are evaluated, but just a few readings are not enough to signify an increase in your BP.
Babble me if you have BP readings for a week, or better yet, two weeks, at different times of the day and then you can evaluate those numbers and say it is within the normal range of variation or is an increase related to the wellbutrin. Getting your pulse too is important.
I wouldn't stop Wellbutrin based on what you are considering an increase in BP, when it is clearly not a significant change.
Stargazer
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