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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by susannah73 on August 22, 2011, at 13:15:55
I have depression & aniexty. For YEARS I took Effexor XR 150mg. This controlled both my depression and anxiety well except I could no longer tolerate the horrible side effects.
I am now taking Wellbutrin 300mg and it seems to control the depression; however it does nothing for the aniexty. My MD suggested increasing Wellbutrin to 450mg and see how that does.
I am skeptical that this dosage increase will do much of anything to control the anxiety. I also cannot sleep because of the anxiety.
I am looking for a better medication or medication combo to treat both my depression & anxiety...however
1. I will not take another SSRI similar to Effexor XR.
2. I prefer not to take a daily supply of Xananx, Valium, Ativan, ect. as I think they would be habit forming.Any suggestions as to an "add-on" to Wellbutrin to treat anxiety or a different medication all together to treat both?
Thank you.
Posted by herpills on August 22, 2011, at 14:36:32
In reply to Need a Depression/Aniexy Medication Combo, posted by susannah73 on August 22, 2011, at 13:15:55
Wellbutrin is not an anxiety medication, so I don't see how raising the dose would help that. In fact, it could make your anxiety worse.
For most people benzos are the best for anxiety but I don't blame you for not wanting to take them.
There is a medication called Buspar which could help.
There are also natural supplements you could try, although I don't know much about them, other people here may be able to offer suggestions. herpills
Posted by B2chica on August 22, 2011, at 15:04:07
In reply to Re: Need a Depression/Aniexy Medication Combo, posted by herpills on August 22, 2011, at 14:36:32
wellbutrin is stimulating, so if you have trouble with sleeping or anxiety increasing is not a good idea. nor do i think 450 would even help more with depression. it seems to peak and once you start having to go up, you are better augmenting, and then it seems to poop out all together.
so hang at the dosage you are at and either aument with something strictly for anxiety, or another AD that aids with anxiety.
perhaps lexapro?i have gabapentin for anxiety, works pretty well, except on those really bad days.
Posted by floatingbridge on August 22, 2011, at 16:10:14
In reply to Re: Need a Depression/Aniexy Medication Combo, posted by B2chica on August 22, 2011, at 15:04:07
B2c, how do you dose your gabapentitine?
Thanks.
Posted by floatingbridge on August 22, 2011, at 16:17:33
In reply to Need a Depression/Aniexy Medication Combo, posted by susannah73 on August 22, 2011, at 13:15:55
Recently I was presented with Luvox as option for depression/anxiety.
I'm not sure if it's in the snri category like effexor. It is supposed to work more specifically on anxiety. I haven't tried it.
Lyrica works on gaba as well. Have you read about that? It is related to the gabapenitine mentioned above, but works more directly on gaba somehow.
If I think of something else, I'll post.
Posted by susannah73 on August 22, 2011, at 16:56:44
In reply to Need a Depression/Aniexy Medication Combo, posted by susannah73 on August 22, 2011, at 13:15:55
Thank you. I have a Dr. appt on Wed to get this straightened out. I'll post the results. Thanks.
Posted by Christ_empowered on August 22, 2011, at 18:44:47
In reply to Re: Need a Depression/Aniexy Medication Combo, posted by susannah73 on August 22, 2011, at 16:56:44
"atypical" antipsychotics, in low doses, are an option, as long as you have good insurance. The more sedating ones include zyprexa and seroquel. Risperdal is an option (its also generic now), but I think its one of the "rougher" atypicals in terms of side effects.
BuSpar. Hydroxyzine. Lyrica. Neurontin. Adding celexa/lexapro to the wellbutrin. Trazadone for sleep. Really, really low dose thorazine.
Posted by jono_in_adelaide on August 22, 2011, at 19:41:14
In reply to Need a Depression/Aniexy Medication Combo, posted by susannah73 on August 22, 2011, at 13:15:55
Three options spring to mind
One would be adding Buspar to the Welbutrin, in a dose of 15-30mg twice a day (this is a non habit forming anti anxiety med)
The second would be stopping the Welbutrin and changing to Remeron, at a dose of 30mg at bedtime
Third would be to keep taking the Welbutrin and add Atarax (hydroxyzine) 25-50mg 3 times a day..... this is an old antihistamine that has tranquilising properties, also non habit forming
Posted by Phillipa on August 22, 2011, at 21:47:09
In reply to Re: Need a Depression/Aniexy Medication Combo, posted by jono_in_adelaide on August 22, 2011, at 19:41:14
FB yes luvox is an SSRI. Suzanne you didn't rule out SNRI's which would be cymbalta. Might be an option. Benzos also don't have to escalate mine haven't. Neurotin works some for anxiety and what about at night lunesta or ambien? Phillipa
Posted by Avenarius on August 22, 2011, at 22:30:10
In reply to Need a Depression/Aniexy Medication Combo, posted by susannah73 on August 22, 2011, at 13:15:55
My situation was much like yours, had to quit effexor after years.
I suggest, as I always do, that you look at this algorithm for finding the right treatment.
http://www.mhc.com/Algorithms/Depression/frames.htm
Also check out the flow chart. These led me to a diagnosis of atypical depression and now I'm having good luck with an MAOi.
Posted by B2chica on August 23, 2011, at 10:35:05
In reply to Re: Need a Depression/Aniexy Medication Combo » B2chica, posted by floatingbridge on August 22, 2011, at 16:10:14
when i was first on gabapentin it was 100mg pills TID, but that only lasted about two weeks.
then i went to self dosing about 600mg a day. then talked with pdoc and he rx 300mgTID.
i currently have that script however i normally take my perphenazine and 1 (300mg) at night, unless 600 is needed.during the day it varies. the perphenazine does a pretty good job of containing it, when it breaks through i was taking anywhere from 300mg TID to 600mg three or so times a day.
i think that upper part of that was before i was put on the perphenazine.sorry i'm not much help. but to be honest i kinda just take it when needed as needed.
i will state a warning though that at the upper range i started to get glaucoma type symptoms...severe pressure and red eye. so be careful. i dont advise going up as high as i was.
i'd stick with max at 300 TID. that should do the job.b2c
Posted by floatingbridge on August 23, 2011, at 10:51:02
In reply to Re: Need a Depression/Aniexy Medication Combo » floatingbridge, posted by B2chica on August 23, 2011, at 10:35:05
Posted by creepy on August 28, 2011, at 16:03:48
In reply to Need a Depression/Aniexy Medication Combo, posted by susannah73 on August 22, 2011, at 13:15:55
Id try adding one of the other SSRIs to wellbutrin.
Effexor is one of the worst with discontinuation. Paxil is also up there. Prozac, zoloft and celexa might be good options.
This is the end of the thread.
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