Psycho-Babble Medication Thread 1027571

Shown: posts 1 to 15 of 15. This is the beginning of the thread.

 

Wellbutrin great for OCD+Anx but not depression

Posted by pedr on October 4, 2012, at 11:06:50

Hi troops, has anyone else found this with WB? My levels of anxiety and OCD are at an all-time low but as the day wears on, I become more and more depressed and flat.

Anyone have any good adjunct suggestions to address the depression? I'm seeing my shrink today and I we're likely going to go with Viibryd.

Cheers, Pete

 

Re: Wellbutrin great for OCD+Anx but not depression pedr

Posted by phillipa on October 4, 2012, at 13:00:54

In reply to Wellbutrin great for OCD+Anx but not depression, posted by pedr on October 4, 2012, at 11:06:50

Pete read above articles on Teva wellbutrin and great luck at pdocs!!!! Phillipa

 

Re: Wellbutrin great for OCD+Anx but not depression phillipa

Posted by pedr on October 4, 2012, at 17:17:09

In reply to Re: Wellbutrin great for OCD+Anx but not depression pedr, posted by phillipa on October 4, 2012, at 13:00:54

@Phillipa: I'm taking the 75's which aren't mentioned in that article. I wonder if those were also under par.

 

Re: Wellbutrin great for OCD+Anx but not depression

Posted by JONO_IN_ADELAIDE on October 4, 2012, at 18:59:47

In reply to Re: Wellbutrin great for OCD+Anx but not depression phillipa, posted by pedr on October 4, 2012, at 17:17:09

What dose are you taking? You generaly need to be at 300mg per day for an antidepressant effect.

My gut feel would be to increase to 300mg per day, and add an SSRI (say Zoloft 50-100mg or Escitraolpram 10-20mg)

 

Re: Wellbutrin great for OCD+Anx but not depression JONO_IN_ADELAIDE

Posted by pedr on October 4, 2012, at 22:35:48

In reply to Re: Wellbutrin great for OCD+Anx but not depression, posted by JONO_IN_ADELAIDE on October 4, 2012, at 18:59:47

> What dose are you taking? You generaly need to be at 300mg per day for an antidepressant effect.
>
> My gut feel would be to increase to 300mg per day, and add an SSRI (say Zoloft 50-100mg or Escitraolpram 10-20mg)

Hi Jono, I've already tried increased to 375mg and it hasn't helped like I hoped it would. Also I haven't done well on SSRI's in the past, they tend to make my depression worse. Thanks for the shout tho.

 

Re: Wellbutrin great for OCD+Anx but not depression

Posted by jono_in_adelaide on October 5, 2012, at 1:09:40

In reply to Re: Wellbutrin great for OCD+Anx but not depression JONO_IN_ADELAIDE, posted by pedr on October 4, 2012, at 22:35:48

Maybe try adding mirtazepine, say 30mg at bedtime?

 

Re: Wellbutrin great for OCD+Anx but not depression pedr

Posted by phidippus on October 5, 2012, at 16:21:01

In reply to Wellbutrin great for OCD+Anx but not depression, posted by pedr on October 4, 2012, at 11:06:50

I don't have any idea why you're OCD has gotten better-there's no mechanism of action that would cause that to happen.

How many mg of Wellbutrin are you on?

Eric

 

Re: Wellbutrin great for OCD+Anx but not depression phidippus

Posted by pedr on October 5, 2012, at 16:28:05

In reply to Re: Wellbutrin great for OCD+Anx but not depression pedr, posted by phidippus on October 5, 2012, at 16:21:01

> I don't have any idea why you're OCD has gotten better-there's no mechanism of action that would cause that to happen.

I'm not surprised at all. It's not like anyone can say with great confidence how any AD achieves (or doesn't achieve) the effects it does or why people exhibit such idiosyncratic responses to them.

>
> How many mg of Wellbutrin are you on?
>

375mg daily in 2 doses. I am hopefully shortly to be adding Viibryd but my insurance is resisting. Sigh.

For the record I'm IBS-C, GERD, OCD with chronic anxiety and depression. I've tried all the main AD classes and IBS treatments. Nothing has delivered sustained appreciable relief. Yay.

Pete

 

Re: Wellbutrin great for OCD+Anx but not depression pedr

Posted by phidippus on October 7, 2012, at 13:44:55

In reply to Re: Wellbutrin great for OCD+Anx but not depression phidippus, posted by pedr on October 5, 2012, at 16:28:05

>I'm not surprised at all. It's not like anyone can say with great confidence how any AD achieves (or doesn't achieve) the effects it does or why people exhibit such idiosyncratic responses to them.

I'm just skeptical. If you look at the pathology of OCD, you'll find serotogenic ADs, namely SSRIs are the frontline treatment for the disorder because the PFC is usually deficient in serotonin.

Wellbutrin doesn't raise serotonin at all. Its only an NDRI.

How long have you been taking it?

You've tried all the ADs?

Eric

 

Re: Wellbutrin great for OCD+Anx but not depression

Posted by pedr on October 8, 2012, at 9:45:28

In reply to Re: Wellbutrin great for OCD+Anx but not depression pedr, posted by phidippus on October 7, 2012, at 13:44:55

> I'm just skeptical. If you look at the pathology of OCD, you'll find serotogenic ADs, namely SSRIs are the frontline treatment for the disorder because the PFC is usually deficient in serotonin.

interesting. My understanding is that the amygdala is "where it's at" with OCD. Also, just cos they're the frontline treatment doesn't mean they're effective of course o_0

>
> How long have you been taking it?

ummm a good few months now. This is my 2nd dalliance with it.

>
> You've tried all the ADs?
>

all the classes and the prominent novels, yes. A fair few of the more noted combo's too.

My main problem is that even when I find a helpful med, my IBS cuts through its effect like butter. When my IBS pain is bad, my depression is bad and I've never been able to sever that causality. My next main issue is that every med that's helped me poops out between 1-2 months later.

As such it's highly likely that I will spend the next few decades suffering greatly. Awesome.

 

Re: Wellbutrin great for OCD+Anx but not depression pedr

Posted by phidippus on October 8, 2012, at 18:30:01

In reply to Re: Wellbutrin great for OCD+Anx but not depression, posted by pedr on October 8, 2012, at 9:45:28

>My understanding is that the amygdala is "where it's at" with OCD

The amygala gets involved, but more prominent brain regions get the blame. Like the Nucleas Accumbens and the prefrontal cortex.

The neurotransmitters believed to be involved are dopamine and seratonin. Norepenephrine is not an agent. Specifically defecits in serotonin and too much dopamine.

That's why a favorite strategy of psychiatrists (who know and have experience with OCD) Is to treat OCD with an SSRI and an antipsychotic.

I found three ADs that work well in treating my OCD-Viibryd,Mirtazapine and Clomipramine.

Adalimumab is a drug used to treat Chron's Disease. I wonder if it would be good for IBS.

Are you on opiates for the pain?

Eric

 

Re: Wellbutrin great for OCD+Anx but not depression phidippus

Posted by pedr on October 11, 2012, at 6:08:53

In reply to Re: Wellbutrin great for OCD+Anx but not depression pedr, posted by phidippus on October 8, 2012, at 18:30:01

> The neurotransmitters believed to be involved are dopamine and seratonin. Norepenephrine is not an agent. Specifically defecits in serotonin and too much dopamine.

but do you really think it's as simple as the 4 main transmitters and talk of deficits&excess? I don't. In fact, that can't be the whole picture otherwise we'd all be effectively treated and very few people would have mental illness. Look at recent papers on ketamine, glutamine and so on. But I agree that we have to work with the information that we have and make the best call that we can.

> Adalimumab is a drug used to treat Chron's Disease. I wonder if it would be good for IBS.

I know a lot of IBS research is looking at IgE and IgG so it's not out of the question. Maybe a trial with IBS'ers is in the pipeline. I paid a bunch of money a while back to get an Ig? panel done and received back a list of foods to avoid. Made no difference whatsoever lol.

> Are you on opiates for the pain?

No and I don't know anyone who is. I think it's "not the done thing" with IBS'ers. Possibly because there isn't a tangible physical problem which is causing pain, unlike arthritis for example. I have seen some people report that strong painkillers just didn't work, too. Another aspect of IBS is that it's not just the pain but the lethargy, weakness, bloating and general feeling of having been poisoned - opiates wouldn't address that.

 

Re: Wellbutrin great for OCD+Anx but not depression pedr

Posted by SLS on October 11, 2012, at 7:07:00

In reply to Re: Wellbutrin great for OCD+Anx but not depression, posted by pedr on October 8, 2012, at 9:45:28

I think clomipramine might be a good drug for you. It is effective for treating both OCD and IBS.


- Scott

 

Re: Wellbutrin great for OCD+Anx but not depression SLS

Posted by pedr on October 11, 2012, at 9:15:53

In reply to Re: Wellbutrin great for OCD+Anx but not depression pedr, posted by SLS on October 11, 2012, at 7:07:00

> I think clomipramine might be a good drug for you. It is effective for treating both OCD and IBS.

I'll add it to my list of prospective meds.

I've only tried Surmontil (Trimipramine) of the Tricyclics. It made me sleep 13+ hours a day and be fatigued when awake. This really spiked my OCD (which ironically, is a fear of becoming so depressed that I kill myself) and exacerbated my IBS-C. And at the time I didn't know I had OCD or IBS. I was not a happy camper.

 

Re: Wellbutrin great for OCD+Anx but not depression

Posted by Hombre on October 17, 2012, at 5:56:34

In reply to Re: Wellbutrin great for OCD+Anx but not depression pedr, posted by SLS on October 11, 2012, at 7:07:00

> I think clomipramine might be a good drug for you. It is effective for treating both OCD and IBS.
>
>
> - Scott

I have nothing useful to add, I'm just overjoyed that Scott is still here. And everyone else, of course :) but I remember going to his web page, and knowing how brilliant he is from the boards and getting to know a little about his history, well damn if you don't want him to find recovery someway somehow, as I wish you all.

OK, that's it for me...take care y'all.
H


This is the end of the thread.


Show another thread

URL of post in thread:


Psycho-Babble Medication | Extras | FAQ


[dr. bob] Dr. Bob is Robert Hsiung, MD, bob@dr-bob.org

Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.