Posted by Wits End on September 11, 2004, at 9:55:20
I have BP2, and I have gone through all kinds of medication combinations over the past 10 years, none of which have worked more than 3 months. Parnate was my last successful try, lasting 3 months but then pooping out on me. Then during my 2 week washout period, I became suicidally depressed. My doctor gave me Zoloft, which lifted the depression immediately, but that relief only lasted a week. Because Adderall has worked in the past, and I knew that Zoloft (100mg) was going to take time to get fully into my system, my pdoc prescribed me Adderall to get me through that point (I have to function at work). When the low dosage of Adderall was not doing enough, I went on disability and into a day program where they added Wellbutrin XL(300mg), Strattera (160mg), Keppra (1000mg), and Geodon (120mg). Things were wonderful after only 3 days of taking the additional meds on top of Zoloft and 10-20mg Adderall.
During the fourth week of that combo, however, I started to feel more and more overwhelmed and overmedicated. I thought it may be the Adderall so I dropped that cold turkey (flushed it down the toilet) and went through withdrawal (2 days of terrible depression). But later I was getting worse and was experiencing tremors, heart palpitations, fever, visual trails. When I first called the pdoc, he said it was a panic attack and prescribed me Risperdal to take care of it (my tolerance to klonopin is becoming too high). By Friday it was evident it was not a panic attack, and I almost went to the ER. My wife and I did tons of research and decided it was a dopamine overdose.
Over the Labor Day weekend, I cut my Strattera and Wellbutrin XL dosage in half (the pharmacist actually cut the 300mg pill--a HUGE no-no). I tried 5mg of NADH hoping for some relief since I no longer had my Adderall, but that only gave me energy and no relief from the depression or anhedonia.
On Tuesday the pdoc gave me 150 Wellbutrin XLs and told me stay at the lower 150mg dose as well as not taking any more Strattera. We also decided to substitute Risperdal for Geodon. The very next day I experienced an extreme rebound depression. On Thursday the pdoc decided to add another 2mg Risperdal (up to 4mg now) to help with the agitation part of the depression (I have energy but no motivation and extreme anhedonia). He didn't want to add to the Wellbutrin, which I know helps with the depression. I can't wait another week so I went ahead and went up to my original dosage of 300mg (went to Wellbutrin SR). I have done that for 2 days now, and I don't feel much different at all.
Why did that initial relief have to disappear? How long before I start feeling any better? Is Wellbutrin going to stop working? Should I go back onto Adderall? I am scared to go back to Adderall because I developed a tolerance to it last year, and it stopped working (but so does everything else, it seems). The withdrawal from it was hell. Any other ideas? I feel like I am about to lose my mind.
At My Wit's End
poster:Wits End
thread:389595
URL: http://www.dr-bob.org/babble/20040909/msgs/389595.html