Posted by yxibow on January 27, 2006, at 23:07:44
In reply to Re: Blueberry, YXIBOW: Your opinion on this??????, posted by qbsbrown on January 27, 2006, at 7:51:00
> Well all psychiatric debates aside, it was still a question of whether or not i was to try something to manage the depression while the taper of the benzos.
>
> Today was day 4 of 150SR wellbutrin. A notice in antidepressant effect, will go to 300 soon. Anxiety/irritibility hasn't skyrocketed at all yet (although derealization has).
> Does seem to induce nasuea and migraines, which are due to my liver (i read wellbutrin is one of the hardest on the liver). If supplements can't maintain and assist the liver, i'll drop it.
>
> So either it'll bomb like the rest of the meds, or it'll be a sucsess (hopefully only through taper). With my extremely addictive personality, im hoping that dopamine and norephrinine are my thing.
I personally wouldn't read too much into supplements that claim to do anything to the liver but you're entitled to your own view.You are right, Wellbutrin has metabolites (3), especially hydroxybuproprion that is metabolized by CYP P450 2B6 at a considerable higher level than the drug itself (7 times). I wouldn't be too concerned about liver levels as long as you're not taking too many multiple drugs. At the level you're currently at, nausea is only slightly higher than placebo in trials. Migraine is near zero, unless you happen to suffer from an organic migraine disorder. But as they say, your miles may vary.
The nausea will probably pass. I wouldn't go to 300 too soon, that will just cause a greater chance of your migraines and nausea. Upward tapers of these things are measured in weeks, not days. These are are largely transient effects of most antidepressants.
At the moment, since you're tapering off of Valium, you're pretty protected from the only thing I would be concerned with patients on Wellbutrin, which is seizures.
Thats the main bold warning, which is on the order of 1 in 1000, and obviously more in those prone to seizures. This goes up exponentially above 450 mg/day. I personally would take it with a pinch of my preferred benzodiazepine per day as a preventative , or Neurontin or something, but that's up to you.
Derealization can occur and is a component of depression itself. Its also a possible component of benzodiazepines. I'm not sure about Wellbutrin.
Although I'm happy you have response on day 4, there are very few antidepressants (with the exception of certain antipsychotics) that have that immediate of an effect. Placebo effects occur as much as 1/3 of the time, and they're just as good :) These things take time and I would take plenty of time to build to 300 or 450mg, to reduce the risk of the rare seizure effect.
To good health
Tidings
-- Jay
poster:yxibow
thread:601675
URL: http://www.dr-bob.org/babble/20060122/msgs/603661.html