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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Don on February 21, 2000, at 12:52:42
In an attempt to alleviate the mood disorders that apparently stem from a malfunctioning pituitary and non-existent thyroid, my endocrinologist and psychiatrist have collaborated and I now take 150 mg of Wellbutrin SR, 10 mg Celexa and 120 mg Armor thyroid each a.m.
Two weeks into this combination I sleep 10 to 12 hours per night and feel groggy, tired and just don't care about much of anything during waking hours. When I went to 20 mg of Celexa, those symptoms worsened. And, the anxiety still rears it's ugly head without apparent cause and without warning.
Anyone have similar experiences with similar combinations?
Posted by CarolAnn on February 21, 2000, at 16:53:43
In reply to Wellbutrin + Celexa = apathy exhaustion, posted by Don on February 21, 2000, at 12:52:42
Hey Don, I'm currently on 200 mgs. Wellbutrin twice per day, and 20 mgs. Celexa once per day, and I am not having any problem with excessive fatigue(which has always been a major symptom of my depression). I think that what is making the difference is the 10 mgs. of Adderall(a stimulant for ADD) that I take three times per day. My Pdoc originally prescribed the Adderall because I was having problems with fatigue while on the highest dose of Wellbutrin, which is supposed to be a stimulating anti-depressant. So, you might want to talk to your Doctor about adding a stimulant. Even though they are mostly used for ADHD, my Dr. says that it is quite common to use stimulants to "boost" the effect of anti-depressants. Seems to be working for me. Good luck!CarolAnn
Posted by torchgrl on February 21, 2000, at 19:50:21
In reply to Re: Wellbutrin + Celexa = apathy exhaustion, posted by CarolAnn on February 21, 2000, at 16:53:43
Don,
When I was taking 20mg/day of Celexa, I was SO apathetic I couldn't even motivate to get out of bed--I just didn't really care if I did or not, or what I would do next. So that could definitely be the source of your apathy...
Posted by JohnL on February 22, 2000, at 4:51:32
In reply to Wellbutrin + Celexa = apathy exhaustion, posted by Don on February 21, 2000, at 12:52:42
> In an attempt to alleviate the mood disorders that apparently stem from a malfunctioning pituitary and non-existent thyroid, my endocrinologist and psychiatrist have collaborated and I now take 150 mg of Wellbutrin SR, 10 mg Celexa and 120 mg Armor thyroid each a.m.
>
> Two weeks into this combination I sleep 10 to 12 hours per night and feel groggy, tired and just don't care about much of anything during waking hours. When I went to 20 mg of Celexa, those symptoms worsened. And, the anxiety still rears it's ugly head without apparent cause and without warning.
>
> Anyone have similar experiences with similar combinations?Don,
The doses of both meds are very low. The fact that you haven't seen a hint of improvement in 2 weeks, and the fact that side effects at such low doses are so troubling, are clues that this approach is targeting the wrong underlying problem.I second the opinion of trying drugs from the psychostimulant class. A one week trial of each of three different ones will find a favorite (if this is the correct med class for you) in a very short time. I don't think Celexa at 10mg is much of a factor one way or the other.
Standard psychiatry would call for raising the doses and giving them more time. But in my experience disappointing results in the first two weeks more often than not predicts less than desired results with continued time. Not always, but usually. It's a hint that the underlying chemical imbalance is not being targeted directly. Give it a couple more weeks to be fair. But in your shoes I would be prepared to replace the Wellbutrin with short trials of stimulants, and possibly replace the Celexa with short trials of 2 or 3 other SSRIs to see if a better fit exists. Usually the best fit makes itself obvious within two weeks.
Posted by Don on February 25, 2000, at 15:15:22
In reply to Re: Wellbutrin + Celexa = apathy exhaustion, posted by JohnL on February 22, 2000, at 4:51:32
> >
>
> Don,
> The doses of both meds are very low. The fact that you haven't seen a hint of improvement in 2 weeks, and the fact that side effects at such low doses are so troubling, are clues that this approach is targeting the wrong underlying problem.
>
> I second the opinion of trying drugs from the psychostimulant class. A one week trial of each of three different ones will find a favorite (if this is the correct med class for you) in a very short time. I don't think Celexa at 10mg is much of a factor one way or the other.
>
> Standard psychiatry would call for raising the doses and giving them more time. But in my experience disappointing results in the first two weeks more often than not predicts less than desired results with continued time. Not always, but usually. It's a hint that the underlying chemical imbalance is not being targeted directly. Give it a couple more weeks to be fair. But in your shoes I would be prepared to replace the Wellbutrin with short trials of stimulants, and possibly replace the Celexa with short trials of 2 or 3 other SSRIs to see if a better fit exists. Usually the best fit makes itself obvious within two weeks.Thanks John,
I see the doc again at the end of March. In the meantime, I contacted the endocrinologist and she suggested cutting the Armour Thyroid pill in half and taking 1/2 with breakfast and 1/2 with dinner. Apperantly the T3 in that product has a relatively short half life and the split dosage provides a more constant delivery of T3. I've also double my daily intake of vitamin B12. These two changes seem to be making a difference.
Now if the urologist, endocrinologist, oncologist and psychiatrist could only find a solution for the absymally low testosterone level. Can't supplement because of the prostate cancer. At this point, I don't know whether the ED is due to the Testosterone levels or the Celexa or both.
Anyway, thanks for the input and I'll discuss it with at my next visit.
Don
This is the end of the thread.
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