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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Margaret on May 15, 2000, at 19:02:17
Cam, I was attempting to reduce my paxil to 10mg and had been taking wellbutrin 150mg. (mostly because I wanted to lose some of the weight I had gained on the paxil) I have been under alot of stress lately and found my depression was returning, ever so slightly, but enough to remind me how much I do not want it back. I spoke to my doctor and he wanted me to go off the wellbutrin and up my dose of paxil back to 20mg. and then 40mg. I have done that. I am feeling better, but not back to my same self. Will I need to wait awhile before the paxil kicks in. I am afraid that I will lose all my benefits from tha paxil or that it has stopped working for me. Any suggestions would help. I wonder if I can stay on the wellbutrin. My doctor thought that serotonin syndrome may result, but I thought the two were different. The wellbutrin helped with my low libido and appetite. My lesson at least is that paxil definitely works best for me. I was hoping to be able to switch over to the wellbutrin completely, but I guess not. Please don't feel like you have to respond, but I feel you take on the psychopharmacology aspect is pretty great. PS I am also from Canada.
Posted by bob on May 15, 2000, at 20:42:26
In reply to drug info needed on paxil (Cam W.,anyone), posted by Margaret on May 15, 2000, at 19:02:17
It's my impression that an SSRI/Wellbutrin combo was generally seen as a fairly potent and reliable mix. Got that impression first from my pdoc ... particularly with respect to prozac, but he told me it could be used with any SSRI.
well, I sure others will chime in ...
cheers,
bob
Posted by Cam W. on May 15, 2000, at 22:45:15
In reply to drug info needed on paxil (Cam W.,anyone), posted by Margaret on May 15, 2000, at 19:02:17
Margaret - To my knowledge there is no likelihood of serotonin syndrome when combining Paxil with Wellbutrin. I have seen the two used together, with mixed results (especially when the Wellbutrin is being used for weight loss &/or sexual dysfunction). I guess it depends on how your body's stress management system (HPA axis) has malfunctioned (serotonin-based, norepinephrine-based, or some other breakdown).It may take a month (or even a little longer) of being on the Paxil to return to full effect. Many people stop an SSRI and return to it upon relapse, having the same success as before.
How long ago did you raise your Paxil dose to 20mg? Are you at 40mg yet? Sometimes raising the dose to 40mg to quickly brings out side effects. I went from 20mg to 40mg to 60mg of Paxil in a matter of weeks. I doubt I'll ever do that again. I felt just terrible (couldn't concentrate, emotionally labile, sleeping all the time). This was when I was taken off Paxil and put on Wellbutrin. I had given Paxil plenty of time at 20mg with no effect. Perhaps my depression had a norepinephrine malfunction.
In short, if Paxil worked before, it should work again.
Hope this rambling helps - Cam
Posted by Margaret on May 16, 2000, at 12:16:31
In reply to Re: drug info needed on paxil (Cam W.,anyone), posted by Cam W. on May 15, 2000, at 22:45:15
>Cam, I have raised my dosage from 10mg to 20mg over the last week and went up to 40mg on Thursday. I am definitely getting some side-effects such as major sweating. I feel a little flat but not too bad. I am wondering if it could also be a withdrawl from the wellbutrin. I would like to stay on it if possible but I don't want to fool around with my med too much. I have been off the wellbutrin for about four days now. Do you think it would be ok to go back on it? Thank you for your imput. I have read earlier how busy you are and am very greatfull for the information. sincerely, one serotonin to a norepinephrine.
Posted by Margaret on May 16, 2000, at 12:30:52
In reply to Re: drug info needed on paxil (Cam W.,anyone), posted by bob on May 15, 2000, at 20:42:26
That is what I thought also. My doctor does not know alot about antidepressant families and what can be mixed but he is definitely receptive to any information I find. Thank you for your response. I really appreciate this forum.
Posted by Cam W. on May 16, 2000, at 18:48:47
In reply to Re: drug info needed on paxil (Cam W.,anyone), posted by Margaret on May 16, 2000, at 12:16:31
Margaret - I have not heard of withdrawl symptoms with Wellbutrin. I had no problem coming off of it the first time and I was looking for the effects. Maybe I felt a little down or blah, but no really bad side effects.If you took the Wellbutrin for a month and really didn't notice any significant weight loss, I don't think it will really help you to be on it. I believe that the effects you are feeling are from the rapid titration (dosage increase) of the Paxil. These should dissipate within a week or two, as your body adjusts to the 40mg.
Hope this helps - Cam
Posted by bob on May 16, 2000, at 19:28:14
In reply to Re: drug info needed on paxil (Cam W.,anyone), posted by Cam W. on May 16, 2000, at 18:48:47
> Margaret - I have not heard of withdrawl symptoms with Wellbutrin....
I *had* to stop wellbutrin cold turkey after better than 6 months on it due to a rather nasty drug interaction. After reading Cam's post, I wanted to chime in to say that I didn't have any withdrawal from it either.
... then again, I was on ativan, zyprexa, & cogentin first and then klonopin and prozac (the one med I kept from before the ER visit), so I was probably so whacked I wouldn't have noticed.
But, if I *was* capable of noticing ... I didn't notice anything.
Um, I hope that helps =^)
bob
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