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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by CLK on August 10, 2001, at 8:12:47
I have been battling depression for years. I have taken Wellbutrin in the past. Unfortunately, it didn't seem to make an appreciable difference. The only side effect I suffered with this med was headaches.
My concern is that I think I may need to take meds again, but my research indicates two side effects common to most meds tha I have grave concerns about.
1 - Weight gain. I am already significantly overweight. The last thing I need is a medication therapy that will cause me to gain weight.
2 - Sexual side effects. I cannot imagine telling my husband, "Well, babe the good news is that you get rid of a lunatic wife, but you won't be having sex. Because my medication will kill my sex drive."
Are these two side effects as prominent and problematic as they appear?
Any insights would be appreciated.
Posted by SalArmy4me on August 10, 2001, at 8:46:27
In reply to Medications and side effects..., posted by CLK on August 10, 2001, at 8:12:47
The only way to combat certain side-effects is with supplemental medication. Adding mirtazapine or sildafenil gets rid of the sexual dysfunction; adding Wellbutrin or Topamax gets rid of the weight-gain.
RePost:
All prescription and in generics:
Bethanechol (Urecholine) - a not so new cholinergic that relieves anticholinergic effects, such as dry mouth, constipation, profuse sweating, urinary retention, etcetera. It can be prescribed with any antidepressant; it was given to me with Parnate and later, Paxil. The side-effect profile is generally benign; I never had any side-effects from it. I don't think I would have lasted as long on Parnate if it hadn't been for this medication.
Calan (Verapamil) - there is such thing as a "depression headache" (I suppose its from anxiety). Also, many people on this message board complain that their headaches are from the antidepressants themselves. At any rate, most doctors will prescribe Elavil for chronic non-migraine headaches, because it has the most anti-pain properties of any antidepressant. But Elavil is like a punishment as far as anticholinergic effects. Verapamil does not have those effects. Verapamil SR 240 mg can be taken once-a-day and it has worked wonders for people. I never had any side-effects.
Inderal - this is the gold standard treatment for essential tremor, caused by antidepressants/anticonvulsants like LITHIUM, Wellbutrin and MAOIs. It has not been shown to cause orthostatic hypotension in otherwise normal adults. It needs to be taken 3 times a day, and the side-effect profile is also benign.
Also Emetrol for nausea.
Surprisingly, many people resist taking medications to combat the side-effects of medications. I understand that. It means that one will be putting another foreign substance in one's body. But I would rather die than not treat the: dry mouth, headaches, myoclonic jerks, extreme constipation, urinary retention, and fatigue from Parnate--when I could easily take Urecholine.
Posted by paxvox on August 10, 2001, at 8:46:32
In reply to Medications and side effects..., posted by CLK on August 10, 2001, at 8:12:47
CLK > > >
How much Wellbutrin were you taking, e.g. 150 mg SR twice daily, and for how long did you TRY it before deciding it was not helping you? As a rule, most AD take 3-4 weeks minimum to begin seeing positive results, sometimes it may take longer, or require changing dosage. My experience with Wellbutin has been fairly positive. Yes, there were side effects such as headache and anxiety as well as sleep disturbances. Most of these can be tolerated, or they disipate over time. Or, your Pdoc may choose to ad a benzo to take the edge off the Wellbutrin (as mine has). This allows the WB to "do its thing" for your depression w/o making its side effects unbearable.
As to your two concerns: I have good news (keep in mind evey one reacts individually to meds so your actual reactions may differ...but I will try to give you the scientific info that I know).1) Most people LOSE weight on Wellbutrin. I lost 30 pounds. A few gain weight, but statistically, more lose weight.
2) Welbutrin has few, if any sexual side effects, except for perhaps INCREASING your libido!
If these are your main concerns, I would not worry about WB causing any problems. Maybe you want to give it another go? I do know that there is a very fine line between the therapeutic dose of WB and where its side effects outweigh its efficacy. For me, 150 SR x 2 is my limit. When I tried 200 mg it gave me chest pains. So I am back at 150. If you look under Wellbutrin, or check with SalArmy4me,there are some excellent studies on it as an anti-depressant.
Posted by mila on August 10, 2001, at 9:09:19
In reply to Medications and side effects..., posted by CLK on August 10, 2001, at 8:12:47
hi CKL,
these side effects are prominent and problematic in those who are succeptible to them, but not everyone does have them. Somehow people are unique and give unique reactions. I haven't gained any weight due to the antidepressants per se. If anything, I lost 35 pounds on Paxil, but not because of Paxil affecting my appetite, more because it made me feel so alive, I started to exercise and enjoy food in some new ways which led to drastic reduction in calories consumed.
out of four antidepressants i tried, one drastically increased my sex drive, one drastically reduced desire, but increased quality of orgasms, and two had no effect on both desire or orgasm (kept the baseline values, my natural amounts of those, so to speak).i think the best attitude here is to keep your hopes high and be curious, adventurous. Individual encounters with antidepressants are full of unusual, unexpected effects. Sometimes we fall into majority of responses, sometimes we give reactions that are not in the book.
keep your focus on getting rid of depression. if you are the "lucky" one as I have been, you won't have to stay medicated for life, and once the treatment is over, you'll get your body back and will be able to enjoy it again. This is something both you and your spouse have to be aware of. Depression is a serious disease, and as with any disease, people who undergo treatment have to be given some slack.
best wishes
mila
Posted by CLK on August 10, 2001, at 9:55:35
In reply to Re: Medications and side effects... » CLK, posted by paxvox on August 10, 2001, at 8:46:32
I started out with WB SR 150 mg once daily - approx 4 months and increased to twice daily for about 2 months.
There was no appreciable change in symptoms and at the higher dose the headaches were unbearable and constant.
So it isn't as if I didn't give them a chance.
I guess I'll just have to be patient through the process of elimination - but it seems like such a pain in the neck. I'm not sure what is worse, the depression or fiddling with meds to get the right dose and or combination.
Posted by Elizabeth on August 11, 2001, at 23:51:28
In reply to Medications and side effects..., posted by CLK on August 10, 2001, at 8:12:47
> My concern is that I think I may need to take meds again, but my research indicates two side effects common to most meds tha I have grave concerns about.
>
> 1 - Weight gain. I am already significantly overweight. The last thing I need is a medication therapy that will cause me to gain weight.
>
> 2 - Sexual side effects. I cannot imagine telling my husband, "Well, babe the good news is that you get rid of a lunatic wife, but you won't be having sex. Because my medication will kill my sex drive."
>
> Are these two side effects as prominent and problematic as they appear?It depends on the drug. Selective serotonin reuptake inhibitors (Prozac, Zoloft, Paxil, Luvox, Celexa) seem to be the worst offenders in the area of sexual dysfunction. Some tricyclics, such as amitriptyline (Elavil) and clomipramine (Anafranil), commonly cause sexual problems, while others, like desipramine (Norpramin) and nortriptyline (Pamelor) usually don't. MAOIs, especially Nardil, can cause sexual problems too, as can the mixed reuptake inhibitor Effexor (venlafaxine). The miscellaneous antidepressants Remeron (mirtazapine) and Serzone (nefazodone) are unlikely to cause this type of side effect. Remeron or Wellbutrin can also be added to an SSRI, and often this approach will reverse or alleviate the sexual side effects.
As far as weight gain goes, some people gain weight on SSRIs, but some don't, and it's not entirely clear to what extent the weight gain is caused directly by the drugs. The tricyclics are probably worse, although there is quite a bit of variation among the tricyclics. (Desipramine and nortriptyline generally have the mildest side effect profiles of the tricyclics, and they are probably the least likely to cause weight gain.) The MAOI phenelzine (Nardil) is associated with a high rate of weight gain; Parnate (tranylcypromine), another MAOI, is unlikely to cause weight gain. Remeron does cause a lot of weight gain for a lot of people, but this isn't universal and may become less of a problem as you increase the dose. FWIW, when I tried it I started at 30 mg and increased it rapidly to 75 mg, and I never had any weight problems on it. The sedation is definitely more of a problem at low doses (7.5-15 mg), and the weight gain may be also. Serzone is probably unlikely to cause weight gain, although experience with this drug is relatively limited (it just never really caught on).
-elizabeth
Posted by wired on August 18, 2002, at 12:13:52
In reply to Re: Medications and side effects... » CLK, posted by paxvox on August 10, 2001, at 8:46:32
I have been taking taking Wellbutrin for seven weeks and I do know one thing for sure.
It does have side effects. I'm not sure if this is good or not. At first I thought it was a good thing. Now I'm not so sure. Increasing ones Libido is one thing. Having an unending and increasingly overwhelming sex drive is another.
I always felt my drive was average to normal, but this is almost too much to bare.
I'm sure not all who take Wellbutrin have this kind of side effect. By the way, I take 150mg twice daily. I have been considering consulting with my physician and perhaps ceasing this medication. I'm not sure if this will help in other ways. But I am sure my drive will return to normal.
Posted by Rick on August 20, 2002, at 13:00:22
In reply to Re: Medications and side effects... » paxvox, posted by wired on August 18, 2002, at 12:13:52
Posted by wired on September 6, 2002, at 23:22:10
In reply to Funny you should say bare instead of bear (nm) » wired, posted by Rick on August 20, 2002, at 13:00:22
your reply was "barely" funny. In fact, I didn't laff at all. Funny I should say, "laff"
Posted by Rick on September 7, 2002, at 23:04:21
In reply to Re: Funny you should say bare instead of bear, posted by wired on September 6, 2002, at 23:22:10
Sorry, no offense intended. Sometimes I misspell things myself, weird.
> your reply was "barely" funny. In fact, I didn't laff at all. Funny I should say, "laff"
This is the end of the thread.
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