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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 Janelle on August 11, 2001, at 17:57:17
I'm still on my cocktail, doing well, and pdoc is having me slowly titrate up on Lamictal (finally reached 50 mg after WEEKS!), but a dear friend of mine who is too out of it to go on the computer recently went on WellbutrinSR for a recurrence of major depression after being off meds for about 7 years. Back then, she was treated successfully with 150 mg of "regular" Wellbutrin (SR wasn't around).
Now, with each day she's been on 150mg of WellbutrinSR, she is getting WORSE in terms of agitation, restlessness, constant worry, paranoia and is saying some strange things.
Could it be that she started at too high a dose of the WellbutrinSR and should switch to "regular" Wellbutrin so she can titrate up gradually? Or might the Wellbutrin not be working this time? Any responses/experiences with Wellbutrin greatly appreciated.
-Janelle
Posted by paxvox on August 11, 2001, at 20:17:06
In reply to WellbutrinSR vs regular Wellbutrin-AGITATION, DOSE, posted by Janelle on August 11, 2001, at 17:57:17
.
> -JanelleYour friend is probably just adjusting to very common side effects of WB. I would suggest that she ask her pdoc for an benzo like clonazepam or clorazepate to "take the edge off" the WB. Especially so if she is having the jitters. Personally, I reuse to take WB w/o a benzo, currently Tranzene (clorazepate). It does not make you groggy, and if you do not up the dose, you can take benzos safely for years. (OK, I'm waiting for the onslaught ot nay-sayers).She should call her Pdoc ASAP for the benzos, even if she has to call before next appointment. She should not give up on the WB. 150 SR x 2 is the standard fair, but a 100 SR is also available. These would have less negative effects than the immediate release formulations. I have used WB for over two years. It works very well for MDI.
PAX
Posted by Cindylou on August 11, 2001, at 20:34:41
In reply to WellbutrinSR vs regular Wellbutrin-AGITATION, DOSE, posted by Janelle on August 11, 2001, at 17:57:17
Hi Janelle,
YES -- I have found that I have much less agitation on the non-SR form of Wellbutrin! Even if I take the same amount. I'm not sure why, but there is a definite difference.Hope this helps,
cindy> I'm still on my cocktail, doing well, and pdoc is having me slowly titrate up on Lamictal (finally reached 50 mg after WEEKS!), but a dear friend of mine who is too out of it to go on the computer recently went on WellbutrinSR for a recurrence of major depression after being off meds for about 7 years. Back then, she was treated successfully with 150 mg of "regular" Wellbutrin (SR wasn't around).
>
> Now, with each day she's been on 150mg of WellbutrinSR, she is getting WORSE in terms of agitation, restlessness, constant worry, paranoia and is saying some strange things.
>
> Could it be that she started at too high a dose of the WellbutrinSR and should switch to "regular" Wellbutrin so she can titrate up gradually? Or might the Wellbutrin not be working this time? Any responses/experiences with Wellbutrin greatly appreciated.
> -Janelle
Posted by sl on August 11, 2001, at 21:17:24
In reply to WellbutrinSR vs regular Wellbutrin-AGITATION, DOSE, posted by Janelle on August 11, 2001, at 17:57:17
I've read the other posts regarding this.
I did not respond as well to SR as I did to immediate release, and will be going back on IR in a week or two.
They may not give a person benzos upon request, they may just catalog you as having "drug seeking behavior". That appears to be what they did with me. (sigh) But I'm on my last option for doctors. :/
Anyway, I'm not saying she shouldn't ask, but be warned it may not do any good.Stick by her...she needs you.
sl
> I'm still on my cocktail, doing well, and pdoc is having me slowly titrate up on Lamictal (finally reached 50 mg after WEEKS!), but a dear friend of mine who is too out of it to go on the computer recently went on WellbutrinSR for a recurrence of major depression after being off meds for about 7 years. Back then, she was treated successfully with 150 mg of "regular" Wellbutrin (SR wasn't around).
>
> Now, with each day she's been on 150mg of WellbutrinSR, she is getting WORSE in terms of agitation, restlessness, constant worry, paranoia and is saying some strange things.
>
> Could it be that she started at too high a dose of the WellbutrinSR and should switch to "regular" Wellbutrin so she can titrate up gradually? Or might the Wellbutrin not be working this time? Any responses/experiences with Wellbutrin greatly appreciated.
> -Janelle
Posted by terra miller on August 11, 2001, at 22:10:51
In reply to WellbutrinSR vs regular Wellbutrin-AGITATION, DOSE, posted by Janelle on August 11, 2001, at 17:57:17
hi-
how long has your friend been at the level that she is at? and did she start at that level or work up to it; and how fast? these are all issues in determining why the agitation is happening.
i've found that sllllllowwwwwwly increasing the wellbutrin is necessary. i seem to keep saying this, but it's hard going at first. it's great after you get over that 2month hump.
i agree with the other comments that a benzo in the first months is helpful if not necessary. i found it necessary to use ativan quite regularly to ride out the irritability and agitation. i no longer take a benzo regularly, though i have one on hand when it's needed on occasion.
i personally did not do well on the SR because i can not take more than 75mg at a time without responding negatively. and since wellbutrin only comes in 75mg tabs in the immediate release version, i have to take those pills. i've tried all the other ones (immediate release 100mg tabs, SR 100mg tabs and 150mg tabs.... i can't take any of these because they are too much. i have to take only the 75mg's and just spread them out over the day.)
i would think, though i don't know your friend obviously, that if she responded well previously to the immediate release that it would be good for her to return to what worked before. just because something is SR doesn't mean it's better, though it can be better for some people.
i have read from others that after being successfully on wellbutrin, and then going off, and then needing to return on it - that they had to go through the "nasties" adjusting to it all over again. it seems that is part of adjusting to it.
hope that's helpful. -terra
Posted by Janelle on August 11, 2001, at 22:53:34
In reply to WellbutrinSR vs regular Wellbutrin-AGITATION, DOSE, posted by Janelle on August 11, 2001, at 17:57:17
Thanks to all who have answered my questions about agitation and dosage for WellbutrinSR vs. immediate release Wellbutrin. On behalf of my friend, I greatly appreciate your input.
For those who might be interested, she could not get an appointment with pdoc for awhile (it's vacation time and what not), so she went to her regular physician who suggested she try WellbutrinSR which was not around during her previous depressive episode which she got helped with by Wellbutrin IR. Anyway, the doc had her start right away on 150 mg of WellbutrinSR (I don't know if SR comes in a smaller dose than that) and it was after only three DAYS that the agitation built to a point where she could not tolerate it.
She has spoken with the doc who told her to just stop the WellbutrinSR because she has an appointment with pdoc in a couple of days and that doc can determine if she should try the IR and go low and slow with the dose, or if Wellbutrin may no longer be the right med for her - a lot can change in one's body chemistry in seven years (that's how long it has been since she previously took Wellbutrin).
Again, thanks so much for your comments and suggestions.
-Janelle
Posted by terra miller on August 12, 2001, at 20:37:02
In reply to THANKS all for responses... a bit more here:, posted by Janelle on August 11, 2001, at 22:53:34
>doc had her start right away on 150 mg of WellbutrinSR (I don't know if SR comes in a smaller dose than that)
it doesn't sound unreasonable where her doc started her.
>and it was after only three DAYS that the agitation built to a point where she could not tolerate it.
extremely common. (thus benzo comments)
i hope all goes well with her pdoc appointment. -terra
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