Shown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Remi on August 14, 2001, at 5:35:00
I am at week four on 150mg Wellbutrin SR for depression, after 10 yrs on SSRIs. Works well. Like the uplifting effect from it. The main side effect is chest tightness. It's like an anxiety type tenseness that slooowly eases off. I take 10mg diazepam for now to deal with it. But, does this pass with time? Previous posters have mentioned it. Did it go away for others? Felt some rage too, initially, but no longer. Can 100mg or 150mg pills be split to dial in a comfortable dosage w/o stomach harm? I prefer the SR due to the lower seizure incidence. I take a 100mg pill in am, then half of one in evening in hopes of spreading out the dosage and easing this side effect. I will probably drop to 100mg until I pass through this stage.
Posted by Joe Schmoe on August 14, 2001, at 6:54:57
In reply to Wellbutrin SR Side Effects and Pill Splitting, posted by Remi on August 14, 2001, at 5:35:00
My chest tightness/pain on Wellbutrin did not go away after a month even after I lowered the dosage to 100 mg/day and even though I am on Klonopin 2 mg/day. However, adding Celexa 20 mg/day made it virtually disappear within a few days of starting the Celexa. I am only on day 5 of the Celexa so I don't know the long term result yet.
Posted by Cam W. on August 14, 2001, at 9:05:12
In reply to Wellbutrin SR Side Effects and Pill Splitting, posted by Remi on August 14, 2001, at 5:35:00
Remi - The SR in Wellbutrin SR stand for sustained release, and if you cut the tablet you will lose the long acting effect of the tablet, turning it into the regular acting variety of Wellbutrin (which must be taken 3 times a day). Therefore, Wellutrin SR tablets must be swallowed whole.
As to the uplifting effect, chest tightness (unless severe), and anxiety are all start-up side effects and should eventually begin to fade. Do watch out for anger outbursts, which usually manifest themselves for a couple weeks, usually starting somewhere between 4 to 8 weeks after starting therapy with Wellbutrin. These will pass and you have to learn to give yourself a "time-out" if these do occur. They don't happen to everyone, but when they do, one ends up yelling at others for no reason.
I hope that this is of some help. - Cam
Posted by terra miller on August 14, 2001, at 12:50:46
In reply to Wellbutrin SR Side Effects and Pill Splitting, posted by Remi on August 14, 2001, at 5:35:00
hi remi-
see what cam said. :-)
i went through the chest pain, found a post similar to yours dated 2/10. i started at 100mg 2x/day S.R. and did fine, then increased to 150mg 2x/day S.R. and got the chestpain thing. so i dropped back down to the 100mg 2x/day S.R. and that did the trick. i didn't know how or when they happened and i can't recall exactly when they stopped (it was within the first 1-2 months though to encourage you... i agree with cam that it's a "start-up" sideeffect) i remember somebody saying that it's smart to not focus on them because then you can get anxious focusing on them. i thought that was smart.
since that time i have switched over the the I.R. version and take 75mg 4times daily. i didn't make the switch because of the chestpains, however, but for other reasons. i like the I.R. lots better.
i went throught the "really angry" phase cam mentioned. he's right that you just have to give yourself a time-out. i used ativan more often during that time as well. i didn't need it as often after that working-in phase, but it was extremely helpful initially.
now i don't get irritable unless i've gone too long between doses. it's important for me to keep a schedule pretty well. but when i do, it's pretty much smooth sailing (relatively speaking... smile...)
just remember that the next few weeks are still the working in phase, and give yourself breaks for peace. maybe it won't be so bad. but also know that after you get through it it's LOTS better... at least from my experience.
terra
Posted by Remi on August 14, 2001, at 17:03:18
In reply to Re: Wellbutrin SR Side Effects and Pill Splitting, posted by Joe Schmoe on August 14, 2001, at 6:54:57
Thanks for the advice, everyone. I am going to stay with 100mgSR per day w/o splitting it, until this side effect subsides. Then I'll bump it up to 200mg per day. That should be enough. Less is more for me with these meds.
Posted by Cressida on August 14, 2001, at 20:59:34
In reply to Wellbutrin SR Side Effects and Pill Splitting, posted by Remi on August 14, 2001, at 5:35:00
>Can 100mg or 150mg pills be split to dial in a >comfortable dosage w/o stomach harm? I >prefer .the SR due to the lower seizure >incidence. I take a 100mg pill in am, then half >of one in evening in hopes of spreading out the >dosage and easing this side effect. I will >probably drop to 100mg until I pass through this >stage.
Quoted from "The PDR Pocket Guide to Prescription Drugs":
You should take Wellbutrin SR, the
sustained-release form, in 2 doses,
at least 8 hours apart. Swallow Well-
butrin SR tablets whole; do not chew,
divide, or crush them.Therfore, I wouldn't recommend "splitting" the tablets; dividing one probably destroys or disrupts the "sustained-release" mechanism.
Posted by Sunnely on August 14, 2001, at 23:17:37
In reply to Wellbutrin SR Side Effects and Pill Splitting, posted by Remi on August 14, 2001, at 5:35:00
Pill splitting is a relatively common practice and is often required by HMOs. Despite its commonality, a group of patients and one physician filed a class action lawsuit against Kaiser Permanente last December (2000), claiming that the HMO's mandatory pill-splitting policy endangers patients' health.
Many studies have shown that splitting pills-particularly splitting of psychotropic medications-offers great cost savings. A recent study of 12 new-generation psychotropic medications found that splitting pills can produce an annual savings of up to $1.45 billion, which represents approximately 10% of the retail sales of the drugs.
Pill splitting is useful when a lower dose of a particular medication is desired, particularly in the elderly population.
Also, when a patient is beginning a psychotropic medication, the psychiatrist may want the patient to begin at a lower dose. Pill splitting is also helpful in dose adjustment for a patient.
Doctors feel more comfortable with pill spitting when the pill has been scored and is designed to be split. Some pills, though, have a very hard or round surface and lack an indentation, making it difficult to split.
However, there are some formulations whose intent would be obviated by splitting. That would be the case with sustained-release formulations, such as venlafaxine (Effexor) XR, bupropion (Wellbutrin) SR, and divalproex sodium (Depakote) ER. These formulations are designed to permit gradual absorption of the medication. Splitting such a pill essentially destroys that goal. In that instance, there can be problems such as loss of efficacy and withdrawal problems.
Cost remains a driving force behind the practice. Sometimes HMOs take the initiative and require pill splitting to cut costs. Sometimes the patient requests it if they are paying for their medications out of pocket.
Some have even suggested that manufacturers reduce the costs of smaller tablets to prevent the need to consider such practices as pill splitting. In a statement, Kaiser said the real issue is "the skyrocketing cost of pharmaceuticals that too often puts life-saving medications beyond the reach of many patients," and spill splitting "can help preserve access to comprehensive, high quality drug benefits without impairing the quality of care."
The American Medical Association, the American Society of Consultant Pharmacists, and the American Pharmaceutical Association oppose policies that require pill splitting, citing health risks associated with improper dosing. In addition to psychotropic medications, antihypertensives (blood-pressure lowering drugs) and antibiotics are also commonly split.
>Can 100mg or 150mg pills be split to dial in a comfortable dosage w/o stomach harm? I prefer the SR due to the lower seizure incidence. I take a 100mg pill in am, then half of one in evening in hopes of spreading out the dosage and easing this side effect. I will probably drop to 100mg until I pass through this stage.
Posted by Darby on August 15, 2001, at 10:56:58
In reply to Wellbutrin SR Side Effects and Pill Splitting, posted by Remi on August 14, 2001, at 5:35:00
According to my MD who works with the manufacturer of Wellbutrin, GSK, splitting the SR tablets is perfectly ok. The extended release formulation is unrelated to the outside coating of the pill; it's integrated into the actual substance of the tablet. Splitting it into halves and quarters would make no difference at all.
Good luck.
Darby
Posted by Cam W. on August 15, 2001, at 11:30:49
In reply to Splitting WellbutrinSR OK, posted by Darby on August 15, 2001, at 10:56:58
Darby - We were told by a rep during an inservice not to divide the tablets. Also, the CPS (Canadian PDR) has the warning not to divide , cut, crush, etc., the tablets or it "may" affect the slow release formulation. If it is not just the coating causing slow-release, by cutting the tablets you would lose some of the slow release action, but you'd figure not enough to warrant a warning (the crushing warning is appropriate, in any case).
Hmmm...I think that I need to give the rep a call. -Cam
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