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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by PaintItBlack on August 25, 2001, at 9:59:13
After simultaneous starting Wellbutrin/Effexor and getting zonked out, I tried Effexor alone. That was what caused the spaciness.
Now I'm verrry gradually starting up on Wellbutrin SR. I know the target dose is in the 300-400 mg range. But I tend to get side effects rather early, so I wondered if anyone has found noticeable improvement at lower Wellbutrin does.
Any info appreciated. Thanks.
Paint It Black
Posted by SalArmy4me on August 25, 2001, at 10:16:57
In reply to Wellbutrin Lowest Working Dose ?, posted by PaintItBlack on August 25, 2001, at 9:59:13
There is no scientifically-based appreciable improvement on Wellbutrin under 150 mg.
Posted by Ed on August 25, 2001, at 11:34:46
In reply to Re: Wellbutrin Lowest Working Dose ? » PaintItBlack, posted by SalArmy4me on August 25, 2001, at 10:16:57
Do you mean on Wellbutrin OVER 150 mg?
> There is no scientifically-based appreciable improvement on Wellbutrin under 150 mg.
Posted by PaintItBlack on August 25, 2001, at 14:33:46
In reply to Re: Wellbutrin Lowest Working Dose ? » PaintItBlack, posted by SalArmy4me on August 25, 2001, at 10:16:57
> There is no scientifically-based appreciable improvement on Wellbutrin under 150 mg.
Have there been studies on Wellbutrin at 150 mg daily?
I suspect there is more accuracy in the experiences of people here than in the double-blind controlled studies, so I wonder if anyone has found WB useful at that dose.
Paint It Black
Posted by Janelle on August 25, 2001, at 16:58:48
In reply to Wellbutrin Lowest Working Dose ?, posted by PaintItBlack on August 25, 2001, at 9:59:13
Glad to hear I'm not the "only" one who got spacey (and lightheaded) on Effexor - I could only tolerate 75mg/day as opposed to the minimal therapeutic dose of 150mg/day.
As for Wellbutrin, I have read that 150 mg/day is the lowest therapeutic dose, meaning that until you get up to at least 150mg/day, you most likely will not get any benefit from Wellbutrin. There are may be some people who do not need more than 150mg/day, but from what I've read the "average" therapeutic dose is 300-350mg/day.
Hang in with any side effects, as they should dissipate within a matter of days. Side effects always come first, then it's a matter of weeks until any beneficial results would begin.
Posted by Remi on August 25, 2001, at 18:09:25
In reply to Re: Wellbutrin Lowest Working Dose ? » PaintItBlack, posted by Janelle on August 25, 2001, at 16:58:48
The Glaxo insert that comes with Wellbutrin does mention 150SR dosing every OTHER day for people with liver problems. I don't see why someone trying to get a handle on startup effects couldn't do that also. I was taking one 100SR Wellbutrin per day for about 5 weeks and stopped for two days (there are no withdrawal concerns, unlike SSRIs), because of side effects. I made an appt. to switch to something else. But decided to give it another shot, and most side effects disappeared. I am still at 100mg, mostly for maintenance, and feel fine. My target is 300mg SR per day, but that probably won't be necessary. Not unusual for me. 10mg of Prozac completely knocked out my depression. 20mg only felt like I was drinking triple espressos or something ALL DAY, w/o any further benefit. But, getting back to my point, Wellbutrin lends itself nicely to taking a "drug holiday" if you need time to adjust to it.
Posted by PaintItBlack on August 25, 2001, at 18:30:44
In reply to Re: Wellbutrin Lowest Working Dose ?, posted by Remi on August 25, 2001, at 18:09:25
> The Glaxo insert that comes with Wellbutrin does mention 150SR dosing every OTHER day for people with liver problems. I don't see why someone trying to get a handle on startup effects couldn't do that also. I was taking one 100SR Wellbutrin per day for about 5 weeks and stopped for two days (there are no withdrawal concerns, unlike SSRIs), because of side effects. I made an appt. to switch to something else. But decided to give it another shot, and most side effects disappeared. I am still at 100mg, mostly for maintenance, and feel fine. My target is 300mg SR per day, but that probably won't be necessary. Not unusual for me. 10mg of Prozac completely knocked out my depression. 20mg only felt like I was drinking triple espressos or something ALL DAY, w/o any further benefit. But, getting back to my point, Wellbutrin lends itself nicely to taking a "drug holiday" if you need time to adjust to it.
The idea of a drug holiday while adjusting to a med is interesting. Many side effects leave me too sedated or distracted to drive, so the first time I absolutely must drive somewhere, I end up stopping the drug. (Of course, that doesn't always mean that the side effect stops immediately.) But that might be a way to hang on to see if the side effects eventually go away. Thanks.
Paint It Black
Posted by mair on August 25, 2001, at 22:46:07
In reply to Re: Wellbutrin Lowest Working Dose ?»Remi, posted by PaintItBlack on August 25, 2001, at 18:30:44
> I've been on WB for some years now. When I started it, I, too, quit after awhile because of some side effects. After maybe only a matter of days, I thought better and started up again. The side effects that drove me off the first time dissipated. It has also been my experience that I've had side effects every time I've increased a dosage, no matter how incrementally. I've figured out now that they go away pretty quickly so I just ride them out. I can't speak to the issue of minimum therapeutic dose. I've always taken more than you're talking about and my improvement was slow and subtle.
Mair
Posted by terra miller on August 26, 2001, at 22:31:23
In reply to Wellbutrin Lowest Working Dose ?, posted by PaintItBlack on August 25, 2001, at 9:59:13
hi-
i don't know of any way to avoid side-effects no matter what the dose. i have taken 75mg 3xdaily immediate release for a few months and found that beneficial. but i am now taking 75mg 4xdaily again and find i am just right... so still 300mg total, but take less at a time. i couldn't handle the s.r. version because i couldn't take 150mg tabs at once s.r. i also couldn't take the immediate release at 100mg tabs. fyi -terra
Posted by Simcha on August 27, 2001, at 7:40:16
In reply to Wellbutrin Lowest Working Dose ?, posted by PaintItBlack on August 25, 2001, at 9:59:13
I'm on 40mg of Celexa and 150 mg of WellbutrinSR. I seem to be getting some benefit from it. It's subtle. I've been on it now for about 4 weeks. The side effects have gone away. Initially I felt like I was on speed. My pdoc will not increase my dose because of this reason. It triggered my sexual compulsion terribly. The Celexa knocks that compulsion right out of me. The Wellbutrin is supposed to help me remain sexually functional.
> After simultaneous starting Wellbutrin/Effexor and getting zonked out, I tried Effexor alone. That was what caused the spaciness.
>
> Now I'm verrry gradually starting up on Wellbutrin SR. I know the target dose is in the 300-400 mg range. But I tend to get side effects rather early, so I wondered if anyone has found noticeable improvement at lower Wellbutrin does.
>
> Any info appreciated. Thanks.
>
> Paint It Black
Posted by PaintItBlack on August 27, 2001, at 13:34:56
In reply to Re: Wellbutrin Lowest Working Dose ? » PaintItBlack, posted by Simcha on August 27, 2001, at 7:40:16
> I'm on 40mg of Celexa and 150 mg of WellbutrinSR. I seem to be getting some benefit from it. It's subtle. I've been on it now for about 4 weeks. The side effects have gone away. Initially I felt like I was on speed. My pdoc will not increase my dose because of this reason. It triggered my sexual compulsion terribly. The Celexa knocks that compulsion right out of me. The Wellbutrin is supposed to help me remain sexually functional.
Were you already on the Celexa when you started WB to restore some sex drive?
Paint It Black
Posted by Simcha on August 27, 2001, at 13:37:52
In reply to Re: Wellbutrin Lowest Working Dose ? » Simcha, posted by PaintItBlack on August 27, 2001, at 13:34:56
Well, yes and no... I was on Effexor before this... No sex drive at all.... The doc was getting me off of Effexor. He wanted to switch me to Wellbutrin SR. It made me all squirly and more compulsive. He added the Celexa to even me out. He says that the Wellbutrin will knock out any possible sexual side-effects of the Celexa... The jury is still out on that one.
> > I'm on 40mg of Celexa and 150 mg of WellbutrinSR. I seem to be getting some benefit from it. It's subtle. I've been on it now for about 4 weeks. The side effects have gone away. Initially I felt like I was on speed. My pdoc will not increase my dose because of this reason. It triggered my sexual compulsion terribly. The Celexa knocks that compulsion right out of me. The Wellbutrin is supposed to help me remain sexually functional.
>
> Were you already on the Celexa when you started WB to restore some sex drive?
>
> Paint It Black
Posted by Tony P on August 28, 2001, at 1:57:58
In reply to Re: Wellbutrin Lowest Working Dose ?, posted by Remi on August 25, 2001, at 18:09:25
I have just started on Wellbutrin (Day 4 at 150mg SR) and am really concerned at the mention of liver problems.
I have some residual liver damage (from my ill-spent youth < g >), doesn't normally bother me or even show up on blood tests, but I've experienced liver pains & other symptoms a couple of times in the last few years when I'm round paint fumes all day etc.
I rode my bike home from work tonight, pushing fairly hard but not an unusual level of exercise for me, and thought I felt liver pain from the exercise. I know from long-ago experience that exercise stresses the liver when it's working overtime already, so I am concerned.
I think I'd better contact my GP regardless, but I would like to know if others have experience / knowledge to share on the problem?
Tony
> The Glaxo insert that comes with Wellbutrin does mention 150SR dosing every OTHER day for people with liver problems. I don't see why someone trying to get a handle on startup effects couldn't do that also. I was taking one 100SR Wellbutrin per day for about 5 weeks and stopped for two days (there are no withdrawal concerns, unlike SSRIs), because of side effects. I made an appt. to switch to something else. But decided to give it another shot, and most side effects disappeared. I am still at 100mg, mostly for maintenance, and feel fine. My target is 300mg SR per day, but that probably won't be necessary. Not unusual for me. 10mg of Prozac completely knocked out my depression. 20mg only felt like I was drinking triple espressos or something ALL DAY, w/o any further benefit. But, getting back to my point, Wellbutrin lends itself nicely to taking a "drug holiday" if you need time to adjust to it.
This is the end of the thread.
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