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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Joe Schmoe on August 29, 2001, at 13:21:36
To summarize my med situation briefly, I was on Wellbutrin SR 300 mg and Klonopin for about a month. Chest pains made me cut back the Wellbutrin to 100 mg/day, still had pains. Doc added Celexa 20 mg/day and that got rid of chest pains immediately. After a few weeks of that, sexual disfunction began.
I have now upped the Wellbutrin SR to 200 mg/day, but after six days, no real improvement sexually. I don't know if this is because the Wellbutrin needs more time to work at this dosage, or whether the dosage is still too small.
I am curious what Wellbutrin dosage is used to augment SSRIs for sexual disfunction. How high can you go on Wellbutrin while on an SSRI? And is there a lag time between each time you raise dosage before effects are felt?
Posted by Cam W. on August 29, 2001, at 17:06:01
In reply to Wellbutrin to augment SSRIs: what dosage?, posted by Joe Schmoe on August 29, 2001, at 13:21:36
Joe - Usually 100mg to 150mg of Wellbutrin SR (bupropion) daily is enough to counteract SSRI-induced sexual dysfunction. But remember, only about 20% of people using this remedy will respond with increased libido. This is in line with clinical observations that anything used to try to reverse SSRI-induced sexually-related problems only works in about 20% of those who try them, for this problem. Perhaps, you are one of that unlucky 80%.
Hope that this is of some help. - Cam
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Toast IS nice!
Posted by JahL on August 29, 2001, at 17:25:37
In reply to Re: Wellbutrin to augment SSRIs: what dosage? » Joe Schmoe, posted by Cam W. on August 29, 2001, at 17:06:01
> Joe - Usually 100mg to 150mg of Wellbutrin SR (bupropion) daily is enough to counteract SSRI-induced sexual dysfunction.###################################################
>
> Toast IS nice!Cheeky. ;-)
Cam, for augmentation purposes what sort of doses do you commonly see for Prozac+Wellbutrin? 20mg+300mg?
Thanks,
J.
++++++++++++++++++++
Water IS wet.
Posted by Cam W. on August 29, 2001, at 17:46:55
In reply to Re: Wellbutrin to augment SSRIs: what dosage? » Cam W., posted by JahL on August 29, 2001, at 17:25:37
Joe and Jah - Sorry, I read the question wrong.
Yes Jah, Prozac 20mg (once daily) and Wellbutrin SR 150mg (twice daily - total 300mg/day) is about average. The dose of Prozac can be tweaked up or down (10mg or 40mg), and the dose Wellbutrin is sometimes lowered (100mg twice daily). The dose of each will vary according to the needs of the taker (a classic example of YMMV - your mileage may vary).
I hope that this helps more than the other post ;^)
- Cam
Posted by Joe Schmoe on August 29, 2001, at 20:38:04
In reply to Re: Wellbutrin to augment SSRIs. Joe and » JahL, posted by Cam W. on August 29, 2001, at 17:46:55
I am a bit confused by these posts. It sounds like it is okay to go up to 300 mg of Wellbutrin as an augmenter.
So should I wait four weeks to see if the increase to from 100 to 200 mg will work, or should I go to 300 mg now (after a week) since 200 is not working?
When you say only 20% of users experience an increase in libido, are you specifically referring to desire as compared to erectile disfunction or delayed ejaculation? Or do you mean sexual disfuction in general is only helped in 20% of cases?
Posted by Cam W. on August 29, 2001, at 20:51:10
In reply to Re: Wellbutrin to augment SSRIs. Joe and » Cam W., posted by Joe Schmoe on August 29, 2001, at 20:38:04
> I am a bit confused by these posts. It sounds like it is okay to go up to 300 mg of Wellbutrin as an augmenter.
>
• Yes, one can raise the dose of Wellbutrin to 150mg twice daily, if need be.
>
> So should I wait four weeks to see if the increase to from 100 to 200 mg will work, or should I go to 300 mg now (after a week) since 200 is not working?
>
• Ask your doctor how he/she wants to handle this. You both need to work together to find the dose that is right for you. Perhaps waiting a week or two after each dose increase, to see if you do get an antidepressant effect might be prudent. In the long-run, this will decrease the risk and severity of unwanted side effects. Again, work with your doctor on this.
>
> When you say only 20% of users experience an increase in libido, are you specifically referring to desire as compared to erectile disfunction or delayed ejaculation? Or do you mean sexual disfuction in general is only helped in 20% of cases.
>
• I was referring to sexual dysfunction, in general. Most "remedies seem to report a response rate of 20%. This figure is more of a clinical judgement from various practioners, rather than an actual scientific fact.• I hope that this clears things up, a bit. - Cam
Posted by Joe Schmoe on August 29, 2001, at 21:38:39
In reply to Re: Wellbutrin to augment SSRIs. » Joe Schmoe, posted by Cam W. on August 29, 2001, at 20:51:10
Thanks for the info. I really am beginning to wonder how anyone can stay on these SSRIs. I will experiment with raising the Wellbutrin and lowering the Celexa, but there is no way I am staying long-term on a regimen that kills my libido. I would rather remain dysthymic and just take Klonopin for my social anxiety. Losing libido is like losing your sense of taste, sure you can go about your daily activities, but what is there to look forward to?
I did not realize Wellbutrin was so ineffective. 20% sounds pretty lame.
Posted by Cam W. on August 29, 2001, at 21:45:06
In reply to Re: Wellbutrin to augment SSRIs. » Cam W., posted by Joe Schmoe on August 29, 2001, at 21:38:39
> I did not realize Wellbutrin was so ineffective. 20% sounds pretty lame.
Joe - Wellbutrin can be an effective antidepressant, and has shown some efficacy in childred and adults with ADHD, and in some people with anxiety disorder.
The 20% figure comes in when Wellbutrin is used to reverse SSRI-induced sexual dysfunction. This is the same percentage for all treatments of sexual dysfunction.
Posted by Remi on August 29, 2001, at 22:25:34
In reply to Re: Wellbutrin to augment SSRIs. » Cam W., posted by Joe Schmoe on August 29, 2001, at 21:38:39
Joe, try adjusting the Celexa dosage if you can. I found the sexual side effects were Very dose related. Was on that one for a while. Wellbutrin is so much better in that regard. > > > > > > > > > > > Thanks for the info. I really am beginning to wonder how anyone can stay on these SSRIs. I will experiment with raising the Wellbutrin and lowering the Celexa, but there is no way I am staying long-term on a regimen that kills my libido.
>
>
Posted by petter on August 30, 2001, at 1:40:30
In reply to Re: Wellbutrin to augment SSRIs: what dosage? » Joe Schmoe, posted by Cam W. on August 29, 2001, at 17:06:01
> Joe - Usually 100mg to 150mg of Wellbutrin SR (bupropion) daily is enough to counteract SSRI-induced sexual dysfunction. But remember, only about 20% of people using this remedy will respond with increased libido. This is in line with clinical observations that anything used to try to reverse SSRI-induced sexually-related problems only works in about 20% of those who try them, for this problem. Perhaps, you are one of that unlucky 80%.
I read an artikel about this side efect from SSRI. Amazingly - Gingo Bilboa was superior to Wellbutrin in this respekt...It´s really wort a treial..
Best Wishes//Petter
>
> Hope that this is of some help. - Cam
>
> ###################################################
>
> Toast IS nice!
Posted by Andre Allard on August 31, 2001, at 23:41:05
In reply to Wellbutrin to augment SSRIs: what dosage?, posted by Joe Schmoe on August 29, 2001, at 13:21:36
I am sure one of the above replies has mentioned what I have to write.
Max dosages of wellbutrin (450mg) can be combined with SSRI's except Prozac and Paxil I believe because of an enzyme that substantially increases the amount of the drugs when combined.
Moderate dosages of either Zoloft or Celexa and Wellbutrin could make for a very good drug regimen.
Good luck!
This is the end of the thread.
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