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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by sl on August 31, 2001, at 21:41:19
I dunno what happened to my post, I know I clicked confirm but it's not here. :(
I'm going to start 300mg IR again tomorrow or tuesday.
I want to know if I should titrate up or if the 300mg SR has prepared my body sufficiently.sl
Posted by SalArmy4me on August 31, 2001, at 21:45:52
In reply to Wellbutrin SR vs IR, posted by sl on August 31, 2001, at 21:41:19
I don't believe any titration is necessary.
Posted by terra miller on August 31, 2001, at 22:19:27
In reply to Wellbutrin SR vs IR, posted by sl on August 31, 2001, at 21:41:19
> I'm going to start 300mg IR again tomorrow or tuesday.
> I want to know if I should titrate up or if the 300mg SR has prepared my body sufficiently.
>
> slwhat does your pdoc say? it "will" feel different at first because your body will be adjusting. (are you going to use 100's?) i highly suggest keeping a journal of symptoms for the first week. just every once in a while notice how you are feeling and note the time. this will help you see if there are any patterns between doses and how long to spread between doses so you can stay level. it was a mildly bumpy ride for a few days when i made the switch... just felt like adjustments though. keep in touch. -terra
Posted by shelliR on August 31, 2001, at 23:47:06
In reply to Re: Wellbutrin SR vs IR » sl, posted by terra miller on August 31, 2001, at 22:19:27
> > I'm going to start 300mg IR again tomorrow or tuesday.
> > I want to know if I should titrate up or if the 300mg SR has prepared my body sufficiently.
> >
> > sl
>
> what does your pdoc say? it "will" feel different at first because your body will be adjusting. (are you going to use 100's?) i highly suggest keeping a journal of symptoms for the first week. just every once in a while notice how you are feeling and note the time. this will help you see if there are any patterns between doses and how long to spread between doses so you can stay level. it was a mildly bumpy ride for a few days when i made the switch... just felt like adjustments though. keep in touch. -terraHaving just started in the last few weeks Wellbutrin SR in the last few weeks, I am curious why you two are switching to IR.
Shelli
Posted by terra miller on September 1, 2001, at 7:56:37
In reply to Re: Wellbutrin SR vs IR ------ SL and terra miller, posted by shelliR on August 31, 2001, at 23:47:06
hi shelly-
i've actually been on the i.r. version for several months. i switched from s.r. to i.r. for what i consider to be those < 1% side-effects. for me the s.r. caused me to have significant peaks and valleys... it would hit me hard and go strong for 2 hours and then slowly fade away until it was time for the other dose and that would repeat itself; lousy. i also had trouble with my body temperature dropping.
therefore, i switched to the i.r. version and dose 4 times a day instead of the 2 doses with s.r. this helps me not experience highs and lows, i have learned from journaling that one dose lasts about 5 hours and then i begin to get irritable or tired... now i no longer journal about it and keep a daily pill box with me and if i get crabby during the day i can look at my watch and giggle because, sure enough it's been 5 hours since my last dose. it took a while to adjust to the extended time from bedtime to wake without a dose overnight, but eventually that evened out as well.
i also cannot take pills higher than 75mg. i have tried all the different levels and they just make my body temperature drop. on the 75's, my temperature still drops, but it's something that i can live with and actually find a benefit during the hot months of summer! my hands and fingers go blue and numb and stuff if i take more than 75 at a time. it took me a while, but i found this reaction in an rxlist for immediate release wellbutrin, even though it's worse for me with the sustained release.
i do best with 300mg, which means i need to take 75mg four times a day. i tried to take less for a while but it didn't work as conpletely. 300mg seems to be the place to land at. i got a pill compartment at kmart with the seven days, each day on itself and divided into 4 boxes (am, noon, eve, night) and this is how i remember to take everything the right time. once i got this system, it's been fairly a nobrainer.
long answer for a short question. :-)
-terra
Posted by sl on September 1, 2001, at 9:27:25
In reply to Re: Wellbutrin SR vs IR ------ SL and terra miller, posted by shelliR on August 31, 2001, at 23:47:06
> Having just started in the last few weeks Wellbutrin SR in the last few weeks, I am curious why you two are switching to IR.
>
> ShelliI was on IR long ago, before SR came out, for several years. And my GP (who was maintaining my meds at the time) switched me to SR because most people respond better. But within 6 months of switching, I could see the difference in mood. And after a year or two, I started developing anxiety. (I thought it was just me, but I talked to an expert psychiatric nurse and she said she's seen some [anecdotal] evidence that long-term use of SR can cause anxiety.)
I decided to go back to the IR in hopes of banishing the anxiety and returning my mood to its previous state (good!).I will state that even Wellbutrin SR was better for me than Effexor, Nortriptyline, Prozac, all of which I tried over this summer before deciding to go back on the IR Wellbutrin.
Dosage has been weird tho.
I found out that Wellbutrin IR dosage is better absorbed than SR, so if one is taking IR and then switches to SR, the dosage should be raised slightly (mine wasn't!).
And the people prescribing it now say I should take 75mg 4x day. But if they think I'm going to remember that, then THEY are the crazy ones. Besides, I'd have to get that last dose MIGHTY close to bedtime, so I'd still have insomnia. I'm going to take it twice/day unless side-effects get too extreme. I might try 100mg 3x day, but that's only if I can't tolerate 150 2x day, which is what I was on before. The last thing to try is taking 200mg SR 2x day.So that's the REST of the story. ;)
sl
Posted by AnneL on September 1, 2001, at 13:57:57
In reply to Re: Wellbutrin SR vs IR » sl, posted by SalArmy4me on August 31, 2001, at 21:45:52
> Sal, can you explain the difference between SR and IR and whether one is more easily tolerated than the other? Thanks, Anne :)
Posted by shelliR on September 1, 2001, at 14:17:53
In reply to shelly, posted by terra miller on September 1, 2001, at 7:56:37
Thanks for the info, Terra
>
> therefore, i switched to the i.r. version and dose 4 times a day instead of the 2 doses with s.r. this helps me not experience highs and lows, i have learned from journaling that one dose lasts about 5 hours and then i begin to get irritable or tired... now i no longer journal about it and keep a daily pill box with me and if i get crabby during the day i can look at my watch and giggle because, sure enough it's been 5 hours since my last dose. it took a while to adjust to the extended time from bedtime to wake without a dose overnight, but eventually that evened out as well.
Okay, so it helps you with irritability and tiredness. How about your depression. This this your base AD or is this an adjunct for you?
> i also cannot take pills higher than 75mg. i have tried all the different levels and they just make my body temperature drop. on the 75's, my temperature still drops, but it's something that i can live with and actually find a benefit during the hot months of summer! my hands and fingers go blue and numb and stuff if i take more than 75 at a time. it took me a while, but i found this reaction in an rxlist for immediate release wellbutrin, even though it's worse for me with the sustained release.
Wow, that is a really strange side effect. I've read on the board that other ADs cause cold extremities, but I didn't think about body temperature dropping.
> i do best with 300mg, which means i need to take 75mg four times a day. i tried to take less for a while but it didn't work as conpletely. 300mg seems to be the place to land at. i got a pill compartment at kmart with the seven days, each day on itself and divided into 4 boxes (am, noon, eve, night) and this is how i remember to take everything the right time. once i got this system, it's been fairly a nobrainer.I think I could (maybe) do the four pill at home thing, but I know I would either forget to bring pills, or forget to take them if I am out. I will be raising my SR to 300 starting Monday to see if I can handle it.
Shelli
Posted by shelliR on September 1, 2001, at 14:28:35
In reply to Re: Wellbutrin SR vs IR ------ SL and terra miller, posted by sl on September 1, 2001, at 9:27:25
Hi sl,
> I was on IR long ago, before SR came out, for several years. And my GP (who was maintaining my meds at the time) switched me to SR because most people respond better. But within 6 months of switching, I could see the difference in mood. And after a year or two, I started developing anxiety. (I thought it was just me, but I talked to an expert psychiatric nurse and she said she's seen some [anecdotal] evidence that long-term use of SR can cause anxiety.)
> I decided to go back to the IR in hopes of banishing the anxiety and returning my mood to its previous state (good!).Thanks for sharing your experience. Interesting that a side effect would start after six months; but glad that wellbutrin was so successful for you. I am taking 200 mg SR and will go up to 300 on Monday. The problem with these time release pills is that I have to go up 100mg at a time, when I know it would be better to go up slowly. (can't split them.) I should have asked my pdoc for a few IRs to take for a few days at 250mg or even 225 mg. Too late, going out of town tomorrow.
Shelli
Posted by sl on September 1, 2001, at 14:53:51
In reply to Re: Wellbutrin SR vs IR » sl, posted by shelliR on September 1, 2001, at 14:28:35
> Thanks for sharing your experience. Interesting that a side effect would start after six months; but glad that wellbutrin was so
I'm not sure it's a side effect per se, or maybe a poop-out of sorts. *shrug*
>successful for you. I am taking 200 mg SR and will go up to 300 on Monday. The problem with these time release pills is that I have to go up 100mg at a time, when I know it would be better to go up slowly. (can't split them.) I should have asked my pdoc for a few IRs to take for a few days at 250mg or even 225 mg. Too late, going out of town tomorrow.
Don't worry about it, you'll be fine. IR wouldn't help, you'd find yourself jittery on IR and not on SR, they're the same med but cuz of the differences the doses aren't really the same.
Wellbutrin is actually one of the easier ones to ramp up on, some have much worse side-effects than jitteriness and too much energy. ;)
Worst-case scenario, you'll get fast heart-beat, possible dizziness, jumpiness, anxiety, etc, but if it's unbearable or you fear for your physical health you can always back it off and try again when you're close to supervision. :)
And don't worry yourself into side-effects you might not have otherwise. *grin*
sl
Posted by shelliR on September 1, 2001, at 19:01:10
In reply to Re: Wellbutrin SR vs IR ------ SL and terra miller, posted by sl on September 1, 2001, at 9:27:25
Hi sl,
A couple more questions, please.
What was your dose when you were on the SR? Were you up to 400mg, or if you go back to it, it would be an increase?
Also, how long, if you remember, did it take for the wellbutrin to kick in a little, and then full force?
And last, are you taking anything else for depression in combination with wellbutrin?
Today was the first day I didn't feel totally hyper since I've been on 200 SR, but I'm not sure if I have any antidepressant effects yet. Not sure, because both yesterday and today I didn't wake up in a total overwhelming depression for the first time in quite a while. I did have breakthrough depression (I am combining with an opiate which has been carrying me until an AD works), so maybe after a week or so on 300 mg I will have more of an idea. I hope it works; I've tried about everything else; I like the energizing effect on me, as well as my lack of appetite since I'm trying hard-- eating--treadmill-weights--to lose 20 pounds more. (Lost 10 since early April).
Shelli
> I was on IR long ago, before SR came out, for several years. And my GP (who was maintaining my meds at the time) switched me to SR because most people respond better. But within 6 months of switching, I could see the difference in mood. And after a year or two, I started developing anxiety. (I thought it was just me, but I talked to an expert psychiatric nurse and she said she's seen some [anecdotal] evidence that long-term use of SR can cause anxiety.)
> I decided to go back to the IR in hopes of banishing the anxiety and returning my mood to its previous state (good!).
>
> I will state that even Wellbutrin SR was better for me than Effexor, Nortriptyline, Prozac, all of which I tried over this summer before deciding to go back on the IR Wellbutrin.
>
> Dosage has been weird tho.
> I found out that Wellbutrin IR dosage is better absorbed than SR, so if one is taking IR and then switches to SR, the dosage should be raised slightly (mine wasn't!).
> And the people prescribing it now say I should take 75mg 4x day. But if they think I'm going to remember that, then THEY are the crazy ones. Besides, I'd have to get that last dose MIGHTY close to bedtime, so I'd still have insomnia. I'm going to take it twice/day unless side-effects get too extreme. I might try 100mg 3x day, but that's only if I can't tolerate 150 2x day, which is what I was on before. The last thing to try is taking 200mg SR 2x day.
>
> So that's the REST of the story. ;)
>
> sl
Posted by sl on September 1, 2001, at 19:14:11
In reply to Re: Wellbutrin SR vs IR » sl, posted by shelliR on September 1, 2001, at 19:01:10
> Hi sl,
>
> A couple more questions, please.
>
> What was your dose when you were on the SR? Were you up to 400mg, or if you go back to it, it would be an increase?Well, yes and no.
When I was on SR I was taking 300mg. 150 2x day.
But yes, if I go back to it, we'll have to try increasing the dosage.> Also, how long, if you remember, did it take for the wellbutrin to kick in a little, and then full force?
A little, perhaps 4-6 days.
Full force, 4-6 wks.
> And last, are you taking anything else for depression in combination with wellbutrin?Not now. I may or may not add something.
My doctors' care is limited and frustrating, I'll probably try to just deal with the wellbutrin solo.
> Today was the first day I didn't feel totally hyper since I've been on 200 SR, but I'm not sure if I have any antidepressant effects yet. Not sure, because both yesterday and today I didn't wake up in a total overwhelming depression forEXACTLY. I remember that was the first hint I had that this was going to work for me...I woke up, my eyes opened, and I WANTED to get out of bed. :)
>the first time in quite a while. I did have breakthrough depression (I am combining with an opiate which has been carrying me until an AD works), so maybe after a week or so on 300 mg I
You have NO idea how lucky you are.
My doctors don't care. It's "wait it out".
See, cuz all the immediate-action stuff is habit-forming, and nobody trusts me to police my own meds. I haven't tried my GP tho, she might....she knows me better than anyone, if I get to a point where I'm desparate, I'll call. :)Actually, they don't even trust me to SCHEDULE my own meds. When the amount is predetermined.
They want me to take 75mg 4x day. It won't happen, I'll end up forgetting a dose or two, and suffering for it. So I'm PERSONALLY choosing to modify it and take 150mg 2x day.>will have more of an idea. I hope it works; I've tried about everything else; I like the energizing effect on me, as well as my lack of appetite since I'm trying hard-- eating--treadmill-weights--to lose 20 pounds more. (Lost 10 since early April).
My appetite came back, but I was on it for a long time and was also on birth control pills.
sl
Posted by terra miller on September 1, 2001, at 20:33:57
In reply to Re: Wellbutrin SR vs IR ------ SL and terra miller, posted by sl on September 1, 2001, at 9:27:25
> Dosage has been weird tho.
> I found out that Wellbutrin IR dosage is better absorbed than SR, so if one is taking IR and then switches to SR, the dosage should be raised slightly (mine wasn't!).wow, that is really interesting. it certainly "feels" that way... the better absorption comment.
> And the people prescribing it now say I should take 75mg 4x day. But if they think I'm going to remember that, then THEY are the crazy ones.
it _is_ tough to remember sometimes, but if you end up having to do it, i highly recommend the pill boxes at kmart with 4 boxes per day. it's saved my life! :-)
Besides, I'd have to get that last dose MIGHTY close to bedtime, so I'd still have insomnia.
(very big smile) for some reason i find no interference with sleep no matter how late at night i take my last dose. can't explain that one either. :-)~terra
Posted by terra miller on September 1, 2001, at 20:46:43
In reply to Re: shelli » terra miller, posted by shelliR on September 1, 2001, at 14:17:53
sorry for misspelling your name previously. :-)
> Okay, so it helps you with irritability and tiredness. How about your depression. This this your base AD or is this an adjunct for you?
this is the only AD i take. originally i wasn't presenting as very depressed because i still had lots of energy, so it was mostly the anxiety. but occasionally i would dive if therapy got rough and i'd hit some suicidal thinking, so that's why i went on an AD. went through lots of them trying to find one that worked. long story.... so when i was first using the wellbutrin it served to get me up and get me going and moving and more productive when personal life was hard, but i didn't notice any AD effect. about 3 months into it i all of a sudden noticed a calming inside and it's been that way ever since. i continue to be motivated, but the "rev" you get when first starting wellbutrin has subsided some. (that is: i no longer feel the need to clean my entire house the first thing in the morning. ha!)
> Wow, that is a really strange side effect. I've read on the board that other ADs cause cold extremities, but I didn't think about body temperature dropping.yes, it is different than just getting cold fingernails. i take my temperature and it has actually readjusted. my normal temperature is about 96.4 now i think. i don't really notice it much. when it dives under 96 i notice but that doesn't last more than a few hours anymore and serves to remind me that i've got medication inside working for me, so it's actually an encouraging event for me.
> I think I could (maybe) do the four pill at home thing, but I know I would either forget to bring pills, or forget to take them if I am out. I will be raising my SR to 300 starting Monday to see if I can handle it.
i still have days when i stare at my bottle and cannot remember if and when i took my last dose, because i took it out of the bottle instead of the pill container. someday i'll learn! but it's kind of unbelievable that i don't think i have messed it up yet... that is, i don't think i've missed or doubled up on a dose this whole time of taking the wellbutrin in this routine. i find that a bit amazing as i am normally quite forgetful.
i hope the increase goes well for you. my best wishes. -terra
Posted by terra miller on September 2, 2001, at 12:01:47
In reply to Re: Wellbutrin SR vs IR, posted by sl on September 1, 2001, at 19:14:11
> My appetite came back, but I was on it for a long time and was also on birth control pills.
oh, gosh. i hope you find this humorous as well. i don't know why, but i think i always assumed you were a guy! apparently not. don't know how i mixed up THAT information. just thought i'd give you a good laugh. -terra
Posted by sl on September 2, 2001, at 21:39:14
In reply to sl- some humor, posted by terra miller on September 2, 2001, at 12:01:47
> assumed you were a guy
*ROFL* *checks pants* Nope, definately female.
A lot of my opinions are very...man-ish, tho. ;)sl
This is the end of the thread.
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