![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 27. This is the beginning of the thread.
Posted by Eric1973 on January 13, 2002, at 20:25:08
I've been taking Wellbutrin-SR for over a year and it helps me maintain a somewhat normal baseline mood (I'm dysthymic-- chronic low-level depression).
I starting feeling a depression "on top of" the dysthymia back in October. I went on Celexa and very quickly, for the first time in my life I actually understood what it meant to feel "normal" -- not an understatement at all. Well the Celexa pooped out after about 2 months. :-/
I then started on Effexor as 75mg/day. That didn't seem to be doing much after about two weeks, so my doc increased it to 112.5mg/day.
Two weeks later, on Dec 20th, I saw my doc again. The Effexor still wan't doing anything for me and I was starting to feel worse (of course that could have been due to the upcoming holidays -- plus my "mourning" the loss of my Celexa happiness), my doc increased my Effexor dosage 112.5mg/day to 150mg/day.
HOWEVER [here's the important part, drum roll please...]
That same day my doc filled a new Rx for Wellbutrin-SR (at the same dosage I've been at for a long time).
I went and had it filled at my HMO pharmacy. (My company changed to a new health plan and this was the first time I'd used that pharmacy.)
*They gave me a generic for Wellbutrin. When I saw what they'd given me, I paused for a minute (I didn't even know there was a generic) but said to myself, "well, it's an HMO and they're saving money and they wouldn't give this to me if it weren't the same thing."
Well, since then, in the last two week especially I have TOTALLY crashed: suicidal thoughts, lots of crying, low energy, zero productivity at work, you name it.
I wonder if basically what happened is that, as far as my brain is concerned, I quit the "real" Wellbutrin-SR cold turkey?
If so, wouldn't that explain this sudden dive?
Has anyone had this same experience? Do you know of anything out there written on this subject????
My new HMO is also making me change psychiatrits right now (BAD timing) so I am not going to have much confidence in my new one until I've been with him a while.
Posted by jane d on January 14, 2002, at 12:14:26
In reply to Generic Unintentional Cold Turkey of Wellbutrin?, posted by Eric1973 on January 13, 2002, at 20:25:08
Eric,
I think you've had too many changes recently to be able to point to any one of them. One possibility is that you have been getting worse continually - and the brief reprieve with Celexa was just a fluke. Another is that the higher dose of Effexor is a problem. A third is that the Celexa was actually helping somewhat and the effects of it have finally completely worn off. Or short dark days and the holidays got to you. And of course you could be right about the switch to generic bupropion.You've made two changes with the Wellbutrin, from name brand to generic and from slow to immediate release. I'd be inclined to suspect the release mechanism first. I've never tried the immediate release but it is supposed to cause more fluctuation in the levels throughout the day meaning you have to dose more often and still may find your energy going up and down. By the way, you should find out if your pharmacy contacted your doctor to get the prescription changed. Since it's not just a change to a generic I don't think it's one that they are allowed to make by themselves.
If you want to change back to Wellbutrin SR, at least until you've gotten used to the other changes you've made, you may be able to get your prescription plan to pay for it. Call them and find out what they would require. I've had to do this several times now and each time all it took was some kind of certification from my doctor. If you don't have a new one yet your old one may be willing to do it. But, even if they do pay, you may have a higher copay for the generic.
Finally, if it comes up again you probably don't want to assume that "they wouldn't give this to me if it weren't the same thing". Mistakes happen and it's worth the time to always check what you are given.
Good luck.
Jane
Posted by eric1973 on January 14, 2002, at 13:11:21
In reply to Re: Generic Unintentional Cold Turkey of Wellbutrin? » Eric1973, posted by jane d on January 14, 2002, at 12:14:26
Jane, thanks for your very clear input.
One wrinkle, though -- I think my doctor wrote my Rx for "Wellbutrin" and just left off the "-SR" even though he knows the SR is what I've been taking and he intended me to. (Does Glaxo even sell the non-SR anymore?)
Also, he wrote the Rx dosage wrong in such a way that the pharmacist had to call him to find out his intention. I know that they did not discuss me getting a generic because I asked my doctor.
Btw, this was the second time my doctor had made this kind of mistake.
Any thoughts, anyone?
> Eric,
> I think you've had too many changes recently to be able to point to any one of them. One possibility is that you have been getting worse continually - and the brief reprieve with Celexa was just a fluke. Another is that the higher dose of Effexor is a problem. A third is that the Celexa was actually helping somewhat and the effects of it have finally completely worn off. Or short dark days and the holidays got to you. And of course you could be right about the switch to generic bupropion.
>
> You've made two changes with the Wellbutrin, from name brand to generic and from slow to immediate release. I'd be inclined to suspect the release mechanism first. I've never tried the immediate release but it is supposed to cause more fluctuation in the levels throughout the day meaning you have to dose more often and still may find your energy going up and down. By the way, you should find out if your pharmacy contacted your doctor to get the prescription changed. Since it's not just a change to a generic I don't think it's one that they are allowed to make by themselves.
>
> If you want to change back to Wellbutrin SR, at least until you've gotten used to the other changes you've made, you may be able to get your prescription plan to pay for it. Call them and find out what they would require. I've had to do this several times now and each time all it took was some kind of certification from my doctor. If you don't have a new one yet your old one may be willing to do it. But, even if they do pay, you may have a higher copay for the generic.
>
> Finally, if it comes up again you probably don't want to assume that "they wouldn't give this to me if it weren't the same thing". Mistakes happen and it's worth the time to always check what you are given.
>
> Good luck.
>
> Jane
Posted by jane d on January 14, 2002, at 15:26:45
In reply to Wellbutrin vs. Wellbutrin-SR, posted by eric1973 on January 14, 2002, at 13:11:21
> One wrinkle, though -- I think my doctor wrote my Rx for "Wellbutrin" and just left off the "-SR" even though he knows the SR is what I've been taking and he intended me to. (Does Glaxo even sell the non-SR anymore?)
>
> Also, he wrote the Rx dosage wrong in such a way that the pharmacist had to call him to find out his intention. I know that they did not discuss me getting a generic because I asked my doctor.
>
> Btw, this was the second time my doctor had made this kind of mistake.
>Eric -
I have a doctor like that. He'll tell you one thing and then his brain will disconnect when he writes the prescription and it says something else entirely. Since this only happens when he writes prescriptions I've decided it doesn't matter so long as I watch what he writes carefully. He ends up crossing out a lot of prescriptions but I always do leave with the right one these days. Let's hear it for computerized prescribing!
I have a few more questions for you. How much bupropion are you taking and how often? And have you noticed any pattern in how you feel at different times during the day?
Jane
Posted by eric1973 on January 14, 2002, at 15:34:44
In reply to Re: Wellbutrin vs. Wellbutrin-SR, posted by jane d on January 14, 2002, at 15:26:45
Dec 20th thru yesterday, I was taking 400mg/day, at least 6 hours between doses.
I've just been feeling really bad all day... not noticed any significant difference in times of day.
As of today, I'm back on the real stuff, again at 400mg/day, 6 hours between doses (usually 9am. and 3:30pm -- on the advice of my doc, I take the 2nd dose at that time because any later and it interferes with my sleep).
> > One wrinkle, though -- I think my doctor wrote my Rx for "Wellbutrin" and just left off the "-SR" even though he knows the SR is what I've been taking and he intended me to. (Does Glaxo even sell the non-SR anymore?)
> >
> > Also, he wrote the Rx dosage wrong in such a way that the pharmacist had to call him to find out his intention. I know that they did not discuss me getting a generic because I asked my doctor.
> >
> > Btw, this was the second time my doctor had made this kind of mistake.
> >
>
> Eric -
>
> I have a doctor like that. He'll tell you one thing and then his brain will disconnect when he writes the prescription and it says something else entirely. Since this only happens when he writes prescriptions I've decided it doesn't matter so long as I watch what he writes carefully. He ends up crossing out a lot of prescriptions but I always do leave with the right one these days. Let's hear it for computerized prescribing!
>
> I have a few more questions for you. How much bupropion are you taking and how often? And have you noticed any pattern in how you feel at different times during the day?
>
> Jane
Posted by Simcha on January 15, 2002, at 7:39:31
In reply to Wellbutrin vs. Wellbutrin-SR, posted by eric1973 on January 14, 2002, at 13:11:21
Eric,
My GP did that with EffexorXR. He left off the XR. The stupid pharmacy (that had filled some XR prescriptions before for me) would not believe me that the doc left the "XR" off of the script. They had to call him. Naturally it took them two days to get an answer from him that yes, he wanted me on the XR formulation.
Thank G-d I had enough of the stuff to tide me over!
Before I leave the office with a script I read it to make sure that the doc wrote what he said he wanted me to take clearly enough to be understood by the pharmacist. This current pdoc has yet to screw up but you just never know. We're all human.....
> Jane, thanks for your very clear input.
>
> One wrinkle, though -- I think my doctor wrote my Rx for "Wellbutrin" and just left off the "-SR" even though he knows the SR is what I've been taking and he intended me to. (Does Glaxo even sell the non-SR anymore?)
>
> Also, he wrote the Rx dosage wrong in such a way that the pharmacist had to call him to find out his intention. I know that they did not discuss me getting a generic because I asked my doctor.
>
> Btw, this was the second time my doctor had made this kind of mistake.
>
> Any thoughts, anyone?
>
>
> > Eric,
> > I think you've had too many changes recently to be able to point to any one of them. One possibility is that you have been getting worse continually - and the brief reprieve with Celexa was just a fluke. Another is that the higher dose of Effexor is a problem. A third is that the Celexa was actually helping somewhat and the effects of it have finally completely worn off. Or short dark days and the holidays got to you. And of course you could be right about the switch to generic bupropion.
> >
> > You've made two changes with the Wellbutrin, from name brand to generic and from slow to immediate release. I'd be inclined to suspect the release mechanism first. I've never tried the immediate release but it is supposed to cause more fluctuation in the levels throughout the day meaning you have to dose more often and still may find your energy going up and down. By the way, you should find out if your pharmacy contacted your doctor to get the prescription changed. Since it's not just a change to a generic I don't think it's one that they are allowed to make by themselves.
> >
> > If you want to change back to Wellbutrin SR, at least until you've gotten used to the other changes you've made, you may be able to get your prescription plan to pay for it. Call them and find out what they would require. I've had to do this several times now and each time all it took was some kind of certification from my doctor. If you don't have a new one yet your old one may be willing to do it. But, even if they do pay, you may have a higher copay for the generic.
> >
> > Finally, if it comes up again you probably don't want to assume that "they wouldn't give this to me if it weren't the same thing". Mistakes happen and it's worth the time to always check what you are given.
> >
> > Good luck.
> >
> > Jane
Posted by MoBe on April 14, 2003, at 16:37:32
In reply to Re: Wellbutrin vs. Wellbutrin-SR » eric1973, posted by Simcha on January 15, 2002, at 7:39:31
I'm taking wellbutrin SR 150 mg twice a day. My problem is that, because I'm taking them 8 hours apart (as per the pharmacists instructions) the second dose ends up being, minimum, at the earliest 2 pm in afternoon, and this of course leaves me a little too "awake" at bedtime. Anyone out there taken there second wellbutrin sooner than the 8 hour mark or at unusual times?
MoBe
Posted by Simcha on April 15, 2003, at 23:35:42
In reply to Re: Wellbutrin vs. Wellbutrin-SR » Simcha, posted by MoBe on April 14, 2003, at 16:37:32
MoBe,
Wow, that post of mine was from a while ago... I'm amazed you found it...
Anyway, these days I'm taking 200mg of Wellbutrin SR in the morning with my 40mg dose of Celexa. My current pdoc says that there is enough in my system throughout the day to keep my mood stable. I agree. And at night I take 600mg of Neurontin which helps me sleep without grinding my teeth. I do think that switching my dosing to 100% of my dose in the am has helped me sleep at night.
I would not change anything without first consulting my pdoc. These meds can be tricky and it helps to have a professional opinion. And, of course, your mileage may vary...
Thanks,
Simcha> I'm taking wellbutrin SR 150 mg twice a day. My problem is that, because I'm taking them 8 hours apart (as per the pharmacists instructions) the second dose ends up being, minimum, at the earliest 2 pm in afternoon, and this of course leaves me a little too "awake" at bedtime. Anyone out there taken there second wellbutrin sooner than the 8 hour mark or at unusual times?
> MoBe
Posted by MoBe on April 17, 2003, at 18:33:20
In reply to Re: Wellbutrin vs. Wellbutrin-SR, posted by Simcha on April 15, 2003, at 23:35:42
> MoBe,
>
> Wow, that post of mine was from a while ago... I'm amazed you found it...
>
> Anyway, these days I'm taking 200mg of Wellbutrin SR in the morning with my 40mg dose of Celexa. My current pdoc says that there is enough in my system throughout the day to keep my mood stable. I agree. And at night I take 600mg of Neurontin which helps me sleep without grinding my teeth. I do think that switching my dosing to 100% of my dose in the am has helped me sleep at night.
>
> I would not change anything without first consulting my pdoc. These meds can be tricky and it helps to have a professional opinion. And, of course, your mileage may vary...
>
> Thanks,
> Simcha
>
> > I'm taking wellbutrin SR 150 mg twice a day. My problem is that, because I'm taking them 8 hours apart (as per the pharmacists instructions) the second dose ends up being, minimum, at the earliest 2 pm in afternoon, and this of course leaves me a little too "awake" at bedtime. Anyone out there taken there second wellbutrin sooner than the 8 hour mark or at unusual times?
> > MoBe
>
> Hi Simcha
Thanks for your comment. My understanding is that above a certain amount of wellbutrin at the same time would seriously increase the seizure risk. I don't think I would increase the 150mg to 300 mg all at once without asking my doc. But I seem to remember some posters doing that. I'll discuss the 200 mg amount with him the next time I see him. Thanks again.
MoBe
Posted by Katia on April 18, 2003, at 17:30:42
In reply to Re: Generic Unintentional Cold Turkey of Wellbutrin? » Eric1973, posted by jane d on January 14, 2002, at 12:14:26
I have just transitioned off of Zoloft after three months of no effect but only exhaustion as though every pore of my bones had heavy weights in them. I started on Wellbutrin SR two weeks ago (at the same time as tapering off of Zoloft). I started having those "mind shivers" again as I had with Effexor. So I stopped the WB SR too. I'm so sick of ADs!!!!! Now all I feel as though I just stepped off of one of those twirling rides at the amusement park. I feel soooo dizzy and nauseous, esp. when I do something abnormal! like physically MOVE my head!!! It's like my equilibrium is way off.
Anyone else experience this either getting off Zoloft OR experience this as a side effect of WB?
thanks.
Posted by Snoozy on April 18, 2003, at 19:54:22
In reply to Zoloft or Wellbutrin rollercoaster ride sensation?, posted by Katia on April 18, 2003, at 17:30:42
I felt terribly sick exactly as you describe when I stopped taking Paxil and Effexor. I stayed on the couch for a week, hating to move. Zoloft might have been the same, but I don't think it was as intense. I think I know what you mean when you say "mind shivers". Did you have these while you were taking the drug or when you stopped?
My main side effect from Wellbutrin was early in the treatment, I was very wired and everything seemed very intense, and I have memories just etched into my brain by the intensity. (This was on a high dose - 400mg). It did go away fairly quickly.
If you're still having this withdrawl, if it's possible, you may want to just take it really easy for a few days. Just lie down and have some 7 Up and saltines, and realize that it will pass and you'll feel better soon.
I hope this helps in some way. Good luck to you.
> I have just transitioned off of Zoloft after three months of no effect but only exhaustion as though every pore of my bones had heavy weights in them. I started on Wellbutrin SR two weeks ago (at the same time as tapering off of Zoloft). I started having those "mind shivers" again as I had with Effexor. So I stopped the WB SR too. I'm so sick of ADs!!!!! Now all I feel as though I just stepped off of one of those twirling rides at the amusement park. I feel soooo dizzy and nauseous, esp. when I do something abnormal! like physically MOVE my head!!! It's like my equilibrium is way off.
> Anyone else experience this either getting off Zoloft OR experience this as a side effect of WB?
> thanks.
>
Posted by MoBe on April 18, 2003, at 23:00:47
In reply to Re: Zoloft or Wellbutrin rollercoaster ride sensation? » Katia, posted by Snoozy on April 18, 2003, at 19:54:22
> I felt terribly sick exactly as you describe when I stopped taking Paxil and Effexor. I stayed on the couch for a week, hating to move. Zoloft might have been the same, but I don't think it was as intense. I think I know what you mean when you say "mind shivers". Did you have these while you were taking the drug or when you stopped?
>
> My main side effect from Wellbutrin was early in the treatment, I was very wired and everything seemed very intense, and I have memories just etched into my brain by the intensity. (This was on a high dose - 400mg). It did go away fairly quickly.
>
> If you're still having this withdrawl, if it's possible, you may want to just take it really easy for a few days. Just lie down and have some 7 Up and saltines, and realize that it will pass and you'll feel better soon.
>
> I hope this helps in some way. Good luck to you.
>
> > I have just transitioned off of Zoloft after three months of no effect but only exhaustion as though every pore of my bones had heavy weights in them. I started on Wellbutrin SR two weeks ago (at the same time as tapering off of Zoloft). I started having those "mind shivers" again as I had with Effexor. So I stopped the WB SR too. I'm so sick of ADs!!!!! Now all I feel as though I just stepped off of one of those twirling rides at the amusement park. I feel soooo dizzy and nauseous, esp. when I do something abnormal! like physically MOVE my head!!! It's like my equilibrium is way off.
> > Anyone else experience this either getting off Zoloft OR experience this as a side effect of WB?
> > thanks.
> >
> I've been on remeron and wellbutrin. Trying to wean myself from remeron because of the usual weight gain/bloated reasons. My doc upped the wellbutrin to 150 mg twice a day. I generally feel better but do wonder when these transient feelings of anxiety will subside. Could you give me an approximate idea of how long it took for you. Thanks.
MoBe>
Posted by Snoozy on April 18, 2003, at 23:17:59
In reply to Re: Zoloft or Wellbutrin rollercoaster ride sensation?, posted by MoBe on April 18, 2003, at 23:00:47
> > I felt terribly sick exactly as you describe when I stopped taking Paxil and Effexor. I stayed on the couch for a week, hating to move. Zoloft might have been the same, but I don't think it was as intense. I think I know what you mean when you say "mind shivers". Did you have these while you were taking the drug or when you stopped?
> >
> > My main side effect from Wellbutrin was early in the treatment, I was very wired and everything seemed very intense, and I have memories just etched into my brain by the intensity. (This was on a high dose - 400mg). It did go away fairly quickly.
> >
> > If you're still having this withdrawl, if it's possible, you may want to just take it really easy for a few days. Just lie down and have some 7 Up and saltines, and realize that it will pass and you'll feel better soon.
> >
> > I hope this helps in some way. Good luck to you.
> >
> > > I have just transitioned off of Zoloft after three months of no effect but only exhaustion as though every pore of my bones had heavy weights in them. I started on Wellbutrin SR two weeks ago (at the same time as tapering off of Zoloft). I started having those "mind shivers" again as I had with Effexor. So I stopped the WB SR too. I'm so sick of ADs!!!!! Now all I feel as though I just stepped off of one of those twirling rides at the amusement park. I feel soooo dizzy and nauseous, esp. when I do something abnormal! like physically MOVE my head!!! It's like my equilibrium is way off.
> > > Anyone else experience this either getting off Zoloft OR experience this as a side effect of WB?
> > > thanks.
> > >
> > I've been on remeron and wellbutrin. Trying to wean myself from remeron because of the usual weight gain/bloated reasons. My doc upped the wellbutrin to 150 mg twice a day. I generally feel better but do wonder when these transient feelings of anxiety will subside. Could you give me an approximate idea of how long it took for you. Thanks.
> MoBe
>
> >
>
>Wow - the first time I took Wellbutrin was about 10 years ago, so I can't remember how long it took to calm down. I've been on it again for about 3 years now. I recall the anxiety went away about the same time as the insomnia - about a month. I actually welcomed the insomnia though(hence snoozy) so I didn't mind it so much.
If you think the Wellbutrin is or will help you, you could try taking a smaller dose and working up to 300 mg. That might help minimize the side effects - ask your doctor. I have a lot of problems with the SSRIs, so Wellbutrin is worth it for me.
Posted by Katia on April 19, 2003, at 3:15:46
In reply to Re: Zoloft or Wellbutrin rollercoaster ride sensation?, posted by Snoozy on April 18, 2003, at 23:17:59
Thanks Snoozy,
Unfortunately I do not have the option to take it easy for a few days...for some crazy reason all these intensity has happened upon me at the same time. This woooooozy feeling, skipped heartbeats, Grad school is esp. intense now as well as work. I want to quit both and almost did today! My mood is out of control. I almost told my boss exactly what I thought in the midst of tears and yelling. But I bit my tongue for as long as I could and it passed...My mood was almost, and I say almost completely out of my control. But need to just hang on for a few more days....
toooooooo many bills each month to not hang on...
Posted by Snoozy on April 19, 2003, at 13:53:40
In reply to Re: Zoloft or Wellbutrin rollercoaster ride sensation? » Snoozy, posted by Katia on April 19, 2003, at 3:15:46
I'm sorry to hear things are so crazy for you. I would recommend that you try to eat well. I know that's really hard with the nausea, but I found the wooziness was better if I was able to force myself to eat a good meal (when I couldn't really deal with solids I drank some of those nutritional supplements.) And just in general I find that my moods can really swing and I feel out of control if I'm eating poorly. It's hard for me, because when I'm really stressed I want to eat a lot of junk food and sweets. Also, if you use caffeine you may want to cut back for a while (just be careful you don't get a withdrawl headache).
Try to take a few minutes each day just for yourself and take good care of yourself. Hang in there - it really will get better.
> Thanks Snoozy,
> Unfortunately I do not have the option to take it easy for a few days...for some crazy reason all these intensity has happened upon me at the same time. This woooooozy feeling, skipped heartbeats, Grad school is esp. intense now as well as work. I want to quit both and almost did today! My mood is out of control. I almost told my boss exactly what I thought in the midst of tears and yelling. But I bit my tongue for as long as I could and it passed...My mood was almost, and I say almost completely out of my control. But need to just hang on for a few more days....
> toooooooo many bills each month to not hang on...
>
Posted by Katia on April 20, 2003, at 13:56:04
In reply to Re: Zoloft or Wellbutrin rollercoaster ride sensation? » Katia, posted by Snoozy on April 19, 2003, at 13:53:40
Posted by Shandra on October 29, 2003, at 18:28:00
In reply to Re: Zoloft or Wellbutrin rollercoaster ride sensation? » Snoozy, posted by Katia on April 19, 2003, at 3:15:46
Dear Katia - I'm new to the site so I'm responding to a post from earlier this spring. Hope things are better for you. I wanted to mention that last spring and summer I was on Wellbutrin SR and had better results on the depression than Zoloft (which I took a couple of years ago - the Zoloft helped some but not nearly enough and I had a variety of side effects). I was taking 150mg Wellbutrin two times a day, just about exactly 12 hours apart as is recommended in the product literature (and my pdoc of course)... I had few of the normal side effects with Wellbutrin @ 300mg (for example, weight gain was not a big problem). However, I felt like 300mg a day was not taking care of my depression, even though it was "supposed to" - seems a lot of people assume that 300mg a day is a "Therapeutic Dose" even if it isn't doing the trick - ha! Well, after 'firing' this pdoc I was seeing (he was more interested in collecting a weekly fee for psychotherapy and didn't really know his stuff as far as meds went), I found a pdoc who really knew his stuff. After trying various things, including a mood stabilizer, we jointly decided to bump me up to 200mg twice a day (sustained release - I was told recently the company only makes a sustained release - could other posters be talking about a generic, possibly gotten in Canada, that is not sustained release? I got deadends when trying to find alternatives). Imagine my surprise when the 400mg of Wellbutrin per day really made an impact in my depression, but the flip side was that I was ANGRY all the time! It's like it gave me enough energy and relief from depression to not be a doormat, but it seemed to push me to the other extreme with irritation and being angry with things (and people, like bosses and significant others) whereas I normally wouldn't react that way at all. Since my pdoc & I had been very careful to add/change only one thing at a time, I am 100% certain that Wellbutrin was what was causing this aggitation & aggression.
It may seem like there should not be such a huge difference between 300mg and 400mg per day, but I found it to be an extreme difference in my moods, both for better & for worse.
Good luck!
-Shandra> Thanks Snoozy,
> Unfortunately I do not have the option to take it easy for a few days...for some crazy reason all these intensity has happened upon me at the same time. This woooooozy feeling, skipped heartbeats, Grad school is esp. intense now as well as work. I want to quit both and almost did today! My mood is out of control. I almost told my boss exactly what I thought in the midst of tears and yelling. But I bit my tongue for as long as I could and it passed...My mood was almost, and I say almost completely out of my control. But need to just hang on for a few more days....
> toooooooo many bills each month to not hang on...
>
Posted by katia on October 29, 2003, at 20:25:25
In reply to Re: Zoloft or Wellbutrin rollercoaster ride sensation? » Katia, posted by Shandra on October 29, 2003, at 18:28:00
Hi Shandra,
Wow. that was a lifetime ago! Wellbutrin was my last AD. I quit after two weeks. I sought out a new pdoc and got a dx of bipolar. Hence nothing working for me. I'm now on moodstabilizers and feeling much better.
thanks for you input tho'.
katia
Posted by Shandra on October 29, 2003, at 22:47:04
In reply to Re: Zoloft or Wellbutrin rollercoaster ride sensation? » Shandra, posted by katia on October 29, 2003, at 20:25:25
Bipolar II is what I wound up being diagnosed with shortly after going with the second pdoc (I had seen therapists, MD's, others prior to seeing the first actual pdoc this past year - diagnosed previously w/depression, anxiety and ADD). the second pdoc knew what was wrong in the first session and confirmed his suspicions on the second visit. Remember the song Killing me softly? "He read my life out loud as if I wasn't there!" Talk about being shocked by how accurately someone could describe exactly what I was going through! Oh the euphoria to finally be understood. And then the shock of how hard it is to find the right combination of meds to help! Yikes!!!
I am hopeful that the pdocs out there are starting to become more knowledgable about bipolar disorder, particularly for women, who seem to struggle with the depression side of things more severly and have terribly underdiagnosed Bipolar Type 2 (as in my situation). Reading everything I could get my hands on has made a world of difference for me since my second pdoc gave me a definite diagnosis of Bipolar II.
After quitting my job (and subsequently losing my insurance as a result), I am now off all prescription meds (because it would cost me $500 per month out of pocket for the mood stabilizer, AD, anti-anxiety and stimulent, and I don't yet meet many of the qualifications for the drug companies' free drug programs, since I have had a decent income this year). In the last couple of months, I have been educating myself about OTC supplements and what works for me. When I got my diagnosis and started mood stabilizer, I swore I would never stop taking my prescription meds. However, since my financial situation has done a complete about-face since leaving my job, it has been interesting to change my attitude from "I'll never stop taking these meds" to "I'll never ignore my disorder just because I'm feeling better today".
The prescriptions/combination that worked for me:I was on Depakote at 750 mg per day for mood stabilization, but went off that about 6 weeks ago and now I'm losing my hair!! (Trying to see what other people had experienced with Dep. & hair loss is how I found this site.) Besides the Depakote, I was on 18mg of Concerta, a new stimulent, which I liked much better than Ritalin, if only because it is a once daily med which works for 12 hours straight, no ups and downs whatsoever, and zero side effects. If you need to be on any kind of ADD-type stimulent drug, you might ask your pdoc about it - it's new and therefore expensive w/out insurance, but I found it to be an excellent alternative to Ritalin, if only because I didn't have to remember to take it except once in the morning and also because there is no energy surge associated with it (which can sometimes throw me into a rapid-cycle depression). I was also on clonazapam .5 mg twice a day (or three times if it was a bad day) for anxiety. Add to that the Wellbutrin, and that's four different prescription meds which were pretty much working for me if I was absolutely diligent (I was about 98% compliant, which I was very proud of myself for). Unfortunately, $500 a month is pretty high, and my agitation level would rise unpredictably with the Wellbutrin, and the mood stabilizer didn't handle that agitation when it got more extreme (ie when the anger/aggitation would come on with no warning).
Another interesting side note was that I wound up feeling suicidal more often than before I went on meds, even with the mood stabilizer, which I thought was weird. Then I would have a tendency to ask myself whether this was all just a matter of adjusting to the diagnosis. However, earlier today I read a new study (article published on 9/17/03, so VERY current) showing that Depakote has a much higher risk of suicide and/or hospitalization than Lithium! As I read these new findings today, it clicked - I have actually had almost no suicidal feelings/thoughts since going off Depakote!! I am not someone who would attempt suicide (I don't fit the profile at all), but that didn't stop me FEELING like it! I have no idea how widespread this phenomenon is, but I actually thought my moods were better on that combination of meds, even though at the same time I was having an awful lot of suicidal thoughts! Weird! Whether I would attempt suicide or not, having those thoughts popping up when you're feeling crappy is just miserable in and of itself! Guess all I'm saying here is that I know my first several months after the bipolar diagnosis were very difficult in terms of sorting out 'how much of this is meds' and 'how much of this is the disorder' and 'how much of this will I settle into/figure out as I discover new coping mechanisms'... In the first several months of the diagnosis, I felt I really second-guessed absolutely everything I felt or thought. That in itself is pretty traumatic! So if you (or others reading this) find yourself feeling suicidal or thinking about death while taking Depakote, given the new study pointing to higher risk on that drug than previously known, definitely check into it further and talk to your pdoc. You can find info on the web about this new study via Google search for "Depakote suicide 9/17/2003".
I would **never** recommend to anyone else that they go off meds without talking with their pdoc about their concerns etc and seeing if they can come up with a solution. However, in my own situation, I felt that I wanted to try a non-prescription route and see how it worked for me. The only problem I seem to be having right now is this very irritating hair loss, which I believe is supposed to subside within the next couple of weeks (as the Depakote completely leaves my system, 6-8 wks after stopping completely - and note, I tapered off the Depakote very slowly).
I may go back to prescription meds at some point, particularly if I start suffering more with my bipolar 2 than I am currently with my present OTC regime (I keep a very close watch on my moods now to make sure I'm always doing ok, not feeling 'too good' etc). But for the moment, with careful buying and reading everything I can get my hands on, I have found a combination of OTC supplements that seems to be giving me at least as good, and in many ways better, results than the Depakote / Wellbutrin / Concerta / Ritalin / Clonazapam combination I had worked out with my very wonderful pdoc.Currently, to manage my bipolar II disorder and its related depression, anxiety, and serious lack of energy, I am taking the following:
*** One-a-day plus iron multivitamin/mineral supp. <<one daily>>
*** St. John's Wort complex: 300mg w/vit's B1, B2, B3, B5, B6, & Ginsing (100mg) <<2 tablets daily>>
*** 5-HTP 50 mg <<two tablets, twice daily for a total of 200 mg per day>>
*** One-a-day Memory & Concentration supplement: contains Ginsing 60 mg, Choline 60 mg, B6 and B12 <<one tablet twice daily>>
*** Fish oil concentrate w/omega 3 fatty acids: 850 mg fish oil concentrate, EPA 240 mg, DHA 200 mg <<One tablet twice per day>>
*** Chewable vitamin C: 500 mg <<I chew two tablets three times per day for a total of 3000 mg per day>>If I have trouble sleeping, which I do only occasionally now, I can take one OTC Valerian Root capsule, and I am able to sleep soundly without bad dreams or grogginess (years ago I would use Melatonin to help me sleep but soon found it gave me bad dreams). When I was taking my prescription meds, I would take Clonazapam right before bed and that did just about the same for me, just maybe about 15 minutes faster.
Katia - I hope your meds & pdoc are working great for you and that this posting will fall under the "I didn't need to know all that" category. However, I know that when I was first diagnosed, I got the latest books on the subject that Barnes & Noble had to offer (ha!) and though current, they were naturally very cautious in their recommendations. These resources, as well as so much I read on the internet, did acknowledge that there is much research being done to find alternatives to prescription meds; however, they were a bit short on specifics in terms of what supplements might work well together. I also found a couple of sites that offer their proprietary supplements, but they were too short on specifics for my own comfort level, in addition to which one in particular is currently doing a trial and their trial participation rules seemed too constricting for me... I'm fairly nervous about meds, so if I was going to go out on a limb and try something on my own, at least I wanted to know exactly what I was putting into my system and what the rationale behind it was. My piecemeal approach allowed me to research, add a single supplement, monitor its effects, and make adjustments.
Perhaps these supplements that are currently working for me wouldn't work for a lot of people, but perhaps there are some folks out there who would like to know what is working for me to help with my Bipolar 2, which includes severe depression, suicidal thoughts (but not attempts), anxiety, and rapid cycling. [Incidently, PMS seems to be a non-issue; I still have my standard chocolate cravings and somewhat increased libido, and this is no different for me now than it has ever been.]
***********
-- My current OTC regime: What does what: (1) For my depression, which was very severe, the 'magic' combination is the 5-HTP plus St. John's Wort. I recently read a study confirming that one without the other doesn't do the trick - put them together and there are impressive results. (2) The Ginko w/vit b's gives me a milder benefit than the Concerta, but very similar in that I don't feel fuzzy-headed and I have energy for the day. (3) The omega-3 fatty acid supplement helps with anxiety and helps combat depression (didn't do much at all by itself). (4) The vitamin C helps with anxiety and generally helps me feel more balanced.
Posted by katia on October 30, 2003, at 13:23:32
In reply to Rollercoaster cont- Supplements instead of Dep etc » katia, posted by Shandra on October 29, 2003, at 22:47:04
Hi Shandra,
Wow what a long post!
I'm just curious. You are on all these OTC products - aren't they adding up to be just as expensive as the prescription meds?How long have you been on the St.JOhn's Wort?
I've heard it takes like three months to get going.I can understand your nervousness about meds - even doctors aren't exactly sure what they are about totally. We're the guniea pigs. At this point, I want meds. I just finished Depakote yesterday and I'll be upping the 50mg of Lamictal and see how that does. I'm actually going in the hole per month with meds and doc visits, but to me right now, it's worth it. I can't live the way I'd been anymore. I've been dxed as BPII and Mixed. also after a frustratingly long period of thinking only depression.
welcome to psychobabble.
katia
Posted by Shandra on October 30, 2003, at 20:46:51
In reply to Re: Rollercoaster cont- Supplements instead of Dep etc » Shandra, posted by katia on October 30, 2003, at 13:23:32
Hi there -
You know, I was worried that it would be just as expensive to be on an otc regime as it would be to get prescription meds with insurance. Actually, it's really not, even though I'm taking a few extra things to make it all work (eg the multi w/iron to help with the post-Depakote hair loss, which I really should have been taking anyway).
I actually found that St. John's Wort complex (not just St. John's Wort even) did NOTHING for me until I added in 5-HTP! But when I put the two together, the depression relief was almost instant! No waiting for these supplements to reach levels in the bloodstream - they just really helped immediately - what a relief and with no side effects. I had some constipation with my prescription meds, but since i take the omega 3 supplement to help with my mood (which is basically fish oil in a capsule) that is much better as a side benefit.
Here's how my analysis comes out for meds w/insurance versus my current over the counter supplements:
With Insurance
********
$25 copay for
dr visit x 4 per month*..100
Depakote..................20
Wellbutrin................30
Clonazapam (gen)...........5
Concerta..................30
Total...................$185 per month
* This is not just a good idea, it is a REQUIREMENT obviously when we're talking about seriously controlled drugs. So even if you know what's working for you and just want the darned prescription, you are reliant on the doctor. Especially in the early phases this is crucial, and also in any kind of crisis etc... but I felt like I was ok without it for now.Over the Counter (note I don't need weekly
pdoc sessions to get these supplements so that's a $100 savings right off the top)
********
Co pays......................0
5HTP (low cost but good
quality brand, health
food store)................8
Vit C (gen @ Walmart)........8
St Johns complex (off
brand w/ correct levels
& quality @Walmart)........7
one-a-day memory
(ginko & chorine - only
name brand avail?)........5
one-a-day multi w/iron
(Walmart store brand)......4
Fish oil supp for
omega 3 (off brand @
Walmart....................7
TOTAL......................$39So, even though when you're making weekly trips to the drug store or Walmart or KMart to read labels and stand there staring feeling like "ok what am I trying to accomplish again!?! :)... it winds up being considerably cheaper, again as I said, as long as I'm buying carefully.
The other thing to keep in mind is that since I don't have insurance right now, the $185 option is no longer an option for me - the meds alone without insurance would be $500, and put on top of the *uninsured pdoc appointments* which would run me $150-250 per hour, per week.... it just became absolutely unfeasible. So for me, this was an act of desperation combined with the conviction that I had to do SOMETHING to similate the positive results I was getting with the prescription meds.
Since you are just coming off Depakote, may I suggest that you immediately go on an iron supplement at the very least, and start shampooing with Nizoral shampoo.... I did not have any serious hair loss while I was taking Depakote for several months, but after I stopped (!!!!) it started falling out to beat the band. Nothing prepared me for that, and now I'm looking at having to find creative ways to disguise the fact that my normally luxurious, full, healthy hair is now healthy as it ever was but seriously diminished in volume and therefore limp as an old wet dishrag! Maybe men deal with this differently - but for me at first this hair loss was just a source of puzzlement, then amazement, then amusement, then, low and behold it became NOTICABLE ot other people and panic set in. I truly hope you'll do this since you're coming off Depakote - this side effect evidently isn't something the drug company & all the pdocs seem to think is a big deal - but if you're anything like me, having my hair look at the very least *normal* turns out to be a very, very big deal for me. I really wish someone had warned me about this. It's supposed to last 6-8 weeks (i just learned) AFTer you STOP taking Depakote. As I mentioned in another post, Nizoral is packaged and marketed as a dandruff shampoo (it was available by prescription only until about 2 yrs ago) but I read on an independent hair loss support group site that they've just discovered it stimulates hair growth/regrowth. I would be interested to see how you react to coming off the meds.....
And... I'm really enjoying this conversation - let me know your thoughts ok?? :) Shandra
> Hi Shandra,
> Wow what a long post!
> I'm just curious. You are on all these OTC products - aren't they adding up to be just as expensive as the prescription meds?
>
> How long have you been on the St.JOhn's Wort?
> I've heard it takes like three months to get going.
>
> I can understand your nervousness about meds - even doctors aren't exactly sure what they are about totally. We're the guniea pigs. At this point, I want meds. I just finished Depakote yesterday and I'll be upping the 50mg of Lamictal and see how that does. I'm actually going in the hole per month with meds and doc visits, but to me right now, it's worth it. I can't live the way I'd been anymore. I've been dxed as BPII and Mixed. also after a frustratingly long period of thinking only depression.
> welcome to psychobabble.
> katia
>
>
Posted by katia on October 30, 2003, at 22:29:25
In reply to Re: Rollercoaster cont- Supplements instead of Dep etc » katia, posted by Shandra on October 30, 2003, at 20:46:51
Hi,
I know not everyone experiences side effects the same way. So hopefully I won't lose my hair as that is my best feature too! I"m always being complimented on it - long, thick and wavy. Since taking Depakote, I've been taking Selenium (200 mcg per day). This is known to help prevent the hair loss. It's interesting that you mention dandruff shampoo because just in the past week I've noticed that I have dandruff. I'VE NEVER HAD THIS BEFORE! I wonder if it's my shampoo or something to do with meds. so maybe I'll get this Nizoral just to be on the safe side. I'm starting to feel a depression coming on - it's these short days. It could also be b/c I stopped the Depakote. I'm seeing my pdoc tomorrow. BTW, I only see him once a month and that's plenty with intermittent phone calls. Your doctor may have been not so honest in regards to the frequency needed?
katia
Posted by Shandra on October 30, 2003, at 23:55:52
In reply to Re: Rollercoaster cont- Supplements instead of Dep etc » Shandra, posted by katia on October 30, 2003, at 22:29:25
You're definitely right about people having different side effects - it's part of what makes these disorders so hard to deal with - it seems like there is a fair amount of similarity as to the primary purpose of a drug, but then the side effects are just all over the board between different people. For example, I could only tolerate 750 mg and that was tough but I have a friend who had zero side effects at 1500 mg a day! I just sure did NOT expect hair loss after stopping Depakote, particularly since it was not something I really had a problem with when I was taking the med. If I had it to do over again, I would play it very safe, since now I'm looking at a very depressing (oh great! more depression) long regrowth period. Ugh. Anyway, I would definitely take a very proactive approach to preventing and/or dealing with the potential of hair loss - honestly I never knew how upsetting it would be. Ironically enough, when I was getting acclimated to Depakote, I told my partner I felt like I was on Chemotherapy all the time - then to have the hair come out en masse - how weird is that?!! (I've never been on chemo - I was just imagining from what I know others experienced with it.)
I will check into some Selenium if this hair loss doesn't really subside in the next few days - I can't take much more of it!If you're feeling depression set in, why don't you try a 5HTP supplement (100mg a couple of times a day) and see if that doesn't help. If you like I can point you in the direction of some of the sites I found that talked about it. While I didn't see any quick relief from St John's Wort by itself, I did when I added 5HTP - but I never tried it by itself, I just added it to St John's Wort and found that I immediately (ie w/in 2 hrs) felt less depressed w/out any kind of bounce into hypomania or mixed episode (I forgot to mention I have mixed episodes too, which I describe as going through hell on speed!)
Oh, almost forgot - my pdoc (the 'second' pdoc I saw, who was fabulous) was happy to see me much less frequently once I got stabilized, even less than once per month (ie every three months) when I got on the right combination, but I was pretty critical and the depression I suffer from is extremely debilitating and seems to be progressively worse over time, so he wanted to make sure I was going to make it through the stabilization period ok. He was also very available by phone to help and w/out charging - I was very, very pleased with him - knowledgeable, kind, reassuring, firm in his convictions, a wonderful listener. Contrast this with the bozo I was seeing before him who only ever perked up in session when the topic got around to sex! Ugh. I mean, psychoanalysis proper certainly has its place, but that was just wrong!!! ;)
Anyway - I've got about 3 projects going that I need to finish up or at least get to good stopping places - this perpetual unfinished projects thing is pretty standard for me and one of the things I'm working on :)
Let me know how things go at your session, ok? Oh, also if you need a quick OTC anti-anxiety, the Valerian root (one tablet is probably fine) is usually good for me if I am feeling things are going out of control for me emotionally and I either don't have anything else available or what I have isn't working. Might make you a bit groggy, but it really does seem to help with anxiety and even depression to a certain extent. Actually its use originated in England several centuries ago and they used it to calm people with overly aggressive tendencies!
Have a good night - more soon!-Shandra
> Hi,
> I know not everyone experiences side effects the same way. So hopefully I won't lose my hair as that is my best feature too! I"m always being complimented on it - long, thick and wavy. Since taking Depakote, I've been taking Selenium (200 mcg per day). This is known to help prevent the hair loss. It's interesting that you mention dandruff shampoo because just in the past week I've noticed that I have dandruff. I'VE NEVER HAD THIS BEFORE! I wonder if it's my shampoo or something to do with meds. so maybe I'll get this Nizoral just to be on the safe side. I'm starting to feel a depression coming on - it's these short days. It could also be b/c I stopped the Depakote. I'm seeing my pdoc tomorrow. BTW, I only see him once a month and that's plenty with intermittent phone calls. Your doctor may have been not so honest in regards to the frequency needed?
> katia
Posted by katia on October 31, 2003, at 0:39:20
In reply to Re: Rollercoaster cont- Supplements instead of Dep etc » katia, posted by Shandra on October 30, 2003, at 23:55:52
HI Shandra,
In response to some of your questions:
> If you're feeling depression set in, why don't you try a 5HTP supplement (100mg a couple of times a day) and see if that doesn't help. If you like I can point you in the direction of some of the sites I found that talked about it. While I didn't see any quick relief from St John's Wort by itself, I did when I added 5HTP - but I never tried it by itself, I just added it to St John's Wort and found that I immediately (ie w/in 2 hrs) felt less depressed w/out any kind of bounce into hypomania or mixed episode (I forgot to mention I have mixed episodes too, which I describe as going through hell on speed!)
** I have actually tried 5-HTP and a St. John's complex (irregularly, but together) almost two years ago and I still (even thought taking those) fell into one of the most awful depressions of my life. From my scant knowledge of antidepressants; it's often not a LACK of serotonin (which is 5-HTP); it's often about it not being processed or absorbed or getting to where it needs to go; something to do with the reuptake inhibitors??? I can't remember all the techonical jargon and description. taking 5-HTP is just taking in more serotonin. Anyway, i tried a lot of alternative supplements before finally giving in to pharma drugs. Valerian doesn't do a thing for me when I have insomnia.
Also, be careful what type of fish oil you buy. Most of it's crap and has loads of mercury in it. A type I take is "nordic naturals" "Arctic Omega" from wild fish only. I take three grams a day. There are threads on this board where people were discussing this very issue. maybe do a search.**BTW, I'm mixed as well sometimes and I KNOW what hell on speed looks like.
>
> Anyway - I've got about 3 projects going that I need to finish up or at least get to good stopping places - this perpetual unfinished projects thing is pretty standard for me and one of the things I'm working on :)** yes, it's a trait we all share.
Katia
Posted by Dr. Bob on October 31, 2003, at 10:51:23
In reply to Re: Rollercoaster cont- Supplements instead of Dep etc » Shandra, posted by katia on October 31, 2003, at 0:39:20
> ** I have actually tried 5-HTP and a St. John's complex (irregularly, but together) almost two years ago...
I'd like to redirect follow-ups regarding supplements to Psycho-Babble Alternative. Here's a link:
http://www.dr-bob.org/babble/alter/20031023/msgs/275243.html
Thanks,
Bob
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