![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by mike21 on March 2, 2002, at 15:46:40
I have finished the first week of a trial of 2x150mg of wellbutrin sr. While it might still be early to make a final judgement, I am close to discontinuing due to anxiety. I have read other posts of people who experienced similar symptoms of anxiety or discomfort and aborted after a couple days. Has anyone pushed through the initial period of anxiety to end up with less anxiety than before you started (presumably due to down-regulation of alpha-2 receptors)?
After a couple of days on the medication, I felt slightly agitated and energized. My sleep began to suffer, which wasn't great to begin with. By the end of the work week, I was having a hard time concentrating, some hand tremor, obsessive thoughts, tightness in the throat, and my anxiety is at a higher level than it's been at in awhile (previously I would have associated it with alcohol withdrawal).
Unless I hear something to suggest a different course, I will be reducing to 1x150mg/day and then probably stopping altogether. I have had success with valium but I have not taken it on a daily basis for a few years, and I want to use that as a last resort. I have a hard time using bzds on an as-needed basis due to the withdrawal. Perhaps I would be better off with an alpha-2 agonist? Any thoughts?
Mike
Posted by allisonm on March 2, 2002, at 16:39:02
In reply to Wellbutrin after one week, posted by mike21 on March 2, 2002, at 15:46:40
It took me at least a couple of weeks to adjust to each increase in WB sr dose. For me, the ttremor, anxiety, etc. wore off. If you are drinking caffeinated beverages while taking WB, I would suggest switching to decaf. Caffeine will only exacerbate the symptom. I have had more luck with WB than I have with the eight or nine others that I have tried so far. I have been on it for more than 2 years.
Posted by JohnX2 on March 2, 2002, at 19:27:41
In reply to Wellbutrin after one week, posted by mike21 on March 2, 2002, at 15:46:40
You can take a beta blocker like Inderal if you
are in a bind.Another pbabble poster was having similar problems
and took Inderal on/off. Eventually the problem
wore off and his anxiety eased.-John
> I have finished the first week of a trial of 2x150mg of wellbutrin sr. While it might still be early to make a final judgement, I am close to discontinuing due to anxiety. I have read other posts of people who experienced similar symptoms of anxiety or discomfort and aborted after a couple days. Has anyone pushed through the initial period of anxiety to end up with less anxiety than before you started (presumably due to down-regulation of alpha-2 receptors)?
>
> After a couple of days on the medication, I felt slightly agitated and energized. My sleep began to suffer, which wasn't great to begin with. By the end of the work week, I was having a hard time concentrating, some hand tremor, obsessive thoughts, tightness in the throat, and my anxiety is at a higher level than it's been at in awhile (previously I would have associated it with alcohol withdrawal).
>
> Unless I hear something to suggest a different course, I will be reducing to 1x150mg/day and then probably stopping altogether. I have had success with valium but I have not taken it on a daily basis for a few years, and I want to use that as a last resort. I have a hard time using bzds on an as-needed basis due to the withdrawal. Perhaps I would be better off with an alpha-2 agonist? Any thoughts?
>
> Mike
Posted by mike21 on March 2, 2002, at 19:52:36
In reply to Re: Wellbutrin after one week, posted by allisonm on March 2, 2002, at 16:39:02
> It took me at least a couple of weeks to adjust to each increase in WB sr dose. For me, the ttremor, anxiety, etc. wore off. If you are drinking caffeinated beverages while taking WB, I would suggest switching to decaf. Caffeine will only exacerbate the symptom. I have had more luck with WB than I have with the eight or nine others that I have tried so far. I have been on it for more than 2 years.
I have eliminated caffeine from my diet. Did you have any anxiety before you started? I feel like the wb is activating exactly that which I am trying to avoid. I have also tried some ssris with little success. I guess I might have pushed it too fast. Thanks for your response.
Posted by JohnX2 on March 2, 2002, at 20:01:54
In reply to Re: Wellbutrin after one week » allisonm, posted by mike21 on March 2, 2002, at 19:52:36
A 5mg dose of Zyprexa will fix the thing that makes
SSRIs cause start up anxiety. So it may probably help with
your Wellbutrin anxiety and sleep problems temporarily,
you may want to talk about it with your doctor. It works quickly.Good Luck,
John
> > It took me at least a couple of weeks to adjust to each increase in WB sr dose. For me, the ttremor, anxiety, etc. wore off. If you are drinking caffeinated beverages while taking WB, I would suggest switching to decaf. Caffeine will only exacerbate the symptom. I have had more luck with WB than I have with the eight or nine others that I have tried so far. I have been on it for more than 2 years.
>
> I have eliminated caffeine from my diet. Did you have any anxiety before you started? I feel like the wb is activating exactly that which I am trying to avoid. I have also tried some ssris with little success. I guess I might have pushed it too fast. Thanks for your response.
Posted by mike21 on March 2, 2002, at 20:05:25
In reply to Re: Wellbutrin after one week » mike21, posted by JohnX2 on March 2, 2002, at 19:27:41
>
> You can take a beta blocker like Inderal if you
> are in a bind.
>
> Another pbabble poster was having similar problems
> and took Inderal on/off. Eventually the problem
> wore off and his anxiety eased.
>
> -John
>
>
I was thinking beta blockers were used more for panic attacks. I don't know if this qualifies, although it could develop into that if it gets worse. I guess it's an option to keep in mind.Mike
Posted by mike21 on March 2, 2002, at 20:12:41
In reply to Re: Wellbutrin after one week » mike21, posted by JohnX2 on March 2, 2002, at 20:01:54
>
> A 5mg dose of Zyprexa will fix the thing that makes
> SSRIs cause start up anxiety. So it may probably help with
> your Wellbutrin anxiety and sleep problems temporarily,
> you may want to talk about it with your doctor. It works quickly.
>
> Good Luck,
> John
>
>
Unfortunately I won't be seeing my doctor for another couple of weeks. I don't think he prescribes without an office visit. I might call him anyway.Mike
Posted by JohnX2 on March 2, 2002, at 20:26:16
In reply to Re: Wellbutrin after one week » JohnX2, posted by mike21 on March 2, 2002, at 20:05:25
Mike,Based on neuropysiology, if you are having
hand tremors, then a beta-blocker is THE
anti-dote. Period. End of story. Call your doctor and ask
about it. It will help your sleep if you
take it at night before sleep.Good Luck,
John> >
> > You can take a beta blocker like Inderal if you
> > are in a bind.
> >
> > Another pbabble poster was having similar problems
> > and took Inderal on/off. Eventually the problem
> > wore off and his anxiety eased.
> >
> > -John
> >
> >
> I was thinking beta blockers were used more for panic attacks. I don't know if this qualifies, although it could develop into that if it gets worse. I guess it's an option to keep in mind.
>
> Mike
Posted by JohnX2 on March 2, 2002, at 22:42:15
In reply to Re: Wellbutrin after one week » mike21, posted by JohnX2 on March 2, 2002, at 20:26:16
Hi Mike,Sorry I was being so short with you. I got
shut out from the pharmacy to pick up my mood
stabilizer and I'm really skimping. Feeling a bit
hot tempered today, maybe I should take a beta-
blocker! ;)Anyways, here's one thing I don't understand about
Wellbutrin, it's the only medicine I was put on that
the doctor pushed to the therapeutic dose more or
less immediately. 4 days at 150 mg and then 300 mg.
Every other medicine I got to taper up very slowly.
Doesn't this seem odd? No wonder a lot of people complain
of start up anxiety! Mind you I just happened to get lucky
and have no real side effects except for after the medicine
kicked in I thought I was superman and felt that there were
conspiracies going on by my work and family (this was before
I was dx'd as bipolar) ;).Anyways, I think a lot of people find relief at doses
lower than 300 mg and for you starting this high might just
be too strong. Also there is a 100 mg SR tab that you can
start with that should be a good option to ween you onto
the medicine.As far as the beta blockers go (Inderal being the gold
standard), they do slow down a hyperactive locus coerulus
like you and I were discussing in another thread. So do
alpha-2 agonists. Its just that the medical community are
much more standardized at prescribing the beta blockers.
I personally took Inderal a few times. One time I was on this
crazy combo of medicines including Remeron and my heart was
racing at like 120 beats per second and I felt really anxious
and I took Inderal and I felt fine minutes later. Slept like
a baby.Hope this info helps.
Best wishes,
John>
> Mike,
>
> Based on neuropysiology, if you are having
> hand tremors, then a beta-blocker is THE
> anti-dote. Period. End of story. Call your doctor and ask
> about it. It will help your sleep if you
> take it at night before sleep.
>
> Good Luck,
> John
>
>
>
>
>
>
>
> > >
> > > You can take a beta blocker like Inderal if you
> > > are in a bind.
> > >
> > > Another pbabble poster was having similar problems
> > > and took Inderal on/off. Eventually the problem
> > > wore off and his anxiety eased.
> > >
> > > -John
> > >
> > >
> > I was thinking beta blockers were used more for panic attacks. I don't know if this qualifies, although it could develop into that if it gets worse. I guess it's an option to keep in mind.
> >
> > Mike
Posted by JohnDoenut on March 2, 2002, at 23:07:23
In reply to Wellbutrin after one week, posted by mike21 on March 2, 2002, at 15:46:40
> I have finished the first week of a trial of 2x150mg of wellbutrin sr. While it might still be early to make a final judgement, I am close to
>I would like to respond to this and other replies to this. It does seem that people who start out right away at such high doses have problems and that's too bad. I was told to either take the 100mg SR tab once a day to start or break it in half and take half in the morning and the other half in the afternoon. However this was too much for me so I started with a 1/4 tab once a day for about 10 days then moved up to a half for about 5 days and then up from there to 1 tablet. I didnt need more. I also pretty much reduced it to half a tab a day cause thats all I really needed. Doing it that was that I did reduced the side effects which I had and didnt go away for 2 to 3 weeks. Buy a pill cutter if you dont have one!
JohnD
Posted by mike21 on March 3, 2002, at 8:04:56
In reply to Re: Wellbutrin after one week, posted by JohnX2 on March 2, 2002, at 22:42:15
John,
I didn't think you were being too short. Nothing wrong with being to-the-point.
I read in a book that the therapeutic dose range is 225-450mg. Obviously not the case. I think there is a conventional wisdom that says you need to treat strongly your depression,anxiety,etc. and I think that can do more harm than good. My doctor didn't even recommend ramping up the dose. I started with one 150 and then immediately started with 2x150 the next day. To further complicate matters, as I mentioned in another thread, remeron was also prescribed. As an alpha-2 antagonist I expect it was further increasing the norepinephrine levels, but the sedative effect was masking it somewhat. I discontinued the remeron after 4 days.
Obviously a lower dose is needed here. I will request the 100mg tabs and the inderal as well.
Thanks for all your input,
Mike
>
> Hi Mike,
>
> Sorry I was being so short with you. I got
> shut out from the pharmacy to pick up my mood
> stabilizer and I'm really skimping. Feeling a bit
> hot tempered today, maybe I should take a beta-
> blocker! ;)
>
> Anyways, here's one thing I don't understand about
> Wellbutrin, it's the only medicine I was put on that
> the doctor pushed to the therapeutic dose more or
> less immediately. 4 days at 150 mg and then 300 mg.
> Every other medicine I got to taper up very slowly.
> Doesn't this seem odd? No wonder a lot of people complain
> of start up anxiety! Mind you I just happened to get lucky
> and have no real side effects except for after the medicine
> kicked in I thought I was superman and felt that there were
> conspiracies going on by my work and family (this was before
> I was dx'd as bipolar) ;).
>
> Anyways, I think a lot of people find relief at doses
> lower than 300 mg and for you starting this high might just
> be too strong. Also there is a 100 mg SR tab that you can
> start with that should be a good option to ween you onto
> the medicine.
>
> As far as the beta blockers go (Inderal being the gold
> standard), they do slow down a hyperactive locus coerulus
> like you and I were discussing in another thread. So do
> alpha-2 agonists. Its just that the medical community are
> much more standardized at prescribing the beta blockers.
> I personally took Inderal a few times. One time I was on this
> crazy combo of medicines including Remeron and my heart was
> racing at like 120 beats per second and I felt really anxious
> and I took Inderal and I felt fine minutes later. Slept like
> a baby.
>
> Hope this info helps.
>
> Best wishes,
> John
>
>
>
> >
> > Mike,
> >
> > Based on neuropysiology, if you are having
> > hand tremors, then a beta-blocker is THE
> > anti-dote. Period. End of story. Call your doctor and ask
> > about it. It will help your sleep if you
> > take it at night before sleep.
> >
> > Good Luck,
> > John
> >
> >
> >
> >
> >
> >
> >
> > > >
> > > > You can take a beta blocker like Inderal if you
> > > > are in a bind.
> > > >
> > > > Another pbabble poster was having similar problems
> > > > and took Inderal on/off. Eventually the problem
> > > > wore off and his anxiety eased.
> > > >
> > > > -John
> > > >
> > > >
> > > I was thinking beta blockers were used more for panic attacks. I don't know if this qualifies, although it could develop into that if it gets worse. I guess it's an option to keep in mind.
> > >
> > > Mike
Posted by mike21 on March 3, 2002, at 8:14:50
In reply to Re: Wellbutrin after one week, posted by JohnDoenut on March 2, 2002, at 23:07:23
John,
That's good advice. I think people spend years reaching one state of mind, strongly alter that state with a medication and expect to have great results immediately. It is tough to be patient when battling any kind of disorder and I guess I was a little too aggressive. I am suprised that you got results from 1mg a day and then 1/2mg. How would you say that wb changed your daily life?
Mike
> > I have finished the first week of a trial of 2x150mg of wellbutrin sr. While it might still be early to make a final judgement, I am close to
> >
>
> I would like to respond to this and other replies to this. It does seem that people who start out right away at such high doses have problems and that's too bad. I was told to either take the 100mg SR tab once a day to start or break it in half and take half in the morning and the other half in the afternoon. However this was too much for me so I started with a 1/4 tab once a day for about 10 days then moved up to a half for about 5 days and then up from there to 1 tablet. I didnt need more. I also pretty much reduced it to half a tab a day cause thats all I really needed. Doing it that was that I did reduced the side effects which I had and didnt go away for 2 to 3 weeks. Buy a pill cutter if you dont have one!
>
> JohnD
Posted by JohnX2 on March 3, 2002, at 18:31:05
In reply to Re: Wellbutrin after one week » JohnX2, posted by mike21 on March 3, 2002, at 8:04:56
Mike,Wellbutrin is a very interesting medicine.
I have been very fascinated by it and Ohh so much
would like to have it be a part of my dosing regimine.
I found that at 150 mg, it more or less relieved my
Major Depression symptoms and really "got me off my Ass".
My depression symptoms are primarily lack of drive, interest,
etc. Unfortunately I was not diagnosed as bipolar at the
time and so the medicine did not do what I wanted it to
do at the higher doses when it REALLY kicked in. Felt
a lot like amphetamines.Anyways, Wellbutrin (buproprion hcl) is actually what is
called a "pro-drug". The parent compound bupropion hcl has
a very short "1/2 life" - the time for 1/2 of the medicine
to clear from the body and doesn't do much. However there
are a few very psycho-active metabolites that get created
by bupropion hcl on its 1st pass through
the liver. The most actives are Hydroxybupropion,
Threohydroxybupropion,and Erythrohydroxybupropion.
These metabolites have longer 1/2 lifes (upto like
20 hours for hydroxybupropion) and accumulate to
high degrees in the body. The degree to which they
accumulate can have a profound impact on the
thereapeutic window, i.e. the dosing window that
works for YOUR BODY. This can be affected by how
YOUR liver and body works.Anyways, I found a really good article discussing
Wellbutrin and some myths regarding its dopamine
mode of action and also how the metabolites build
up in the body. So I really feel you should tinker
with smaller doses.Here is the website if you are interested
(written by a researcher on Wellbutrin):
http://www.preskorn.com/columns/0001.htmlSorry to present such technical detail.
Just for your own education if you are interested.Best Wishes,
John> John,
>
> I didn't think you were being too short. Nothing wrong with being to-the-point.
>
> I read in a book that the therapeutic dose range is 225-450mg. Obviously not the case. I think there is a conventional wisdom that says you need to treat strongly your depression,anxiety,etc. and I think that can do more harm than good. My doctor didn't even recommend ramping up the dose. I started with one 150 and then immediately started with 2x150 the next day. To further complicate matters, as I mentioned in another thread, remeron was also prescribed. As an alpha-2 antagonist I expect it was further increasing the norepinephrine levels, but the sedative effect was masking it somewhat. I discontinued the remeron after 4 days.
>
> Obviously a lower dose is needed here. I will request the 100mg tabs and the inderal as well.
>
> Thanks for all your input,
>
> Mike
>
> >
> > Hi Mike,
> >
> > Sorry I was being so short with you. I got
> > shut out from the pharmacy to pick up my mood
> > stabilizer and I'm really skimping. Feeling a bit
> > hot tempered today, maybe I should take a beta-
> > blocker! ;)
> >
> > Anyways, here's one thing I don't understand about
> > Wellbutrin, it's the only medicine I was put on that
> > the doctor pushed to the therapeutic dose more or
> > less immediately. 4 days at 150 mg and then 300 mg.
> > Every other medicine I got to taper up very slowly.
> > Doesn't this seem odd? No wonder a lot of people complain
> > of start up anxiety! Mind you I just happened to get lucky
> > and have no real side effects except for after the medicine
> > kicked in I thought I was superman and felt that there were
> > conspiracies going on by my work and family (this was before
> > I was dx'd as bipolar) ;).
> >
> > Anyways, I think a lot of people find relief at doses
> > lower than 300 mg and for you starting this high might just
> > be too strong. Also there is a 100 mg SR tab that you can
> > start with that should be a good option to ween you onto
> > the medicine.
> >
> > As far as the beta blockers go (Inderal being the gold
> > standard), they do slow down a hyperactive locus coerulus
> > like you and I were discussing in another thread. So do
> > alpha-2 agonists. Its just that the medical community are
> > much more standardized at prescribing the beta blockers.
> > I personally took Inderal a few times. One time I was on this
> > crazy combo of medicines including Remeron and my heart was
> > racing at like 120 beats per second and I felt really anxious
> > and I took Inderal and I felt fine minutes later. Slept like
> > a baby.
> >
> > Hope this info helps.
> >
> > Best wishes,
> > John
> >
> >
> >
> > >
> > > Mike,
> > >
> > > Based on neuropysiology, if you are having
> > > hand tremors, then a beta-blocker is THE
> > > anti-dote. Period. End of story. Call your doctor and ask
> > > about it. It will help your sleep if you
> > > take it at night before sleep.
> > >
> > > Good Luck,
> > > John
> > >
> > >
> > >
> > >
> > >
> > >
> > >
> > > > >
> > > > > You can take a beta blocker like Inderal if you
> > > > > are in a bind.
> > > > >
> > > > > Another pbabble poster was having similar problems
> > > > > and took Inderal on/off. Eventually the problem
> > > > > wore off and his anxiety eased.
> > > > >
> > > > > -John
> > > > >
> > > > >
> > > > I was thinking beta blockers were used more for panic attacks. I don't know if this qualifies, although it could develop into that if it gets worse. I guess it's an option to keep in mind.
> > > >
> > > > Mike
Posted by mike21 on March 4, 2002, at 19:27:55
In reply to Re: Wellbutrin after one week, posted by JohnX2 on March 3, 2002, at 18:31:05
That's great- I was going to ask you for any good sites dealing with wellbutrin. If you know of any more, feel free to send them my way, the more technical the better. I've looked at some abstracts for studies done at www.biopsychiatry.com. Some of them have left me with more questions. I might be making a trip to the library to search through psychiatry journals.
You are right about the lower dose. The fact that I am a little sensitive to it makes me think it could have a lot of potential for me, especially in the area of down regulation. But I am still getting a handle on all that is involved there. I am going to go with the 100s/max to get a baseline measurement.
Do you know if it has a better record for sustaining its action long-term than other ADs do?
Thanks again,
Mike
>
> Mike,
>
> Wellbutrin is a very interesting medicine.
> I have been very fascinated by it and Ohh so much
> would like to have it be a part of my dosing regimine.
> I found that at 150 mg, it more or less relieved my
> Major Depression symptoms and really "got me off my Ass".
> My depression symptoms are primarily lack of drive, interest,
> etc. Unfortunately I was not diagnosed as bipolar at the
> time and so the medicine did not do what I wanted it to
> do at the higher doses when it REALLY kicked in. Felt
> a lot like amphetamines.
>
> Anyways, Wellbutrin (buproprion hcl) is actually what is
> called a "pro-drug". The parent compound bupropion hcl has
> a very short "1/2 life" - the time for 1/2 of the medicine
> to clear from the body and doesn't do much. However there
> are a few very psycho-active metabolites that get created
> by bupropion hcl on its 1st pass through
> the liver. The most actives are Hydroxybupropion,
> Threohydroxybupropion,and Erythrohydroxybupropion.
> These metabolites have longer 1/2 lifes (upto like
> 20 hours for hydroxybupropion) and accumulate to
> high degrees in the body. The degree to which they
> accumulate can have a profound impact on the
> thereapeutic window, i.e. the dosing window that
> works for YOUR BODY. This can be affected by how
> YOUR liver and body works.
>
> Anyways, I found a really good article discussing
> Wellbutrin and some myths regarding its dopamine
> mode of action and also how the metabolites build
> up in the body. So I really feel you should tinker
> with smaller doses.
>
> Here is the website if you are interested
> (written by a researcher on Wellbutrin):
> http://www.preskorn.com/columns/0001.html
>
> Sorry to present such technical detail.
> Just for your own education if you are interested.
>
> Best Wishes,
> John
>
>
>
>
>
> > John,
> >
> > I didn't think you were being too short. Nothing wrong with being to-the-point.
> >
> > I read in a book that the therapeutic dose range is 225-450mg. Obviously not the case. I think there is a conventional wisdom that says you need to treat strongly your depression,anxiety,etc. and I think that can do more harm than good. My doctor didn't even recommend ramping up the dose. I started with one 150 and then immediately started with 2x150 the next day. To further complicate matters, as I mentioned in another thread, remeron was also prescribed. As an alpha-2 antagonist I expect it was further increasing the norepinephrine levels, but the sedative effect was masking it somewhat. I discontinued the remeron after 4 days.
> >
> > Obviously a lower dose is needed here. I will request the 100mg tabs and the inderal as well.
> >
> > Thanks for all your input,
> >
> > Mike
> >
> > >
> > > Hi Mike,
> > >
> > > Sorry I was being so short with you. I got
> > > shut out from the pharmacy to pick up my mood
> > > stabilizer and I'm really skimping. Feeling a bit
> > > hot tempered today, maybe I should take a beta-
> > > blocker! ;)
> > >
> > > Anyways, here's one thing I don't understand about
> > > Wellbutrin, it's the only medicine I was put on that
> > > the doctor pushed to the therapeutic dose more or
> > > less immediately. 4 days at 150 mg and then 300 mg.
> > > Every other medicine I got to taper up very slowly.
> > > Doesn't this seem odd? No wonder a lot of people complain
> > > of start up anxiety! Mind you I just happened to get lucky
> > > and have no real side effects except for after the medicine
> > > kicked in I thought I was superman and felt that there were
> > > conspiracies going on by my work and family (this was before
> > > I was dx'd as bipolar) ;).
> > >
> > > Anyways, I think a lot of people find relief at doses
> > > lower than 300 mg and for you starting this high might just
> > > be too strong. Also there is a 100 mg SR tab that you can
> > > start with that should be a good option to ween you onto
> > > the medicine.
> > >
> > > As far as the beta blockers go (Inderal being the gold
> > > standard), they do slow down a hyperactive locus coerulus
> > > like you and I were discussing in another thread. So do
> > > alpha-2 agonists. Its just that the medical community are
> > > much more standardized at prescribing the beta blockers.
> > > I personally took Inderal a few times. One time I was on this
> > > crazy combo of medicines including Remeron and my heart was
> > > racing at like 120 beats per second and I felt really anxious
> > > and I took Inderal and I felt fine minutes later. Slept like
> > > a baby.
> > >
> > > Hope this info helps.
> > >
> > > Best wishes,
> > > John
> > >
> > >
> > >
> > > >
> > > > Mike,
> > > >
> > > > Based on neuropysiology, if you are having
> > > > hand tremors, then a beta-blocker is THE
> > > > anti-dote. Period. End of story. Call your doctor and ask
> > > > about it. It will help your sleep if you
> > > > take it at night before sleep.
> > > >
> > > > Good Luck,
> > > > John
> > > >
> > > >
> > > >
> > > >
> > > >
> > > >
> > > >
> > > > > >
> > > > > > You can take a beta blocker like Inderal if you
> > > > > > are in a bind.
> > > > > >
> > > > > > Another pbabble poster was having similar problems
> > > > > > and took Inderal on/off. Eventually the problem
> > > > > > wore off and his anxiety eased.
> > > > > >
> > > > > > -John
> > > > > >
> > > > > >
> > > > > I was thinking beta blockers were used more for panic attacks. I don't know if this qualifies, although it could develop into that if it gets worse. I guess it's an option to keep in mind.
> > > > >
> > > > > Mike
Posted by JohnX2 on March 4, 2002, at 23:51:10
In reply to Re: Wellbutrin after one week » JohnX2, posted by mike21 on March 4, 2002, at 19:27:55
Hi Mike,I think I might wake up with screaming nightmares
of Wellbutrin Sr and Deprynl pills chasing after me if
you have been following any of these other threads.As for me, I'm just glad that I've been hitting home runs
on my last 3 or 4 medicine picks. I'm finally get rid of these
crummy facial neuralgia headaches and my mood is really picking
up on Serzone.I hope your conversation with your pdoc went well?
Did you get a chance to talk to him? As far as studying Wellbutrin
goes, I would just trust that the medicine works for
people. Not everyone, as always. Reading much more beyond the
material presented (and you've learned A LOT about the medicine)
may just add to any anxiety about getting a response. Lately I've been so
desperate to get a response from medicines that I don't even think about
side effects and this strategy seems to be doing well. I wouldn't want
to discourage you from doing your own research. Someone on the other
Wellbutrin thread below posted a number of links to abstracts if you are interested.
I don't know if they clarify any mystery about WB. I guess the real test
is just seeing how YOU do on the medicine.As far as sustainability goes, I don't have a good answer.
Everyone has their "this medicine did wonders for me, and then
left me for broke story". I haven't really seen where wellbutrin
falls in this plot.Good luck, you deserve a break with your medicines.
Let us know how it goes. Please take it easy.Best Wishes
John> That's great- I was going to ask you for any good sites dealing with wellbutrin. If you know of any more, feel free to send them my way, the more technical the better. I've looked at some abstracts for studies done at www.biopsychiatry.com. Some of them have left me with more questions. I might be making a trip to the library to search through psychiatry journals.
>
> You are right about the lower dose. The fact that I am a little sensitive to it makes me think it could have a lot of potential for me, especially in the area of down regulation. But I am still getting a handle on all that is involved there. I am going to go with the 100s/max to get a baseline measurement.
>
> Do you know if it has a better record for sustaining its action long-term than other ADs do?
>
> Thanks again,
>
> Mike
>
>
> >
> > Mike,
> >
> > Wellbutrin is a very interesting medicine.
> > I have been very fascinated by it and Ohh so much
> > would like to have it be a part of my dosing regimine.
> > I found that at 150 mg, it more or less relieved my
> > Major Depression symptoms and really "got me off my Ass".
> > My depression symptoms are primarily lack of drive, interest,
> > etc. Unfortunately I was not diagnosed as bipolar at the
> > time and so the medicine did not do what I wanted it to
> > do at the higher doses when it REALLY kicked in. Felt
> > a lot like amphetamines.
> >
> > Anyways, Wellbutrin (buproprion hcl) is actually what is
> > called a "pro-drug". The parent compound bupropion hcl has
> > a very short "1/2 life" - the time for 1/2 of the medicine
> > to clear from the body and doesn't do much. However there
> > are a few very psycho-active metabolites that get created
> > by bupropion hcl on its 1st pass through
> > the liver. The most actives are Hydroxybupropion,
> > Threohydroxybupropion,and Erythrohydroxybupropion.
> > These metabolites have longer 1/2 lifes (upto like
> > 20 hours for hydroxybupropion) and accumulate to
> > high degrees in the body. The degree to which they
> > accumulate can have a profound impact on the
> > thereapeutic window, i.e. the dosing window that
> > works for YOUR BODY. This can be affected by how
> > YOUR liver and body works.
> >
> > Anyways, I found a really good article discussing
> > Wellbutrin and some myths regarding its dopamine
> > mode of action and also how the metabolites build
> > up in the body. So I really feel you should tinker
> > with smaller doses.
> >
> > Here is the website if you are interested
> > (written by a researcher on Wellbutrin):
> > http://www.preskorn.com/columns/0001.html
> >
> > Sorry to present such technical detail.
> > Just for your own education if you are interested.
> >
> > Best Wishes,
> > John
> >
> >
> >
> >
> >
> > > John,
> > >
> > > I didn't think you were being too short. Nothing wrong with being to-the-point.
> > >
> > > I read in a book that the therapeutic dose range is 225-450mg. Obviously not the case. I think there is a conventional wisdom that says you need to treat strongly your depression,anxiety,etc. and I think that can do more harm than good. My doctor didn't even recommend ramping up the dose. I started with one 150 and then immediately started with 2x150 the next day. To further complicate matters, as I mentioned in another thread, remeron was also prescribed. As an alpha-2 antagonist I expect it was further increasing the norepinephrine levels, but the sedative effect was masking it somewhat. I discontinued the remeron after 4 days.
> > >
> > > Obviously a lower dose is needed here. I will request the 100mg tabs and the inderal as well.
> > >
> > > Thanks for all your input,
> > >
> > > Mike
> > >
> > > >
> > > > Hi Mike,
> > > >
> > > > Sorry I was being so short with you. I got
> > > > shut out from the pharmacy to pick up my mood
> > > > stabilizer and I'm really skimping. Feeling a bit
> > > > hot tempered today, maybe I should take a beta-
> > > > blocker! ;)
> > > >
> > > > Anyways, here's one thing I don't understand about
> > > > Wellbutrin, it's the only medicine I was put on that
> > > > the doctor pushed to the therapeutic dose more or
> > > > less immediately. 4 days at 150 mg and then 300 mg.
> > > > Every other medicine I got to taper up very slowly.
> > > > Doesn't this seem odd? No wonder a lot of people complain
> > > > of start up anxiety! Mind you I just happened to get lucky
> > > > and have no real side effects except for after the medicine
> > > > kicked in I thought I was superman and felt that there were
> > > > conspiracies going on by my work and family (this was before
> > > > I was dx'd as bipolar) ;).
> > > >
> > > > Anyways, I think a lot of people find relief at doses
> > > > lower than 300 mg and for you starting this high might just
> > > > be too strong. Also there is a 100 mg SR tab that you can
> > > > start with that should be a good option to ween you onto
> > > > the medicine.
> > > >
> > > > As far as the beta blockers go (Inderal being the gold
> > > > standard), they do slow down a hyperactive locus coerulus
> > > > like you and I were discussing in another thread. So do
> > > > alpha-2 agonists. Its just that the medical community are
> > > > much more standardized at prescribing the beta blockers.
> > > > I personally took Inderal a few times. One time I was on this
> > > > crazy combo of medicines including Remeron and my heart was
> > > > racing at like 120 beats per second and I felt really anxious
> > > > and I took Inderal and I felt fine minutes later. Slept like
> > > > a baby.
> > > >
> > > > Hope this info helps.
> > > >
> > > > Best wishes,
> > > > John
> > > >
> > > >
> > > >
> > > > >
> > > > > Mike,
> > > > >
> > > > > Based on neuropysiology, if you are having
> > > > > hand tremors, then a beta-blocker is THE
> > > > > anti-dote. Period. End of story. Call your doctor and ask
> > > > > about it. It will help your sleep if you
> > > > > take it at night before sleep.
> > > > >
> > > > > Good Luck,
> > > > > John
> > > > >
> > > > >
> > > > >
> > > > >
> > > > >
> > > > >
> > > > >
> > > > > > >
> > > > > > > You can take a beta blocker like Inderal if you
> > > > > > > are in a bind.
> > > > > > >
> > > > > > > Another pbabble poster was having similar problems
> > > > > > > and took Inderal on/off. Eventually the problem
> > > > > > > wore off and his anxiety eased.
> > > > > > >
> > > > > > > -John
> > > > > > >
> > > > > > >
> > > > > > I was thinking beta blockers were used more for panic attacks. I don't know if this qualifies, although it could develop into that if it gets worse. I guess it's an option to keep in mind.
> > > > > >
> > > > > > Mike
Posted by mike21 on March 5, 2002, at 19:39:09
In reply to Re: Wellbutrin after one week » mike21, posted by JohnX2 on March 4, 2002, at 23:51:10
John,
Good to hear you are having success with serzone. My mood is becoming flat as the wb leaves my system. Today I had 1/2 of a 150. My sleep has not bounced back yet. I alternate between states of anxiety and depression. I don't think that makes me bi-polar as I don't seem to have manic phases. The wb seemed to induce the state of anxiety I usually work up to every week around wed. or thursday.
I have started augmenting with st. johns wort- hoping for some positive seratonergic action. I have never tried it, but supposedly it has fewer side effects.
My biggest fear is that I will do more harm than good to myself. That is driving me to find some solutions and be a little less patient waiting for something to work. If something is not working my instinct is telling me I'm better off without it. Not saying I will stop it altogether, but contemplating it.
Thanks again for your feedback. Talk to you later,
Mike
>
> Hi Mike,
>
> I think I might wake up with screaming nightmares
> of Wellbutrin Sr and Deprynl pills chasing after me if
> you have been following any of these other threads.
>
> As for me, I'm just glad that I've been hitting home runs
> on my last 3 or 4 medicine picks. I'm finally get rid of these
> crummy facial neuralgia headaches and my mood is really picking
> up on Serzone.
>
> I hope your conversation with your pdoc went well?
> Did you get a chance to talk to him? As far as studying Wellbutrin
> goes, I would just trust that the medicine works for
> people. Not everyone, as always. Reading much more beyond the
> material presented (and you've learned A LOT about the medicine)
> may just add to any anxiety about getting a response. Lately I've been so
> desperate to get a response from medicines that I don't even think about
> side effects and this strategy seems to be doing well. I wouldn't want
> to discourage you from doing your own research. Someone on the other
> Wellbutrin thread below posted a number of links to abstracts if you are interested.
> I don't know if they clarify any mystery about WB. I guess the real test
> is just seeing how YOU do on the medicine.
>
> As far as sustainability goes, I don't have a good answer.
> Everyone has their "this medicine did wonders for me, and then
> left me for broke story". I haven't really seen where wellbutrin
> falls in this plot.
>
> Good luck, you deserve a break with your medicines.
> Let us know how it goes. Please take it easy.
>
> Best Wishes
> John
>
>
>
> > That's great- I was going to ask you for any good sites dealing with wellbutrin. If you know of any more, feel free to send them my way, the more technical the better. I've looked at some abstracts for studies done at www.biopsychiatry.com. Some of them have left me with more questions. I might be making a trip to the library to search through psychiatry journals.
> >
> > You are right about the lower dose. The fact that I am a little sensitive to it makes me think it could have a lot of potential for me, especially in the area of down regulation. But I am still getting a handle on all that is involved there. I am going to go with the 100s/max to get a baseline measurement.
> >
> > Do you know if it has a better record for sustaining its action long-term than other ADs do?
> >
> > Thanks again,
> >
> > Mike
> >
> >
> > >
> > > Mike,
> > >
> > > Wellbutrin is a very interesting medicine.
> > > I have been very fascinated by it and Ohh so much
> > > would like to have it be a part of my dosing regimine.
> > > I found that at 150 mg, it more or less relieved my
> > > Major Depression symptoms and really "got me off my Ass".
> > > My depression symptoms are primarily lack of drive, interest,
> > > etc. Unfortunately I was not diagnosed as bipolar at the
> > > time and so the medicine did not do what I wanted it to
> > > do at the higher doses when it REALLY kicked in. Felt
> > > a lot like amphetamines.
> > >
> > > Anyways, Wellbutrin (buproprion hcl) is actually what is
> > > called a "pro-drug". The parent compound bupropion hcl has
> > > a very short "1/2 life" - the time for 1/2 of the medicine
> > > to clear from the body and doesn't do much. However there
> > > are a few very psycho-active metabolites that get created
> > > by bupropion hcl on its 1st pass through
> > > the liver. The most actives are Hydroxybupropion,
> > > Threohydroxybupropion,and Erythrohydroxybupropion.
> > > These metabolites have longer 1/2 lifes (upto like
> > > 20 hours for hydroxybupropion) and accumulate to
> > > high degrees in the body. The degree to which they
> > > accumulate can have a profound impact on the
> > > thereapeutic window, i.e. the dosing window that
> > > works for YOUR BODY. This can be affected by how
> > > YOUR liver and body works.
> > >
> > > Anyways, I found a really good article discussing
> > > Wellbutrin and some myths regarding its dopamine
> > > mode of action and also how the metabolites build
> > > up in the body. So I really feel you should tinker
> > > with smaller doses.
> > >
> > > Here is the website if you are interested
> > > (written by a researcher on Wellbutrin):
> > > http://www.preskorn.com/columns/0001.html
> > >
> > > Sorry to present such technical detail.
> > > Just for your own education if you are interested.
> > >
> > > Best Wishes,
> > > John
> > >
> > >
> > >
> > >
> > >
> > > > John,
> > > >
> > > > I didn't think you were being too short. Nothing wrong with being to-the-point.
> > > >
> > > > I read in a book that the therapeutic dose range is 225-450mg. Obviously not the case. I think there is a conventional wisdom that says you need to treat strongly your depression,anxiety,etc. and I think that can do more harm than good. My doctor didn't even recommend ramping up the dose. I started with one 150 and then immediately started with 2x150 the next day. To further complicate matters, as I mentioned in another thread, remeron was also prescribed. As an alpha-2 antagonist I expect it was further increasing the norepinephrine levels, but the sedative effect was masking it somewhat. I discontinued the remeron after 4 days.
> > > >
> > > > Obviously a lower dose is needed here. I will request the 100mg tabs and the inderal as well.
> > > >
> > > > Thanks for all your input,
> > > >
> > > > Mike
> > > >
> > > > >
> > > > > Hi Mike,
> > > > >
> > > > > Sorry I was being so short with you. I got
> > > > > shut out from the pharmacy to pick up my mood
> > > > > stabilizer and I'm really skimping. Feeling a bit
> > > > > hot tempered today, maybe I should take a beta-
> > > > > blocker! ;)
> > > > >
> > > > > Anyways, here's one thing I don't understand about
> > > > > Wellbutrin, it's the only medicine I was put on that
> > > > > the doctor pushed to the therapeutic dose more or
> > > > > less immediately. 4 days at 150 mg and then 300 mg.
> > > > > Every other medicine I got to taper up very slowly.
> > > > > Doesn't this seem odd? No wonder a lot of people complain
> > > > > of start up anxiety! Mind you I just happened to get lucky
> > > > > and have no real side effects except for after the medicine
> > > > > kicked in I thought I was superman and felt that there were
> > > > > conspiracies going on by my work and family (this was before
> > > > > I was dx'd as bipolar) ;).
> > > > >
> > > > > Anyways, I think a lot of people find relief at doses
> > > > > lower than 300 mg and for you starting this high might just
> > > > > be too strong. Also there is a 100 mg SR tab that you can
> > > > > start with that should be a good option to ween you onto
> > > > > the medicine.
> > > > >
> > > > > As far as the beta blockers go (Inderal being the gold
> > > > > standard), they do slow down a hyperactive locus coerulus
> > > > > like you and I were discussing in another thread. So do
> > > > > alpha-2 agonists. Its just that the medical community are
> > > > > much more standardized at prescribing the beta blockers.
> > > > > I personally took Inderal a few times. One time I was on this
> > > > > crazy combo of medicines including Remeron and my heart was
> > > > > racing at like 120 beats per second and I felt really anxious
> > > > > and I took Inderal and I felt fine minutes later. Slept like
> > > > > a baby.
> > > > >
> > > > > Hope this info helps.
> > > > >
> > > > > Best wishes,
> > > > > John
> > > > >
> > > > >
> > > > >
> > > > > >
> > > > > > Mike,
> > > > > >
> > > > > > Based on neuropysiology, if you are having
> > > > > > hand tremors, then a beta-blocker is THE
> > > > > > anti-dote. Period. End of story. Call your doctor and ask
> > > > > > about it. It will help your sleep if you
> > > > > > take it at night before sleep.
> > > > > >
> > > > > > Good Luck,
> > > > > > John
> > > > > >
> > > > > >
> > > > > >
> > > > > >
> > > > > >
> > > > > >
> > > > > >
> > > > > > > >
> > > > > > > > You can take a beta blocker like Inderal if you
> > > > > > > > are in a bind.
> > > > > > > >
> > > > > > > > Another pbabble poster was having similar problems
> > > > > > > > and took Inderal on/off. Eventually the problem
> > > > > > > > wore off and his anxiety eased.
> > > > > > > >
> > > > > > > > -John
> > > > > > > >
> > > > > > > >
> > > > > > > I was thinking beta blockers were used more for panic attacks. I don't know if this qualifies, although it could develop into that if it gets worse. I guess it's an option to keep in mind.
> > > > > > >
> > > > > > > Mike
Posted by allisonm on March 6, 2002, at 21:44:52
In reply to Re: Wellbutrin after one week » allisonm, posted by mike21 on March 2, 2002, at 19:52:36
Yes, I had anxiety before taking the WB.
This may be a moot point as I have not had time to read the earlier posts: Have you considered asking your doc to reduce the dosage and build up more slowly?
Posted by Anyuser on March 7, 2002, at 11:44:13
In reply to Re: Wellbutrin after one week » mike21, posted by allisonm on March 6, 2002, at 21:44:52
Do you miss your appetite? Do you consider lack of appetite to be a kind of apathy? I ask because I wonder if Wellbutrin eventually causes the "flattening" that I, and I think others, experience with an SSRI.
Posted by anyuser on March 7, 2002, at 15:47:56
In reply to Re: Wellbutrin after one week » allisonm, posted by Anyuser on March 7, 2002, at 11:44:13
I meant to post my questions in the thread above regarding weight loss on Wellbutrin.
This is the end of the thread.
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