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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by harry1 on March 6, 2005, at 9:46:28
I've been a reader of this forum for many years, and this is my first post.
I've been suffering with cyclical depression for 9 years. For the past four years I have been treated medicinally. It has certainly helped the quality of my life, but it hasn't prevented relapses. My p-doc thinks I have some sort of bipolar variant.
Anyway, I am currently on prozac 20mg, wellbutrin 300mg, pamelor 50mg, and lamictal 150mg. I've tried many meds and different combos. But this is the first time I am on 4 meds. I am having a psychological problem with that. Is it justified, should I stick it out? I was thinking that 3 antidepressants is too much.
If I was going to drop one it would be the wellbutrin since the other combo has worked for me in the past, but hasn't prevented a relapse.
Posted by banga on March 6, 2005, at 10:07:03
In reply to how many antidepressants can one take?, posted by harry1 on March 6, 2005, at 9:46:28
I was personally a one-med person earlier; then I decided for myself that taking a lot of one med may be too much of one thing--pushes one type of imbalance into another type with time. I now feel that a little bit of several meds may be more "balanced." And in fact may be less intrusive with side effects and stressing the body. Now when I travel I am a bit self-conscious that I have all these bottles with me, but then I remind myself it is just a small dose of each.
Wellbutrin in particular I think of more as an energy booster than an antidepressant. I would probably be taking it if it weren't for its reputation for increasing anxiety.
Posted by harry1 on March 6, 2005, at 12:20:04
In reply to how many antidepressants can one take?, posted by harry1 on March 6, 2005, at 9:46:28
Banga,
Thanks for the input.
Why don't you consider wellbutrin to be an antidepressant?
Posted by HappyGirl on March 6, 2005, at 12:31:28
In reply to how many antidepressants can one take?, posted by harry1 on March 6, 2005, at 9:46:28
Hi:
The '300 mg.' Wellbutrin sr is an 'average dosage' and along with other meds., ... in my guess, your pdoc. primarly rx'ed WB for your motivation, energy and concentration due to 'stimulant' efficacy. Also, if you have some 'Bipolar' trait, then Wellbutrin sr is quite safe to use. Unlike other A.D. with stimulant effect, the WB does NOT induce 'mania'/hypomania. However, if you truly would like to take off of the WB, in my suggestion, ... first, try to reduce its dosage, like 200 mg. for the first week, then gradually tapering off over the period of weeks. Because, an abrupt discontinuation of any psycho. meds. could contribute 'bad' withdrawal symptoms.In regard to, 'too many A.D.s,.... in my opinion through the experience, if you could assess any beneficial results from taking 'four' meds., then you might not need to concern over the # of the med. Because, most of folks here on this board along with my own 'personal' experience, four different meds. are NOT uncommon. Most of cases, actually get a good result from taking more than three meds.
Furthermore, ... nowadays, most of pdocs. rx atypical meds., such as Seroqeul, Zyprexa, Geodon, Ability and other APs for 'speedy' fix and stabilization, as knowking the A.P.s has a good augumentative property due to its 'potency,' rather putting 'med. after med.' strategy. The A.P.s are widely rx'ed not only Shizo. and Bipolar also any other 'serious' form of mental illness, one of which is 'major depression.'
In my case with Bp II, I've been fairly stabilized my 'hard-to-treat' condition thanks to 'Zyprexa' along with other 'three' more conventional meds., Lithium, WB and Trazodone.
H.G.
Posted by harry1 on March 6, 2005, at 14:03:05
In reply to Re: how many antidepressants can one take?, posted by HappyGirl on March 6, 2005, at 12:31:28
H.G.,
Thanks. My problem with it is not so much in that it is 4 meds as much as it is 3 antidepressants. However, if they were all bundled into one pill, then I would not have a problem with it...I know for myself it is so important to think confidently about the treatment plan, and in this case it just keeps bothering me.harry1
Posted by HappyGirl on March 6, 2005, at 16:55:26
In reply to Re: how many antidepressants can one take?, posted by harry1 on March 6, 2005, at 14:03:05
Hi:
Your concern over 3 different meds. are quite understandable, *if* your depression is milder to moderate form. However, if your dep. is severe form, then your pdoc. might be right about rx'ed '3' A.D.s. Actually, Lamictal is not only mood-stabilizer but also 'A.D.' property, not like a 'pure' A.D., but is good for a depressive side of Bipolar. A lot of Bper's have a good successful rate on Lamictal due to 'good' A.D. property for Bp depression.In my guess, ... probably your pdoc. have NOT yet dx'ed your problem correctly in terms of Bipolar. Or, the pdoc. thinks more likely major depression which is hard to get under control. Like Bipolar, ... Major depression is one of those 'rough' roads for pdocs. to find a right med. combo. However, if you are NOT convisible for the pdoc.'s practice, then you might need to look for a new pdoc. to analyze your '3' different A.D.s regimen.
One thing I wonder about is whether you get a 'good' relief from taking those 'four' different meds. If you have enough relief to lead everyday's life, ... probably not to bother on a reduction of the WB. Because, it's truly 'hard' to find a right med. combo. which helps you get 'old-self' back. It's quite a time-consuming along with a lot of frustration, say the least from the experience. However, if you're still puzzling over this, then ask your pdoc. about your concern straight-forwardly or else, ... maybe it's time for you to search a new pdoc. who is good at M.I. tx plan.
H.G.
Posted by Phillipa on March 6, 2005, at 17:13:25
In reply to Re: how many antidepressants can? » harry1, posted by HappyGirl on March 6, 2005, at 16:55:26
I'm on two, one zoloft in the am and one at bedtime to help with sleep l5mg of remeron. I'm supposed to be taking more of the zoloft than I am but I'm taking my time. Fondly,Phillipa
Posted by banga on March 7, 2005, at 0:08:02
In reply to how many antidepressants can one take?, posted by harry1 on March 6, 2005, at 9:46:28
Also take note that the three antidepressants have different modes of action. Prozac works more on serotonin levels, while Pamelor is a potent norepinephrine reuptake inhibitor; and Wellbutrin has a mode of action that is difficult to pinpoint. I also take two antidepressants--one acting on nortryptiline and one on serotonin; and I also take a small dose of Lamictal. Wellbutrin of course is an antidepressant officially, but it is actually used more to give energy not antidepressive effects.
If you feel the need to reduce, some people have benefit from just 150mg Wellbutrin. YOu could then say you are at the minimum of therapeutic dosage.
I too would feel best if I could say to myself I just need one little pill and all is OK. But one little pill couldn't help me.
Posted by harry1 on March 7, 2005, at 15:41:52
In reply to Re: how many antidepressants can one take?, posted by banga on March 7, 2005, at 0:08:02
Banga,
Thanks for the input. I've decided to drop the wellbutrin altogether, and see how it goes.
If I'm too tired I'll probably try some adderall, which in the past has helped, but has caused sleep problems.h1
This is the end of the thread.
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