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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by sac on March 25, 2005, at 14:24:10
Hi, I have multiple questions regarding Wellbutrin. This is my 5th trial with the medication as I really want it to work. I am currently on Prozac and Lithium for bipolar II. Trouble is, I still have lack of motivation, anhedonia, difficulty concentrating. I though Wellbutrin might help and tried it several years ago. I was so stimulated and aggressive on the immediate release (what scared me was that I kept wanting to keep taking it though). I finally switched to 100 mgs. of the SR version and was so anxious I couldn't stand it (I was even taking oxazepam and the anxiety was still overwhelming) I was also nasty on this one as well. As most of you probably know from your own experiences, I have jumped around from so many different meds trying to find the right combo. I'm back to trying the wb again for the fifth time and , again, I feel like I could kill someone. Should I throw in the towel with this one? How long does this side effect last? Please help. Thanks.
Posted by jessers11581 on March 25, 2005, at 14:40:09
In reply to Need help with Wellbutrin! Trouble with s/e's, posted by sac on March 25, 2005, at 14:24:10
I have also tried a couple of times to use Wellbutrin. I'd love to be able to take it because it noticibly reduces my cravings for cigarettes and decreases my appetite. HOWEVER, the first time I used it I was an emotional wreck (crying, aggressive, just felt insane). So I stopped. The second time I tried (1 1/2 years later),it made me develop an itchy rash all over my stomach and arms. So I think I may have developed an allergy from the first time or something. I don't know. I really wish I could use it because it sounds like a wonder pill as far as anti-depressants go. But I guess it's just not meant to be. If you already have trouble with anxiety (which I definitely do), then I don't think Wellbutrin is the way to go. It's mainly for depression, and can be way too stimulating for those of us who have trouble calming down as it is. I wish you the best of luck finding the right med!
> Hi, I have multiple questions regarding Wellbutrin. This is my 5th trial with the medication as I really want it to work. I am currently on Prozac and Lithium for bipolar II. Trouble is, I still have lack of motivation, anhedonia, difficulty concentrating. I though Wellbutrin might help and tried it several years ago. I was so stimulated and aggressive on the immediate release (what scared me was that I kept wanting to keep taking it though). I finally switched to 100 mgs. of the SR version and was so anxious I couldn't stand it (I was even taking oxazepam and the anxiety was still overwhelming) I was also nasty on this one as well. As most of you probably know from your own experiences, I have jumped around from so many different meds trying to find the right combo. I'm back to trying the wb again for the fifth time and , again, I feel like I could kill someone. Should I throw in the towel with this one? How long does this side effect last? Please help. Thanks.
Posted by Minnie-Haha on March 25, 2005, at 14:54:55
In reply to Need help with Wellbutrin! Trouble with s/e's, posted by sac on March 25, 2005, at 14:24:10
> Hi, I have multiple questions regarding Wellbutrin. This is my 5th trial with the medication as I really want it to work. I am currently on Prozac and Lithium for bipolar II. Trouble is, I still have lack of motivation, anhedonia, difficulty concentrating. I though Wellbutrin might help and tried it several years ago. I was so stimulated and aggressive on the immediate release (what scared me was that I kept wanting to keep taking it though). I finally switched to 100 mgs. of the SR version and was so anxious I couldn't stand it (I was even taking oxazepam and the anxiety was still overwhelming) I was also nasty on this one as well. As most of you probably know from your own experiences, I have jumped around from so many different meds trying to find the right combo. I'm back to trying the wb again for the fifth time and , again, I feel like I could kill someone. Should I throw in the towel with this one? How long does this side effect last? Please help. Thanks.
What time of day do you take the Wellbutrin? I am on the Wellbutrin XL, which I take along with Cymbalta and Trileptal. So far, so good. (My appetite, which was up on Cymbalta, seems to be normalizing.)
What is your Lithium dosage? Would it help to increase that?
Posted by Chris O on March 25, 2005, at 15:29:07
In reply to Need help with Wellbutrin! Trouble with s/e's, posted by sac on March 25, 2005, at 14:24:10
Sac:
Everyone reacts differently to these meds. No truer statement has ever been said. I have a strong case of GAD, obsessive worrying, and panic disorder. Back in 2000, I took a Prozac (20mg)/Wellbutrin (150mg) combo for a while, and it worked fairly well. It prevented my anxiety attacks while at the same time taking the "fatigue edge" off the Prozac. I can't say why it worked. I know if I took Wellbutrin alone, it would probably cause me to have anxiety attacks, but in that dosage combo at that time, it worked. I can't say why it's not working for you. I guess, like all of us, you just have to keep trying until you get that magic combo. I still haven't found mine yet either.
Good luck,
Chris
Posted by JKL on March 25, 2005, at 15:47:25
In reply to Need help with Wellbutrin! Trouble with s/e's, posted by sac on March 25, 2005, at 14:24:10
A couple things you might be able to do. First, cut your dose in half or even quarter, and just start lower and go slower. Your body might adjust that way. But after sampling it so many times without a hint of promising results, it might be better to forget it.
I also take prozac, along with zyprexa. They keep me undepressed and stable, but blaw and apathetic.
I know most people would friek out at the idea, but I added in 600mg st johns wort as a trial and am surprised with the good results. I was on the lookout for a number of adverse effects including serotonin syndrome, but the combination actually goes together very well. Not suggesting you do the same, but just wanted you know that I am familiar with the feelings you described and wanted to share what works for me.
Posted by HappyGirl on March 25, 2005, at 16:53:38
In reply to Need help with Wellbutrin! Trouble with s/e's, posted by sac on March 25, 2005, at 14:24:10
Hi:
In my guess, ... if you REALLY want the WB work good on your problems listed above, ... probably you may need 'anxiety' med. to counteract stimulating effect from taking the WB. Lithium and Prozac is nothing to do with the Anxiety, rather for Bipolar only. In my case, I've been on Zyprexa and Trazodone along with two more meds. Both meds. have sedating property which in turn helping alleviate the Anxiety caused by the WB.I, too agree with other posters regarding WB efficacy on concentration, motivation and other 'good' efficacy. Then, I truly understand your earnest desire on this med., despite of your past 'not-happy' results with the WB.
H.G.
Posted by Phillipa on March 25, 2005, at 19:02:57
In reply to Re: Need help with Wellbutrin! Trouble with s/e's » sac, posted by Chris O on March 25, 2005, at 15:29:07
Chris, It just shows how different we all are. I had severe anxiety when I tried Prozac.The first day I wallpapered the foyer, second day I was anxious despite xanax, the third was a constant panic attack. I stopped it and it took 3 days with increased xanax to feel "normal" again. I can't imagine what would have happened if I'd been taking wellbutrin as that alone put me in the hospital. We are unique! Fondly, Phillipa
Posted by Chris O on March 25, 2005, at 19:13:24
In reply to Re: Need help with Wellbutrin! Trouble with s/e's, posted by Phillipa on March 25, 2005, at 19:02:57
Phillipa:
That is weird. I saw your post above regarding this too. In truth, all the SSRIs make me both more and less anxious. It is...annoying, odd, to put it mildly. These drugs are so "inexact" in their effects; I wish science could discover the way to map out the neurons in the human brain more exactly, and to understand what is going on in each individual's brain, but that is probably many, many years away. Sorry about your bad experience with the Prozac. Yeah, Wellbutrin + Prozac for you, sounds like you would have been having one of these "lie on the floor screaming" panic attacks. I've had those before. Not pleasant. Just like I am disintegrating or completely losing it. Not fun. Well, what can you say except: Oh, the joys of an anxiety disorder!
Sincerely,
Chris> Chris, It just shows how different we all are. I had severe anxiety when I tried Prozac.The first day I wallpapered the foyer, second day I was anxious despite xanax, the third was a constant panic attack. I stopped it and it took 3 days with increased xanax to feel "normal" again. I can't imagine what would have happened if I'd been taking wellbutrin as that alone put me in the hospital. We are unique! Fondly, Phillipa
Posted by sac on March 26, 2005, at 6:23:40
In reply to Re: Need help with Wellbutrin! Trouble with s/e's, posted by JKL on March 25, 2005, at 15:47:25
Thanks for your reply. I might try the lower dose again and go extremely slow. I actually have 5htp capsules that I bought but was too scared to try. Do you if this is as safe as St. John's Wort?
> A couple things you might be able to do. First, cut your dose in half or even quarter, and just start lower and go slower. Your body might adjust that way. But after sampling it so many times without a hint of promising results, it might be better to forget it.
>
> I also take prozac, along with zyprexa. They keep me undepressed and stable, but blaw and apathetic.
>
> I know most people would friek out at the idea, but I added in 600mg st johns wort as a trial and am surprised with the good results. I was on the lookout for a number of adverse effects including serotonin syndrome, but the combination actually goes together very well. Not suggesting you do the same, but just wanted you know that I am familiar with the feelings you described and wanted to share what works for me.
Posted by sac on March 26, 2005, at 6:27:38
In reply to Re: Need help with Wellbutrin! Trouble with s/e's » Phillipa, posted by Chris O on March 25, 2005, at 19:13:24
Thanks for all the replies..it really helps.
Yes, I would like to give the WB a fair trial because it helps so much with motivation and concentration. I am taking a tranquilizer with it (Serax) and that is not enough to quell the anxiety/hostility. I guess if I knew that this hostility would go away in a week or so I would try to stick it out.
Posted by sheer on March 26, 2005, at 8:51:03
In reply to Re: Need help with Wellbutrin! Trouble with s/e's, posted by sac on March 26, 2005, at 6:27:38
WB must deserve the award for the most unpredictable of all the ads! my therapist, altho she, of course, can't prescribe, thinks the world of it. i, on the other hand, put it right up there, as very probably my #1 worst of all ads/ ad side-effects experience/s. i actually envy you because you have been able to endure it long enough to experience some of the cognitive goodies.
my only "drug of choice" was cocaine, used to self-medicate my major depression, (i can't understand how anyone is ever attracted to alcohol). so, knowing this, i was so sure WB would be "my" ad. a friend with similar history/ dx does great on it.
what i dont' hear often AT ALL (quite miraculous to me!) is mention of WB's gi side-effects. for me, just the worst: every time (of 3) i've convinced myself to give WB - IR or SR - another try, from the very 1st pill, i get extreme "urping" (eructation) that very literally never subsides. also, like you & so many others, i get the extreme anxiety, and hostility/ anger; my mood becomes so scary that WB is, to date, the only ad any pdoc has ever had me stop, as an emergency situation.
i even know several who don't have an "official" psych dx, (altho they are quite probably depressives just doing the "work cure") who have tried WB to quit smoking "only"; they have all gone into such states of extreme anxiety, to the point of paranoia/ thinking they are "losing their minds." a real shame.
i sure hope you finally make it, but, you may well have to accept, as mentioned, that WB is simply not...to be. i have...finally!
Posted by jrbecker on March 26, 2005, at 10:00:22
In reply to Re: Need help with Wellbutrin! Trouble with s/e's » sac, posted by HappyGirl on March 25, 2005, at 16:53:38
my pdoc has had a lot of experience with Wellbutrin and reports that unless a patient is willing to give it at least a 2-3 week trial, you really won't know if it will pass. In his estimation, about 2/3 of his patients who reported intial side effects of anxiety on the medication find that it is not a problem after this period passes. Personally, this echoes my own experience with the drug.
Additionally, for every subsequent dose increase, you will most likely have a similar adjustment period [but not as long as the need for aclimatizing to the initial titration]. He recommends starting low if you are senstive -- 37.5 - 75 mg twice daily. He also believes the SR and XL version are superior to the immediate release version...I personally prefer the XL version.
Posted by sac on March 26, 2005, at 16:33:07
In reply to Re: Wellbutrin demands at least 2-3 week trial, posted by jrbecker on March 26, 2005, at 10:00:22
Thanks again for replies...
I've never tried the XL version. For me, the immediate release gives me an initial good stimulating effects which then escalates into agitation, aggressivess and hostility although I do believe it helps my cognitive functioning.
I'd like to go with the SR version (my pdoc prefers as well) but my problem here is EXTREME anxiety that oxazepam is not helping. The anxiety I feel then ends up making me feel more depressed. If I could stick it out(without harming anyone) I would love WB to work. Today I am taking a break from it and I may try again tomorrow or the next day.
Posted by KaraS on March 26, 2005, at 16:34:57
In reply to Re: Wellbutrin demands at least 2-3 week trial, posted by jrbecker on March 26, 2005, at 10:00:22
> my pdoc has had a lot of experience with Wellbutrin and reports that unless a patient is willing to give it at least a 2-3 week trial, you really won't know if it will pass. In his estimation, about 2/3 of his patients who reported intial side effects of anxiety on the medication find that it is not a problem after this period passes. Personally, this echoes my own experience with the drug.
>
> Additionally, for every subsequent dose increase, you will most likely have a similar adjustment period [but not as long as the need for aclimatizing to the initial titration]. He recommends starting low if you are senstive -- 37.5 - 75 mg twice daily. He also believes the SR and XL version are superior to the immediate release version...I personally prefer the XL version.
>When I took Wellbutrin I felt like it was difficult to breathe. I was on it for only about a week. My doctor thought it might be an allergic reation and it scared me so I got off of it. Recently I read a post about someone who said that their chest felt tight on the medication so I started thinking that maybe that's what I had experienced. If that's the case, and as you have indicated, there's a good chance that the anxiety/muscle tightness would tend to go away in 2-3 weeks, then maybe it's worth it for me to try this medication again.
K
Posted by Patient on March 27, 2005, at 16:04:03
In reply to Need help with Wellbutrin! Trouble with s/e's, posted by sac on March 25, 2005, at 14:24:10
> Hi, I have multiple questions regarding Wellbutrin. This is my 5th trial with the medication as I really want it to work. I am currently on Prozac and Lithium for bipolar II. Trouble is, I still have lack of motivation, anhedonia, difficulty concentrating. I though Wellbutrin might help and tried it several years ago. I was so stimulated and aggressive on the immediate release (what scared me was that I kept wanting to keep taking it though). I finally switched to 100 mgs. of the SR version and was so anxious I couldn't stand it (I was even taking oxazepam and the anxiety was still overwhelming) I was also nasty on this one as well. As most of you probably know from your own experiences, I have jumped around from so many different meds trying to find the right combo. I'm back to trying the wb again for the fifth time and , again, I feel like I could kill someone. Should I throw in the towel with this one? How long does this side effect last? Please help. Thanks.
I find this topic interesting. It appears that women are the only ones that become hostile and have anger outbursts while taking Wellbutrin. Maybe I'm wrong; there might be a few men.
I also had the same reaction after switching from Celexa to Wellbutrin SR 150mg. I was supposed to increase dosage to twice daily, but couldn't do it for my husband and I couldn't take it any longer (became argumentative with him, especially in eves. I really thought it was from Celexa withdrawal). I was only on it for two weeks or so.
I'm wondering if it has anything to do with dopamine reuptake of which I believe is how Wellbutrin works in part. I know Zoloft is the one SSRI with slight affinity for dopamine as well as being a serotonin reuptake inhibitor, and while taking this med. I lost my temper big time, but this occured after being on it for several months. I've always had a problem with anger discontrol. But this severe. Anyway, I found a post that may have put a finger on it-women with PMS and Wellbutrin=hostility. Read the thread:
http://www.dr-bob.org/babble/newbs/20040812/msgs/434119.html
Wellbutrin anger/rage problems
I've read quite a few posts where people felt XL verson of Wellbutrin was "smoother" and different than SR. Here is one person's description from the RXList site http://www.rxlist.com/rxboard/wellbutrin.pl?read=3171
"I have about a week's worth of 150mg XL (white tabs), but was started on a course of the blue SR 100mg's. I do not believe that these two are even the same recipe, as it were-the blues are more "speedy", and the 150-extended are more latently "hallucinatory inducing" and honestly made me feel more "low"."
Maybe, the XL verson might be a better choice if you still wanted to give it a try, but that is what the woman in the post was taking.
My recent drug story is that I discontinued 10mg Lexapro on 17, Feb. '05 in hopes that I could live without meds. due to very tight budget. I did all right with the withdrawal symptoms, (i.e. dizziness, vertigo, brain sandpaper sound sensations while sleeping, headache) and was taking a supplement that I had hoped would help smooth out the irritability that returns whenever I've discontinued in the past. I did fine for about 3 weeks, then two weeks ago my irritabililty began to come back, and not sleeping well. I had some leftover Wellbutrin SR 100mg which I started to take every other day for the past 4 or more days-it didn't help much. It made me feel anxious and an uncomfortable agitation in my chest. And, my irritability was still there. Yesterday I took 5mg Lexapro and felt loads better by evening and I slept well. Woke up feeling fine today. So, obviously I do better on SSRI's than Wellbutrin. I couldn't help but think it is a week serotonin increaser at best, and was more like taking pseudophedrine in a cold remedy. I would lie awake in the middle of the night feeling anxious, too. I like to sleep. I do have PMS, besides borderline personality disorder. So, maybe doctors shouldn't prescribe Wellbutrin for women with PMS. I do fine on Wellbutrin SR 150mg when it is an add-on med. to the SSRI Lexapro. I took this combination for a few months over a year ago while we could afford it. It helped get rid of the daytime sleepiness.
This is the end of the thread.
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