![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by TrishP on October 31, 2005, at 16:14:15
I've only been on Lamictil for 4 days and my mouth is starting to feel funny again. I tried Lamictil a year ago and I thought my teeth were going to fall out.
I'm afraid to go back to Effexor due to the awful discontinuation syndrome.
I like taking Wellbutrin - it just makes me a little hypomanic sometimes.
Any comments on these combos?
Wellbutrin / Buspar / Trazodone (to sleep)
or Wellbutrin / Klonopin / Trazodone
I'm running out of options.
I'm afraid to combo Wellbutrin with an ssri - then I would be manic for sure.
Help!
Posted by SLS on October 31, 2005, at 17:04:30
In reply to Help me! Mouth sores with Lamictil..., posted by TrishP on October 31, 2005, at 16:14:15
> I've only been on Lamictil for 4 days and my mouth is starting to feel funny again. I tried Lamictil a year ago and I thought my teeth were going to fall out.
If you are actually developing sores in and around your mouth, or anywhere else from the neck and above, you might be experiencing the serious rash reaction that one must always watch for when starting Lamictal. Stevens-Johnson Syndrome can be fatal.
I can't tell from your description whether you should be alarmed or not. You are going to have to speak to your doctor about this. If it is the rash-reaction, you are going to need to discontinue Lamictal immediately. It can often be restarted at a lower dosage and using a more gradual dosage titration.
> I'm afraid to go back to Effexor due to the awful discontinuation syndrome.
You don't have to discontinue something if it works. Why did you discontinue it the first time? If your depression is recurrent, it might be desirable to continue treatment indefinitely. Besides, there are tricks to withdrawing from Effexor with a minimum of discomfort. This includes flexible dosing for which you are in control of dosing. You simply take a minute amount of Effexor as soon as you feel the withdrawal symptoms appear.
> I like taking Wellbutrin - it just makes me a little hypomanic sometimes.The hypomania might be an easy thing to treat. If Wellbutrin controls the depression, but leaves you hypomanic, you can simply add an antimanic drug to stabilize your mood.
What is it about about Wellbutrin monotherapy that you find inadequate?
- Scott
Posted by Phillipa on October 31, 2005, at 19:40:28
In reply to Re: Help me! Mouth sores with Lamictil..., posted by SLS on October 31, 2005, at 17:04:30
What is your diagnosis anyway? Fondly, Phillipa
Posted by TrishP on November 1, 2005, at 6:16:51
In reply to Re: Help me! Mouth sores with Lamictil..., posted by SLS on October 31, 2005, at 17:04:30
Thanks for your reply. I did stop the Lamictal again. Second time I've tried it with the same awful result.
Wellbutrin monotherapy is ok - it just leaves me anxious and a little too hyper.
Effexor was a good combo with Wellbutrin - I was just afraid of the fact that I may have to take it for life, due to the fact that I have a hard time stopping it. My fear is the day or two that I may be without Effexor and the immediate discontinuation syndrome.
Maybe I'm just fighting the inevitable.
> > I've only been on Lamictil for 4 days and my mouth is starting to feel funny again. I tried Lamictil a year ago and I thought my teeth were going to fall out.
>
> If you are actually developing sores in and around your mouth, or anywhere else from the neck and above, you might be experiencing the serious rash reaction that one must always watch for when starting Lamictal. Stevens-Johnson Syndrome can be fatal.
>
> I can't tell from your description whether you should be alarmed or not. You are going to have to speak to your doctor about this. If it is the rash-reaction, you are going to need to discontinue Lamictal immediately. It can often be restarted at a lower dosage and using a more gradual dosage titration.
>
> > I'm afraid to go back to Effexor due to the awful discontinuation syndrome.
>
> You don't have to discontinue something if it works. Why did you discontinue it the first time? If your depression is recurrent, it might be desirable to continue treatment indefinitely. Besides, there are tricks to withdrawing from Effexor with a minimum of discomfort. This includes flexible dosing for which you are in control of dosing. You simply take a minute amount of Effexor as soon as you feel the withdrawal symptoms appear.
>
> > I like taking Wellbutrin - it just makes me a little hypomanic sometimes.
>
> The hypomania might be an easy thing to treat. If Wellbutrin controls the depression, but leaves you hypomanic, you can simply add an antimanic drug to stabilize your mood.
>
> What is it about about Wellbutrin monotherapy that you find inadequate?
>
>
> - Scott
Posted by TrishP on November 1, 2005, at 6:21:03
In reply to Re: Help me! Mouth sores with Lamictil..., posted by Phillipa on October 31, 2005, at 19:40:28
Not exactly sure. My doctor thinks its not full blown bipolar (even though my Dad was and committed suicide due to it), but depression and anxiety.
Since the age of 35, with my hormones and mood swings, I do think that it it bipolar.
Possibly also a little ADD - I noticed that I am able to focus & concentrate and get jobs done faster and more accurately when I take Wellbutrin & Effexor.
I also have this weird OCD thing about counting. Not sure if Wellbutrin or what meds help with OCD.
> What is your diagnosis anyway? Fondly, Phillipa
Posted by SLS on November 1, 2005, at 7:33:08
In reply to Re: Help me! Mouth sores with Lamictil..., posted by TrishP on November 1, 2005, at 6:16:51
> Wellbutrin monotherapy is ok - it just leaves me anxious and a little too hyper.
You should work with your doctor to discuss whether adding an anticonvulsant mood stabilizer or neuroleptic would be indicated to protect against mania.
> Effexor was a good combo with Wellbutrin
It is a great combination. Have you ever tried Effexor without the Wellbutrin? Does the Effexor help prevent you from feelng "hyper" on Wellbutrin?
You should probably begin thinking of your condition as something that is going to need long-term treatment. In my opinion, it makes very little sense to deny yourself an effective treatment out of the worry of how difficult it might be to withdraw from when you may never have to. As I mentioned in my last post, there are ways to greatly reduce the discomfort of withdrawal from Effexor and other SRI drugs. You won't be "stuck" on it if you don't need it.
- Scott-------------------------------------------
- I was just afraid of the fact that I may have to take it for life, due to the fact that I have a hard time stopping it. My fear is the day or two that I may be without Effexor and the immediate discontinuation syndrome.
>
> Maybe I'm just fighting the inevitable.
>
> > > I've only been on Lamictil for 4 days and my mouth is starting to feel funny again. I tried Lamictil a year ago and I thought my teeth were going to fall out.
> >
> > If you are actually developing sores in and around your mouth, or anywhere else from the neck and above, you might be experiencing the serious rash reaction that one must always watch for when starting Lamictal. Stevens-Johnson Syndrome can be fatal.
> >
> > I can't tell from your description whether you should be alarmed or not. You are going to have to speak to your doctor about this. If it is the rash-reaction, you are going to need to discontinue Lamictal immediately. It can often be restarted at a lower dosage and using a more gradual dosage titration.
> >
> > > I'm afraid to go back to Effexor due to the awful discontinuation syndrome.
> >
> > You don't have to discontinue something if it works. Why did you discontinue it the first time? If your depression is recurrent, it might be desirable to continue treatment indefinitely. Besides, there are tricks to withdrawing from Effexor with a minimum of discomfort. This includes flexible dosing for which you are in control of dosing. You simply take a minute amount of Effexor as soon as you feel the withdrawal symptoms appear.
> >
> > > I like taking Wellbutrin - it just makes me a little hypomanic sometimes.
> >
> > The hypomania might be an easy thing to treat. If Wellbutrin controls the depression, but leaves you hypomanic, you can simply add an antimanic drug to stabilize your mood.
> >
> > What is it about about Wellbutrin monotherapy that you find inadequate?
> >
> >
> > - Scott
>
>
Posted by TrishP on November 1, 2005, at 8:49:00
In reply to Re: Help me! Mouth sores with Lamictil..., posted by SLS on November 1, 2005, at 7:33:08
Yes - the Effexor evens out the Wellbutrin - they are a great combo. I guess I'm really having a hard time accepting that I may just have to take it for the rest of my life.
I think bipolar disease is difficult to accept.
I only took Wellbutrin today and I feel hyper and high. I know I need to just accept it and go back to my Eff/Well combo - with Traz for sleep.
Thank you!
Posted by SLS on November 1, 2005, at 9:25:15
In reply to Thanks Scott..., posted by TrishP on November 1, 2005, at 8:49:00
GOOD LUCK!
:-)
- Scott----------------------------------
> Yes - the Effexor evens out the Wellbutrin - they are a great combo. I guess I'm really having a hard time accepting that I may just have to take it for the rest of my life.
>
> I think bipolar disease is difficult to accept.
>
> I only took Wellbutrin today and I feel hyper and high. I know I need to just accept it and go back to my Eff/Well combo - with Traz for sleep.
>
> Thank you!
Posted by Bill LL on November 1, 2005, at 9:52:37
In reply to Re: Help me! Mouth sores with Lamictil..., posted by TrishP on November 1, 2005, at 6:21:03
Your condition is very common since a lot of people have a combination of bipolar, anxiety, depression, OCD, and ADD. An "official" diagnosis is somewhat arbitrary. Some docs will say that a patient is bipolar (or bipolar 2 or bipolar 3), and some will say he or she has depression. But labels aren't very helpful or important in my opinion. It's just that the doctor needs to put a diagnosis on the claim form in order to have insurance cover the visits.
I totally agree with one of Scott's suggestions. If Effexor was helpful, go back on it. Just be extra vigilant that you don't skip a dose. As for discontinuation, people who take Prozac while very slowing weaning off of Effexor generally don't have much of a problem.
> Not exactly sure. My doctor thinks its not full blown bipolar (even though my Dad was and committed suicide due to it), but depression and anxiety.
>
> Since the age of 35, with my hormones and mood swings, I do think that it it bipolar.
>
> Possibly also a little ADD - I noticed that I am able to focus & concentrate and get jobs done faster and more accurately when I take Wellbutrin & Effexor.
>
> I also have this weird OCD thing about counting. Not sure if Wellbutrin or what meds help with OCD.
>
>
>
> > What is your diagnosis anyway? Fondly, Phillipa
>
>
Posted by TrishP on November 1, 2005, at 14:27:51
In reply to Re: Thanks Scott..., posted by SLS on November 1, 2005, at 9:25:15
I was only taking a small dose of Effexor - 75mg. a day. I remember someone telling me that is the same as taking an ssri. Is this true? The Eff felt different to me than an ssri -Prozac or Zoloft.
> GOOD LUCK!
>
> :-)
>
>
> - Scott
>
> ----------------------------------
>
> > Yes - the Effexor evens out the Wellbutrin - they are a great combo. I guess I'm really having a hard time accepting that I may just have to take it for the rest of my life.
> >
> > I think bipolar disease is difficult to accept.
> >
> > I only took Wellbutrin today and I feel hyper and high. I know I need to just accept it and go back to my Eff/Well combo - with Traz for sleep.
> >
> > Thank you!
>
>
Posted by Colleen D. on November 1, 2005, at 16:01:21
In reply to Only 75mg Effexor - ssri?, posted by TrishP on November 1, 2005, at 14:27:51
Yes, Trish. I believe the NE effects start to kick in at dosages 225mg and higher. I read that here on the board. Tomorrow I'm going up to 300mg Effexor to see if it will give me a boost. I've been at 150mg for 1.5 years.
Colleen
Posted by TrishP on November 4, 2005, at 13:32:59
In reply to Re: Only 75mg Effexor - ssri? » TrishP, posted by Colleen D. on November 1, 2005, at 16:01:21
Did you notice a big difference when you went from 75mg up to 150mg? Have you had any weight gain with Effexor? I'm afraid of the fattness I get from serotonin.
I am also using Wellbutrin.
> Yes, Trish. I believe the NE effects start to kick in at dosages 225mg and higher. I read that here on the board. Tomorrow I'm going up to 300mg Effexor to see if it will give me a boost. I've been at 150mg for 1.5 years.
>
> Colleen
Posted by Colleen D. on November 5, 2005, at 20:59:33
In reply to Colleen, Did you notice a..., posted by TrishP on November 4, 2005, at 13:32:59
Yes; a big difference between those two doses. Now I'm on 300mg and I've lost almost 30 lbs. since I started Effexor.
> Did you notice a big difference when you went from 75mg up to 150mg? Have you had any weight gain with Effexor? I'm afraid of the fattness I get from serotonin.
>
> I am also using Wellbutrin.
>
> > Yes, Trish. I believe the NE effects start to kick in at dosages 225mg and higher. I read that here on the board. Tomorrow I'm going up to 300mg Effexor to see if it will give me a boost. I've been at 150mg for 1.5 years.
> >
> > Colleen
>
>
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.