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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by bleauberry on May 8, 2008, at 20:27:20
Wellbutrin in 4 days took me from medium depression to suicidal ideation and almost total incapacitation. Barely able to get through work. Thought I was hiding it pretty well, but at least 5 people commented stuff like, "Smile, it aint that bad", "Don't be so depressed it's a sunny day, "You don't seem like yourself", "Are you ok?" People noticed for sure despite my years of training at hiding it.
Anyway, first two days were the usual wellbutrin stuff...nervousness, heart palpitations, lousy sleep, sweating. I got through that ok. Then third day was total mind numbing calm and deep dark clouds without even a hint of any of the earlier stimulation. Weird also is that sex drive went from normal to absolute zero.
If I ever wanted to feel as bad as anyone could possibly feel, all I need do is take wellbutrin. I've had periods of really really deep bad depression in my life, but it's hard to recall any as bad as what wellbutrin did.
I wonder what mechanism did that?
Doses were only 75mg per day. Scary to think any more might have had me driving my car into a tree to end it all.
It's 24 hours since the final dose so I have hope to return to my baseline within the next day, two or three. Baseline is lousy, but a whole lot better than wellbutrin. I just wonder what mechanism it was that did that. Hard to explain, but it didn't feel like a dopamine thing or a norepinephrine thing. Maybe it was, dunno.
Posted by Bob on May 8, 2008, at 21:20:12
In reply to Wonder Why Wellbutrin was So Bad, posted by bleauberry on May 8, 2008, at 20:27:20
> Wellbutrin in 4 days took me from medium depression to suicidal ideation and almost total incapacitation. Barely able to get through work. Thought I was hiding it pretty well, but at least 5 people commented stuff like, "Smile, it aint that bad", "Don't be so depressed it's a sunny day, "You don't seem like yourself", "Are you ok?" People noticed for sure despite my years of training at hiding it.
>
> Anyway, first two days were the usual wellbutrin stuff...nervousness, heart palpitations, lousy sleep, sweating. I got through that ok. Then third day was total mind numbing calm and deep dark clouds without even a hint of any of the earlier stimulation. Weird also is that sex drive went from normal to absolute zero.
>
> If I ever wanted to feel as bad as anyone could possibly feel, all I need do is take wellbutrin. I've had periods of really really deep bad depression in my life, but it's hard to recall any as bad as what wellbutrin did.
>
> I wonder what mechanism did that?
>
> Doses were only 75mg per day. Scary to think any more might have had me driving my car into a tree to end it all.
>
> It's 24 hours since the final dose so I have hope to return to my baseline within the next day, two or three. Baseline is lousy, but a whole lot better than wellbutrin. I just wonder what mechanism it was that did that. Hard to explain, but it didn't feel like a dopamine thing or a norepinephrine thing. Maybe it was, dunno.I can't really tell you why what happened happened (and I suspect no one can), but I can maybe offer you a very small consolation that I've had many terrible outcomes to treatments over the years, some quite similar to what you describe where I can't make any sense of it. I've had meds that have almost killed me and it was all I could do to discontinue it without offing myself. No one can ever, ever tell me why.
In any case, I'm sorry to hear that your experience went so badly.
Posted by Phillipa on May 8, 2008, at 23:32:22
In reply to Re: Wonder Why Wellbutrin was So Bad » bleauberry, posted by Bob on May 8, 2008, at 21:20:12
Me too it made me manic in a week. Wierd? Love Phillipa
Posted by James_Glasgow_UK on May 9, 2008, at 1:09:19
In reply to Re: Wonder Why Wellbutrin was So Bad » bleauberry, posted by Bob on May 8, 2008, at 21:20:12
I am experiencing the same sort of reaction, I have posted it in the Abilify thread just above, did not see this one before i put it there.
I was also feeling very depressed much more so then what I am taking this medicine for at the moment, but not as bad as I have gotten in the past with and without medication.
Hope you feel better soon, I currently feel so bad I cant make up my mind what do to do.
James
Posted by SLS on May 9, 2008, at 5:00:41
In reply to Wonder Why Wellbutrin was So Bad, posted by bleauberry on May 8, 2008, at 20:27:20
Hi BB.
I always react to Wellbutrin by feeling worse. It is the depression itself that gets worse, and not some added dimension of suffering.
It would be nice to know what caused these reactions, so that you might glean a hint as to what biological pathology exists in the brain. Just to know which drugs to avoid would be nice.
Unfortunately, Wellbutrin is a poorly understood drug, and I don't think there is enough information readily available to draw conclusions. If I had to choose between DA and NE reuptake, I would choose the NE as the culprit at some point along the chain of events, and not necessarily the result of reuptake inhibition.
- Scott> Wellbutrin in 4 days took me from medium depression to suicidal ideation and almost total incapacitation. Barely able to get through work. Thought I was hiding it pretty well, but at least 5 people commented stuff like, "Smile, it aint that bad", "Don't be so depressed it's a sunny day, "You don't seem like yourself", "Are you ok?" People noticed for sure despite my years of training at hiding it.
>
> Anyway, first two days were the usual wellbutrin stuff...nervousness, heart palpitations, lousy sleep, sweating. I got through that ok. Then third day was total mind numbing calm and deep dark clouds without even a hint of any of the earlier stimulation. Weird also is that sex drive went from normal to absolute zero.
>
> If I ever wanted to feel as bad as anyone could possibly feel, all I need do is take wellbutrin. I've had periods of really really deep bad depression in my life, but it's hard to recall any as bad as what wellbutrin did.
>
> I wonder what mechanism did that?
>
> Doses were only 75mg per day. Scary to think any more might have had me driving my car into a tree to end it all.
>
> It's 24 hours since the final dose so I have hope to return to my baseline within the next day, two or three. Baseline is lousy, but a whole lot better than wellbutrin. I just wonder what mechanism it was that did that. Hard to explain, but it didn't feel like a dopamine thing or a norepinephrine thing. Maybe it was, dunno.
Posted by llurpsienoodle on May 9, 2008, at 8:11:28
In reply to Wonder Why Wellbutrin was So Bad - Me too. » bleauberry, posted by SLS on May 9, 2008, at 5:00:41
I just started on wellbutrin about 6 weeks ago. I've been posting lots about my experiences on wellbutrin. This is definitely a very psychoactive med. Acts quickly and with oomph.
So I was depressed (moderately) and having side effects from SSRI (zoloft100mg) I added 150mg wellbutrinSR and ideation went to planning. It was all I could think of. Intrusive thoughts. Nightmares. Very powerful images. Very scary. I took an overdose of sedating meds (basically anything I could get my hands on) and wound up in the hospital drinking a charcoal smoothie.
I stuck it out in the hospital with the wellbutrin and was released feeling better each day. I even got to feeling REALLY good. hypomanic for about 3 weeks. I started SO many craft projects and stuff like that.
Wellbutrin has been very good for my anxiety. I have come to speculate that the anxiety stemmed from apathy to choose between two competing alternatives (what should I do- get dressed or stay in bed and play on babble). Well, now I can decide and I DO decide to get up and get dressed (and THEN play on babble :)
My first trial of wellbutrin went pretty poorly that was a year ago. I was in the hospital (unrelated to WB) and they Rx'd me WB 150mg XL in the hospital. I lasted about 5 days. Pdoc's conclusion "clearly Wellbutrin does not agree with you". Well, I'm glad I gave it another chance, even if the initial start-up was quite a wave rocking the boat.
(((((bleauberry))))))
sorry you're feeling so crappy. Take good care of yourself. Some self-soothing may be in order?
-Ll
Posted by James_Glasgow_UK on May 9, 2008, at 8:25:25
In reply to Re: Wonder Why Wellbutrin was So Bad - Me too., posted by llurpsienoodle on May 9, 2008, at 8:11:28
I have put myself on 2mg of clonazepam twice a day for all of the psychological side effects, naproxen 500mg BD and 30mg codiene/500mg paracetamol (acetaminophen)for the constant headache. I can still feel the wellbutrin underneath it but at least today is not as torturous as yesterday was.
I am doing this to try and ride it out as I would like the same response as llurpsienoodle.
Oh, I have those meds in the house as I am supposed to be taking them for my knee pain, PHN, and the clonazepam in case I start to become manic.
James
Posted by johnj on May 9, 2008, at 8:29:29
In reply to Wonder Why Wellbutrin was So Bad - Me too. » bleauberry, posted by SLS on May 9, 2008, at 5:00:41
Scott,
If that was the case with NE wouldn't you react the same way to nortriptyline?
Posted by llurpsieNoodle on May 9, 2008, at 8:32:58
In reply to Re: Wonder Why Wellbutrin was So Bad - Me too., posted by James_Glasgow_UK on May 9, 2008, at 8:25:25
> I have put myself on 2mg of clonazepam twice a day for all of the psychological side effects, naproxen 500mg BD and 30mg codiene/500mg paracetamol (acetaminophen)for the constant headache. I can still feel the wellbutrin underneath it but at least today is not as torturous as yesterday was.
Hi James_G,
I forgot to mention that I had a 4-week long headache on wellbutrin. I was able to use mindfulness to move beyond the pain, but I was taking naproxen everyday for about 2 weeks until I felt well enough to do some meditation/guided imagery.hang in there.
-Ll
>
>
Posted by James_Glasgow_UK on May 9, 2008, at 10:19:37
In reply to Re: Wonder Why Wellbutrin was So Bad - Me too. » James_Glasgow_UK, posted by llurpsieNoodle on May 9, 2008, at 8:32:58
I will.
Thanks for the support.
Take care
James
Posted by SLS on May 9, 2008, at 12:02:15
In reply to Re: Wonder Why Wellbutrin was So Bad - Me too. » SLS, posted by johnj on May 9, 2008, at 8:29:29
> Scott,
>
> If that was the case with NE wouldn't you react the same way to nortriptyline?Not necessarily. I personally do not believe that the NE or DA reuptake inhibition of Wellbutrin is significant enough to account for its long-term efficacy. It seems to be through an indirect pro-NE property that NE activity is potentiated.
I wish I could remember the details of the international symposium on the mechanism of action of Wellbutrin that took place several years ago. Even that think-tank couldn't come up with an answer.
I think one of the most important factors accounting for the varied reactions to similar drugs is that they are dissimilar in where they act in the circuitry of the brain.
As an example, I respond to some degree to imipramine, desipramine, and nortriptyline, but I am made very much worse by protriptyline and reboxetine. All of these drugs are NE reuptake inhibitors. Go figure.
- Scott
Posted by mav27 on May 9, 2008, at 12:53:40
In reply to Re: Wonder Why Wellbutrin was So Bad - Me too. » johnj, posted by SLS on May 9, 2008, at 12:02:15
> > Scott,
> >
>
> As an example, I respond to some degree to imipramine, desipramine, and nortriptyline, but I am made very much worse by protriptyline and reboxetine. All of these drugs are NE reuptake inhibitors. Go figure.
>
>Yeah it's wierd how this sort of thing happens. I respond quite well to imipramine, but nortriptyline makes me very irritable and not much else where as reboxetine makes me feel so relaxed and calm inside, it's almost, but not quite, a sort of euphoric feeling.. hard to describe it but it just feels 'nice'
Posted by 4WD on May 9, 2008, at 16:01:42
In reply to Wonder Why Wellbutrin was So Bad, posted by bleauberry on May 8, 2008, at 20:27:20
Hi,
Wellbutrin had a similar effect on me though not as bad and it took longer to happen. It also caused severe insomnia. I felt like I couldn't stand myself or the way I was feeling. It was horrible. And it made me smoke more, too instead of less, which is why I was taking it. It was in general a horrible experience.
Norepinephrine drugs are not good for me. I had a similar anxious reaction to nortriptyline. It's funny though, SNRI's don't do it. They actually help a little with anxiety.
Go figure,
Marsha
> Wellbutrin in 4 days took me from medium depression to suicidal ideation and almost total incapacitation. Barely able to get through work. Thought I was hiding it pretty well, but at least 5 people commented stuff like, "Smile, it aint that bad", "Don't be so depressed it's a sunny day, "You don't seem like yourself", "Are you ok?" People noticed for sure despite my years of training at hiding it.
>
> Anyway, first two days were the usual wellbutrin stuff...nervousness, heart palpitations, lousy sleep, sweating. I got through that ok. Then third day was total mind numbing calm and deep dark clouds without even a hint of any of the earlier stimulation. Weird also is that sex drive went from normal to absolute zero.
>
> If I ever wanted to feel as bad as anyone could possibly feel, all I need do is take wellbutrin. I've had periods of really really deep bad depression in my life, but it's hard to recall any as bad as what wellbutrin did.
>
> I wonder what mechanism did that?
>
> Doses were only 75mg per day. Scary to think any more might have had me driving my car into a tree to end it all.
>
> It's 24 hours since the final dose so I have hope to return to my baseline within the next day, two or three. Baseline is lousy, but a whole lot better than wellbutrin. I just wonder what mechanism it was that did that. Hard to explain, but it didn't feel like a dopamine thing or a norepinephrine thing. Maybe it was, dunno.
Posted by bleauberry on May 9, 2008, at 17:19:31
In reply to Wonder Why Wellbutrin was So Bad - Me too. » bleauberry, posted by SLS on May 9, 2008, at 5:00:41
Hi Scott,
Thanks for your input. I always appreciate hearing your thoughts.
As you said, I believe Wellbutrin is a weak reuptake inhibitor. I saw somewhere at pubmed where 300mg provides 20% occupancy of dopamine reuptake. Consider that zoloft has 90% occupancy of serotonin reuptake at just 25mg, or even 50% at a mere 9mg, wellbutrin is weak compared to peers. I've read other postulated effects of wellbutrin having to do with nitric oxide and nicotinic receptors and who knows what.
This happened with a trial of adding wellbutrin to zoloft about 2 years ago. Enough time has passed that I figured it was a fluke and surely wouldn't happen again. Surely it had something to do with the combination of zoloft, but with wellbutrin by itself it would be different. Wrong. While I see other people get huge benefits from wellbutrin, to me it is like taking rat poison.
As far as norepinephrine reuptake goes, reboxetine made my depression a lot worse and fast, nortriptyline was neutral, and milnacipran had me feeling better than in a long time within a week. Go figure. It just seems a lot more complicated than saying norepinephrine reuptake is bad for me or is good for me. I think it depends on what drug is doing it, how it is doing it, and where in the brain it is doing it. as well as other intricate detailed secondary functions we may or may not know about.
Posted by bleauberry on May 9, 2008, at 17:33:53
In reply to Wonder Why Wellbutrin was So Bad, posted by bleauberry on May 8, 2008, at 20:27:20
I am grateful to you all who took the time to write me some words. Much appreciated.
I read somewhere that something like 5% to 9% of people who take wellbutrin become severely depressed on it. I didn't want to be in that group and I was sure I wouldn't be. Guess I got that one about as wrong as wrong can be.
My spouse commented I seemed a little better today, and yeah, I feel like I am returning to my baseline quickly. The deep darkness is mostly gone, the inability to move is gone, the desire to weep is gone, the thoughts of this world being so much better without me are gone. Back to my usual self, which seems to be melancholic dysthmia with prominent anhedonia as the core feature. And thus the purpose of wellbutrin in the first place.
If I find any mice or rats around at least I have some leftover bupropion to kill them with.
Once again, you all are so thoughtful and kind. I just wanted to say I appreciate each and every response in this thread.
Posted by SLS on May 9, 2008, at 19:19:47
In reply to Re: Wellbutrin....Response to all Posters, posted by bleauberry on May 9, 2008, at 17:33:53
> If I find any mice or rats around at least I have some leftover bupropion to kill them with.
I'm dying.
LOL
- Scott
Posted by johnj on May 11, 2008, at 11:57:33
In reply to Re: Wonder Why Wellbutrin was So Bad - Me too. » SLS, posted by johnj on May 9, 2008, at 8:29:29
Interesting thought on NE. I am struggling right now with anxiety and sleep. The strange thing is I have had a severe cold this weekend and have been taking the antihistamine chlorpheniramine maleate. I was leary of taking an antihistamine because allegra distrubed my sleep and made me feel weird and benadryl helped me sleep but made me very angry the next day. I have not had much anxiety the last day or so.
I am thinking of a low dose tca but am struggling with which one as I get side effects quickly. The anxiety I have also makes me leary of trying one. I have a lot of physical sytmptoms of anxiety like light headness, sleep disruption, chest tightness and spaciness under stress. I really need something that will calm down my adrenaline reaction. Any thoughts? Thanks
johnj
Posted by SLS on May 11, 2008, at 12:18:33
In reply to Re: Wonder Why Wellbutrin was So Bad - Me too. » johnj, posted by johnj on May 11, 2008, at 11:57:33
> Interesting thought on NE. I am struggling right now with anxiety and sleep. The strange thing is I have had a severe cold this weekend and have been taking the antihistamine chlorpheniramine maleate. I was leary of taking an antihistamine because allegra distrubed my sleep and made me feel weird and benadryl helped me sleep but made me very angry the next day. I have not had much anxiety the last day or so.
>
> I am thinking of a low dose tca but am struggling with which one as I get side effects quickly. The anxiety I have also makes me leary of trying one. I have a lot of physical sytmptoms of anxiety like light headness, sleep disruption, chest tightness and spaciness under stress. I really need something that will calm down my adrenaline reaction. Any thoughts? Thanks
It is possible that the anxiety you struggled with after taking chlorpheniramine was due to its serotoninergic properties. I would not look at NE exclusively. Nortriptyline is a mild drug that is not as likely to produce anxiety as some of the other TCAs. Desipramine might produce anxiety early on, but the drug can act to reduce chronic anxiety when it is related to depression.
- Scott
Posted by johnj on May 11, 2008, at 15:46:35
In reply to Re: Wonder Why Wellbutrin was So Bad - Me too. » johnj, posted by SLS on May 11, 2008, at 12:18:33
I meant that I have had bad anxiety and physical anxiety, tight chest, night sweats, dizziness, etc., but after taking chlorpheniramine maleate I have had no chest tightness and don't feel as tense. However, ssri's really make me more anxious so this is really strange. This makes me really wonder more about polypharmacy and getting a good combo that one needs.
When you say anxiety related to depression that is really hard to know. I always thought that anxiety was the cause and my couselor has made observations that I have had this low grade depression. Which came first is hard to figure out. I know, being med sensitive, that I can probably not tolerate much more than 25 mg of nortryptline. I do well on it years ago but a physical illness made me hypersensitive to meds. Too bad this was figured out and my doses lowered to see what happens. So, I may have to start really low. Whatever works is fine by me.
Posted by SLS on May 11, 2008, at 16:15:53
In reply to SLS, sorry I misspoke. » SLS, posted by johnj on May 11, 2008, at 15:46:35
> When you say anxiety related to depression that is really hard to know.
Interestingly, Major Depressive Disorder is often the sequalae to years of anxiety. In this case, it seems that the anxiety is the stress that causes the break-down of important brain functions. In this case, the depression might have been precipitated by psychosocial stresses and anxiety. However, extreme anxiety can be a feature of MDD that automatically improves when the depression is successfully treated. Yes, it is hard to know. Have you ever tried Paxil or Effexor?
- Scott
Posted by johnj on May 11, 2008, at 18:13:32
In reply to Re: SLS, sorry I misspoke., posted by SLS on May 11, 2008, at 16:15:53
Yes, paxil was a nightmare. I felt so weird on it and had anxiety worse than normal. Effexor I have not tried. Srri's have caused me insomnia and agitation. I only made it up to a dose of 25-mg of luvox, a baby dose and couldn't sleep. I didn't like the way it made me feel either. Paxil, just plain scary.
I wonder if chlorpheniramine works for anxiety does that indicate a what type of med would work for me? I did some googling and it appears close to imipramine and amitrypttline (nor's mother drug), and effexor.
The reason I wonder about lower doses of tca's for me is two-fold. One, after my pneumonia I am med sensitive as 50mg of nort seemed like the old 100-mg that I could not tolerate. Two, if anxiety is my major problem if I get that under control the low grade depression should dissipate.
I have tried so much alternative stuff like yoga, meditation, tai-chi, etc., and just can't knock out the last bit of anxiety. I have had days of feeling ok then the anxiety will just come right back. Nothing too stable to write home about. For me, anxiety results in loss sleep and there are days I am just trying to survive the day. That is not a fun feeling. I just don't want to wait too long without meds for fear of a spiral downward into a depression.
This is the end of the thread.
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