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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Stubenhocker on April 25, 2009, at 13:37:24
I wanna try a Lexapro (20mg) + Wellbutrin (300mg) + Klonopin PRN (+-3X a week) for social phobia and depression soon. Anyone tried this combo yet? What do you think, will it work?
Posted by Zana on April 25, 2009, at 17:26:20
In reply to Lexapro + Wellbutrin + Klonopin Combo, posted by Stubenhocker on April 25, 2009, at 13:37:24
If you are looking for an SSRI/SNRI combo you might try Pristiq, the new Effexor. I couldn't tolerate Effexor but am having pretty good luck with the Pristiq. It's stimulating but I can also feel the calming seratonin effects. I take klonopini and think it's a pretty "clean" med. I do think that it impairs your memeory somewhat.
I tried Wellbutrin a couple of times and it either made me irritable or feel like I was tripping, kind of hypersensitive, and zoned. I didn't like it and I was really anxious for it to work because I smoke a few cigarettes a day and know people who have had good luck quitting with Wellbutrin (or Zyban- same thing.)Good luck getting the mix right. It's all so individual. Sometimes I think you have to just try it and see what it's like in your brain.
Zana
Posted by Phillipa on April 25, 2009, at 23:04:22
In reply to Re: Lexapro + Wellbutrin + Klonopin Combo, posted by Zana on April 25, 2009, at 17:26:20
What meds have you been on so far and what is your diagnosis and how do you tolerate the meds you've taken. Is this the first or one of many? Love Phillipa
Posted by Stubenhocker on April 26, 2009, at 6:10:37
In reply to Re: Lexapro + Wellbutrin + Klonopin Combo, posted by Phillipa on April 25, 2009, at 23:04:22
Social phobia and depression but social phobia is the main problem (I'm "only" depressed 'cause of it). I was on Valium and Ativan a while ago. I'm currently on Celexa since three years and it works pretty fine but I think Lexapro is somewhat better. AFAIK social phobics have low serotonin and dopamin levels while norepinephrine is too high (tell me if I'm wrong). So I want to increase dopamine levels beside to Lexapro's serotonin increasing. I want to use Klonopin for very stressful social situations.
Posted by West on May 4, 2009, at 16:34:45
In reply to Re: Lexapro + Wellbutrin + Klonopin Combo, posted by Stubenhocker on April 26, 2009, at 6:10:37
I've been on that cocktail. If SA is your primary problem you need to work through interpersonal therapies and cbt as well as meds. Remember thoutgh that wellbutrin overall effect is noradrenergic and basically, give or take, makes you more tense (it is also a cns stimulant). Klonopin at 2mg nocte was gravely debilitating cognitively, even 0.25mg right now is, though some of this will be subjective and dependent on other factors including weight, drug absorption, biases in neurochemistry and so on. I think 20mg lexapro is too high. Almost complette saturation is achieved at 10, for the majority that is sufficient. I didn't like the spaciness and apathy at 20mg.
I do have panic as a component of my depression and i found propanolol (inderal) very helpful when it was out of control - 10mg was enough, anymore can make you feel a bit grotty. I'm sure there are variants which do a similar job.
But the forgetfullness and cognitive clouding that benzos inflict are best avoided where others can help AND let you hang on to your intellect. Buspirone is a thought that comes to mind or feverfew, an antiserotonergic herb with anxiolytic properties.
Posted by metric on May 4, 2009, at 17:14:26
In reply to Re: Lexapro + Wellbutrin + Klonopin Combo, posted by West on May 4, 2009, at 16:34:45
> I've been on that cocktail. If SA is your primary problem you need to work through interpersonal therapies and cbt as well as meds. Remember thoutgh that wellbutrin overall effect is noradrenergic and basically, give or take, makes you more tense (it is also a cns stimulant). Klonopin at 2mg nocte was gravely debilitating cognitively, even 0.25mg right now is, though some of this will be subjective and dependent on other factors including weight, drug absorption, biases in neurochemistry and so on. I think 20mg lexapro is too high. Almost complette saturation is achieved at 10, for the majority that is sufficient. I didn't like the spaciness and apathy at 20mg.
>
> I do have panic as a component of my depression and i found propanolol (inderal) very helpful when it was out of control - 10mg was enough, anymore can make you feel a bit grotty. I'm sure there are variants which do a similar job.
>
> But the forgetfullness and cognitive clouding that benzos inflict are best avoided where others can help AND let you hang on to your intellect. Buspirone is a thought that comes to mind or feverfew, an antiserotonergic herb with anxiolytic properties.Have you taken clonazepam by itself? Or just in combination with an SSRI?
Posted by West on May 5, 2009, at 7:05:55
In reply to Re: Lexapro + Wellbutrin + Klonopin Combo » West, posted by metric on May 4, 2009, at 17:14:26
> Have you taken clonazepam by itself? Or just in combination with an SSRI?
In combination with escitalopram only. Wouldn't be here without it.
Posted by Stubenhocker on May 5, 2009, at 13:49:27
In reply to Re: Lexapro + Wellbutrin + Klonopin Combo, posted by West on May 4, 2009, at 16:34:45
> If SA is your primary problem you need to work through interpersonal therapies and cbt as well as meds.
I'm about to do this. I was in CBT yet but the psychotherapist was a fresh fish and had no clue about SA.
> Remember thoutgh that wellbutrin overall effect is noradrenergic and basically, give or take, makes you more tense (it is also a cns stimulant).Yeah, I'm afraid the noradrenergic effect will make me even more anxious (especially worsen the physical symptoms)? Through I read the dopaminergic effect is actually good for SA.
> I think 20mg lexapro is too high. Almost complette saturation is achieved at 10, for the majority that is sufficient. I didn't like the spaciness and apathy at 20mg.You're really thinking? I'm on 40mg Celexa right know, without any problems.
Posted by West on May 6, 2009, at 17:41:37
In reply to Re: Lexapro + Wellbutrin + Klonopin Combo, posted by Stubenhocker on May 5, 2009, at 13:49:27
Claims vary over equivalence between the two. I haven't taken citalopram so i can't really comment. Hope it goes well for you, switching should be a breeze. I just have mixed feelings about the higher dose - it relieved the symptoms and to that extent it -works- but sort of slows down areas like involved with drive + creativity ime.
> > If SA is your primary problem you need to work through interpersonal therapies and cbt as well as meds.
>
> I'm about to do this. I was in CBT yet but the psychotherapist was a fresh fish and had no clue about SA.
>
>
> > Remember thoutgh that wellbutrin overall effect is noradrenergic and basically, give or take, makes you more tense (it is also a cns stimulant).
>
> Yeah, I'm afraid the noradrenergic effect will make me even more anxious (especially worsen the physical symptoms)? Through I read the dopaminergic effect is actually good for SA.
>
>
> > I think 20mg lexapro is too high. Almost complette saturation is achieved at 10, for the majority that is sufficient. I didn't like the spaciness and apathy at 20mg.
>
> You're really thinking? I'm on 40mg Celexa right know, without any problems.
>
Posted by desolationrower on May 13, 2009, at 3:09:46
In reply to Re: Lexapro + Wellbutrin + Klonopin Combo, posted by West on May 6, 2009, at 17:41:37
wellbutrin improves anxiety. its quite similar to ssris in that it helps some, and makes others wores (especially in short term)
-d/r
Posted by Phillipa on May 13, 2009, at 20:08:54
In reply to Re: Lexapro + Wellbutrin + Klonopin Combo, posted by desolationrower on May 13, 2009, at 3:09:46
Sure made me worse one week was hospitalized. Love Phillipa
This is the end of the thread.
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