Posted by bleauberry on August 15, 2008, at 19:05:41
In reply to Wellbutrin/stimulant poop-out--pls help w/ idea, posted by oceancat on August 15, 2008, at 2:36:32
Pure hypothesis on my part, but when stimulating noradrenergic meds poopout and leave you feeling worse and tired, it is my guess that what happens is the feedback loops sense too much NE and slow down or stop firing in an effort to maintain genetically programmed homeostasis. This has been a possible theory as to the lag time for an antidepressant to work...as the neuros are increased, firing comes to a slowdown, but after a few weeks they adjust and firing resumes. But with some people, maybe the firing never does resume? And then they just feel yuck?
If that hypothesis were correct, then a med that will stimulate firing, such as remeron, possibly risperdal, might work to restore things.
And yes, some people do best on very low doses that are supposedly subtherapeutic. I've seen reports of people where their magic doses were things like...25mg lamictal; 15mg cymbalta; 5mg prozac; 3mg lexapro; 150mg st johns wort; and like that. Everyone's bodies are different. Everyone metabolizes drugs differently. Malfunctions of each of us are different. When drug companies set dose levels, it is mainly for convenience of doctors to prescribe and for economics. Those doses are usually justified with clinical trial evidence, but that is not always reliable. But that's another story.
A recent article in Consumer Reports said patients should take the smallest dose that works, which is apparently often lower than what their doctor prescribed. Lower doses can work just as good but can take longer to do so.
Some clinical trials show that there is no benefit from higher doses. For example, 120mg cymbalta was no better than 60mg; 100mg zoloft was no better than 50mg; and such.
Anyway, back to your situation. Been there done that. Sorry. It does feel really bad, I know. The only way I've been able to get out of it is to lower doses of the meds I suspect.
Also keep in mind that a not-too-uncommon side effect of Wellbutrin is...depression. Check the side effects for Zyban (the name wellbutrin gets when used to quit smoking). Depression is a possible side effect. The depression can kick in anywhere from a few days to a few weeks.
Not sure what you should do. In your shoes I would be reducing doses, which aint easy either. I just don't see how I could stay where I was if I felt like you do now. Something would have to change.
poster:bleauberry
thread:846321
URL: http://www.dr-bob.org/babble/20080814/msgs/846483.html