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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Greg on May 3, 2000, at 9:32:07
Cam,
I took your suggestion about increasing the Wellbutrin (with my docs blessing of course) from 150 mgs to 300. Seems to be making a difference, the awareness is coming back, a little less brain dead. Although there are a few things I'm not sure I want to be aware of.... My doc also increased my Ambien to 15mgs (from 10) offset the possibility of increased insomnia, so far so good. I'm curious, how long have you been taking the Wellbutrin?Not that you don't already hear this about 30 times a day, but I can't thank you enough for your informative replies and quick reasponses.
In keeping with the earlier 60's LSD references... I'll sign off now as,
Purple Microdot
Posted by Cam W. on May 3, 2000, at 10:25:54
In reply to Wellbutrin Update - Cam, posted by Greg on May 3, 2000, at 9:32:07
Greg - The first time I was taking Wellbutrin for a depressive episode I took it for 9 months. The depression returned about 6 to 8 months later and now I have been taking it again since August or September (I'd have to check with my pharmacist to be sure). I plan on taking it for at least a year, maybe more. It depends on what my psychiatrist and I decide at the year anniversary. Another relapse and I will probably have to take antidepressants for life (sigh). So, around September I will probably be bugging everyone on what I should do.
Sincerely - Cam (blotter) W.
Posted by JohnB on May 3, 2000, at 20:21:26
In reply to Re: Wellbutrin Update - Cam, posted by Cam W. on May 3, 2000, at 10:25:54
Cam- Re Wellbutrin; Are you doing any augmentation? If you ever did augment, what would be your first, second, and third choice? Thanks -JohnB
Posted by Cam W. on May 3, 2000, at 21:51:41
In reply to Re: Wellbutrin Update - Cam, posted by JohnB on May 3, 2000, at 20:21:26
John - I never really felt the need to augment. I did have my Paxil dose (2nd drug) raised to 40mg for a while, but it made me really tired, emotionally labile and confused. I really think my first 2 SSRI attempts (other was Zoloft; too much stomach upset) were half-hearted tries, not really believing that I was depressed and I probably stopped them too soon (around 6 months). I did not like the way they made me feel. Being a guy, the sexual dysfunction was not really a problem (sorta felt like I was 18 again).I never did consider augmentation and at the time (1992 - 93) augmentation was not being used as much as it is today. With the Wellbutrin I am fine using it as a monotherapy. Some days I am bitchier than I should be (can you figure it out from some of my posts?), but other than that, no real funks or crawl-into-a-corner-and-curling-up blues, anymore.
If I had to choice, I would probably like to mix an SSRI with a drug like Reboxetine (kinda like a TCA without the anticholinergic and alpha-adrenergic blockade).
Second choice, perhaps Zyprexa with a partial responding antidepressant. Perhaps another mood stabilizer, like lamotrigine.
Third choice, depending on residual symptoms (esp. if lethargy and sloth still present) an AD with a stimulant like Adderal. I have seen too many problems with people coming out of hospital taking Dexedrine (eg taking a month's worth in a week or chewing up the sustained release caps - Did you know that they work better, but don't last as long, when you chew up the long-acting - duh). Ritalin is a weird drug; maybe because I don't use it in my practice very often, but I don't think I'd like to use that one.
Take care - Cam W.
Posted by JohnB on May 3, 2000, at 23:01:19
In reply to Re: Wellbutrin Update - JohnB, posted by Cam W. on May 3, 2000, at 21:51:41
Thanks Cam- I took Zoloft also. Was taking 50mg with a TCA. One day upped the dose to 75mg and was totally euthymic, wow, but had to keep upping dose to keep effect until poopout at 200mg.ceiling. Felt like Robert DeNiro in "Awakenings"
Regarding your choices; were those "instead of" Well. or "in addition to" Well.
- Thanks again, JohnB
Posted by Cam W. on May 3, 2000, at 23:52:35
In reply to Re: Wellbutrin Update - Cam, posted by JohnB on May 3, 2000, at 23:01:19
> Thanks Cam- I took Zoloft also. Was taking 50mg with a TCA. One day upped the dose to 75mg and was totally euthymic, wow, but had to keep upping dose to keep effect until poopout at 200mg.ceiling. Felt like Robert DeNiro in "Awakenings"
>
> Regarding your choices; were those "instead of" Well. or "in addition to" Well.
> - Thanks again, JohnBJohn - "Instead of". I don't know if I would augment Wellbutrin with anything. It's mechanism of action is too vague. What I would like to see Wellbutrin used for is for non-drug addictions (or even perhaps drug addictions) like gambling, sex, etc. The increase of dopamine in the nucleus accumbens is intriguing.
Any docs using Wellbutrin in addiction cases? I would really like to hear of successes or failures.
Thanks - Cam W.
This is the end of the thread.
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