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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 DP on April 25, 2002, at 20:38:09
Does anyone have any experience/input with regard to combining two or more antidepressants?
I was just prescribed Wellbutrin (150mg x qd 'once a day') in addition to the Zoloft (50mg x qd) that I've been taking for about a month now.
It concerns me that I have lots of meds pumping through my system. Anyone care to expand on this for me? Has anyone taken an SSRI with Wellbutrin?
Also, the doctor has left it up to me when I should actually take the meds. If there is anyone taking Wellbutrin with an SSRI, what time of day do you take them? I figure since Wellbutrin can act as a stimulant (so I hear), and that Zoloft makes me sleepy, I should just take the Wellbutrin in the morning and Zoloft before bed. What do you think?
Thanks so much, in advance, for your help and input!
Jimmy
P.S. If Wellbutrin is *NOT* an SSRI, an MAOI or a TCA, then what category does it fall under?
Posted by sid on April 25, 2002, at 22:44:26
In reply to COMBINING ANTIDEPRESSANTS?! Can you even do that?, posted by DP on April 25, 2002, at 20:38:09
Combining antidepressants is common, although it is not always done as early as in your case in the course of treatment. It permits to affect neurotransmitters differently, with different molecules, in order to have better overall results. Also, depending on your side effects, they may complete one another.
Your idea of taking your current AD at night and Wellbutrin in the morning sounds good. I'm on Effexor XR myself and I may start Wellbutrin soon, taking the Effexor XR at night (which I currently do) and the Wellbutrin in the morning. My doc wanted to wait a while before giving me a second molecule, but the Effexor XR tends yo make me exhausted, so I may take Wellbutrin earlier than she initially thought. I recently switched from morning to evening dosage, which helped with my sleep and my energy level. But if the fatigue returns, I'll gove Wellbutrin a try. Many people take 2 or 3 ADs at once, it is very common. So your doc's recommendation is not unusual.- sid
Posted by mat on April 26, 2002, at 4:24:45
In reply to COMBINING ANTIDEPRESSANTS?! Can you even do that?, posted by DP on April 25, 2002, at 20:38:09
hi
bupropion (wellbutrin) is a NDRI, a noradrenaline and dopamine reuptake inhibitor.
mat
Posted by DP on April 26, 2002, at 9:59:48
In reply to Re: COMBINING ANTIDEPRESSANTS?! Can you even do that?, posted by mat on April 26, 2002, at 4:24:45
I heard that Wellbutrin doesn't have much effect on Dopamine at such low doses as what I'm taking (150mg qd).
Posted by mat on April 26, 2002, at 11:48:24
In reply to Wellbutrin and Dopamine » mat, posted by DP on April 26, 2002, at 9:59:48
> I heard that Wellbutrin doesn't have much effect on Dopamine at such low doses as what I'm taking (150mg qd).
hi!
from stephen m. stahls "essential psychopharmacology":
bupropion itself seems to have rather week dopamine reuptake-inhibiting properties, and weaker yet noradrenaline reuptake-inhibiting effects. bupropion is more of a "pro-drug" than a drug itself: it is metabolized to several (three?) different compounds, one of which (hydroxybupropion) seems to be the active metabolite, that is responsible for the antidepressant effects of bupropion.
i know that this doesn't answer your question exactly, but i can't find out more at the moment!
mat
Posted by Phil on April 27, 2002, at 7:41:48
In reply to Re: Wellbutrin and Dopamine, posted by mat on April 26, 2002, at 11:48:24
I think drug monotherapy is rare. I wish just one drug would work for me.
Current cocktail FWIW,
Celexa 60mg night
Clonazepam 2-3 mg time varies
Wellbutrin SR 200mg a.m. / 200mg 6 hours later
Adderall XR 60 mg / day 30 a.m. 30 noon or earlierHope this helps
Posted by henryO on April 28, 2002, at 3:37:01
In reply to COMBINING ANTIDEPRESSANTS?! Can you even do that?, posted by DP on April 25, 2002, at 20:38:09
It is called a cocktail. Not only can you do it but for many of us here it is the only thing that works. Thank God it does. I have four meds in my cocktail. It used to bother me too. Untill I came to see it as a packaging issue rather than anything else. Maybe one day the pharmacy will just put all this stuff together in one capsule. Till then mix and match has helped me crucially. All this with the blessing and supervision of my doctor.
Posted by Phil on April 28, 2002, at 7:21:37
In reply to Re: COMBINING ANTIDEPRESSANTS?! Can you even do th, posted by henryO on April 28, 2002, at 3:37:01
DP,
Amitriptyline is a dirty drug but it worked for me years ago. I had more SE on it than I do on 4 drugs.
Posted by ST on April 28, 2002, at 19:48:22
In reply to COMBINING ANTIDEPRESSANTS?! Can you even do that?, posted by DP on April 25, 2002, at 20:38:09
Hey there,
I've been on Wellbutrin in combination with a lot of different SSRIs over the past 5 years. What it has done is simply kick everthing in to gear. I was doing "OK" on Wellbutrin. But once I added an SSRI, my depression really lifted. It's pretty common, I guess.
Now, for a number of reasons, I'm tapering off Effexor (another SSRI). I'm going to see how I feel with just the Wellbutrin again as my sole AD. If I still need a boost to my seratonin levels, my pdoc wants to put me on a low level of a thyroid med. Now THAT I've never heard of - until recently. This web site is really informative.
Good luck,
Sarah
Posted by sid on May 1, 2002, at 16:42:01
In reply to Yes!, posted by ST on April 28, 2002, at 19:48:22
Just a little note, Effexor XR is a SNRI - seratonin and norepinephrin reuptake inhibitor. It is different from more common SSRIs, which only increase the amount of seratonin to the brain.
- sid
Posted by waterlily on May 2, 2002, at 16:57:54
In reply to COMBINING ANTIDEPRESSANTS?! Can you even do that?, posted by DP on April 25, 2002, at 20:38:09
I think everyone reacts differently to medications, so what works for me may not work for you. I have been on Wellbutrin SR 150 mg twice a day for many (4+) years now and have tried a few different SSRIs (Paxil, Prozac) and neither did any good at all to help with anxiety. The only thing they did was cause my marriage to be strained. I just started with Serzone in addition to the Wellbutrin a few months ago and have found it to be a very good addition. I am motivated and in a reasonably good mood most of the time.
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