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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by Fearful on May 10, 2002, at 16:45:33
I really need some info on WBSR. I have been on it now for seven days (150 mg. once a day). I am scheduled to go to two a day, but I am afraid that my side effects will be compounded. I am having terrible insomnia and an uneasy, panicky feeling. So first...has anyone had any success with staying at 150 once a day. My depression is mild, just meloncholy and anxiety. I got to my MD fast. I was severely depressed 12 years ago, so I didn't wait. Second...will the side effects be worse by increasing...or just stay the same. I am afraid, but lately I'm afraid of most everything. Which brings me to last WBSR question.....Does fear and anxiety usually accompany depression. THANKS SO MUCH FOR ANY INFO FROM YOU EXPERIENCED WBSR USERS!!
Posted by Phil on May 10, 2002, at 16:58:31
In reply to Wellbutrin Questions, posted by Fearful on May 10, 2002, at 16:45:33
Fear and anxiety go hand in hand with depression. Ask your doc if you can stay at 150 another week. It never hurts to go low and slow.
WBSR can make one a bit irritable, some people if not most. I would talk with your doc about the panic and sleep problems. Don't want to advise poly pharmacy but you could get a 30 day supply of Zanax and take PRN. Wellbutrin is an activating med so with panic, I'm surprised that was his first choice. Is he a psychiatrist or an MD?
If he's an MD, find a good psychiatrist. Lots more options than 12 years ago.Writing fast..leaving work.
You can do a search on WBSR at the top of the page and get more info than you can shake a stick at.
Good luck
Posted by allisonm on May 10, 2002, at 21:18:35
In reply to Re: Wellbutrin Questions, posted by Phil on May 10, 2002, at 16:58:31
Hi. I've taken WBSR since June of 1999, up to 400mg/day. I would suggest going slow as you start. When I started WB, it was an augment to Remeron 'cause I was sliding downhill and Rem couldn't stop it. I have depression with anxiety. Over time, doses were adjusted and now WBSR is my primary drug. Remeron became an augment, then was dropped, and then several others were tried as augments with not much better results over the long-term. My pdoc and I are looking for another augment to try. Keeping WBSR as the primary, though. It's the most effective for me.
As Phil said, WB will make you irritable for a couple of weeks. Then you may feel a time of tremendous energy. I got all kinds of things done. It was great and I felt good. Too good: that's a side-effect too. Do not think that it has pooped out when the energy wears off -- that means the WB is jjust starting to work. It will take several weeks for you to experience this. I would wait until you have adjusted on the first dose. If anything, why doesn't your doc put you on 100mg (blue) tablets and double that to 200 sted 150 to 300? 400 is about the max dose. Also remember that every time your dose is increased, you will experience the irritability etc. again. That will not go away with dose increase, just so that you know.
I don't see why you have to go up that fast. It may well work for you, but if you are hit with unbearable side-FX from starting too high, you'll never know 'cause you will have quit taking it long before the benefits start up.
Just my opinion. Your mileage, of course, will vary. I agree with Phil. If you don't already have a psychiatrist, I would seek out a good one from the start. Finding a good pdoc who know his/her stuff will safe you a LOT of time in your search for a solution.
Some other things to keep in mind: STOP caffeine intake; it will only make the irritability and the hand tremor worse! You may eventually be able to work it back in if you want, but you will be happier if you can cut it out while titrating up. Also, don't take WBSR too late in the day because it might interfere with your sleep. I don't take mine later than 3pm.Hope this helps.
Good luck.
Allison
Posted by Fearful on May 10, 2002, at 21:42:41
In reply to Re: Wellbutrin Questions, posted by allisonm on May 10, 2002, at 21:18:35
Thanks so much to Phil and Allison for the advice. Yes I am with my MD. I am a self-pay and I just can't spring for the pdoc right now. I can tell by our conversations that although he cares...he's just not that knowledgable in this area. I am feeling better everyday, and I am praying that the 150 once a day will do the trick. I am so afraid to go to twice a day, especially since the side effects are just getting better after 7 days. I hope someone who has been successful with this low dose will respond to give me some hope. Also a non-smoker for 14 days....I am proud of myself, but putting down the cigs is exactly what brought on this depression...I am sure of that. But I will not start that again. You can treat depression but lung cancer isn't so easy they say. Thanks Again. I don't feel so alone anymore. Fearful (still)
Posted by paxvox2000 on May 11, 2002, at 20:11:55
In reply to Re: Wellbutrin Questions, posted by Fearful on May 10, 2002, at 21:42:41
Give the WB a chance to work. Twice a day does take a while to adjust to, but it is NOT the highest dose used. I agree with the post about using the 100 mg pills to go up to 200 before 300 if that helps you. Just make sure never to split the pills in half.
Also, I WOULD ask for a benzo to help the rough edges of WB. I have been on Klonopin, and now Tranzene. W/O the benzo, I would have the other irritability and anxiety issues to deal with as well. Keep with it, I don't think it will hurt you. It may take a montht to 6 weeks to get the full therapeutic effects.
PAX
Posted by terra miller on May 11, 2002, at 23:05:36
In reply to Wellbutrin Questions, posted by Fearful on May 10, 2002, at 16:45:33
hi. hang on and go slow. i don't think wellbutrin is something to jump fast to up. yes, anxiety comes with depression. also, if you are stopping smoking (i did also) i found it hard to readjust to finding other ways to cope... the wellbutrin was making me agitated but i didn't want to smoke, but that's what i did to deal with being agitated before... you see the cycle? i had to find other ways to handle it than smoking. you might be experiencing some of that.
taking a benzo helps in the first if you need it. i still do from time to time.
you can do the 100mg s.r. if you want to go up slower. i personally think it's better to spread doses out over the day for uniformity, but that's MHO and i'm not a doc. i ended up using the immediate release which comes in 75mg tablets because i needed to spread it out over the day because i can't tolerate more than that at once.
it takes time - weeks- to get to the right dose for you. you have to be patient, which is a drag when you don't know if this is working or not. but the support here can really help you get through the first weeks.
if you can't get to a psychiatrist but are willing to read and read to educate yourself, you might do just fine with your MD but you just might have to work a little harder educating yourself on what you need to do. (i have a psychiatrist who is good, but i still read and read anyway because i want to know what's going on.)
take care,
terra
Posted by Fearful on May 12, 2002, at 11:01:55
In reply to Re: Wellbutrin Questions » Fearful, posted by terra miller on May 11, 2002, at 23:05:36
Just a quick update. Still on the WBSR 150, still just once a day. Still a little shakey, but I actually have a hint to add instead of another question. I spent the day at a theme park yesterday. Walking all day and really enjoying myself with hubby and kids. Guess what...I slept pretty good last night. Not straight through, but I only woke say three times. Maybe exercize helps. I can't do that much everyday, but I guess I will try to pick it up a bit. I'm feeling much better, still a little shaky, and every now and again I have a little wave of feeling all alone, even when I'm with my family. It's a scary feeling, but it goes away pretty fast. Keep the info coming. I really appreciate it soooo much. This is a life-line. Thanks Again
Posted by Fearful on May 12, 2002, at 11:28:46
In reply to Re: Wellbutrin Questions » Fearful, posted by terra miller on May 11, 2002, at 23:05:36
Another question, almost forgot....I'm slightly dizzy all the time???? Normal I guess. Hope it doesn't last.
Posted by terra miller on May 12, 2002, at 19:20:22
In reply to Re: Wellbutrin Questions, posted by Fearful on May 12, 2002, at 11:28:46
dizzy or a buzzing feeling is something i also experience.
Posted by TedR on May 13, 2002, at 1:23:55
In reply to Re: Wellbutrin Questions » Fearful, posted by terra miller on May 12, 2002, at 19:20:22
It is funny about Wellbutrin. I thought it was going to be the answer for me but since the pdoc has bumped up the dose to get a more fuller AD effect. 400mgs/day. I have been agitated, constantly worrying, moody,(had to have a couple of beers to stop that)jittery. unsure of myself. he will probably tell me to drop the dose down for a While, but haven't gotten the AD effect at 300 mgs/Day, and I just need to relax and get my mood steady ,consistent, and light again. I am driving myself and my wife crazy.
Posted by terra miller on May 13, 2002, at 6:00:52
In reply to Re: Wellbutrin Questions, posted by TedR on May 13, 2002, at 1:23:55
i didn't see the AD effects for nearly 6 months. it just happened one day and i remember thinking, wow... this is different. all of a sudden i was mellowing out. but it sure took it's time! :-) hope it kicks in soon for you, too
~terra
Posted by Roo on May 13, 2002, at 9:14:16
In reply to Re: Wellbutrin Questions » TedR, posted by terra miller on May 13, 2002, at 6:00:52
I've tried to take wellbutrin 2 different times and
each time I felt really angry and irritable...I didn't
get that 'peaceful' feeling I get on the SSRI's. I'd
really like the Wellbutrin to work for me b/c of the
no sexual side effects....maybe I just haven't been able
to make it through the irritability phase...is it normal
for it to last a little over a month without much of a
feeling of improvement over the depression? I don't know
if I should just wait it out, or if it just isn't for
me. The ssri's always work great for me, and really
quickly...but those darn sexual side effects! ugh!
Posted by TedR on May 13, 2002, at 11:27:30
In reply to Re: Wellbutrin Questions--about irritability, posted by Roo on May 13, 2002, at 9:14:16
> I've tried to take wellbutrin 2 different times and
> each time I felt really angry and irritable...I didn't
> get that 'peaceful' feeling I get on the SSRI's. I'd
> really like the Wellbutrin to work for me b/c of the
> no sexual side effects....maybe I just haven't been able
> to make it through the irritability phase...is it normal
> for it to last a little over a month without much of a
> feeling of improvement over the depression? I don't know
> if I should just wait it out, or if it just isn't for
> me. The ssri's always work great for me, and really
> quickly...but those darn sexual side effects! ugh!
> I have had a similar situation except for some down right apathy with the SSRIs. What bothers me about the Wellbutrin this time is that I not only feel irritated, jumpy, nervous, but my mood is very flat. I am not sure what is going on..TR
Posted by mair on May 13, 2002, at 13:30:14
In reply to Wellbutrin Questions, posted by Fearful on May 10, 2002, at 16:45:33
I can't do much other than to endorse what others have said. I've always found it necessary to titrate WB slowly. I've been on it for years now, but discovered that with a recent increase, I still went through about a week of pretty unpleasant side effects, including dizziness and agitation. I reported to my pdoc that it was like my brain couldn't keep up with my heart rate. That was with a 100 mg increase. Previous increases were much smaller - 25 or 50 mgs and brought some side effects as well.
Although i tolerate WB well, I've always taken klonopin as well. When I went through this recent increase, I added xanax at night because I wasn't getting to sleep well enough with klonopin alone.
WB does take a long time to kick in and it's never going to bowl you over with its effectiveness. I quit once after I started, and then started up again and just kept taking it not because I thought it was really working but more because I could tolerate it. At some point it finally dawned on me that I had been doing pretty well for awhile.
I'm perennially in search of a good augmentation drug because I don't think WB really works as well as I need it to. However, a couple of different pdocs have endorsed the idea that I should keep it as my primary drug.
Lastly, WB is probably the only AD that will actually help you quit smoking.
Mair
Posted by sl on May 13, 2002, at 18:57:19
In reply to Re: Wellbutrin Questions » Fearful, posted by mair on May 13, 2002, at 13:30:14
> WB does take a long time to kick in and it's never going to bowl you over with its effectiveness. I quit once
Please don't assume your experience is the only one.
For me it kicked in at about 2 1/2 weeks, and indeed it DID "bowl me over with its effectiveness."
I'm almost a normal person thanks to Wellbutrin...it DOES work for some people, and sometimes when nothing else does (for me, no other meds have worked without disabling side-effects!).sl
Posted by terra miller on May 13, 2002, at 22:10:57
In reply to Re: Wellbutrin Questions--about irritability, posted by Roo on May 13, 2002, at 9:14:16
roo- i have no idea what to expect as "normal" :-) but i know that for me i was well into the second month before i got a small handle on the irritability. heck, for me, it was more like rage. i was really angry. what i noticed first was my adjusting to it (ie: i stopped being so angry) and that's when i got all this energy and was really high. 6 months or so into it there started to rise in me a sense of wellbeing and contentment. but it took that long.
i've tried serzone and zoloft previously, long enough to know how they work on me and i would say that they kicked in as far as AD affects long before wellbutrin did. zoloft made me calm, but i couldn't feel. wellbutrin revs me up and finally gives me a calming but i also can feel and focus.
i'm not sure if i'd have stuck with the wellbutrin if i didn't have people here who told me to hang in there because the anger phase was really tough. it helps to have people encouraging you.
for what it's worth. :-)
~terra
Posted by ST on May 14, 2002, at 3:33:28
In reply to Wellbutrin Questions, posted by Fearful on May 10, 2002, at 16:45:33
Hi,
Yes, fear and anxiety often accompany depression. Wellbutrin has been a great drug for me. I've been on 300 mg for about 6 years, along with Depakote and various SSRIs added to the mix. The anxious, panicky feelings *do* go away. Your body adjusts. Once things settle down with the side effects, then you can see if perhaps the dose should be raised to further help your depression. I don't think the side effects got *worse* when I upped my dosage, but every time I have a dose increase on any AD, I get anxious, panicky and ill feeling for a little while. It always goes away.
Sarah
Posted by Fearful on May 14, 2002, at 6:01:24
In reply to Re: Wellbutrin Questions, posted by ST on May 14, 2002, at 3:33:28
Good News Here! At day number nine my side effects almost completely disappeared. Sleep is still not easy, but I manage to get enough I think. I'm feeling better, more like my old self. I am still fearful to go up to 300. My doc seems to think it won't be a big deal, and that jump is recommended in the literature. I at least have the hope that the side effects will pass, hopefully it won't take nine days of not sleeping and shaking. Anyone else who's made the jump from 150 to 300, let me know. If it bother me too much I go back down right? Maybe I could do the extra 150 every other day? Any wisdom would be appreciated. Thanks
Posted by terra miller on May 14, 2002, at 8:28:20
In reply to Re: Wellbutrin Questions, posted by Fearful on May 14, 2002, at 6:01:24
great news!
i think generally speaking that each increase has return of side effects but not to the extreme as when you just started up. just adjusting.
terra
Posted by mair on May 14, 2002, at 13:41:35
In reply to Re: Wellbutrin Questions, posted by sl on May 13, 2002, at 18:57:19
I see your point and obviously wasn't as clear as I should have been. The point I was trying to make was not that it doesn't work or that it can't work quickly, rather only that the fact that it hasn't kicked in quickly does not mean it isn't going to be a very effective drug. Before WB I had definitely struck out with prozac, effexor and luvox. Since starting it, I have tried to augment it at different times with sam-e, zoloft, serzone and lamictal. I've now taken it for about 5 years I think and throughout that period, it's been the only constant in my drug arsenal. While I wish it could do more for me, I can't deny that it's made an enormous difference to me.
Mair
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