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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 Sari on September 23, 2006, at 1:08:38
My Dr started me on Wellbutrin this past January for mood iritability and fatigue. I felt better immediately on 150 mg once a day and still okay at 150 mg bid, but when I moved up to 450 mg (300 mg in am and 150 mg pm) I had insomnia (never a problem!), constant yawning, and shakiness. I went back down to 150 mg bid and it didn't seem to be as effective as before, so she added prozac (30 mg? am). I felt pretty good on this, but it may have been partially due to the sunshine since it was spring/summer ( I think I may have SAD). After about 2 months on the prozac I started to be unable to orgasm ( I have a low sex drive anyway - maybe due to OC? I stopped them recently too, since they also contribute to depression), so I stopped the prozac. Now that it's fall, I can feel the crankiness begin to creep in, so after discussing my options, my dr gave me samples of effexor xr (75 mg to start for 1 week and then 150 mg once a day). I am supposed to start this on Monday, following the weekend of no Wellbutrin. After reading the posts on Effexor, I am having second thoughts due to the side effects and withdrawal symptoms. Does anyone have any suggestions? Would cymbalta be a better choice. I am hesitant to take any more SSRI's due to the sexual side effects. And I'm worried that if I stop the Wellbutrin, it won't be effective if I start up again.
Posted by Meri-Tuuli on September 23, 2006, at 1:30:41
In reply to Wellbutrin to ???, posted by Sari on September 23, 2006, at 1:08:38
You sound as if you might benefit from St John's Wort; according to some studies affective for SAD and it doesn't affect your sex drive one bit. In fact, there aren't really any side effects.
If you do decide to go with the SJW, you'll need a washout period of a couple of weeks. I don't what your docs attidude to SJW would be. They sometimes don't like it when you take non-convenctional drugs, but if he's a good doc, he'll only care about whats best for you, not how many scripts he fills for Big Pharma Drug X.
See: http://www.sjwinfo.org/ a sort of babble just for SJW.
Kind regards
Meri
Posted by Sari on September 23, 2006, at 2:45:59
In reply to Re: Wellbutrin to ???, posted by Meri-Tuuli on September 23, 2006, at 1:30:41
What about something to counteract the sexual side effects of prozac (ie.. continuing with the wellbutrin and prozac plus??)? Has anybody had any success with that? Or something to take the edge off a higher dose of wellbutrin?
Posted by Sari on September 23, 2006, at 2:49:32
In reply to Re: Wellbutrin to ???, posted by Sari on September 23, 2006, at 2:45:59
My only concern with the SJW is that, since it's not FDA regulated, the concentration and inactive ingredients are variable.
Posted by Meri-Tuuli on September 23, 2006, at 4:00:27
In reply to Re: Wellbutrin to ???, posted by Sari on September 23, 2006, at 2:45:59
I think Ginkgo biloba works to counteract the sexual side effects of the SSRIs...
But are you waking wellbutrin + prozac together? If so, I was under the impression that wellbutrin counteracted some of the side effects of prozac, including the sexual side of things.
Posted by Meri-Tuuli on September 23, 2006, at 4:09:05
In reply to Re: Wellbutrin to ???, posted by Sari on September 23, 2006, at 2:49:32
> My only concern with the SJW is that, since it's not FDA regulated, the concentration and inactive ingredients are variable.
No, you don't need to worry about that -- as long as you buy a reputable brand, for instance Kira, or Perika. And make sure it says 'standarised to contain...' They specically standarise the ingrediants, and are pretty scruperlous about the whole thing.
Seriously, I would bet that prozac and wellbutrin are far more likely to produce serious adverse effects than SJW. Although I do believe that SJW should be treated along the lines of drug. That being said, even grapefruit juice has some interactions (and that isn't FDA regulated), and I guess any substance has serious interactions if you're allergic to it.
Honestly, SJW was by far more helpful to me than prozac, celexa, effexor, reboxetine, wellbutin, moclobemide, ever were.
I wouldn't dismiss it too readily just because its not FDA regulated.
Posted by alexandra_k on September 23, 2006, at 7:02:59
In reply to Wellbutrin to ???, posted by Sari on September 23, 2006, at 1:08:38
> My Dr started me on Wellbutrin this past January for mood iritability and fatigue. I felt better immediately on 150 mg once a day and still okay at 150 mg bid, but when I moved up to 450 mg (300 mg in am and 150 mg pm) I had insomnia (never a problem!), constant yawning, and shakiness.
Can I ask why your Dr kept increasing the dose when you felt better on 150?
Posted by SLS on September 23, 2006, at 8:04:40
In reply to Wellbutrin to ???, posted by Sari on September 23, 2006, at 1:08:38
I would consider decreasing the Wellbutrin to 300mg/day and add either Effexor or Lexapro.
These are very safe combinations. There is really no downside to leaving the Wellbutrin in there. If anything, it will continue to give you energy and perhaps counter any sexual dysfunction that these drugs produce. I know someone doing very well on Wellbutrin + Lexapro who remains orgasmic. She also did well on Wellbutrin + Effexor, but made the switch to Lexapro to explore its potential benefits. She likes it better.
- Scott
Posted by Phillipa on September 23, 2006, at 9:42:02
In reply to Re: Wellbutrin to ??? » Sari, posted by SLS on September 23, 2006, at 8:04:40
Yeah me too. But it made me horribly panicky. Just me I guess Love Phillipa
Posted by Sari on September 23, 2006, at 13:44:43
In reply to Re: Wellbutrin to ??? » Sari, posted by Meri-Tuuli on September 23, 2006, at 4:00:27
She increased the wellbutrin to 450 mg because even though I felt better, I was feeling probably 70-80% better, not quite back to normal. When I couldn't tolerate the increase and dropped back down, I still felt better than before the meds, but not as good as I did before I went from 300 to 450 mg. I didn't have any sexual side effects form Wellbutrin (positive or negative - I was hoping for an increase in sex drive since I had read that that was a side effect for many people). I didn't notice anything at first with the prozac, but after a few months I couldn't orgasm which was really frustrating. Since I have stopped prozac, I have regained that ability.
As far as taking wellbutrin with lexapro or effexor, what do they add?
Posted by SLS on September 24, 2006, at 9:25:47
In reply to Re: Wellbutrin to ???, posted by Sari on September 23, 2006, at 13:44:43
> She increased the wellbutrin to 450 mg because even though I felt better, I was feeling probably 70-80% better, not quite back to normal. When I couldn't tolerate the increase and dropped back down, I still felt better than before the meds, but not as good as I did before I went from 300 to 450 mg. I didn't have any sexual side effects form Wellbutrin (positive or negative - I was hoping for an increase in sex drive since I had read that that was a side effect for many people). I didn't notice anything at first with the prozac, but after a few months I couldn't orgasm which was really frustrating. Since I have stopped prozac, I have regained that ability.
>
> As far as taking wellbutrin with lexapro or effexor, what do they add?They can add a brightening of mood and a sense of desire to do things. You actually come to "like" things and get involved in life more. Sometimes, this is counteracted by side effects of apathy and amotivation, so it is better to find the lowest effective dosage of the Effexor or Lexapro. Effexor might be less apt to produce sexual side effects and problems with apathy. However, you never know. Lexapro might be the perfect drug for you. I would really consider keeping the Wellbutrin, though.
You can try adding Lamictal to the Wellbutrin first if you are reluctant to add a SRI (serotonin reuptake inhibitor). It should not have any sexual side effects. It takes 5 weeks to build up to a therapeutic dosage, though. The reason for the gradual dose increase is to prevent certain adverse reactions. Once you arrive at your target dosage, it is a remarkably clean drug.
- Scott
This is the end of the thread.
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