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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Four Feathers on April 2, 2008, at 17:13:15
Last month I was prescribed 50mg daily of Wellbutrin SR. In the past I had tried the 150mg XR and this created nasty headaches and chest tightness. For days 2-4 of treatment at the 50mg dose I felt better than I had in many years. My mind was quiet, I was organized with thoughts and physical surroundings, I had a libido back, and I had an overall sense of calm like I remember having 15 years ago. I was not "overwhelmed" by simple tasks and approached things logically. I even sat down and began reading a book which is usually unheard of for me!
Unfortunately, this was short lived as the 5th and additional days on this dose caused a headache, bit of chest tightness, and increased blood pressure (which for me results in headaches). I discontinued this after about 8 days. Any thoughts on why this was effective for such a short time...possibly my body is very sensitive and the buildup was too much over time? I have tried stimulants in the past and all were overactivating and caused foggy headedness even at low doses (i.e. 5mg methylphenidate) with single dose.
After a couple of weeks, I then began Strattera at 25mg per day for about 4 weeks and recently went up to 50mg/day per pdoc. The first 2 weeks on Strattera saw a return to organization albeit, nothing like the Wellbutrin had provided. I do feel more relaxed for a few hours after taking the Strattera, but motivation and getting up and going in the morning is still very challenging. I now feel as though I am in a bit of a fog as I did before taking either WB or ST.I am also taking 10mg of Lisinopril (for hypertension) and 10mg of Lexapro.
Has anyone experienced or heard of medications at very low levels (below 50mg of Wellbutrin or 25mg of Strattera) being effective? Based on my symptomology of hypersomnia, low motivation, lack of organization, anhedonia, foggy head, etc I believe a norep and/or dopaminergic med would be of most benefit. Any thoughts on this, based on my limited symptomology shown above, is greatly appreciated.
Thank you!
4F
Posted by iforgotmypassword on April 3, 2008, at 17:22:36
In reply to Experiences with low dose Wellbutrin or Strattera?, posted by Four Feathers on April 2, 2008, at 17:13:15
feel my strattera may be fading on me too. :-(
are the capsules sustained release?
Posted by undopaminergic on April 3, 2008, at 18:20:48
In reply to Re: Experiences with low dose Wellbutrin or Stratt » Four Feathers, posted by iforgotmypassword on April 3, 2008, at 17:22:36
Have you tried modafinil (Provigil)? It should be less adrenergic than bupropion or methylphenidate, and more useful than Strattera for motivation. Otherwise, you can try to find an antihypertensive agent that neutralises the side effects of the Wellbutrin. Maybe a higher dose of the lisinopril, or an alpha1-antagonist.
Posted by Four Feathers on April 3, 2008, at 22:13:27
In reply to Re: Experiences with low dose Wellbutrin or Stratt, posted by undopaminergic on April 3, 2008, at 18:20:48
Thank you for the information. I have tried modafinil once at a low dose, I believe it was 100mg. It actually gave me headaches very similar to those experienced with the wellbutrin and methylphenidate. However, at that time I was on nothing other than the lisinopril. I tend to be very med sensitive, but am confident that the right cocktail can be found in time.
I meet with my pdoc tomorrow and am going to discuss this with him and bring up the possibility of perhaps trying modafinil and atomoxetine together as I have read that this is a very beneficial combo for some.
I understand that modafinil has effects on the histamine receptors as well as others. Does this help to "reset" the body's clock and help with getting up and going in the morning?
This is the end of the thread.
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