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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Kat26 on April 25, 2003, at 14:02:09
Hello all,
if any of you have experience with Wellbutrin, could you write a little bit about it? A friend of mine is thinking about suggesting it to her doctor. She has been on Prozac for many many years but she just still gets so depressed and maybe it isn't working that well for her anymore. Wellbutrin would be nice because she is terrified of anything that causes weight gain (she has an eating disorder). Would Wellbutrin be an option?
Kat
Posted by Snoozy on April 25, 2003, at 15:02:41
In reply to Wellbutrin, posted by Kat26 on April 25, 2003, at 14:02:09
Hi Kat -
I've been on Wellbutrin for about 3 years. (I was also on it 10 years ago for a while). One of my main problems is excessive sleepiness/tiredness so I was looking for an AD with a stimulating side effect profile. I seem to have fewer side effects from Wellbutrin than the SSRI's (mainly headaches). When I first started (at 300mg) I did have insomnia for a few weeks, which I didn't mind, it was a novelty to feel awake. I've been on 400mg for about 2 years.
There was some concern about using Wellbutrin in people with eating disorders, particularly bulimics, as they seemed to have a higher incidence of seizure with the drug. I don't know what the current view on that is.
I'm rather thin, although I do not have an eating disorder, and I've been fine with Wellbutrin. My weight has stayed the same this whole time. Hope this helps some - I'd be happy to try and answer any other questions about my experience.
> Hello all,
>
> if any of you have experience with Wellbutrin, could you write a little bit about it? A friend of mine is thinking about suggesting it to her doctor. She has been on Prozac for many many years but she just still gets so depressed and maybe it isn't working that well for her anymore. Wellbutrin would be nice because she is terrified of anything that causes weight gain (she has an eating disorder). Would Wellbutrin be an option?
>
> Kat
Posted by paxvox on April 25, 2003, at 15:56:56
In reply to Wellbutrin, posted by Kat26 on April 25, 2003, at 14:02:09
Snoozy has good points. I have been on Wellbutrin since 1997. The reason it is *generally* NOT recommended for people with weight/eating disorders stems from the fact that most people WILL lose weight on WB (which might negatively reinforce eating aversions). Secondly, because they are slight of frame the drug would be in a higher concentration in the blood and serum levels. Seizure threats took WB off the market in the 1980's, It was actually developed in the 1970's. However, the dose used was too high, and seizures DID happen. WB was revisited in the early 90's as an alternative to SSRI AD meds. IT works differently than serotonin meds in that it works mainly on dopamine. It mirrors amphetamines in many of it's actions, though it is not chemically related to them. This is why it works for attention deficit problems and for people without "energy" to concentrate. I am very sensitive to dose levels. However, there are now many dosing options available with the "standard" 150MG SR (sustained release) and the newer 100mg pills. There are also immediate release formulations. They MAIN side effects I have had are jitters, shakiness and some chest tightening (as well as sleep problems). The sleep problems can be reduced by taking last dose no less than 6-8 hours before bedtime. Or better yet, the addition of a benzo to "take the edge off". There is a great deal of literature on this board, as well as on the WEB about Wellbutrin.
PAX
Posted by ricardo on April 25, 2003, at 22:08:08
In reply to Re: Wellbutrin, posted by paxvox on April 25, 2003, at 15:56:56
Hi
My experience with Wellbutrin was not a very positive one. I started on it right after a one-month trial period with Paxil. Paxil had made me too sleepy and I was having the famous ejaculation delay problem, so my doctor suggested that I take Wellbutrin. At first, I felt great, but I still think it could still be the Paxil working on me. However, still in the first week, I had some rage attacks that really scared me (and others). Those went away, fortunately. About two months later, I had a major relapse of my depression. Depressed as I was, I decided to stop taking it (I had never missed one tablet ever!) Two weeks later, I decided to go back on it. The rage attacks started again, and once again I was scared. This time I decided to quit it once and for all. My therapist says that I might have insisted on it. She believes that it was the circumstances of my life that caused the relapse of my depression, and not the fact that Wellbutrin was uneffective for me. I could have asked my doctor to adjust the dosage, but I didn't. After a short and even more negative attempt with Tofranil, I'm now in my first week on Effexor. So far so good. I'm hopeful this time I'll be able to stay on it. Back to Wellbutrin, I was really sorry that it wasn't effective for me (considering that it really wasn't), because I was hoping to profit from the side-effects as well, such as weight loss and greater libido. However, I lost more weight while on Paxil that on WB. My libido was OK (normal), but I did get impotent once or twice.
Anyway, that's my experience on it.
Cheers,
Ricardo
Posted by Snoozy on April 25, 2003, at 22:24:37
In reply to Re: Wellbutrin, posted by ricardo on April 25, 2003, at 22:08:08
Hi Ricardo -
I was just curious what dose of Wellbutrin you were on. I'm sorry it didn't work out for you - I hope the Effexor does.
> Hi
>
> My experience with Wellbutrin was not a very positive one. I started on it right after a one-month trial period with Paxil. Paxil had made me too sleepy and I was having the famous ejaculation delay problem, so my doctor suggested that I take Wellbutrin. At first, I felt great, but I still think it could still be the Paxil working on me. However, still in the first week, I had some rage attacks that really scared me (and others). Those went away, fortunately. About two months later, I had a major relapse of my depression. Depressed as I was, I decided to stop taking it (I had never missed one tablet ever!) Two weeks later, I decided to go back on it. The rage attacks started again, and once again I was scared. This time I decided to quit it once and for all. My therapist says that I might have insisted on it. She believes that it was the circumstances of my life that caused the relapse of my depression, and not the fact that Wellbutrin was uneffective for me. I could have asked my doctor to adjust the dosage, but I didn't. After a short and even more negative attempt with Tofranil, I'm now in my first week on Effexor. So far so good. I'm hopeful this time I'll be able to stay on it. Back to Wellbutrin, I was really sorry that it wasn't effective for me (considering that it really wasn't), because I was hoping to profit from the side-effects as well, such as weight loss and greater libido. However, I lost more weight while on Paxil that on WB. My libido was OK (normal), but I did get impotent once or twice.
>
> Anyway, that's my experience on it.
>
> Cheers,
> Ricardo
Posted by Rocket Jackson on April 26, 2003, at 0:39:02
In reply to Re: Wellbutrin » ricardo, posted by Snoozy on April 25, 2003, at 22:24:37
I tried Wellbutrin SR for a few months last summer in an attempt to treat my Social Anxiety, as I was attracted to its lack of sexual side effects. As it turns out, it actually ended up exacerbating my condition at times. I felt very anxious and irritable the majority of the time I was on it, and as a result of being so ramped up on it during the day (I was taking 150mg in the am and then around 3pm) I was usually exhausted by late evening (this went away after a few weeks). I also experienced some unwanted weight loss (though this may be beneficial to some).
Having said this, I can definitely see how this med might work well for someone who functions more on a depressed or dysthymic level as compared to a more anxious person such as I am. I have also heard of it working well in the augmentation of other meds such as the SSRIs, which often cause fatigue and weight gain. I may end up having to add it to the Zoloft I'll be trying soon for these very reasons. :)
Best of luck!
Rocket
Posted by Viridis on April 26, 2003, at 1:11:11
In reply to Wellbutrin, posted by Kat26 on April 25, 2003, at 14:02:09
Wellbutrin is good for some, but be extremely careful if you're prone to anxiety -- it can REALLY increase this. I'm a case in point; WB dramatically increased my anxiety and caused a bunch of strange side effects (dizziness, anger, "stuffy head" feeling, shaking, light sensitivity, etc.). I can't tolerate it at all, but I know people who have done very well with it.
Posted by Kat26 on April 26, 2003, at 5:35:27
In reply to Re: Wellbutrin » Kat26, posted by Viridis on April 26, 2003, at 1:11:11
Thank you all for relpies so far. They have been extremely helpful!
Kat
Posted by Snoozy on April 26, 2003, at 10:52:50
In reply to Re: Wellbutrin - Thanks, posted by Kat26 on April 26, 2003, at 5:35:27
I was just wondering if your friend had considered augmenting the Prozac with another drug. Prozac is marketed for eating disorders, and perhaps if she added another AD that would give her more relief.
I don't know what that might be - but there are plenty of people here that have experience with various combinations!
Just another option perhaps....
Posted by ricardo on April 26, 2003, at 11:51:45
In reply to Re: Wellbutrin - others? » Kat26, posted by Snoozy on April 26, 2003, at 10:52:50
My dose was really small, as far as I understand: 75mg/day. As soon as I got my first prescription, I had to travel for a month, so it wasn't possible for me to actually see my pdoc during that period and make any adjustment to my dosage.
Good luck,
Ricardo
Posted by Sarah S on April 26, 2003, at 14:01:12
In reply to Re: Wellbutrin - others?, posted by ricardo on April 26, 2003, at 11:51:45
I have always had extreme anxiety, especially social anxiety, so I was a little nervous about starting Wellbutrin. And yeah, for the first week it did increase some of my anxiety symptoms, such as noise sensitivity and jitteriness. But after about two weeks (and after adding a benzo) it kicked in great--it gave me more confidence and motivation, which helped a lot with the depression. It isn't a silver bullet--my social phobia is better but it's still a big problem, and sometimes I cry for no reason. It also makes me nauseated, which really sucks. But overall it's been pretty good for me, and I'm hoping that adding another med will make it even better. So even if you've got anxiety, I'd say give it a try--its effects are different for everyone and sometimes even really nervous people like me can benefit from it.
Posted by fendel on April 26, 2003, at 15:12:31
In reply to Wellbutrin, posted by Kat26 on April 25, 2003, at 14:02:09
Hi, I've been on Wellbutrin for almost 8 years. It has worked extremely well for me. I'm on 400mg/day of the SR formulation.
When I was first diagnosed, my primary doctor prescribed Paxil. For the 30 days I was on Paxil, I was exhausted (make that "more exhausted"... my depression made me tired to begin with), I had trouble concentrating, my sex drive evaporated, and I felt miserable. I did a little research, went back, and asked for Wellbutrin. Been on it ever since.
I noticed an effect within 12 hours of my first dose--it was like my world went Technicolor. (The package insert mentioned "unusual feeling of well-being" as a possible side effect. Gimme more of those side effects!) Generally I've found it energizing. The only side effects I've experienced have been occasional dry mouth and increased heart rate & blood pressure (which I take a beta blocker for).
From what I've read, Wellbutrin is thought to work on norepinephrine and dopamine, while Prozac and other SSRIs (Paxil, Zoloft, Celexa) work on serotonin. (Apologies if this info is too basic, but I don't want to assume.) My poor response to Paxil and, later, Celexa (an attempt to augment the Wellbutrin when some symptoms resurfaced) suggests to me that the serotonin drugs are not the answer for me. If the Wellbutrin stops working for me, I'll be looking
into other norepinephrine/dopamine-related drugs.A friend of mine had a similar experience--Celexa didn't help her, Wellbutrin felt like a miracle to her. I have another friend who was too irritable and anxious on Wellbutrin and feels better on Prozac. YMMV.
That's my two cents...Good luck,
fendel
Posted by zeliva on April 27, 2003, at 0:26:37
In reply to Re: Wellbutrin » Kat26, posted by fendel on April 26, 2003, at 15:12:31
I take Prozac 40mg with 100mg Wellbutrin. I have been on the WB for about a month. I haven't felt this good in a long time. I am finally feeling back to my old self. I don't know what they do together but it has been working. I also had anxiety problems when I tried it a few months ago, so I was hesitant to try it again. It has been good so far. Good luck.
jill
Posted by Kat26 on April 30, 2003, at 2:24:49
In reply to Re: Wellbutrin, posted by zeliva on April 27, 2003, at 0:26:37
Hello,
my friend started taking Wellbutrin now. Her doctor doesn't seem to monitor her at all. She has anorexia, but she says the seizure risk is probably just increased for somebody with a history of bulimia, but not anorexia. Is that true?
Kat
Posted by fairnymph on May 2, 2003, at 22:03:38
In reply to Re: Wellbutrin - dangerous with anorexia?, posted by Kat26 on April 30, 2003, at 2:24:49
From what I could find, that seems to be the case -- that it is safe for anorexics.
I still think it's a bad idea...as they tend to be already thin and bupropion can cause weight loss.
fn
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