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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Thereishope on March 1, 2004, at 20:14:11
Today I had my first panic attack in about one year.
I was on 300mg. of Wellbutrin XL, which caused my blood pressure to become substantially elevated so I was prescribed Microzide for my bp. My blood pressure remained high, so my internal med. dr. and I decided to lower the Wellbutrin to 150mg. Now my bp is back to my normal range of 107/69.
Since taking the 150mg of Wellbutrin XL I've began feeling some of the old anxiety, ocd (more c than o), depression an IBS. Today after being on 150mg. for almost 5 weeks I had a panic attack. I've had signs for weeks that this was coming.
Has anyone else experienced anything like this when they lower their dosage or weaned from Wellbutrin?
I can not go back up because of my blood pressure. I can't tolerate SSRI (Zoloft, Celexa, Paxil, Lexapro, Prozac). I have tried Remeron and Zyprexa both once...Ahhh...I hate to think about how they made me feel.
I'm thinking about trying Desipramine...any suggestions for someone with panic disorder which triggers depression???????
I need some positive feedback.
Thanks.
Posted by zeugma on March 1, 2004, at 20:19:02
In reply to Withdrawal from Wellbutrin, posted by Thereishope on March 1, 2004, at 20:14:11
Desipramine is actually known to have antipanic efficacy, unlike Wellbutrin. If you liked WB, desipramine would probably work as well. But you never know till you try.
Posted by Thereishope on March 2, 2004, at 17:29:35
In reply to Re: Withdrawal from Wellbutrin » Thereishope, posted by zeugma on March 1, 2004, at 20:19:02
Thanks for replying. Have you tried Desipramine? What was your experience?
> Desipramine is actually known to have antipanic efficacy, unlike Wellbutrin. If you liked WB, desipramine would probably work as well. But you never know till you try.
Posted by zeugma on March 2, 2004, at 17:43:33
In reply to Re: Withdrawal from Wellbutrin » zeugma, posted by Thereishope on March 2, 2004, at 17:29:35
> Thanks for replying. Have you tried Desipramine? What was your experience?
>
>
> > Desipramine is actually known to have antipanic efficacy, unlike Wellbutrin. If you liked WB, desipramine would probably work as well. But you never know till you try.
>I've never tried desipramine, but I have been taking nortriptyline for the past year and a half, which is similar, and it has helped me tremendously with functioning and coping with life. The major side effects are constipation and dry mouth, which are common to most of the TCA's as well as any drug that increases NE transmission.
Another drug which is like desipramine, but much more expensive, is Strattera. I am taking this one too. I am going to ask my pdoc next time I see him what he thinks about someone who seems to need two NE reuptake inhibitors. I can only think that I have major noradrenergic dysregulation, leading not only to severe depression but also responsible for severe inattentive ADD and anxiety. I doubt he'll say anything I don't know already- such is the state of psychiatry.
>
Posted by Thereishope on March 2, 2004, at 21:09:53
In reply to Re: Withdrawal from Wellbutrin, posted by zeugma on March 2, 2004, at 17:43:33
I've read that the side effect of constipation and dry mouth usually subsides in a couple of weeks. Have you found this to be true?
> > Thanks for replying. Have you tried Desipramine? What was your experience?
> >
> >
> > > Desipramine is actually known to have antipanic efficacy, unlike Wellbutrin. If you liked WB, desipramine would probably work as well. But you never know till you try.
> >
>
> I've never tried desipramine, but I have been taking nortriptyline for the past year and a half, which is similar, and it has helped me tremendously with functioning and coping with life. The major side effects are constipation and dry mouth, which are common to most of the TCA's as well as any drug that increases NE transmission.
>
> Another drug which is like desipramine, but much more expensive, is Strattera. I am taking this one too. I am going to ask my pdoc next time I see him what he thinks about someone who seems to need two NE reuptake inhibitors. I can only think that I have major noradrenergic dysregulation, leading not only to severe depression but also responsible for severe inattentive ADD and anxiety. I doubt he'll say anything I don't know already- such is the state of psychiatry.
>
>
> >
>
>
Posted by zeugma on March 3, 2004, at 5:08:46
In reply to Re: Withdrawal from Wellbutrin » zeugma, posted by Thereishope on March 2, 2004, at 21:09:53
I found that on nortriptyline alone, the side effects mostly went away after 3 weeks at my maintainance dose (75 mg). Adding Strattera was like doubling the dose again (except for sedation effects). Also, I have chronic digestive problems, which nortriptyline actually helped me with (nausea and abdominal pain). I can blame the dry mouth on the meds, but I have constipation that antedates any medication. My GI dr. has put me on Citrucel.
If I wasn't piling noradrenergic drugs on top of one another, I would probably have no side effects at all.
Posted by Thereishope on March 3, 2004, at 15:11:45
In reply to Re: Withdrawal from Wellbutrin » Thereishope, posted by zeugma on March 3, 2004, at 5:08:46
Hmmm...I've read another post where desipramine helped someone with their IBS. That is also one of my concerns.
Any sexual side effects or derealization with nortriptyline?
Thanks for the information. I eagerly await my visit with my pdoc on Friday to discuss my research and info. that I've collected.
> I found that on nortriptyline alone, the side effects mostly went away after 3 weeks at my maintainance dose (75 mg). Adding Strattera was like doubling the dose again (except for sedation effects). Also, I have chronic digestive problems, which nortriptyline actually helped me with (nausea and abdominal pain). I can blame the dry mouth on the meds, but I have constipation that antedates any medication. My GI dr. has put me on Citrucel.
>
> If I wasn't piling noradrenergic drugs on top of one another, I would probably have no side effects at all.
Posted by zeugma on March 3, 2004, at 18:35:59
In reply to Re: Withdrawal from Wellbutrin » zeugma, posted by Thereishope on March 3, 2004, at 15:11:45
TCA's are good medications for IBS. They are excellent analgesics (I'm talking analgesia for certain kinds of pain that are opiate-level or better). It took very little nortriptyline to relieve the gastointestinal pain- 20 mg- and this took effect immediately. And the pain had been so severe as to itself be the cause for major dysphoria. And like I said- the nausea.... I love taking nortriptyline because it RID me of the constant desire to vomit after putting anything in my stomach! I trust my new GI doc knows what he's doing, because he told me I was on a great drug for IBS. the constipation i still have is unpleasant but it is nothing to the constant pain and nausea.
I have never had sexual side effects from nortriptyline. I'm not sure exactly what derealization is, which means that I've probably never experienced it, so that question answers itself.
Basically- I consider TCA's far superior to their successors, the SSRI's, particularly if you have severe depression. And I think their side effect profile is a lot more tolerable in the long term.
This is the end of the thread.
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