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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by theo on February 27, 2009, at 20:45:42
I was wondering, I was taking Wellbutrin XL 150mg for 2 months and went to 300mg 2 weeks ago. When you are on a med for a couple of months and increase the dose, do you still need to wait 4 weeks to give the dose increase a fair trial?
By the way, the dose increase actually made me tired, 150mg was actually more stimulating to me, weird.
Posted by garnet71 on February 27, 2009, at 22:12:28
In reply to Wellbutrin XL question for SLS + others, posted by theo on February 27, 2009, at 20:45:42
Hi,
Maybe it depends on the doctor. One PDoc gave me 2 weeks in between dose adjustments starting at 150 mg., another monthly adjustments (after follow up appt.); a different doctor started me on 450 mg on the first day (but I think he was a lousy doctor). If I recall correctly, the drug's website indicates tapering on, so you might want to check the standard recommendation.
Wellbutrin takes some getting used to--did you feel tired when you first took 150 mg?
Posted by theo on February 27, 2009, at 22:29:03
In reply to Re: Wellbutrin XL question for SLS + others » theo, posted by garnet71 on February 27, 2009, at 22:12:28
> Wellbutrin takes some getting used to--did you feel tired when you first took 150 mg?
No, but when I increased to 300mg I felt tired, even after 2 weeks at the increased dose.
Posted by Neal on February 27, 2009, at 23:17:51
In reply to Wellbutrin XL question for SLS + others, posted by theo on February 27, 2009, at 20:45:42
theo,
you went up because? need more AD effect? more stim?
Posted by Phillipa on February 27, 2009, at 23:56:55
In reply to Re: Wellbutrin XL question for SLS + others » theo, posted by Neal on February 27, 2009, at 23:17:51
Wow sure didn't make me tired was like manic on 150mg. And that was with lots of benzos. Love Phillipa
Posted by SLS on February 28, 2009, at 7:52:37
In reply to Wellbutrin XL question for SLS + others, posted by theo on February 27, 2009, at 20:45:42
> I was wondering, I was taking Wellbutrin XL 150mg for 2 months and went to 300mg 2 weeks ago. When you are on a med for a couple of months and increase the dose, do you still need to wait 4 weeks to give the dose increase a fair trial?
Yes.
Great question. It has been both my experience and those of the doctors I have seen that you really cannot judge the efficacy of a dosage adjustment for at least 3 weeks. Of course, it can happen sooner. I don't understand your being treated for so long at 150mg, even thought the sweet spot for most people is 300mg. I would not look at the lack of stimulating effects from Wellbutrin as a sign that it wouldn't work. It very well might be, but since there is no empirical evidence of this being presented to us, there is no way one can be absolutely certain of this, it makes sense to persist. You know, I almost always felt weird in some way when a drug was going to elicit a positive response.
Posted by theo on February 28, 2009, at 9:24:22
In reply to Re: Wellbutrin XL question for SLS + others » theo, posted by SLS on February 28, 2009, at 7:52:37
> I don't understand your being treated for so long at 150mg, even thought the sweet spot for most people is 300mg.
I wanted to see if 150mg alone would work and honestly thought going to 300mg was going to make my anxiety erupt, but it was totally the opposite effect. I like many in the past have tried a med for 2 weeks and thrown in the towel, only to wonder "what if" I would have stuck with it for a month. So I'm on a mission to give this a try for a month and if it doesn't work, scrap it and never waste my time obsessing about it as an option for me. I also am trying 50-100mg Trazodone at night and read numerous places that Wellbutrin and Trazadone have a major seizure risk, whereas SSRI's don't seem to be as bad with it which threw me off a bit as Trazodone totally slows me down.
> You know, I almost always felt weird in some way when a drug was going to elicit a positive response.
I hope this is true as this is how I've felt. I just have a lot of pressure at work right now and timing for feeling weird isn't great, but maybe the pressure I'm feeling is self inflicted because I'm feeling weird! If this doesn't work in 2 more weeks, I might try Remeron as I have never tried it. I'm 6 foot 175 so the weight problem isn't much of a worry for me. Did you have any luck with Remeron? By the way, I'll probably start with the Remeron then add a small dose of Vyvanse in the morning. Do you think Remeron/stimulant will work okay together? I'm trying to find a good combo for obsession/anxiety plus ADD. SSRI's never did squat for my OCD and if anything made it worse. If the Remeron/stimulant combo doesn't work together I may try an anticonvulsant/stimulant combo. The big question here will be which anticonvulsant to try for the obsession/anxiety? I've also read alot about Namenda for these symptoms?
Posted by theo on February 28, 2009, at 9:28:16
In reply to Re: Wellbutrin XL question for SLS + others » theo, posted by Neal on February 27, 2009, at 23:17:51
> theo,
>
> you went up because? need more AD effect? more stim?Not more "stim" feeling. Stimulants actually can have an initial calming effect then have a little overfocus. But to answer your question, more of an obsession/aniety/ADD relief is what I'm searching for.
Posted by theo on February 28, 2009, at 9:29:52
In reply to Re: Wellbutrin XL question for SLS + others, posted by Phillipa on February 27, 2009, at 23:56:55
> Wow sure didn't make me tired was like manic on 150mg. And that was with lots of benzos. Love Phillipa
It did make me stimulated at 150mg, but when I went to 300mg that went away and I feel tired and zoned on 300mg.
Posted by garnet71 on February 28, 2009, at 11:14:26
In reply to Re: Wellbutrin XL question for SLS + others » Phillipa, posted by theo on February 28, 2009, at 9:29:52
Theo,
If 150 mg was good, why did you want to up the dosage? Just guessing because you did not feel you were at your best?
My PDoc told me anxiety and ADD often go hand in hand. I read a great article about that too...it also said OCD was the other most common issue with ADDers..wish I remember where to find it now to pass it along to you.
FYI, I started buspirone for (severe) anxiety and Ritalin for ADD. I also take .25 of Xanax at night, but don't need it every night. All those xxRIs worked horribly for me over the past few years, and I'm doing 100 times better than before. No anxiety and the motivation I need to do extremely boring or complex tasks, amd more ability to concentrate. I no longer have to read things while my brain goes off in a million directions, linking context of every little bit of information I come across that sends me off in tangents that take me away from the topic at hand, stifling my productivity and leading to the inability to finish them. I just coined a new term for that trait - orbital thinking.
However, the Ritalin is very short-acting (I'm not taking the slow release), so 20 mg twice per day gives me about 6 hours total of relief, but then wears off quickly.
Anyway, at least look into the buspirone combo with ADD meds. Not because it worked for me, but because it sounds like the xxRIs don't give you optimal benefit and it might be best to find and evaluate all your options to enable yourself to make the best decision.
This is the end of the thread.
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