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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by alchemy on August 12, 2010, at 22:19:54
I was on Effexor a long time ago & I only remember the hellish withdrawal when I didn't have insurance. It probablyl helped a little. I've been on Cymbalta, I think I also just had some minor help. I've matched Wellbutrin w/ a lot of SSRIs over the years.
My dr. mentioned Pristiq, but he thought I should also lose the Wellbutrin besides the Celexa. But I thought it was common to combine Wellbutrin w/ a SSNR?
I don't know how much/if Wellbutrin helps, but it probably helps a little. I'm mostly worried about trying to withdraw from 2 meds while starting a new one.
On the other hand, why even try another one of these "minimal/if anything helpers"? The transition period won't be fun, it's all in the same category - nothing special for a tx resistant brain. I need a new brain. I had a miserable down shift last week for no reason that has faded back to normal down. Over, and over. Sorry, I just needed to vent a little.
So my question is, how important is it to stop the Wellbutrin?
...and are there any good stories of trying another SNRI that turned out great?
Posted by Phillipa on August 12, 2010, at 23:34:37
In reply to Pristiq to replace Celexa + Wellbutrin?, posted by alchemy on August 12, 2010, at 22:19:54
In my thread above they pointed out on TV DR OZ that generic wellbutrin was one of the psych meds that doesn't work the same as namebrand. Have you switched brands? Phillipa
Posted by ed_uk2010 on August 13, 2010, at 12:31:06
In reply to Pristiq to replace Celexa + Wellbutrin?, posted by alchemy on August 12, 2010, at 22:19:54
> I was on Effexor a long time ago & I only remember the hellish withdrawal when I didn't have insurance.
Desvenlafaxine (Pristiq) is very closely related to venlafaxine (Effexor). The withdrawal symptoms are the same. Pristiq does not have any established advantages over Effexor.
>I don't know how much/if Wellbutrin helps, but it probably helps a little.
That is the norm I'm afraid. Psych meds can often help to relieve our symptoms to some extent, but they don't usually get rid of them completely. Sometimes it's best to settle on a medication (or a combination of a couple of medications) which provide a reasonable amount of relief without causing unacceptable adverse effects.
>So my question is, how important is it to stop the Wellbutrin?
I don't think it is. On the other hand, I don't see any advantage in switching to Pristiq anyway.
I would be very cautious of any doctor who was pushing Pristiq. It is an expensive new 'patent extender' which was developed to maintain Wyeth's profits when Effexor went generic.
Celexa + Wellbutrin is an established combination. Have your doses been adjusted to get the best effect? Celexa tends to work best for depression at 20mg, 30mg or 40mg per day. Doses of less than 20mg are not consistently effective. Doses above 40mg are not usually any more effective than 40mg. It is necessary to try different doses in order to find out what works best for YOU. Wellbutrin is often given at around 300mg per day.
Tell us more.
Posted by emmanuel98 on August 13, 2010, at 21:18:31
In reply to Re: Pristiq to replace Celexa + Wellbutrin?, posted by ed_uk2010 on August 13, 2010, at 12:31:06
My p-doc refuses to prescribe pristiq because it is, as you said, just a ahameless patent extender. Like when prilosec went OTC, the company started pushing Nexium, a patented prescription only drug that worked no better than prilosec
Posted by KarenRB53 on August 18, 2010, at 20:16:10
In reply to Re: Pristiq to replace Celexa + Wellbutrin?, posted by ed_uk2010 on August 13, 2010, at 12:31:06
> > I was on Effexor a long time ago & I only remember the hellish withdrawal when I didn't have insurance.
>
> Desvenlafaxine (Pristiq) is very closely related to venlafaxine (Effexor). The withdrawal symptoms are the same. Pristiq does not have any established advantages over Effexor.
>
> >I don't know how much/if Wellbutrin helps, but it probably helps a little.
>
> That is the norm I'm afraid. Psych meds can often help to relieve our symptoms to some extent, but they don't usually get rid of them completely. Sometimes it's best to settle on a medication (or a combination of a couple of medications) which provide a reasonable amount of relief without causing unacceptable adverse effects.
>
> >So my question is, how important is it to stop the Wellbutrin?
>
> I don't think it is. On the other hand, I don't see any advantage in switching to Pristiq anyway.
>
> I would be very cautious of any doctor who was pushing Pristiq. It is an expensive new 'patent extender' which was developed to maintain Wyeth's profits when Effexor went generic.
>
> Celexa + Wellbutrin is an established combination. Have your doses been adjusted to get the best effect? Celexa tends to work best for depression at 20mg, 30mg or 40mg per day. Doses of less than 20mg are not consistently effective. Doses above 40mg are not usually any more effective than 40mg. It is necessary to try different doses in order to find out what works best for YOU. Wellbutrin is often given at around 300mg per day.
>
> Tell us more.
>
>Sorry for jumping here but I've been on combo of Celexa w/Wellbutrin and it really does work well except for the anxiety which is high. But my anxiety is always high. I do think the SSRI's make it higher though. When I was on just Celexa it did help with depression but I had increased anxiety and then after approx a year my pdoc added WellbutrinXL 150mg daily because of lack of motivation, energy etc on Celexa. So I wouldn's say my anxiety is worse with the combo but its definitely always there. I do take lorazepam 1mg nightly and 1/2mg during the day. But it doesn't seem to be enough. Just wondering if I should decrease my Celexa from 20mg to 10mg or should I lower my dose of Wellbutrin (but I'd have to go to SR instead of XL. Or I could increase the lorazepam or try another benzo. Any suggestions greatly appreciated. Again, sorry for jumping into this thread but as soon as I saw Celexa + Wellbutrin I thought I'd try to get some help.
Posted by islan on August 21, 2010, at 17:38:43
In reply to Pristiq to replace Celexa + Wellbutrin?, posted by alchemy on August 12, 2010, at 22:19:54
I can't answer your question about Wellbutrin, as I have never taken that drug.
I can tell you that I switched from Celexa (30 mg) to Pristiq and then to Effexor this Spring. The transition period was really difficult and I had a lot of extreme emotions. In other words, Pristiq was not an adequate replacement for Celexa. Things calmed down when my Effexor was upped to 150.
Good luck.
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