Jump to content

Can I trade in my WellbutrinXL for


Recommended Posts

I'm on 150mg Effexor and have never been able to tolerate a higher dose.

Also 200 mg Topamax and

.5mg clonazepam 3x/day

300mg Wellbutrin XL

My shrink doesn't want me on the Wellbutrin anymore. Infact, shrefused to write any more scripts for it at our last appointment and this is all because she's too lazy to do the minimal research required to find that my risk of having a seizure on Wellbutrin. . .at less than 450mg/day. . .on the XL version. . . now on TWO anti-convulsants. . . is probably actually lower than that of your average, non-eating disordered joe-schmoe who just wants to quit smoking. 

My deal is this-- I don't want to give up the benefits of the norepinephrine and dopamine I've been basking in from the WellbutrinXL. So maybe, just maybe. . .if she can be farsighted enough to understand the role of neurotransmitters in her profession. . .she'll do it.

What do you think? I think I should be on these meds. But what is the wicked bitch of County Mental East going to say?

And do you think it makes sense?

Link to comment
Share on other sites

Hmmm...I do love Wellbutrin. Is the seizure connection specific to WB, or is it related to the appetite suppressing effects? I think Straterra would be very similar to WB, but it might be an option. They must be different enough if people are prescribed both simultaneously.

I'm not sure why you were on WB. For me it was because I tend to be tired when I'm depressed. I'm also anxious, so I have 10 mg lexapro thrown in to keep things smooth.

I had a pdoc take me off Wellbutrin a few years ago after one week because I said I got headaches the first few days, a very common occurance for starting WB. It was only a year ago I worked my way back to it after many other ADs. So sometimes docs can be a little too conservative.

Then again, I don't know how dangerous the ED/WB connection is.

Ask her for Strattera, see what she says. As for Provigial, I don't know enough about it. I'd like it just for it's stimulating/appetite suppressing effects, so I don't dare ask for it. I know my vulnerabilities.

Good luck.

Link to comment
Share on other sites

Hmmm...I do love Wellbutrin. Is the seizure connection specific to WB, or is it related to the appetite suppressing effects?
Fear of the seizure connection. If she were worried about appetite suppression, she'd have taken me off of the Topamax immediately. But I put up a huge fit about that at our initial meeting.  I'm bulimic-- taking me off Topamax would be a bloody brilliant way to make me more bulimic.  And lose even more weight.

I think Straterra would be very similar to WB, but it might be an option. They must be different enough if people are prescribed both simultaneously.

According to the info on the Crazymeds pages, they shouldn't be.

I'm not sure why you were on WB. For me it was because I tend to be tired when I'm depressed. I'm also anxious, so I have 10 mg lexapro thrown in to keep things smooth.
WBXL was added to EffexorXR, Topamax and OCP's because I have treatment resistant major depressive disorder.  Lexapro was the last SSRI I wasted my time on, in 2003. It made me fat and tired, and I knew doom was coming on and that an SSRI just wasn't going to cut it. I made my then pdoc put me back on EffexorXR. 

I've never had any problems with Wellbutrin, although I think it may be making me a bigger bitch than I can personally take responsibility for.  There's really almost no danger of seizure activity for a person with my profile-- balanced electrolytes, on anti-convulsants, taking less than 450mg a day, not taking the immediate- or sustained-release version.

They haven't done any research since the immediate-release came out, AFAIK. Back then they found that bupropion caused seizures in 2 out of 10,000 non-Ed'ed people and 4 out of 10,000 eating-disordered people. But those studies tend to eliminate candidates with as many variables as me-- plus, almost all doctors and reasonable human beings as well tend to believe that these sorts of side effects are less common in the extended-release versions of drugs. 

Ask her for Strattera, see what she says. As for Provigial, I don't know enough about it. I'd like it just for it's stimulating/appetite suppressing effects, so I don't dare ask for it. I know my vulnerabilities.

I did ask her for Strattera. She said, "Here we prescribe according to diagnosis." What if your fucking dX is wrong?

As far as Provigil goes, I think I can probably understand what you mean by "knowing your vulnerabilities," but AFAIK, modafinil isn't even close to being in the same class with traditional ADD drugs, or even stimulants/ diet drugs. While methylphenidate, mixed amphetamine salts, d-amphatamine, and (rarely) methamphetamine are long since drugs prescribed for ADD placed in the most highly controlled class, Provigil was actually approved in the USA for narcolepsy and co-opted for ADD, which is probably the main reason it was even moved into the C-IV schedule in recent months.

I've heard plenty of testimonies that there's no "buzz" from Provigil, just a "droop" when it wears off. This doesn't surprise me. There are plenty of drugs in the US that are over-controlled.

So sometimes docs can be a little too conservative.

Yeah, no shit.  Well, I've already lost the use of one of my limbs to the CYA portion of the Hypocritical Oath.  I'm a little tired of "conservatism." I've already taken all those drugs, been there, done that. I've come closer, more times, to killing myself on accident in the past few years than I ever did as a teenager.

I understand that I have to rely on welfare-grade mental health care, but why can't they make use of the drugs that have come on to the market in the past decade?

Link to comment
Share on other sites

As far as Provigil goes, I think I can probably understand what you mean by "knowing your vulnerabilities," but AFAIK, modafinil isn't even close to being in the same class with traditional ADD drugs, or even stimulants/ diet drugs.

I've been on Provigil for a few months now, because no matter how stimulating my other meds are, I just can't stay awake more than 12 hours a day without it.  This is with a BiPAP to treat my sleep apnea, and I am religiously compliant with that.

When I was on Ritalin years ago, I felt positively hallucinogenic and wigged out.  With Provigil, I might feel a slight physical tension, but nowhere near what a cup of coffee can do to me.  I feel a slight mood boost from Provigil, but that could be from being able to stay awake and aware of the world around me.  I have noticed no appetite changes, no "stimulation," no aggravation at all of my own eating disordered behavior.  On the other hand, I'm not sure what Provigil could possibly do for you, if you don't suffer from a serious sleep disorder.  It's certainly no replacement for Wellbutrin.  It's also exorbitantly expensive, and almost impossible to get insurance to pay for without a formal sleep study/diagnosis.  I'm fighting with my insurance company even with an FDA approved diagnosis.

I am also on WellbutrinXL, and Prozac, for treatment resistant major depression.  I can't understand why your doc has problems with continuing your Wellbutrin.  Do you have epilepsy?  If not, there's no earthly reason to discontinue the stuff if it works for you.  Removing an effective med for no good reason is a grave mistake.  Is it even remotely possible for you to get another doctor?  Maybe you should just toss this paper on this person's desk, which says that Wellbutrin is quite favorable for depressed eating disordered people, with NO increased risk of seizures.

J Clin Psychiatry. 1998 Jul;59(7):366-73.

(If you want the PDF, E-mail me)

The only published data that suggest a higher seizure rate for bulimics was published  ten years earlier, and only studied 55 people.  The one I referred to above studied 3100.

I'm not sure that Strattera could be any kind of replacement.  It probably doesn't affect dopamine, and it DOES interact with Effexor.  It might also be really expensive, I think it's pretty new.

Link to comment
Share on other sites

As far as Provigil goes, I think I can probably understand what you mean by "knowing your vulnerabilities," but AFAIK, modafinil isn't even close to being in the same class with traditional ADD drugs, or even stimulants/ diet drugs.

I've been on Provigil for a few months now, because no matter how stimulating my other meds are, I just can't stay awake more than 12 hours a day without it.

Link to comment
Share on other sites

From my experience, your only hope for getting medical intervention for your sleep troubles is getting a formal sleep study at a hospital.  Usually only big hospitals can do this kind of thing.  I'm not sure what kind of health care access you have, but consider this route.  Docs have all kinds of cool meds that they only pull out after an abnormal sleep study, because of the high potential for abuse.

Link to comment
Share on other sites

Aside from the sleep thing- which is a real thing, every one admits, but I'm too wigged out by the idea of being stuck in a room for a week with nothing having electrodes glued to my head trying to sleep to do the sleep study- I do have hard core major depressive disorder, which is why I'm on two anti-depressents. She wants to take me off one of them, which is dumb. . .I'm leaving at the end of the summer, she's not gonna have to clean up the consequences. but as soon as Strattera came out I was like "YEAH! Here's another head drug that might work but no one will try it.. 

So depression and major sleep ills we know are real.

But I kind think I may have some sort of ADD as well.  I don't know. Something that gets really evident under excruciating stress.  Hmm.

Link to comment
Share on other sites

Well,  a sleep study is only overnight, and maybe a few hours the next day.  I brought multiple books, any food I liked, and was allowed to watch all the cable TV I wanted.  I admit that I found the electrodes really irritating, but I survived, and I have access to a lot more treatment options now.

Can you get any other doctor to write you a Wellbutrin prescription?  My PCP will rewrite anything that another doc started me on.  Hell, my rheumatologist would probably continue a long term psych prescription if I said I was running out. 

It may be tough to say that you have attention problems from ADD, rather than from depression or piles of psych meds.  These are both famous for making people flaky.  Most ADD people I know are obvious, and were from childhood, psych meds or not.

If it would help, I could send you even more journal articles to wave at the doc.  I'm a professional biologist, so that kind of research would take me less than five minutes.  I would bet that this doc has no idea where to look for the information, so she decided not to bother.

Link to comment
Share on other sites

So. . . it doesn't matter whether you actually fall asleep during the sleep study?

I have a hard time believing she "doesn't know" where to look for the information. . . research is one of those pretty basic things you learn in post-bacchalaureate education, no matter where in the world you take your degree.

I still have WellbutrinXL, I'm not out of it yet. But for a short period of time I did try giving her the benefit of the doubt, plus I've been on this combo for over a year and a half. It needs some tweaking.  Serotonin has a ceiling effect with me, norepinephrine (from my ltd exposure through Effexor and Wellbutrin) do something, but I can't tolerate a whole lot without getting neurologically wonky. So why not try dopamine? I mean, everybody loves dopamine, right? (And there's *no way* anyone's going to prescribe me anti-parkinson's meds)

Okay, I'll see if this get's through before the free wireless disconnects again. . .

Link to comment
Share on other sites

  • 4 weeks later...

september- sorry I didn't reply to your 2nd e-mail. The crazymeds downtime seems to have coincided with my free Wi-Fi connection downtime (still cloudy to damnable durin g the day).

O well. I'm off now to a new state to live with (groan) my mother in  the middle of nowhere, so that should be a fresh start, eh?

On the plus side, there's a kind of city-ISH like an hour away, so I should be able to get a sleep study there, and more mental health care than I want.

Link to comment
Share on other sites

Archived

This topic is now archived and is closed to further replies.

×
×
  • Create New...