chipmunk Posted January 26, 2009 Share Posted January 26, 2009 A year ago: I was on 10 mg Prozac and Wellbutrin 180 (?) mg twice a day (think it works better than the Wellbutrin 24 hr variety). Four months ago: I started on Concerta for my ADD and stopped taking my Prozac and Wellbutrin except occasionally due to drug interaction warnings. A couple weeks ago: I became so depressed that I was suicidal. Stopping depression meds was NOT a good idea, in hindsight! DUH!! Anyway, when I take the Prozac, Wellbutrin, and Concerta together I get a weird vision change where it's like I'm high (although I don't *feel* high, no racing heartrate or high blood pressure that I know of). It's like when you look at a bright window and then look somewhere else, you can see the outline of the window, but it happens with everything I look at. Everything seems brighter too and my close-up vision is blurred. My pupils are not dilated but it's kind of like what it feels like when they dilate your pupils at the eye doctor's. Has anyone experienced this vision change? I *really* need the ADD meds - they have made unbelievable changes in my ability to get things done - but obviously I *really* need the depression meds as well. Right now I am taking the Concerta and Prozac in the mornings and the Wellbutrin at night and the vision changes have gone away for the most part but I'm just curious if anyone knows which drug in the cocktail may have caused it. Thanks in advance for any feedback. Link to comment Share on other sites More sharing options...
null0trooper Posted January 26, 2009 Share Posted January 26, 2009 A year ago: I was on 10 mg Prozac and Wellbutrin 180 (?) mg twice a day (think it works better than the Wellbutrin 24 hr variety). Four months ago: I started on Concerta for my ADD and stopped taking my Prozac and Wellbutrin except occasionally due to drug interaction warnings. I cannot think of any antidepressant that are meant to work correctly when taken "occasionally." Even if there are any, Prozac and Wellbutrin aren't. If "drug interaction warnings" are an important issue for you, you really should be asking a professional - a pharmacist, not a web page - about the risks posed by the combination at the dosages prescribed. Most of the automated drug interaction web pages that I've seen do not account for multiple metabolic pathways, nor do they account for dosages being reduced to account for known interactions. Right now I am taking the Concerta and Prozac in the mornings and the Wellbutrin at night and the vision changes have gone away for the most part but I'm just curious if anyone knows which drug in the cocktail may have caused it. Thanks in advance for any feedback. Before venturing a guess, I want to know what your doctor thinks caused the problems. Link to comment Share on other sites More sharing options...
Jack M. Crazyfish Posted January 26, 2009 Share Posted January 26, 2009 A year ago: I was on 10 mg Prozac and Wellbutrin 180 (?) mg twice a day (think it works better than the Wellbutrin 24 hr variety). Four months ago: I started on Concerta for my ADD and stopped taking my Prozac and Wellbutrin except occasionally due to drug interaction warnings. A couple weeks ago: I became so depressed that I was suicidal. Stopping depression meds was NOT a good idea, in hindsight! DUH!! Anyway, when I take the Prozac, Wellbutrin, and Concerta together I get a weird vision change where it's like I'm high (although I don't *feel* high, no racing heartrate or high blood pressure that I know of). It's like when you look at a bright window and then look somewhere else, you can see the outline of the window, but it happens with everything I look at. Everything seems brighter too and my close-up vision is blurred. My pupils are not dilated but it's kind of like what it feels like when they dilate your pupils at the eye doctor's. Has anyone experienced this vision change? I *really* need the ADD meds - they have made unbelievable changes in my ability to get things done - but obviously I *really* need the depression meds as well. Right now I am taking the Concerta and Prozac in the mornings and the Wellbutrin at night and the vision changes have gone away for the most part but I'm just curious if anyone knows which drug in the cocktail may have caused it. Thanks in advance for any feedback. i think it is pretty common with these type of drugs to have the burnt in visuals you are having. i get them all the time with prozac, seroquel and klonopin. Link to comment Share on other sites More sharing options...
chipmunk Posted January 26, 2009 Author Share Posted January 26, 2009 My doctor has no idea what caused the interactions. She is a GP and freely admitted that she was in over her head when it came to drug cocktails. That is why I have an appt with a psych that specializes in adult ADD/depression but the soonest I could get in was two months out (now one month out). She was mostly concerned about vision changes due to high blood pressure, which I did not have, in fact my blood pressure was perfectly fine 110/70. Due to the lack of other side effects and her lack of experience with these drugs in combination she recommended taking whichever one was the most crucial, which right now is the Prozac so I don't become severely depressed again but I have had to start the Concerta again as my grad school started up again and I can't function in school w/o it. Her recommendation was to cut out the Wellbutrin (which I did) as she thinks Prozac is better for my situation anyway but I was just curious as to if anyone else had this happen. It seems to be a fairly rare side effect as I can't find any mention of it but I had a similar thing happen when I accidentally took too much cough medicine. I went to school and told the kids (I teach high school) and they were like hee hee b/c little did I know that taking lots of cough medicine is a recreational drug for some of them. Ay, the things you learn as a high school teacher! The effect was much more pronounced and was more like a slo-mo video instead of shadows/enhanced brightness but both were odd vision changes. Anyway, would love your guess, thanks so much. Link to comment Share on other sites More sharing options...
null0trooper Posted January 26, 2009 Share Posted January 26, 2009 Her recommendation was to cut out the Wellbutrin (which I did) as she thinks Prozac is better for my situation anyway but I was just curious as to if anyone else had this happen. It seems to be a fairly rare side effect as I can't find any mention of it but I had a similar thing happen when I accidentally took too much cough medicine. Incidentally, dextromethorphan is metabolized specifically by the liver enzyme that Wellbutrin shuts down. It becomes very easy to overshoot the dosage and very hard to get your head cleared again, no matter how much your cough was bothering you. The same version of the P450 enzyme (isoenzyme 2D6) is also needed to metabolize Wellbutrin and Prozac, and both inhibit it. So either one can raise the blood levels of the other (and Wellbutrin is functionally synergistic with stimulants.) A doctor can still use the two meds and compensate by starting at lower dosages and increasing slowly while the liver produces enough of the right enzymes to deal with the meds ... but it sounds like you restarted at the full dose instead. The resulting "trippy" effects could have come from excess serotonin and activation of the serotonin receptors that many hallucinogens bind to. Or, they could have been a sign that the Wellbutrin was lowering your seizure threshold too much. Since the situation makes it hard to tell what really caused the problems, and you want to stay on the Concerta, discontinuing the Wellbutrin may have been the best way to go. Link to comment Share on other sites More sharing options...
chipmunk Posted January 27, 2009 Author Share Posted January 27, 2009 Fascinating, thank you so much for the info! I felt like I was on a (mild) bad trip and was REALLY glad when the end of the day came and the meds wore off. I will ask my psych about it when I see him and update the thread as to *his* theory. Thanks again! Link to comment Share on other sites More sharing options...
chipmunk Posted January 27, 2009 Author Share Posted January 27, 2009 i think it is pretty common with these type of drugs to have the burnt in visuals you are having. i get them all the time with prozac, seroquel and klonopin. How do you deal with it? It was so frustrating! Do you notice them more when you are tired? Link to comment Share on other sites More sharing options...
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