Wellbutrin Questions

[littleshelly]

Hi everyone, I am on my 20th day of Wellbutrin XL 150MG. I started out on the generic but switched to name brand 5 days ago. The first two days were bad. I was extremely tired. Then the next three were pretty good. I felt like I was a new person, positive, happy, less stressed, motivated, caring, calm temper. Then for the next 14-15 days I had side effects and the good feeling went away. Soar shoulders and back, daily headache, migraines, extreme irritability, depression, quick to anger, agitation. For the past 4-5 days the headache has gone away. I don't feel as agitated and angry but definitely not as good as I did in the very beginning. Almost like I am not taking anything at all. I do notice that my racing thoughts and crashing mood are somewhat better. My depression and mood fluctuate from minute to minute. Very bothersome. My mind is always racing ahead. I still have that but it seems to be a little better. My chest is always tense and tight.That also seems better.

Have others experienced this and if so how long until you noticed a real change? Where you could definitely tell this was the right medication for you and that it was working.

Also what dosage and kind of Wellbutrin are you taking? I would like to stay at 150MG due to the cost. I would not be able to afford name brand at a 300MG dose but also because I am very sensitive to medication in general. An Aleve will put me to sleep. I am a female 4'11" 95LB so that may be enough for me.

I am interested in hearing about other peoples reactions and symptoms, why you are taking Wellbutrin and how it has helped you and did you go through a period where you though it was not working at all and then it got better.

I have depression, OCD and I believe ADD though the ADD has not been officially diagnosed I am almost certain I am ADD.

Thank you.

[water]

Wellbutrin was my first AD. I started with the immediate release (IR) and for the first time in 50 years I felt like the world was this exciting adventure to explore. I was so high I couldn't drive. I switched to the sustained release (SR) and would crash after 8 hours. I then went to the extended release (XL), starting at 150 XL and then settling on the 300 XL.

My initial side effects - restlessness, not being able to fall asleep, irritability, racing heart and thoughts, distraction, etc, all went away after a month or so.

My depression, while not completely gone, lifted more than it had ever done in my whole life.

After 8 months or more I started noticing that my depressed episodes were returning with more frequency however lessened the intensity and my anxiety was increasing. So I added Lexapro, which came with it's own brand of side effects that eventually receded. This combo has been fabulous for me. I still get depressed, anxious, whatever, but I know for sure that these episodes will be quick and will end eventually.

I did add a sleep aide and an occasional benzo as needed, which totally helped.

And last but not least, I never ever tried the generic version. My cousin went into a major depressive episode after taking wellbutrin for years when her pharmacist switched her to the generic without letting her know. From what I understand it is the release method that is different with the generics. However, there are many many people on this board that take generic Wellbutrin and do absolutely fine. I think some generics work better than others. And I do suggest that if your generic is working, be sure to insist that your pharmacy not switch the generic brand on you. Not all generics are the same.

Hope this helps!!

Edit: Coffee had a huge influence on my side effects. In fact now I have stopped altogether. Don't know if you are a coffee drinker or not, but I would cut back on any caffeine in your diet at least during these first weeks of wellbutrin.

[olga]

It's important to know which generic you are being given. The Teva one is the brand that has the messed-up release mechanism.

There are generics made by Watson Pharmaceuticals and by Anchen, and both of them are working for me after 4 years of being on the brand name stuff. (These are all the XL version. The SR version did nothing for me)

If you can hold on long enough to get by the worst of the side effects, it might be really good for you.

In terms of dose, 300mg is considered the therapeutic dose, but whatever works for you.

I used to pay $340 for a 3-month supply of the name brand, as opposed to $20 for the generic. I just can't afford the name brand.

olga

[water]

I used to pay $340 for a 3-month supply of the name brand, as opposed to $20 for the generic.

I am blessed. My otherwise really crappy insurance charges $10 month for generic bupropion and $20 for GSK Wellbutrin so I could immediately soothe all my web triggered paranoia.

[SashaSue]

I'm wondering why you switched to the brand, after starting out on the generic? From what you're saying, I *think* it sounds like you're getting partial results at your current dosage, in which case you should probably talk to your pdoc about increasing your dosage.

[littleshelly]

I take the generic Wellbutrin at 300 mg a day (it's called Buproprion XL-300mg ) - but I have severe OCD (plus depression) and so I am also on another AD (generic Celexa, 40mg a day) because for moderate to severe OCD I read (and my P-doc agrees) that it's a good idea to take as high as tolerable (for you) a dose of SSRI or SNRI AD's (whatever of those ADs you tolerate well. Mine happens to be the generic Celexa.) You didn't indicate how severe a form of OCD you have; it's generally classifed as: Mild, Moderate or Severe.

(If you don't know, just ask your doctor.)

Maybe it's a result of some trauma in my background, but I am not always that aware of how well my body is "tolerating" a med. I can tend to ignore bodily reactions to meds - unless they get really bad. However, I've had no problems (so far) w/the Wellbutrin. But that's just me...

It pays to keep in mind that it can take time to get used to a new drug (maybe another week or two)- even if you're just switching to the brand name from the generic. But if your reactions to a med are severe (for you), call you doc ASAP, no matter what. You be the judge of what a "severe enough" bad reaction is. Better safe than sorry though, if there's a question (call your P-doc (prescribing psychiatrist) if in doubt.)

I always have a period of adjustment on any new psychiatric med. It usually takes a full 5-6 weeks for me to feel the full effect of an anti-depressant. There have been times when I thought a med wasn't working AT ALL (an anti-depessant) and then it suddenly "kicks in" 5-6 weeks after I begin taking it. That happened when I took Lexapro, and also on some tri-cyclic ADs.

For people with OCD it can take even longer for an anti-depressant to help "tone down" their OCD. Also, some ADs work better on OCD than others. Good ones to try for OCD include: Luvox, Paxil, Celexa and Lexapro (and there may be others.) Wellbutrin isn't as effective for OCD - from what I've read, but it does work on many people for depression alone, and it has an "energizing" effect that my P-doc thinks will benefit me - as well as helping my depression (I quit taking Lexapro because it made me so tired, even though it worked for my depression.) Fortunately, the Celexa I take is also working on my OCD (as well as my depression.)

Taking longer than 4-6 weeks for an AD to affect OCD is documented. ADs can start affecting depression in 5-6 weeks BUT, it can take up to 12 weeks sometimes, for an AD med to affect OCD (dunno why, but I read this in "The OCD Workbook" by Bruce Hyman, Ph.D. I consider this a reliable source of information, since it's one of the most credible and best-selling books re: OCD treatment.) But specific ADs do work on many people, as far as helping "tone down" their OCD - especially, apparently, at higher doses.

Depending on how intense your OCD is, you might want to take a higher dose of a different AD (anti-depressant). You can get whatever AD it is (most likely) in generic form, so the cost doesn't have to be prohibitive. Then again, you are a small person (95 pounds.)

So - Ask your P-doc what he/she recommends.

NOTE: IMPORTANT**If your mind "is always racing" now (and it didn't before you were on this drug - I'd tell your P-doc. If you have this kind of reaction (racing thoughts) in general to anti-depressants, I've heard it could be a sign of being bi-polar (vs. having "regular" (uni-polar) depression. I am not a doctor, so please don't take this as "gospel." (HOWEVER, I hear this frequently around these boards, so often that I think it's something to consider.) Ask your doctor if they think "racing thoughts" as a reaction to your AD meds may be a sign of bipolar illness - if your thoughts race in reaction to AD meds generally (did they race when you were on the generic Wellbutrin also? Did they race before you took any AD meds, and the AD meds made it worse? In any case, I'd definitely mention this to your doctor.) I especially think this, since Wellbutrin is supposedly one of the least likely AD meds to cause this kind of reaction.

Wish I had better advice - but IMO, people can be pretty idiosyncratic (individual) when it comes to med reactions; I dunno if what you're experiencing is "normal" or not. But I hope my coments have been at least a bit helpful.

I don't think I have ADD, so I don't have specific advice re: ADD - BUT - when my OCD was at its worst, I could mimic someone with ADD pretty well; I was jumpy, irritable, and had a shorter attention span.

So - I'd describe what you think are ADD symptoms to your doc, and ask them how to discern the difference between: Worsening OCD, and ADD.

I'd describe what you think may be your ADD symptoms pretty carefully to your doctor (maybe write them down after monitoring them for a week or two, and take the notes about that to your next appointment) - if you "think" you may have ADD, but aren't sure - your doctor can probably help you figure it out.

In a nutshell:

If you end up really hating the Wellbutrin you're on, there are other meds you can try.

Not all P-docs out there know a ton about meds for OCD.

Depending on how severe your OCD is - you might want to add a new AD that works specifically for OCD (Paxil, Luvox, Celexa, etc.) - that AD will also (hopefully) work on your depression. If it's a generic, it likely won't be that expensive (I'm taking 2 ADs every day, at pretty high doses, and it costs me less than $60 a month.)

If the Wellbutrin ends up working well for your depression, then that's good, keep it (you can add a different AD for the OCD, if your doctor thinks that is appropriate for you.)

BUT - If the Wellbutrin ends up driving you crazy, then I'd find a new AD altogether (and one that works for OCD as well: Paxil. Celexa, Lexapro, or Luvox) - ask your doctor about taking a higher dose, too (for your OCD.)

And If there isn't a specific reason you're taking Wellbutrin for depression, and since you also have OCD - then maybe consider taking: Luvox, Celexa, Paxil or Lexapro, instead. That will probably work on BOTH your OCD and the depression.

Definitely mention those "racing thoughts" to your doctor. "Racing thoughts" are not the same as agitation (as far as side effects go.)

IMO, racing thoughts are a different symptom altogether, and well worth mentioning to your doctor, since that may affect his choice of AD (or any psychiatric drug) for you.

I'd give an AD 5-6 weeks to work on depression - and longer to work on OCD (up to 12 weeks.)

To clarify: I am not a doctor, but I've read up some about this stuff, and I've been dealing with OCD & depression for a loong time.

This (above) is what I'd do if I were you.

Hang in there. Good luck

- suzie

Hi Suzie, thank you so much for your detailed and informative reply. I would describe my OCD as moderate and it seems to cycle. I go through horrible periods where it pretty much consumes me and then other times where it seems managable. Part of my OCD I believe is Pure OCD. My thoughts always race and when the OCD is bad it is terrible. I cannot turn my thought off. I can obsess about something, a person, a thing, things I need to do etc and it consumes me. I also check things, doors, windows. (to be sure they are shut/locked) I can get stuck on that for a long time. Repeating over and over in my mind, check, check, check or locked, locked, locked. I check the stove, refrigerator, water faucets, plugs.

I also clean. That sometimes becomes extreme. I am not afraid of germs like some people who suffer from OCD. I clean to keep things in order, have some control. I get stuck doing that also. For example if I am cleaning the shower i can get stuck on cleaning one spot for a long time. Recently I have been reading about behavior therapy and OCD and have been forcing myself to quit doing something after 2-3 times. I am not always succesful but am trying.

My thoughts have always raced. That is nothing new with the Wellbutrin. I can never turn my thoughts off. One of the very worst things for me, the thing I really would like the Wellbutrin to help me with is the inability to "have fun, live in the moment and relax". My mind is always racing ahead of things I "have" to do. I cannot really go to a family gathering or go somewhere with friends without fretting about it constantly before hand and then when I actually do it I am thinking about getting home to "get it done" I often cancel plans because I become so tense about going. I am always forcing myself to be on this tight schedule and If I am not on that schedule I am very uncomfortable and tense.

And the depression in general. I don't feel happy, don't laugh or look forward to things that most people would consider fun.

Also I have only been to my family Dr. Not a Psychiatrist. My insurance is not very good and there are no Psychiatrists covered under my plan. My sister has been diagnosed with OCD and I am very sure my Dad and Brother both have it although they have not sought treatment or been diagnosed.

The reason my doctor and I chose Wellbutrin is because I had horrible side effects once when taking Zoloft. I had a blood test to measure the levels of serotonin and they were within the normal range. I also did not want to gain weight. I know myself and If I started taking a medication that worked but caused weight gain I would stop. I workout 5 days a week. Lift/cardio, etc and eat very well. Clean/balanced. Being fit and healthy is very important to me.

[littleshelly]

Wellbutrin was my first AD. I started with the immediate release (IR) and for the first time in 50 years I felt like the world was this exciting adventure to explore. I was so high I couldn't drive. I switched to the sustained release (SR) and would crash after 8 hours. I then went to the extended release (XL), starting at 150 XL and then settling on the 300 XL.

My initial side effects - restlessness, not being able to fall asleep, irritability, racing heart and thoughts, distraction, etc, all went away after a month or so.

My depression, while not completely gone, lifted more than it had ever done in my whole life.

After 8 months or more I started noticing that my depressed episodes were returning with more frequency however lessened the intensity and my anxiety was increasing. So I added Lexapro, which came with it's own brand of side effects that eventually receded. This combo has been fabulous for me. I still get depressed, anxious, whatever, but I know for sure that these episodes will be quick and will end eventually.

I did add a sleep aide and an occasional benzo as needed, which totally helped.

And last but not least, I never ever tried the generic version. My cousin went into a major depressive episode after taking wellbutrin for years when her pharmacist switched her to the generic without letting her know. From what I understand it is the release method that is different with the generics. However, there are many many people on this board that take generic Wellbutrin and do absolutely fine. I think some generics work better than others. And I do suggest that if your generic is working, be sure to insist that your pharmacy not switch the generic brand on you. Not all generics are the same.

Hope this helps!!

Edit: Coffee had a huge influence on my side effects. In fact now I have stopped altogether. Don't know if you are a coffee drinker or not, but I would cut back on any caffeine in your diet at least during these first weeks of wellbutrin.

Hi Water, thank you for your reply. I did a lot of reading about the generic brands of Wellbutrin. I read that Teva brand was the worst and there were better alternatives. I wanted to try the name brand and see how I did on that. I do feel like it has caused less side effects but that could also be because I took the generic during the period when you experience the most side effects. Right now the side effects have almost disappeared. Headache, muscle aches, migraine, chest pain, racing heart. That all seems better. Today seemed a little better a little more positive. Although I suffer from insomnia. Not due to Wellbutrin. I am awake each morning at 2:30-3:00 If I sleep until 3 I do pretty well but today it was 2:20 and I was sick and tired all day from lack of sleep.

I drink one cup of coffee in the morning. No more the rest of the day. The only thing I drink is water and a lot of it.

I am hoping so much to have a similar experience with Wellbutrin as you have. I would just like to feel normal, healthy, balanced and happy.

[littleshelly]

It's important to know which generic you are being given. The Teva one is the brand that has the messed-up release mechanism.

There are generics made by Watson Pharmaceuticals and by Anchen, and both of them are working for me after 4 years of being on the brand name stuff. (These are all the XL version. The SR version did nothing for me)

If you can hold on long enough to get by the worst of the side effects, it might be really good for you.

In terms of dose, 300mg is considered the therapeutic dose, but whatever works for you.

I used to pay $340 for a 3-month supply of the name brand, as opposed to $20 for the generic. I just can't afford the name brand.

olga

Hi Olga, thank you for your reply. I have read about Teva and was not on that. The brand I was on was made by Actavis. It is so sad that drug companies can charge so much for medication. Right now I am paying $80.00 for a 60 day supply 150MG of name brand. I will see how I do on that.

[littleshelly]

I'm wondering why you switched to the brand, after starting out on the generic? From what you're saying, I *think* it sounds like you're getting partial results at your current dosage, in which case you should probably talk to your pdoc about increasing your dosage.

Hi SashaSue, thank you for your reply. I switched because I read so much negative information about the generic brand and it did not seem to be helping. It helped some but I just wanted to try name brand and not take any chances.

[fluffybirdie]

Hi littleshelly. I've been taking wellbutrin for several years now to treat depression. It was not my first med, nor is it my only med, but it is far and away the best for me. Like you, I'm also pretty tiny and 150 mgs. is the right dose for me. 300 just plain old had me climbing the walls. I did try the generic, I don't remember the manufacturer, but I felt like poo after a week, so that was the end of that. :devlish:The brand is pricey. Luckily for me ( in a way) in live outside the US and am paying only about $10 a month-yay! But in the US I was paying $40 for the brand. Bargain shopping was really not an option on this one though.

When I first started I did feel a little wacky: energetic, maybe snappy with people, just tweaky. *that devil faced guy is suppsed to be here, I have no idea how he ended up there*. But after things settled out, it has proven to be a very helpful med. Not so much in a wow, I'm magically better way, but in a way thast I can look back over time and see that there was an improvement.

I do take it in combination with topamax as a mood stabilizer as agitation and anxiety are issues with me. Together they work well for me.

I certainly understand your desire to just feel normal and healthy, that's all I wish for every day. I read that fitness is important to you and is is for me--it's been a big part of making me feel somewhat in control and probably kept me from falling as deep into the hole as I could have.

So, try to stick with it. It really is one of the better meds out there. And most of us here have been on some really doozies!!!

Keep us updated on how you're doing.

[littleshelly]

Thank you Suzie and Fluffybirdie, I appreciate your replies so much. It helps to know other people are going through the same thing and can understand. Mental issues are so misunderstood and judged in a negative way. People think nothing of someone being treated for diabetes or high blood pressure, etc but mention depression, OCD, Bipolar and people just don't understand that it is an illness just like any other.

Suzie, I have given much thought to me being Bipolar. Some of the symptoms do not fit me. I don't have weeks or months of highs and then weeks or months of lows. My racing thoughts can be very severe for a few days and then I may have a few days where they are not so bad but it is more bad than good. I did notice when I first started taking the Wellbutrin that was one of the first symptoms that the medication seemed to help. I think they call that a "honeymoon" period. It did not last for long. Then the side effects started. They are mostly gone now but now feel as though I am taking nothing most days but I am going to stick with it and not give up.

I will look into the psychiatrist information you gave me thank you so much for that. I did find a Dr. in the next town. They are not in my health care plan but my insurance will pay some of it. I called about an appointment and they are scheduling 6 weeks out. I told them I would call back.

And I do think the OCD is the biggest problem for me. And part of the depression is related to that. I also have a pretty stressful life. My husband it totally disabled and my son has epilepsy. I work full time and part time some weekends so not much free time or extra money to pay any more medical bills.

Fluffybirdie, I am glad the Wellbutrin is working for you. I hope for the same and glad you are able to get it at such a good price. I agree that exercise makes a huge difference. It definitely helps with my stress and doing it releases some of the tension. I believe that I am able to deal with things as well as I do because I keep in shape. I see in your signature that you also have insomnia. I feel for you. I have not slept past 3am in years and it is hard to function each day when you are chronically exhausted.

Thank you again for the support and information. This is a great site and I am glad I found it.

[littleshelly]

Thank you again Suzie, I thought that was a long time too. That is why I said I would call back because I did not want to wait that long to start on medication. I may still call and schedule an appointment. I think I will wait a few weeks and see how I am doing on the Wellbutrin.

I do get out occasionally but because of the OCD/Depression I have a hard time relaxing and enjoying myself when I do. I am hoping the medication helps with that.

Thank you again and I will keep you posted.

[littleshelly]

I really, really hope the Wellbutrin helps you. I know the combo of OCD and depression is a challenging one. Plus you have added stressors on your plate.

I wish you the very best with all of this. I can almost feel how difficult things must be for you right now. Please hang in there.

Please take care of yourself, and yes, please update on how things are going. Hope they go well!

Wishing you much good luck,

-suzie

Thank you again Suzie. You are a sweetheart.

[rollercoaster]

go to glaxosmith-kline website, they have a program called "bridges to access" where the supply meds at no cost. (they make wellbutrin and lamictal), and their income requirement are quite high...like 2000 a month or more. it is worth checking out. i get both meds for free, non generic. was'nt a prob when i was working as an R.n., before i injured my back. went without meds for a couole of years after i was disabled...then stumbled onto their site...am lovin it now. good luck.