Back on Lexapro, still not feeling it. Should I add Wellbutrin? Other suggestions/support?

[C_Bear]

I've been dealing with depression, anxiety, and OCD for what seems like my whole life. I've been on and off meds: Effexor (I think?) in middle school, Paxil and Zoloft in high school and college, wellbutrin after college, off for a while altogether, then lexapro 2 years ago shortly after my son was born.

Recently I've been feeling worse and worse and felt that the 20mg of lexapro was just pooping out. Generally, I feel tired, unmotivated, like a huge failure, gross since I've also put on weight through these ups and downs, and extraordinarily overwhelmed all the time. I get overwhelmed and just want to sleep/hide, but of course that's not really an option when I work full time (I'm an RN and work three 12hr shifts/week on a very acute floor), have my son to raise, and am also trying to be a good housewife. I have a lot of stressor in my life so it's hard to tell what's situational/normal stress, what's from being tired, what's depression/anxiety, and what's everything mixed in together! My previous pdoc moved practices and no longer took my insurance, but I shelled out the $$$ out of pocket because I value her opinion. She was, however, just about to go on maternity leave, and that's how I got stuck where I am at the moment.

 

We decided to try Pristiq, but I felt terrible. Just angry, dizzy, nauseous, and it was hard to get through the day, so I switched after about 3 weeks. Next try: Brintellix. I had such hopes for that one and the nausea was doable. My doc prescribed 10mg tabs and said to advance to 20mg when I felt ready. At this point she peaced out on maternity leave and I was on my own. At 20mg, I had daily panic attacks, worse than I'd ever experienced. They lasted hours and my PRN ativan didn't touch them. Thank God for helpful coworkers, because I was a mess! Went back down to 15mg and the panic attacks stopped, but I felt my overall anxiety was always high on the Brintellix. No relief. Plus, the depression wasn't helped much either. I stuck to it for about 6 weeks.

 

The jerk covering for my pdoc was helpful and seemed annoyed when I called, even though my pdoc encouraged me to call and talk to one of the other doctors in the practice if I had trouble with my new meds during her leave. He said he couldn't make any changes except to go back to one I had already been prescribed, so he has me back on 20mg of Lexapro.

 

It's been about a week and a half and in some ways I feel more like myself, not irritable or panicky. I still feel so crushingly overwhelmed and exhausted. I feel like a crappy mom and not very fun, my husband has pretty much avoided me since he says I've been a different person every week for the last few months, and I am still having trouble even looking in the mirror with the weight game (about 40lbs including baby weight, baby weight loss, than gaining it back plus some in the last year). I also have a desperate feeling all the time. Like I just HAVE to eat everything, do something, etc.

 

Wow, this got long! I had been seeing a counselor, but we had just generally been talking/venting, nothing structured. I am going back to the center where I previously got help to all but completely overcome my OCD years ago with CBT, and I'm very lucky that the main doc there is taking new patients and my friend's nanny is open to watching my son so I can make the appointments regularly.

 

My women's health NP mentioned someone in a similar situation did great when the added a tiny dose of Wellbutrin to their SSRI. My pdoc had mentioned this as well but was somewhat hesitant since I had some increased anxiety on the full dose before (although it had worked wonderfully for my depression in the past). I could probably call her office and she would call it in until my pdoc comes back from leave. Anyone do this combo? Another combo? See what happens with the CBT and wait it out? I just feel lost without a pdoc to bounce ideas off of and make them happen and I value the opinion of others who are dealing with this. Thank you!

[peacelizard]

With the way you're feeling, honestly, I don't think it could hurt. If it ramps up your anxiety, you can always titrate down again. That's the view I took when I was trying to decide whether or not to take it to see if it improved my social anxiety. Turns out that it did. But it was a gamble. It just depends on if you're comfortable with taking the risk.

 

I hope you get it all straightened out though. I've been where you are -- well, minus the pregnancy/husband thing -- and it sucks. It's definitely not just "life." It's "life" + "symptoms of depression."

[Jessamine]

I think the wellbutrin is worth a try. I'm in a similar situation at the moment in that what I am on is not helping whatsoever, my GP won't prescribe anything for me, wants my pdoc to do that but the pdoc I saw didn't have much of a clue so I'm waiting on another appointment which isn't for a couple of months so I'm just sort of floundering and hoping that the time goes quickly.

As peacelizard said, if you find yourself too anxious on the added wellbutrin then you can always come off it but in the meantime it's worth giving it a go. It might just help. And just because you didn't do well on higher doses doesn't mean it won't give you the effect you need at a lower dose without the anxious side effect.

[Gearhead]

I've been on Lexapro since July 2012, and I've been feeling as if it's quitting on me, too. My anxiety has been creeping up, I'm tired and unmotivated and I feel dumb, I've put on a distressing amount of weight and I really miss my sex drive. I've been on 15 mgs since...years (I split the pills).

 

This weekend during a camping trip I got caught without the right dose of Lexapro and in in effort to stretch it out I went down to 10 mgs a day. I felt sick to my stomach and mildly dizzy, but nothing I couldn't function around. That was Friday. And now, Monday, I've just left the dose at 10 mgs and I'm starting to wonder if maybe reducing the dose isn't making me feel better. Cleared headed. Stomach still a little grumbly, but I've got my period too, so hard to assign blame for that.

 

I hate changing meds so much that I'm going to give this a serious try first.

[C_Bear]

Made the call and picked up the rx for Wellbutrin XL 150mg. I'm planning to continue the Lexapro 20mg at night and try the Wellbutrin in the morning. I also had my first appt with a new psychologist this morning that went really well, so I'm crossing my fingers that I can get moving in the right direction!

[water]

Wellex has been my combo from the beginning. I now use aplenzin which is also bupropion. 

I started with Wellbutrin and added the Lexapro after.

 

I also took the Lexapro at night but stopped after a few days. It was too activating.

 

I take both pills in the morning and have been since I joined Crazyboards. I am blessed I believe with this  combo. Nothing works all the time, but so far, **knocks loudly on wood** this combo has served me very well.

 

I think the 150XL is a great start. Good luck!

[peacelizard]

I'm glad you're trending in the right direction. Hopefully the Wellbutrin will help you and not add to your anxiety. Have you thought about going up on your Lexapro? I'm surprised your pdoc hasn't suggested it already. The rule of thumb I've always heard -- my treaters included -- is to max out on one med before moving onto another, that way you're sure that if you were going to get any benefit from it, you would've seen it and a second medication wouldn't make it harder to tell.