Questions about Bupropion

[ToxicBunny]

I have been taking generic bupropion for about more than 2 months starting at 100mg SR. I took 100mg SR once daily for a month, then started 150mg SR once daily for about 2 weeks before going up to 300mg SR daily (150mg SR x 2) one in the morning at 10 and the other at 6. I've been on the 300mg SR since. I never had the 'honeymoon' phase and I've gotten into the habit of sleeping in even later now.. till 11:30am-12:00pm. And I go to bed at 11:30 at night, sometimes later. I know I'm getting too much sleep and I feel like the bupropion is maybe making me tired. I've also been taking Lexapro 5mg every night to help counteract anxiety. I started it first but I felt it made me flat so I asked to go on bupropion. I feel like it isn't helping me with my mood lately.. just curious if it's a lost cause.. or if I should ask to switch generics (on Sandoz) or maybe add Abilify or something. Before taking these meds I had bad obsessive thoughts and paranoia about my boyfriend (stupid things that I shouldn't be thinking about) and depression. No motivation to do anything and nothing excites me.. still doesn't. I had a couple days where I took adderall once in awhile while on bupropion, of course I felt euphoria on it but very wired and then what's weird is I would feel a few hours of general happiness the next day. I thought it was the bupropion trying to work.. but since a few sporadic days of that I haven't had that feeling since. I used to be addicted to adderall 4 years ago for about 2 years (would take around 160mg a day till I ran out) and quit cold turkey. Also smoked 'spice' legal weed for 8 months, pretty sure that messed me up.. I thought Adderall could help me again but I ended up feeling the addiction coming back so I threw it away. Also to add, I've been taking Synthroid for my low thyroid since I was 18 (26 now) .1 mcg in the morning at 7am daily.

Any insight would be great!

[melissaw72]

Welcome to CB!

I would get your thyroid checked out first ... if your thyroid is "off," (low), it could make you tired, sluggish.  That would rule that out.

 

2 hours ago, ToxicBunny said:

and I feel like the bupropion is maybe making me tired.

Maybe you are on too low of a dose?

2 hours ago, ToxicBunny said:

so I asked to go on bupropion. I feel like it isn't helping me with my mood lately..

How long have you been on it for?

 

Does your psychiatrist (pdoc) know about the wellbutrin not working for you?  Maybe the dose needs to be increased?  Personally the SR didn't work for me ... am currently on the IR, which I find works better for me.

 

[iaawal]

I'm on bupropion XL. It took a bit of time till I got settled at the right dose and the right type. I tried XL then I tried SR before switching back to XL. When I first started taking XL (150mg AM) I would crash by the afternoon (think of how you feel after an all-nighter). We then tried the following schedules: 300mg AM, 150mg AM/150mg PM, 300mg AM/150mg PM. The crashing kept happening and then we switched to SR (200mg AM/200mg PM I think). I was still crashing on that one till we went back to the XL and tried 450mg (3-150mg tablets) in the morning. That one doesn't lead to a crash for me.

Not sure what your situation is in terms of diagnoses but for me, bupropion doesn't really help with my depression. I'm on antidepressants for other reasons. I'm bipolar, and like some bipolar folks, AD's don't do that much for my depression. Bupropion just helps my concentration a bit and helps me to not be a zombie or stare at my wall/computer screen for long periods of time. It was activating in that sense. It didn't help with the loss of interest/pleasure though. 

Edited September 29, 2016 by iaawal

[melissaw72]

I agree with the wellbutrin (when I was on SR) not doing much for the depression (if anything).  It kept me awake and kind of focused, so pdoc took me off of it and just stayed off of it.  Awhile later I needed something to make it so I just didn't sit and start, so pdoc put me on the IR, which works great for me.  The SR (for me) didn't work very well, and is nothing like the IR ... which is helping a lot. 

[ToxicBunny]

5 hours ago, melissaw72 said:

Welcome to CB!

I would get your thyroid checked out first ... if your thyroid is "off," (low), it could make you tired, sluggish.  That would rule that out.

 

Maybe you are on too low of a dose?

How long have you been on it for?

 

Does your psychiatrist (pdoc) know about the wellbutrin not working for you?  Maybe the dose needs to be increased?  Personally the SR didn't work for me ... am currently on the IR, which I find works better for me.

 

 

Hey there!

Well, my doctor made sure to check my thyroid levels before I decided to go on antidepressants to rule that problem out. I've been on thyroid medication since I was 18, I'm now 26. So I don't think that's the problem. Lol wish it was so it would probably be an easy fix!

I've been on 300mg SR for about a month now, before I was on the 100mg and 150mg for a month and a half. I just don't feel any different, maybe a TINY bit but I don't know. 

I'm actually doing all this through my primary doctor. Pretty much telling him what I think I want lol, if the next visit doesn't do anything (in a week) I'm going to go find a psychiatrist. I've been to numerous psychiatrists throughout earlier years (during high school and early 20s) and that's how I ended up being prescribed Adderall, which ruined 2 years of my life. I told her I was tired all the time and she said, "Maybe you need a stimulant' and prescribed it to me. At that time I had no idea about how addictive Adderall was. I've also been on Lexapro before, Zoloft, Prozac, Wellbutrin (don't remember it besides sweating a lot), Abilify and I think that's it. I don't really want to go the SSRI route because of the horrible decreased libido and weight gain I've had in the past.. so that's why I went with Wellbutrin, not only that but I figured it was a dopamine deficieny that I have because of how much Adderall I used to take.

Did you feel any relief with the SR before you switched to the IR? What made you want to switch? I've been reading your other posts on the board, and I feel like more and more that I might be one of those people that needs to take the IR version. Because more medication is released at a time. Also are you on Generic? If so, what manufacturer? I just hope my doctor agrees on it. It was either that or go up to 450mg SR. I just don't see how it would work better if it releases so slow anyway but I don't know. Do you think I should switch to the IR and add abilify or just go with the IR and try it for awhile first.

I was thinking about just biting the bullet and trying brand name Wellbutrin but it's so expensive and my insurance doesn't cover it..

Also did you have any side effects from starting Wellbutrin? Because I had barely any besides increased anxiety in the beginning. 

Thank you for your reply! I really appreciate.

 

[melissaw72]

25 minutes ago, ToxicBunny said:

Did you feel any relief with the SR before you switched to the IR? What made you want to switch? I've been reading your other posts on the board, and I feel like more and more that I might be one of those people that needs to take the IR version. Because more medication is released at a time. Also are you on Generic? If so, what manufacturer? I just hope my doctor agrees on it. It was either that or go up to 450mg SR. I just don't see how it would work better if it releases so slow anyway but I don't know. Do you think I should switch to the IR and add abilify or just go with the IR and try it for awhile first.

Not much relief.  I did give the SR time to get into my system too, but I eventually went off of it because it didn't seem helpful.  Later when I was put back on it, because there hadn't much of a difference with the SR, I was put on the IR (in divided doses ... 100 mg AM, 100 mg PM, and if I go to 300 mg/day I take an afternoon dose of 100 mg as well), which made a world of difference for me.  YMMV though.

I think mine is generic, along with all the others except one.  And not sure of the manufacturer.

I think if the SR isn't working out for you, you could ask about the IR, but I would HIGHLY suggest finding a pdoc to prescribe your meds.  They know so much more about meds than a general DR does as well as interactions between meds.  What you think you want (whichever med) and then asking for it can be dangerous if there are any interactions you are unaware of.

(in bold, inside the quote box) ... I'm not a DR so I can't do/say much about taking what meds with what other meds, or which meds to try with all of that.  IF it were me though, I would only go on one new med at a time, so if I had a reaction I'd know which med it was coming from.  You wouldn't know if you started more than one at a time.

If you want the brand name, then I would think about it on a long-term basis in terms of cost.

The only side effects I had when starting the IR, was the one I needed, which was to make me more alert.  The only other one I had was when we were increasing the dose, I found myself to be jittery more than usual, so we backed down on the dose and that went away.

Edited September 29, 2016 by melissaw72

[ToxicBunny]

36 minutes ago, melissaw72 said:

Not much relief.  I did give the SR time to get into my system too, but I eventually went off of it because it didn't seem helpful.  Later when I was put back on it, because there hadn't much of a difference with the SR, I was put on the IR (in divided doses ... 100 mg AM, 100 mg PM, and if I go to 300 mg/day I take an afternoon dose of 100 mg as well), which made a world of difference for me.  YMMV though.

I think mine is generic, along with all the others except one.  And not sure of the manufacturer.

I think if the SR isn't working out for you, you could ask about the IR, but I would HIGHLY suggest finding a pdoc to prescribe your meds.  They know so much more about meds than a general DR does as well as interactions between meds.  What you think you want (whichever med) and then asking for it can be dangerous if there are any interactions you are unaware of.

(in bold, inside the quote box) ... I'm not a DR so I can't do/say much about taking what meds with what other meds, or which meds to try with all of that.  IF it were me though, I would only go on one new med at a time, so if I had a reaction I'd know which med it was coming from.  You wouldn't know if you started more than one at a time.

If you want the brand name, then I would think about it on a long-term basis in terms of cost.

The only side effects I had when starting the IR, was the one I needed, which was to make me more alert.  The only other one I had was when we were increasing the dose, I found myself to be jittery more than usual, so we backed down on the dose and that went away.

 

So then the IR helped with depression too? 

Yes, I'm definitely going to start seeing a psychiatrist soon.. especially if the IR doesn't work out for me. 

I've also had a low grade fever for 3 years and finally saw an infectious disease doctor a couple days ago who is going to do a cat scan on me as well as extensive blood work to see what could be the problem, if any. 

It would say on the bottle what manufacturer it is, I'm just curious to see if you can find it!

Do you drink caffeine at all?

[melissaw72]

I was already on another anti-depressant (Prozac), and I didn't see any difference (good or bad) when I started the IR.

I hope the CT scan and blood work turn out ok.  (For me though, I would want to see a problem so that it could be treated ... as opposed to have nothing wrong ... then you would still have the fever etc with no explanation).  Those are just MY thoughts on it.

Mylan brand.

No, I don't drink caffeine.  I mainly drink water.

[ToxicBunny]

1 hour ago, melissaw72 said:

I was already on another anti-depressant (Prozac), and I didn't see any difference (good or bad) when I started the IR.

I hope the CT scan and blood work turn out ok.  (For me though, I would want to see a problem so that it could be treated ... as opposed to have nothing wrong ... then you would still have the fever etc with no explanation).  Those are just MY thoughts on it.

Mylan brand.

No, I don't drink caffeine.  I mainly drink water.

 Oh, I know.. I'd like to know what's wrong with me too!  Two doctors I've been to still don't know that's why I'm finally going to specialists. Thanks for the responses!

[olga]

You might also ask to be checked for Lyme Disease.  I don't know where you live (and you don't need to tell us), but in some regions of the US, Lyme Disease is a serious problem.  Some of your symptoms could be attributed to that.

I (like other people here) tried the SR version of Wellbutrin and it did nothing.  I tried other antidepressants and they were also ineffective.  Then I tried Wellbutrin XL, and it was like night and day.  I've been on it for 10 years now, although I switched to the Bupropion generic several years back.

Keep asking questions, take notes at all your doctor appointments, and write down questions for the doctors in advance, so you don't forget them.  It sounds like you are trying very hard to get effective treatment.  Hang in there!

olga

[ToxicBunny]

25 minutes ago, olga said:

You might also ask to be checked for Lyme Disease.  I don't know where you live (and you don't need to tell us), but in some regions of the US, Lyme Disease is a serious problem.  Some of your symptoms could be attributed to that.

I (like other people here) tried the SR version of Wellbutrin and it did nothing.  I tried other antidepressants and they were also ineffective.  Then I tried Wellbutrin XL, and it was like night and day.  I've been on it for 10 years now, although I switched to the Bupropion generic several years back.

Keep asking questions, take notes at all your doctor appointments, and write down questions for the doctors in advance, so you don't forget them.  It sounds like you are trying very hard to get effective treatment.  Hang in there!

olga

Hello!

Yeah, I'm definitely determined to figure out what the low grade fever is from. People just say, "Maybe that's just your normal temperature now." But how would it just change like that? Lol.

So SR didn't do anything for you? I wonder why XL works. Lol, now I'm torn between trying the IR and XL. What generic XL are you on?

[mikl_pls]

I know you said you don't want to go down the SSRI route (can't blame you). There are a few alternatives I'd like to suggest.

When I was on Wellbutrin, I was on Wellbutrin XL 300 mg + Wellbutrin IR 100 mg twice a day to augment it for 500 mg (a little over the max dose but I was pretty depressed and needed the boost). It seemed to work pretty well and hold my head above the water so to speak. Perhaps if you try the IR version by itself, you might have better luck.

Just thought I would mention some alternatives in case that doesn't work. You can use these to augment the Wellbutrin or take in lieu of Wellbutrin entirely.

SNRIs don't often cause as much weight gain as SSRIs do (they can, but it's pretty uncommon for them). Plus the norepinephrine reuptake inhibition actually increases dopamine in the prefrontal cortex (but not elsewhere in the brain). The generics available are venlafaxine/venlafaxine ER (Effexor/Effexor XR) and duloxetine (Cymbalta), while the brand-name only's are Pristiq (desvenlafaxine ER) and Fetzima (levomilnacipran). It's worthwhile to mention that most SNRIs are actually more serotonergic than noradrenergic except for Fetzima; the ratios of SRI to NRI go something like this: 30.2439...:1 for Effexor, 13.89...:1 for Pristiq, 9.375:1 for Cymbalta, and supposedly 1:2 for Fetzima. These meds tend to be pretty stimulating for most people, only occasionally will you find someone who gets sedated from Cymbalta or Fetzima. Effexor was like a weak form of speed for me or something. Pristiq wasn't that impressive for me, probably because it's dosed so low in comparison to Effexor (it only comes in 50 mg and 100 mg, and they say no additional proven benefits above 50 mg, so 50 mg is essentially the dose... however, the amount of 50 mg desvenlafaxine (Pristiq) is roughly equivalent to 100 mg Effexor (55 mg = 100 mg), and with Effexor you can go all the way up to 375 mg (FDA approved max dose, = just over 70 mg Pristiq) and beyond, like 450 mg is the highest I've seen (= just over 80 mg Pristiq), I was on 825 mg before I quit (= just over 150 mg Pristiq)).

Another drug class that might be worthwhile to try is a new class called SPARIs (serotonin partial agonists and reuptake inhibitors) or SMSs (serotonin modulators and stimulators). They are essentially an SSRI with serotonin 5-HT1A partial agonism or full agonism, and some might have additional binding properties that enhance its pharmacodynamic profile. One might say "that's just like adding Buspar to an SSRI." It is not. According to Stephen Stahl explains why the SPARI Viibryd (vilazodone) (brand-name only) is different from augmenting an SSRI with buspirone.

• Buspirone and its active metabolite 6-hydroxybuspirone are weaker 5-HT1A partial agonists than Viibryd and are estimated to occupy fewer 5-HT1A receptors for a shorter time at clinically administered doses than does Viibryd.
• Buspirone and 6-hydroxybuspirone also bind to 5-HT1A receptors with lower affinity than serotonin itself, whereas Viibryd binds to 5-HT1A receptors with higher affinity than serotonin This suggests that administration of buspirone as an augmenting agent to an SSRI/SNRI likely results in 5-HT1A receptor occupancy that occurs more robustly in states of low serotonin levels and not as robustly in states of high serotonin levels, whereas administration fo Viibryd results in binding to 5-HT1A receptors even in the presence of serotonin.
• Another difference between buspirone + SSRI/SNRI versus Viibryd is that when busprione augments an SSRI, the buspirone is generally dosed so that about 10-20% of 5-HT1A receptors are occupied and the SSRI is dosed so that about 80% of the SERTs are blocked. OTOH, human neuroimaging studies suggest that Viibryd is dosed so that about 50% of both SERTs and 5-HT1A receptors are occupied. Whether this accounts for clinically significant differences is unknown, but it could account for the apparent lesser incidence of sexual dysfunction with Viibryd than with either SSRIs alone or with the augmentation of buspirone.

The SMS Trintellix (vortioxetine) I imagine would have the same or similar properties to Viibryd in this regard, although Trintellix has additional binding properties, like 5-HT1B partial agonism/5-HT1D antagonism (which disinhibits serotonin release), 5-HT3 antagonism (acetylcholine, norepinephrine, histamine, and possibly dopamine and serotonin release as well, probably accountable for the pro-cognitive effects of Trintellix), 5-HT7 antagonism (enhanced serotonin release with beneficial effects on circadian rhythm).

5-HT1A partial agonists act presynaptically at 5-HT1A autoreceptors immediately after the drug is given, which theoretically is additive/synergistic with simultaneous SERT inhibition (serotonin reuptake inhibition). This hypothetically causes faster and more robust elevation of synaptic serotonin than is possible with SSRIs alone. In addition, 5-HT1A partial agonism with Viibryd's mechanism of action (and probably Trintellix's too) occurs immediately at postsynaptic 5-HT1A receptors too, with actions at these receptors that are faster and with a different type of stimulation than the delayed full agonist actions of serotonin itself when increased by SERT inhibition alone. The downstream actions of 5-HT1A receptors that lead to enhanced dopamine release may be hypothetically responsible for the observed reduction in sexual dysfunction seen in patients with the combination of SERT inhibition plus 5-HT1A partial agonist actions compared to SERT inhibition alone.

 

You may not be willing to make this jump quite yet, but if you want to avoid weight gain and sexual dysfunction, you might take a look at the MAOIs, especially Emsam (selegiline transdermal), tranylcypromine (Parnate), and selegiline oral (Eldepryl) (and probably try and avoid phenelzine (Nardil) and Marplan (isocarboxazid ), the hydrazine derivitaves, which are known to cause weight loss that never plateaus for as long as you take the drug, at least from what I've read...).

 

The secondary amine tricyclic antidepressants (TCAs) are supposedly more weight friendly, like nortriptyline (Pamelor), desipramine (Norpramin), and protriptyline (Vivactil), plus they aren't sedating for most people (they're actually stimulating for some people so much so that they are used for ADHD and narcolepsy, especially protriptyline). I personally didn't have any sexual dysfunction or weight gain on any of the TCAs mentioned, but I didn't lose weight either (except with Norpramin for a short period of time). They're mostly noradrenergic over serotonergic, and in fact, desipramine is so preferentially noradrenergic, it could almost be called a selective norepinephrine reuptake inhibitor (SeNRI) like Strattera (atomoxetine).

 

Speaking of which... Strattera might be a worthy augmenting agent for you. It's a selective norepinephrine reuptake inhibitor (SeNRI), and as I mentioned above, NRI increases dopamine in the prefrontal cortex, so it's like 1½ actions in 1 pill... It can be used to augment an SNRI like Cymbalta or something to make the SRI-to-NRI ratio more noradrenergic. It can help with focus, concentration, possibly even energy if you're lacking in norepinephrine. Personally from my experience, interestingly I noticed it helped with my OCD and helped calm me down a little, like I wasn't as liable to snap or make comments on things that were uncalled for or whatever. Not sure how it did that.

 

Hope you find something that helps you, and hope this helps some!

[ToxicBunny]

1 hour ago, mikrw33 said:

I know you said you don't want to go down the SSRI route (can't blame you). There are a few alternatives I'd like to suggest.

When I was on Wellbutrin, I was on Wellbutrin XL 300 mg + Wellbutrin IR 100 mg twice a day to augment it for 500 mg (a little over the max dose but I was pretty depressed and needed the boost). It seemed to work pretty well and hold my head above the water so to speak. Perhaps if you try the IR version by itself, you might have better luck.

Just thought I would mention some alternatives in case that doesn't work. You can use these to augment the Wellbutrin or take in lieu of Wellbutrin entirely.

SNRIs don't often cause as much weight gain as SSRIs do (they can, but it's pretty uncommon for them). Plus the norepinephrine reuptake inhibition actually increases dopamine in the prefrontal cortex (but not elsewhere in the brain). The generics available are venlafaxine/venlafaxine ER (Effexor/Effexor XR) and duloxetine (Cymbalta), while the brand-name only's are Pristiq (desvenlafaxine ER) and Fetzima (levomilnacipran). It's worthwhile to mention that most SNRIs are actually more serotonergic than noradrenergic except for Fetzima; the ratios of SRI to NRI go something like this: 30.2439...:1 for Effexor, 13.89...:1 for Pristiq, 9.375:1 for Cymbalta, and supposedly 1:2 for Fetzima. These meds tend to be pretty stimulating for most people, only occasionally will you find someone who gets sedated from Cymbalta or Fetzima. Effexor was like a weak form of speed for me or something. Pristiq wasn't that impressive for me, probably because it's dosed so low in comparison to Effexor (it only comes in 50 mg and 100 mg, and they say no additional proven benefits above 50 mg, so 50 mg is essentially the dose... however, the amount of 50 mg desvenlafaxine (Pristiq) is roughly equivalent to 100 mg Effexor (55 mg = 100 mg), and with Effexor you can go all the way up to 375 mg (FDA approved max dose, = just over 70 mg Pristiq) and beyond, like 450 mg is the highest I've seen (= just over 80 mg Pristiq), I was on 825 mg before I quit (= just over 150 mg Pristiq)).

.........

 

Hello!

Yeah, my doctor was suggesting Effexor too, but I want to exhaust all options of Wellbutrin first before I start a different med, because Wellbutrin takes so dang long to work apparently. Did Effexor help with depression at all? I see you are on Adderall (I think) and I know that makes me feel good, but it's no good for me. I know a lot of people say Wellbutrin makes them feel like they are on speed when I first take it, I never got that feeling. Probably because I abused Adderall so much in the past.. maybe Wellbutrin is too weak for me. I think if it doesn't work out I'll ask to go on Effexor. 

The reason why I started Lexapro was for really obsessive thoughts and anxiety. After I was on that for a bit I still felt blah.. so I wanted to try Wellbutrin for motivation and depression. I just really don't want to spend the next 2 years or even longer trying to find the right medication. I used to drink a lot too and I completely gave that up for about 3 months now. It's not a big deal though, I'd rather feel good most of the time than get drunk and feel good temporarily, harming my body and feeling hungover a lot. 

I saw that Trintellix but they probably don't have a generic version yet so I'd be paying a lot of money for that one.

Thank you for all the info!

[olga]

9 hours ago, ToxicBunny said:

Hello!

Yeah, I'm definitely determined to figure out what the low grade fever is from. People just say, "Maybe that's just your normal temperature now." But how would it just change like that? Lol.

So SR didn't do anything for you? I wonder why XL works. Lol, now I'm torn between trying the IR and XL. What generic XL are you on?

I don't know the answer to your question---as we say around here "Your Mileage May Vary."  Our bodies all absorb things differently and react to them in strange ways.

SR means Standard Release, so I'm not sure what that means in terms of how the med is released in your body.  All I know is that XL (Extended Release) worked very quickly to lift me out of the Black Pit.  I've been on the name brand and a couple of generics---the one I'm taking now is made by Par Pharmaceuticals.  I know that XL means it's releasing the active ingredient for several hours after you take it.  Since Bupropion can be a little energizing for some people, I usually advise people to take it in the morning.  (That's assuming your doctor agrees:  we want to  be careful around here about telling people what they should take and when.)

I would caution you that Wellbutrin is not always a good choice for patients with anxiety.  Also, it's not a good idea to drink while you're on it.  In terms of time, I noticed a difference within 2-3 days---but again, YMMV.  Keep doing your research and I hope you find a med or combination of meds that is effective for your particular issues.

olga

[melissaw72]

7 hours ago, olga said:

All I know is that XL (Extended Release) worked very quickly to lift me out of the Black Pit. 

This is what the IR did for me. I agree with taking it in the AM if your DR says it is ok.  And I also noticed a difference very soon after I started it (IR).  It didn't take very long. 

 

19 hours ago, ToxicBunny said:

Yes, I'm definitely going to start seeing a psychiatrist soon.. especially if the IR doesn't work out for me. 

again, I would highly suggest you find a pdoc to manage the meds, even before you try the IR.

[mikl_pls]

14 hours ago, ToxicBunny said:

 

Hello!

Yeah, my doctor was suggesting Effexor too, but I want to exhaust all options of Wellbutrin first before I start a different med, because Wellbutrin takes so dang long to work apparently. Did Effexor help with depression at all? I see you are on Adderall (I think) and I know that makes me feel good, but it's no good for me. I know a lot of people say Wellbutrin makes them feel like they are on speed when I first take it, I never got that feeling. Probably because I abused Adderall so much in the past.. maybe Wellbutrin is too weak for me. I think if it doesn't work out I'll ask to go on Effexor. 

The reason why I started Lexapro was for really obsessive thoughts and anxiety. After I was on that for a bit I still felt blah.. so I wanted to try Wellbutrin for motivation and depression. I just really don't want to spend the next 2 years or even longer trying to find the right medication. I used to drink a lot too and I completely gave that up for about 3 months now. It's not a big deal though, I'd rather feel good most of the time than get drunk and feel good temporarily, harming my body and feeling hungover a lot. 

I saw that Trintellix but they probably don't have a generic version yet so I'd be paying a lot of money for that one.

Thank you for all the info!

 

I'll caution you on Effexor, it has a nasty, nasty withdrawal syndrome if you ever try to stop it or go to something else (not so bad if you have something else to go to immediately after and it's sufficiently dosed). Other than that, Effexor made me feel great for the first time in years, but only for a few months, and I had to be on the highest dose, 375 mg, and it pooped out. After that, we tried escalating the dose and wound up on 825 mg (!!) before I decided to call it quits on Effexor. The combination of Prozac and desipramine did quite well, but my pdoc didn't want me on Prozac and put me back on Cymbalta instead. She let me go up to the max dose, 120 mg, but then made me come down to 80 mg, not sure why. It's helping but not much.

I'm actually on Dexedrine (dextroamphetamine, whereas Adderall is dextroamphetamine + amphetamine), though I am thinking about switching back to Adderall. I find that it reduces my anxiety, paradoxically to what many doctors think, and that it improves my focus and impulse control. I'm able to sit still in a chair for longer periods of time and focus on working on something rather than working for 15 minutes and getting up and wandering around the house aimlessly... lol. It's like I'm still a child sometimes. XD Perhaps it could be because you abused Adderall, or not. Perhaps you just need a higher dose of Wellbutrin, some people don't really respond until they get up to 450 mg. Hell, I didn't really, really respond until I was on 500 mg (300 mg XL + 100 mg IR twice a day). But oh, the constipation it caused at that dose... Glad you were able to give up drinking! I gave up drinking myself, not that I was ever a heavy drinker, just a social drinker, but I didn't like how it interacted with my meds and made me feel 10x drunker than I should be feeling (anticonvulsants + alcohol = that's a nono, Cymbalta + alcohol = another nono). 

You know there's nothing wrong with polypharmacy—you can be on both Lexapro and Wellbutrin at the same time. The Lexapro blahs... I remember those. I was in high school and my room became a landfill it was so messy. You could hardly walk in it, but I just... didn't... give... a shit... lol. If you want an SSRI that doesn't produce the blahs so much, you could try Zoloft (it has minor dopamine reuptake inhibition) or Prozac (5-HT2C antagonism = dopamine and norepinephrine release), or you could just try an SNRI. And if the doctor isn't overly conservative, they should be okay with prescribing either an SSRI/SNRI + Wellbutrin. It's done very often.

Yep, Viibryd and Trintellix are brand names only; however, if you have insurance, you can use the discount card from their website (print it out and bring it to the pharmacy with your prescription), or your doctor may even have some samples and a discount card him/herself s/he may give you. Either way, the discount card can make the copay much more affordable (like $25-$40, within that vicinity, depending on your insurance). Much better than paying ≥$125. Pristiq and Fetzima are also brand names only, although there seem to be some companies trying to release "generic" versions of Pristiq (desvenlafaxine), but my insurance company at least still treats them as brand-name meds and charges out the ass for them.

No problem!  

[melissaw72]

Sorry for the tangent, just wanted to add this in, FWIW:

 

2 hours ago, mikrw33 said:

You know there's nothing wrong with polypharmacy

I think that depends on what DR you ask.  I have no problem with it, but I've never had a DR tell me that there was nothing wrong with polypharmacy.  Maybe some like it, just I have personally never had one DR in my lifetime that told me it is a good thing. 

 

[mikl_pls]

Just now, melissaw72 said:

I think that depends on what DR you ask.  I have no problem with it, but I've never had a DR tell me that there was nothing wrong with polypharmacy.  Maybe some like it, just I have personally never had one DR in my lifetime that told me it is a good thing. 

 

Good point. Duly noted.  

[crtclms]

On 9/30/2016 at 8:17 AM, melissaw72 said:

Sorry for the tangent, just wanted to add this in, FWIW:

 

I think that depends on what DR you ask.  I have no problem with it, but I've never had a DR tell me that there was nothing wrong with polypharmacy.  Maybe some like it, just I have personally never had one DR in my lifetime that told me it is a good thing. 

 

I've heard many pdocs, AND ndocs support poly-pharmacy when necessary. Thank god for me! But non-pdocs always tell you you are on too much medication. Ignore them, they don't understand how hard it is to treat MI. Unless you are talking about a drug interaction, and even then, you should run it past your pdoc.

SR is actually sustained release, at least in the case of Wellbutrin. SR works better for me. When I was taking the XL, it wasn't quite working. My pdoc put me on 450mg of SR, once a day, and apparently if you are lucky, there is some amount of synergy boosting the med's efficacy, as opposed to 450mg of buproprion XL. I love buproprion. Except for a 9 month detour, I have been on it since 1989. The only reason I came off of it was that I thought it was making me anxious, and not working as well. I was wrong on both counts. Within a few weeks of stopping it, I was getting depressed. I'm back on it (actually, at a smaller dose, 300mg instead of 450mg), and it's been like night and day. Buproprion is considered a pretty good anti-depressant for bipolar illness, as opposed to some of the SSRIs. I tried prozac and zoloft (which were all the SSRIs that were available at the time). Prozac made me manic, and zoloft made me a angry, sad, bitch.

If you are taking 500mg or above of buproprion, watch out for hallucinations. I was on 600mg back in the day, and I was definitely hallucinating. Not of people or anything large. But for example, when I would look at patterned things, or the tendrils on towels, they would move. Things like that. They didn't stop until we backed down to 450mg.

[melissaw72]

23 minutes ago, crtclms said:

I've heard many pdocs, AND ndocs support poly-pharmacy when necessary. Thank god for me! But non-pdocs always tell you you are on too much medication. Ignore them, they don't understand how hard it is to treat MI. Unless you are talking about a drug interaction, and even then, you should run it past your pdoc.

 

I totally agree about the primary DRs not supporting poly-pharmacy.  At one point I couldn't go back to my gdoc only because no matter what I went there for, he ALWAYS told me it was because I was on too much medication.  I have another DR now, but it got to be really ridiculous.

 

[notloki]

This is what psychiatrists are for. They have the education and clinical experience with these meds to mix and match them and use them additively. . I think is it is asking a lot of a generalist to prescribe multiple psychotropic meds. Some do but this does not mean it is a good idea.

 

[ToxicBunny]

So since I've written this post I asked my doctor if I could go up to 450mg a day of SR but he refused to go any higher and told me to see a psychiatrist. So that's what I'm going to do.

I thought I was starting to feel a little better on 300mg SR a day, but now I feel like I've gone backwards a bit.. and it's been almost a month and a half of me being on 300mg SR and about 3 months altgother being on Bupropion. About to give up on it.