Wellbutrin/Bupropion Tiredness

[Lauliza]

I'm just wondering if anyone else has had the experience of feeling completely exhausted when taking immediate release Wellbutrin/Bupropion? My doc started me low - at 75mg a day (37.5mg twice per day), then up to 150 (75mg twice per day) for about a month now. For the first few days I felt the "honeymoon" effect some people experience- increase in energy, motivation, etc. After then, however, I've noticed I feel very tired. It's not a crash after some initial energy, I am just exhausted soon after taking it. Moodwise I am ok, and even notice I feel a bit calmer. Definitely not the energy, motivation and rage other people report. 

I've been on a variety of AD's for the past 30 years and have taken Bupropion in the past, with some success. I remember feeling depleted on the XR version but switched to the IR version and felt fine. I also take dexedrine for ADD and that helps  counteract the tiredness, but if I forget I'm exhausted.

I know this is a paradoxical response, as is some of the water retention that I've noticed as well. I asked the pharmacist and she said that it is possible to feel tired from bupropion but didn't offer much else. I'm curious if, of those who do feel tired on this med, do you still feel like it's working in other aspects, or is this side effect a sign it's not the right one? If that's the case, I suppose taking it at night could help but I'm more curious about why I have the opposite reaction than everyone else.  

[Juniper29]

Wellbutrin IR made me feel exhausted. Also just generally sick. I was so impaired I couldn't take care of my son so I stopped taking it.

[argh]

Can you take the extended release?

That said, 150mg of the XL made me tired too. Wasn't until 300mg that the activation and insomnia (yay) came in.

 

[Lauliza]

The Extended release version unfortunately was worse - it depleted my energy such that even standing for extended periods made me tired (not normal at all). So I won't take that again, but the SR version is a possibility. Have you tried this version?

Edited June 12, 2018 by Lauliza

[argh]

Sorry I havent been on IR.

How high did your dose go in XR? Did you ever hit 450?

[notloki]

31 minutes ago, argh said:

Sorry I haven't been on IR.

How high did your dose go in XR? Did you ever hit 450?

I've been at 450 mg for several years. No problems. The issue with going above 300 mg is seizures. Apparently someone had a seizure during the pre-marketing studies. In truth all AD's and AP/AAP's have some incidence of seizure. Lithium is used to induce seizures in test animals as it has a high rate of seizure. Wellbutrin at 300 mg has a .1% incidence of seizures but so do most crazymeds, except benzos. Some AD's have a higher incidence of seizure than Wellbutrin does. When you move up to 450 mg the seizure incidence rises to .3 %. 3 in 1000 have a seizure but seizure is very common, 1% of the general population is on meds for seizures. Above 450 the incidence rises quickly. They used to allow 600 mg when it first came out !

450 mg made a big difference for me, no side effects at all except raised heart rate. I would not go above 450 mg but I have epilepsy so I am primed for a seizure. It does not seem that Wellbutrin does not cause seizures in me.

To me a .3 % incidence is acceptable, after all it is just 3 people in 1000 so the likelihood of seizure is low.  

[browri]

@Lauliza another option if your insurance will be willing to cover it is to try brand name Aplenzin, which is bupropion hydrobromide instead of bupropion hydrochloride which is used for brand name Wellbutrin and the currently available generics. Bupropion hydrobromide is not yet available as a generic.

I found that the Aplenzin formulation didn't make me feel as jittery. It was smoother and lasted all day, whereas the generic bupropion XL felt like it was dissolving too quickly and I would have afternoon crashes. In that regard, pdoc's are more willing to use the bupropion hydrochloride SR formulation over the XL formulation because the release mechanism in the SR formulation of the generics is more consistent. Otherwise you would have to get brand name Wellbutrin XL which you'll have to pull out teeth to get your insurance to cover. Although you might have the same amount of difficulty with insurance for either Wellbutrin XL or Aplenzin.

I'm not sure if @water is still taking it, but she used to swear by it last I checked. I took it for quite some time. Ultimately my pdoc and I determined that bupropion regardless of whether it was the chloride or bromide salt caused too much anxiety. But it was very effective for my depression and didn't cause me any manic switches. (BP2).

I do believe also that they did one study where they determined that with Aplenzin at the 522mg dose compared to Wellbutrin XL at the 450mg dose. They compared the two to determine if there was a similar seizure risk. They found that bupropion hydrobromide didn't result in FEWER seizures but the ones that did occur were shorter in duration and less severe than the ones caused by bupropion hydrochloride. This is likely because the bromide salt itself may actually have some anti-seizure activity as bromides were some of the first compounds use to treat seizures.

[notloki]

During the bupropion shortage a few years ago I could not get generic bupropion or brand Wellbutrin but since almost no one was taking Aplenzin Express Scripts and several pharmacies had it on hand. So I took Aplenzin until it ran out. I then moved to Fortivo XL, another "brand" of bupropion, which again no one took so it was available. 

 

[browri]

54 minutes ago, notloki said:

During the bupropion shortage a few years ago I could not get generic bupropion or brand Wellbutrin but since almost no one was taking Aplenzin Express Scripts and several pharmacies had it on hand. So I took Aplenzin until it ran out. I then moved to Fortivo XL, another "brand" of bupropion, which again no one took so it was available. 

 

Out of curiosity, how did you feel about Aplenzin 522 vs the Forfivo 450, @notloki?

[notloki]

13 minutes ago, browri said:

Out of curiosity, how did you feel about Aplenzin 522 vs the Forfivo 450, @notloki?

They were equivalent. 

[water]

On 6/11/2018 at 5:29 PM, Lauliza said:

I'm just wondering if anyone else has had the experience of feeling completely exhausted when taking immediate release Wellbutrin/Bupropion?

YES. Absolutely HATED the immediate release Wellbutrin.  Too strong a med to be dumped out all at once in my sensitive body. 

The SR - sustained release, 12 hour, was also awful. By the time it wore off I was depressed and then going to sleep when I had to take another one!  Settled on the extended release. Eventually switched to Aplenzin because...it was only one pill for the same amount as the 450 XL.

I never ever took a generic. Always always the brand. Sorry....didn't read all of the posts, apologize if this is all besides the point. :-}

[notloki]

I would try for Aplenzin and if not get the XL. One person's bad experience is not significant when millions took it with success. If you take 450 mg you will need to take a 300 mg XL and a 150 mg XL. The Aplenzin has a better time release system than the generics. 

[browri]

19 minutes ago, notloki said:

I would try for Aplenzin and if not get the XL. One person's bad experience is not significant when millions took it with success. If you take 450 mg you will need to take a 300 mg XL and a 150 mg XL. The Aplenzin has a better time release system than the generics. 

This is probably why it caused me less jitters and anxiety. The smoother release mechanism means you don't get it "all at once" and therefore less major spikes in drug level early in the day that could lead to anxiety or a crash in the afternoon.

[notloki]

On 6/11/2018 at 8:51 PM, Lauliza said:

The Extended release version unfortunately was worse - it depleted my energy such that even standing for extended periods made me tired (not normal at all). So I won't take that again, but the SR version is a possibility. Have you tried this version?

SR version does not distribute the medication over time evenly as well as the XL.

[browri]

7 hours ago, notloki said:

SR version does not distribute the medication over time evenly as well as the XL.

That was certainly the case for the brand name Wellbutrin SR and XL, but what about the generics?

[notloki]

4 hours ago, browri said:

That was certainly the case for the brand name Wellbutrin SR and XL, but what about the generics?

I take a generic XL, 300 mg and 150 mg that works well. My pdoc says "They finally got the time release right" and he has a lot of patients on bupropion. 

Edited June 19, 2018 by notloki

[browri]

14 hours ago, notloki said:

I take a generic XL, 300 mg and 150 mg that works well. My pdoc says "They finally got the time release right" and he has a lot of patients on bupropion. 

Interesting! Certainly took them long enough to figure out how to do it. Lol. 

[Lauliza]

On ‎6‎/‎18‎/‎2018 at 9:10 AM, notloki said:

I would try for Aplenzin and if not get the XL. One person's bad experience is not significant when millions took it with success. If you take 450 mg you will need to take a 300 mg XL and a 150 mg XL. The Aplenzin has a better time release system than the generics. 

I will suggest Aplenzin to my pdoc...I'm curious to see what he says. As for the XL, I've taken the it in the past and felt awful on it - I felt depleted of all my energy, as if I could never get enough oxygen. I don't remember if I've been on the SR version or not so if Aplenzin isn't an option I'll ask for that. Interestingly, many years ago I took brand name Zyban and it worked well, giving me none of these side effects. My insurance won't cover brand name Zyban or Wellbutrin, unfortunately.

Interesting how for some people, the fatigue goes away as the dosage hits 300-450. When I took 150 (2 75mg doses) of the IR, I was almost falling asleep at my desk at work. And that was all day, not after a crash at the end. I was just tired all day long. 

[sming]

On 6/24/2018 at 11:15 PM, Lauliza said:

I felt depleted of all my energy, as if I could never get enough oxygen

This is me. I call it "chemical exhaustion" since it's very distinct to being naturally exhausted. It's like gravity is 10x stronger and it's as if someone has somehow removed every single calorie of energy from my body. I can't sleep but am beyond exhausted.

Hence @Lauliza, did you have any success with the options at hand? I'm in a terrible way with the fatigue and need some suggestions for my PDoc. FTR I'm on generic (Actavis) 300mg XL. 

Edited May 26, 2019 by sming

[notloki]

On 6/24/2018 at 9:15 PM, Lauliza said:

Interesting how for some people, the fatigue goes away as the dosage hits 300-450. When I took 150 (2 75mg doses) of the IR, I was almost falling asleep at my desk at work. And that was all day, not after a crash at the end. I was just tired all day long. 

That is a common reaction to not being on a high enough dose.

[sming]

12 hours ago, notloki said:

That is a common reaction to not being on a high enough dose.

Hi @notloki, I believe you but do you have any documentation/evidence of this? My PDoc is very by-the-books and will likely need convincing to try 450mg. Thanks.

[CrazyRedhead]

3 hours ago, sming said:

My PDoc is very by-the-books and will likely need convincing to try 450mg. Thanks.

I have this problem, too with my pdoc.......I am on Wellbutrin 300mg XL, and she refuses to increase to 450, because, in her opinion, it might cause more anxiety.

[notloki]

4 hours ago, sming said:

Hi @notloki, I believe you but do you have any documentation/evidence of this? My PDoc is very by-the-books and will likely need convincing to try 450mg. Thanks.

Yes, this kind of reaction is posted all the time on this board

Edited May 27, 2019 by notloki

[argh]

If shes by the book, the fourfiveo brand exists. That is exactly what it sounds like 450mg once a day. The fact that it exists implies that its a valid dose. Work that angle? A partial response, given your trd...the pdoc should be thrilled that something works/shows promise.

[notloki]

51 minutes ago, argh said:

If shes by the book, the fourfiveo brand exists. That is exactly what it sounds like 450mg once a day. The fact that it exists implies that its a valid dose. Work that angle? A partial response, given your trd...the pdoc should be thrilled that something works/shows promise.

Good idea. I took it for a while during a Wellbutrin shortage and I found it worked just the same.as Wellbutrin XL brand. 

[sming]

7 hours ago, notloki said:

Yes, this kind of reaction is posted all the time on this board

Yes but that's not the same as a research paper or a trial. I'll try anyway.

FTR this is the link to ForFivo 450mg XL : https://www.forfivoxl.com/ .

[notloki]

39 minutes ago, sming said:

Yes but that's not the same as a research paper or a trial. I'll try anyway.

FTR this is the link to ForFivo 450mg XL : https://www.forfivoxl.com/ .

 

What do you expect for free ?

[mikl_pls]

There's also Aplenzin, FWIW. 522 mg = 450 mg.

[sming]

10 minutes ago, notloki said:

 

What do you expect for free ?

Jesus man, I was merely asking if there were any papers. Forget that I even asked ffs.

[notloki]

I was on Aplenzin 522 mg for quite some time and it worked well. I stepped off Wellbutrin XL 350 mg and 150 mg directly to Aplenzin 522 mg and felt no difference.