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Sephiroth999

I started wellbutrin 100mg, how can you tell it's working?

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Hello. I asked my pdoc to be put on this med.

I figured I would bite the bullet about it "increasing anxiety" and am giving it an honest try.

Right now I feel it is doing something very vague. I respond very quickly to antidepressants and am sensitive to low doses. I actually do get a temporary lift from lamotrigine at only 25, but as usual wears off and need to increase to 50...75etc. I am hoping it makes it do I don't need Adderall everyday. My escitalopram and lamotrigine merely prevent the lows but do sort of nothing for the anhedonia. One really effective one was Cymbalta 30mg. After about 10-14 days I became "assertive me" ,stared caring about things again and had no emotional blunting but had to go off it because of side effects. I am hoping the wellbutrin works in a similar way.

I would love to hear your experiences with this med whether it be positive or negative, especially if you are/were in a similar situation as me. Thank you.

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I love Wellbutrin. It works better for me than any SSRI ever has. I felt it at the initial loading dose, which I think was 150 mgs, but didn’t get the full effect until I reached 300 mgs, of the XL. It did make my anxiety worse at first, I think, and it took a couple of months to settle down, but for me it’s been worth it.

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I started at 150 mg SR from my GP. I loved it, felt the stimulation right away. But then after a few weeks I felt I needed more, so I went back, and they told me they wouldn't increase it in case I needed more down the road. (Um, you're supposed to increase it to 300 mg SR after a week... They just didn't know how to prescribe it.) So I struggled with it until that summer when he increased it to 200 mg SR once a day. It still wasn't enough. They had added phentermine also to the mix to help both meds work better and because I had gained a significant amount of weight while depressed (and from constant Benadryl overdosing).

I attempted suicide late that summer right after school started back. They took me off phentermine and put me on Klonopin (first benzo I ever took, besides an occasional Xanax my mom would give me in a panic). Tried Prozac and Lamictal together but that wasn't a good match for me as I was started on 40 mg Prozac and 100 mg Lamictal (not titrated up correctly). That lasted a week... It wasn't until late fall (November) that year that I saw a different doctor at my clinic and he was like, "if it's working, why change it?" So he put me on Wellbutrin XL 300 mg, and it was a miracle. That was when the magic hit me. My anxiety went away mostly, my depression subsided, etc. A few weeks later I was put on Adderall 20 mg/day, and it synergized with the Wellbutrin in the most beautiful and harmonious way. My anxiety was completely gone, I could concentrate for the first time in my life, and I thought "where has Adderall been my whole life?" (Turns out I was put on it back when it first came out when I was in elementary school and I couldn't tolerate it, so my mom took me off it and didn't bother to pursue other avenues of ADHD treatment...) Then my boyfriend at the time broke up with me and I was like "okay, I'm gonna need something extra," so I started the Lamictal again, again at 100 mg not knowing any better about titration, and got through the initial side effects fine, and that was my miracle combo for the longest time. I eventually was increased to Adderall 40 mg/day. But that was my cocktail for years, eventually adding Latuda and Viibryd after I started seeing my pdoc.

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Wellbutrin has been the magic cure for my depression for 17 years. I tend to do best on 300mg. When they took me off it briefly for a year or so, my depression came back, but now it's gone again. 

It takes awhile to feel the effects of it, but you start thinking and acting less like a depressed person and that's how you know. I felt like getting up and doing things, I wasn't so blank, I was creative again etc...

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Takes a bit but then again I started with the 150mg XL version. Generic of course. Took about a month on 300mg xl to kick in. Pretty wonderful.  Wrecked my cognition and memory. Sort of made me a bit hypomanic.  Dropped the 300mg xl. 300mg ir, did the same thing to me to a lesser extent. 

Doc has been adjusting it for a while. Settled on 200mg of the instant release.  Despite also being bupropion,  the instant release feels different..but is hard to quantify how.  

I'd like 300 again but cognitive issues are intolerable and it wouldn't make sense to add more shit to stabilize from the top to nix the hypomania. 

I'd rather take this than an SSRI..well maybe sertraline is ok. Rule of thumb is if antidepressants work quickly or you failed a few, there's some bipolarity going on and you need to watch yourself. 

No anxiety here. If anything it lessens it

Edited by argh
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On 2/8/2020 at 2:44 PM, argh said:

Takes a bit but then again I started with the 150mg XL version. Generic of course. Took about a month on 300mg xl to kick in. Pretty wonderful.  Wrecked my cognition and memory. Sort of made me a bit hypomanic.  Dropped the 300mg xl. 300mg ir, did the same thing to me to a lesser extent. 

Doc has been adjusting it for a while. Settled on 200mg of the instant release.  Despite also being bupropion,  the instant release feels different..but is hard to quantify how.  

I'd like 300 again but cognitive issues are intolerable and it wouldn't make sense to add more shit to stabilize from the top to nix the hypomania. 

I'd rather take this than an SSRI..well maybe sertraline is ok. Rule of thumb is if antidepressants work quickly or you failed a few, there's some bipolarity going on and you need to watch yourself. 

No anxiety here. If anything it lessens it

If I am indeed a bipolar (not saying it's impossible, just IDK right now) my lows would have to be somewhere between "stay in bed and watch Star Trek for two weeks" and "feeling normal~mildly ecstatic".

Edited by Sephiroth999

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My "lows". (usually in bed)

 

My "normal~mildly ecstatic"  (Usually practicing Kenpo during listening to this kind of music)

 

Edited by Sephiroth999

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Question for all of you: did you ever take Wellbutrin alone, or always with other meds? Which other meds? Are there different formulations? How long until it worked? Did it "brighten" both mood/energy?

i've trialed Wellbutrin twice, heard so many great things, no blunting, doesn't obliterate sex life. But I don't remember really noticing much antidepressant effect. I had tinnitus, sweating, rapid heartbeat, mild restless legs...I think I took it for 2 months at 300 or 350mg. It was either by itself or with Lamictal only...

Maybe it's redundant, but I'm still tempted to try it instead of Effexor...I'm really over the apathy/blunting from SSRIs/SNRIs... maybe Ritalin would work synergistically with it...

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Quite the journey. Multiple types and with multiple meds.

Alone initially,  300mg xl. Pretty good initially. Mood and energy brightened.  Started not sleeping and not being tired...or as tired as I should be.

Needed sleep, added gabapentin.  Gabapentin felt more like an AD to me. Dropped it because of a rash scare.

Added remeron for sleep.  Holy mixed episode batman. Added gabapentin back in..adhoc. felt fine even with remeron.  Dropped remeron because gabapentin with zyrtec was fine. Gabapentin continues to feel like my primary AD.

Summer, 300mg xl was too much. Went down to 150mg xl, upped gabapentin. Went on vacation,  ended up hypomanic...we considered this a one off and not...really weird jet lag was all.

Back up to 300mg xl because seasons. Couldn't sleep. Went to 100mg ir 2x day. Ok but wanted 300mg back. Got trazodone to help as 200mg did cause some sleep issues.

Back to 150mg xl in spring. Not as good, asked for 150mg xl and 300mg xl alternating.

Got hypomanicish early summer,  pdoc saw it. Lamotrigined my ass

Got hypomanicish again. back down to 150mg xl and upped lamotrigine to 200.

At this point 200mg lamotrigine,  150mg xl bupropion., 1200mg gabapentin. New dx, bp2. Fuck.

Asked for IR again as it was a nice middle ground between 150xl and 300mg xl. Winter continued to suck. Asked for 300mg xl. Was perfect though I forgot that 300mg xl also demolished my memory. So changed to 300mg IR which wasn't as awesome but less memory wrecking. 

Back down to 200mg IR. Dropped trazodone recently to prn because I need 300mg of any form of bupropion to counteract the grogginess.

Fuck it. Balance between efficacy vs tolerability. Current cocktail in sig. Dont see changing it any time soon. Despite you not being BP,  I'd recommend what I have but at 300mg xl.

@Melancholya is on something similar. - gabapentin + buspar. 300mg bupropion xl. Might or might not be bp2.

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First time Wellbutrin alone. 150mg gave a mild energy boost that worn off quickly. 300mg was better, until it was too energizing (increased anxiety).

Second time around, Wellbutrin 300mg+Prozac 20mg. Really good so far (6 months give or take).

For the record, this combination worked better than 80mg Prozac I used to take some time ago.

Side note: I am the depressed/no energy/no motivation type, so an energizing NDRI is really what I needed.

Only side effect: I feel hot most of the time, even when the environment is not so.

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On 2/8/2020 at 5:44 PM, argh said:

Rule of thumb is if antidepressants work quickly or you failed a few, there's some bipolarity going on and you need to watch yourself. 

 

Where does the rule of thumb come from that is accepted in the wider psychiatric community?  Surely not every treatment-resistant depressed person is bipolar or has bipolarity, whatever that is supposed to be.  

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School of thought relating to a mood spectrum. Neat little packages dont fit mood disorders which the dsm dictates.

Dr Sachs, ghaemi, Aiken, 

https://psycheducation.org/diagnosis/bipolar-diagnosis-spectrum-or-yesno/the-bipolarity-index/

Links to studies on page. 

There is a constellation of what are referred to as non manic markers. Reaction to antidepressants,  either via switching poop out or failed trials suggests there is more going on. This is not just related to antidepressants,  other markers include age of onset, presence of mixed episodes, episode duration, cycling 

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That sounds to me like it is ONE facet of potentially bipolarity (I dislike the term; mood disorder to describe MI without hypo/mania would be more accurate IMO) and that the lack of response to a few ADs does not a rule of thumb create.

I'm not saying they're wrong; I just don't like you suggesting to people diagnoses based on how many antidepressants they've been on.  That's for their pdoc to do.  I get that it's been difficult for you to accept your BP dx and maybe that's what's at the root of this but not everyone on here has 'bipolarity' assuming such a thing exists, and it does not have consensus scientific agreement based upon the link you gave.  There are plenty of foremost experiments in mood disorders/depression/bipolar who would disagree....but then, perhaps, they're all part of 'Big DSM'.  

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23 hours ago, argh said:

K. Agree to disagree.

Sorry if I was overly bitchy yesterday - I've been all over the place and yeah.  I do apologize.

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You need at least 300 mg to see anything most report. It also takes more time as 1) generally you titrate to 300 mg, that takes time 2) it is generally a slow to act AD. With its weak effect on dopamine and noradrenaline so it takes a good dose to see effects. 

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