Posted by Patient on August 5, 2003, at 17:11:54
In reply to PLEASE I need your advice/knowledge, posted by Lainy on August 3, 2003, at 15:25:49
Hi,
Wellbutrin is not the best choice for anyone that suffers from high anxiety and especially panic attacks, as it can make these worse-this may be from its increase in norepinephrine. You are also on the higher end dosage for Wellbutrin. Are you taking the slow-release form? Normally Wellbutrin SR is prescribed as one 150mg tablet once daily for three weeks, then if needed increase to twice daily (300mg total) taking each slow release tablet no less than 8 hours apart. Some people that have been on it a while will take both doses in the morning since it can be stimulating and cause insomnia.
I have Borderline Personality Disorder with anxiety and recurrent major depression. I started out on Zoloft (25mg and then 50mg then up to 75mg); my anxiety rose with each increase in dosage, as well as hand shakiness. Then I was switched to Celexa 20 mg, then Wellbutrin SR was added to counteract sexual dysfunction from SSRI drug. It didn't help in that respect, but I do remember the first time I took it I had taken 20mg Celexa that morning (Celexa made me sleepy) and the Wellbutrin at 3P.M. and within an hour or two I was overly stimulated like having too much caffeine. I only took it as an augmented drug for one month. A few months later I went to another psychiatrist who suggested I switch from Celexa to Wellbutrin SR. (The Celexa didn't work too well during premenstrual syndrome time of month, besides had extremem apathy). Anyway, I tried Wellbutrin SR 150mg once a day in morning for two weeks, then tried increasing to twice a day, taking second dose around 4P.M. It only made me irritable and verbally lash out at my husband. I couldn't take it anymore and quit and went back on Celexa. After the irritability and anxiousness of Welbutrin, Celexa's sedating qualities looked good.
The switch from Celexa to Wellbutrin can also result in withdrawal effects, since these drugs do not work quite the same way. When I switched from Celexa to Wellbutrin, within a week I was hearing strange sounds, like sand being shaken in a box. I've only heard this sound (it is also a sensation, for I could feel it as well-difficult to explain) after going cold turkey off of SSRI, which usually starts about 4 days after stopping drug. It would only do it after I'd gone to bed. Some people refer to this as "brain shivers" or "brain bounce". So, your terrible state could be a result of withdrawal from the Celexa.
I am currently on 5mg Lexapro taken twice a day, sometimes taken once a day. If I take 10mg at one time it causes mild anxiety, but at the lower dose it has more of a calming effect. If I had to make a suggestion, it would be that you try a lower dose of Lexapro, say 5 mg daily. If you still want to take Wellbutrin, you can take it as an augmented drug with the Lexapro, but it is best to take it at a lower dose to see how it affects you. You could take 5 mg Lexapro once or twice a day, and Wellbutrin once in the morning. The Wellbutrin did reduce my appetite, but so do the SSRI drugs. It is strange that I used to suffer from bulimia from about 15 years of age until my early to mid 30's. I stopped upchucking once we moved to the country and I no longer was concerned about my outward appearance so much. Anyway, I did still binge quite a bit, and would gain a bit of weight especially in the winter time. When my gynecologist prescribed Zoloft for PMS symptoms, I tried it and the binge eating stopped-I no longer obsessed about food. Since that time, every SSRI I have been on has made food less appealing and I rarely have an appetite to eat much. At the beginning, this resulted in a loss of a few pounds, or "stones" as they say in Great Britain. I am 5'5" and before starting Zoloft in 2000 I weighed about 134 pounds, then after a year I went down to 116. I currently weigh 124, which is a decent weight for me at 39 yrs. of age.
If I can offer any advice on weight gain and medications, it would be to give chromium picolinate a try. This mineral supplement is involved in the metabolism of glucose, and is also vital in the synthesis of cholesterol, fats, and proteins. It helps to maintain blood sugar levels, and aids insulin efficiency to keep those simple carbohydrates from converting so easily to fat stored on the body. SSRI's seem to affect how carbohydrates are converted into fat in the body, causing a Cushing's-type syndrome (weight gain in belly area and face). I take 200mcg chromium picolinate first thing in the morning on empty stomach. I don't take it daily, but about 3 times a week. Caution: if you have diabetes, consult your physician before taking this supplement.I would also suggest reducing simple carbohydrate intake. Many people think that fat is the main culprit in weight gain, when actually simple carbohydrates like white flour, sugar, highly processed carbohydrate snacks like rice crackers and chips, alcohol, cookies, cakes, white bread; a diet high in these can easily cause insulin inefficiency, resulting in fat stores.
Another helpful supplement is lecithin. It breaks down fat so it can be used by the body. Kelp is good, as well as spirulina. Nutritional yeast or brewer's yeast is also very helpful, especially if you are not getting enough quality protein. It is also wise to take a quality vitamin/mineral supplement with a high ratio of the B vitamins. First though, try taking just 150 mg of Wellbutrin instead of 300mg, or stop it completely if you feel you need to, and go back on the Lexapro. You may need to go back on 30mg and reduce slowly over a period of a few weeks if you plan on taking a lower dosage. Tell your doctor. There, I'm finally finished. Hope the best!
poster:Patient
thread:247789
URL: http://www.dr-bob.org/babble/20030802/msgs/248347.html