Posted by Flipsactown on November 21, 2003, at 4:33:27
In reply to Intro and Question -- Wellbutrin SSRI Combo, posted by Tim B on November 20, 2003, at 21:07:52
Hello Tim,
Disregard the effexor comments as I got you confused with another post. But do increase the lamictal because from my research lamictal's A/D
effectiveness is in the higher dosage 300 to 500mgs. Also wellbutrin did nothing for me but adding lamictal maybe a different story.Flipsactown
> Hello everyone,
>
> I am a new member and have been lurking for about two weeks to get a feel for things before I hop on in. I hope that this message finds each of you well and I'm glad I found this group.
>
> Let's see, a little about me. I am 45, male, and I live in Washington DC. I was diagnosed with bipolar back in 1991 so I guess I've been dealing with the issues for more than ten years now. Over the years the diagnosis has evolved into what I feel is pretty accurate at this point of Bipolar II. When I first presented it was of course for depression and have been under continuous treatment for most of the past 12 years. There were two periods, after two - three years of stability where I tried to drop the meds and fly "clean" so to speak but the stability would always devolve and I would end up going back on the meds again.
>
> Right now I'm severely depressed and was pretty suicidal for a while and found it necessary to take some time off of work and deal with this current situation for a period of time. Kind of brought it on myself because I wanted to monkey around with my meds and started to change thing around in July. Things were going pretty well for awhile and I was hopeful about the situation. But then disaster struck towards the latter part of October and I went totally down into the pits. It was unusual for me because I destabilized and went to pot over the course of a single weekend and I've never really experienced such a rapid onset. Usually I can see them coming so this one really confused me. I do have a fairly technical question and was hoping some of you could share your experience and perhaps offer some advice.
>
> Lets see... I was on 1000mg Depakote, 600mg of Serzone, with Ambian as needed for sleep. That was my routine since late 1999 and it worked *adequately* (note lack of enthusiasm). Nothing great but it kept me relatively stable. That with some very generous flexibility at work and I was able to function pretty well since going on that regimen. Towards the beginning of this year I started to want to try for something better because I seemed to have settled into a fairly continuous mixed state and was having increasing problems keeping things under control. That and the black box warning about Serzone had me wanting to drop that drug specifically. Weight gain had me wanting to get off the Depakote.
>
> Right now I am on 75mg of Lamictal and 300mg of Wellbutrin. I really didn't want the Wellbutrin because I had tried that one before and didn't really find it of much help. But the doc wasn't enthusiastic about my first thought which was to go back to the only drug that I found really addressed my symptoms which was an MAOI (Parnate). I guess they really don't like that class of drugs any longer. I had also suggested substituting Lamictal for the Depakote since I've been hearing good things about it in my research.
>
> I have been here for about four weeks now and still am fluctuating wildly. My thoughts on Wellbutrin are the same and I feel that I am under medicated on the Lamictal. I have an appointment next week and really got to figure something out because I need to get back to my office. I am a Network Manager for a Federal Agency and my absence is causing some turmoil at work.
>
> So here is my plan and my question. I was going to say let's start titrating the Lamictal up towards 200mg since I am totally off the Depakote now. Drop the Wellbutrin down to 100-150mg a day with a single dose XL or SR in the morning. Add in a SSRI flavor of the month (Lexapro 10mg??). Was reading Dr. Bob's and saw that the Wellbutrin SSRI combination was a fairly common approach. This actually disappoints me because I was hoping to get down to one drug maybe the Lamictal and not add a third for >>even more fun<<! Note sarcasm.
>
> I have responded to SSRIs in the past but they usually would, as expected, peter out for me after some varying period of time. My initial experience with Prozac so many years ago was a lifesaver. Hate the sexual side effects that they would usually cause. I dealt with the nausea because heck, I needed to loose weight anyhow and the constant urge to ralph made me eat less. Food tends to be my only addictive behavior. So here finally is the question (phew!). What are your collective experiences with a Wellbutrin SSRI combo? Would all of you say that this is a good approach or should I press my doc to give me Parnate since I know it works? Keep the Lamictal at a higher dose or same dose?
>
> Comments? Compare and contrast? <g> Thanks everyone.
>
poster:Flipsactown
thread:281900
URL: http://www.dr-bob.org/babble/20031121/msgs/281986.html