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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Soraya on December 6, 2000, at 19:32:44
I was taking Wellbutrin for about one month at 150mg a day and doing fine and then my Dr.
told me to add the afternoon dose at another 150mg. I was doing ok then too, and even on about the 5 day of the increase I was almost wonderful :),
but then I started getting the ear ringing thing, couldn't sleep, very jittery, and a strange full feeling in my ears. So then I got scared thinking about all that I read about Well. and seizures so I went
off of it. Now I feel really down again. Is it ok to restart taking it or should I look for another AD without such side-effects? Any info is mch appreciated.
Soraya
Posted by Cam W. on December 7, 2000, at 15:30:40
In reply to Help with Wellbutrin please....., posted by Soraya on December 6, 2000, at 19:32:44
Soraya - What you are probably experiencing are the start-up side effects of Wellbutrin (bupropion). The increase in dose causes the effects you mention, but they usually go away after a couple of weeks of being on that dose. Your body just hasn't adjusted to the drug, yet.
When I started Wellbutrin, I had the same side effects. It was like someone had implanted a vibrator inside me. This eventually went away, but it took about a month.Many people, it seems, begin to feel good within the first week of starting Wellbutrin. This is probably a start-up side effect and is not a true antidepressant effect. It may have something to do with increasing dopamine levels in the body's pleasure center (ie nucleus accumbens). Many people think that the drug has stopped working when this initial mild euphoria disappears, when in fact the Wellbutrin is just beginning to work. As with any antidepressant, one should give it an adequate trial of at least 6 to 8 weeks.
Seizure risk with Wellbutrin is low at 300mg per day, unless you have predisposing factors (taking drugs that lower seizure threshold - TCAs, older antipsychotics, history of seizures, head injury, etc.).
What you could do is try taking a Wellbutrin every morning and one every second afternoon for a week, before increasing to twice daily. Ask your doctor about this (also tell him/her about the side effects - keeps you on the same page).
All antidepressants (or all drugs, for that matter) cause side effects. With antidepressants, the side effects begin to disappear within the first month and can usually be explained by the changes the antidepressant is producing in the mix of neurotransmitters and receptors in your body (adjusting the levels back to "normal").
Hope this helps - Cam
Posted by Soraya on December 7, 2000, at 15:45:35
In reply to Re: Help with Wellbutrin please..... » Soraya, posted by Cam W. on December 7, 2000, at 15:30:40
Cam,
Thanks so much that does make semse and helps! So you had the same effects? Did the ear ringing dissapate for you? I know someone who has been on Wellbutrin for a year and still has it, but I don't think I could cope with this. Do you know of many people who have been on Wellbutrin long term and if so what were the consequences if any. My Dr. seemed to think that one should be one it for about a year, but as far as I can gather, there are no studies on its long term usage. Is it dangerous?
Again thank you for your response. :)
Soraya
> Soraya - What you are probably experiencing are the start-up side effects of Wellbutrin (bupropion). The increase in dose causes the effects you mention, but they usually go away after a couple of weeks of being on that dose. Your body just hasn't adjusted to the drug, yet.
> When I started Wellbutrin, I had the same side effects. It was like someone had implanted a vibrator inside me. This eventually went away, but it took about a month.
>
> Many people, it seems, begin to feel good within the first week of starting Wellbutrin. This is probably a start-up side effect and is not a true antidepressant effect. It may have something to do with increasing dopamine levels in the body's pleasure center (ie nucleus accumbens). Many people think that the drug has stopped working when this initial mild euphoria disappears, when in fact the Wellbutrin is just beginning to work. As with any antidepressant, one should give it an adequate trial of at least 6 to 8 weeks.
>
> Seizure risk with Wellbutrin is low at 300mg per day, unless you have predisposing factors (taking drugs that lower seizure threshold - TCAs, older antipsychotics, history of seizures, head injury, etc.).
>
> What you could do is try taking a Wellbutrin every morning and one every second afternoon for a week, before increasing to twice daily. Ask your doctor about this (also tell him/her about the side effects - keeps you on the same page).
>
> All antidepressants (or all drugs, for that matter) cause side effects. With antidepressants, the side effects begin to disappear within the first month and can usually be explained by the changes the antidepressant is producing in the mix of neurotransmitters and receptors in your body (adjusting the levels back to "normal").
>
> Hope this helps - Cam
Posted by Cam W. on December 7, 2000, at 16:30:47
In reply to Re: Help with Wellbutrin please..... » Cam W., posted by Soraya on December 7, 2000, at 15:45:35
Soraya - I did notice the ringing in my ears every now and then, usually when it was really quiet. It was like what you get after leaving an arena after a Grateful Dead concert, only a lot less intense. It wasn't really intense, though. If it was at a level where it bothered me 2 months after stabilizing on the drug, I would ask my doc to change meds. I don't think that the ringing in the ears will cause any damage, but I am not positive. I haven't heard of any structural damage occurring (maybe that's because I can't hear anymore, ha ha).
As with any antidepressant, Wellbutrin should be taken for at least 9 months after resolution of the depressive symptom (or about 1 year) for acute depressions. It takes this long for the body to "set" in non-depressed mode. If you stop before this, the body always takes the path of least resistance and will revert back to the depressive mix of neurotransmitters and receptors. The body needs to be retrained to work in non-depressed mode. Also, during the year, you will need to work on whatever problem caused the depression in the first place.
As for long term Wellbutrin use. I had been taking Wellbutrin for about 2 - 3 years until my doctor took me off of it about 3 weeks ago (but maybe I'm not the best person to use as an example of long term effects. It's hard to tell which deficits I had before starting the Wellbutrin and which I aquired after). I know of many people who have been taking Wellbutrin for several years, with no obvious problems).
Hope this helps - Cam
Posted by ChrisK on December 8, 2000, at 5:16:38
In reply to Re: Help with Wellbutrin please....., posted by Cam W. on December 7, 2000, at 16:30:47
Why did you stop the Wellbutrin? I am in the middle of my own experiment of stopping Wellbutrin for a couple of weeks but feel that it may have been doing more good than I expected. I use it to augment Nortriptyline and have found myself thinking more about suicide in the week since I've stopped the Wellbutrin.
Did you switch to a different AD to replace the Wellbutrin? Like I said - just curious.
Thanks
Chris
Posted by Cam W. on December 8, 2000, at 7:02:38
In reply to Cam - Just Curious, posted by ChrisK on December 8, 2000, at 5:16:38
Chris - I was using Wellbutrin to treat a longstanding (endogenous?; genetically-linked?) depression, but, as you know, this last summer (June 5) my 18yr old daughter was killed in a crosswalk in Florida on our second day of vacation. I was maintained on Wellbutrin, but really, due to the possibility of another depression (a breakdown of the stress circuits possibly more responsive to serotonergic antidepressants, than to that of Wellbutrin's proposed mechanism of action) super-imposed on my current depression, my doc and I wanted to see if taking away the Wellbutrin did anything. My depressive state hadn't improved since June. We stopped to Wellbutrin 3 (or is it 4 - I'm getting too old) weeks ago and I am actually starting to feel a little better (he says with cautious optimism). It is too early to tell if I will need another antidepressant, yet. This is not to say the Wellbutrin hadn't work for the past few years, it is just that the nature of my condition changed. Also, it is not like I am not getting any treatment. As the COO of Mental Health Services (where I work 1/2 time) told me, "We take care of our own." Everyday, I am being watched over by the best-of-the-best in shrink game in our area.
Actually, it is sort of funny because, in a bizarre way, I have 3 or 4 treatment teams. I don't think that they all fully realize that the others are also helping, at the same time. This is okay. Their response and the responses of support I have received from this board have been phenomenal and much needed. This tragic event has actually reaffirmed my faith in the decency of humanity.
Stick with your doc through any changes that you make. Keep him/her informed. You need some outside yoursel to be able to objectively and critically judge how your therapy is going. Especially in light of the suicidal ideations (even if they are just a glimmer).
Good luck Chris. Your partner in change. - Cam
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