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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by sharonlmiracle on May 31, 2004, at 14:24:42
I've suffered from atypical depression since I was a teenager. My father also had it, and attempted suicide after a major traumatic event (i.e., my mother's sudden and unexpected death) and several times thereafter.
I'm currently taking 400 mg/day of Wellbutrin, and it seems to have helped with the fatigue, but I still don't feel normal. Sometimes I'm very irritable, and sometimes I'm in tears. The past week or so, I've been tired and don't feel motivated to do much of anything, even though I've been getting enough sleep. I might also mention that I've been unemployed for close to a year now (so much for the two degrees!), so it's not surprising that I'm depressed.
I'm very confused as to what Wellbutrin works on. I've read that it's a dopamine reuptake inhibitor, but I've also read that it works on noradrenaline as well. The weird part is that I had a sleep study a few years ago, and it said that my sleep patterns (missing the last two sleep cycles) was indicative of depression. When I read up on this recently, I found out that a disrupted sleep cycle indicates melancholic depression, so I guess that I have both. With this in mind, perhaps I need to add something like Effexor?
Has anyone tried a combination of Wellbutrin and Effexor? I read on the internet that they theorize that this combo mimics the effects of MAOI's, which are often useful for atypical depression, but which have a lot of bad side effects.
Posted by Sad Panda on June 1, 2004, at 9:26:26
In reply to Atypical depression - Wellbutrin + Effexor?, posted by sharonlmiracle on May 31, 2004, at 14:24:42
Hi,
You are right in saying that Wellbutrin is a Dopamine & Norepinephrine reuptake inhibitor, Wellbutrin is generally regarded as a mild antidepressant/stimulant & is normally added to other AD to relieve SSRI side effects & give a little energy. Personally I would swap it for an SSRI so that you could judge the SSRI's effectiveness & maybe add it back later. I would recommend Zoloft or Lexapro as the first SSRI's to try, Effexor is normally reserved as a second or third choice because it is difficult to withdrawl from.
Cheers,
Panda.
Posted by sharonlmiracle on June 1, 2004, at 10:35:11
In reply to Re: Atypical depression - Wellbutrin + Effexor? » sharonlmiracle, posted by Sad Panda on June 1, 2004, at 9:26:26
Whoops. I should have told you that I've already taken Prozac, Paxil, Serzone, Zoloft and Effexor. None of them helped with the atypical depression. However, my friend DID say that I was less morose and weepy when I was on Prozac. Effexor made me nauseated, but it might have been because I was taking a dosage that was too high. Forget Paxil: it made the atypical depression even worse!
What's weird is that the symptoms of what I have aren't consistent. More often than not, I'm negative, bitter, and agitated and the least little thing sets me off. Other times (less frequently) I'm really sad and weepy. Without the Wellbutrin, I don't feel motivated to do anything and I sleep all the time.
Posted by delna on June 1, 2004, at 10:46:01
In reply to Atypical depression - Wellbutrin + Effexor?, posted by sharonlmiracle on May 31, 2004, at 14:24:42
hey
I'm sorry to hear about your state. I relate to it, mainly the exhaustion with the depression.i was once very fatiqued too- for no reason (apart from depression). I was put on ritalin and then provigil but they didnt help.
The combination of wellbutrin and effexor really helps me. I too was once considering the MAO inhibitors. But these two have worked great for tiredness and the depression. wellbutrin on its own does not help my depression at all. It only works on dopamine and noradrenaline. Effexor is a great SSRI. if you need more of a 'pick up' the dose is just increased beyond 150mg. At this point it acts on noradrenaline as well.
In my experience this is a really good combination . Effexor helped me where all other SSRI's failed. I find most are sedating .
Another thing I noticed was that lamotrigine, in addition to these two drugs ,is activating for me. I too have atypical depression which turned out to be bipolar II hence the lamotrogine.
anyway
hope you feel better
d
Posted by Sad Panda on June 1, 2004, at 10:55:03
In reply to Re: Atypical depression - Wellbutrin + Effexor?, posted by sharonlmiracle on June 1, 2004, at 10:35:11
> Whoops. I should have told you that I've already taken Prozac, Paxil, Serzone, Zoloft and Effexor. None of them helped with the atypical depression. However, my friend DID say that I was less morose and weepy when I was on Prozac. Effexor made me nauseated, but it might have been because I was taking a dosage that was too high. Forget Paxil: it made the atypical depression even worse!
>
> What's weird is that the symptoms of what I have aren't consistent. More often than not, I'm negative, bitter, and agitated and the least little thing sets me off. Other times (less frequently) I'm really sad and weepy. Without the Wellbutrin, I don't feel motivated to do anything and I sleep all the time.
>
>
>Was Effexor helpfull at all? I have atypical depression too, I am taking Effexor + Remeron. Remeron is a heavily sedating AD, but it reduced sleep time down to 8 hours & it is a anitnausea drug, so it combines really well with Effexor.
If Effexor wasn't that good I would suggest you try a TCA like Nortriptyline, or try an MAOI, since SSRI's have failed.
Cheers,
Panda.
Posted by sharonlmiracle on June 1, 2004, at 14:35:04
In reply to Re: Atypical depression - Wellbutrin + Effexor? » sharonlmiracle, posted by Sad Panda on June 1, 2004, at 10:55:03
There's no way I'd ever go on an MAOI. Have you seen the list of things that you can't eat? It's an encyclopedia! I've read that Effexor + Wellbutrin combo produces an effect very similar to that of an MAOI. That's why I posted this thread, i.e., to see if anyone's taking both, and what was the combo's effect on atypical depression.
Posted by Sad Panda on June 2, 2004, at 6:53:24
In reply to Re: Atypical depression - Wellbutrin + Effexor?, posted by sharonlmiracle on June 1, 2004, at 14:35:04
> There's no way I'd ever go on an MAOI. Have you seen the list of things that you can't eat? It's an encyclopedia! I've read that Effexor + Wellbutrin combo produces an effect very similar to that of an MAOI. That's why I posted this thread, i.e., to see if anyone's taking both, and what was the combo's effect on atypical depression.
>
>I wouldn't be inclined to dismiss a MAOI totally, the diet restrictions are no where as bad as what you would think, in return you get the best possible effect with the least side effects. In these pages somewhere is some truely good info on what you can safely eat & which drugs you can safely take.
MAOI's raise the levels of serotonin, norepinephrine & dopamine evenly, OTOH, Effexor is a weak NE inhibitor & Wellbutrin is a very weak NE & Dopamine inhibitor. Zoloft raises Dopamine just as much as Wellbutrin, Zoloft + Desipramine or Nortriptyline would likely be closer to the perfomance of an MAOI. Effexor + Remeron is another good combo, it has been dubbed 'Califonia Rocket Fuel' by various people. The MAOI's Nardil & Marplan are real rocket fuels as they are hydrazine derivatives. :)
Cheers,
Panda.
This is the end of the thread.
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