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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by rainbowbrite on June 25, 2005, at 19:40:00
I am feeling so awful, im feeling so anrgy/irritable and so depressed lately. I am trying and trying to fight it but it just wont go away. Could the effectiveness of my AD be killed because of extreme stress? It feels like I am not even taking one. I dont feel myself at all anymore! Any suggestions? should I take more for a little while?
Posted by linkadge on June 25, 2005, at 19:46:15
In reply to Please Help, posted by rainbowbrite on June 25, 2005, at 19:40:00
Try to reduce stress as much as possable.
Linkadge
Posted by rainbowbrite on June 25, 2005, at 19:47:38
In reply to Re: Please Help, posted by linkadge on June 25, 2005, at 19:46:15
do you know how to?
Posted by Phillipa on June 25, 2005, at 20:32:29
In reply to Re: Please Help » linkadge, posted by rainbowbrite on June 25, 2005, at 19:47:38
Take a trip! Fondly, Phillipa
Posted by linkadge on June 25, 2005, at 20:50:00
In reply to Re: Please Help » rainbowbrite, posted by Phillipa on June 25, 2005, at 20:32:29
Just from my own experience, really. I have antidepressants poop, I have had increaded doses sometimes help, and increased doses sometimes create much more anxiety.
Many times, I have found that after some effective stress reduction techniques and supplements, the AD seems to have more of an effect.
Linkadge
Posted by ed_uk on June 25, 2005, at 21:09:18
In reply to Please Help, posted by rainbowbrite on June 25, 2005, at 19:40:00
Hi,
Which antidepressants are you taking at the moment?
Ed x
Posted by SLS on June 25, 2005, at 21:42:51
In reply to Please Help, posted by rainbowbrite on June 25, 2005, at 19:40:00
> Could the effectiveness of my AD be killed because of extreme stress?
Yes. Most definitely. The phenomenon is known as medication breakthrough. Managing stress is the most important thing you can do in your life if you are prone to depression. Medication can build a scaffolding beneath you to hold you up, but it is never as sturdy as the solid ground that healthy people stand on. The scaffolding cannot withstand as much depressive pressure before it loses its integrity and crumbles. Negative stress is a destabilizing force than can cause a relapse of depression despite successful drug treatment.
I don't know if temporarily increasing the dosage of your antidepressant will help. However, it is quite possible that you have been slightly undermedicated all of this time. It is probably a good idea to call your doctor and have him give you instructions on how to go about increasing it.
- Scott
Posted by rainbowbrite on June 25, 2005, at 23:38:02
In reply to Re: Please Help, posted by SLS on June 25, 2005, at 21:42:51
I think I am a little undermedicated I lowered my dose a while ago, but I was determined to beat it. I think if this and the stress dont get better I may need to give in and raise it. the medication/stress thing have always puzzled me.
Thanks so much!
Posted by rainbowbrite on June 25, 2005, at 23:39:42
In reply to Re: Please Help » rainbowbrite, posted by ed_uk on June 25, 2005, at 21:09:18
wellbutrin 100mg - its very low...will still do something though wont it?
Posted by rainbowbrite on June 25, 2005, at 23:41:11
In reply to Re: Please Help » rainbowbrite, posted by Phillipa on June 25, 2005, at 20:32:29
hmm a trip sounds nice, I am coming to visit you soon so maybe that will help.
Posted by ed_uk on June 26, 2005, at 8:31:31
In reply to Re: Please Help » ed_uk, posted by rainbowbrite on June 25, 2005, at 23:39:42
Hi Raino!
Perhaps you could increase? Were the side effects that bad? You seem keen to get off it.
Ed x
Posted by rainbowbrite on June 26, 2005, at 9:13:05
In reply to Re: Please Help » rainbowbrite, posted by ed_uk on June 26, 2005, at 8:31:31
it wasnt really the side effects, just hate taking medication. But at this point Im wondering if it is doing anything at all and what the lowest dose is that would still be effective might be?
thanks
Posted by ed_uk on June 26, 2005, at 10:25:40
In reply to Re: Please Help, posted by rainbowbrite on June 26, 2005, at 9:13:05
Hi!
>But at this point Im wondering if it is doing anything at all and what the lowest dose is that would still be effective might be?
Probably quite a bit more than 100mg!
~Ed
Posted by SLS on June 26, 2005, at 10:39:40
In reply to Re: Please Help, posted by rainbowbrite on June 26, 2005, at 9:13:05
To establish the lowest effective dosage of a medication requires a clinical titration that is sometimes tedious. It often results in overshoot in order to determine the optimal dosage. Dosages can always be reduced once it is known just how much benefit you can glean from the drug or drug combination. It is probably better that you take slightly too much medication than slightly too little. If you are chronically underdosed, you will never fully realize the potential benefits that the drug offers you.
That's just how I approach things.
Are you a perfectionist?
- Scott
Posted by rainbowbrite on June 26, 2005, at 10:57:20
In reply to Re: Please Help » rainbowbrite, posted by SLS on June 26, 2005, at 10:39:40
>Are you a perfectionist?
yes
>>Probably quite a bit more than 100mg!
maybe 150? or should I try 200? at this point Im willing to go back up, Im really really stressed and I can reduce it at the moment. Maybe I could start with 150... Is there a minimun effective wellbutrin dose that you guys no of?thanks
rain
Posted by ed_uk on June 26, 2005, at 11:11:59
In reply to Ed and » SLS, posted by rainbowbrite on June 26, 2005, at 10:57:20
Hi,
>Maybe I could start with 150...
Sounds reasonable :-)
>Is there a minimun effective wellbutrin dose that you guys no of?
The minimum effective dose is different for every person.
~Ed
Posted by Jazzed on June 26, 2005, at 11:55:24
In reply to Please Help, posted by rainbowbrite on June 25, 2005, at 19:40:00
> I am feeling so awful, im feeling so anrgy/irritable and so depressed lately. I am trying and trying to fight it but it just wont go away. Could the effectiveness of my AD be killed because of extreme stress? It feels like I am not even taking one. I dont feel myself at all anymore! Any suggestions? should I take more for a little while?
Maybe a change in the AD? Have you been on others? I know some ppl have said that Wellbutrin is aggitating.
Jazzy
Posted by barbaracat on June 27, 2005, at 2:13:14
In reply to Re: Please Help, posted by rainbowbrite on June 26, 2005, at 9:13:05
**My husband is currently taking WB and doing great at 300. He noticed he felt alot more jagged at 100 and much better as he increased it. Weird.
You wouldn't have a touch of bipolar would you? Have you tried a mood stabilizer? Lithium helped me tremendously, smoothed the edges, kept things from pooping. I am bipolar, but you don't have to be to get benefit from the right mood stabilizer.
> it wasnt really the side effects, just hate taking medication. But at this point Im wondering if it is doing anything at all and what the lowest dose is that would still be effective might be?
>
> thanks
Posted by SLS on June 27, 2005, at 7:05:21
In reply to Ed and » SLS, posted by rainbowbrite on June 26, 2005, at 10:57:20
I think it would be accurate to say that some people with moderate-severe depression respond well to 150mg. However, I think that this represents the minority. On the other hand, just about everyone who will go on to respond well to Wellbutrin end up at 300mg. I know you want to feel as good as possible as soon as possible. I would raise the dosage up to 300mg at a rate that does not challenge your ability to tolerate the side effects. People do respond to 200mg. I guess that makes for a good place to start. If it were me, I would continue to raise it from there unless your response is robust and stable. Also, I think using the SR version twice a day is better than using the XL version once per day. If you do go with the once-a-day dosing with Wellbutrin, try to notice if your mood fluctuates throughout the day in a predictable fashion.
It is no crime to treat a medical condition with a medication. Furthermore, it is no crime to establish and utilize the dosage of that medication that provides optimal treatment of that condition. Using a lower dosage does not somehow make you less dependent on that medication or medical treatment globally. I think your perfectionism causes you to believe that taking more medication defines you as being less perfect. It probably also drives you to find that perfect dosage that is the absolute minimum necessary to produce the desired effect. This is, of course, the objective. Unfortunately, your reluctance to explore higher dosages of Wellbutrin now is preventing you from establishing that dosage in a timely fashion.
- Scott
Posted by rainbowbrite on June 27, 2005, at 16:15:20
In reply to Re: Please Help, posted by Jazzed on June 26, 2005, at 11:55:24
it may be me, I fiddle with my meds and it takes me getting all stressed out to realise that I fiddled too much. im just afraid of meds :-(
But it may be worth talking to my pdoc about this and other options.
Posted by rainbowbrite on June 27, 2005, at 16:22:28
In reply to Re: Please Help » rainbowbrite, posted by barbaracat on June 27, 2005, at 2:13:14
> You wouldn't have a touch of bipolar would you?
Well that was the inital diagnosis...but then it was thought that my hyperness is a result of ADHD..plus depression.
>Have you tried a mood stabilizer?
lots :-(, actually I did get alot of help from certain ones but I found the side effects unbearable.
>Lithium helped me tremendously, smoothed the edges, kept things from pooping. I am bipolar, but you don't have to be to get benefit from the right mood stabilizer.
Lithuim helped for awhile for me years ago but I found it hard to tolerate...
I think the mood stabilizers are a good point, I took myself off them...without doc permission.
Thanks
Posted by rainbowbrite on June 27, 2005, at 16:37:39
In reply to Re: Ed and » rainbowbrite, posted by SLS on June 27, 2005, at 7:05:21
> I think it would be accurate to say that some people with moderate-severe depression respond well to 150mg. However, I think that this represents the minority. On the other hand, just about everyone who will go on to respond well to Wellbutrin end up at 300mg.
i ranged from 300mg to 400mg until I started trying to go off them.
>I know you want to feel as good as possible as soon as possible. I would raise the dosage up to 300mg at a rate that does not challenge your ability to tolerate the side effects. People do respond to 200mg. I guess that makes for a good place to start. If it were me, I would continue to raise it from there unless your response is robust and stable. Also, I think using the SR version twice a day is better than using the XL version once per day. If you do go with the once-a-day dosing with Wellbutrin, try to notice if your mood fluctuates throughout the day in a predictable fashion.
I take SR, Im thinking of getting some 150's from doc and then going gradually to 200mg. I think realisticly I should go to 300 but :-(. My mood lately has been fluctuating on a stange biweekly pattern LOL I think, but I notice weird moodiness lately.
> It is no crime to treat a medical condition with a medication. Furthermore, it is no crime to establish and utilize the dosage of that medication that provides optimal treatment of that condition. Using a lower dosage does not somehow make you less dependent on that medication or medical treatment globally.:-) I think you understand where im coming from LOL i just keep thinking that if I stay at this dose for awhile and then very very slowly...like alternating days wean myslef right off, kind of like tricking my body. I know thats silly but its what I keep thinking...sigh..Im so scared of dependence.
>I think your perfectionism causes you to believe that taking more medication defines you as being less perfect. It probably also drives you to find that perfect dosage that is the absolute minimum necessary to produce the desired effect. This is, of course, the objective. Unfortunately, your reluctance to explore higher dosages of Wellbutrin now is preventing you from establishing that dosage in a timely fashion.
Yes, exactly! I feel so imperfect on drugs! i feel like I failed myself and my family. I rarely even use motrin....I find it so hard, Im a closet medication taker...I hide it from almost everyone. One day maybe ill get over this, I just keep this little light of hope in the back of my head that says ...you can do it without! Its so hard to get off though! And to take sleeping meds and etc...I wait till Im so sleep deprived....sigh...I know Im ridiculous I just cant seem to break this habit. Some people keep all their drugs, when I find I no longer need them, I throw them away...till the next time.
Thanks Scott
Posted by barbaracat on June 27, 2005, at 17:22:51
In reply to Re: Please Help » barbaracat, posted by rainbowbrite on June 27, 2005, at 16:22:28
Hoo boy! Having a dx of ADHD does not rule out bipolar - au contraire! Bipolar and ADD/ADHD can be practically synonomous. Much overlap. When I'm even mildly hypomanic I find my car keys in the fridge and am either hyperfocused or wildly distractable. I benefit greatly from Ritalin during my unfocused periods but don't need it ongoing, only when my bipolar pixie is active.
Take a look at this website and explore its many useful pages. It's been the single best informational tool I've found online in recognizing how prevalent bipolar disorder is and how it touches people in so many different ways:
www.psycheducation.org
Some people simply can't tolerate lithium but moretimes it's a matter of taking more than is needed. Since ADs and lithium augment each other, the best of both worlds would be to find the lowest dose of each that provides relief and causes no side effects.
Perhaps lithium isn't the answer for you, but what evidence is bringing to light more and more is that when ADs poop accompanied by a jagged edgy agitation, it's usually due to a need to add some kind of mood stabilizer. ADs may balance the chemical component, but lithium especially balances the electrical, and both components are necessary for optimal neuron functioning.
> > You wouldn't have a touch of bipolar would you?
>
> Well that was the inital diagnosis...but then it was thought that my hyperness is a result of ADHD..plus depression.
>
> >Have you tried a mood stabilizer?
>
> lots :-(, actually I did get alot of help from certain ones but I found the side effects unbearable.
>
> >Lithium helped me tremendously, smoothed the edges, kept things from pooping. I am bipolar, but you don't have to be to get benefit from the right mood stabilizer.
>
> Lithuim helped for awhile for me years ago but I found it hard to tolerate...
>
> I think the mood stabilizers are a good point, I took myself off them...without doc permission.
>
> Thanks
This is the end of the thread.
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