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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by suebird on May 6, 2007, at 13:04:12
i have been on paxil 40 mgs twice a day and clonzapam 0.5 2 in the morning and one in the evening and reglan also 10 mgs when needed now p-doc added 100 mgs of Bupropion SR for 3 days then he wants me to upped it to 200 mgs after that has anyone ever heard of this just want to be like I was about a month ago before I got emergency gall bladder surgery. PLEASE HELP ME. Suebird have been on the Paxil and Clonazepam for about 4 yrs but the p-doc just up the dose of Clonazapam an added the other meds.
Posted by Phillipa on May 6, 2007, at 13:24:34
In reply to starting new med, posted by suebird on May 6, 2007, at 13:04:12
Hi Suebird I saw that you are new to the site. I wanted to welcome you and say we're glad to have you. I take it the paxil and clonazapam had worked before the gall bladder surgery. I hope someone with knowledge of how the gall bladder would affect your meds answers you. Have you thought of posting this on health too? Love Phillipa
Posted by Racer on May 6, 2007, at 13:56:04
In reply to starting new med, posted by suebird on May 6, 2007, at 13:04:12
Yes, I've heard of it. It's part of a sort of algorithm that many doctors use: start with a serotinergic med, like an SSRI; if that doesn't do anything, switch to Wellbutrin (buproprion); if that doesn't work, switch to another class of drugs, often an SNRI like Effexor. If there's some response, but not enough, add in a drug of another class -- in this case, add Wellbutrin to an SSRI. It's often a pretty good choice, although it depends on what's going on for you.
In your case, it has sounded as though your biggest concerns involve anxiety, and I wouldn't necessarily think of Wellbutrin for that. Wellbutrin can be pretty activating for some people, which can be experienced as anxiety. You're on such a low dose of clonazapam that I would think of swapping that out for either another benzo, or for a low dose anti-psychotic.
(I know you're new to this board, so I'll explain that last one a bit more: "anti-psychotics" are not just for psychosis. The older, "typical" anti-psychotics were also known as "heavy tranquilizers." The newer, "atypical" anti-psychotics are often very, very effective for anxiety. Seroquel would probably be my first choice, and then maybe Risperdal. Zyprexa is great for a lot of people, but can cause pretty significant weight gain. Despite the name, though, they can be great for anxiety -- better than benzos for some people.)
On the other hand, if your anxiety is mostly a symptom of your depression, adding Wellbutrin is a GREAT idea. One particular benefit of Wellbutrin is that it often works faster than many other antidepressants. You should have an idea of whether it will help or not within three to four weeks, although it's likely to take longer to get full benefit.
Phillipa's idea, though, of posting a question on the Health board regarding the effect of gall bladder surgery on drug metabolism is a good one. I'd recommend doing that, with a subject line about gall bladder surgery affecting meds, or something.
Good luck.
This is the end of the thread.
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