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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by ncrainbow on May 7, 2008, at 23:28:55
Okay....the short version been off 40 mg Celexa for a month
Been on 150 and then up tp 300 Wellbutrin during that month
taking 2mg klonopin at night.the funny thing is that this whole thig started with a brand new diagnosis of cyclothymia (versus previous anxiety diagnosis) at age 40.
So, now my days go like this
1. I wake up a very grumpy, am very crabby to my spouse and children, with an extremely short fuse. All very rare for me.
2. Take 300 mg of wellbutrin with breakfast and then 1.5 hours later, I am happy and Super Duper productive...seems to majorly improve both my ADD and daytime fatigue.
3. Then, around 8:00 p.m. the wellbutrin wears off and I am crabby until I take my 2mg's of klonopin at bedtime.
4. I sleep soundly until it is time to start it all again.Also, I must add that in the past week, I have been much more hypomanic than I have ever been in my life. Now all of the syptoms are "low-grade" but each and every sypmtom is there (but lack of sleep)....pressured speech, big ideas, very happy periods of the day, lots of shopping, etc. however, I do sleep like a baby 8 hours a night.
So, here is my question/thought...
rather than jumping to the conclusion that the wellbutrin and klonopin are at the root of this extreme crabbiness cycling to hypomania, couldn't it just be the fact that I am coming up on 4 weeks free of an SSRI after 8 years at a hefty dose?
Has anyone else experienced agitation and hypomania coming off an SSRI that they could attribute to the serotonin withdrawal and not whatever new cocktail that is being prescribed?
Does this make sense?
I am really trying to justify staying on Wellbutrin because for the first time in many years, I actually feel clear-headed and awake during the day.....even if I am a little racy.
Posted by llurpsienoodle on May 8, 2008, at 8:22:23
In reply to what is making me so irritable and impulsive, posted by ncrainbow on May 7, 2008, at 23:28:55
> Okay....the short version been off 40 mg Celexa for a month
> Been on 150 and then up tp 300 Wellbutrin during that month
> taking 2mg klonopin at night.I'm gonna jump in here and tell you about myself so that we can compare notes. I've also been Rx'd 150mg wellbutrin SR about a month ago. I take lamictal 300mg, sonata 10mg prn, zyprexa 10mg prn, abilify 10mg, zoloft 100mg
>
> the funny thing is that this whole thig started with a brand new diagnosis of cyclothymia (versus previous anxiety diagnosis) at age 40.
>I've been Dx'd as bipolar II
> So, now my days go like this
> 1. I wake up a very grumpy, am very crabby to my spouse and children, with an extremely short fuse. All very rare for me.yep. sounds about right
> 2. Take 300 mg of wellbutrin with breakfast and then 1.5 hours later, I am happy and Super Duper productive...seems to majorly improve both my ADD and daytime fatigue.
mmm yep!
> 3. Then, around 8:00 p.m. the wellbutrin wears off and I am crabby until I take my 2mg's of klonopin at bedtime.
yep!
> 4. I sleep soundly until it is time to start it all again.
>
> Also, I must add that in the past week, I have been much more hypomanic than I have ever been in my life. Now all of the syptoms are "low-grade" but each and every sypmtom is there (but lack of sleep)....pressured speech, big ideas, very happy periods of the day, lots of shopping, etc. however, I do sleep like a baby 8 hours a night.
>
yeah! me too- I'm sleeping fine, but I am pretty speedy during the day
> So, here is my question/thought...
>
> rather than jumping to the conclusion that the wellbutrin and klonopin are at the root of this extreme crabbiness cycling to hypomania, couldn't it just be the fact that I am coming up on 4 weeks free of an SSRI after 8 years at a hefty dose?
>I dunno about that...
> Has anyone else experienced agitation and hypomania coming off an SSRI that they could attribute to the serotonin withdrawal and not whatever new cocktail that is being prescribed?
>
> Does this make sense?
>
> I am really trying to justify staying on Wellbutrin because for the first time in many years, I actually feel clear-headed and awake during the day.....even if I am a little racy.
>
>you don't need to justify it to anyone. if it's working, keep it. Sorry the SSRI withdrawal is the pits. Sounds icky. Do take care of yourself. (try not to spend too much money!!!)
-Ll
Posted by dbc on May 8, 2008, at 11:49:10
In reply to Re: what is making me so irritable and impulsive » ncrainbow, posted by llurpsienoodle on May 8, 2008, at 8:22:23
Its the wellbutrin.
Posted by undopaminergic on May 8, 2008, at 12:55:54
In reply to Re: what is making me so irritable and impulsive » ncrainbow, posted by llurpsienoodle on May 8, 2008, at 8:22:23
>
> I'm gonna jump in here and tell you about myself so that we can compare notes. I've also been Rx'd 150mg wellbutrin SR about a month ago. I take lamictal 300mg, sonata 10mg prn, zyprexa 10mg prn, abilify 10mg, zoloft 100mg
>Can you describe the role/effects of the Zoloft in your regimen?
In my personal experience, serotonergic agents (e.g. Zoloft or 5-HTP) have a dampening effect on my "hypomanic" response to activating drugs (such as stimulants and memantine).
Posted by llurpsienoodle on May 8, 2008, at 13:13:00
In reply to Re: what is making me so irritable and impulsive, posted by undopaminergic on May 8, 2008, at 12:55:54
> >
> > I'm gonna jump in here and tell you about myself so that we can compare notes. I've also been Rx'd 150mg wellbutrin SR about a month ago. I take lamictal 300mg, sonata 10mg prn, zyprexa 10mg prn, abilify 10mg, zoloft 100mg
> >
>
> Can you describe the role/effects of the Zoloft in your regimen?
>
> In my personal experience, serotonergic agents (e.g. Zoloft or 5-HTP) have a dampening effect on my "hypomanic" response to activating drugs (such as stimulants and memantine).well, I was initially Rx'd zoloft because I was very depressed, about 10 mos ago now. It worked very well, even a smallish 50mg dose. Then I started to have breakthrough depression (and when I get depressed I go to a very dark place) increased zoloft to 100mg. that was fine for a month or so, but I was apathetic, lazy, and had sexual side effects. then augmented with 150mg wellbutrin (generic bupropion) SR for the apathy and sexual side effects. Little did I know that the wellbutrin was going to unleash a sea of suicidal snakes. Llurpsie into hospital. Continued taking the wellbutrin though, and it's working well. At this point, I'm no longer sure of what the zoloft is doing. I'm not tempted to mess with the polypharmacy though, because it's working.
-Ll
Posted by undopaminergic on May 8, 2008, at 13:32:49
In reply to Re: what is making me so irritable and impulsive » undopaminergic, posted by llurpsienoodle on May 8, 2008, at 13:13:00
> > >
> > > I'm gonna jump in here and tell you about myself so that we can compare notes. I've also been Rx'd 150mg wellbutrin SR about a month ago. I take lamictal 300mg, sonata 10mg prn, zyprexa 10mg prn, abilify 10mg, zoloft 100mg
> > >
> >
> > Can you describe the role/effects of the Zoloft in your regimen?
> >
> > In my personal experience, serotonergic agents (e.g. Zoloft or 5-HTP) have a dampening effect on my "hypomanic" response to activating drugs (such as stimulants and memantine).
>
> well, I was initially Rx'd zoloft because I was very depressed, about 10 mos ago now. It worked very well, even a smallish 50mg dose. Then I started to have breakthrough depression (and when I get depressed I go to a very dark place) increased zoloft to 100mg. that was fine for a month or so, but I was apathetic, lazy, and had sexual side effects. then augmented with 150mg wellbutrin (generic bupropion) SR for the apathy and sexual side effects. Little did I know that the wellbutrin was going to unleash a sea of suicidal snakes. Llurpsie into hospital. Continued taking the wellbutrin though, and it's working well. At this point, I'm no longer sure of what the zoloft is doing. I'm not tempted to mess with the polypharmacy though, because it's working.
>
> -LlWas the Lamictal (or Abilify?) added to fight the suicidal snakes, or did they go away by themselves?
Posted by llurpsienoodle on May 8, 2008, at 13:50:30
In reply to Re: what is making me so irritable and impulsive, posted by undopaminergic on May 8, 2008, at 13:32:49
> > > >
> > > > I'm gonna jump in here and tell you about myself so that we can compare notes. I've also been Rx'd 150mg wellbutrin SR about a month ago. I take lamictal 300mg, sonata 10mg prn, zyprexa 10mg prn, abilify 10mg, zoloft 100mg
> > > >
> > >
> > > Can you describe the role/effects of the Zoloft in your regimen?
> > >
> > > In my personal experience, serotonergic agents (e.g. Zoloft or 5-HTP) have a dampening effect on my "hypomanic" response to activating drugs (such as stimulants and memantine).
> >
> > well, I was initially Rx'd zoloft because I was very depressed, about 10 mos ago now. It worked very well, even a smallish 50mg dose. Then I started to have breakthrough depression (and when I get depressed I go to a very dark place) increased zoloft to 100mg. that was fine for a month or so, but I was apathetic, lazy, and had sexual side effects. then augmented with 150mg wellbutrin (generic bupropion) SR for the apathy and sexual side effects. Little did I know that the wellbutrin was going to unleash a sea of suicidal snakes. Llurpsie into hospital. Continued taking the wellbutrin though, and it's working well. At this point, I'm no longer sure of what the zoloft is doing. I'm not tempted to mess with the polypharmacy though, because it's working.
> >
> > -Ll
>
> Was the Lamictal (or Abilify?) added to fight the suicidal snakes, or did they go away by themselves?so, in Spring, 2007 I had bad reaction to cymbalta withdrawal. (llurpsie into hospital). I had made it clear that I couldn't tolerate sexual side effects of SSRI's, so they started me on 150mg wellbutrin XL. It was a disastrous trial lasting only 6 sleepless days. Pdoc started me on lamictal as the primary antidepressant. At the time I was taking geodon 240mg and tapering up on lamictal. Lamictal helped with suicidal impulses, at least once I got up past 200mg.
Geodon had too many side effects, most notably mind dulling apathy, and extreme debilitating fatigue. In a stroke of brilliance, geodon was replaced with abilify. smooth sailing at 5mg until I had some nasty flashbax. it was upped to 10mg and I haven't had hardly any psychotic symptoms since then. yay!
(if it wasn't obvious, I have PTSD and major depression. I suppose bipolar as well. sigh)
-Ll
Posted by bleauberry on May 8, 2008, at 16:30:27
In reply to what is making me so irritable and impulsive, posted by ncrainbow on May 7, 2008, at 23:28:55
I think what you are feeling is a combination of a couple things. After 8 years on an ssri, the brain and body is not going to undo that and adjust in a mere month. It will take months. That is my experience anyway. Some of what you are feeling is either permanent or temporary from the longterm ssri use. The other thing is wellbutrin itself. The side effects you describe are fairly common for wellbutrin. At askapatient.com reviewers of this drug that stuck it out for a few months said the agitation stuff eventually went away.
It isn't very often that things are perfect with medicines, so I don't know what to tell you.
Maybe you could set your cell phone to wake you up about 2 hours before your usual waking time to take the morning dose of wellbutrin and then go back to sleep. When you get up it will be kicking in
This is the end of the thread.
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