Hello All, I and 've posted a couple of time in the past but visit often to find so many helpful responses from all of the great peolple who post. I have been on wellbutrin SR now for about 8 weeks. I have been on 300mg/ day for only a week, but I don't seem to feel anything but jitters and the feeling of needing to crawl out of my skin. I have been on other AD's but my Doc perscribed this because of my always being down, tired and having no interest in anything. It's been that way for a good year now. It's pretty bad at times. I started on 100mg twice daily and now take 300 mg/day. I take 200 in the morning and 100 in the afternoon. I told my doc I couldn't sleep and he thought maybe instead of 150mg twice each day that maybe the 200 in the am and 100 in the pm may help with sleep. My first issue is that I have not noticed any effect other than a greater feeling of anxiety and difficulty sleeping. I don't know if it's too early to tell at 8-9 weeks. I've read that many have felt some relief almost immediately, but does anyone have a different story regarding their experience. Are the anxiety and sleeplessness just temporary side effects. One interesting aspect to this story is that I have had chronic back issues, herniated discs, and surgery. I take oxycodone almost daily anywhere from 10 to 40 mg per day. Is the effect of the opiates on dopamine receptors possibly altering the effect of the wellbutrin as a dopamine reuptake inhibitor. My Dr. says no but I wonder. I really want to simply feel like doing something, ANYTHING on at least a couple of days a week. This total loss of interest in doing anything at all is becoming such a long term thing I'm really getting more depressed as I find it a hard thing to accept, that "it's ok, you'll feel ok someday". Well, I don't and haven't. Any wellbutrin experiences from anyone that may help shed light on things would be graciously looked forward to. Thanks, Brian
p.s. I just wanted to add that the opiates have not caused a problem with being tired ever in the past. Actually, the opposite seems to occur. It seems I feel more energetic after taking. Also, there are some days where I take no pain killers at all, so I don't believe the opiates are a reason for tiredness. I've suffered depression and have seen pdocs and taken many different meds before back problems occurred. I never have felt as though I've experienced any significant relief from anxiety or depression from any meds. Anyway, I don't think the opiates conribute to any depression. Thanks Again!

This post has been edited by bbrian123: Feb 10 2008, 01:18 PM

Hi Brian, Not sure I can help too much, but here goes...

Oxycondone definitely elevates dopamine levels, which is primarily what wellbutrin also does. But I haven't a clue if this means you're suffering from any kind of a dopamine overload. You might benefit greatly from getting a second medical opinion, perhaps from a PDoc who specializes in psychopharmacology.

Also, since serotonin and dopamine levels tend to counterbalance each other: whenever serotonin is raised dopamine tends to be lowered and when dopamine is raised serotonin is lowered.

As you also may know, there are definite links between depression and back pain/disc problems

I also take 200mg of WB in the morning, plus 100mg in the afternoon. But I don't have any insomnia, perhaps because I also take an SSRI (Lexapro) at bedtime. I find the Lex a bit sedating, while the WB is energizing. Lots of people seem to thrive on a combo of WB and an SSRI. Have you asked your doctor whether such a combo might be good for you?

Sorry I couldn't help more, but maybe someone else here can. Good luck!

I second the notion of a Wb/SSRI combination. After 8 weeks you should know if Wellbutrin is gonna work. I take 150mg twice a day, plus Zoloft. For me, neither one works without the other.

Thanks for the response-I know that an extra variable is added with the opiates. I was hoping that the WB would actually decrease the need for pain killers. I have been on SSRI's before but never with a dopamine reuptake inhibitor. I was once offered Effexor but I did not like what I read about side effects and stopping if necessary. I really didn't like the SSRI side effects. I guess there's a trade off that one has to be willing to make. I just feel lost in the whole mess right now. Going back to the therapist is scheduled, but I had a Pdoc who had me on such a cocktail of meds I had enough. Adjusting or changing wasn't her preference, just add another med. What to do???? Thanks, Brian

Hi Brian, I'm also taking 200mg SR in the morning and 100mg in the afternoon. The WB did interfere with my sleep quite a bit early on, but now I'm sleeping okay. My pdoc also gave me Trazadone to help me sleep. I only take 25mg per night. I don't know if it helps me fall asleep really, but it does help me stay asleep, which is a big deal for me. Regarding the positive effects of WB, has it ever helped you even for a few days? For me, I was up and down for the longest time. My doc increased my dose slowly from 75mg a day to 300 over the course of six months. I was in a bad state when he finally let me go to 300. At first, I didn't think it was helping any. I actually thought it could be making it worse, but then magically the last couple weeks I've felt like a new person again. It took about a month after increasing the dose to really feel better. If it has never helped you, then I suspect it's either not the right med for you or the Oxycodone could be interfering. As others suggested, you might get a second opinion from another doc. I'm also very hesitant to add an ssri to the mix, since I had bad side effects from them in the past, so I can understand why you might not want to rush into that. Maybe even a sleeping med would help. It could be that you just have no energy from not getting enough sleep. Good luck to you. I hope you find something that works.

Hi L.A., I should've mentioned that I just increased my dose to 300 mg/day 6 days ago. Maybe need more time. I take 0.5 mg xanax at night to sleep. Sometimes it helps but I still wake up early on nights I do fall asleep. I work in the healthcare field and found my current doc about 6 yrs ago. It was after talking to him and his patients I asked if he would take me on. He's great. Listens, consults and refers when needed, and an incredibly intelligent guy who keeps current with changes unlike some docs I know. He is looking into oxy/WB interaction even though he initially does not think it is significant. I do get other MD's opinions when I need to. I really do respect my primary MD though. I am reluctant to take more xanax for anxiety and to sleep. Xanax addiction can be ten times worse than opiate addiction. My oxy intake is such that if I miss a day I don't get sick at all, unlike when I was at over 100mg/day. Missing doses was awful. I am going to try to forgo opiates for the back pain for a while if I can to see what happens. I'm unsure of adding SSRI's just yet. Thanks much for your helpful input!!!

Hi Michael, Just a quick question. Ever heard of or know anything about 5HTP ? I have read a some things that it is a lttle more readily available to be coverted to serotonin than some other supplements and can "naturally" help to produce more serotonin. One thing about supplements is I hate to take 3000 times more of something than is normally produced or found in the body. Anyone with any experience or knowledge of this supplement I would be interested. Thanks.

bbrian123:

Hello! I've been taking WB (300 mgs) for over 8 years now. I also take Effexor, Risperdal, Lithium, Halcion, and Xanax. My doc and I added WB to my little meds cocktail because, even with all of the other meds, I wasn't getting much relief from depression. WB was the answer. No doubt about it. It's brought me up and out of the initial depression, adds an extra kick when I have a set-back, and keeps me going. However (didn't you just know there would be a "however"), WB is well-known for making one jittery and nervous, and for causing sleepless nights. My anxiety increased and the med spurred on my insomnia. That's where the Xanax (for anxiety) and Halcion (for sleep) come into play. It is best to take WB as early in the morning as possible.

How's it working for you? How long have you been on this med?

Please keep us posted.

-Bean

Hey Bean, it's been 8 weeks, only 6 days at 300mg/day. 200mr SR in am and 100 SR in afternoon. I don't feel as though it's really working on the depression. I used to sleep alot during the day. I still try but the WB doesn't let me so I am kind of forced to get up and at least do something even when I have no desire to. Thanks for reply.

Brian-

If you've only been on the 300mg dosage for 6 days, I think you may have to give it another week or two before you fully adjust. WB can be a rollercoaster at the beginning, and after a dosage increase.

As for 5-HTP, yeah -- it's a natural amino body in the body, linked to tryptophan, and a precursor of serotonin. I haven't seen a lot of hard science on it, but there are many people (and some docs) who claim that 5-HTP supplements can be great for mild depression. As my recent depression wasn't mild, it probably wouldn't have helped me.

If you go that route, just make sure you get those supplements from a high-quality manufacturer. In 1989, there was an outbreak of a potentially-fatal disorder caused by a contaminated batch of tryptophan. It led to the removal of all tryptophan from the US market. Although the manufacturing of 5-HTP is different from that of tryptophan, there is still concern that some 5-HTP supplements may contain similar contaminants. There are two groups (NSF and U.S. Pharmacopeia) that I think certify the manufacturing processes, so look for those names (like the Good Housekeeping seal of approval) on the labels of the containers.

This post has been edited by MichaelBlue: Feb 9 2008, 09:08 PM

Just a thought,
Have you talked to your doctor about taking WellbutrinXL 300 mg in the mornings? This form is once daily dose. Wellbutrin does tend to have a stimulant effect. If you do decide to do this stay away form the TEVA brand generic, even the FDA admits the release rate with the TEVA is not even close to the actual brand WellbutrinXL
Greg


-Bean[/quote]
Hey Bean, it's been 8 weeks, only 6 days at 300mg/day. 200mr SR in am and 100 SR in afternoon. I don't feel as though it's really working on the depression. I used to sleep alot during the day. I still try but the WB doesn't let me so I am kind of forced to get up and at least do something even when I have no desire to. Thanks for reply.
[/quote]

Greg-- Are you positive that the FDA reached that conclusion? I knew they were investigating it, but didn't hear anything since. I do know that a consumer lab reached that conclusion, which is what led to the FDA probe. All Best!

Her you go:


The Director of the Office of Medical Policy of the FDA's Center for Drug Evaluation and Research, Dr. Robert Temple, has acknowledged that TEVA Budeprion XL 300 releases drug at a different rate than the brand name Wellbutrin XL 300, consistent with ConsumerLab.com's findings in this report. Dr. Temple's remarks were made during a radio broadcast on Southern California Public Radio station KPCC on December 19, 2007. He noted that the FDA was aware that bioequivalence studies in people showed the once-a-day generic to release drug sooner than its brand-name counterpart but that the FDA "thought that that wouldn't make any difference." He admitted that the once-a-day generic "had an early release pattern that was a little closer to the original [three-times-a-day] product" than to once-a-day Wellbutrin XL. The FDA approved the once-a-day generic without mention of this difference, further clinical testing or special follow up.

Two weeks prior to Dr. Temple's remarks, on December 1, 2007, the United States Pharmacopeia (USP) officially released information indicating that the dissolution of the Budeprion XL 300 varied significantly from the original drug. According to the USP, tablets of Wellbutrin XL release only a small amount (less than 20%) of drug during the first two hours of dissolution. In contrast, the Budeprion XL releases at least 25% and as much as 50% of its drug in that period. These USP dissolution standards are based upon performance characteristics that the FDA approved for the original and generic drugs, respectively, and were provided to USP by the manufacturers.

Greg:

Your info is invaluable. Thank you!

-Bean

Wow, Greg! Thanks for that. I've been sitting here waiting to see the FDA's opinion, and -- by golly -- they've already issued it! Great to know this.