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[Sangdataroi]

Hi,

Since Prozac doesn't seem to be doing anything for me anymore, except making it impossible to achieve orgasm (I'm male), I've started 150 mg. WellButrin XR on doctor's advice.

However, I, at age 68, have a problem with chronic insomnia, and varying sleep cycle, and have been using Valium (diazepam), one of the benzopiadene group, for a few years typically 10-20 mg. per night, along with Zolpidem (trade name: Ambien).

I have been evaluated both by a neurologist, and an endocrinologist, and the "signs" are within normal ranges: note I am a lower-tongue cancer survivor (no recurrence for five years), and I consider it possible there might be some effect on my thyroid from the relatively broad-spectrum radiation put through my neck, but the endocrinologist sees no sign of that in terms of what his tests show.

I find Zolpidem sleep-inducing, but not sleep-maintaining.

So, starting on Wellbutrin, and reading the warnings about sudden dis-continuation of benzopiadene group substances, which my doctor did not describe to me, I would appreciate your advice.

I'm assuming the logical thing would be to slowly reduce both Zolpidem and Diazepam intake over a few weeks, until I see what WB is going to do, or not do, for me.

Dis-continuing Prozac (20 mg.per day): not sure about the right way to do that, or if total cut-off is okay. Not sure if I can obtain 10mg. Prozac, or even lesser doage, here in the S.E. Asian country where I live.

thanks, Sangdataroi

Edited by Sangdataroi, 09 July 2012 - 08:19 PM.

[MaddieLouise]

Sangdatoroi- Hi and welcome to the DF,

Are you saying that your Dr. didn't give you any advice on discontinuation of either the benzos, Prozac or Ambien? Can you call back and ask them their advice?

Honestly, not being a Dr., all I can do is give a few pointers based on what I have heard worked for other people, and what I know about these medications.

First of all, I wouldn't go cold turkey off of any of these medications. I would slowly decrease the dosages or if you cannot get lower dosages (10 mg. Prozac for example) where you live, you might try taking the 20 mg. every other day for a week or so and then every two days for a week, etc.

Is there a reason for going off the Diazepam? Many people take them in conjunction with an antidepressant, but if you are going to discontinue it, I would do it very slowly as well, either by decreasing the dosage (cutting in half if possible) or again taking it every other day. I've never been a big fan of Ambien because for me, I never felt "rested" in the morning. It was like fake sleep or that I never went into a REM state or stage 4 sleep. It wasn't restorative sleep for me.

I know many people personally who have had great luck on Wellbutrin and I can certainly understand the lack of libido being a big reason why it's popular and widely prescribed for men. It is supposed to be sexually neutral.

I would run all these ideas past your Dr. because they may have a totally different take, and they know your medical history, etc. These are just suggestions, as I'm no Dr. Your Dr. is the expert.

Thanks for checking in on the forums and feel free to look around, post and let us know how it goes.

Sincerely,

MaddieLouise

[Sangdataroi]

Are you saying that your Dr. didn't give you any advice on discontinuation of either the benzos, Prozac or Ambien? Can you call back and ask them their advice?

Hi Maddie,

Thanks for your kind words of welcome, and response to my questions !

WB 150 was prescribed at my request, to see if it could re-potentiate the anti-depressant effects of Prozac; I had done this once before. I didn't realize until I got home that I received the XR version, which I didn't really want. I will see the doctor again next week, and inquire about dis-continuing Prozac.

The only thing that "scares" about WB is the potential it may have to exacerbate my existing tinnius, for which I take SERC.

thanks, Bill

[MaddieLouise]

Do you mean you got the SR (sustained release) or the XL (extended release) dosage? Here is an interesting article about their differences:

http://www.helium.co...d-wellbutrin-sr

Sincerely,

MaddieLouise

[Sangdataroi]

Do you mean you got the SR (sustained release) or the XL (extended release) dosage? Here is an interesting article about their differences:

Hi Maddie,

Thanks again for a prompt answer to a newcomer's question.

I do have the XL, once-a-day, version. Whether the XL was chosen on purpose, or because it was this version the hospital (in Thailand) chose to import, I don't know. The article was interesting, but did not have any information on what the lifestyle/mental implications of SR vs. XL are, or why a psychiatrist would choose one over the other, or just the "plain vanilla" form of the drug.

In any case, because of my sleep problem, and the possible stimulant effects of WB, I would not be wanting to take it at night :)

I'll have a chance to discuss all this the doctor, again, soon.

thanks, Bill

[MaddieLouise]

Do you mean you got the SR (sustained release) or the XL (extended release) dosage? Here is an interesting article about their differences:

Hi Maddie,

Thanks again for a prompt answer to a newcomer's question.

I do have the XL, once-a-day, version. Whether the XL was chosen on purpose, or because it was this version the hospital (in Thailand) chose to import, I don't know. The article was interesting, but did not have any information on what the lifestyle/mental implications of SR vs. XL are, or why a psychiatrist would choose one over the other, or just the "plain vanilla" form of the drug.

In any case, because of my sleep problem, and the possible stimulant effects of WB, I would not be wanting to take it at night :)

I'll have a chance to discuss all this the doctor, again, soon.

thanks, Bill

I agree with you completely about the article, but when I really thought about it, the point may have been that there really is not much difference except in the way they dissolve. It's going to take longer most likely for the XL to completely dissolve since the shell stays intact, so I'd surmise it's in your system longer while it slowly leaves the coated shell. Your Dr. would know the true answer.

Sincerely,

Maddie