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GCAC's - Wellbutrin Weekly Journal

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Purpose:

This is going to be my journal for as long as I'm on Wellbutrin (Bupropion). I have been keeping this journal privately on Evernote the first 4 weeks (which I will share now), but I thought it might be useful to someone, somewhere if it were online. Obviously, I don't know if this medicine will work for me and whether I will be on it short-term or long-term, so I guess we will find out together. I am committed to at least letting you know if I quit. I will try and keep my posts short and to the point. Am also committed to posting once a week throughout the initial phase, and probably monthly at some later stage, if I get there.

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About Me:

I am a 37 year old male, married, two lovely daughters. Lucky in life, but haven't felt well in general, or good about myself in a long time. Apparently have been dysthymic for the last 10+ years, didn't realize it until the last couple of months: I thought I had some other health problem (suspected hormones or early Alzheimer's), never imagined depression could be the cause. I finally had myself examined at Mayo Clinic in Feb-2019, and the resulting diagnosis was basically depression/dysthymia (now it makes all the sense in the world).

This is my first ever anti-depressant. Usually don't take much medicine and am not taking any other medicine concomitantly. I will also be treating with psychotherapy at the same time, as I understand both together are more effective than either/or by itself. 

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Posted (edited)

Week 1

Started on Wellbutrin XL at 150 mg/day (non-generic). Prescription was to switch to 300 mg/day after fist four days, but I am stubborn and avoid medication when possible, so will stick at 150 mg/day through first 8 weeks or so, before attempting a higher dosage.

Negative effects:

Dry mouth, scalp and skin, got anxious, had a couple of itchy "mosquito bites" pop up, insomnia, a bit agitated/overzealous, and muscle pain. Totally manageable.

Positive effects:

Wow! Had an almost immediate effect (non-placebo). Wellbutrin apparently is thought (by many) to have a "honeymoon"  right at the beginning, before regressing for multiple weeks and then stabilizing. There is a thread on here about that (wish I had read it earlier). Totally true in my case. The last 5 days of my first week I was feeling exactly good. Not high, or drugged. Just like I remember normal feeling.

I felt much more physical energy, more mentally clear and focused, parts of my brain were activating that I hadn't felt in years, I was able to be more magnanimous and avoid arguments with my spouse, could speak in a more open and honest fashion, was able to retain interest in things, felt more emotions, and was much more sexually aroused. Everything was like I remembered from the good old days, when I wasn't depressed. All of this was super encouraging and promising (obviously).

Edited by gcac

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Posted (edited)

Week 2

Negative effects:

Physical side-effects mostly went away, except for the dry mouth. However, I hit the slump after the honeymoon pretty hard. Got the same or more depressed than before starting.

Positive effects:

All the positive effects described from Week 1 vanished. Did retain an increased physical energy level, so that's something.

Edited by gcac

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Week 3

Same as week 2. Pretty much as depressed as before beginning treatment, with the exception that I have more physical energy, enough to do exercise.

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Week 4

Just finished up Week 4 yesterday, so this brings us up to date. Still feeling the same as Weeks 2 and 3. Forgot to mention that my blood pressure has been slightly raised from my normal range, something I am monitoring, but not yet worrisome.  I am committed to sticking this out through at least Week 8. If there is no improvement by then, I will probably go up to the 300 mg/day dosage that was initially prescribed, and give it another 8 weeks.

FWIW, the "honeymoon" theory regarding Wellbutrin goes like this: You feel great right at the beginning (usually for a short amount of time), then you feel crappy for many weeks (taking you through about Week 8), then you stabilize, gravitating closer to the way you felt in the honeymoon (though probably not as intensely). Some have hypothesized that IF you experienced a honeymoon under Wellbutrin, it's a sign that you are a candidate for it to work well for you once you stabilize in the medium/long term. All of this is anecdotal of course.

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Thanks for the progress report. It’s nice to see how other people are doing and going through the same symptoms. 

I started 150mg XL a week ago and definitely had the “honeymoon” period of about 4 days. I still feel good but not as great. I see my pdoc in a few days and I think he may want to increase to 300mg XL. Wondering if it’s a good idea since it seems like there hasn’t been many success stories of the increase. 

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Yeah, I'm going to be patient with the 150 mg and see how it goes. I can always bump up to 300 mg a month from now.

Seems we are beginning treatment around the same time, so I would be interested to keep an open line of communication. If you want to share some brief details about yourself (ailment, other medicines, sex, age, WB side effects, and positive effects so far); that would be great. Might also enrich the thread for anyone else who wanders by.

Best of luck to both of us!

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Week 5

Felt like I somewhat exited the slump I was in during weeks 2, 3 and 4 (where I was markedly down). I did have a couple of days where I experienced some increase in want during Week 5. My psychologist says appetite is pretty important in anhedonia -- appetite for food, appetite for sex, etc. Overall, I felt an improvement over the preceding weeks, and some stabilization. Nothing dramatic. Still not sure if more improvements are forthcoming, if I will require an increase in dosage, or whether this medicine will ultimately work for me, but the experiment will be ongoing at least several more weeks. Still on 150 mg/day.

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Week 6

Went to see pdoc mid-week. He told me I needed to move up to 300 mg/day, as they had originally prescribed. He explained that 150 mg has an effect on norepinephrine, but too weak on dopamine. He said I needed to go at least to 300 mg/day to generate an effect on dopamine. His explanation is consistent with what I have been feeling: an increase in energy, but not an increase in pleasure.

Anyway, started on 300 mg a couple of days ago. Will see how it goes and keep updating the thread. Pdoc told me to come see him again in two weeks.

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Glad to hear gcac! Keep us posted.

I feel like I'm finally in the clear. I stuck it out and feel pretty great. The only negative side effects I have are some slight gas pain and a bit of fatigue when the med hits its peak. Overall, I don't feel as "heavy" anymore, I'm not always tired (minus the 6 hour mark after taking it), I sleep better at night, I'm much more mellow, and don't get as antsy I used to.

I've also been on Prozac 20mg for a long time and have been cutting back on that. Taking it once every other day or every two days.

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@JetstreamSam Good to hear! Will keep sticking it out, as you suggest. In a sense I'm starting over, because the first 6 weeks on low-dose (kind of) don't count. 

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Week 7 -- (1st Week @300 mg/day)

Moved up to 300 mg/day as psychiatrist had always recommended. Had an episode of significantly raised blood pressure, was told by a trusted doctor not to put too much stock into that, but will continue to monitor. Not much to report at the moment, will see how everything evolves.

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Thanks for posting this. I just started and feel honeymoonish on day 1. I will also post my updates to see if they are consistent with yours,

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Bad news gcac, I started to notice weight gain and may have to go off my Wellbutrin.

I've been on it for about 5 weeks and gained 7 lbs. This is not poor eating habits or lack of exercise either. I'm in the gym Monday through Friday and I lift hard (for me at least), my weight is always consistently around 185lbs, checked today and 192lbs.

Really sucks. I'm gonna give it 2 more weeks and see if I keep gaining.

Hope you're still progressing man.

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On 4/23/2019 at 8:48 PM, exhs said:

I just started and feel honeymoonish on day 1

Just today my psychiatrist confirmed that there is a fair amount of logic to the honeymoon period some people seem to experience. A bit of a rush of neurotransmitters your body is craving. He says for it to work in any long-term capacity takes a lot more time with the medicine. More on that in a second.

On 4/24/2019 at 8:54 AM, JetstreamSam said:

I started to notice weight gain and may have to go off my Wellbutrin.

Sorry to hear that. It's more common for people to lose weight on Wellbutrin than gain it, but all person's internal chemistry are not necessarily the same.

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Week 8 -- (2nd Week @300 mg/day)

Positive effects:

Energy is still better. My digestion has gotten better. I have become less defensive and more comprehensive. My brain does feel "fuller" (kind of a weird thing to say, but it's the only way I can describe it). My mood is a bit better, I feel a little more at peace. All of these are gradual changes. I have not gone from 0 to 100 magically. My understanding is that you go from 0 to 10... then 20... and so on.

Negative effects:

None really. Maybe a 5-10 mm/Hg increase in what my "normal blood pressure" had previously been?

Psychiatrist's explanations worth sharing:

Forgive me if I get anything wrong, but I'm going off memory and what I understood. His ultimate aim is to have an increase in Dopamine eventually make it's way into my nucleus accumbens. This is likely to be a slow process. It has to do with RNA transcription and gene expression. Rather than get the science wrong, my laymen understanding is: My neurons are accustomed to operating with low amounts of dopamine, hence depression/dysthymia. We want to "train" each neuron to operate with a larger presence of dopamine and alter downstream gene expression in a cascade. This NDRI starts "training" some neurons to express genes differently, and those neurons train other neurons, and so on. It's a process that takes time. It does not happen magically at week 6 or whenever. That is why you monitor if progress is being made (an indication the medicine may be appropriate for you) or progress is not being made (potentially time to look somewhere else). In my case, so far, so good, we are encouraged by the progress.

YMMV is obviously implicit in all recommendations that happen on this site. What works for one person may not work for another. But the big take away for me is: PATIENCE. Correcting these things is slow.

 

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Week 9 -- (3rd Week @300 mg/day)

Kind of similar to last week. Overall, I somehow feel a bit better when compared to before beginning medication. Though I'm fully waiting on moments where it's clear that dopamine is increasing and/or reaching the places where it needs to be present (ie: improving things like pleasure, reward, motivation, attention, appetite, etc.). Because the first 6 weeks @ 150 mg/day are considered (by my psychiatrist anyway) too low a dose to have any significant effect on dopamine, I pretty much consider myself to have started over and am currently in the 3rd week of treatment. This means I should still be patient for several more weeks on expecting positive dopamine-related effects. 

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Posted (edited)

Week 10 -- (4th Week @300 mg/day)

I feel like I'm reaching a turning point, most likely related to the fact that I am reaching the 4 week mark after switching to 300 mg/day -- a dosage my psychiatrist considers the minimum in order to produce dopaminergic effects. My mood continues to stabilize and improve. I am much less apt to become defensive or react poorly in my interactions with others. I am more apt to be helpful or understanding. I noticed something kind of unexpected, I no longer have to wake up to urinate at night (for years I had been waking up nearly every night to pee). I am also sleeping better -- this means I may actually be sleeping less hours, but I am resting more, and sleeping more soundly. And the thing that briefly interrupts my sleep, recently, is my dreams, which have returned and/or become more vivid. My brain also feels "fuller" in that whole frontal part of my brain directly behind the forehead and above the eyes... during the depression years I have always felt like that area was "deflated". Weird, but that is the only way I can describe the feeling.  Best of all, I am improving in areas surrounding sexual function and desire. I have had fuller erections and testicles. I've had more intense sexual desires, my brain has gotten really "turned on" probably twice during that first week honeymoon, and three times during this past week. That is probably more than the previous decade combined. The sexual improvements are huge for me, because it was sexual symptoms that ultimately lead to my visiting Mayo clinic and discovering I have been living with depression (dysthymia/anhedonia). I knew something was very wrong with me for the past 12 years, but because I thought it was all downstream of hormonal issues caused by long-term Propecia use, I never suspected it might be depression. 

The only negative effects I am feeling really are occasional fasciculations and maybe a slight increase in blood pressure, though it's hard to say for sure.

I should add that the positive effects are not yet at pre-depression levels, they are still in the infancy stage, but they appear to be heading in the right direction. 

Edited by gcac

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5th Week @300 mg/day

Arrgghh! I took a pretty significant step backwards in the way I felt this week compared to how I felt during Week 4. The quality of my sleep worsened some, as well as the vivid dreaming appears to have gone. I could feel my attitude slip some, and the return of some of the mental side effects. Lastly, everything that has to do with pleasure also took a step back, including the sexual desire and functioning that I mentioned last week, went down to unsatisfactory levels. It all kind of came hand in hand, and that's the same way it went, hand in hand.

Luckily, I had a visit with my psychiatrist today. He considers it normal to have steps backward like the one I experienced, because it takes a while for the organism to "reprogram" itself (paraphrasing). He thinks that's why it's important to be patient in reaching 12 weeks of treatment in order to decide if a medicine is working for you. And if you find one that works, it's important to stick with it for at least two years (a lot of people start feeling better and they stop taking it too early).

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Just want to thank you for posting your progress!  I had started Bupropion last summer.  Increased it really slow, since I originally presented with anxiety.  Was on 20mg.  Paxil for 6 months before starting Bupropion.  Paxil took care of the anxiety, but I was very sedated and sluggish, (still taking Paxil)  So far, I've had only positive effects since starting B. Did not feel it to be too stimulating or anxiety inducing at all, like some people have reported.  I had a setback at 4 months on Wellbutrin 300sr and ended up going down to 200mg. I think there was something wrong with the generic I was on that threw me off.  Developed dizzy headaches and muscle and joint pain.  I feel rather like I have ADHD on this dose and need to increase it back to 300.  That's where I'm at right now.

Anyway, I so appreciate reading your experience and thoughts with the Wellbutrin.  Thanks so much for sharing.

Edited by Laura123
misspelled words

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@Laura123 Thank you for your post and your encouragement. Will keep updating (good or bad) just in case it's useful to someone later on. Can you elaborate some on the positive side effects you have experienced with Bupropion? 

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The positive response I have to bupropion is that overall it normalizes me.  I can handle stress like a normal person.  Improved cognition, can think better.  Breathing is more relaxed.  Calms edgy nerves and restlessness. Better sleep.  Keeping in mind I am also taking Paxil 20mg. which only took care of the anxiety, yet turns me into a muzzy mess.  I'm still fighting the heavy tiredness from being on Paxil.  One side effect of Bupropion is constipation and that is a positive for me because the Paxil causes the opposite.  (Perhaps I can lower the Paxil dose at some point.)

I have to say,  I can relate to what you said about knowing there was something wrong but you didn't know what.  Around 2006/07, my family heard me say those exact words quite often.  And in 2015 when I presented to a new doctor with extreme anxiety and agitation, I also told them I don't know what this is!  That was the beginning of antidepressants/ssris.  I was diagnosed with depression w/anxiety.  Also GAD. And tobacco use disorder- a fancy name for 'I smoke cigarettes'.  

Edited by Laura123
corrections

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