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Dr. Bob is Robert Hsiung, MD,
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Posted by Patient on October 26, 2003, at 17:33:11
In reply to Re: Lexapro w/ Wellbutrin , posted by Patient on October 11, 2003, at 18:24:22
> Hello,
>
> Many doctors will add or augment Wellbutrin to SSRI's. The added boost from the reuptake of norepinephrine and dopamine from the Wellbutrin can be helpful if one isn't completely responding to an SSRI, or, as in your case, to counteract daytime somnolence, as well as some other side effects of SSRI's.
>
> I have, unofficially, Borderline Personality Disorder-can be difficult to treat, especially anger outbursts have been a problem for me, as well as still getting depressed while taking SSRI's. I've been taking Lexapro since February of this year. I started out with 5mg daily in morning, and 250mg of carbamazepine(Tegretol, mood stabiliser) for the first month, then increased Lexapro to 5mg twice a day. (I couldn't tolerate 10mg at once on most days-it made me a bit on the anxious side.) After a month of this combination I couldn't take the severe somnelence-I was a walking and napping zombie. So, stopped the carbamazepine, only taking it a week or two before my period starts, since this is when I'm most irritable. After a couple months I reduced down to 5mg daily Lexapro, mainly due to affordability. For me, 5mg daily is just as effective as the twice a day dosage. As of recent, I no longer take Tegretol as it seemed to make the daytime sleepiness even worse, especially 12 or so hours after taking it. I really didn't notice any improvement with it anyway, though was taking a low dose.
>
> Here is where I finally get to the part about my experience with Wellbutrin (I can be long-winded).
>
> A couple of years ago I had been prescribed Wellbutrin SR and took 150mg a day. It made me relaxed, but I was quick to snap at my husband-it was a strange combination-to be relaxed and easily irritated at the same time. I tried increasing to 300mg a day and couldn't handle the "snappiness". That was my month+ experience with Wellbutrin by itself.
>
> In the past couple of months I have been experiencing what I call, false hunger pangs. While eating I would feel hungry, but an uncomfortable hunger. Just recently I stopped drinking real coffee-my stomach said no more. I don't know if it is from the Lexapro, but someone else on this board said they experienced acid reflux after taking Celexa. I have some leftover Wellbutrin SR and for the past few days I've been taking 150mg once in morning, and 5mg Lexapro in mid-afternoon. Wow-what a difference! I thought the Lexapro was helping, but after a few days on the Wellbutrin I feel ten times better-more alert-able to fill out a crossword puzzle within a shorter period of time, do not feel lethargic or tired during the day (just as you mentioned). The best part is that I feel relaxed-a calm feeling-and an added surpise is that my stomach is no longer bothering me. I do know that Wellbutrin can supress the appetite. I no longer am aware of my stomach throughout the day-no more pangs. I've only been on this combination a few days, but I am happy with the results so far. I'm ashamed to admit that I usually drink a glass of homemade wine or beer in the evenings to help calm me, and this isn't good, especially if you are taking any medications. Since I've taken the Wellbutrin I no longer want a glass of wine to relax me in the evenings. I have Ativan (lorazepam) if I need it, but I try to avoid it as my doctor told me the benzos can disrupt sleep cycles-eveningtime was usually when I'd take Ativan-it's effects lasting well into the A.M. hours.
>
> You are on a low dosage of Wellbutrin-make sure you take it as early in the morning as possible. Sometimes the insomnia-effect goes away after you've been on Wellbutrin a while.
>
> I would suggest you ask your doctor about trazodone (Desyrel). It's an older antidepressant that today is more commonly prescribed in a low dose to counteract insomnia caused by stimulating antidepressants. In my opinion, it works better than Ambien (zalpidem)or Sonata (zaleplon), as these only last a few hours, whereas trazodone helps one sleep the night through. Months ago my doctor prescribed 50mg trazodone taken at bedtime-he said it doesn't disrupt sleep cycles. It worked great at helping me sleep, but would cause stuffy nose and dry mouth, enough to keep me awake for the first two hours after taking it. Eventually I found 12.5mg worked fine without side effects. For me, it usually starts to make me sleepy in about thirty minutes to an hour.
>
Escitalopram and Bupropion updateI saw the psychiatrist last week. I have been doing well, so he merely renewed my prescriptions. He had written me a renewed prescription for Wellbutrin SR 150mg tablets a few months ago, but I never got it filled, because I had some tablets remaining from 2001 prescription. We talked about how much better I am doing since I added the Wellbutrin to the 5mg Lexapro; feeling calmer during day and into evening, no more alcohol, and I'm not snapping from the Wellby. The only trouble was that I had to start taking a small dose of trazodone every night to help me sleep, since the Wellbutrin in combination with Lexapro was causing mild insomnia. He gave me some samples of 100mgs of Wellbutrin SR to see if this lower dose would be better. It was! Now I rarely, if ever, need to take 12.5mg of trazodone to help me sleep. Doctor also told me, according to the Wellbutrin drug literature, that due to Wellbutrin's affect on certain isoenzymes (CYP2B6), that it could cause an increase in certain other drugs, including SSRI's; one may have to reduce SSRI dosage when taking them with Wellbutrin. I'm already taking a low dose of Lexapro, so this isn't a problem for me. If anything, he said I could take the Wellbutrin every other day, because many of Wellbutrin's important metabolites-with actions not quite understood-last in the body for more than a day (hydroxybupropion, threohydrobupropion, and erythrohydrobupropion). I haven't tried every other day Wellby, yet. Right now I am taking the Wellby in the morning and Lex in afternoon.
Doctor also renewed carbamazepine (Tegretol), but this time he forgot to make it the extended-release form. I tried the regular 200mg form and within about an hour+ I had false-hunger pangs like I complained about. I thought this was caused by the Lexapro, or maybe from my vitamin/mineral supplement. I looked in my drug journal and sure enough, during those days I took carbamazepine, whether timed-release formula or regular, it caused those wrenching false-hunger pangs. That mystery is solved! I looked at the side effect profile for carbatr. and it states "stomach distress" or "gastic distress". I'm not going to take it any more. If I can do well on the Lexapro and Wellbutrin combination, than that is all I want to take-don't like to take any more drugs than I have to. I like this energy I now have-no more apathy-and no more need for a glass of wine to calm me down in the evenings for I already feel calm. I find it strange that a so-called stimulant can make one feel calm-now I understand why some doctors prescribe it for those that have anxiety, not just depression-in certain situations stimulants have a calming effect instead of setting off anxiety.
That's it really. Just an update.
Posted by platinumbride on October 27, 2003, at 9:12:15
In reply to SEXUAL SIDE EFFEECTS, posted by GEEKUS on October 25, 2003, at 18:58:12
I am not a doctor
(though I play one on TV ha ha h a)I have heard that wellbutrin can spice up the sex drive and that ssris and wellbutrin taken together can sometimes be of help.
But talk to your doc. If you are bipolar or something, I don't want to see that you have had a terrible episode from advice given by a novice who may have heard something from someone........
Diane
Posted by Scribbler on October 27, 2003, at 9:16:43
In reply to Re: YOU WOMEN ARE DOING GREAT » BLKVETTES, posted by Mariposa on October 25, 2003, at 9:49:10
Just wanted to let you know that I had a potentially stressful weekend with two public speaking engagements and then an occasion in which I found myself seated in the middle of a church pew with people packed in on either side (an instant panic attack situation!) and was able to relax. No cold sweats, racing heart, light-headed fainting feelings. I'm beginning week #3 of Lexapro today and doubt I'd be this far without your encouragement and reassurance. Thank you SO MUCH for helping me get this far! I wonder if you who respond to our pleas for help realize how much it means to know you're here with us and understand so completely what your compassion means. Wish there were something I could do to repay your kindness.
Posted by platinumbride on October 27, 2003, at 9:22:06
In reply to Re: SEXUAL SIDE EFFEECTS, posted by carolee on October 26, 2003, at 15:38:14
I experieced that problem on the great lexapro as well as celexa. (well, they worked for depression for over a year,so I guessI can be grateful for that)
OK kids, get the giggles out now.......
What my hubby suggested was a vibrator. The nice feminine ones with the light touches couldn't do it for me anymore......
I had to get one with more strength.
I don't own stock in vibrator companies.......
I don't knwo how to say this without offending anyone or seeming like I am trying to sell something, so I will just dare to offend and apologize in advance.accuvibe was a very good choice for me.
You may want to visit www.goodvibes.com and write to customer service, which is what I did. They recommended several products based on my question. And I ddint get gross spam the day after either. Well, I did, but who doesn't???
Diane
Posted by platinumbride on October 27, 2003, at 9:25:16
In reply to Re: SEXUAL SIDE EFFEECTS, posted by carolee on October 26, 2003, at 15:38:14
www.goodvibes has customer service and products for guys too....
and they are not judgemental
Posted by LynneDa on October 27, 2003, at 9:55:03
In reply to Re: SEXUAL SIDE EFFEECTS one more thing, posted by platinumbride on October 27, 2003, at 9:25:16
> www.goodvibes has customer service and products for guys too....
>
> and they are not judgementalThanks for your frankness. I've been wanting to broach the subject because this is the only side effect I really have a problem with. I've only been on 10mg of Lex for one week and the inability to *get there* started almost immediately, altho desire has not changed. My husband is against me being on meds due to this one thing. But, it is really working on my depression and anxiety - I am so much nicer to be around, happier, less angry, etc. The alternative you mentioned would be nice to discuss with him. Thanks!
~ Lynne
Posted by sfmom on October 27, 2003, at 9:56:00
In reply to Re: Lexapro for anxiety/switching pm to am » sfmom, posted by Mariposa on October 26, 2003, at 11:12:09
> > I'm on day four of Lexapro and can't sleep even with Clonopin (sp?) although I'm exhausted during the day. Haven't had a panic attack yet on Lex but I'm so jittery I can barely type. Can't sleep because my legs and ankles jerk and hand shake. This is really a problem for me because I have to be up before 7 with my 2 year old. Has anyone found a time of day to take Lex that makes it easier to sleep at night. I've been taking 10mg after dinner to help with the nausea, not that it's really helping. Also, I'm totally out of it and can't concentrate. Is this the Lex, or just the depression I'm feeling now that the panic attacks are gone? Help please.
> >
> >
> I started off taking in the morning, had some of the same problems you mention, switched to afternoons, then to evenings, and now I'm back to mornings again. The first couple of weeks can be tough w/se's but they should go away, mine were mostly gone by end of 4th week. Had insomnia in the beginning, but now I fall asleep quickly and easily and sleep soundly through the night - THANK YOU Lex for THAT!!! I took OTC for sleep (Tylenol PM, Unisom, Ibuprofen, Acitomenifen).Trouble concentrating - I had that too but OK now. I think the time of day thing is something you have to play with, try different times to see what works for you. As I said before, I moved around a bunch but settled on mornings in the end.
>
> Good Luck to You!~~~8|8Is it okay to take an OTC sleep aid on top of the Lex and Klonopin? I really need some sleep! I'm going to start to move my Lex dose earlier in the day so see if that helps too. I'm exhausted, but still going to drag myself to group now. . .who scheduled these things first thing in the morning?!?
Posted by ginger C on October 27, 2003, at 10:47:44
In reply to Re: Lexapro for anxiety/switching pm to am » sfmom, posted by Mariposa on October 26, 2003, at 11:12:09
Im taking Lexapro in the mornings now because I was having problems sleeping and legs jerking. I don't know if my concentration problems are medicine related or depression related but I am beginning to suspect it is mostly the depression.
Posted by GEEKUS on October 27, 2003, at 16:25:56
In reply to Re: SEXUAL SIDE EFFEECTS one more thing » platinumbride, posted by LynneDa on October 27, 2003, at 9:55:03
I SPOKE TO MY DOC ABOUT THE SEXUAL SIDE EFFECTS AND THE INCREASING GENERAL ANXIETY - CANNOT FOCUS - EXTREME FOOT & FINGER TAPPING. THIS IS AFTER 6 WEEKS OF LEXAPRO 20MG.
WHEN I FIRST STARTED ON PROZAC, I HAD THIS WAVE OF EUPHORIA THAT CAME TO ME AFTER A FEW WEEKS. I STAYED ON IT FOR 3 YEARS AND THEN IT TUCKERED OUT ON ME, AND THE DEPRESSION CAME BACK.
I MENTION THIS BECAUSE I HAVE NOT HAD EVEN THE SLIGHTEST HINT OF THE ABOVE DESCRIBED 'EUPHORIA'. INSTEAD, WITH LEXAPRO IT HAS BEEN A REDUCTION IN FATALISTIC THOUGHTS, BUT AN INCREASED ANXIETY, SEXUAL DISFUNTION, AND AN INABILITY TO FOCUS.
IT HAS BEEN MENTIONED TO ME THAT BUSPAR MIGHT BE ABLE TO HELP WITH THE ANXIETY. AS FOR THE SEXUAL ISSUES, I TOO HAVE HEARD ABOUT WELBUTRIN HELPING.
THE DOC HAS ADVISED ME TO REDUCE DOSEAGE TO 10 MG.
Posted by vandy on October 27, 2003, at 17:25:56
In reply to Re: SEXUAL SIDE EFFEECTS » carolee, posted by platinumbride on October 27, 2003, at 9:22:06
People here are sooo open. Why should I be any different?
My wife and I both take lex. One might guess that could mean a challenge on the desire issue. My wife doesn't initiate as she used to before Lex and it's been enough time for both of us so we can't say it's a temporary side effect. I volunteer. It's the least I can do! And we make sure she is rewarded by using one of the "Silver Bullet" variety vibrators. It's perfect for clitoral stimulation during penetration. It gets my wife where she wants to go. When I see and feel her in full enjoyment it's easy for me to go over the edge as well.
Good vibes has one of these things called "Bullet Blaster" and it carries Mr. & Mrs. Vandy's seal of approval.
> I experieced that problem on the great lexapro as well as celexa. (well, they worked for depression for over a year,so I guessI can be grateful for that)
>
> OK kids, get the giggles out now.......
>
> What my hubby suggested was a vibrator. The nice feminine ones with the light touches couldn't do it for me anymore......
>
> I had to get one with more strength.
>
> I don't own stock in vibrator companies.......
> I don't knwo how to say this without offending anyone or seeming like I am trying to sell something, so I will just dare to offend and apologize in advance.
>
> accuvibe was a very good choice for me.
>
> You may want to visit www.goodvibes.com and write to customer service, which is what I did. They recommended several products based on my question. And I ddint get gross spam the day after either. Well, I did, but who doesn't???
>
> Diane
Posted by DQBLIZ on October 27, 2003, at 18:04:49
In reply to Re: Lexapro for anxiety/switching pm to am, posted by sfmom on October 26, 2003, at 10:47:25
Has anyone been placed on 20mg of Lexapro right after being on 10mg for one week? My doc said that I should jump up to 20 right away.
Posted by platinumbride on October 27, 2003, at 18:08:49
In reply to Re: SEXUAL SIDE EFFEECTS, posted by vandy on October 27, 2003, at 17:25:56
Well, since we havne't been censored by prudes yet (mean of me.......I should just say people for whom this is not an ucmfortable thing)
ATTETNION ALL WOMEN WHO HAVE GAINED WEIGHT ON MEDS
a more "vigorous" vibrator with a longer handle and no stupid bunnies or dolphins are really a help. I am one of those women, so I know what i say......
Libido can be enhanced by a few "good vibrations", not in the sweet spot right away, but in areas around it.
It does take a little effort.....but the climax and what follows is worth it, i think.......Sex can make things a little more bearable in life....Diane
Posted by platinumbride on October 27, 2003, at 18:11:44
In reply to Re: Lexapro for anxiety/switching pm to am, posted by DQBLIZ on October 27, 2003, at 18:04:49
yes
about 20 minutes agoDiane
Posted by Mariposa on October 27, 2003, at 18:34:57
In reply to Re: Lexapro for anxiety/switching pm to am » DQBLIZ, posted by platinumbride on October 27, 2003, at 18:11:44
> yes
> about 20 minutes ago
>
> DianeIt sounds a little *excessive* to me also. Literature says 10mg is recommended dose.
I had bad side effects starting at 5mg. Have you experienced any SE's?Keep us posted!~~~8|8
Posted by Mariposa on October 27, 2003, at 18:37:16
In reply to Re: YOU WOMEN ARE DOING GREAT » Mariposa, posted by Scribbler on October 27, 2003, at 9:16:43
> Just wanted to let you know that I had a potentially stressful weekend with two public speaking engagements and then an occasion in which I found myself seated in the middle of a church pew with people packed in on either side (an instant panic attack situation!) and was able to relax. No cold sweats, racing heart, light-headed fainting feelings. I'm beginning week #3 of Lexapro today and doubt I'd be this far without your encouragement and reassurance. Thank you SO MUCH for helping me get this far! I wonder if you who respond to our pleas for help realize how much it means to know you're here with us and understand so completely what your compassion means. Wish there were something I could do to repay your kindness.
I feel it's the least I can do....I got so much help from this board myself and am just trying to re-pay. But THANK YOU, it's nice to be appreciated!!
Hang in there~~~8|8
Posted by sfmom on October 27, 2003, at 19:26:03
In reply to Re: Lexapro for anxiety/switching pm to am, posted by ginger C on October 27, 2003, at 10:47:44
> Im taking Lexapro in the mornings now because I was having problems sleeping and legs jerking. I don't know if my concentration problems are medicine related or depression related but I am beginning to suspect it is mostly the depression.
Can you sleep again? Did the leg jerking stop? I switched from evening to afternoon today and am planning to go to morning tomorrow. Is there anything I can do to counteract the tension and jerking? I took my Lex a couple of hours ago and my ankles are killing me right now and I'm feeling really anxious, although yogurt seems to be helping with the nausea. If this continues, I don't know if I'm going to be able to stay on Lexapro. It's only been five days and I'm supposed to go up to 20 mg after two weeks!
Posted by Mariposa on October 27, 2003, at 22:05:08
In reply to Re: Lexapro for anxiety/switching pm to am » ginger C, posted by sfmom on October 27, 2003, at 19:26:03
>
I took my Lex a couple of hours ago and my ankles are killing me right now and I'm feeling really anxious, although yogurt seems to be helping with the nausea. If this continues, I don't know if I'm going to be able to stay on Lexapro. It's only been five days and I'm supposed to go up to 20 mg after two weeks!The initial side effects can be quite bothersome, but they should taper off and go away. The worst was over for me after 2nd week, mostly gone after 5th week.
I started at 5mg, went to 10mg 5th week, and 20mg at 5 months. May I ask, why the big rush to go up to 20mg?~~~8|8
Posted by Esmarelda on October 28, 2003, at 8:58:11
In reply to Re: Lexapro for anxiety/switching pm to am, posted by DQBLIZ on October 27, 2003, at 18:04:49
No. I took 10 mg of Lexapro for a couple months, then started feelings kind of anxious again and bumped it up to 15mg where I have been for about 2 more months and everything is just fine. Of course, listen to your doctor, but people don't automatically need 20 mg. I think there are some that come to this board who have always been on 5 or 7.5 mg. If the 10 mg is working, I would talk to my doctor about keeping it right there and then easing up if you have problems with that dosage.
Posted by sfmom on October 28, 2003, at 9:48:01
In reply to Re: Lexapro for anxiety/switching pm to am » sfmom, posted by Mariposa on October 27, 2003, at 22:05:08
> >
> I took my Lex a couple of hours ago and my ankles are killing me right now and I'm feeling really anxious, although yogurt seems to be helping with the nausea. If this continues, I don't know if I'm going to be able to stay on Lexapro. It's only been five days and I'm supposed to go up to 20 mg after two weeks!
>
> The initial side effects can be quite bothersome, but they should taper off and go away. The worst was over for me after 2nd week, mostly gone after 5th week.
>
> I started at 5mg, went to 10mg 5th week, and 20mg at 5 months. May I ask, why the big rush to go up to 20mg?~~~8|8The quick answer is because my pdoc said so. The longer answer is that I have been totally non-functioning because of anxiety and panic attacks and since Lex is mainly for depression, she wants to get me up to a higher dose quicker so it can work for the anxiety too and I can taper off the Klonopin which she doesn't want me to stay on too long. Also, I'm out on disability only until Dec 1 so she wanted to get me functioning before then so I can go back to work. Anyway, this is how it was explained to me, don't know how much truth it holds. I was planning to take my Lex this morning in hopes of being able to sleep better tonight but am putting it off in fear of feeling sick the rest of the day. The joint pressure and pain seems to be getting worse with every dose. There's got to be something to help with this! Have you heard of anything that lessens it? My mom said to try calcium (sp?) but that's mainly for cramping, not joint pain and jerking.
Posted by Esmarelda on October 28, 2003, at 9:51:19
In reply to Re: Lexapro for anxiety/switching pm to am » Mariposa, posted by sfmom on October 28, 2003, at 9:48:01
Hang in there. The SE's will go away. I was only nauseated for about one week. I never did have the joint pain. I feel for you. While Lex may not be for everyone, I know those who have hung in there, have sure been glad they did. Myself included.
Posted by platinumbride on October 28, 2003, at 11:17:07
In reply to Re: SEXUAL SIDE EFFEECTS one more thing » platinumbride, posted by LynneDa on October 27, 2003, at 9:55:03
I'm not a sick perv, but I would like to know if anyone has any luck with anything that vibrates. It has really helped me a lot.....
Diane
Posted by Gator on October 28, 2003, at 11:18:55
In reply to Re: Lexapro for anxiety/switching pm to am » sfmom, posted by Esmarelda on October 28, 2003, at 9:51:19
This is the first time I have posted, but I read all of the posts every day. I've been taking Lexapro for 3 weeks now. In the begining I had several SE's including migraines, nausea, problems with my blood sugar going too low, feeling diconnected and being very tired. But at about 2 weeks everyone of them were almost completely gone. I am taking this for depression and I am feeling better, even like I deserve to be on this earth.
Thank you for all of the people that post - you guys were my inspiration to get through the SE's and feel the way I am today.
Posted by Esmarelda on October 28, 2003, at 11:24:04
In reply to Re: Lexapro for anxiety/switching pm to am, posted by Gator on October 28, 2003, at 11:18:55
Congratulations! Glad to hear that you are feeling better. Lexapro has been a miracle drug for me. You just gotta hang in there a bit!
Posted by LynneDa on October 28, 2003, at 11:29:16
In reply to Re: Lexapro for anxiety/switching pm to am, posted by Gator on October 28, 2003, at 11:18:55
Thanks for posting. I'm heading into week 2 and am seeing some of my s/e's leave,am feeling much more balanced. It's encouraging to hear most of your s/e's are gone. I am looking forward to that!
~ Lynne
Posted by Mariposa on October 28, 2003, at 22:10:31
In reply to Re: Lexapro for anxiety/switching pm to am » Mariposa, posted by sfmom on October 28, 2003, at 9:48:01
I was planning to take my Lex this morning in hopes of being able to sleep better tonight but am putting it off in fear of feeling sick the rest of the day. The joint pressure and pain seems to be getting worse with every dose. There's got to be something to help with this! Have you heard of anything that lessens it? My mom said to try calcium (sp?) but that's mainly for cramping, not joint pain and jerking.
If it's really painful you should consult your physician.
I take all kinds of supplements (Calcium,B12,E,fish oil, etc.) I didn't have the joint pain you mention...I have arthritis so I probably wouldn't have noticed it anyway. Jerking was not a side effect I experienced, aand hopefully so of the more knowledgeable posters will respond???~~~8|8
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Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
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