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Dr. Bob is Robert Hsiung, MD,
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Posted by mrporter1 on February 22, 2004, at 14:45:32
In reply to Re: WELLBUTRIN;...Cutting XL pills? » Viridis, posted by NG on February 20, 2004, at 5:58:21
It won't hurt you to divide XL tablets. But (big but) you'll lose the "XL-ness" - the drug will be released all at once instead of over the day. The tablet shell is the key.
> Viridis mentioned that the developer of Wellbutrin SR said that cutting the pills did not really affect the absorbtion rate. Based on this information, I started cutting some Wellbutrin XL pills in half--I wasn't paying attention to the difference between XL and SR. I'm backing off of that strategy for now, but I have a bunch of halved pills and halving the dosage would be useful.
>
> So... I guess I'm wondering how you managed to get ahold of one of the actual developers to ask about this, so I could ask about XL.
>
> The prescibing packet for both XL and SR say don't cut / divide pills.
>
> > I've mentioned this here before, but the coating on WB SR pills has nothing whatsoever to do with the sustained-release effect.
> >
> > When I was on 150 mg SR and couldn't tolerate it, I called the company and spoke to one of the people who actually developed the SR version. He explained that the drug is imbedded in a slowly-dissolving wax, and the coating disappears almost immediately in your stomach. I was told that there was no danger in cutting the pills (they researched this), but they discourage this because:
> >
> > 1) It's hard to get exact dosing.
> >
> > 2) Once cut, the med can absorb moisture from the atmosphere and lose potency.
> >
> > His advice was to go ahead and cut the pills, just do only a few at a time to avoid water-absorption problems. He then faxed me graphs of uptake rates of cut vs. uncut pills, which showed a very slight increase in absorption rate in the first 15 minutes, then almost identical rates. My pdoc said this all made sense, and to try the lower dose with divided pills. It had about half the side effects, still intolerable for me.
> >
> > I have no idea whether this applies to other slow-release meds, but these are the facts (from the manufacturer/developer) for Wellbutrin SR.
>
>
Posted by Cybele on February 22, 2004, at 16:39:03
In reply to Re: WELLBUTRIN;...Cutting XL pills?, posted by mrporter1 on February 22, 2004, at 14:45:32
> It won't hurt you to divide XL tablets. But (big but) you'll lose the "XL-ness" - the drug will be released all at once instead of over the day. The tablet shell is the key.
>Are you positive about that? Someone on here had contacted the mfg, and found out that SRs are splittable and still retained their time-releaseness because the grains were encapsulated in a slow-dissolve coating, IIRC.
I wonder if the generic SRs are the same way?
Anyway, I finally have my PDOC appt tomorrow, for which I had to wait 3 months. I'll ask him about it.
Posted by NG on February 23, 2004, at 17:39:09
In reply to Re: WELLBUTRIN;...Cutting XL pills?, posted by mrporter1 on February 22, 2004, at 14:45:32
Well, I also must also politely ask if you have a source of information which contradicts or amends the information given by Viridis, who spoke to one of Wellbutrin SR's developers.
Thanks for your response!
mrporter1:
> It won't hurt you to divide XL tablets. But
>(big but) you'll lose the "XL-ness".Me:
>> Viridis mentioned that the developer of Wellbutrin SR said that cutting the pills did
>>not really affect the absorbtion rate.Vidridis' Original Post:
(at http://www.dr-bob.org/babble/20030912/msgs/260546.html)EXERPTS:
>>> I called the company and spoke to one of the people who actually developed the SR
>>> version...>>> He then faxed me graphs of uptake rates of cut vs. uncut pills, which showed a very
>>> slight increase in absorption rate in the first 15 minutes, then almost identical
>>> rates.
Posted by mrporter1 on February 25, 2004, at 11:36:54
In reply to Re: WELLBUTRIN;...Cutting XL pills? » mrporter1, posted by NG on February 23, 2004, at 17:39:09
Not sure about SR - speaking of XL.
> Well, I also must also politely ask if you have a source of information which contradicts or amends the information given by Viridis, who spoke to one of Wellbutrin SR's developers.
>
> Thanks for your response!
>
> mrporter1:
> > It won't hurt you to divide XL tablets. But
> >(big but) you'll lose the "XL-ness".
>
> Me:
> >> Viridis mentioned that the developer of Wellbutrin SR said that cutting the pills did
> >>not really affect the absorbtion rate.
>
> Vidridis' Original Post:
> (at http://www.dr-bob.org/babble/20030912/msgs/260546.html)
>
> EXERPTS:
>
> >>> I called the company and spoke to one of the people who actually developed the SR
> >>> version...
>
> >>> He then faxed me graphs of uptake rates of cut vs. uncut pills, which showed a very
> >>> slight increase in absorption rate in the first 15 minutes, then almost identical
> >>> rates.
Posted by katia on February 26, 2004, at 2:10:56
In reply to Re: WELLBUTRIN;...Cutting XL pills? » NG, posted by mrporter1 on February 25, 2004, at 11:36:54
Hi-
Any bipolar people out there on a MS in conjunction with Wellbutrin? Is this too much of an activating med for BP folks?Katia
Posted by platinumbride on February 26, 2004, at 12:03:24
In reply to Bipolars on Wellbutrin? » mrporter1, posted by katia on February 26, 2004, at 2:10:56
I am BP II and I cycle very rapidly...always have...
I am on Wellbutrin SR and it doesn't seem to make me cycle anymore than not being on it. I wondered if it would be too much for me, but it doesn't stimulate me at all. I am as nutty as I was before it!
Of course, the eternal caveat reamins: everyone is different.
Good luck, Katia
Diane
Posted by katia on February 26, 2004, at 12:17:54
In reply to Re: Bipolars on Wellbutrin? » katia, posted by platinumbride on February 26, 2004, at 12:03:24
> I am BP II and I cycle very rapidly...always have...
>
> I am on Wellbutrin SR and it doesn't seem to make me cycle anymore than not being on it. I wondered if it would be too much for me, but it doesn't stimulate me at all. I am as nutty as I was before it!
>
> Of course, the eternal caveat reamins: everyone is different.
>
> Good luck, Katia
>
> Diane
>
Hi Diane,
But does it do anything good for you?
Katia
Posted by platinumbride on February 26, 2004, at 12:22:56
In reply to Re: Bipolars on Wellbutrin? » platinumbride, posted by katia on February 26, 2004, at 12:17:54
Katia,
To be honest I don't think anything really does me any good...I stay on it because it helps my ravenous appetite, and I have a notion that it will improve my sex drive....The appetite supressing qualities are enough for me to stay on it for now.....
I think my sex drive is low because I am depressed, which means that as an AD it isnt;' doing @^&*^...or at least not much!
D
Posted by platinumbride on February 26, 2004, at 12:28:49
In reply to Re: Bipolars on Wellbutrin? » platinumbride, posted by katia on February 26, 2004, at 12:17:54
Katia,
off the subject, what are you using as a mood stablizer?Cause I am wondering why I try so many different ones, and have eveb dabbled in seroquel, but still have major mood swings......
Sometiems i think i just need a hysterectomy or something lol
Posted by katia on February 26, 2004, at 12:29:46
In reply to Re: Bipolars on Wellbutrin? » katia, posted by platinumbride on February 26, 2004, at 12:22:56
What else have you tried? Are you on a mood stabilizer too? if so, which one?
Maybe you're more serotonin/noreph. deficient rather than dopamine = Wellbutrin.
How long have you been on it?
Have you tried Paxil?
Katia
Posted by platinumbride on February 26, 2004, at 12:34:01
In reply to Re: Bipolars on Wellbutrin? » platinumbride, posted by katia on February 26, 2004, at 12:29:46
I haven't been on paxil in years. I have been on them all...remeron and effexor included. For a time celexa and lamictal seemed to work, but not forever.....:-(
The mood stablizer du jour (which isn't stablizing at all ) is keppra.Thanks for your brain power in this :-)
Diane
What else have you tried? Are you on a mood stabilizer too? if so, which one?
>
> Maybe you're more serotonin/noreph. deficient rather than dopamine = Wellbutrin.
>
> How long have you been on it?
> Have you tried Paxil?
> Katia
Posted by katia on February 26, 2004, at 12:43:00
In reply to Re: Bipolars on Wellbutrin? » katia, posted by platinumbride on February 26, 2004, at 12:34:01
What is keppra?
I just started Trileptal at 150mg for four days now.
I was off of meds for 5 weeks, except for Seroquel for sleep and 12g of fishoil. It was great, but now i'm feeling unstable again.It would be one thing to choose to go on meds and have them WORK. But same goes for me I've yet to find something that does.
I was on: Celexa, Effexor, zoloft, Serzone before I found out I was BPII. Then Depakote, Dep/Lamictal, Lamictal, Lam/Lithium, Lithium, then nothing. Now Triletpal.
I want now to try a MS with an AD as I've never done that before. I'm trynig to figure out which is the best one for me. I don't want to gain anymore weight, don't want to be agitated, want to be focused, and less anxious.
Did you gain weight on Paxil?
katia
Posted by sarahsundae on February 26, 2004, at 12:48:41
In reply to Re: Bipolars on Wellbutrin? » katia, posted by platinumbride on February 26, 2004, at 12:03:24
I am recently (finally) diagnosised as BPII and I am on Wellbutrin (I have a fear of gaining weight) and Topamax. Works for me.
Posted by katia on February 26, 2004, at 12:55:30
In reply to Re: Bipolars on Wellbutrin?, posted by sarahsundae on February 26, 2004, at 12:48:41
Do you have anxiety? Is it better w/ WB? You don't become too agitated?
Posted by platinumbride on February 26, 2004, at 13:18:28
In reply to Re: Bipolars on Wellbutrin? » platinumbride, posted by katia on February 26, 2004, at 12:43:00
What is keppra? It is a MS, so they say....really an anticonvulsant. Shrink also says it is a cognitive enhancer. I'll give it a shot for that purpose. I haven't seen much on this board about it. I think he just likes the idea that it is a cognitive enhancer.
I haven't done the heavy duty ones like lithium or depakote for reasons of weight...
I did topamax...gave me nothing but headaches.
Sigh......D
I did gain weight on paxil even though i was a gym rat at the time. I have gained weight and appetite with so many things...and I am now 5'1 at a glowing "venus of Willendorf" 240 lbs.
Posted by katia on February 26, 2004, at 13:19:52
In reply to Re: Bipolars on Wellbutrin? » katia, posted by platinumbride on February 26, 2004, at 13:18:28
Does Keppra go by any other name? I'm in the US.
Katia
Posted by platinumbride on February 26, 2004, at 13:22:06
In reply to Re: Bipolars on Wellbutrin? » platinumbride, posted by katia on February 26, 2004, at 13:19:52
Keppra.....look it up on www.drugstore.com
I'm in the US too
Posted by katia on February 26, 2004, at 13:32:12
In reply to Re: Bipolars on Wellbutrin? » katia, posted by platinumbride on February 26, 2004, at 13:22:06
Interesting....I've never ever heard of that one before. Is it older? How does it work for you?
Posted by platinumbride on February 26, 2004, at 13:34:03
In reply to Re: Bipolars on Wellbutrin? » platinumbride, posted by katia on February 26, 2004, at 13:32:12
I think it is rather new.....
It isn't really working.....my moods are still swinging and rapidly....D
Posted by sarahsundae on February 26, 2004, at 15:15:13
In reply to Re: Bipolars on Wellbutrin? » sarahsundae, posted by katia on February 26, 2004, at 12:55:30
I had a little anxiety in the beginning but it went away.
The Topamax has helped a lot to stablize my moods so I'm not so up and down all the time. But only time will tell if these are the meds I will continue to stay on.
Posted by PsychoSage on February 26, 2004, at 18:27:36
In reply to Re: Bipolars on Wellbutrin? » katia, posted by sarahsundae on February 26, 2004, at 15:15:13
I am BP, and I am on 1200mg of Trileptal. I am also on 300mg of Wellbutrin. Wellbutrin irritates me I think because sometimes it starts activating or i just notice it, and my body isn't really doing anything and wants to relax. It is more of a norepinephrine drug than dopamine I think. I just started on a little bit of provigil on top of those two, and that gives a lot more energy as well as brain stimulation.
I think wellbutrin is good if you do not do well with anything with serotonin which makes me indifferent and sleep more. Those drugs also make me cloudier or almost stoned. Lots of Bipolars are switched on by those SSRIs because if the serotonin really works well, then the dopamine will kick in as well. It is odd how these drugs never work the way they claim they work, and that even goes for the selective ones. All the systems and pathways are connected and overlap in varying degrees, so if one is being revved up, I think a signal might go to another pathway to say it's time to party.
Wellbutrin will be very strong when you start and then it will mellow out. It will almost be too activating for some people at first, but look at it as your body getting used to it or start at 150 for not just 4 days but a few weeks or months actually. You shouldn't jerk yourself up on this one if you are sensitive to it.
I think it is a good buffer for depressives who sleep too much. It may curb your appetite in the beginning too.If you have continual insomnia, overactivation or weight loss {less of an appetite for a long time] then maybe it's a bit too much of what you need. Think about keeping it real low or moving on elsewhere.
Weight loss is common on this drug. I have not experienced that though.
I never slept less than normal on it, except maybe the first two days. I have never had insomnia except once, and that was the first personal trial ever on it 4 years ago.
When you dose up you will always have an amphetamine like experience for maybe just the first day or first few. Otherwise, it mellows out like I said. I have heard some people say it makes them want to jump out of their skin though.
I don't think this drug really triggers seizures the way many people say it does. There were probably too many epileptics in the sample they used in the study. I had an epileptic friend who had good results during her period with it, but she lost a lot of weight.
I am interested in Keppra, but the same friend told me she had a horrible week on it.
I would love to know more though because I hate dulling drugs like most of the MS.
Posted by katia on February 26, 2004, at 23:51:40
In reply to Re: Bipolars on Wellbutrin?, posted by PsychoSage on February 26, 2004, at 18:27:36
>>I just started on a little bit of provigil on top of those two, and that gives a lot more energy as well as brain stimulation.
HI Psychosage,
Thanks for such a long post!! very helpful. What you said above - you have more brain stiumlation and energy on Provigil. 1. What is Provigil? and 2. Doesn't wellbutrin give enough energy and stimulation? That's what I'm hoping for anyway. Focus and energy, but not agitation.>>I think wellbutrin is good if you do not do well with anything with serotonin which makes me indifferent and sleep more. Those drugs also make me cloudier or almost stoned. Lots of Bipolars are switched on by those SSRIs because if the serotonin really works well, then the dopamine will kick in as well. It is odd how these drugs never work the way they claim they work, and that even goes for the selective ones. All the systems and pathways are connected and overlap in varying degrees, so if one is being revved up, I think a signal might go to another pathway to say it's time to party.
**The problem is, I only tried ADs prior to being dxed as BP. I have no idea how I'll do on any of them with a mood stabilizer. I was a zombie on Zoloft and Celexa made me more depressed and an insomniac. Effexor and Serzone made me hypomanic and then with Eff. depressed and stoned feeling. Do you think this is an inidication how they will do for me WITH a MS? I too have just started Trileptal - I'm only at 125mg right now. I also currently take a smidge of Seroquel for sleep and 12g of fish oil.
Thanks again-
Katia
Posted by PsychoSage on February 27, 2004, at 5:21:55
In reply to Re: Bipolars on Wellbutrin? » PsychoSage, posted by katia on February 26, 2004, at 23:51:40
> >>I just started on a little bit of provigil on top of those two, and that gives a lot more energy as well as brain stimulation.
>
> HI Psychosage,
> Thanks for such a long post!! very helpful. What you said above - you have more brain stiumlation and energy on Provigil. 1. What is Provigil?It is a stimulant that is not like amphetamine or ritalin [methylphenidate]. It has less side effects than those drugs, but some experienced stimulant users claim that it doesn't do much for them. I think it is very potent. It is prescribed for shift-work disorder and narcolepsy[first approval was for this in 98 i believe] It is relatively knew on the market in the US. It is prescribed off-label for many things including depression and ADD..
and 2. Doesn't wellbutrin give enough energy and stimulation? That's what I'm hoping for anyway. Focus and energy, but not agitation.It is more of an antidepressant for me. Many ADHD people take it alone for their symptoms, and they are successful with it.
>
> >>I think wellbutrin is good if you do not do well with anything with serotonin which makes me indifferent and sleep more. Those drugs also make me cloudier or almost stoned. Lots of Bipolars are switched on by those SSRIs because if the serotonin really works well, then the dopamine will kick in as well. It is odd how these drugs never work the way they claim they work, and that even goes for the selective ones. All the systems and pathways are connected and overlap in varying degrees, so if one is being revved up, I think a signal might go to another pathway to say it's time to party.
>
> **The problem is, I only tried ADs prior to being dxed as BP. I have no idea how I'll do on any of them with a mood stabilizer. I was a zombie on Zoloft and Celexa made me more depressed and an insomniac. Effexor and Serzone made me hypomanic and then with Eff. depressed and stoned feeling. Do you think this is an inidication how they will do for me WITH a MS? I too have just started Trileptal - I'm only at 125mg right now. I also currently take a smidge of Seroquel for sleep and 12g of fish oil.
>
> Thanks again-
> KatiaI am new to mood stabilisers too. i think I started out at 300, then I moved to 600. I was having some issues, so they bumped me up to 1200 which is generally the upper limit for most, but it's not unusual for epileptics to hit 1800 or 2400. check out www.bipolarworld.net
Mood stabilizers are supposed to keep you from being a little lightening bug, so it's like insulation. They can also prevent depression, but that depends on the person and the drug.
An antidepressant should just be added if you are having trouble while a MS should be a maintenance drug unless you are depressed a lot then you need both as maintenance.
Basically, I do not go near the serotonin drugs for the reasons I admitted above. I wouldn't care if they are activating or if they even worked perfectly. They always either poop out or just cause more trouble for me, and I have a hard time figuring them out. I say that because I fiddled with the dosage for them for years. I couldn't tell if they helped my anxiety or caused it by making me irritable or agitated. I think they may be good for short-term therapy, but they take my emotions away from me.
I don't like antipsychotics either even though my brain glitches occasionally.
You have several different drugs going on there, so be vigilant about side effects. Seroquel is sedating, and doesn't just affect you after you take it. it can have a partial effect all day.
You will make your own path obviously, so my experience will not predict yours but try to track your symptoms. good luck
Posted by katia on February 27, 2004, at 14:21:25
In reply to Re: Bipolars on Wellbutrin?, posted by PsychoSage on February 27, 2004, at 5:21:55
Hi psychosage,
Thanks again for your post.
Are you bipolar and ADHD? I'm losing track of people, so excuse me if you've already told me.My system is extremely sensitive and less is better for me. I'll probably ONLY go up to 300mg of Trileptal if even that. I do need something to pull me out of a depression I feel myself falling into.
How long have you been on the med rollercoaster ride?
Katia
BPII
Seroquel 12g
Fish oil 12g
Trileptal 125mg
Posted by PsychoSage on February 27, 2004, at 15:45:58
In reply to Re: Bipolars on Wellbutrin? » PsychoSage, posted by katia on February 27, 2004, at 14:21:25
> Hi psychosage,
> Thanks again for your post.
> Are you bipolar and ADHD? I'm losing track of people, so excuse me if you've already told me.
>
> My system is extremely sensitive and less is better for me. I'll probably ONLY go up to 300mg of Trileptal if even that. I do need something to pull me out of a depression I feel myself falling into.
> How long have you been on the med rollercoaster ride?
> Katia
> BPII
> Seroquel 12g
> Fish oil 12g
> Trileptal 125mg
I am not really ADHD. I have inattention and perceptual problems due to substance abuse with methamphetamine.There is no doubt that I am not ADHD because I was an excellent student until I went to college. I was very well-behaved. It may not matter now what caused my symptoms because I need some assistance through stimulating psych drugs now.
I am bipolar, mid 20s. I've had psychotic symptoms, but they were tied into mania and depression and emanated from meth abuse: ampehtamine induced psychosis officially.
I have done meds for a little more than 6 years now. Zoloft saved my life during my first major depression at 19, but it did me no favor after the first month.
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Dr. Bob is Robert Hsiung, MD,
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