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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by DebbieLynn on August 25, 2001, at 15:27:56
I have been on Effexor Xr at 225 mg for about 4 months and my doctor just increased my dose to 300mg. I also take Wellbutrin SR 100mg to augment sexual side effects of the Effexor. I have been experiencing FREQUENT urination today and I am kind of worried because I have experienced serotonin syndrome when I added Celexa (20mg) to 225mg of Effexor. It took about 3 weeks of taking the Celexa, but frequent urination was one of my first signs. (I did not know at the time, I thought I was getting a bladder infection) It went on for about a week before I started in with the rest of the symptoms...then I went to the ER.
Excuse me male readers....I have been on my period for about 3 days...I know sometimes when you bloat you can experience frequent urination after you start. I don't know if that is what it is or not. I have been at 300mg for about a week. I did start the increase slow...adding 37.5 mg to the 225mg for a week then the full 75mg.
Does anyone know if this is enough to produce serotonin syndrome? My thoughts are no....because Wellbutrin does not have a big effect on serotonin. 300mg is a relatively high dose of Effexor XR...I know I will handle that fine. (I thought I could handle Celexa and Effexor! But guess what!)
Any comments or information is welcomed!
Thanks--Debbie
Posted by phillybob on August 25, 2001, at 22:25:28
In reply to 300mg of FXR *100mg Wellbutrin SR**too much??, posted by DebbieLynn on August 25, 2001, at 15:27:56
I had built up and then been steady (with occassional increases to 300 mg/day) on the 225 mg/day FXR dose for about 3 weeks. The last 2 weeks on that dose, I added 150 mg/twice daily (300mg total daily) of Wellbutrin to help with energy.
The first week was quite nice, but the second week, I did have frequent urination and, in fact, a non-urine discharge when urinating. I re-called a similar problem before with Wellbutrin alone. Needless to say, I stopped the Wellbutrin (and pretty close thereafter, the Effexor, for other reasons which I'm too tired to even go into right now).
Just off-hand, if the Effexor is benefiting you, I'd probably stay with that and kill the WB. But, you might want to check on whether that's a WB side-effect that'll go away.
While weight gain is an almost automatic issue, Remeron might be a good adjunct for sexual function (?). Check that out, but I suppose serotonin syndrome would have to be more carefully monitored with that combo. [I had a good experience with Remeron but then ... see my last paragraph.]
It does not, though, seem as if the FXR/WB combo would result in serotonin syndrome for the same reasons you've already stated.
I personally just have these serotonin syndrome-like reactions to many meds after being on them for a while, whether alone or in combo with something.
Best wishes.
Posted by DebbieLynn on August 27, 2001, at 12:12:48
In reply to Re: 300mg of FXR *100mg Wellbutrin SR**too much??, posted by phillybob on August 25, 2001, at 22:25:28
> I had built up and then been steady (with occassional increases to 300 mg/day) on the 225 mg/day FXR dose for about 3 weeks. The last 2 weeks on that dose, I added 150 mg/twice daily (300mg total daily) of Wellbutrin to help with energy.
>
> The first week was quite nice, but the second week, I did have frequent urination and, in fact, a non-urine discharge when urinating. I re-called a similar problem before with Wellbutrin alone. Needless to say, I stopped the Wellbutrin (and pretty close thereafter, the Effexor, for other reasons which I'm too tired to even go into right now).
>
> Just off-hand, if the Effexor is benefiting you, I'd probably stay with that and kill the WB. But, you might want to check on whether that's a WB side-effect that'll go away.
>
> While weight gain is an almost automatic issue, Remeron might be a good adjunct for sexual function (?). Check that out, but I suppose serotonin syndrome would have to be more carefully monitored with that combo. [I had a good experience with Remeron but then ... see my last paragraph.]
>
> It does not, though, seem as if the FXR/WB combo would result in serotonin syndrome for the same reasons you've already stated.
>
> I personally just have these serotonin syndrome-like reactions to many meds after being on them for a while, whether alone or in combo with something.
>
> Best wishes.
Did the Effexor make you tired at 225mg? I had increased energy until I started the Wellbutrin. The increase to 300mg is causing insomnia, and of course I am tired during the day! The Wellbutrin really works with the sexual side effects, I would hate to stop it, but I wonder if I should? Hopefully in a few weeks I will see benefits from the 300mg dose. By the way, did you have problems tapering from the Effexor??The frequent urination has gone away, it was probably because of my monthly friend :) Anyway, sometimes I feel like I have to go and can't. I have also had an increase in anxiety in the past few days (I take ativan for that) and have had some nausea...the same side effects I had when I initially started with the Effexor, but I feel I can stick it out. The only thing I am having problems with is being SO TIRED! It is 1:00 in the afternoon on a beautiful summer day and I want to sleep. I could not go to sleep last night for anything. I have Trazadone to help me sleep, but I feel "hungover" the next day.
Sorry to ramble....
Thanks for your experience!
Debbie
Posted by phillybob on August 27, 2001, at 13:11:20
In reply to Re: 300mg of FXR *100mg Wellbutrin SR**too much??, posted by DebbieLynn on August 27, 2001, at 12:12:48
You are taking WB primarily to increase sexual senses/desire, right?
I am unclear as to why you have increased the FXR from 225 mg to 300 mg. Is that something you did after the WB because of insomnia or because you started having a greater lack of energy?
Anyway, sounds like you might want research the WB threads here a bit to see if you think it's worthwhile to hang out with that for some time with the FXR. I guess you could try and eliminate the FXR entirely, but, depending upon your brain's needs, you might be eliminating a necessary component to your health. Reading the WB threads might give you an idea of that drug's abilities/limitations in treating depression in solo use.
If the FXR 225 mg/day was working for you except the sexual side effects and the addition of WB results in more and/or new side effects, you might try and eliminate the WB and instead augment the FXR with a stimulant like Adderall or Dexedrine. They can counteract sexual side effects and often augment a drug's ability.
Currently, you might try the FXR at bedtime to minimize the sleepiness (unless it ends up keeping you awake).
I'm in over my head here, but I'm sure others'll respond accordingly.
[also, coming off FXR was not pretty mostly for the first 3 days (feeling of something missing in my brain and general miserableness) and has slowly improved to where I feel the withdrawal part is more or less gone (less than a week after stopping). i did it cold turkey (and with the addition of prozac to help), but from what i've read here, my experiences would be not much different had i tapered instead, so i just bit the bullet. i'm sort of glad i knew what to expect, but had i not known, i'm not sure i woulda even realized that i was feeling like crap because i had stopped the fxr.)
Posted by DebbieLynn on August 30, 2001, at 10:33:11
In reply to Re: 300mg of FXR *100mg Wellbutrin SR**too much??, posted by phillybob on August 27, 2001, at 13:11:20
> You are taking WB primarily to increase sexual senses/desire, right?
>
> I am unclear as to why you have increased the FXR from 225 mg to 300 mg. Is that something you did after the WB because of insomnia or because you started having a greater lack of energy?
>
> Anyway, sounds like you might want research the WB threads here a bit to see if you think it's worthwhile to hang out with that for some time with the FXR. I guess you could try and eliminate the FXR entirely, but, depending upon your brain's needs, you might be eliminating a necessary component to your health. Reading the WB threads might give you an idea of that drug's abilities/limitations in treating depression in solo use.
>
> If the FXR 225 mg/day was working for you except the sexual side effects and the addition of WB results in more and/or new side effects, you might try and eliminate the WB and instead augment the FXR with a stimulant like Adderall or Dexedrine. They can counteract sexual side effects and often augment a drug's ability.
>
> Currently, you might try the FXR at bedtime to minimize the sleepiness (unless it ends up keeping you awake).
>
> I'm in over my head here, but I'm sure others'll respond accordingly.
>
> [also, coming off FXR was not pretty mostly for the first 3 days (feeling of something missing in my brain and general miserableness) and has slowly improved to where I feel the withdrawal part is more or less gone (less than a week after stopping). i did it cold turkey (and with the addition of prozac to help), but from what i've read here, my experiences would be not much different had i tapered instead, so i just bit the bullet. i'm sort of glad i knew what to expect, but had i not known, i'm not sure i woulda even realized that i was feeling like crap because i had stopped the fxr.)Hello...
Well I have had some changes made! I have been EXTREMELY tired for the past few week! My pdoc increased the Effexor because I told her that it seemed as if it was not "working as well". I am not sure if the Wellbutrin has anything to do with it. I would not think so at the 100mg dose. Well, I went to the doctor yesterday because I could not tolerate the tiredness. I would sleep all night, wake up in the morning and be ready to sleep again within an hour of being up. I mean to the point of not being able to keep my eyes open. Then about 3:00 in the afternoon I would get extremely tired again, and take a 2 1/2 nap. That is not me! I haven't wanted to do anything because of lack of energy. I find it a chore to do dishes, or any kind of housework! It took all I had to even take a shower! Sounds like a little depression, huh? This was on 225mg of Effexor XR and 100mg of Wellbutrin SR. Anyway, I bumped up my dose of Effexor to 300mg about a week ago. Yesterday my doctor told me to decrease back to 225mg and added 100mg in the afternoon of Wellbutrin SR. She really could not understand why I have been so tired because normally Effexor and Wellbutrin are activating meds. BUT, occasionally Effexor can cause somnolence. 225mg USED to energize me. Her plan is to decrease the Effexor to comfortable dose, or eliminate it and up the dose of Wellbutrin. But I am with you on elimination of the Effexor. I have had a lot of benefit from the Effexor, and I am scared to eliminate it completely. She wants to slowly decrease the dose. I am confused. I have read SO MUCH on these meds.So...yesterday I took 150mg of Effexor and 100mg of Wellbutrin in the morning, and in the late afternoon/early evening I took just 75mg of Effexor and 100mg MORE of Wellbutrin.
Have I confused you yet? :)
We'll see what happens!
Thanks again for the info...Sorry for the book. I like hearing your opinions and suggestions!
Debbie
Posted by phillybob on August 30, 2001, at 15:40:51
In reply to Re: 300mg of FXR *100mg Wellbutrin SR**too much??, posted by DebbieLynn on August 30, 2001, at 10:33:11
from what i've read here and what my doctor has tried to get me to learn is that some meds, especially the shorter life ones such as effexor, have a very small therapeutic window meaning ... 225 mg or more might be right for you but 300 mg or less might be wrong. hopefully, you'll get back in synch with the effexor.
good luck.
p.s. washing dishes IS a chore. :)
This is the end of the thread.
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