Any Advice For Tolerating Wellbutrin/bupropion?

[denise]

My husband has decided to try Wellbutrin (he just started a couple days ago), and while he's experiencing some good things (more motivation/focus, and the weight on his head has lifted) he's also experiencing insomnia. I'm guessing it's the boost in norepinephrine that's causing that? Assuming that's the case, I've been trying to think of a good way to help with that aspect of it that won't cause even more problems. Any suggestions?

 

[Queequeg]

RP has always talked about the dangers of excess stress hormones like nor-epinephrine. I wonder what he would think of the long term safety of a drug that increases its presence.

 

[denise]

RP has always talked about the dangers of excess stress hormones like nor-epinephrine. I wonder what he would think of the long term safety of a drug that increases its presence.

I have the same concern. He's now feeling great on it though (and no more side effects), so who knows if/when he'll give it up.

 

[DaveFoster]

Dr. Peat has mentioned that NE can prevent seizures. He views adrenaline and NE as less harmful than serotonin, estrogen or lactate, possibly for the former's pro-metabolic effects.

 

[jitsmonkey]

My husband has decided to try Wellbutrin (he just started a couple days ago), and while he's experiencing some good things (more motivation/focus, and the weight on his head has lifted) he's also experiencing insomnia. I'm guessing it's the boost in norepinephrine that's causing that? Assuming that's the case, I've been trying to think of a good way to help with that aspect of it that won't cause even more problems. Any suggestions?

It WILL cause more problems.
This isn't a negotiable "side" effect.
This is a problematic mechanism of action.

He could drink a liter of scotch everyday and "feel good" but he probably wouldn't choose that as a therapeutic tool. Education as to what his choice of drug is actually doing will either
get him to unchoose it or when things inevitably go south he'll understand/expect it and be able to make a more informed choice. Continuing to just cruise forward because his first few days /weeks are "good" and not prepare for the coming backlash would be a mistake.

This one of the more succinct descriptions I've seen re: why some people respond "well" to SSRI's.
another example of responding "well" really NOT being a good thing...

Those that find great relief from SSRIs, tryptophan, or 5-HTP might be interested to know that serotonin activates the pituitary's secretion of ACTH (Martin, 1985; Heisler, et al. 2007), which invariably leads to the production of cortisol (Lefebvre H, et al., 1992; Selye, 1952). Constance Martin and Hans Selye have both noted that cortisol, a short-term protective, long-term degenerative "stress" hormone, can produce feelings of euphoria and wellness followed by psychic depression and suicidal tendencies (Selye, 1952; Martin, 1985).
from this article (don't be fooled by the article topic/title... its a worthwhile read for anyone trying to understand serotonin, depression, etc....

http://www.dannyroddy.com/…/psychosisorgnosissocialhistoryo…

 

[Queequeg]

It WILL cause more problems.
This isn't a negotiable "side" effect.
This is a problematic mechanism of action.

He could drink a liter of scotch everyday and "feel good" but he probably wouldn't choose that as a therapeutic tool. Education as to what his choice of drug is actually doing will either
get him to unchoose it or when things inevitably go south he'll understand/expect it and be able to make a more informed choice. Continuing to just cruise forward because his first few days /weeks are "good" and not prepare for the coming backlash would be a mistake.

This one of the more succinct descriptions I've seen re: why some people respond "well" to SSRI's.
another example of responding "well" really NOT being a good thing...

Those that find great relief from SSRIs, tryptophan, or 5-HTP might be interested to know that serotonin activates the pituitary's secretion of ACTH (Martin, 1985; Heisler, et al. 2007), which invariably leads to the production of cortisol (Lefebvre H, et al., 1992; Selye, 1952). Constance Martin and Hans Selye have both noted that cortisol, a short-term protective, long-term degenerative "stress" hormone, can produce feelings of euphoria and wellness followed by psychic depression and suicidal tendencies (Selye, 1952; Martin, 1985).
from this article (don't be fooled by the article topic/title... its a worthwhile read for anyone trying to understand serotonin, depression, etc....

http://www.dannyroddy.com/…/psychosisorgnosissocialhistoryo…

wellbutrin is not an SSRI. It is a norepinephrine-dopamine reuptake inhibitor

 

[jitsmonkey]

wellbutrin is not an SSRI. It is a norepinephrine-dopamine reuptake inhibitor

I stand corrected
opinion same. (just don't have a danny roddy lsd article that's relevant lol)
dangerous at best.
far better options available to someone with mental illness needing help.

 

[Queequeg]

I stand corrected
opinion same. (just don't have a danny roddy lsd article that's relevant lol)
dangerous at best.
far better options available to someone with mental illness needing help.

that is probably true

 

[aguilaroja]

My husband has decided to try Wellbutrin (he just started a couple days ago), and while he's experiencing some good things (more motivation/focus, and the weight on his head has lifted) he's also experiencing insomnia.... I've been trying to think of a good way to help with that aspect of it that won't cause even more problems....

Briefly, putting aside the question of other metabolic supports for mood/motivation difficulties, here are some possibilities:

Medication timing: Experiment with the time of day the substance is used. For instance, even when medication is “spaced out” during the day, an evening/late afternoon dose can be taken earlier.

Medication form: Many pharmaceuticals, including many psychoactive ones, are prescribed in sustained release/SR/extended release/XL/long acting forms. For individual adjustments of timing, it is sometimes better to start with the “regular” (non-long acting) form. This may mean taking pills more often per day.

Minimum effective dose: Prescribers often insist that the increments listed are the absolute ones. In practice, few practitioners work with their patients to fine tune the amount to find a level that is effective using the smallest quantity. Optimum levels may be less than or in between “recommended” doses, and may change over time.

Individual response to pharmaceuticals is never uniform. For the long acting substance forms, the working idea is a reliable steady state level during the stated time interval. In practice, sometimes long-acting formulations have unsteady effects throughout the day.

There are many simple questions about medication action that are not researched and many never be. I have met practitioners who insist on speaking with authority, even with contradictory journal articles placed literally in front of them. Better practitioners work with their patients, and gather feedback. For instance, it is taken as given that medication should be a continuous 24 hour amount. I have seen situations where people do better with most medication quantity during the day time hours.

“YMMV”

 

[Frankdee20]

Mirtazepine has a strong antihistamine effect that typically knocks people out at night, he could try that. Trazadone also knocks people out in low doses, via alpha adrenergic and serotonin antagonism. It’s a weak SSRI in higher doses though.

Wellbutrin is an effective anti smoking aide as well as antidepressant. It’s a modified cathinone substance. These are the alkaloids derived from the psychoactive stimulant shrub Khat, that grows in the Middle East.

His prescribing doctor should’ve accounted for the propensity this drug has at eliciting insomnia. A non addictive GABA Nergic can help at night. Do not use benzodiazepines or the lunesta and ambien subtypes.

 

[Queequeg]

just found a bonus for the two of you
Bupropion - Wikipedia

 

[denise]

It's so funny that I posted this a year ago but am only now getting lots of responses! I do still appreciate them, and hopefully this thread will help others, too.

My husband has been using the bupropion all this time, although he's talking about getting off of it because it's not really providing obvious benefit. I've suggested trying Metergoline after he quits this stuff.

One interesting thing has been that it seems like every few months, the pills he gets will be from a different manufacturer, and although they're all supposedly the same stuff, he can tell that they aren't. There was one version that caused him to feel really weird if he drank any alcohol at all, but with the version he's on now he can have several beers without problems.

Dr. Peat has mentioned that NE can prevent seizures. He views adrenaline and NE as less harmful than serotonin, estrogen or lactate, possibly for the former's pro-metabolic effects.

Interesting, I didn't realize that.

Briefly, putting aside the question of other metabolic supports for mood/motivation difficulties, here are some possibilities:

Medication timing: Experiment with the time of day the substance is used. For instance, even when medication is “spaced out” during the day, an evening/late afternoon dose can be taken earlier.

Medication form: Many pharmaceuticals, including many psychoactive ones, are prescribed in sustained release/SR/extended release/XL/long acting forms. For individual adjustments of timing, it is sometimes better to start with the “regular” (non-long acting) form. This may mean taking pills more often per day.

Minimum effective dose: Prescribers often insist that the increments listed are the absolute ones. In practice, few practitioners work with their patients to fine tune the amount to find a level that is effective using the smallest quantity. Optimum levels may be less than or in between “recommended” doses, and may change over time.

Individual response to pharmaceuticals is never uniform. For the long acting substance forms, the working idea is a reliable steady state level during the stated time interval. In practice, sometimes long-acting formulations have unsteady effects throughout the day.

There are many simple questions about medication action that are not researched and many never be. I have met practitioners who insist on speaking with authority, even with contradictory journal articles placed literally in front of them. Better practitioners work with their patients, and gather feedback. For instance, it is taken as given that medication should be a continuous 24 hour amount. I have seen situations where people do better with most medication quantity during the day time hours.

“YMMV”

Thanks for these thoughts. Given all this, it still blows my mind that anyone can walk into any GP's office and walk out with a prescription for depression, virtually no questions asked (my husband's doctor didn't even ask him about his current life circumstances, which were obviously 90% of the reason for his malaise!) and yet most clearly hypothyroid people can't get decent meds for love or money.

just found a bonus for the two of you
Bupropion - Wikipedia

LOL. The lack of sexual impairment was definitely a point in its favor. He had a bad experience with Lexapro years ago.

 

[Frankdee20]

It's so funny that I posted this a year ago but am only now getting lots of responses! I do still appreciate them, and hopefully this thread will help others, too.

My husband has been using the bupropion all this time, although he's talking about getting off of it because it's not really providing obvious benefit. I've suggested trying Metergoline after he quits this stuff.

One interesting thing has been that it seems like every few months, the pills he gets will be from a different manufacturer, and although they're all supposedly the same stuff, he can tell that they aren't. There was one version that caused him to feel really weird if he drank any alcohol at all, but with the version he's on now he can have several beers without problems.

Interesting, I didn't realize that.

Thanks for these thoughts. Given all this, it still blows my mind that anyone can walk into any GP's office and walk out with a prescription for depression, virtually no questions asked (my husband's doctor didn't even ask him about his current life circumstances, which were obviously 90% of the reason for his malaise!) and yet most clearly hypothyroid people can't get decent meds for love or money.

LOL. The lack of sexual impairment was definitely a point in its favor. He had a bad experience with Lexapro years ago.

How’s his sleeping been ?

 

[denise]

How’s his sleeping been ?

The insomnia caused by starting bupropion ended long ago. Work stress can still cause it (especially on Sunday nights, when he dreads the next morning), but doxylamine succinate works well for that. The best insomnia solution would be for him to quit his job! But that's not feasible just yet.

 

[Frankdee20]

The insomnia caused by starting bupropion ended long ago. Work stress can still cause it (especially on Sunday nights, when he dreads the next morning), but doxylamine succinate works well for that. The best insomnia solution would be for him to quit his job! But that's not feasible just yet.

Ha ha, good luck then

 

[DaveFoster]

It's so funny that I posted this a year ago but am only now getting lots of responses! I do still appreciate them, and hopefully this thread will help others, too.

My husband has been using the bupropion all this time, although he's talking about getting off of it because it's not really providing obvious benefit. I've suggested trying Metergoline after he quits this stuff.

One interesting thing has been that it seems like every few months, the pills he gets will be from a different manufacturer, and although they're all supposedly the same stuff, he can tell that they aren't. There was one version that caused him to feel really weird if he drank any alcohol at all, but with the version he's on now he can have several beers without problems.

Interesting, I didn't realize that.

Thanks for these thoughts. Given all this, it still blows my mind that anyone can walk into any GP's office and walk out with a prescription for depression, virtually no questions asked (my husband's doctor didn't even ask him about his current life circumstances, which were obviously 90% of the reason for his malaise!) and yet most clearly hypothyroid people can't get decent meds for love or money.

LOL. The lack of sexual impairment was definitely a point in its favor. He had a bad experience with Lexapro years ago.

There's not as much money involved with thyroid prescriptions.

Newer antidepressants cost ~$60-100 per month, and some antipsychotics (Seroquel XR) cost several $100's.

 

[DaveFoster]

The insomnia caused by starting bupropion ended long ago. Work stress can still cause it (especially on Sunday nights, when he dreads the next morning), but doxylamine succinate works well for that. The best insomnia solution would be for him to quit his job! But that's not feasible just yet.

Has bupropion helped him better tolerate stress at work, and has he mentioned or have you observed changes in his coffee consumption or other habits (sweating, humor, sex drive, and so on)?