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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Sarah S on April 26, 2003, at 14:14:25
I suffer from social phobia, anxiety, depersonalization, and constant fatigue (I'm tired even when I get tons of sleep and even when I'm not depressed). I'm on Wellbutrin which helps the social phobia and depersonalization, but I'm still exhausted all the time, nervous, etc. I'm seeing a new pdoc on Tuesday and would like to add one or two meds to Wellbutrin to help with my remaining symptoms. Does anyone have any suggestions? I am considering the following combos:
Wellbutrin + Klonopin+ Provigil: should help with fatigue, anxiety, depersonalization, and social phobia. The only downside I can think of is that most doctors won't prescribe Klonopin long-term.
Wellbutrin + Zoloft: should help with social phobia, although it may increase the fatigue and depersonalization
Wellbutrin + Zoloft + Provigil: I think this would tackle the social phobia, depression, and fatigue, but I don't know if it would help anxiety.If anyone has tried any of the above combos, or has had success with other med combos for the same problems that I have, then I'd be really grateful if you would post your experiences.
Posted by Edgefield on April 26, 2003, at 16:23:54
In reply to best combo for social phobia and fatigue?, posted by Sarah S on April 26, 2003, at 14:14:25
I can not suggest a med. combo at this time, but hopefully I will soon :) I wanted to know if the the Wellbutrin has totally eliminated depersonalization? God Bless
> I suffer from social phobia, anxiety, depersonalization, and constant fatigue (I'm tired even when I get tons of sleep and even when I'm not depressed). I'm on Wellbutrin which helps the social phobia and depersonalization, but I'm still exhausted all the time, nervous, etc. I'm seeing a new pdoc on Tuesday and would like to add one or two meds to Wellbutrin to help with my remaining symptoms. Does anyone have any suggestions? I am considering the following combos:
> Wellbutrin + Klonopin+ Provigil: should help with fatigue, anxiety, depersonalization, and social phobia. The only downside I can think of is that most doctors won't prescribe Klonopin long-term.
> Wellbutrin + Zoloft: should help with social phobia, although it may increase the fatigue and depersonalization
> Wellbutrin + Zoloft + Provigil: I think this would tackle the social phobia, depression, and fatigue, but I don't know if it would help anxiety.
>
> If anyone has tried any of the above combos, or has had success with other med combos for the same problems that I have, then I'd be really grateful if you would post your experiences.
Posted by Snoozy on April 26, 2003, at 16:55:50
In reply to best combo for social phobia and fatigue?, posted by Sarah S on April 26, 2003, at 14:14:25
Funny - I am in the exact same position. I've been on Wellbutrin(400mg) for a couple of years. I have a big big problem with sleepiness. I'm also seeing my pdoc on Tuesday!!
I wish I could increase my Wellbutrin dose, but I'm at the upper limits already. I'm planning to talk to my dr about Provigil and Ritalin (or one of the long-acting ADD meds).
I hope we both get some answers Tuesday!!
> I suffer from social phobia, anxiety, depersonalization, and constant fatigue (I'm tired even when I get tons of sleep and even when I'm not depressed). I'm on Wellbutrin which helps the social phobia and depersonalization, but I'm still exhausted all the time, nervous, etc. I'm seeing a new pdoc on Tuesday and would like to add one or two meds to Wellbutrin to help with my remaining symptoms. Does anyone have any suggestions? I am considering the following combos:
> Wellbutrin + Klonopin+ Provigil: should help with fatigue, anxiety, depersonalization, and social phobia. The only downside I can think of is that most doctors won't prescribe Klonopin long-term.
> Wellbutrin + Zoloft: should help with social phobia, although it may increase the fatigue and depersonalization
> Wellbutrin + Zoloft + Provigil: I think this would tackle the social phobia, depression, and fatigue, but I don't know if it would help anxiety.
>
> If anyone has tried any of the above combos, or has had success with other med combos for the same problems that I have, then I'd be really grateful if you would post your experiences.
Posted by Carlos on April 26, 2003, at 19:45:33
In reply to best combo for social phobia and fatigue?, posted by Sarah S on April 26, 2003, at 14:14:25
I have SP and have tried a lot of drug cocktails. I'm not a big fan of them beacause first off you're taking many medications at once and it's really hard to single out what is causing what. Second when you mix certain drugs you get a completely different reaction it's just not like stacking meds, it's truly a cocktail mix. Finally I personally just don't like the idea of having to take more than one or two pyschotropic drugs a day. Have you tried a MAIO?
Posted by utopizen on April 26, 2003, at 20:58:19
In reply to Re: best combo for social phobia and fatigue?, posted by Carlos on April 26, 2003, at 19:45:33
P-docs are nice, they can help fatigue by prescribing things like Provigil and stims. But you really should see a neurologist as well for your sleepiness. It's a result of poor sleep architecture-- the way your brain sleeps at night. You'll probably need a sleep-deprived EEG, it charts your brain waves as you sleep. This will help pin point the problem.
YOu may have a sleep disorder that they can't find the cause of, which they can treat with things like Xyrem and Provigil, according to my neuro. But if it's sleep apnea, you can try surgeries or a oxygen machine.
Posted by Rocket Jackson on April 26, 2003, at 22:38:25
In reply to best combo for social phobia and fatigue?, posted by Sarah S on April 26, 2003, at 14:14:25
> I suffer from social phobia, anxiety, depersonalization, and constant fatigue (I'm tired even when I get tons of sleep and even when I'm not depressed). I'm on Wellbutrin which helps the social phobia and depersonalization, but I'm still exhausted all the time, nervous, etc. I'm seeing a new pdoc on Tuesday and would like to add one or two meds to Wellbutrin to help with my remaining symptoms. Does anyone have any suggestions? I am considering the following combos:
> Wellbutrin + Klonopin+ Provigil: should help with fatigue, anxiety, depersonalization, and social phobia. The only downside I can think of is that most doctors won't prescribe Klonopin long-term.
> Wellbutrin + Zoloft: should help with social phobia, although it may increase the fatigue and depersonalization
> Wellbutrin + Zoloft + Provigil: I think this would tackle the social phobia, depression, and fatigue, but I don't know if it would help anxiety.
>
> If anyone has tried any of the above combos, or has had success with other med combos for the same problems that I have, then I'd be really grateful if you would post your experiences.Hi Sarah,
How long have you been on the WB so far? I tried it for a few months last summer for my SP (150mg bid), and experienced the same symptoms of exhaustion (mainly in the evening) and anxiety (during the day) over the first few weeks of treatment. And though the exhaustion eventually subsided, I continued to experience increased anxiety and thus decided to stop it after a few months.
As for adding the Klonopin, I did this on a prn basis when social situations were anticipated, and I felt like the Klonopin effects were essentially dampened by the WB-induced anxiety. So I know if I were to have added Provigil at the time, I probably would have been ramped up that much more. Take away the WB, and the Provigil/Klonopin combo I now use seems to work perfectly for me. I'm adding Zoloft next week for the first time to see how that works out...
If your exhaustion doesn't seem to be subsiding, then the addition of Provigil may very well be a good idea. Then if you get too nervous over time, an addition of Zoloft, or even Klonopin might help. Perhaps even Buspar might help?
Please let us know what you decide. I'll be particularly interested, as your situation sounds very similar to mine. :)
Good luck!
Rocket
Posted by Sarah S on April 27, 2003, at 14:15:46
In reply to Re: best combo for social phobia and fatigue?, posted by Edgefield on April 26, 2003, at 16:23:54
WB has helped a lot with the depersonalization, and I feel more like a person than I have in years. I still get DPed sometimes, but it isn't severe and constant like it used to be. My guess is that WB helps because it increases dopamine (which gives you more pleasure in life) and norepinephrine (which stimulates you).
This is the end of the thread.
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