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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by cee on April 8, 2009, at 16:13:07
This will be my first time taking two types of anti depressants, cymbalta and now wellbutrin has any one else had any sucess with this combo?
thanks
cee
Posted by rskontos on April 9, 2009, at 10:36:05
In reply to Wellbutrin 150 mg low dose?, posted by cee on April 8, 2009, at 16:13:07
I've only taken them separately. Currently on wellbutrin alone.
Good luck
rsk
Posted by cee on April 9, 2009, at 11:00:35
In reply to Re: Wellbutrin 150 mg low dose? » cee, posted by rskontos on April 9, 2009, at 10:36:05
Thanks for responding how do you find the side effects
thankscee
Posted by sowhysosad on April 10, 2009, at 21:39:37
In reply to Wellbutrin 150 mg low dose?, posted by cee on April 8, 2009, at 16:13:07
> This will be my first time taking two types of anti depressants, cymbalta and now wellbutrin has any one else had any sucess with this combo?
>
> thanks
> ceeYou'd think that combo could push your norepinephrine really high as both drugs prevent its reuptake.
However, I'd guess that cymbalta acts only like an SSRI in lower doses, much like Effexor does.
Posted by garnet71 on April 10, 2009, at 22:46:59
In reply to Re: Wellbutrin 150 mg low dose?, posted by sowhysosad on April 10, 2009, at 21:39:37
> However, I'd guess that cymbalta acts only like an SSRI in lower doses, much like Effexor does.
Hi - Do you know of any other XXRIs, besides Effexor, with that sort of behavior?
Posted by sowhysosad on April 10, 2009, at 23:25:26
In reply to Re: Wellbutrin 150 mg low dose? » sowhysosad, posted by garnet71 on April 10, 2009, at 22:46:59
> > However, I'd guess that cymbalta acts only like an SSRI in lower doses, much like Effexor does.
>
> Hi - Do you know of any other XXRIs, besides Effexor, with that sort of behavior?
>In another thread desolationrower recently explained the concept of sigmoid function:
"binding is http://en.wikipedia.org/wiki/Sigmoid_function sigmoidal. this is relevant when the drug binds to two different receptors, like velafaxine. that rapid increase in the middle of the curve means that the first receptor gets almost full before the other one really gets going, which is why you only start to get a little bit of NA effect at a high dose of venlafaxine, especially since the binding is quite different."
So, basically, the first receptor would have to reach "saturation point" before reuptake of the second neurotransmitter kicks in.
That would imply that ANY dual uptake inhbitor would behave in the same way as venlafaxine at low doses, albeit favouring the monoamine for which it has the greatest affinity. Duloxetine, milnacipran, amitriptyline, sibutramine, imipramine and cloripramine would all behave that way.
That ties in with my experience with imipramine, where at a moderate dose it had significant noradrenergic effect but little impact on my serotonin.
Posted by garnet71 on April 11, 2009, at 3:18:59
In reply to Re: Wellbutrin 150 mg low dose? » garnet71, posted by sowhysosad on April 10, 2009, at 23:25:26
Thanks for your reply. I've never ventured into the realm of those other drugs, but was thinking about alternatives recently, including SSRIs. I really don't remember the dosage of Effexor i took or what the protracted effects were since the initial script; it's been too long.
But I've been lucky because I haven't had a trace of anxiety in days. It just disappeared again. I was beginning to think it was situational, but I'm facing some pretty intense deadlines right now and have been symptom free.
It seems like something/someone else is controlling my brain in making anxiety appear and disappear at their free will, like someone has an Anxiety Voodoo Doll of me..lol.
Hey - did you ever think of changing your screen name to GetHappy, or something similar?
Posted by sowhysosad on April 11, 2009, at 16:04:20
In reply to Re: Wellbutrin 150 mg low dose? » sowhysosad, posted by garnet71 on April 11, 2009, at 3:18:59
> Thanks for your reply. I've never ventured into the realm of those other drugs, but was thinking about alternatives recently, including SSRIs. I really don't remember the dosage of Effexor i took or what the protracted effects were since the initial script; it's been too long.
>
> But I've been lucky because I haven't had a trace of anxiety in days. It just disappeared again. I was beginning to think it was situational, but I'm facing some pretty intense deadlines right now and have been symptom free.
>
> It seems like something/someone else is controlling my brain in making anxiety appear and disappear at their free will, like someone has an Anxiety Voodoo Doll of me..lol.
>
> Hey - did you ever think of changing your screen name to GetHappy, or something similar?
>lol! maybe when my depression finally goes into remission!
Great news about your anxiety.
I've had good results with some of the SSRI's, but I guess startup anxiety could be an issue for you.
Based on what d/r taught me about sigmoid function it seems that all dual-action drugs are pretty gimmicky, unless you push the dose really high and risk more long and short-term side effects.
Logically it would make more sense to combine a solid SSRI with a noradrenergic tricyclic. You'd be able to use lower doses and have more control over the proportion of reuptake.
Posted by cee on April 12, 2009, at 11:00:15
In reply to Re: Wellbutrin 150 mg low dose? » cee, posted by rskontos on April 9, 2009, at 10:36:05
Thanks for your response how long did it take to get a response on wellbutrin
cee
Posted by sowhysosad on April 12, 2009, at 16:59:32
In reply to Re: Wellbutrin 150 mg low dose?, posted by cee on April 12, 2009, at 11:00:15
> Thanks for your response how long did it take to get a response on wellbutrin
Personally I have no experience of Wellbutrin as it's not licenced as an antidepressant in the UK, but I hear it takes about as long as an SSRI.
CAn anyone give cee a more specific answer?
Posted by 4ed on April 15, 2009, at 16:06:29
In reply to Re: Wellbutrin 150 mg low dose?, posted by sowhysosad on April 12, 2009, at 16:59:32
> > Thanks for your response how long did it take to get a response on wellbutrin
>
> Personally I have no experience of Wellbutrin as it's not licenced as an antidepressant in the UK, but I hear it takes about as long as an SSRI.
>
> CAn anyone give cee a more specific answer?
>
>
I find Wellbutrin has a faster and more noticeable effect, the immediate release form worked instantly (pleasurable, stimulant like effect) for me the first time. XR & SR do still appear to build up as it seems your brain accumulates more dopamine/NE over time. I had to go up to the full 300mgs with those, even in combo with an ssri. The key here is to always have an even, adequate supply in your bloodstream for maximum benefit over time.Therefore in my experience: for noticeable effect - faster than SSRIs, peak effect - about the same as SSRIs.
Posted by cee on April 19, 2009, at 15:24:05
In reply to Re: Wellbutrin 150 mg low dose?, posted by 4ed on April 15, 2009, at 16:06:29
Iwould like to thank everyone for your help ,i have decided to get off the wellbutrin the side effects were just to harsh. I will try and get back to feelin 70% on cymbalta and klonipin
god bless
cee
Posted by sowhysosad on April 19, 2009, at 15:35:14
In reply to Re: Wellbutrin 150 mg low dose?, posted by cee on April 19, 2009, at 15:24:05
> Iwould like to thank everyone for your help ,i have decided to get off the wellbutrin the side effects were just to harsh. I will try and get back to feelin 70% on cymbalta and klonipin
>
> god bless
> ceeSounds like a sensible course of action cee. Has your doc tried ramping the cymbalta dose a bit to boost your serotonin and maybe get 100% remission? Only downside would be that the noradrenergic effects would kick in harder at the higher dose, so you might get a minor return of the kind of unpleasant effects you had with the wellbutrin if you pushed it TOO high.
Actually, thinking about it, I can't see the logic in adding a largely noradrenergic med like welbutrin when you were already on a dual action med and tolerating it OK...
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