Is 150mg. Wellbutrin enough for med-resistant depression?

[Crazy Cat]

I know no two people have the exact same experience with the same med but I still need some guidance.

I was on 300 mg. Zoloft and 150 mg. Lamictal for at least 8 years. I went off of them completely for about 3 weeks then went on to 150 mg. Wellbutrin XR two weeks ago. I have long-term, drug resistant depression.

My question is . . . Should I double the dose of the Wellbutrin to the recommended 300mg. daily and/or add the Lamictal back? My doctor will tell me what he thinks I want to hear - basically he has no idea what I should do, so I'm asking the people with the most experience with this - the people who have to take these meds regularly.

My depression is extremely bad now and I'm desperate. I have no motivation to go anywhere or do anything, don't care about anything, am angry about everything and generally hate myself and everyone else. But I do realize I need help.

And I'll address this before anyone even answers me; there is one psychiatrist in my general area who I've met with and I can't stand him. (and I might add my doctor doesn't think he's worth going to either) And switching doctors isn't an option because either #1, a lot of doctors around here won't prescribe anti-psychotic meds or #2, have no idea what I should be taking either and it would still be a crap shoot and #3 they are over an hour away.

With my depression right now, it's almost impossible for me to even go out of my apartment to get my mail, let alone have to go somewhere.

Just let me know what your experiences are with Wellbutrin XR are and if you've taken it with Lamictal.

Thanks.

Adriane

 

[David Baxter PhD]

I know no two people have the exact same experience with the same med but I still need some guidance.

I was on 300 mg. Zoloft and 150 mg. Lamictal for at least 8 years. I went off of them completely for about 3 weeks then went on to 150 mg. Wellbutrin XR two weeks ago. I have long-term, drug resistant depression.

My question is . . . Should I double the dose of the Wellbutrin to the recommended 300mg. daily and/or add the Lamictal back? My doctor will tell me what he thinks I want to hear - basically he has no idea what I should do, so I'm asking the people with the most experience with this - the people who have to take these meds regularly.

That's really not a question anyone here can answer and it would be dangerous and unethical to even try to answer it. Other members can tell you what there experience has been but that should not be the basis for a decision about medications in your case. Everyone is different.

My depression is extremely bad now and I'm desperate. I have no motivation to go anywhere or do anything, don't care about anything, am angry about everything and generally hate myself and everyone else. But I do realize I need help.

And I'll address this before anyone even answers me; there is one psychiatrist in my general area who I've met with and I can't stand him. (and I might add my doctor doesn't think he's worth going to either) And switching doctors isn't an option because either #1, a lot of doctors around here won't prescribe anti-psychotic meds or #2, have no idea what I should be taking either and it would still be a crap shoot and #3 they are over an hour away.

With my depression right now, it's almost impossible for me to even go out of my apartment to get my mail, let alone have to go somewhere.

Honestly, your best bet would be to consult one of the other psychiatrists. And to do that, you don't need to know "what you should be taking" - that's why you're consulting a psychiatrist. Yes, it may require some trial and error but that could be the case no matter what you do.

I do understand that when you're in a major depression it is difficult to go places and do things... Is there someone who could take you to an appointment? And can your doctor make a referral for an urgent appointment?

Also, often there is one particular psychiatrist in an area who is known as the go to psychopharmacologist, the specialist in medication issues. Can you ask your family doctor if he knows whether there is such a person in your area?

Just let me know what your experiences are with Wellbutrin XR are and if you've taken it with Lamictal.

I hope other members with appropriate experience will reply here but please do keep in mind the caution I voiced above.

 

[forgetmenot]

Caution is needed here because each person is different ok.

Add ons with an antidepressant can help to increase the affect of the antidepressant and that too should be discussed with a psychiatrist who knows these med.

Are you able to get someone to take you in to see a psychiatrist in the emergency dept.

They always have a pdoc on call so maybe you could talk to that psychiatrist there or as said some pharmacist can prescribe meds .

 

[GaryQ]

I know no two people have the exact same experience with the same med but I still need some guidance.
...Wellbutrin XR two weeks ago. I have long-term, drug resistant depression.

Hi Adriane,
Sorry to hear you are not feeling well. I totally understand and have the same drug resistant MDD. The only thing that has ever helped the depression has been Wellbutrin but sadly for me it comes with side effects I can't live with or afford to live with. It puts my Tourette tics in OVERDRIVE and my OCD impulsive/compulsive behavior is over the wall; let's just say I'm like a teenage girl with Dad's credit card on boxing day (every day). Tried 4 times over the years. Last attempt at my request was with Abilify about two months ago for a month.

You are right that no 2 people have the same experience with a given med or combination. 20 people probably 20 answers.
Wellbutrin is a stimulant and can act fast to give a boost but like all anti-depressants the side effects come faster than the positive effect. 2 weeks isn't enough time to evaluate positive/negative effects unless it's a bad side effect/reaction to a med.

My question is . . . Should I double the dose of the Wellbutrin to the recommended 300mg. daily and/or add the Lamictal back? My doctor will tell me what he thinks I want to hear - basically he has no idea what I should do, so I'm asking the people with the most experience with this - the people who have to take these meds regularly.

NO! Do not take a double dose of any med or take "leftovers" as combination therapy unless it is being prescribed by a doctor! Speak with your doctor unless you can get proper psychiatric help.

My depression is extremely bad now and I'm desperate. I have no motivation to go anywhere or do anything, don't care about anything, am angry about everything and generally hate myself and everyone else. But I do realize I need help.

Realizing you need help is a great start. Depression as you know is debilitating, just take it like a storm and hold on tight as best you can and call/cry for help till the storm passes.

The sun WILL come out again! Even those of us with chronic MDD see the sun come out every now and then between storms

Warmest Regards,
Gary

 

[Daniel E.]

I have long-term, drug resistant depression.

Personally, socialization, exercise, and therapy helped me more than medications.

Similarly:

The treatment for depression generally involves behavioral activation--taking some sort of action to increase contact with pleasurable events or rewarding activities. Depressed people become easily overwhelmed, tend to avoid people and activities, and withdraw from life. This inactivity also decreases contact with naturally rewarding interactions. The agenda of behavioral activation is to get people engaged with with people, activities, or events that generate pleasure, give meaning, and provide a sense of accomplishment. Without these things, it kind of makes sense that people get depressed. So the message is essentially: Put your energy towards getting active, engaged, and connected!

On the other hand, people who are depressed often feel a great deal of misery. Often they struggle with unreasonable guilt and low self-esteem. They may have made multiple attempts at making connections and have had bad experiences. They may have reached out and been punished for it. They may feel so bad about themselves--and have worked so hard on changing who they are--that they got lost along the way. They may have stopped liking themselves because they worked so hard to make things different. They may have become exhausted at the prospect of change. They may have a very strong need to be accepted as they are--without having to do something, keep changing, and keep trying.

Do you see the dialectic? 1) Changing behavior is a part of the treatment for being less depressed. Get involved! 2) Don’t try to be or become something that you are not. You are fine just the way you are!

DBT for Depression Anxiety

 

[David Baxter PhD]

Something else to discuss with your doctors: Overview of Ketamine for Treatment-Resistant Depression