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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Excellent camper on April 8, 2005, at 11:59:44
Long-time listener to babble, first-time poster. I have long appreciated the info I've found here -- the best source for first-hand experiences of meds on the Web.I suffer from unipolar depression. After many years of trial and error with meds (and mostly error), I've found the best combination so far. I take 300 mg of Wellbutrin XL and 25 mg of Lamictal. (If I go over 50 of Lamictal, I start to feel very flat.) With the addition of this light dose of Lamictal, I've felt more energetic and motivated than I have in years. When I feel it coming on, I'll even let out a little Austin Powers "yeah, baby" -- it feels so good to feel the brain fog fading.
Only problem is I'm a little too wired to fall asleep at night. To shorten the time release of Wellbutrin, we tried the regular formulation and the SR. On regular I felt awful, on the SR there was no antidepressant effect. (I know they are the same medicine, but we all metabolize them differently.) So now I'm having to take a mg or two of Ativan at night to sleep. I'd rather not do that, both for its habit-forming nature and the haze it leaves in the morning. I am highly sensitive to any kind of downer. Even on Ambien, I have a hangover in the morning.
Since Wellbutrin works on dopamine and Lamictal works on sodium, couldn't I add another a-d to the mix that works on different neurotransmitters? A light dose of Remeron? Or Anafranil, which one time was a lifesaver for my obsessive rumination? Or should I be thinking about something like melatonin?
Does anyone take a "light dose" of any a-d just for sleep that doesn't drag you down during the day?
Your thoughts highly appreciated.
Posted by Spriggy on April 8, 2005, at 13:05:08
In reply to Great on Wellbutrin XL-Lamictal except sleep, posted by Excellent camper on April 8, 2005, at 11:59:44
I know Remeron helps a lot of people fall asleep- so maybe that's a possibility.
What about a benzo for sleep or an actual sleeping med like Ambien?
Another option, I suppose could be Seroquel- it definitely will knock you out.
Posted by Excellent camper on April 8, 2005, at 13:19:24
In reply to Re: Great on Wellbutrin XL-Lamictal except sleep, posted by Spriggy on April 8, 2005, at 13:05:08
Thanks. May try Remeron but am definitely trying to avoid the benzos and sleeping pills like Ambien, which leave me groggy in the morning. From what I have read online since posting the original message, melatonin is not recommended if you are on an SSRI because serotonin and melatonin production are related in the body. But I don't see taking melatonin ruled out with the use of all ADs.
Posted by Cybele on April 8, 2005, at 17:27:39
In reply to Great on Wellbutrin XL-Lamictal except sleep, posted by Excellent camper on April 8, 2005, at 11:59:44
How long have you been on the XL? I think the insomnia thing goes away after a while. (I could not take XL because my REM sleep latency on WB-XL is, like, 5 minutes).
Have you tried some Trazadone before bedtime? On nights when my hubby (who is on ADs) is kind of keyed up, I remind him that he'll need to "traz it" to get to sleep. His doc prescribed it for him as a sleep aid only. Alternatively, two over-the-counter Bendadryl works like a dream for me, when I need it. That was my doctor's suggestion to me.
One simple non-med thing to try is to set a time after which you will only talk about or think about fluff. For example, if someone wants to talk to you about finances or upcoming travel plans for the family, just say "Sorry, I am only allowed to think about fluffy, low brain-power things now." I also do not read heart-wrenching or thought-provoking books, nor watch TV shows that get you really involved, after 7 at night. Don't pay bills or balance your checkbook, but do keep a note pad handy as a brain dump if any "to do" items enter your head. It's been a big help once I made this a rule in my life.
Posted by Phillipa on April 8, 2005, at 17:40:36
In reply to Re: Great on Wellbutrin XL-Lamictal except sleep » Excellent camper, posted by Cybele on April 8, 2005, at 17:27:39
Well, Lunesta is supposed to be out now. it's approved as a non-addictive long-term aid for sleep with antidepressant properties. I'm waiting to hear the first repors from fellow Babblers. We've been waiting for this drug for a long time. Fondly, Phillipa
Posted by MidnightBlue on April 8, 2005, at 23:45:18
In reply to Re: Great on Wellbutrin XL-Lamictal except sleep, posted by Excellent camper on April 8, 2005, at 13:19:24
There is another sleeping pill similiar to Ambien, but it only "lasts" for 4 hours. You might want to try that. Sorry, but for the life of me I can't remember the name of it. I always had trouble sleeping on Wellbutrin. I took the regular type and SR.
Posted by Phillipa on April 8, 2005, at 23:47:20
In reply to Re: Great on Wellbutrin XL-Lamictal except sleep » Excellent camper, posted by MidnightBlue on April 8, 2005, at 23:45:18
Is it Sonata? For some reason that's the first name that pops into my mind. Fondly, Phillipa
Posted by MidnightBlue on April 9, 2005, at 0:56:27
In reply to Re: Great on Wellbutrin XL-Lamictal except sleep » MidnightBlue, posted by Phillipa on April 8, 2005, at 23:47:20
Yes it is thanks! You know I even was thinking of musical terms tonight and how they keep using them for the names of drug. Oh well, I've had a halfway decent day, but my word recall has been terrible lately.
Posted by Excellent camper on April 9, 2005, at 16:55:52
In reply to Re: Great on Wellbutrin XL-Lamictal except sleep » Phillipa, posted by MidnightBlue on April 9, 2005, at 0:56:27
Thanks to all very much for replies. I'll take all those drugs under advisement. Since I seem to get a hangover effect from almost anything (from more than one drink and even after 6 mg of melatonin last night), I think I'm going to try chamomile tea and an easy crossword tonight. We'll see how that works. I've been back on the XL only three days now. One weird side-effect has been this shuddering feeling I get in my head that affects my eardrum.
Posted by Excellent camper on April 11, 2005, at 11:48:19
In reply to Re: Great on Wellbutrin XL-Lamictal except sleep » Excellent camper, posted by Cybele on April 8, 2005, at 17:27:39
>
> One simple non-med thing to try is to set a time after which you will only talk about or think about fluff. For example, if someone wants to talk to you about finances or upcoming travel plans for the family, just say "Sorry, I am only allowed to think about fluffy, low brain-power things now." I also do not read heart-wrenching or thought-provoking books, nor watch TV shows that get you really involved, after 7 at night. Don't pay bills or balance your checkbook, but do keep a note pad handy as a brain dump if any "to do" items enter your head. It's been a big help once I made this a rule in my life.
>Especially appreciated these views I can use to snooze.
I've decided that I might want to add Anafranil to the mix again. I've been doing so much rumination about past events -- about quitting a job more than 6 years ago, which led to me ending up in the hospital, to my seeming never-ending shame -- that I think I need the help of this old med for my obsessive thinking tendencies. As I recall, it made me sleepy, too.
Posted by Colleen D. on April 11, 2005, at 20:40:55
In reply to Great on Wellbutrin XL-Lamictal except sleep, posted by Excellent camper on April 8, 2005, at 11:59:44
doxepin for you? I take 25mg before bed and it works like a charm. It's a TCA and my GP prescribed it after I tried all OTC meds plus valerian root, melatonin. She first gave me trazadone and that left me having a hangover in the morning. Doxepin leaves me feeling well rested and ready to go. Good luck!
Colleen
Depression, GAD, OCD and SP
on
300mg Wellbutrin
75mg Effexor
1.25mg clonazepam
and 25mg doxepin
Posted by sapphiremystic64 on April 16, 2005, at 20:12:08
In reply to Re: Great on Wellbutrin XL-Lamictal except sleep, posted by Phillipa on April 8, 2005, at 17:40:36
just wanted to chime in since you'd mentioned melatonin. I've had various physical/mental health issues for at least 25 years and finally saw my first sleep doc (despite always talking about my sleep problems and fatigue, etc. with anyone who would listen). Anyway, this guy is trained in psychiatry and sleep medicine. Said lots of mental health issues arise as a result of sleep disorders (duh). My sleep issue appears to be Delayed Sleep Phase Syndrome which is common in many mental health disorders (which comes first, chicken or egg?). Anyway, it basically means my circadium rythym is messed up (i want to be up at night and sleep in the daytime). So I worked at getting that reversed and part of the protocol was taking 1/2 mg melatonin 8 hours after I got up and 1 mg melatonin 1 hour prior to bedtime. I've been amazed by the sleepiness this brings on and the sound sleep I get. I no longer hear every breath my dog and husband take, etc. This is the first time I can remember feeling like I've slept (despite many sleep drugs and all the hang-over effects) and the first time I remember dreaming. So give it a try! Best of luck.
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