Wellbutrin: not going well

Today marks my second day on Wellbutrin, which was prescribed to help me focus.

It is sapping my energy, slowing me down mentally, and today I have been angry at everything, even at people close to me, and I’ve been hallucinating all day (same ol’ with my reflection).  I know I’m openly angry about things wrong with the world in my normal everyday life, but that is a healthy anger, I think.  In person I’m often soft-spoken and generally pretty chill.  But right now I just want to lay into anybody who speaks to me.

These may just be intro-level symptoms.  Sometimes when taking SSRIs/SNRIs you will experience odd symptoms at first that will go away (when I took Zoloft I slept 12-15 hour/day for the first few days).  However, the alteration in mood would generally come because these types of drugs provide energy and restore the reward mechanism in the brain before they provide the upswing in mood.  That’s why SSRIs slightly increase the likelihood of suicide within the first couple of weeks before they really have an impact on the depression.  They make you feel motivated while you’re still depressed.

But I’m still on Lexapro, so I shouldn’t be seeing this alteration in mood.  I have talked to various psych people I’m close to and they all concur on that.  So this is a mystery.

Let me tell you how much it sucks having to say to the girlfriend I freaking love, “Honey, right now this med is having this effect on me, so if today or the next few days I say or do something extremely stupid, please understand.”

Luckily for me, I have very understanding people in my life, including Michaelyn.

But I really want to punch things.  This is so unlike me.  And I’m aware of the change, but I can’t reason away the emotions.  I can’t just tell myself that this is the meds and it’s not me and have it go away.  I’m so worried that I’m going to do or say something incredibly stupid and lose control of this anger.  It’s really hard right now.

I am going to call my doctor tomorrow and tell her what’s going on.  I’m torn between sticking it out and seeing if this goes away or stopping taking them.  I’m leaning toward the latter.

  • JD

    Stick it out. I’m not sure what your psych friends are telling you, perhaps they’re picking up on your unease, but these types of things happen pretty often.
    I personally had very similar feelings/effects when going on Wellbutrin; they receded within a week or so.

  • neatospiderplant

    Hugs.

  • http://donaldmorton.wordpress.com Donald Morton

    That’s normal. My doctor told me to expect anger symptoms at first, but that they would subside. I did get angry, and it did go away.

  • A. Noyd

    And I’m aware of the change, but I can’t reason away the emotions.

    It’s the ultimate betrayal, isn’t it?

  • http://tasteofmore.blogspot.com Kay

    Hang in there bud. Call your doctor and see what they say. Remember, there is an adjustment period and you’re only on day two. Maybe stop by the gym and take that anger out on a canvas bag? We’re rooting for ya :) *HUGS*.

    • gwen

      I couldn’t have said it better. Ditto on what Kay says. Keep us updated.

  • Nikki Scull

    I wouldn’t stop without talking to your doctor first. I would definitely call your doctor in the morning if it is still bothering you. Just dropping meds on your own isn’t a good thing. Just remember we all still love you! Keep kicking ass!

  • Katie G.

    JT – Best of luck with your med changes. I feel you bro.

  • http://orbitalteapotlaser.blogspot.com Keith Nielsen

    You have my sympathies. Irrational unfocused rage is what I feel all the time when I’m unmedicated.

  • Rory

    I don’t imagine there’s much we could do to help, but there are an awful lot of folks out here who have got your back. Wish I could offer more than that.

  • Kiwi

    In my experience (which is admittedly limited as i have only been a doctor for a couple of years) I have seensome people who contine to have the anger and tension after weeks or months of use. I have read case studies of people being so tense that they crack teeth from grinding them or becoming physically violent.
    I onky mention this so that you don’t carry on too long with symptoms that can be probkematic or even damaging.

    • Michelle

      I experienced terrible rage when I went on Wellbutrin for at least 2 months. It was uncharacteristic of me to even get mad & I’m afraid that i damaged a few relationships with people who I told I was on new meds, because it was viewed as just and “excuse”. I lost 30lbs in 2 months but it wasn’t worth the feeling that I was going crazy. I got in arguements with random people on the street! After two months of suffering though, I felt the cloud move away and now I am generally in a good/playful mood. No suicidel thoughts. I feel better and I’m glad that I stuck it out!

  • cammie

    Call you doctor first thing tomorrow. It’s not something you want to mess around with. Welbutrin worked great for me, but when my son tried it (and adult in his early 20s), the results were the exact opposite. The anger came on quickly and then progressed into an active phase of self-destruction. I’m going to sound like a mother here…call your doctor. Make sure that lovely anger you use to make the world a better place isn’t twisted into something ugly by a med that may not be right for you. Maybe it is just a short-term side effect, but just in case, it’s worth making the call.

    *hugs* from a mom

  • Roving Rockhound, collector of dirt

    I’m sorry you are going through this. It’s really amazing how different people react to the same med.

    Definitely talk to your doc, but I would suggest you stick it out for a few days until your blood has reached equilibrium – I think the half-life, even for XR, is pretty short. At least for me, missing a dose is a disaster (angry, dizzy, out-of-body feeling, hallucinating – for about hours 24-48 after the missed dose), and it takes a few days for things to go back to normal.

    You absolutely and completely rock, JT. You’ve heard this before, but your openness about mental illness has helped a lot of us very much. It’s a lot less scary when you know you are not alone.

  • Katie T

    *hugz*
    You sound like me on my period. This too will pass. Definitely talk to your doctor, but I wouldn’t go off these just yet. Good luck!

  • Angela Oswald

    First, *big hugs* to you JT. I can so understand what you are going through. To steal from the christians it is a “blessing” to have people in your life that will love and support you even if they can’t understand what is happening to you. I think it is awesome that you are able to recognize what is happening and explain it so well. Unfortunately, when I was on wellbutrin I had absolutely no change, except that when I went off the drug I had terrible dizziness. Definitely work with your doctor on this, and remember that ultimately you know your body best. Remember too that you have the support not only of your family and friends, but of all your loyal readers! I am sure I am not alone in saying that I am here if ever you need a shoulder or an ear. Best wishes to you!

  • geocatherder

    Call your doctor! I’ve been on as many antidepressant & related meds as there are fingers on my hands, and some of them sort of worked. Some of them worked well but had unpleasant side effects. One that I tried once sort of worked; when I tried it again two years later (in a different drug combination) it gave me the most incredibly itchy hives that lasted for two weeks. One I tried really, really messed with my mind and I found myself at work one day not sure of what my job was. The current cocktail works well; I’ve been stable on it for a number of years. But it takes time to find the Magic Mix for each person.

    Whatever you do, don’t despair!!!!!

  • satan augustine

    Hey JT! Frank Wall here.

    Aside from some degree of anger these symptoms you describe:

    “It is sapping my energy, slowing me down mentally, and today I have been angry at everything, even at people close to me, and I’ve been hallucinating all day”

    are not at all common for Wellbutrin. Wellbutrin is the closest any antidepressant comes to being a stimulant, so the slowing you down mentally and sapping your energy are definitely idiosyncratic reactions. And the hallucinations alone are enough to necessitate informing your doctor about your symptoms ASAP. Even the intensity of the anger you feel sounds unusual for Wellbutrin. It can definitely cause irritability, but what you describe sounds like it goes beyond that.

    I’m so terribly sorry you’re having this reaction to Wellbutrin. I take Wellbutrin in addition to the SNRI Cymbalta. When the Wellbutrin was first added and later, when the dose was increased, I felt great. Loads of energy and an excellent mood. However, in the past I have tried Wellbutrin in combination with other antidepressants (Remeron, Elavil) and found the stimulation intolerable. For me the only way I can take Wellbutrin is with the Cymbalta. It somehow takes the edge off the stimulation.

    Bottom line though is that you really need to see, or at least call, your doctor and explain your symptoms to her/him. The side effects you’re experiencing are not at all normal for Wellbutrin. My guess is, given the severity of your side effects, that they would tell you to stop taking the Wellbutrin.

    • http://www.facebook.com/mgafm ashleymiller

      I just want to second this. Wellbutrin is a stimulant, it may cause irritability, but slow mental processing and tiredness are not typical at all. It is often prescribed to get rid of those side effects from SSRIs – it has a very different side effect list. Hallucinations and extreme anger are also not typical. It may very well be that the Wellbutrin is not causing these things, especially considering how little you have in your system, but you should definitely be in touch with a doctor if you’re hallucinating.

  • confusion

    Try to stick it out. It takes a few weeks to start working. It messed with me too in the beginning. Also expect horrible heartburn and decrease of appetite. Are you taking generic bupoprion or brand name wellbutrin? This could be an issue too. My doctor says lots of people don’t do well on the generic. This seems to be an issue just for wellbutrin as generics for other drugs like celexa are just fine. Also is your doc titrating you up to the optimal dose?

  • Alice

    I had some problems when I went on Wellbutrin. I was so dehydrated that I got bloody noses the first week and then a couple weeks after that sometimes my hands would shake, but this subsided after a month or so. These could have been due to drug interactions of course, since I was on about 5 when I started. But anyway, I really didn’t see a huge benefit from Wellbutrin until I was on 300mg. I went from threatening to kill myself every day to a much better but far from perfect state. I’m still on 300mg and I haven’t tried to kill myself in over a year so I’d say I’m doing pretty well. The moral of the story is, these kinds of drugs can take a long time to take effect, or for your body to get used to them, and sometimes you just might need a different dose. But most importantly, consult with your doctor about any side effects.

  • Marshall

    *HUGS*

    I have nothing worth saying, except that I hope you feel better and figure all this out.

  • howardpeirce

    Alls I know is my own experience. We chatted briefly in Cincinnati when you were in town, and you were dubious of my attitude toward psychotropics at the time, but I wasn’t going to press it.

    It’s been a long haul, but I’ve gotten much better results over the long term (3 – 5 years) from psychotherapy than I ever got from medication.

    (I’m mood-disordered; diagnoses vary, but it’s something like clinical depression and anxiety with obsessive features, depending on who you ask. This includes a short period of involuntary sequestration, so it’s not some sort of trivial middle-class ennui.)

    Cognitive-emotive therapy (CEBT) is a learnable, evidence-based methodology that you can practice like any other skill (in your case, much like diet, exercise, and karaoke) that really helps. Medication is such a crapshoot, requiring constant monitoring and titration, but practical skills are something I can own and control. And that’s important to me.

    I inquired about Wellbutrin (I figured I could break my nicotine addiction while treating my mood disorder), but for some reason (long hair? beard?), psychiatrists and other MDs always seem to think I’m doctor-shopping, even though I’m not an abuser.

    I assume you’re in some kind of talk therapy in addition to medication? If not, you should be.

    I’m very excited about the Recovering from Religion therapist project. My current therapist is yer standard-issue cafeteria Catholic, but she’s always shown respect for my non-beliefs, and has been a treat to work with, even when it’s difficult for her. (“What about your sp- sp- sp- sense of wonder?”) A real trouper, and like I say, much better than medication as long as I’m not in crisis. But crises tend to be temporary and triggered externally.

    Oh, and before I forget, ((((hugs)))).

  • Gen, The Longest Tealdeer

    Hi JT. I’m sorry to hear that you are struggling. I swear, sometimes I feel like trying to find the correct mix of medications that works well for you while not ruining other aspects of your life that’s important to you is like trying to play the Lottery.

    I, too, haven’t found the right combination yet (tl;dr: have been on 40mgs of Fluoxetine, an SSRI, for the past year, *still* not sleeping and depressed as hell to the point of suicide ideation, so thinking that I may need an added NDRI, or at least a NSRI, since the increase in seratonin levels has helped at least a bit) so I offer you much hugs and wish you strength.

  • Ryan

    Whether or not you stick it out is obviously up to you. I just want to warn you to make sure you always keep someone close to keep an eye on you. You seem to be aware enough about the effects of Wellbutrin on your body and personality, but speaking from my personal experience, it is possible for you to lose that perspective and really do some damage.

    Everyone has different reactions to every medication, but my reaction to Wellbutrin about 3 years ago was negative to say the least. I know other people who have been taking Wellbutrin for years to help them sleep and/or quit smoking, without the slightest sign of adverse side effects. However, my side effects included complete loss of all motivation, panic attacks, and the worst suicidal convictions I’ve ever had.

    I hope Wellbutrin ends up working for you, as I know how frustrating finding a compatible medication can be, but I want to stress that no matter how convinced you are of thoughts such as “it’s not the medication making me have these thoughts, I am depressed for ‘real’ reasons”, the people around you who love you and care for you will almost always know better if you are being changed significantly by a new medication.

    I hope you begin to feel like yourself again, and I hope my experiences could help you in some small way.

    Best,

    Ryan.

  • LadyBlack

    I hope you can get things sorted, I have heard that getting the medicine right is really, really hard. It sounds like a conversation with your doctor is probably the best way to go. I’m sure if you just talk to Michaelyn, she will understand. I’m sure she’s sitting behind you going, “I do understand, I do understand!”

    Please let us know how you’re getting on.

  • http://mamamara.wordpress.com Mara

    ::hugs:: I’m a mommy, so I’m going to tell you to call your doctor. Then I’m going to worry about you. Because that’s what mommies do. ::more hugs::

  • Mark

    Just check with your doctor for peace of mind.

  • Parse

    As much as it sucks having to say “please understand” to Michaelyn, it’s awesome to have people there that will understand.
    As far as the meds go, I’m with everybody else: call your doctor, and don’t wait for tomorrow. I’m reading the med sheet here, and hallucinations is one of the “Call your doctor immediately” side effects.
    Take care of yourself.

  • PossumRoadkill

    I had the same reaction to Wellbutrin. It didn’t start right away but a few days into using it. The anger increased over a couple of days to the point where I couldn’t take it and I had to leave work. I took a couple of days off so I wasn’t around people who irritated me. My doctor had me reduce the dose over the next two days to wean me off it. I wouldn’t just stop using it without talking to your doctor. I was back to my abnormal self after a couple of days. Later that year he put me on Paxil. I took it for a couple of years until I had a long time friend die. I realized that I felt absolutely nothing when he died and we were very close. I decided that day to go off the Paxil and just deal with life’s ups and downs on my own. It works for me. Don’t get me wrong, I have nothing against people using anti-depressants, my wife is on Prozac and does better on it than off. I think it takes time and patience to find the right thing that works. Good luck. I hope you’re better soon.

  • R. Johnston

    But I really want to punch things. This is so unlike me. And I’m aware of the change, but I can’t reason away the emotions.

    The great thing about being a rationalist and a skeptic is that you have no need to ever reason away your emotions. You analyze them. You understand them. And even if you largely can’t control what emotions you feel, you can react rationally to your emotions.

    I’ve always thought that the Spock stereotype–not the actual character so much, but the stereotype–has it exactly backwards. Rational people are the ones who can embrace their emotions because they’re the ones willing to analyze and understand them. In this case you are angry, you admit to yourself that you’re angry, you’ve discovered why you’re angry, and you know what will have to change if the anger doesn’t abate. Being rational gives you the power to understand, accept, and control your anger in circumstances like this.

    They great thing about having friends and family who are rationalists and skeptics is that they understand all this too.

  • John D

    First up, I am not at all, anyway tied to the field of medicine.

    JT, may you have had a negative food/drug interaction with Wellbutrin?

    Do you per chance indulge in Cruciferous vegetables such as cabbage, broccoli, brussels sprouts, many others…which produce a Cytochrome (P450) which in turn induces isoenzyme CYP2B6 (for one CYP) which Wellbutrin uses to metabolize.

    How about grapefruit/lime and some oranges (juices)? Grapefruit juice is well known to cause negative interaction with many meds.

    I have tried anti-depressants Zoloft, Prozac, Effexor and Wellbutrin. I experienced negative side effects with all, including seizures with hallucinations while on Wellbutrin.I would be happy to share some of these experiences with you. My letters to Doctors are chronicled and quite lengthy, so I’m not sure if the comment section here is appropriate.

    In my case, I am almost positive that I over indulged on broccoli, brussels sprouts, and cabbage while on Wellbutrin, giving me the effect of having overdosed on the drug itself.
    I was absolutely shoveling those veggies into my head during my Wellbutrin experience. And recently cabbage, while on
    metoprolol to lower my blood pressure. My neurologist told me: “yes, it’s like you absorbed your time release meds very quickly. Eat those vegetables in moderation only”.

    Screw that, I don’t touch them anymore. And no warning anywhere. Nothing with my meds. Nothing from the pharmacy. No warning from docs until I became ill and offered them my experience and study results into these vegetables.

    On the other hand, perhaps “in moderation” is key, and perhaps you and I would benefit from having enough but not too much Cytochrome P450 in our bodies, in order to metabolize our meds.

    Damn JT, I was preparing to launch Monday, to see my neurologist and to pursue one more time, the golden happy pill. I wanted to take the cap off possible future meds, and hear an angelic chorus with a golden glow emit when I opened them. But I dunno, I’m so tired of eating pills.

    Anyhow, would you like a word document of my experiences , or how about a lengthy cut and paste post in the comments? Or nothing at all?

    “Cruciferous” vegetables… named for their cross-shaped flower. Surely Jesus is pissed at me. Well Jesus, fuck your stupid cabbage. and your broccoli too. Might as well chew on a tree limb if I want broccoli anymore. It’d be the same chewing experience. Of course I’ll need my wisdom teeth back. Give me my goddam teeth back, now Jesus!

  • http://www.victoriaeasley.com Victoria

    Are you on Wellbutrin XR or Wellbutrin XL? I started off with 75mg of the XR once a day, then was bumped up to twice a day. It was awful. I hated everyone, especially Thad. Then, my new shrink switched me to 150mg of XL, which is the extended release. It’s so much better! Doing two pills a day was making me go up and down, up and down, through out the day, which is what caused me to be irritable. The extended release remedied that.

  • amyc

    I’ve personally had great results with Welbutrin. I take it for major depressive disorder. The only bad reaction I had was that when they tried to up my dosage to two/day I almost stopped eating (it was suppressing my appetite somethin’ fierce). I would get so much done and keep myself so busy that I just wouldn’t eat. It wasn’t until the end of the day that I was shaky and dizzy and realized I hadn’t eaten all day. They then just upped the dosage a little on the individual pill and put me back to one/day, it’s working out great so far (I still lose my appetite for a few hours after I take it though).

    Overall though, it’s been great. I have noticed a definite improvement on my emotions and attitude. I’m a server, so having a good attitude and being perky gets me way more money.

    It hasn’t really had the effect of making me irrationally angry though. Of course, being a ginger, I have spent the last few years consciously working on keeping my temper and directing any anger I have to positive and productive activities, or things that use my anger and sharpen my mind at the same time (like online debating). I’m commenting a little late on this, so I don’t know if you’re still feeling this way, but channeling that irrational anger into something productive has always worked for me.

    –Amy C.

  • http://lordsetar.wordpress.com Setár, self-appointed Elf-lord of social justice

    But I really want to punch things. This is so unlike me. And I’m aware of the change, but I can’t reason away the emotions. I can’t just tell myself that this is the meds and it’s not me and have it go away. I’m so worried that I’m going to do or say something incredibly stupid and lose control of this anger. It’s really hard right now.

    -hugs- I feel you. This is…well, me, every day pretty much. If I’m having a shitty day/week/month, I’m liable to be like this all day. Hell, on a lot of good days, some random insignificant thing will go wrong and make me fly off the handle, and from that point my good day is suddenly a shitty day even if I don’t want it to be or think it should be a shitty day. And I don’t take any meds.

    Instability sucks. And given my experience, I can’t honestly say “stick it out” because instability isn’t just harmful to you but also those around you. Sounds like you should look at options that won’t do that.

  • Gerry

    If you are having issues just getting used to it you should seriously consider something else. The reason being, if you are having problems adjusting to it just wait until you try to get off it!

    I didn’t have much of an issue when I was on it and it worked well but when I decided to stop taking it I was a mess. Weening myself off it took forever and the “mood” issue was just out of control.

    Maybe it was just me but I heard from others that experienced the same problems when trying to get off it.

    Just my two cents but I will never use that stuff again. I couldn’t go through those symptoms ever again.

    Peace,

    Gerry


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