Curious - what AD are you on?

[judytiger]

Husband, Tiger, has MS and Parkinsons, recently he was dxd with cardiac problems. As you can imagine, he is depressed. Even tho he is on Lexapro, the depression is there and becoming more severe.

His visiting RN has recommended that we ask his neuro about Wellbutrin or Cymbala as a replacement AD for him. Because he is on numerous meds, I did check out interactions and couldn't find any problems but....

Any thoughts or experience with either of these meds?

[gaykir]

Judy,
My only caution is do not take any anti depressant if he is on the newly approved drug rasagiline (Azilect). See below:
Gayle


Wellbutrin
Generic Name: bupropion (oral) (byoo PRO pee on)
Brand Names: Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban SR,

What is the most important information I should know about Wellbutrin?
You should not take Wellbutrin if you have epilepsy or a seizure disorder, an eating disorder such as anorexia or bulimia, if you are using a second form of bupropion, or if you have suddenly stopped using alcohol or sedatives. Do not take Wellbutrin if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl), or tranylcypromine (Parnate) in the last 14 days.

You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are 18 years of age or younger. Talk with your doctor about this risk. While you are taking this medication you will need to be monitored for worsening symptoms of depression and/or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Contact your doctor if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/or physical hyperactivity), or thoughts of suicide or hurting yourself.

[jeri]

but it seems to be losing it's effectiveness. Does that usually happen over time? It is the only AD I have tried, so I am not sure whether one builds a tolerance to it or not. Anyone know?

Oh, and it is WONDERFUL to have BT back! Thanks JL and all. :)

-jeri

[judytiger]

My understanding is that YES, one can build up a tolerance for an AD. Tiger was on Paxil and it worked for a couple of years. Then, he was put on Lexapro and has been on it for a couple of years (maybe it is time for a change?)

Gayle - thanks for the Wellbutrin info. He is not on the new med but any change will be up to his neuro (anyway).

[proudest_mama]

Hi Judy,

I was on Lexapro, too, and it did the trick BUT I totally and unequivically lost not only my sex drive, but the ability to feel anything sexual. I am certainly not trying to be crude, but could this be at least a contributing factor for your husband as well?

I have now been on Wellbutrin XL which is not only working, but my sex drive has increased ten fold. I need to do a bit of research because I thought Mirapex was affecting my sex drive and not the Wellbutrin. All I DO know is that the combination of those three drugs sure does spice things up over here.

Terri

[october]

but it seems to be losing it's effectiveness. Does that usually happen over time? It is the only AD I have tried, so I am not sure whether one builds a tolerance to it or not. Anyone know?

Oh, and it is WONDERFUL to have BT back! Thanks JL and all. :)

-jeri

Yes you can develope a tolerance and will notice this when it d oesn't seem to work as well. I have been on 4 or 5 different ones. I am currently on effexor which seems to work okay. Zoloft worked well for along time. There are many out there so the doctor will find something else that might even work better.

[Eve]

I was on Paxil for over 2 years and it did work althoughit affected my sex life. I became very numb. It wasn't easy to get off the Paxil, I had side effects that were quite unpleasant. Now I take a small amount of Effexor and It seems to be working well. I also have not gained any weight with the Effexor.

[GregD]

Hi Judy,
I am taking Wellbutrin XL. I had been on Paxil for about 2 years and just felt it wasn't working anymore. My MDS want me to stop all anti depressants for at least 6 months. I managed to get through it but was felling quite depressed by the time my next appointment came around. I asked to start back on the Paxil but my MDS wanted to try Wellbutrin. She said typically she has found that PWP seem to do better on Wellbutrin. I don't know how true that is, maybe she's getting a kickback on the Wellbutrin or something. Anyhow, it seems to be working for me.

GregD

[chksix]

Hi judytiger. Very sorry to hear about your husband. Go to http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202098.html and you will see that wellbutrin (bupropion) is probably not good for someone with a heart-condition. Your husband's doc is probably aware.
I have been taking remeron (mirtazapine) for several years, and it really helps. It is also a good sleep-aid.

[K Hamilton]

I thought I had replied to this previously, but I don't see it here, so I must have been dreaming??

Anyway, in the last fourteen years I have pretty much been through the list of anti-depressants, starting with the old tri-cyclics. They all would start to give out in 1 -2 years. Right now, I am taking Lamictal and Lexapro (which is usually aimed more at anxiety than depresion). The Lamictal is a wonder drug, so far as I am concerned. It lifted me out of a then 12 year long depression, just in time for PD to assert itself. It has been three years, and the Lamictal is still doing fine. I have not experienced any side effects, so far as I know.

Good luck in finding the right combo for bigtiger.

[DJM]

The first AD I tried was in 1999 and it was Zoloft. Although the drug did a GREAT job of controlling the depression symptoms, I put on 60 pounds in a very short time period. It seems like it was only two months, but may have been as long as four months.

My GP then put me on Wellbutrin because it doesn't have the weight gaining propensity that many other AD's have. I immediately lost 40 pounds without even trying. So, the weight wasn't an issue with Wellbutrin, but it made me very, very emotional. My family called it my "Boo Hoo drug" as I cried at everything that was even the slighest bit emotional - AT&T commercials, while reading confirmation cards, at my son's parent-teacher conference, etc. etc. I heard later that Wellbutrin tends to enhance whatever your emotions are so we "cryers" may turn into total blubberers! This was an experience several of us shared in previous posts on this subject (BTC = Before The Crash).

I stayed off of AD's for awhile after Wellbutrin, but eventually felt that apathy - the total lack of motivation and lack of interest that for me signals depression. This time - possibly a year and a half ago? - I took Lexapro. Not a good AD choice for me as, like Proudest Mama, I too lost any interest in and pleasure from sex. I really felt kind of distanced from all emotion. I only took it for a couple of months before deciding it just wasn't for me.

Currently, I don't need an AD. My med combo of Sinemet, Mirapex, Comtan, and an experimental drug called Istradefylline (the KW-6002 drug study) is working well so that depression isn't a problem. If I need one again in future, I would probbly try Effexor as I've heard that works well for PD depression. But, considering the extreme reactions I've had with the AD's I've tried, I would have to think long and hard before using any AD again. They just don't seem to be good for me!

Good luck to you as you help your husband find something that works well for him.

[indigogo]

I have had success with Effexor for about 6-7 years now (one 150-mg slow release capsule a day). Good for both depression and anxiety.

[judytiger]

Thanks All for responding with your experiences. Good to know about these when we visit the neuro next week. Wellbutrin seems a bad choice for him for a number of reasons.

More later,
Judy