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What Causes Depression While On Wellbutrin, Ativan And Valium?
Question: Yes i am taking 150mg wellbutrin (2 months) and 10mg of brintellix (2 months) in the morning amd 10mg of Valium at night 2 months) and one fourth of 25mg of quetiapine so it puts me to sleep. Before i was only taking 2mg of Ativan for years and gradually tapered following the XXXXXXX manual guideines. I felt so bad i went to the doctor and told me to take the antidepressants and the quetiapine. He told me to stop tapering the valium. In the morning i feel depressed. Kind of. And during the day i feel a bit energized but with lack of emotions and passion. What do you suggest? Should i continue tapering off the valium? I suspect this is causing all this. Thanks very much.
Brief Answer:
Brintellix is more likely cause
Detailed Answer:
Dear XXXX,
Thanks for using Healthcaremagic.
I read your query and understand your concerns.
First of all I like to inform you that brintellix is most likely cause for lack of passion and emotions among the current prescription medicines.
Now regarding feeling depressed in the morning, I feel it will take some more time to get response with current two antidepressants. I also feel that dose of wellbutrin should be increased (150 is below the therapeutic dose range) and dose of brintellix should be lowered as there is no rationale for use of two antidepressants from the day one.
Although I must acknowledge that another can be added if there is inadequate response with single antidepressant.
I do not think valium should be touched at this moment beforeyou can get natural sleep with treatment of depression.
I hope this helps you.
If you have more questions feel free to write back to me.
Thanks again.
Brintellix is more likely cause
Detailed Answer:
Dear XXXX,
Thanks for using Healthcaremagic.
I read your query and understand your concerns.
First of all I like to inform you that brintellix is most likely cause for lack of passion and emotions among the current prescription medicines.
Now regarding feeling depressed in the morning, I feel it will take some more time to get response with current two antidepressants. I also feel that dose of wellbutrin should be increased (150 is below the therapeutic dose range) and dose of brintellix should be lowered as there is no rationale for use of two antidepressants from the day one.
Although I must acknowledge that another can be added if there is inadequate response with single antidepressant.
I do not think valium should be touched at this moment beforeyou can get natural sleep with treatment of depression.
I hope this helps you.
If you have more questions feel free to write back to me.
Thanks again.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Dear Dr. XXXXXXX
The doctor says that Brintellix would counteract the high sex drive that Wellbutrin may cause. I have been battling anxiety depression all my life and have been diagnosed with ADD. Given all that I graduated from the University of Michigan on Engineering (barely) and I am currently doing an MBA and at the same time a Masters in Finance. I am on top of the class, at the same time I am working for the family company which and I live in a superficial and superfluous society. I have a brother that is a racer Formula 1 driver XXXXXXX Gutierrez (search him on the internet if you want) and everybody seems to think i have the perfect life in this society but I don't like it. I rather have a normal job in another city or country and earn a salary and not having to be working in the family company that my father owns, but I can't since I am married and my wife is not willing to move somewhere else.
Also I have been socially isolated, I reject lot's of invites, I struggle to keep and build strong relationships, people see me as cold and distant and I don't like being that way.
Also I was taking 4mg of Ativan and tapered cold turkey to 2mg without knowing the secondary effects. Then I tapered 2 months ago from 2mg of Ativan to 10mg of Valium following the "Ashton Manual" guidelines.
*What dose of Wellbutrin would be adequate in your opinion?
*What dose of Brintellix do you recommend? or do you recommend eliminating it and replacing it by something else?
*What do you think of Valium 10mg and the quarter of the 25mg of quetiapine I take at night to enhance sleep?
*¿What do you think of the brintellix and wellbutrin interaction? It talks about the serotonin syndrome.
i just read on www.drugs.com that the interaction is "major" and it says the following: "BuPROPion may increase the blood levels and effects of vortioxetine. You may be more likely to experience side effects, including a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. Contact your doctor if you experience increased side effects or your condition changes during treatment with these medications. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor."
Dr. XXXXXXX hopefully with this little bit of background you could give me your professional opinion about this other issues. I am 35 years old, male and weigh around 187 pounds and my height is 5 feet 7 inches. I do very little exercise.
I appreciate your response.
Thanks a lot
XXXX
The doctor says that Brintellix would counteract the high sex drive that Wellbutrin may cause. I have been battling anxiety depression all my life and have been diagnosed with ADD. Given all that I graduated from the University of Michigan on Engineering (barely) and I am currently doing an MBA and at the same time a Masters in Finance. I am on top of the class, at the same time I am working for the family company which and I live in a superficial and superfluous society. I have a brother that is a racer Formula 1 driver XXXXXXX Gutierrez (search him on the internet if you want) and everybody seems to think i have the perfect life in this society but I don't like it. I rather have a normal job in another city or country and earn a salary and not having to be working in the family company that my father owns, but I can't since I am married and my wife is not willing to move somewhere else.
Also I have been socially isolated, I reject lot's of invites, I struggle to keep and build strong relationships, people see me as cold and distant and I don't like being that way.
Also I was taking 4mg of Ativan and tapered cold turkey to 2mg without knowing the secondary effects. Then I tapered 2 months ago from 2mg of Ativan to 10mg of Valium following the "Ashton Manual" guidelines.
*What dose of Wellbutrin would be adequate in your opinion?
*What dose of Brintellix do you recommend? or do you recommend eliminating it and replacing it by something else?
*What do you think of Valium 10mg and the quarter of the 25mg of quetiapine I take at night to enhance sleep?
*¿What do you think of the brintellix and wellbutrin interaction? It talks about the serotonin syndrome.
i just read on www.drugs.com that the interaction is "major" and it says the following: "BuPROPion may increase the blood levels and effects of vortioxetine. You may be more likely to experience side effects, including a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. Contact your doctor if you experience increased side effects or your condition changes during treatment with these medications. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor."
Dr. XXXXXXX hopefully with this little bit of background you could give me your professional opinion about this other issues. I am 35 years old, male and weigh around 187 pounds and my height is 5 feet 7 inches. I do very little exercise.
I appreciate your response.
Thanks a lot
XXXX
Brief Answer:
Brintellix can be stopped altogether
Detailed Answer:
Dear XXXX,
Thanks for reverting to me with required details.
First of all I am not convinced about use of a medication for the purpose of preventing 'may be' side effects. The basic principle of side effects is that they do not occur in everybody and treat them if they do occur. Why we need a medication for may be increased sex drive of bupropion.
Now regarding your questions the effective dose of bupropion is 300 to 450 mg for an adult person. I mean to say that at least 300 mg should be given for current problems as 150 is too low to be effective.
As stated above I am not convinced with use of brintellix for sole purpose of preventing side effects. As stated in my first answer I feel single antidepressant is often required and brintellix should be eliminated in gradual manner. Say 25% per week over the next four to five weeks.
Valium and Seroquel can be kept for time being and once there is good amount of sleep can be phased out. Even among this I request you to discuss possibility of using seroquel 12.5 mg and valium 5 mg.
The possibility of serotonin syndrome is well documented but it is almost rare. In addition mostly it starts during initial 48 hours of dose start/change so I do not think now you need to worry about serotonin syndrome.
Last but not least, despite having all family comforts and facilities people develop depression and there is no point in taking others opinion. Many of our society members feel depression is disease of deprivation/loss but unfortunately no link established between two till date.
I hope this helps you further.
In case you have more query I can assist you further.
If not, you may close the discussion and if possible you may rate the answer for my future patients.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.
Brintellix can be stopped altogether
Detailed Answer:
Dear XXXX,
Thanks for reverting to me with required details.
First of all I am not convinced about use of a medication for the purpose of preventing 'may be' side effects. The basic principle of side effects is that they do not occur in everybody and treat them if they do occur. Why we need a medication for may be increased sex drive of bupropion.
Now regarding your questions the effective dose of bupropion is 300 to 450 mg for an adult person. I mean to say that at least 300 mg should be given for current problems as 150 is too low to be effective.
As stated above I am not convinced with use of brintellix for sole purpose of preventing side effects. As stated in my first answer I feel single antidepressant is often required and brintellix should be eliminated in gradual manner. Say 25% per week over the next four to five weeks.
Valium and Seroquel can be kept for time being and once there is good amount of sleep can be phased out. Even among this I request you to discuss possibility of using seroquel 12.5 mg and valium 5 mg.
The possibility of serotonin syndrome is well documented but it is almost rare. In addition mostly it starts during initial 48 hours of dose start/change so I do not think now you need to worry about serotonin syndrome.
Last but not least, despite having all family comforts and facilities people develop depression and there is no point in taking others opinion. Many of our society members feel depression is disease of deprivation/loss but unfortunately no link established between two till date.
I hope this helps you further.
In case you have more query I can assist you further.
If not, you may close the discussion and if possible you may rate the answer for my future patients.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.
Above answer was peer-reviewed by :
Dr. Raju A.T
Dear Dr. XXXXXXX
How do you suggest to dose up the Wellbutrin to 300mg?
Yesterday I talked to my doctor and he said to leave a little bit more time for the medicines to take effect.
I told him that if the Brintellix is the thing numbing the emotions. I asked him about going to 300mg of Wellbutrin and eliminate the Brintellix; he said that perhaps we should give a bit more of time to see how it goes.
He said that if he withdraws the Brintellix and increase the dose on Wellbutrin perhaps my anxiety levels will go up since I have anxiety depressive symptoms.
My main concern right now is that I am waking up depressed and as the day passes after a couple of cup of coffees I feel good. Not perfect but stable.
The doctor said as you said too that as i start sleeping better naturally he will withdraw he will start to withdraw the Valium a bit. I would love to live my life med free sometimes I think what would it be like?
Since I've been on meds since I was 15 years old.
It's nice to have your professional opinion i really appreciate it.
Thanks very much Dr. XXXXXXX
Wish you the best, if anything I will give you a call.
Don't worry about your rating. I will give it the maximum possible.
How do you suggest to dose up the Wellbutrin to 300mg?
Yesterday I talked to my doctor and he said to leave a little bit more time for the medicines to take effect.
I told him that if the Brintellix is the thing numbing the emotions. I asked him about going to 300mg of Wellbutrin and eliminate the Brintellix; he said that perhaps we should give a bit more of time to see how it goes.
He said that if he withdraws the Brintellix and increase the dose on Wellbutrin perhaps my anxiety levels will go up since I have anxiety depressive symptoms.
My main concern right now is that I am waking up depressed and as the day passes after a couple of cup of coffees I feel good. Not perfect but stable.
The doctor said as you said too that as i start sleeping better naturally he will withdraw he will start to withdraw the Valium a bit. I would love to live my life med free sometimes I think what would it be like?
Since I've been on meds since I was 15 years old.
It's nice to have your professional opinion i really appreciate it.
Thanks very much Dr. XXXXXXX
Wish you the best, if anything I will give you a call.
Don't worry about your rating. I will give it the maximum possible.
Brief Answer:
Thanks for positive feedback
Detailed Answer:
Dear XXXX,
Thanks for reverting back to me.
I am glad to know that your doctor agreed to reduce the dose of Valium when there is natural sleep. In other words he expects that there will be more improvement over the next couple of weeks.
I have slightly different opinion. Generally an antidepressant shows maximum effect by six weeks and rarely may take 12 weeks. Since you have already crossed six weeks I do not see any great rationale to still hold on with 150 mg bupropion. Regarding increasing the dose the wellbutrin is available in 300 mg XL preparation. In addition the therapeutic dose of wellbutrin is 300-450 mg so sticking at 150 mg can not be justified. It can be taken instead of 150 mg pill. In case that is not available the 150 mg tablet SR or IR preparation can be taken one in morning and other in evening. Please remember not to take IR or SR preparation 300 mg at the same time.
Regarding brintellix he is completely right in saying that anxiety may not be under control if it is removed. I understand that it is causing numbing feeling but we can continue to have it for sake of anxiety symptoms for time being.
I hope this helps you further.
Thanks again.
Thanks for positive feedback
Detailed Answer:
Dear XXXX,
Thanks for reverting back to me.
I am glad to know that your doctor agreed to reduce the dose of Valium when there is natural sleep. In other words he expects that there will be more improvement over the next couple of weeks.
I have slightly different opinion. Generally an antidepressant shows maximum effect by six weeks and rarely may take 12 weeks. Since you have already crossed six weeks I do not see any great rationale to still hold on with 150 mg bupropion. Regarding increasing the dose the wellbutrin is available in 300 mg XL preparation. In addition the therapeutic dose of wellbutrin is 300-450 mg so sticking at 150 mg can not be justified. It can be taken instead of 150 mg pill. In case that is not available the 150 mg tablet SR or IR preparation can be taken one in morning and other in evening. Please remember not to take IR or SR preparation 300 mg at the same time.
Regarding brintellix he is completely right in saying that anxiety may not be under control if it is removed. I understand that it is causing numbing feeling but we can continue to have it for sake of anxiety symptoms for time being.
I hope this helps you further.
Thanks again.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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