New Med Effects
 

I have been on a new depression/bi-polar drug for a weeks now. The drug is Aplenzin. I have been suffering from headaches, dizzyness, and lack of motivation. It actually feels like I have gone backwords in my treatment. I attempted to contact my pdoc Friday to get him to change my meds, but the office was closed.
Anyone taking this medication, let me know if it is affecting you the same way.
Anyone that is not taking the drug, please contact me before you do.

new formulation of Wellbutrin?
 

Hi,
This is Bupropion / Wellbutrin, right?
Yes, those side effects sound about right.
They should lessen or abate -- it seems like the headaches could go away soon.

I took regular release Wellbutrin for 12 years and did very well.
But I did not take the slow release / extended release versions.


Wellbutrin takes four or more weeks to take effect.

In my case the cognitive problems seemed to be less than the other ADs that were available at that time (early 1990s).

If you have been on it for a short period of time, you could stop taking it. Is your pdoc off for Labor Day?
I hate long weekends when I need someone.


M.

http://www.empr.com/aplenzin/drugproduct/72/
.

hi... i take this...
 

i take bupropion extended release also. i started 2 months ago (have been titrating up slowly).

mine comes in the package so i have the drug insert which says that headaches happen in MORE than ONE OUT OF TEN patients!

i have migraines, and i had migraine headaches while getting used to it... worse ones during my more susceptible times of month.

i didn't get the lack of motivation (already had that) but had a lot of fatigue at first... could be a similar sort of thing.

the good news is all the sx you are reporting are usually transient - i.e. they stop once you get used to the med.

oh one question... do you consume any alcohol? if so how much/how often? the effect of alcohol can be increased by this med, and in my case, alcohol triggers migraines, so i have had to stay away from it. i think it could also increase the likelyhood/severity of your getting headaches. however do NOT stop drinking alcohol suddenly if you do, because that can have serious consequences too, including seizures.

Like Mari says if you have only been on bupropion for a short amount - like? a week or less... you can suspend it, and start again after you discuss these things with your pdoc to your satisfaction.

----------

I preferred the SR formulation because doses were easier to control and could be altered even by a small amount for a day here or there as needed. i took that before with other medications and it worked best of all the other antidepressants for me.

currently, i only have the extended release formulation available to me however. so i am stuck. also i am taking different other meds than before.

i am currently taking Wellbutrin brand at a dose of 150mg/300mg on alternating days. i have been on it 2 months. i did have migraines badly during my luteal phase when adusting to each titration. they seem to have remitted now... but i have just entered new cycle, so jury's kind of out on that.

i don't know if i will be able to keep up with this med/formulation, with my current med combo however... if we don't change it, we may have to change or add something else.

anyway, good luck to you. :) i hope the headaches remit quick. i will check this thread in case you have other effects about it you want to talk about.

~ waves ~

Aplenzin
 

No, I do not drink at all. Luckily, I stopped drinking several years ago.

This Aplenzin is actually doing a lot of things to me. The headaches I expected, as I had the same problem when I was on Welbutrin years ago. However, I am also light headed, weak, and can't sleep. A more serious problem that has popped up is that I have become much more obsessive and compuilsive. I have always had a little bit of OCD in me. My Mother is also OCD. However, I have never had any symptoms to this degree. I don't know what is in that drug to cause this, but it scares me a little. I hope it is the drug and not just my OCD getting worse. I have got enough problems to deal with. That's all I need, I am already suffering from severe chronic lower back pain, I have Type II Bi-polar disorder, and severe depression. Let's see what else we can add to the pool.....lol

this sounds like hypomania, which can happen to bipolar folks when given an antidepressant. the not sleeping and the increased OCD...sounds like hypomania which can turn to mania if not corrected.
just my opinion keep us posted
bizi

hi there
 

i think things are a little more complex actually.

i mean, not saying you couldn't be getting some activation symptoms like bizi suggests, but i would need to know more before i could say it sounds hypomanic. also, i would like to make a distinction.

IMPULSIVITY can be an indicator of hypomania. COMpulsivity is different, and OCD-like symptoms are not really in the hypo/manic picture, even though in mania one certainly can get certainly get over-focused on a project and obsess over things to the point where it may look OCD-like... but in mania it is more of a fascination and energy drive than a true obsessive/compulsive issue. Now, with increased activation and decreased inhibition, i could see where compulsions you might normally control would be harder to control, but it would be the activation/lack of inhibition that hint at hypomania.

--- are you more IMPulsive?
--- do you feel activated (hyper, agitated, overly energetic) in general?
--- are you experiencing racing thoughts or rapid speech?

just remember, every med has a different effect on every person's brain. we are all quite different. if you have the predisposition to OCD as your family history might suggest, could be this med is bringing it out some.

also when you say you can't sleep. that is a broad statement in the sense... i say that too, meaning i have trouble falling asleep. but i do sleep, and i get enough sleep. also, i am tired during the day due to how much benzo i am taking now. these aspects are important.... by "can't sleep" do you mean

--- you have difficulty falling asleep?
--- you have difficulty remaining asleep (or wake frequently/poor quality sleep)
--- are you tired (besides feeling weak) during non-sleeping hours?

i would be a bit concerned if you were getting a reduced amount of sleep - less than 5 hours a night average, and i would be WORRIED about mania if you were not sleeping AT ALL, or sleeping less than 3 hours per night. that is definitely a big red flag.


the dizziness should be another transient symptom.

i hope you get to talk to your doc tuesday. what is your dosage? can you skip a pill? i do if things are going too fast for me. the problem with this dang extended release stuff is we can't titrate gradually we have to start at 150mg per day!!! :mad: hummmph.

:hug:

in sympathy (TRULY!!!)

~ waves ~

Dear Southerngq,

I thought that anxiety can feed the ocd --making it worse.

Is that the case for you?


M.

Drug
 

--- are you more IMPulsive?
--- do you feel activated (hyper, agitated, overly energetic) in general?
--- are you experiencing racing thoughts or rapid speech?

No, No, and No to the above questions.
As for the OCD, my Mother has OCD and I have always had some of the same issues, but never anything like this.
--- you have difficulty falling asleep?
--- you have difficulty remaining asleep (or wake frequently/poor quality sleep)
--- are you tired (besides feeling weak) during non-sleeping hours?
I am having difficulty falling asleep, which is one thing I do not normally have a problem with.
After I do fall asleep, I am waking up numerous times during the night. Also something I never do.
Before and now, I am always tired, theres no change there.

I called the doc this morning and let them know I am having a lot of issues. I am just waiting for them to call me back to see what he is going to do.
I am misurable on this stuff.

these are all good signs you are NOT becoming hypomanic.

sleep problems per se are quite common with bupropion, even in non-bipolars. btw, i had these problems in my first month of wellbutrin - especially the night awakenings, but i settled down after a while at the same dosage (then 150mg).

this is consistent with the lack of sleep and, along with everything else you've said, i would not say you are hypomanic. the flag to hypomania is loss/reduction in sleep but not feeling tired.

i do not know how/why this med would worsen OCD symptoms, but apparently you are not alone. i looked for some studies testing for efficacy of bupropion in treating OCD and it fails miserably... one small study on 12 patients reports that 4 improved, but only two of these to the extent of established "responder criteria." The other 8 patients WORSENED!

link to abstract:

Bupropion for patients with obsessive-compulsive disorder: an open-label, fixed-dose study

Authors: Nienke C C Vulink, Damiaan Denys, Herman G M Westenberg

i hope he calls you back soon and can get you on something else, or combine it with an SSRI. it sounds like it is not going to be a good med, at least not alone, due to the OCD. The SSRI's are very good for BOTH depression and OCD, but must also be taken with stabilizers to avoid hypomania/mania.

have you ever taken one of those before? Zoloft, Paxil, Prozac, Celexa or Lexapro are the most popular. I am not sure which are most indicated for OCD as well - certainly Zoloft is, but in any event they would not worsen it.

good luck dear. hang in there. :hug:

~ waves ~

Dear Southerngq,

I hope that you heard from your pdoc and got some help.
Med changes can be difficult.

M.

Med
 

The PDOC called the other day and he wants me to be off the Aplenzin for three days before he prescribes a new drug. I can really tell that there is a missing medication, whether good or bad. I have been really unsteady this week as far as moods and physical issues. I have gotten nothing accomplished this week. Just don't feel like doing anything at all.

We call this the medication merry go round or rollar coaster either one...though it is not fun at all.
Hope taht you are feeling more like yourself as soon as possible.
keep posting...we are here to listen.
bizi

Yes,
I understand about having a lost week.
And we start a new med hoping that it will work -- when it does not we are disappointed.

I'm hoping that the pdoc can come up with a new plan for you.

M.

yeah med rollercoaster sucks
 

i'm really glad your pdoc called... that is a step forward... stopping the Aplenzin.

I hope the next med will help you better - and without all the nasty side effects. :o

i too had a lot of hopes banked on Wellbutrin... as it had been my #1 antidepressant in the past, functionally. But i will likely have to give it up. Jury's still out on it in my case though, because we'd rather i not go back to Zoloft just yet, since i took it for 5 years - my brain needs a break. On the other hand getting depressed would be worse.

So i don't know what the heck is going to happen to me, either. :o

Good luck, and I hope you feel better. Let us know what happens.

~ waves ~

Hugs to both of you
((((((HUGS))))))
bizi

a little history
 

Let's see, in the past I have been on:
Seroquel
Prisitq
Prozac
Effexor
Zoloft
Amitriptyline
Welbutrin
Lexapro
Paxil
Cymbalta
Depakote
Remeron
Lamictal

That's all I can remember. Sometimes I wonder if I am going to run out of crap to take. Of course, this list is over the last 10 years.
I just hope that this current pdoc will eventually hit the right combination.
Only time will tell.

are you bipolar 1 or 2 or other?
what meds are you taking now?
just curious.
feel free to ignore me or PM me if more comfortable.
bizi

Condition
 

I am Bipolar II. Right now I am taking Seroquel XR 150/ Vyvanse 50/ and Lexapro 10.
Just started the Lexapro today. Not sure if such a low dose is going to help me much, but we'll see.

Are you seeing a therapist to help you deal with the trauma of our disorder? Does that sound too harsh to say? trauma? I think it can be traumatic having to deal with our being bipolar...just my opinion.
bizi

HI,
The doc is giving you
-Seroquel
-VyVanse
-and Lexapro.

Good luck.
It really is possible to find a good med regime that can work and that you can pretty much follow.

M.

Meds
 

Well, I can tell you right now that this is not the 'right" combination. I have felt worse in the last few days than I have in the last 6 months. We still have some work to do, but this aint it!

could any of this worseness be hormonal?
I don't know your age?????
jsut a thought,
have you had a good physical lately?
how about your thyroid checked?
some people can't take SSRI'S at all.
which med are they using as your mood stabilizer?
what went wrong with the lamictal?
do you recall?
the reason I ask is that it has antidepressant qualities to it, and I am biased...I take it.:o
I like it a lot.
I am sorry that you have not been doing well...awful to feel that way.
(((((HUGS)))))
bizi

hey there... hold on a sec... or a few weeks rather
 

Dear Southerngq,

Lexapro is an antidepressant which will take a while to show its effects. Often there is no improvement for the first 2 weeks with SSRIs... depending on which one they can take about a month to really kick in. This is because of the brain chemistry adapting and changing... not something that happens overnight.

After one week, if you have no improvement at all, you can see if your doc wants to increase the dosage to 20mg. He may want to wait a little longer... but if you are not having side effects you could twist his arm. You may metabolize it faster than other people... there are such variances amongst individuals.

Anyway, it is too early to tell whether this drug will work or not. Right now, there is no way it would be having any effect on you unless for some reason you could not tolerate it...

are you having specfic UNDESIRABLE SIDE EFFECTS? ... or are you simply not any better, and perhaps a bit more depressed? An exacerbation of depression can occur in the very initial phase of treatment. But please give the med a fair trial... or you will never know. I'm sorry it is such a drag. I know it is a drag waiting it out.

Beth gave some good thoughts above about having the other checks done. Also, Lamictal is often used IN COMBINATION with antidepressants - not just alone, to augment the effect.

But as for this Lexapro... for now... patience is required. Good luck.

:grouphug:

~ waves ~

Hi,
Dear Southerngq,

In the first few weeks we often feel the side effects while we are waiting for the benefits of the drug to kick in.

In many cases the side effects will diminish or go away after the initial few days / weeks.

However, sometimes the side effects are so intolerable that we cannot wait to see if /when they diminish.
Is that is what is happening?

What is your main symptom/s that you and the pdoc are dealing with? Depression?

M.

Feeling
 

It is kind of hard to explain. I feel almost as bad as I did before I started taking anything. I am weak, light headed, sore all over, and my mind wonders greatly. It is NOT a good feeling. I do feel a little better today compared to yesterday, but nowhere as good as I felt before I started taking the Aplenzin. Its almost like that one drug erased all of the progress I had made in the last 6 months. Really a strange feeling.

I am sorry that you are feeling this poorly.
I wish you felt better!:hug:
bizi

links
 

Dear Southerngq,
I've been thinking about this.
It's entirely possible that the Aplenzin has not really effected you much one way or another.

Perhaps a pdoc might need to give more consideration to a second mood stabilzer.


http://www.psycheducation.org/depres...tabilizers.htm


http://www.psycheducation.org/depres...nxiety.htm#OCD


http://www.psycheducation.org/bipolar/controversy.htm
'Just some thoughts.
I hope that something starts working for you soon.
Mari