View Full Version : 600mg Wellbutrin, Is my Doc crazy?


Nelius
01-15-16, 11:38 AM
I just went into a free clinic and been there for about 2 months so far seeing this Dr.

First he had me on 40mg of Stattera (I believe thats is how it is spelled) and 150mg of Wellbutrin.

I took both one at a time first before taking them at the same time and the result:

The wellbutrin worked perfectly fine.

As for the stattera.. Electricity type of feeling in my body, Extra tired, I was itching all over, vomiting, and having these vivid thoughts of family members dying.

So he tells me to throw the stattera away. Next time I come, He decides to tell me to take 600mg of Wellbutrin and set me up for social anxiety counseling.

I'm not sure where social anxiety counseling comes from after I tell him my problems that have been ruining me which are making Impulsive decisions, Nonstop thoughts about anything, and no thought about consequences of any action I take.

But however, on the 4th day of 600mg of Wellbutrin, I've never bleed out of my nose before until now, I've never seen so much blood in my life, and it's almost nonstop, and I feel as I'm about to faint.

Today is day 5, I only took one (150mg) and the same thing happened again.

So far I'm just holding my head up hoping it'll fix itself.

My Doc has yet to respond to my calls. If anyone can let me know any actions that will help and if it happens often, should I be very alarmed? Could it be a one time thing? I just don't want to take extreme measures if I don't have to.

Thanks,
Nelius

GoalieMel33
01-15-16, 03:55 PM
I'm wondering why he increased your medication if it was working ? It does look like a big dosage increase too. As for the counseling, that would be something to ask him. Perhaps he though it could help you with your other symptoms?

The nosebleed might indeed be a side effect from the Wellbutrin (less common maybe). If you can't get a hold of your doctor, you could try to contact your pharmacist.

They are probably the the most knowlegeable people in regards to meds, and they will be able to give you advice in the meantime. I'm not sure for your area, but if there is a health phone line that you could call for questions, that could also be a good place to start with.

Lunacie
01-15-16, 04:20 PM
Find a different (better) doctor.

Here's the info from drugs.com on dosage of Wellbutrin ...

To minimize the risk of seizure, increase the dose gradually [see Warnings and Precautions (5.3)]. Increases in dose should not exceed 100 mg per day in a 3‑day period. WELLBUTRIN Tablets should be swallowed whole and not crushed, divided, or chewed. WELLBUTRIN may be taken with or without food.

The recommended starting dose is 200 mg per day, given as 100 mg twice daily. After 3 days of dosing, the dose may be increased to 300 mg per day, given as 100 mg 3 times daily, with at least 6 hours between successive doses. Dosing above 300 mg per day may be accomplished using the 75- or 100-mg tablets.

A maximum of 450 mg per day, given in divided doses of not more than 150 mg each, may be considered for patients who show no clinical improvement after several weeks of treatment at 300 mg per day. Administer the 100‑mg tablet 4 times daily to not exceed the limit of 150 mg in a single dose.

You may be lucky nothing worse happened with such a large increase.

If the Wellbutrin seemed to be helping, the best thing would have been to increase it 100 mg no more often than twice a week.

That would have allowed you to see which dose was best while minimizing any side effects.


Wellbutrin can cause dry mouth, perhaps it also dried out your nasal passages.

However last week my granddaughter had a sudden severe nose bleed that lasted a quarter hour, no meds.

Either the weather is very dry or there's a virus going around.

dvdnvwls
01-15-16, 04:33 PM
Is there any potential of a misunderstanding? Poor handwriting by the doctor, garbled instructions from the pharmacist, that type of thing?

Nelius
01-15-16, 07:51 PM
Yes I honestly have no idea why it was such a huge increase also, cause he first asked how is the 150mg working out, I told him perfectly fine and that I feel pretty good right there.

To then he goes to say, "alright were gonna try and just up the dose to 300, so I want you to take 2 when you wake up and 2 more in the afternoon."

I asked him if he was sure, because I'm positive to anybody that would sound like a bit much. He had the most confident 'yeah' I've almost ever seen. Now I take decide to go back to 150mg on my own again, and the nosebleeds continued anyway.


But now I think about it, I read that people should start on 18mg of Stattera, which he started me at 40mg which came with all kinds of horrible side effects.

So now I'm getting all these red flags and alarms about this guy. But the thing is I believe it's the only place I can really go as I have no insurance.

Nelius
01-15-16, 08:00 PM
I'll definitely check the pharmacist tomorrow when they open.

A couple thing's have been happening with this dose increase. Starting the the nosebleeds, body feels weak, hurts to really move any body part, especially when I try to carry something, runny nose, and I got real sick, which I'm still sick and have been in the bed for a while now, and It's kinda hard to tell the difference between a dream and reality.

Just makes me wonder if he is trying to make it to a point where I would rather go thru everything and not take any medication.

And he rather not prescribe any stimulants for some reason, He doesn't even believe in ADD, cause when I told him my situations, he started with all this "law of attraction" talk", how i need to go into things with a positive mind in order to do better.

DJ Bill
01-15-16, 09:23 PM
You really need to find a different doc, perhaps at a different free clinic. Do you qualify for Medicaid? That would open up your options..

If your tablets are 150 mg, two in the Am and two in the PM would mean 600 mg, not the 300 he was trying for. He's a bit math challenged.

The fact that he does not believe in ADHD is a huge red flag.

Lunacie
01-15-16, 09:26 PM
I've been going to a free health clinic for several years. Different doctors volunteer their time so I usually saw a different doc each time.

BellaVita
01-15-16, 09:35 PM
I'll definitely check the pharmacist tomorrow when they open.

A couple thing's have been happening with this dose increase. Starting the the nosebleeds, body feels weak, hurts to really move any body part, especially when I try to carry something, runny nose, and I got real sick, which I'm still sick and have been in the bed for a while now, and It's kinda hard to tell the difference between a dream and reality.

Just makes me wonder if he is trying to make it to a point where I would rather go thru everything and not take any medication.

And he rather not prescribe any stimulants for some reason, He doesn't even believe in ADD, cause when I told him my situations, he started with all this "law of attraction" talk", how i need to go into things with a positive mind in order to do better.

Okay so a doctor who doesn't "believe" in something that is a real medical disorder.

This isn't something that people get to "choose" to believe in or not - it's a real medical disorder.

It's like a doctor saying he "doesn't believe in diabetes."

He also doesn't seem to know what he's doing.

Find a new doctor.

Nelius
01-15-16, 11:00 PM
Thanks everyone for the inputs, one last question I want to ask while it is on my mind:

Has anyone here stopped Wellbutrin cold turkey without problems? I've only been on it for 1 1/2 months.

Because It got to this weird point I've never felt before.. Where when I watch T.V or play a video game that moves really fast, my mind feels like it really can't keep up and about to spin out of control to the point if I don't turn off the T.V and lay down I feel something worse will occur.

sarahsweets
01-16-16, 09:30 AM
I was always under the impression that 450mg was the max dose of wellbutrin. Any more above that and your seizure threshold increases. I would find a different doctor. He doesnt believe in something that he is treating you for? And he is treating you with medication that he seems to know nothing about.

Nelius
01-16-16, 11:43 AM
I was always under the impression that 450mg was the max dose of wellbutrin. Any more above that and your seizure threshold increases. I would find a different doctor. He doesnt believe in something that he is treating you for? And he is treating you with medication that he seems to know nothing about.

Oh I'm so glad im not prone to them or never had one yet, or else im pretty sure I would of had one within the first 4 days. phew.. I just don't understand how could someone who "knows so much" or is a "professional" in that field already came close to messing me up twice already.

I was so mad that he started me on stattera at 40mg when there are lower doses, not even knowing i was allergic to it my heart almost stopped. I really hope getting a new doctor will be a option in a new clinic.

aeon
01-16-16, 07:51 PM
The property of reduced threshold for seizure of bupropion/Wellbutrin was statistically significant upon its introduction in its original formulation, but SR, and then XL, formulations lowered this risk such that bupropion/Wellbutrin has a seizure risk that is the same as other antidepressant drugs such as fluoxetine/Prozac, etc.

450mg is the recommended maximum dose, but 600mg is far from unheard of, and not of particular concern as long as it is well-tolerated in the patient.

Or so says many a research study.


Cheers,
Ian

Lunacie
01-16-16, 08:29 PM
The property of reduced threshold for seizure of bupropion/Wellbutrin was statistically significant upon its introduction in its original formulation, but SR, and then XL, formulations lowered this risk such that bupropion/Wellbutrin has a seizure risk that is the same as other antidepressant drugs such as fluoxetine/Prozac, etc.

450mg is the recommended maximum dose, but 600mg is far from unheard of, and not of particular concern as long as it is well-tolerated in the patient.

Or so says many a research study.


Cheers,
Ian

That's good, but shouldn't there be a titration process in getting to the max dose?

aeon
01-16-16, 08:36 PM
That's good, but shouldn't there be a titration process in getting to the max dose?

Thatís likely best practice, but itís not a med that is in particular need of it, based on its clinical history.


Cheers,
Ian

BellaVita
01-17-16, 01:44 AM
Still, this doctor doesn't believe in a medical condition, new doctor needed.