Hey Everyone,

I am new to the forums...wish I had found this a long time ago.

Here is my story, curious if anyone else has experienced anything like it.

I have been on 300mg of Wellbutrin for approx 3 years. Everything was going well, in fact people around me could tell if I had not taken it in a few days.

I recently went through a divorce after 11 years of marriage. Of course trying adjust to living by myself, not seeing my kids but once a week, etc, etc, kinda put me in a depression state. I went to see my Dr. to get my annual rx, and after a 10 minute discussion, he up'ed my dosage to 450mg.

That was 20 days ago...

The last 7 - 10 days have been hell. I sleep no more than 2-3 hours, do not eat for days at a time, I have been fighting with my girlfriend everyday (did not happen before), I am so irritable, paranoid, assuming the worst in every situation. This is so unlike me it is scary. I actually pondered dricing my car into a bridge today...really scary!

I am starting to think that these issues may be due to the increased wellbutrin. I am calling my dr in the morning, but thought I would also check to see if anyone has experienced this.

TIA!

In my opinion... it's definitely the Wellbutrin. 450mg is considerably above the established maximum dose(300mg), and the side effects you're experiencing are consistent with too high of a dose of Wellbutrin.

Not only is that dose high, but you jumped up 150mg in one day. If you have any 300mg tabs left, d/c the 450mg and go back to 300mg.

I also think that, instead of trying to throw meds at your situation, maybe meeting with a therapist/counselor would be beneficial. Right now your life is in disarray, and there's no medication on this earth that can fix the world around you.

I'm sorry you're having such a hard time, and then having this med debacle added to it. Good luck, and please keep us updated!

I'd go back to 300mgs, which is a healthy dose. It is interesting that Tenuate and Wellbutrin are nearly identical in composition - but Tenuate comes in max 75mg doses and WB comes in doses up to 300mgs. It would be great if the pharmas recognized this and made doses of 50 and 75mgs, and you could try 300 + 50, for a total of 350, which may be just right for you. Instead you jumped by 150 - which is just too much. But it seems that companies do not want to spend the $$ to do this.

From www.fda.gov/medwatch (http://www.fda.gov/medwatch):

Seizures: Bupropion is associated with seizures in approximately 0.4% (4/1,000) of
patients treated at doses up to 450 mg/day. This incidence of seizures may exceed that of
other marketed antidepressants by as much as 4-fold. This relative risk is only an
approximate estimate because no direct comparative studies have been conducted. The
estimated seizure incidence for WELLBUTRIN increases almost tenfold between 450 and
600 mg/day, which is twice the usually required daily dose (300 mg) and one and one-third
the maximum recommended daily dose (450 mg). Given the wide variability among
individuals and their capacity to metabolize and eliminate drugs this disproportionate
increase in seizure incidence with dose incrementation calls for caution in dosing.
8
During the initial development, 25 among approximately 2,400 patients treated with
WELLBUTRIN experienced seizures. At the time of seizure, 7 patients were receiving daily
doses of 450 mg or below for an incidence of 0.33% (3/1,000) within the recommended dose
range. Twelve patients experienced seizures at 600 mg/day (2.3% incidence); 6 additional
patients had seizures at daily doses between 600 and 900 mg (2.8% incidence).
A separate, prospective study was conducted to determine the incidence of seizure
during an 8-week treatment exposure in approximately 3,200 additional patients who
received daily doses of up to 450 mg. Patients were permitted to continue treatment beyond
8 weeks if clinically indicated. Eight seizures occurred during the initial 8-week treatment
period and 5 seizures were reported in patients continuing treatment beyond 8 weeks,
resulting in a total seizure incidence of 0.4%.
The risk of seizure appears to be strongly associated with dose. Sudden and large
increments in dose may contribute to increased risk. While many seizures occurred early in
the course of treatment, some seizures did occur after several weeks at fixed dose.
WELLBUTRIN should be discontinued and not restarted in patients who experience a
seizure while on treatment.
The risk of seizure is also related to patient factors, clinical situations, and concomitant
medications, which must be considered in selection of patients for therapy with
WELLBUTRIN.

I really would not go above 300 mgs myself. I was on it before and the combination of Wellbutrin plus Adderall made me obsessive, anxious, depressed, hyperfocused, etc. IT was too much stimulation.

If i were you instead of lowering the dose I might switch to a different antidepressant; Wellbutrin is known to cause insomnia and agitation, and it is especially contradindicated in OCD and people with anxiety problems.

Quick update:

Starting on Monday, I went down to a 150Mg and have been taking that since. I am not sure how long Wellbutrin stay in your system, but I seem to be feeling better, and actually sleeping more than 2 - 3hours a night.
I am going to a new Dr on Monday, so I will see how it goes.

Thanks for everyone's help!!!

WB is likely mismarketed and becuase of it's stim effect should be given to those who would benefit from the stimulant aspect - but perhaps Adderall is too strong.

Loosing sleep, excitability, agitation and anxiety will catch folks off guard if they wen't anticpating these side effects at theraputic doses.

On the otherhand, if you are fataiged or need energy - and have ADHD and are also depressed - it can be a godsend. I've a friend who suffers from MS and Wellbutrin raised her energy level longer and more consistently then first-line stims (adderall and ritilan) did. Insominia is welcomed in her case as she could sleep all day. But if your high-strung, it could push you over the edge. I am insomiac by nature, as my Mother was, but the Wellbutrin keeps my energy-level up when otherwise I'd crash when the Adderall wore off. The crash can be so bad it reduces the benefit.

Want to chime in. 300 is not the maximum dose of Wellbutrin XL (as someone posted above). 300 is the recommended dose; 450mg is the maximum dose.