Katamo: Introduction & Wellbutrin Experience

[Katamo]

This is a very long introduction... Actually it is more of a complete psychiatric medical history and I don't expect anyone to actually read it all.  I just want to document my experience and maybe it will be helpful for someone or help raise awareness.  Basically, I have been following mainstream medicine's advice for the past 11 years and now my brain is 'addicted' to Wellbutrin XL.  I have tried to get off multiple times but have not been successful yet.  You may just want to skip to the tldr paragraph at the bottom...

 

In 2002 (age 17) I was a junior in high school and I was depressed.  I hated my life, I was cutting myself, and I had a terrible relationship with food (bulimic/anorexic). My mom took me to a psychiatrist and surprise, I was prescribed an antidepressant.  Over the next year I switched around (effexor, lexapro, celexa, prozac, etc) until I found something that 'worked' which ended up being Wellbutrin XL.  I say 'worked' because they all worked for a few weeks or months and then kind of pooped out.  I stayed on 150mg of Wellbutrin XL for a few months and then was upped to 300mg in about 2004 or so.  After this increase I definitely had a manic phase where all social inhibitions were gone and I was super talkative.  I'm usually very quiet and kind of shy. This manic phase passed and in a few days and I felt good.  I decided that I should stay on the Wellbutrin 300mg until I finished college. 

 

But in 2007, my junior year of college, I had a very abrupt change in my skin.  It seemed like overnight, I was super oily, I had acne all over my face, and wrinkles appeared out of nowhere.  I also felt really spacey and developed a bad memory. I had a hard time communicating and gathering my thoughts.  I decided it must be the Wellbutrin and started a taper that I discovered was too fast.  I only allowed 1 week at each drop to stabilize.  From 300mg I dropped to 150mg, 75mg, 38mg, 19mg then done.  I actually felt fine for a while. I had one day where I felt completely clear headed and like my old self. Then after a couple months it all went downhill fast.  I was in a very deep depression and I dreaded everything, from taking a shower to finishing a school project.  My hygiene was terrible and I wasn't taking care of myself. So I talked to my psychiatrist which was the worst thing I could have done.  He prescribed Imipramine then Cymbalta and in about a week I went absolutely crazy.  I had racing thoughts (worst side effect I ever had), my blood pressure was through the roof, I couldn't sleep and I was pacing my apartment for hours.  I had my mom take me to the emergency room because I thought something was seriously wrong.  They did some tests to satisfy me and gave me some Ativan to shut me up.  I felt like my life was over and I had permanently damaged my brain.  This is when I dropped out of college and went home for the summer to "fix" my brain.

 

In the summer of 2007 I went to a different psychiatrist who was by far, the worst medical professional I have ever seen.  In the midst of recovering from the Imipramine/Cymbalta experience, he decided that I must be bipolar.  I tried to tell him that my current symptoms were from Imipramine and Cymbalta but he didn't buy it.  In my diminished mental state, I thought he might be right.  Maybe I have just been misdiagnosed as depressed all these years and I really am bipolar.  I was given a slew of antipsychotics & antidepressants: Lamictal, Lithium, Geodon, Seroquel, Emsam... I felt like a zombie on all of them and somewhat paranoid. By the end of the summer this psychiatrist was ready to give up and he said, "Well, I have tried everything and I don't know what else to give you.  The only option left for you is electroshock therapy."  What!!??  This is when I knew this psychiatrist was really awful.  So I went to a new psychiatrist and he suggested that I go back to the Wellbutrin since it worked before.  I got back up to 300mg of Wellbutrin in the fall of 2007 and was able to go back to school.  Then he added Prozac 20mg to it and that seemed to help. 

 

In 2008, I was able to graduate college and get a job.  In 2011 I decided that I didn't want to spend my life on Wellbutrin and Prozac so I tapered off the Prozac 20mg.  I did 14mg for three weeks, then 7mg for three weeks and then nothing.  I did fine and didn't notice any drastic changes in my mood.  However, I did and still do feel very spacey, less outgoing, less goal oriented and more socially awkward (social anxiety & not able to communicate/formulate thoughts well).  Then after about 4.5 months I decided to get off the Wellbutrin XL 300mg and I was going to do it right this time with a very gradual taper.  I did 240mg for 3 weeks then 180mg for 3 weeks then 120mg for 3 weeks then 60mg for 3 weeks then done. I should note that after each drop I noticed one day with headache, and a couple nights where I would wake up in a sweat and couldn't go back to sleep.  Other than that I felt the same mentally/emotionally.  But at 3 months after being off the Wellbutrin the withdrawal hit.  I was dreading everything even the vacation to the beach and I felt even more spacey and out of it than usual.  So I went back up to 150mg Wellbutrin and stayed there for about a year. 

 

tldr: On August 20, 2013 I dropped from 150mg Wellbutrin XL to about 135mg (it is hard to be exact with only calipers and no accurate scale).  I still feel spacey and less motivated.  I changed careers last year (probably due to stopping meds and just being unhappy in general) and I am currently in school part time (second bachelor's degree).  I got my first job in this new career and I don't want to screw up that opportunity by messing around with my meds.  But at the same time, I am really struggling with this job because of my spaciness and poor memory.  These are some of the most troubling symptoms that I am currently dealing with:

 

1) Terrible short term memory - for example, I have great difficulty adding 2 numbers in my head because I cannot remember the number from the previous step.  Adding 17 + 15, I first do 7 + 5 and get 12, then I add 1+1+1 but then I cannot remember the 2 left over from 12.  This was super embarrassing in my previous career that required a lot of fractional math. In my new career, I have to remember a lot of steps (computer programming) and I get lost on things that any lay person would understand.  I forget the "if" condition when I am reading a simple "if-then" statement.

 

2) Cannot follow conversations - I think this has to do with my bad short term memory as well.  I can only remember or comment on what a person just said and not what they said 5 minutes ago.  I have a vague memory of what someone said in the past but nothing that I can articulate.  I have to write everything down.

 

3) Trouble communicating - I have a very hard time communicating my thoughts clearly which I think feeds the next symptom...

 

4) Social anxiety - I get very stressed when I have to say anything to people at work or people in general.  All I have to say is "yes" or "no" and I get all nervous, turn red, sweaty, etc.  Even when I'm just sending an email to someone and not talking to them directly! Hell, I'm getting nervous writing this.

 

5) I still have acne and oily skin that was completely out of character for me up until about 5 years ago.  I am also experiencing hair loss.

 

Needless to say, my current mental retardation of sorts is very embarrassing for someone who has prided herself on being smart, graduating in the top of her class in high school and graduating from a top nerd college.  I feel stupid basically.  In high school (before meds) I was pretty arrogant about being smart.  I felt like I was on a higher level than everyone else.  Now I feel like it is the complete opposite... I am the dumb person and everyone else is functioning on a higher level.  Maybe this is my punishment for being so arrogant when I was younger.

 

I am starting to think that I went off the Wellbutrin/Prozac combination in the wrong order.  Maybe I should have stopped the Wellbutrin first and then the Prozac.  I am seriously considering going back on a small dose of Prozac (~10mg or less) just to see if it will help me be more of a functioning human at work.  Right now coworkers are seriously wondering how on earth I got the job because I am so incompetent and spacey.  Does anyone have any thoughts on whether I should have stopped the Wellbutrin or the Prozac first?  Would it be a bad idea to start back on 10mg of Prozac then finish tapering the Wellbutrin?

 

It has been very hard for me to find people who understand or even sympathize with what I am going through.  My mom thinks it is all in my head (I guess it is) and that I am just being too hard on myself.  I tell her that I am constantly walking into rooms and forgetting what I am there for and she says, "Oh that is normal, everyone does that."  Well, not me!  I have a good diet.  Usually the only meat I eat is fatty fish like Salmon and I eat plenty of whole fruits and vegetables.  I only take a multivitamin, fish oil, and of course the stupid Wellbutrin.  I also have a good workout routine consisting of some cardio and weights, but nothing too strenuous.  I am so grateful that I have found this website with people that I can identify with.  I have the "Tips for tapering off Wellbutrin..." discussion bookmarked on my browser, but apparently I am too sensitive for even the most gradual taper recommended in that post.  And it appears that three months is the point when a previous drop in the Wellbutrin hits me.  So my taper will have to be very gradual as in multiple years of tapering and I am definitely starting to lose patience!

[Rhiannon]

Well I don't know if I have anything very helpful to offer you (except to say that I can definitely relate to your problems with memory and going from being smart to being stupid). But looking over your sig I can say I am not surprised that you are now so sensitive to med changes. It looks like you've been through a lot of med trials and changes and a couple of too-quick tapers. And from your age and the dates you give I'm guessing you must have been started on psych meds during your teen or early adult years, before your brain was mature (mid 20s).  With a history like that it would be very surprising if you were able to taper fast.

 

It's up to you if you want to risk it with another med. I don't recall Prozac helping my memory at all--the contrary, in fact, when I took it. I think it made me spacier than Wellbutrin did, actually. But that's me. And my self-insight was terrible on both of those meds so how I remember it may not be how it was at all.

 

Personally I think the more you perturb your brain chemistry, the harder it's going to be for your brain to ever normalize. And just from watching hundreds of people come and go on Internet forums over the past four years and following their stories, most of the time adding in meds leads to being on more meds to taper and rarely does it help make things actually go faster or more smoothly.

 

I know this job is important, but if it were me, from this vantage point I'm at now in life, I'd say lean on other techniques (take lots of notes, use mnemonics, take even more notes, experiment with mental tricks) rather than screwing around with your valuable, precious brain. You only get one of those and it has to last you your whole life.

 

These drugs do bad things to brains and our ability to bounce back and heal from that kind of damage is limited and gets only more limited over time. I would give anything to have the chance to go back and un-decide to take the meds I decided to take, now that I see what havoc they have wrought on my CNS and my body, and how they ruined my life.

[Rhiannon]

Oh actually I see you give your ages in your post (I skipped to the tldr as suggested, blush.) So yes, you started during those years when the brain's still developing.

 

Wow, if you were my daughter I would heartily discourage you from screwing around with any more psych drugs ever. Ever. 

 

Also, please read Anatomy of an Epidemic by Robert Whitaker--at the very least do that before deciding. Read his Mad in America, too.

 

And you're smart and nerdy, read some neurochemistry and get a sense of how complex these systems are that we're dumping these drugs into.

 

Hon, you're smart, and you're young--you have the chance to recover from this history of overmedication and damage. Please educate yourself before making this decision.

[Katamo]

Thank you for the input, Rhi.  I will definitely look into the books you have suggested before I make a decision.  I know what you mean about wanting to go back and undo what you have done to your brain.  I am starting to feel like I have permanently damaged my brain and it will never be normal again.

My theory (emphasis on the word, theory) about going back on the prozac goes something like this...
I was doing a lot better when I was on the wellbutrin and prozac a few years ago probably because it was helping with both serotonin and dopamine.  When I stopped the Prozac, I lost my serotonin regulator and now my brain is out of balance because I am only affecting dopamine with the Wellbutrin.  I understand that the serotoninergic and dopaminergic systems are incredibly complex and not fully understood.  But I think there is an interaction between the two (maybe inverse or maybe direct, I don't know). Studying neuropharmacology can be incredibly frustrating for me because ultimately no one really knows precisely what these drugs are doing or how they are interacting. Ideally, I think I should have gone off the Wellbutrin and Prozac combination at the same time by gradually tapering both.  My idea about going back on approximately 10mg Prozac with the 135mg Wellbutrin is that it will be about the same ratio as before only less of both drugs overall.  Then maybe I could taper off both at the same time.  But again, I will do more research before I add the Prozac back.

[Altostrata]

Welcome, Katamo.

 

I haven't seen anyone figure out the serotonin-dopamine balance etc. As you probably know, the "chemical imbalance" theory has been soundly debunked. Addressing neurohormones at this point is probably not going to lead you anywhere.

 

It could be you are still suffering the consequences of going off Prozac in 2011, or of drug changes, as Rhi suggested. These effects change the ways our nervous systems function and can last for years. Read this and see if it fits http://survivingantidepressants.org/index.php?/topic/603-what-is-antidepressant-withdrawal-syndrome/

 

Whether additional Prozac will help you at this point is unknown. If you wish to experiment, you might take 1mg to start. If you're sensitized, you'll feel it, one way or the other, and adverse effects will be limited, if it goes that way.

 

Also see http://survivingantidepressants.org/index.php?/topic/877-tips-for-tapering-off-wellbutrin-sr-xr-xl-buproprion/

[Meimeiquest]

Just wanted to say I played with Wellbutrin and Cymbalta and Prozac and got the same bipolar diagnosis. I am still on some meds which probably complicate things, but I struggle cognitively and with motivation...I miss those Adderall tablets sometimes, but overall I think I am slowly improving. My vote would be with not adding anything back in, but we are here for you either way. Good luck!

[Katamo]

Well I put a lot of thought into this and decided to add back ~5mg of Prozac to my ~135mg Wellbutrin XL.  I know it is unfortunate but my inability to do my job right now is not acceptable for me.  I am hoping this will help with my memory and weird social anxiety and semi-ocd issues that I have developed.  Since I last posted I tried taking a magnesium supplement, but it really upset my digestive system so I had to stop.  Honestly, I think I get plenty of magnesium in my diet because I eat about 2 servings of sunflower seeds at lunch everyday.   I have been on the prozac now for 2 weeks and haven't noticed anything other than the usual side effects when you first start an antidepressant (occasional headaches and some difficulty sleeping).  I hope that I will eventually see some improvement from the Prozac and then maybe I can start tapering off the Wellbutrin then the Prozac.

[Altostrata]

Are you feeling better now?

[Katamo]

Alto, I'm not feeling better yet, but I've been on it for two weeks.

[Altostrata]

Additional Prozac may not help if you're suffering from Wellbutrin withdrawal. You can have withdrawal syndrome even if you're on another drug.

 

Time has passed and your nervous system has changed. It's not surprising going back to a cocktail that worked before does not work now.