Wellbutrin SR Effectiveness

Hello,

In February, I began taking Wellbutrin. I was taking 100 mg, twice daily along with a second medication. It is a combination that I took approximately 9 years ago (I do not remember the exact doses and there were other medications in the ****tail at the time) successfully. The combination was working OK this time around but adjustments were necessary and an increase in the dosage of Wellbutrin was determined necessary.

My doctor wrote the prescription for Wellbutrin SR, 200 mg twice a day. She is aware of my BPD/DS but due to the length of time that has passed since the surgery (almost 15 years) and the research she did on her own, she felt that the SR version (which is sustained release, not extended) would be thoroughly absorbed. I had a different opinion but the 2 post ops I've spoken to have both said they have not had an absorption problem going to the SR and what little current information I've found online has not given me any reason to doubt either of my friends nor my doctor.

Yet despite doubling the medication, I find myself feeling worse emotionally almost daily since starting the SR version. When I said as much to my doctor last Wednesday, she said that I wasn't giving it a chance because it's only been 10 days. I would be inclined to agree with this sentiment if I had not been feeling so much better in the month before that on the lesser dose. It's as if I've gone off the medication completely.

So I'm reaching out to inquire if anyone has had a similar experience with regular Wellbutrin vs Wellbutrin SR or with Wellbutrin SR absorption issues in general. Please feel free to contact me privately if you'd rather not discuss it in an open forum as well.

Thank you in advance for any information or insights.

Marybeth

People's reactions to extended release drugs are very individual. Your villi may have increased some in your intestines, but remember that you are using around 3 feet instead of 26 feet, so there is still plenty of malabsorption going on. I'll bet you dollars to donuts she looked up gastric bypass instead of DS. If you don't feel it's working for you, speak up. There are other dosages and other drugs available to try.

I had to change from XR to immediate release 2x a day. My doctor did it at the time of surgery and I experienced no changes in my mental state. I don't get why your doctor is giving you a hard time. She is not the one taking it twice. And I agree with the above poster, she looked up RNY.

What she's doing isn't working. That's the bottom line. The goal is to find a drug (or combination of drugs) in doses that work for YOU, whether they are right for someone else is irrelevant.

Over the years, I've seen many people need to adjust doses on all sorts of meds that you would think would work just fine, i.e. not SR, not extended release, but somehow, they don't work. Your doctor needs to keep an open mind and listen to you.

Larra

Hi,

Thanks for the thoughts, they are appreciated. I'm a bit disappointed to see that an assumption is made not only that my doctor lacks the intelligence to know the difference but that after nearly 15 years, I would be so naive as to not ensure that they are educated. Give me a little credit, please.

I received a PM from someone who said it took her 4 weeks before the switch from immediate release to SR kicked in but she's been on SR for 2 years.

Val, good to see you - you look fantastic :) There's allegedly a really big difference between the SR (sustained release) and the XL (extended release) versions. Why do they call the extended release XL and not ER, by the way? I digress. I don't know if the dropping a pill in glass of water trick is actually useful; I hate to waste a pill though I will do it if it tells me something.

To answer the comments about my doc, I will say it's quite likely she was acting in my best interest to give me the SR over the immediate release for a couple of reasons:

• It's much cheaper
• In order to get the same amount daily, I'd have to take it 3 or 4 times a day and that's more pill-popping than I can realistically commit to. Taking it twice a day is annoying enough.
• Not just having to take it 3 or 4 times a day but on a very regular schedule and then work my coordinating medications around it would make things even more annoying. I hate annoying. It annoys me.

I have very specific reasons for the medications I'm taking that aren't relevant to the original question. If I'm wrong and I have to feel crappy before things level out and get better, so be it. It's been a huge surprise because I was feeling so much better but as someone pointed out, it's also possible that maybe I was just feeling relieved that I was getting started and it wasn't actually the medication yet (nah, it was the medication).

I don't know enough about the SR. I wish I could find out what form or dosage I was taking before. Unfortunately that doctor has since died and my old laptop which may have had the information on it in either an old blog or a data file died in a basement flood last year.

Wanted to follow-up.

I've come to the conclusion that I am absorbing absolutely zero of the Wellbutrin SR formula. As an experiment over the weekend, I started taking the IR in place of the SR. I guessed at the dosage and did 100 mg 3x daily instead of 200mg SR 2x a day.

By yesterday afternoon (1.5 days), I felt completely back to where I was before switching to the SR. I called my dr and was right - she is extremely concerned about having to take this 3, possibly 4x a day. She did not look up RNY (I did ask as gently as I could, because Val's comment has remained in my head) but did point out that there isn't much literature on DS specifically.

Anyway, we are going to taper me up for a month and hopefully I will be able to tolerate two 100 mg morning and evening.

The awful experience I had? I genuinely believe now that I had no absorption from the sustained release and I'll tell you why. On Sunday night, I made a big mistake with my pill minder containers and from Sunday night until Monday night, inadvertently took both the SR and the IR at the same time. That's a whole lot of Wellbutrin. In the past if I've accidentally taken too much (too soon between doses, etc), I felt the effects - dizzy, rapid heartbeat, headache, etc. Sunday night, Monday morning, and Monday afternoon, I took an instant release AND a sustained release. That should have laid me on the floor or at made me feel SOMETHING different.

Nothing. I felt nothing strange at all. In fact, I didn't even notice. It wasn't until Monday night when I was refilling that I was counting things out that it looked odd to me and I saw what happened. So what that tells me is not only did I absorb nothing from the sustained release, but the awful feelings I had were probably cold turkey withdrawal.

Not that any of it matters now. But I thought I'd detail what happened because it was so different from what the other DS experiences were that had been told to me. I will ALSO say that I did find several articles that were very specifically against sustained release as well. Thanks again.

My endocrinologist has me on 500mcg of levothyroxine. This would be considered a lethal dose for a normal person. It took a long time before he would let me take that much - I had to "prove" to him through time and many blood tests that lesser amounts were not working for me. On the other hand, my other meds did not need to be adjusted. And one is an ER formula. I think this area is definitely in the YMMV category!

Our metabolism is really a wonky thing. I need so little of an NSAID to take away pain that I now use my son's child formulation. Yet I feel like I could chew these SR formulas all day long and get nada.