Psychiatry & Psychology--General/bupropion hcl xl


I have been deeply depressed for over 3 years (when I found out my daughter has an uncurable fatal generic disease). I tried paxil in 2012 and gained 30 lbs in 2 months so I quit it. I started bupropion hcl xl 150mg a month and a half ago. The first two days were awful, I cried constantly but I suck with it and the next three weeks were amazing, I had so much less stress, I had energy for the first time since giving birth, I am interested in life again and can focus on other things (including myself) instead of only focusing on my daughter. After the first the weeks the anxiety got worse again and my energy level went down (no where near pre-wellbutrin but not as good as the first 3 weeks). I have been going to my pcp to get wellbutrin. She said it takes three months to take full effect. My question is, should I ask for the dosage to be increased or is it normal for it to work really really great and then lessen a little as it gets into the system fully?
Thank you!

It does take three months, and you should take as much as you can tolerate (more is better, provided there are no side effects).  However, Bupropion is a great anti-depressant but not so good for anxiety, which can accompany depression.  You may need to add an anxtianxiety meedication like Ativan or Valium (or Vistaril or Benedryl if you have had a problem with addiction in the past). at low dosages for a number of weeks until the anti-depressant has its full effect.

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Daniel S. Harrop, M.D.


Dr. Daniel S. Harrop received his B.A. and his M.D., both from Brown, and his M.B.A. from the Edinburgh Business School, Scotland. Board-certified in adult and geriatric psychiatry, he is a past president of the R.I. Psychiatric Society and a member of the Committee on Medical Quality of the American Psychiatric Association and the Committee on Continuing Medical Education of the R.I Medical Society. He serves as a consultant to four of the top five major medical management companies, including OptumHealth/United Healthcare, Magellan Behavioral Health Services, ValueOptions and APS Healthcare, and maintains a private practice in Providence, R.I. He also serves as chief psychiatric consultant on the Medical Advisory Board at the R.I. Workers Compensation Court. He was formerly on the faculty at the medical schools at both Brown University and Harvard University.

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