Hi, I'm new here and have been taking Cymbalta and welbutrin for the past 8 years and topped out at the highest dose for Major Depressive Disorder and ADHD (aderrall for that). 3 weeks ago, my doctor suggested that Cym and Wel may no longer be helping and suggested Sertraline. He had me ween myself off of the welbutrin and cymbalta while increasing the Sertraline (I'm now at day 1 of 150 mg sertraline and no cymbalta/ Wel because I went to the office SOBBING uncontrollably. (This has been happening for over a week and I'm causing my poor family so much stress). Im also grumpy and throwing around f bombs like a sailor.
I think that the low dose of the Sertraline has kicked in a little because Im less concerned with what people think about me (this is a little refreshing) but I'm not feeling ANY happiness and my ADHD is through the roof and Im crying all the time.
Please, someone tell me that it gets better or give me ANY kind of hope. Is there a schedule or are there any success stories out there that I can share with my family? This is hell. I'm almost 50 years old and still broken.
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Nolagrace
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I'd like to know why he made his/her decision. Did you ask? "Why do you think they no longer help? Why aren't they working as they did? Can you explain clearly for me so I can understand?"
In truth, there are no correct answers to that. It's still a lot of calculated guesswork. And still nobody really knows for sure how these medications work. There are facts and there are measurements, results. They know what their actions are but can't actually prove how that explains their effects.
It is never 100% accurate. A bit like a double-blind study where you have a group taking the test drug (medication in question), a group taking an already established treatment drug and the placebo group taking sugar pills. Double-blind means that neither the patients nor the doctors administering the pills know which pill is which, not until the end when the results are in. And the results are always a bit 'iffy'.
I can see why your doctor has made the medication change and the reasoning behind it. I know what I'd do but I'm not a doctor so I cannot say. I do know that you are no longer getting the dopamine elevating effects from the Wellbutrin. Dopamine is thought to play a large role in 'pleasure' and 'reward'.
And yet you are taking Adderal? That's a powerful dopamine-enhancing drug. I myself take Wellbutrin (Zyban here) with dexamfetamine. I don't think we have Adderal in the UK. Isn't it a mix of various Levo & Dex amphetamine salts? It should say on the bottle.
I can say for sure that I know exactly how you feel. Not very convincing am I.
Thank you for your response! The summer months were extremely challenging and I found myself going back to that "dark place" where I didn't want to wake up or do anything productive, sobbing over everything. (I've been on cymbalta and welbutrin for 8 ish years along with the adderal for ADHD) In the US, Adderal (it's the amphetamine salt combo) is a controlled substance and I'm to see my Doc every 3 months for monitoring. When I told him about recent events, we went down a list of meds that I can remember taking from younger years for the Major depressive disorder. At first, he recommended just stopping the welbutrin (maxed out at 450 mg) and cymbalta (also maxed) to begin the Zoloft (sertraline 50 mg a day) because he thought through the years, I may have developed a tolerance for them.
I told him this wasn't an option as I've attempted to quit meds cold turkey before which resulted in mental chaos. So we agreed to taper down the W &C and implement the Sertraline. It's been 3 weeks and my ADHD is through the roof, I can't finish sentences or even complete thoughts even though I'm still on the Addy. He's very sympathetic and explained that it's basically hit or miss.
Made an emergency appointment on Thurs and he upped the Zoloft to 200 mg. It had been 3 days completely off of Wel and Cymb and although I believe there was a little relief from the zoloft (I just felt kind of "numb") I'm still depressed and crying, can't function. Like you mentioned, I've gone from taking SNRI to one SSRI and after speaking to the pharmacist, she said that it would be ok to take some of the welbutrin as they are compatible. I've decided to take 150 of the Welbutrin and 150 of the zoloft to see if there is any relief. This is the second day and I think I'm feeling a tiny bit better (not crying). I'm determined to give the Zoloft/ welb 3 more weeks in hopes of relief. I probably am still detoxing from the others and read that Cymbalta is a bitch to come off of.
Thank you, again for your kindness and feedback. I'll let you know how it goes! *fingers crossed*
Maybe you are still withdrawing from the two meds?
I've been on and off many meds. I've done a few of theses overlapping taper down scenarios. Always caused me some problem.
Our chemistries are all different. There may be standard protocol they use to taper and add a Med. But, that doesn't mean we won't be symptomatic with the change.
Hopefully given more time things will even out.
If you are feeling horrible and emotionally having difficulty ( work etc) you might want to call MD and talk about it.
Hey Dolphin! Thank you for your response. I completely agree with you about withdrawals from the Cymbalta and Welbutrin. (taken for years) Im on week 3 of tapering and starting the zoloft (sertraline) at 50 mg.
Made an emergency trip to the Doc's on Thursday because I've just been a mess and in that "Dark place". He upped the zoloft to 200 mgs and I have a follow up in 2 weeks.
Although Im experiencing kind of a "who cares" attitude, I cant seem to find any happiness, just indifference. The pharmacist suggested adding a little bit of welbutrin back in so for the past 2 days, I've been taking 150 Welbutrin and 150 of the Zoloft and may increase the Zoloft to 200 next week.
I'll let you know and please, if you have suggestions, I'm all ears.
The only thing I would probably do is wean that wellbutrin down slow over the next week. Keep cutting the tab down. It's a tablet right? Not a capsule?
I've been through this so many times. I learned if the Dr said " stop taking" I would wean myself off slowly. It she said taper off over one week I have done it in two. I'm just too sensitive to the stuff
Just saying what I did and what worked for me. My info doesn't replace that of your md of course.
Just noticed your reply to Nolagrace. I also noticed that you recommended that he/she keep cutting 'down' the Wellbutrin dose in very small doses at a time. However, maybe you overlooked the fact that Nolagrace has said adding back some of the Wellbutrin actually helped to some extent. It even seems to have stopped him/her from crying. Nolagrace even decided to carry on with both meds for a few weeks. Kind of conflicting ideas, don't you think?
Not arguing, just saying.
Nolagrace, how are you getting on? And is it 'he' or 'she'? lol
I'm actually starting Zoloft right now too! And I was previously taking adderall for my ADHD and stopped that, and now have just been taking Ativan for panic attacks but my drs thought I needed something for every day help for my anxiety and depression.
I posted about the side effects and symptoms of Zoloft a few days ago since I too have been extremely emotional and my body has felt off physically as well. Just about everyone who replied to my post said that it does take time to get through the side effects in the beginning. But they also all said it's worth all the side effects in the end, and it usually starts working well within 2-3 weeks. They said Zoloft is actually a really great medicine, it just takes time to work and for your body to adjust. Also, I'm sure after being on those medications for 8 years, it's going to take awhile for your body to come down from them. It's actually impressive at how fast your body is handling the changes and adapting! That's really good news.
Stay strong! You'll get through this. Just know that you're not alone and try to explain to your family that this is a big change, it's going to take some time before it gets better. Sending lots of hugs and good, healing vibes your way!
Snowwhite~ Thank you SO much! I'm sorry you're going through this also! My Doc also said that Zoloft (Sert) is a great medicine with great response and I just have to "get through it" (tell that to my boss and family, right?) I trust him, though and the pharmacist suggested that I implement some of the welbutrin back in. (I was on the highest dose before, now trying 150 mg of wel and 150 of Zoloft. I'm on day 2 of this, maybe a little better but unsure.
I really appreciate your comment and hugs and healing vibes back at ya! Please let me know how you're doing!
Sertraline takes a few weeks for your brain to begin "accepting" the serotonin, even though it is in your body immediately after taking the meds. I have been on Sertraline for 18 years and it has been a life-saver, however I am now up to 175mgs so I am almost maxed out.
UPDATE* It's been about 1 month since I started this journey and I must admit it's been a huge struggle but I think adding the Welbutrin back at a low dose has made it more tolerable.
I'm feeling like maybe I'm "human" again. It's a little easier to get out of bed in the morning, I'm not obsessively overthinking or worrying and I may be a little more compassionate? Crying has subsided.
Here's the weird thing, after I started my period (yes, Nolagrace is a she ) I TRULY started feeling better. Had my cycle early but didn't realize that the past 2 weeks I've also been going through PMS which has been vicious for me for years. I know that zoloft is also used for severe pms so maybe this is all a part of it.... what a crazy ride but I'm getting there.
Thank you, everyone for your thoughts and concern. Gonna keep trying
I am a fan of Wellbutrin, I must admit. Since starting it back in '06 I've never been off it. Been switched between Nardil & Marplan 3 times (Nardil to Marplan to Nardil to Marplan) but always kept the Wellbutrin. It's a surprisingly safe med, few side effects and a decent antidote to some specific SSRI side effects too (sexual 'difficulties', drowsiness/somnolence). It has a good get-up-and-go effect and, being part NRI can protect from MAOI + tyramine triggered hypertensive crises. This has been proven using reboxetine (a strong NRI) and Parnate (tranylcypromine). I'll look for the link on Pubmed. Seems same applies here.
1st time I was put on it I was already taking Nardil. 'Honeymoon period' over I was getting drowsy all the time with hypersomnia/somnolence & pseudo-narcolepsy (would sometimes miss my train stop, falling asleep at the cinema etc). I had always wanted to try it but had a suspicion it would worsen my social phobia. But the DRI action was attractive I will admit, with dopamine being closely linked to confidence. Also, at the time, the link between social anxiety & dopamine was growing bigger & bigger. And what other antidepressant has a significant dopaminergic effect? (I said 'significant'). I can't think of any, none with a direct effect anyway. Pitty about amineptine.
Proff. Nutt okayed it after I said: "but I thought NRIs generally protected against HTC?" He agreed & dropped his guard. Can't argue with that! Mind you, he had a med student with him & said it was MY choice and he had a witness. Tongue in cheek I'm sure.
It helps that Zyban (sometimes Wellbutrin with a Zyban sticker covering it) here in the UK is only available as slow-release. Its only licenced for smoking cessation therapy too but an off-label script takes care of that. Slow-release is helpfull in preventing convulsion that the instant release is famous for, especially in the 450-600mg range. I also now have clonazepam which is only licenced here for epilepsy, but again, when a signed script is off-label there are few boundaries.
450mg is my highest dose but 300 is usually enough. I used to take 300mg at night! My hypersomnia is that bad.
I tried sertraline once. Was Lustral brand I think. Stopped after just a few days. Seemed to trigger awful nightmares. I've had a few meds do that to me. Trimipramine was the worst but it is well known for inducing lucid dreaming. Normally this is a good thing but for a few its quite the opposite.
I've tried all SSRIs except for Luvox (fluvoxamine). I swear a lot of these brand and even a few generic names are to hopefully induce some kind of subconscious, part-placebo effect. Even if solely to get a patient to comply. LUSTral, LUVox, PROzac, SEROxat, EFFExor, PROvigil. And what about generic SEROquel (QUETIapine, much like QUIET, it is an antipsychotic). Some med Brand names are obvious. NYTol ( sleep-inducing antihistamine - diphenhydramine), PRO-PLUS (caffeine).
Kinda funny when you're not taken in by transparency.
Update: Guess it's been about 2.5 months. My pharmacist recommended I add the welbutrin back with the sertraline because I've still been depressed but just felt "Meh" after the sert finally kicked in.
Good news is, I'm not stressing like crazy (under a huge amount of home life/ work stress right now) like when on cymbalta and welbutrin, no weight gain or sexual side effects. I feel more sympathetic towards others and part of me feels like I'm relearning how to behave and assert myself after 10 years of being on Cymb, Welbutrin combo.
Also, I feel a little more confident and standing up for myself. When faced with major stressors, I'm like, "Crap! Ugh, whatever" but I can kind of cope.
Cons: Even though I'm still taking the aderral as prescribed for adhd (been taking this for over 20 years , my Adhd is horrible. Also, I'm a runner but haven't been keeping up with it since starting sertraline. (Again, the meh) My husband says I now use the "F bomb" to much.
Just wanted to give an update and thanks to all that have inquired. Any further advice is greatly appreciated and I hope I can help others with this odyssey.
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) I TRULY started feeling better. Had my cycle early but didn't realize that the past 2 weeks I've also been going through PMS which has been vicious for me for years. I know that zoloft is also used for severe pms so maybe this is all a part of it.... what a crazy ride but I'm getting there. 
, my Adhd is horrible. Also, I'm a runner but haven't been keeping up with it since starting sertraline. (Again, the meh) My husband says I now use the "F bomb" to much.
sertraline and propranolol 
Miserable, unhappy, and anxious
Switching medication from sertraline to Duloxetine i am coming off 125mg sertraline to start 30 mg duloxetine
Lost, Miserable and Alone.
