Wellbutrin and Anxiety

Rahant

I have been dealing with some moderate depression that has become more severe as time goes on. Without going into too much detail, it stems from a combination of things, such as financial trouble, extended unemployment, chronic pain, and marital problems (in that my wife is emotionally abusive; she herself suffers from bipolar depression and as time goes on I suspect that she may have undiagnosed high-functioning autism, but that's a different topic).

I have not been in therapy until recently, when I started intensive group therapy, recommended by our couples' therapist as he felt that my lack of motivation was originating from depression. He had talked about possibly starting medication to at least kickstart things and offered to refer me to psychiatrist, but I stated that I was not sold on medication and wanted to try to work through therapy first. I have been reluctant to take anything that could alter brain function, so much so that I will only take Tylenol when I'm in excruciating pain (I can't take Ibuprofen because of hypertension, which plays into my problem which I'll get to in a moment). However, recently, I've been completely unable to focus on anything no matter how hard I try, which I understand to be a symptom of depression. At this point, I consulted with a psychiatrist about medication because what's the point in worrying about altering your brain function when your mind is already so scattered that it's not functioning on its own.

So, here's the deal, and I'll give technicals in case anyone knows about it and it effects your answer: The doctor prescribed Wellbutrin SR (actually Bupropion HCL SR) 100 mg once per day, but warned me about the possible side effects, mainly about potential interaction with another medication I take (Metoprolol Tartrate 25 mg, 2X daily) for hypertension and tachycardia. Also, she warned me about potentially increased anxiety. However, she said that it will take a few weeks for the medication to take full effect, which I assumed would also mean an anxiety issue would take a while to appear.

I am now on my second day of this medication, and I've been feeling anxious. Not in a panicked state, but feeling a generalized and troubling anxiety, to the point where the muscles in my face and throat are feeling tight. I did experience some very minor nausea earlier, too. I checked my blood pressure and heart rate and those seem to be okay for now.

Is this kind of reaction normal? Is this to be expected for those who have knowledge and/or experience with Wellbutrin? I'm concerned about experiencing this on only the second day. Should I prepare that it may get worse?

dispatch.o

That's probably you being obsessive and anxious about the fear of being obsessive and anxious. If you're concerned call your physician.

In all probability If they'd have told you it causes random moles and skin blemishes to sprout on your body, you'd be finding all sorts of new blemishes and moles you never noticed before.

After a couple of weeks on it (to quit smoking) I had sort of an odd appetite change and a little bit of a funny feeling like something was different. Which went away around 10 days later and wasn't entirely unpleasant.

Also, medications do things. That's why they exist and why we use research and things to determine what works for what. If you're non compliant with a medication you are given, at least let the doctor know so they can try something else or not waste their time.

ceres

My medication, when I start it up, gives me the shakes for a few days, and I get random periods of minor faintness where I have to sit down. It's less than a week of that, and I'm so much better on it.

If you have a doubt, if you aren't feeling right, give your prescribing doctor a call, especially since she warned of possible interaction. Let her confirm or allay your fears, because telling an anxious person that anxiety is a side effect is like throwing gasoline on a flame and not necessarily indicative of a problem with your meds.

cabsy

Wellbutrin is a different kind of psych medication and it may increase anxiety. If you're worried, call your prescribing doctor, because they're gonna know a lot better than we will. I have an anxiety disorder and I went on wellbutrin to quit smoking three different times a few years apart, and all three times I had a different reaction - the first time was great except that I couldn't sleep! the second time I became deeply suicidal, and the third time it helped me quit smoking but I was 100% rage monster like having to lay in bed and count my dog's heartbeats to stop myself from going out into the kitchen and starting a physical fight with the people I was living with. I tell you this not to make you nervous or more anxious or anything but just to illustrate - as good as it is to check in with others and see if a result is normal, antidepressants can vary so much from person to person and even from time period to time period that if you're having concerns it's best to talk to your doctor about it because we simply don't and can't know if it's normal tapering on anxiety or a sign of a bigger problem.

Cog

I'm on the exact same dose of Wellbutrin. It does have a small incidence of anxiety in some people, but it's a low percentage. My doctor never even mentioned it to me, and I've never felt anything of the sort. More likely than not, you're feeling some moderate to strong observational bias.

_J_

Rahant wrote: »

So, here's the deal, and I'll give technicals in case anyone knows about it and it effects your answer: The doctor prescribed Wellbutrin SR (actually Bupropion HCL SR) 100 mg once per day, but warned me about the possible side effects, mainly about potential interaction with another medication I take (Metoprolol Tartrate 25 mg, 2X daily) for hypertension and tachycardia. Also, she warned me about potentially increased anxiety. However, she said that it will take a few weeks for the medication to take full effect, which I assumed would also mean an anxiety issue would take a while to appear.

I am now on my second day of this medication, and I've been feeling anxious. Not in a panicked state, but feeling a generalized and troubling anxiety, to the point where the muscles in my face and throat are feeling tight. I did experience some very minor nausea earlier, too. I checked my blood pressure and heart rate and those seem to be okay for now.

Is this kind of reaction normal? Is this to be expected for those who have knowledge and/or experience with Wellbutrin? I'm concerned about experiencing this on only the second day. Should I prepare that it may get worse?

I am on 300 mg Bupropion + FLUoxetine 20 mg. I do not recall feeling anxious when I started the Bupropion, or having muscle tightness, but I did feel "kinda weird". Not deleterious weird, but a "different" weird.

Something to keep in mind with psych drugs is that you'll likely experience some placebo effect whatnot when you begin each medication. If you're too self-aware (which is likely the case with anxiety / depression) you'll pick up on every minor psychological tick, over-analyze it, and so think yourself into feeling weird. That, as I understand it, is normal.

If you are worried, then talk to your doctor. They deal with this sort of thing every day. My general rule is that if I don't experience anything life-threatening, or a collection of the symptoms of Serotonin syndrome, then I assume I'm thinking myself into feeling that way.

Try to calm down, distract yourself, and stop thinking about it so much. But if you notice something is *really* wrong then contact your doctor, or get to an ER. In your case, the muscle tightness and nausea are things to keep an eye on, but initially it's likely ok to assume you're thinking yourself into feeling that way.

But if it gets worse, talk to your doctor.

I hope something in that was helpful. Just know that what you're experiencing is normal, and you're in good company.

Raif Severance

Wellbutrin is one of the antidepressants with an "activating" effect. Basically, part of the way it works is it increases one of your body's natural chemicals called norepinephrine which gets changed to epinephrine (aka adrenaline) - this is why there is that warning of increased heart rate/blood pressure. This is also why you may be feeling anxious/agitated. This effect happens as soon as you start taking it but the good news is you and your body will eventually get more accustomed to the effect and you won't notice it as much. The actual antidepressant effect will take about a month for you to notice. My advice is to hang in there for a week and see if you can tolerate it - if it gets too unbearable give a call to your doctor. Make sure you check your blood pressure periodically as well. One thing you and your doctor may be able to try is the "XL" formulation which will give you less of a peak in the drug after you take it though it may be more expensive.

Rahant

Thank you for the advice. I'm doing okay for the moment, but I'm having ups and downs in terms of anxiety. I had the nausea for a couple of days, then it went away, then I had it again yesterday. I'm probably still evening out. Actually, that is the thing. It feels like my brain is "waking up" a bit, but not on even ground. I consulted with the doctor, who told me that the anxiety effect often happens immediately, and it takes a few weeks for the antidepressant effect to kick in, so nothing seems abnormal. She said that I should try to ride it out as long as it's bearable, and that the anxiety effect should go away. If it becomes too much or doesn't stop, then we'll try to find another solution.

Usagi

Just a thought: if you're taking 100mg SR once a day you might be experiencing peaks and valleys because the SR is a 12 hr dose.

Wellbutrin makes a 24hr dose called XL which might help even things out, or ask about taking a 50mg SR twice a day.

The Crowing One

All I can add is my own experience on Wellbutrin. Everyone is different, but each time it made me agitated, angry, anxious and paranoid 2-3 days after the first dose.

The second time (more recent) I ended up basically locking myself in the basement for a weekend because I didn't trust myself not to yell/scream/throw things at anyone who so much as moved wrong in my vision. So you can take that as a vote of "I had a similar experience and so you're probably not crazy".

hsu

Just FYI, there are other anti-anxiety meds out there. I have a friend that didn't do well on Wellbutrin, but she took really well to Buspar (buspirone). Basically, give it a little while, but if problems persist, insist on a different med.

Rahant

Just for the record, I've been prescribed it for depression, not anxiety. I have noticed that I'm experiencing a much shorter fuse lately, although I've also been experiencing a significant surge in my chronic back pain, which I'm not sure is related to the medication, but could and probably is affecting my mood. I'm supposed to see a prescribing doctor in a week for a full-on medical evaluation, so I might try to ride it out until then and explain my concerns.

@usagi : The prescribing RN (she was an RN, not a doctor) had suggested XL, but opted for once per day SR because she was concerned about problems with insomnia, which I guess she saw something in my medical history that made her concerned about that.