Operation Bupropion: SNAFU

TW: Mentions of self harm and suicidal thoughts.

So, I’ve been gone for a while. After having a bad reaction to the first ADHD medication, I had another bad reaction to the second, Bupropion, as well. Everything fell apart and I was really unwell for months; I couldn’t get out of bed, let alone write. I’m still not feeling great but things are better than they were and I am starting to feel able to write again, hence this new post.

After the mess that was Xaggitin, I was hopeful (kind of – in the only way you can be when you’re feeling hopeless and suicidal) that Bupropion would be better, given that it was an antidepressant but one that’s supposed to help with ADHD. I honestly don’t know whether it was better, which is somewhat mindblowing considering how awful the Xaggitin was.

As always, this is just my experience. Please don’t start, change, or stop taking any medications without the advice and support of a medical professional.


BUPROPION – 150mg

WEEK 1

The most pressing of the side effects was the nausea: it was overwhelming. And it went on all day, every day. It was horrendous. I was barely eating and while I can’t see it, I’ve had multiple people comment that I’ve visibly lost weight. (I also had a weird reaction to the Christmas tree in that it made the nausea even worse – it also irritated my eyes, nose, and throat, making my cough even worse, which wasn’t pleasant.)

I had consistent difficulty sleeping. I was always wide awake until very late at night (or early in the morning) and then I struggled to get up at anything approaching a reasonable time the next day – I also had a lot of very vivid, stressful dreams, which is something I’ve noticed pops up when I change medication. I was physically exhausted all the time (both therapy and hydrotherapy, for example, had me falling asleep on the sofa, which I haven’t done in months) and I was feeling very burned out and overwhelmed with nothing left emotionally as well as physically. I had a couple of almost meltdowns as a result (I think the only reason they didn’t turn into full on meltdowns was because I was so physically exhausted so I just shut down instead).

I was very depressed, feeling hopeless and having suicidal thoughts. I was also restless and had this ongoing sense of unease. It was awful but my psychiatrist strongly encouraged me to stick with it for a month to really get a feel for it, for whether it would help or not. The depression and suicidal thoughts could’ve been a hangover from the Xaggitin and the only way to know was to give it more time.

I was also having headaches, not quite at migraine level but not far off.

WEEK 2

The nausea continued, unfortunately. It was still bad but it was a little better on some days, I think. All of the food around Christmas was pretty stressful though: I still didn’t really have any appetite but I did manage to eat a bit, although what I used to consider a normal potion made me feel very unwell.

My sleep schedule remained messed up too. I was getting to sleep at around three in the morning (regardless of any help, that being medication or the methods I’ve used in the past that have helped) and then struggling to get up the next day. There was one night where I never got to sleep and then, the night after, I slept for fourteen hours and felt well rested for the first time in longer than I can remember. I’d hoped that that would right my schedule – at least a bit – but it didn’t. I was back to struggling to sleep the night after that. And I was still having the terrifyingly vivid nightmares. I was also physically exhausted: Christmas Day and a small family thing the day after Boxing Day, in particular, absolutely wiped me out.

The anxiety and depression persisted, plus I felt very, very emotional; I was restless and uneasy and I felt very raw and lost. It was pretty overwhelming.

The headaches continued too, plus the weird response to the Christmas tree: it made me feel very nauseous and made my eyes burn horribly. I love having the Christmas tree up so that didn’t help my mood.


BUPROPION – 150mg (+ PROPRANOLOL (20mg))

WEEK 3

I hadn’t wanted to start Bupropion and Propranolol at the same time since it would be impossible to tell if one of the two wasn’t working. So, two weeks in, I added the Propranolol. But while I’d remembered that, I’d lost track of time and forgotten that, after two weeks, I could up the Bupropion. So I was taking the half dose three days longer than I’d intended to (in which I also got my COVID booster).

The trouble sleeping continued. I was finally getting to sleep between two and five in the morning and then, of course, struggling to wake up in the morning. I was completely exhausted and finding it a real struggle to get out of bed at all, something that certainly wasn’t helped by my depression. Feeling depressed, hopeless, overwhelmed, and anxious… getting up and facing the world felt like more than I was capable of.

The nausea was still very present too and there were moments when I had to stop and sit down on the floor and just focus on not throwing up. It was very unpleasant. I couldn’t really handle food, not that I really had any appetite anyway.

I also had a headache that grew into a vicious migraine (with intensely painful light sensitivity). The COVID booster was positively pleasant in comparison. My arm was sore and heavy for a few days but that was it, symptom wise, as far as I could tell.


BUPROPION – 300mg (+ PROPRANOLOL (20mg))

WEEK 1

I only managed five days on the full dose of Bupropion. It was clear straight away that it wasn’t agreeing with me.

If I was sleeping, I was sleeping terribly: I was getting to sleep around three at the earliest and then desperately struggling to wake up in the mornings. But between the depression and the anxiety, I found getting out of bed felt overwhelming. The depression had gotten even worse – the worst it’s ever been – and everything just felt hopeless. The self harm urges and suicidal thoughts were relentless. I felt checked out of my life and I just couldn’t engage with anything, even things that I love and things that have previously helped when my depression’s been bad. The anxiety amped up too. I was just overwhelmed, terrified that something bad was going to happen; I felt like I was constantly trying to stop myself from panicking. The nausea and lack of appetite also persisted; I was barely eating anything. But I have to confess that I didn’t really care. Food is so stressful for me that not eating was a relief.


BUPROPION – 150mg (+ PROPRANOLOL (20mg) + LORAZEPAM (2-4mg))

WEEK 1

With things getting so bad, my Mum was calling anyone who could help us and my GP told us to go back to the half dose, adding Lorazepam to help with the overwhelming anxiety (which apparently not uncommon when taking Bupropion).

At this point, I’d basically stopped getting out of bed, only getting up to have a shower and try to eat something before going back to bed. My anxiety (including racing thoughts, which I’ve only had a handful of times) was so bad and so overwhelming that I just couldn’t engage with anything: everything made my anxiety worse. It messed with my sleep even more and I barely ate at all; just the thought of food made me incredibly nauseous. I had meltdowns and I self harmed (which didn’t actually make me feel any better) and just being up in the daylight made everything so much heavier so I stayed hidden in my darkened room. I was beyond miserable.

Halfway through that week, the Crisis Team (or Assessment and Treatment Team as I believe they’re formally called although everyone we spoke to called them the Crisis Team) came out to see me. As nice as they were, I’m not really sure what the point of it was. The guy wanted to make sure I was eating at least a bit; he wanted to know about my anxiety and depression; he wanted to know whether I was having thoughts of self harming and suicide, although he didn’t ask if I was planning on acting on those thoughts. And then he rambled a bit about me being monitored over the medication change. I’m not sure what good that would do. I’ve changed medications so many times now; I’d just be doing what I do every single time but with someone coming to see me everyday. How was that supposed to help? What was that going to achieve? They offered to refer us to one of their psychiatrists, which my Mum asked them to so so that we could find out whether, at this point, there was any point in continuing with the Bupropion or whether I should start coming off it officially. As I said, they were nice but it was a pretty frustrating and upsetting experience and I just wanted to cry. I wrote in my diary afterwards: “Oh my fucking god, I can’t keep feeling like this every day, over and over again. It just makes me want to tear my hair out and rip my skin off and scream until my throat tears.” 

Over the rest of the week, I continued to sleep badly and struggle to wake up. I lay in bed all day, my brain just spinning out of control: my thoughts felt very chaotic and it was all just big, overwhelming feelings that I couldn’t make sense of. I felt like I was losing control of my mind – like I was just a spectator – and I felt like I couldn’t breathe. And I couldn’t stop crying. I was depressed, anxious (by the end of the week, I was up to 4mg of Lorazepam daily – prompted by calls to 111 and then my psychiatrist – although I was still paralysingly anxious), terrified, miserable, and exhausted: those seem to be the words I wrote down the most. Eating was an ongoing struggle, although the nausea had finally dissipated (for the most part).

After speaking to my Mum, my psychiatrist recommended I come off the Bupropion and, with my depression so bad, go back to an MAOI antidepressant since we’ve had the most success with them. I wasn’t thrilled by that plan (I’m still not wild about it) because the Phenelzine isn’t great, plus it massively limits the options for ADHD medication. But there don’t seem to be any other available options so I just went with it. With the two week wash out period, I didn’t have to make the decision straight away.


WASH OUT

WEEK 1 (20mg Propranolol + 4mg Lorazepam)

My sleeping schedule got worse: it was taking longer and longer to get to sleep until I was eventually drifting off at around five in the morning. That, of course, meant I was waking up later. I didn’t really mind that: I didn’t really want to be awake anyway and being awake in the dark didn’t feel quite as difficult as it did in the daylight hours. I did get up each day – to shower, to try to eat – but it was a miserable experience that usually resulted in tears. I felt completely overwhelmed and just didn’t know what to do with myself but I was still restless and felt like I was constantly on the verge of a meltdown. Even though I wasn’t doing anything, I was completely exhausted, which just made the inability to get to sleep that much more frustrating.

I had periods of intense anxiety but for the most part, the depression was overwhelming and suffocating. I felt separate and disconnected from my life, and like I couldn’t get back to it. I felt completely hopeless and the suicidal thoughts continued. I was completely miserable.


WEEK 2 (20mg Propranolol + 4mg Lorazepam)

I was constantly exhausted, barely eating and my sleeping just kept getting worse, getting more screwed up and out of sync. I took sleeping pills, I tried every strategy that’s ever worked, every possible combination… but I just couldn’t get to sleep; it just got later and later until I was going to sleep at eight in the morning. It was miserable. I was miserable: I was in tears multiple times every day; I was incredibly anxious (I’m not convinced the Lorazepam was doing anything); I was deeply depressed and consistently having suicidal thoughts and thoughts about self harming (which I did act on although it didn’t make me feel any better). It was the worst I’d ever felt. Everything just felt impossible, overwhelming and hopeless and I just didn’t know how to act like that wasn’t how I felt. It was all too much and I just didn’t know what to do with myself: I couldn’t engage or connect with anything. Everything felt wrong and uncomfortable and sad.

It’s a really hard state of mind to describe so I thought I’d include some of the things I wrote in my diary during the week:

  • “I hate being in my own brain.”
  • “I feel like screaming and tearing my face off and breaking things.”
  • “I feel like I’m constantly on the edge of a meltdown.”
  • “Everything about all of this medication stuff feels hopeless. It just feels like this is forever because I either have to choose between my depression and my ADHD, which one to treat, which one is worse. I don’t want to be me. Why couldn’t I have had a brain like everyone else I know? I feel so desperately jealous of people who’ve never struggled this way; I’m even jealous of those who have struggled but can take medication to manage whatever they need to manage, lead the lives they want to live, be functional, be happy… Apparently, I can’t. There’s always going to be something wrong, something pressing down on me and making life harder. It feels like everything could shatter any second and I’ll end up in a meltdown that I’ll never be able to get out of.”
  • “I miss me. I miss who I was before all of this. But after everything, I don’t know if it’s possible to get back to that person. That person doesn’t feel like me anymore. I feel trapped. I hate being me.”
  • “I feel like I’m being forced to choose between my depression and my ADHD and I’m just so angry that it’s almost ten years later and I’m still dealing with this; I’ve tried almost twenty different medications to manage it all and yet, I’m still in the same place. It’s still so difficult.”

So it was a rough week after a rough few months. The wash out period is up but I still don’t know what to do. There are so many reasons why I don’t want to go back to MAOIs – messy, convoluted reasons that I don’t even know how to put into words – but there doesn’t seem to be another option. I still don’t want to take them though. I feel completely stuck.


This was several weeks ago now and as much as I didn’t want to go back to an MAOI, I had a bit of a breakdown and started taking a new antidepressant, Moclobemide. I was desperate. And, as I said, things aren’t great but they are better than they were. I still feel very conflicted about what to do around the medication and the clash between the medications for each condition but at least I am feeling clearer and not so completely overwhelmed.

The New Plan

The last few months have been tough, medication wise. I had a wonderful, un-depressed Christmas (which I’m massively grateful for) but since then, I’ve been struggling. My mood just kept dropping and my anxiety just kept getting worse and we tried to alter the medication to compensate, to find that perfect balance, but it’s gotten to the point where we just need to try something new. So I’m taking stock of everything and trying to figure out how I feel about all of it.

The Clomipramine (a Tricyclic anti-depressant) worked for a while. As I said, I had a really good Christmas where I felt joyful and energetic and actually happy for the first time in a really, really long time. But then it seemed to lose its effectiveness and my mood dropped, whether that was because I was taking a magnesium supplement (I talk about that here) or because it just had a short shelf life. I don’t know. But it stopped working and my depression returned. Since then, my depression has been stifling and I’ve really struggled with suicidal thoughts, at an intensity I’ve never experienced before.

My anxiety also skyrocketed so, in addition to the Pregabalin (also known as Lyrica) I was already taking, I started taking Flupentixol to help manage it. At first I felt no different but after adjusting the dose, my anxiety decreased dramatically and I started to feel a bit more functional. But in the months since then, it seems there have been a number of difficult side effects: my energy levels dropped dramatically, to the point where even a shower is a real struggle. Standing for any length of time is impossible and I ended up being wheeled around multiple airports in a wheelchair during my Nashville trip. The worst part though was that my hands felt thick and clumsy, like my fine motor skills had just evaporated into thin air. Playing guitar was practically impossible.

At first I didn’t realise that these things were connected to the Flupentixol but thanks to my Mum and her incredible attention to detail, we realised that the dates all seem to match up and since we reduced said medication, these problems have disappeared. I’m ridiculously grateful to have my hands back, even if my anxiety has flooded back in.

We’ve reached a point where I can remain where I am or start over. So I’m starting over. I don’t want to live like this. So, after a lot of thinking and talking to my psychiatrist, I’m coming off both the Clomipramine and the Flupentixol. I’m not a massive fan of the Pregablin either to be honest but even changing two things at once is ambitious. So that one can wait. I’ve already started reducing the meds and I’m bracing myself for a barrage of mood swings, depressive episodes, and more. It’s not going to be fun. But it will be worth it. Hopefully.

The current plan is to come off the two drugs, go the ‘wash out’ period (two weeks of no drugs – apart from the Pregablin – so that there aren’t any negative interactions between the medications), and then start Phenelzine again. Yes, Phenelzine – the drug I stopped taking two years ago because it had stopped working, because the joyfulness it gave me felt fake and suffocating. BUT it’s the only drug that’s allowed me to be functional – creatively and otherwise – so we’re giving it another try. It did work for a long time and if it doesn’t, we’ll try another MAOI (monoamine oxidase inhibitor) anti-depressant.

I’m not sure how I feel about it, to be honest. Part of me is frustrated and disappointed. I’ve spent two years trying to find something better only to end up where I started. But on the other hand, that’s two years of knowledge, experience, and confidence that I didn’t have before. I’m a different person and chances are, my reactions will be different: our bodies change and our chemical makeup is constantly shifting. These medications all but cause a hurricane inside us. So I’m trying to be optimistic. I’m trying to be hopeful.

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