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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Fatigue, ED, Somnolence And Tremors While Treating GAD And SAD?

Hello, The doctor has updated and given me new plans to select instead of the current one that (40 mg Prozac daily along with 150 mg Wellbutrin XL daily) which I have used to treat GAD and SAD , Note that I have started treatment from GAD and SAD since 2007 with SSRIs, and Note that I can not do without medications to control the GAD because when I stopping the medication I getting relapse. PLEASE, can you lead me which one the best accordingly to your experiences If I would like to control GAD and avoid the current side effects that I suffer from as much as we can which it is (Fatigue, weight gain, somnolence and tremor or shaking in hands) and along with premature ejaculation and get good erection : Option 1: Replaced the current medications I use (40 mg Prozac daily along with 150 mg Wellbutrin XL daily) with Effexor XR 150 mg daily, but we hesitate because of weight gain, increase the pressure and harm the liver which related to Effexor maybe.. what do you think about that please ?? Option 2 : Replaced the current medications with Buspar 15 mg 3 times daily along with 150 mg Wellbutrin XL daily.. what about weight gain and fatigue about Buspar ? What the reality of Buspar ? is it ZERO effect ?? What do you think about this option please ? Option 3 : Replace the current medications with Buspar 15 mg 3 times daily along with 20 mg Prozac ?? here weight gain, your opinion ??? Thank you very much. Best Regards Arman
Mon, 7 Sep 2020
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General Surgeon 's  Response
Hello,

You have combination of side effects from the current drug basket taken on regular basis since long period. The Prozac containing Fluoxetine as an anti depressant from Selective serotonin reuptake inhibitor group and has major side effect of weight gain and sexual disturbances in form of loss of libido and sex drive.

The Wellbutrin is containing Bupropion, norepinephrine and dopamine re uptake inhibitor (NDRI) with side effect profile consisting of:
- Constipation
- Blurred vision
- Tremors and others.

Kindly discuss the issue in details with your primary care provider as there needs change of the Prozac with different anti depressant along with dose reduction of Wellbutrin XL after clinical evaluation.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Bhagyesh V. Patel, General Surgeon
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What Causes Fatigue, ED, Somnolence And Tremors While Treating GAD And SAD?

Hello, You have combination of side effects from the current drug basket taken on regular basis since long period. The Prozac containing Fluoxetine as an anti depressant from Selective serotonin reuptake inhibitor group and has major side effect of weight gain and sexual disturbances in form of loss of libido and sex drive. The Wellbutrin is containing Bupropion, norepinephrine and dopamine re uptake inhibitor (NDRI) with side effect profile consisting of: - Constipation - Blurred vision - Tremors and others. Kindly discuss the issue in details with your primary care provider as there needs change of the Prozac with different anti depressant along with dose reduction of Wellbutrin XL after clinical evaluation. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon