I feel like I've been on so many different medications over the past 7 years, but seem to have stabilized somewhat with this current combination. Earlier in the year, I'd been on 300mg Effexor and 150mg Wellbutrin for several months but was still crying most days and not sleeping very well. At that point Effexor was still under patent and my insurance excludes psychotropics so it was costing me about $200/month, which I would have been happy to pay if it helped, of course. As it wasn't, I started to wean myself off the Effexor. Went to a clinic to look at my sleeping patterns, and the psychiatrist there, before the sleep test agreed with weaning off Effexor and increased Wellbutrin to 300mg, and after the test added 30mg Remeron. On that combination, I fell asleep when I went to bed, but the anxiety and irritability were there constantly.
I'd forgotten that I still had a substantial amount of Effexor 150mg -- in a multi-vitamin container, of all places! -- and unwittingly took a couple one morning, thinking that they were, surprise, surprise, multi-vitamins. As I sat down to work after breakfast, I thought at first that I was having a niacin rush -- some multi-vitamins will do this to me, particularly when combined with certain breakfast cereals -- which, if others haven't experienced this, is a sort of whole body flush and tingling. But there wasn't the redness that I'd usually get with a niacin rush. Then I noticed the dry mouth and I clued in to what I'd done. So, besides the wooziness and disorientation that came from going from 0 to 300 on Effexor, I had a good refresher on the side effects it gives me: some nausea and headaches (went away after a couple of weeks), loss of appetite, blurry vision, night sweats -- the last three are persistent. As to the near/slight aphasia, KrissyRN, I was attributing that to other things, namely 40's moments, poor concentration, attention span of a gnat. I don't think that it improved at all in the 6 months that I was off the Effexor, so I don't think that I can blame it on the pills, unfortunately.
On the upside, once the wooziness wore off, it felt like I'd taken a happy pill. So I checked with my psychiatrist and he gave me the ok to go back on the Effexor at 150mg (it's off patent now, yay!) and continue on the 300mg Wellbutrin and 30mg Remeron. The Remeron and Effexor seem to cancel each other out in terms of affecting my appetite, and the night sweats and blurry vision are back, but my mood is considerably elevated, the irritability is down, and there are times when I actually feel joyous.
I can't comment on the fatigue, as not feeling exhausted is but a very distant memory... As per another thread, though, perhaps eliminating wine from my diet will also improve my sleep quality, along with all the other impacts/benefits discussed.:)