Dr_Anderson : Greetings, and tha k you for your question. I'm sorry you are in such a pickle! So, there are a few options available, and of course switching meds is one. Since the pharmacist was able to dissolve the tablets in water, the first question is, was the water made to flavor to overpower the taste?
Dr_Anderson : Since they will dissolve in water, I would first of all try to find a flavor that countered the pill taste and add that flavor to the water. Then, the same time you take the pill/water/flavor mixture, plug your nose to avoid the olfactory input to the gustatory sensation. Here is the key: KEEP YOUR NOSE PLUGGED until the mixture is swallowed! Otherwise the taste will remain. Now, if that does not work, it may be necessary to switch to another agent, and quickly to avoid both withdrawal and rebound symptoms for which the Wellbutrin was being prescribed.
Dr_Anderson : Effexor XR is a pill which may be sprinkled on soft foods and taken as a non-pill form. Many of the SSRI's, such as Paxil and Prozac, are available in a liquid form and may serve as viable alternatives.
Dr_Anderson : I know these are not ideal solutions, given that the Wellbutrin has worked so well, but if the "flavored-water-nose-plug" technique does not work or is impractical, then these other options would be reasonable to switch to.
Dr_Anderson : Hope this helps! Please let me know if you have any questions about this, or follow-on questions.
Dr_Anderson : Regards,
Dr_Anderson : Dr. Anderson
Thanks for your response. I had company which is why it took me so long to get back to you. I did actually try what you suggested before and not great but my options are limited. I was on effexor in the past and would never take it again. Coming off was awful!!. i am also on celexa 20 mg qd which is available in liquid form. A psych colleague called me and told me i shouls still take the wellbutrin 300 xl qd and dissolve in water. What are your thoughts on that?
Well, given your bad experience with Effexor (very common problem with it, the one you mentioned!), that leaves Cymbatla or Pristiq as options on the SNRI class. Cymbalta cannot be chewed, crushed, or placed in liquid, so that one is out. Pristiq is fairly small and might be cut up into smaller pieces, but I have not had a lot of patients do well on it, so there is that as a counterpoint.
I agree that staying on the Wellbutrin XL 300 mg, if possible, is the most desired option. It has been the medication to work well for you. You can dissolve it in water, but my guess is it won't taste any better than the 100 mg pills.
So, if you want to stay with the Wellbutrin option, try the same ideas listed above. Another creative one is to cut the pill into smaller pieces (but not dissolve it in water) and try to down it with something potent, such as Nyquil (not necessarily Nyquil! Just something obnoxious that wil distract you from the taste and let you get the medicine down.
There's always the G-tube option! (I'm not serious, of course)
Please let me know if you have other questions!