Hi, everyone. I'm new to the board and am in search of some answers about the comparison between Wellbutrin XL and SR.
My boyfriend has been on Ritalin + 300mg Wellbutrin XL for about a month now due to moderate adult ADD, and this combination's done wonders for him. He's taking the XL at about 11pm, and this gets him awake and ready to go to work quickly in the morning. Work puts significant demands for concentration on him - and this is just fine until about 5pm, when he's found that the XL wears off and his ability to focus is pretty much gone.
After sharing this with his doctor, the doc put him on Wellbutrin SR, 2x/day, 200mg/time. This just happened today, so he hasn't started the dosage yet. We are wondering how he should time his doses to facilitate maximum concentration at work for the maximum amount of hours. If he needs to work till 7 or 8pm - this has previously been impossible on XL because it has worn off, leaving him unable to focus past 5pm. He's hoping to time doses of SR so that working late, and concentrating while doing so, will be possible. We know it needs to be 6-10 hrs apart - but should he still take the SR at night so it can kick in first thing in the morning? Should he take it in the morning because it will kick in sooner than XL does? How long should he expect to feel the effects of a dose of SR?
The doctor had little to no input on this. So I'm hoping someone here can answer my questions:
1. *How much* faster does SR release than XL? Like, would a dose of SR taken at 3 am make one peak at 8am or at noon? and when would that dose's effects stop being felt?
2. Would a dose of SR taken at noon make one only start feeling that dose's effects a few hours later (making a person who works "lose a few hours" in the afternoon before the SR would kick in)? For how long, in the course of the day, does one usually feel the effects of Wellbutrin SR?
What is your boyfriend's Ritalin dose? When does he take it? Is it a time release or an instant release formula?
The reason I ask is that Wellbutrin is not a stimulant and doesn't have the peaks and valleys effect of stimulant meds. Wellbutrin is an antidepressant that is only used off-label as a treatment for ADHD, and like most antidepressants takes time for the effect to build up (two weeks to a month). Once the effect is in place, it shouldn't wax and wane. As a Dopamine and Norepinephrine reuptake inhibitor, it will lead to a constantly higher supply of those neurotransmitters, and that should not vary by time of day.
On the other hand, Ritalin is a stimulant med and works only for a short time. Ritalin instant release formulas are generally active for about four hours, sustained release formulas for twice that. It is likely the loss of the Ritalin effect that's causing your boyfriend's lack of focus after 5 pm. In my experience, your boyfriend should talk to his doctor about getting an IR dose of Ritalin to compliment his SR on days that he's required to focus past 5.
As Wellbutrin is not a stimulant, it shouldn't matter what time of day your boyfriend takes it, it shouldn't interfere with his sleep.
Ask the pharmacist for the inserts from the manufacturer (or maybe you can find them online). I believe they include a section with results of studies on average blood levels of the medication over a 24 hour period. That might give you an idea, but I think each person responds differently to some degree.
I never noticed that the XL wore off, though if it did, I might have associated it with normal fatigue at the end of the day. I felt more peaks and valleys when I was on SR, but it was partly because I didn't always take my pills at the same time of day.
Note, XL comes in 150 mg pills too. So if the SR 200+200 is too much for him (e.g. disrupts his sleep or makes him irritable) then he might try taking one XL 150 at night, and another in the morning. That should smooth out the results.
Thunor, Wellbutrin does have a stimulant effect for ADD. It's not nearly as strong as Adderall, but it does have an effect on concentration and something akin to impulse control (it helps with cravings for food or cigarettes).
I definitely agree with you that Wellbutrin is longer lasting (with fewer peaks and valleys), and that it makes more sense for this man to adjust the timing of his Adderall. I used to take one Adderall in the morning and an extra half of a pill at noon.
I beg to differ. Wellbutrin IS a stimulant, and in my opinion that it is not the Wellbutrin that is causing the concentration/focus issues. My guess is it is the illness, and the drugs have not taken effect yet.
The XL is slow release and DOES NOT wear off. That is why...
... You should take it early in the morning as to avoid sleeping troubles, not only that but, by 5:00 p.m. he is now on the last 6 or so hours before another dose can be administered, and because he has just started this, there may not be enough in his system yet. It can take up to 4 weeks for the Wellbutrin to take effect. Be patient, and give it time to work...
...In my opinion I would stick with the XL as you only take it once a day, hence no worries about forgetting the second dose...
...Try REAL hard to take it at the same time as it WILL ALWAYS be in your system...
. . . it does have an effect on concentration and something akin to impulse control (it helps with cravings for food or cigarettes).
Agreed, I don't see where I made a contrary claim. Wellbutrin has been shown in some cases to improve the symptoms of ADHD in adults, as it acts to block the reuptake of the neurotransmitters Dopamine and Norepinephrine. These have a role in a variety of activities, including concentration and decision making. While Wellbutrin makes these neurotransmitters more available in the brain, it does not directly stimulate their release, which is why it is not classed as a stimulant.