Wellbutrin SR for ADD???

[goody2shuz]

Hi all....my 19 year old daughter who has had problems since she was 14 was recently diagnose with ADD Type 6 "Ring OF Fire"/Mood Disorder by one of Dr. AMEN's clinics using SPECT Imaging as well as a thorough psychiatric evaluation and testing. We had lost over 4 years not knowing what was going on and our daughter refusing to accept that something was wrong, that is, until she saw a visual scan of her brain all lit up with hot spots all over the place!!! If anything was going to convince her this was it!!

The treatment plan recommended to us was that she be started on an anticonvulsant (Lamictal) since the mood centers of her brain were involved which would stabilize the ups and downs and irritability that she was experiencing. After she was up to a therapeutic dose of Lamictal and she was still "stuck in having things her own way" or experiencing impulsiveness it was suggested that an antidepressant should be added. And after that if needed an ADD med such as Daytrana be tried.

Our daughter is away at college in her second year. She started the Lamictal at the end of August and has been following up with a psychiatric Nurse Practioner at college. She brought a copy of her SPECT findings as well as her diagnosis using testing, history and a thorough intake as well as the suggested treatment plan for the NP to look over.

She went to see the NP for the second time who had decided to increase the Lamictal the first time they met to 150mgs before adding anything else. I was really happy with this plan.

Meanwhile we have noticed some improvements as has our daughter. When she calls her conversations are not as flighty with her jumping from one subject to another or her talking about something going on in the room at the same time. It was actually pleasant talking to her and we didn't end up in an argument with her hanging up like we had going on last year. She also said that she was not as upset as usual by things people said or did and was able to sleep better too. The biggest thing was that she didn't feel as if she had to be doing something every minute of the day and was able to relax more.

Today the NP decided to start her on Wellbutrin saying that it would help her ADD and wasn't a stimulant. I thought that she was perhaps convincing my daughter that this was an ADD med since I always throught of it as an antidepressant but when I looked into it I did find out that it is used for ADD when I read that it is also sometimes used to treat episodes of depression in patients with bipolar disorder (manic depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods) and to treat attention deficit disorder (ADHD; more difficulty focusing, controlling actions, and remaining still or quiet than other people who are the same age). This definitely describes my daughter and I was actually not only surprised but impressed that the NP picked this particular med and was relieved especially since I was concerned about my daughter's drinking habit and use of recreational drugs including Adderall that was not prescribed to her. At this time I am convinced that alot of her alcohol and use of other substances had more to do with self-medicating than anything else.

So.....I was wondering if anybody else was ever on Wellbutrin for their ADD and how it worked and what to expect.

Any insight and advice would be most appreciated.

Thanks ~ Goody

[addprogrammer]

Hey Goody,

Wellbutrin is used off label for ADHD. The bottom line is if it isn't a stimulant it doesn't work - at least not for ADHD symptoms. Wellbutrin is a stimulating antidepressant in the same class as Strattera but without most of Strattera's nastiness. So it just may do the job.

Better than Daytrana? It depends. The Daytrana patch is hands down the most consistent delivery system. The patient isn't subjected to the ups and downs of most other methylphenidate meds. That significantly reduces its abuse potential because the patient does not feel undermedicated at any time during the day. In my book undermedicated is worse than not medicated.

Wellbutrin SR is also consistent. I would opt for Wellbutrin SR over any methyphenidate med except Daytrana or Concerta. But Wellbutrin isn't as stimulating as methylphenidate.

Is Wellbutrin SR less risky for the bipolar? I haven't read as much but suspect not. Daytrana releases 2.5mg methylphenidate/hour if I'm not mistaken. Methyphenidate is metabolized quickly so blood levels never get too high. My best guess is Daytrana is less risky for the bipolar.

Relevancy: If the Wellbutrin SR works, all is well. If it doesn't work, it'll put your daughter again at risk for self-medication.

If I remember correctly, Amen's clinic recommended Daytrana. If correct, why corrupt a plan that up until now has worked well?

One of the things I had to learn for my work is not to switch technologies in the middle of a project. Best way I can think of to screw up a perfectly good program - code or med.

I wanted to start a thread titled "ADHD Remediation and Reality." The few that I think it would interest will read this post so I'll do it here.

Past couple years I've been experimenting with several "natural" ADHD remedies. Fact is, our pantry is filled with hundreds of dollars worth of "natural" failures.

Some of these substances namely DMAE and most recently phosphatidyl serine seem to help. Both are cheap and relatively low risk. But neither are as effective as Ritalin.

It would be my pleasure to quit the Rit and go hug trees. But I can't.

I get paid well for my work - when I can work. The funny thing about our society is no one gets paid well unless they produce well. I can afford very little inattention and hyperactivity while I'm working. My production goes down the toilet.

I'll quit the Rit the day someone gets the rest of the world to accomodate me.

OR ---

I'll quit my job as soon as I find someone to pay our bills. Then quit the Rit.

Bob

[kjrunner]

I use Wellbutrin in conj with Adderall. I tried WB first, it works great as low level coverage. When I went on Adderall, it seemed to lose something when I stopped WB. So, we added it back. I believe that is smooths out the peaks and valleys with Adderall

[fineanddandy]

Is Wellbutrin SR less risky for the bipolar? I haven't read as much but suspect not.

I would say that it is definitely NOT less risky in BPD - it is MORE risky. Wellbutrin flipped me into hypomania.

Wellbutrin is being prescribed more frequently for ADD, especially since many ADD'ers have comorbid depression. But, it's tricky with BPD, so be careful.

[goody2shuz]

Thanks everybody for your posts!!!

Bob...once again your experience and knowledge is much appreciated. You are right in regard to the AMEN Clinic's recommendations, however, I had failed to mention that in the treatment plan it was suggested that we start with an anticonvulsant and once it was at a therapeutic level if still experiencing the "getting stuck" (stubborn hardheaded behaviors) that adding an antidepressant may be beneficial. Our daughter was started on Lamictal which is also a mood stabilizer. The treatment plan also mentioned that the pdoc would be interested so see if she would also benefit from one of the classic ADD meds suggesting the Daytrana patch.

I guess that with our daughter's history (she provided the NP a copy of the diagnosis and suggested treatment plan from the AMEN clinic) the NP felt that trying the Wellbutrin SR might be worth a try in the sense that it would serve as both an antidepressant as well as an ADD med and not a stimulant that could be abused (although the patch probably has a low chance of being abused). I thought that it might be worth a try and with the mood stabilizer on board the chances of it inducing a mania are signifcantly less. If our daughter could significantly improve with one med such as Wellbutrin rather than two I figured it was worth a try.

One thing that I found while looking into a site that had personal accounts of people's experiences with Wellbutrin SR in treating their ADD was that...

1) It was quite effective and surprisingly so in treating their ADD

2) It took away the urge to use drug and alcohol that they had bee using to
treat the symptoms of ADD that they were having. One person actually
mentioned how she smoked alot of marijuana and after starting Wellbutrin
she had no need to. Wellbutrin also was successful in allowing some of the
people to quit smoking (which is something our daughter has been trying
to do especially since having bronchitis multiple times in the past year.

3) Some had even said that it worked even better than the other ADD meds
that they had tried such as Adderall and Ritalin.

4) It is also a great med used to treat SAD (seasonal affective depression)
which our daughter feels that she has. She hates the winter and states
that her mood is definitely down during the winter months.

Kjrunner & Fine&Dandy ~ thanks for sharing your positive experience with Wellbutrin and for you genuine concern about the possibility of it triggering mania. Fine&Dandy....were you on a mood stabilizer when that happened with you??? I know that was my first concern but when I looked at the info the Wellbutrin is not a SSRI but rather is a NDRI (Norepinephrine Dopamine Reuptake Inhibitor) and less likely to trigger mania....but still there is a chance that it will in somebody who is truly BP. With the Lamictal as a mood stabilizer I feel as if we have an extra safety net in place.

I have spoken to my daughter about the things to look out for and am confident that she will call me if she has any problems.

Thanks again for your wonderful posts and I will try to keep you updated with how things go. I am glad to have heard that others have heard that Wellbutrin can be used for ADD since I wasn't aware of that.

((((HUGS)))) and thanks ~ Goody