Wellbutrin SR for ADD???

[fineanddandy]

Hi Goody,

Interestingly, of the 2 antidepressants that clearly flipped me into hypomania, neither was a SSRI. Wellbutrin did it and Effexor did it. They are both very stimulating. So, do warn your daughter to watch for the signs - especially insomnia!

And no, I wasn't on mood stabilizers at the time.

I agree with you that Wellbutrin is worth a try, just warn your daughter to be hyper-alert to the signs that she is getting into trouble.

Good luck!

[addprogrammer]

Goody,

This post may appear to be an attempt to hijack your thread but you'll find it relevant at end.

KjRunner,

You and I are very close psychological twins. I find that interesting because we differ from gender to upbringing to every other psychological property. I can only conclude that you and I are part of an psychological pattern that is rooted in biology not environment.

You may be able to replace Wellbutrin and Adderall with concerta.

What follows is my Concerta recommendation basis.

The two years following my diagnosis was very difficult for me med wise. I must take part of the blame. But the balance I am going to place right where it belongs - on the medical "profession."

The short of it: I resisted stimulants for about six months after a doctor suspected ADHD. During those six months I was losing money faster than the Feds. My deficit budget was because to I couldn't work and I can't raise taxes. Brain problems were between me and a paycheck. I went to my family doctor and told him I need speed. Honestly I said it just like that. He knows me. He says "adult ADHD is a very complex disorder that requires a specialist. I don't want to prescribe because I don't know what I am doing. You need a shrink." I said "ok." The HMO I had at that time would not allow my doc to refer a shrinK. I was livid. My brain is more important to me than my liver. Can refer a liver guy. Can't refer a shrink. What gives?

So I go to my HMO's web to find their shrinks - zillions of them. I picked the one that was geographically closest to me. That is not a good way to choose a doc that will work on my brain. I called and his girl says, three months for an appointment. I took it.

Three months? I'm desperate. I go back to fam doc and tell him it's three freaking months till I see the shrink and I am going broke. Give me a speed prescription so I can get off the ground. I hounded him and he acquiesced. He writes a script for two 10mg generic ritalins AM/PM because my HMO won't pay for any ADHD med other than generic - not Strattera, Adderall, Ritalin LA, Concerta, etc. Generic or pay out of the pocket. With my deficit budget I took the generic.

So I get my generic Rit (methylin) and take my AM dose. The lights came on for about two hours. I was wonderful. I was "cured." But had to wait another couple hours for my noon dose. Same deal - for about two hours the lights were on - then off again. So I go on the net and find that the generally accepted max for Rit is 60 mg per day. Well, this is a no brainer - I'll fill in the blanks to determine how many pills I need, tell doc and he'll write me an update. I tell doc that 5 10mg pills per day is pay dirt. He went ballistic. He was screaming at me "how dangerous what I did was." He carried on like a lunatic. I told him I looked it up on the net and 60 mg is max. I only need 50. He kept on ranting. Then he writes me a script for 2 20mg Ritalin SR. Please note that SR is old technology that doesn't work well.

I take the AM 20mg pill and about 2 hours later the lights went out and an overwhelming depression came over me. Two years later I discovered that 20 mg in one shot is too much for me. How I wish that I hadn't hounded family doctor. He was right. I was wrong. ADHD meds should not be managed by a family doctor.

Finally I get my shrink appointment. The guy is a bozo. He knew less about ADHD than my family doctor.

I find another shrink that shingled ADHD. I got an appointment in two weeks. I tell him that the two 20mg pills isn't enough. No problem. He upped it sequentially to 80mg. I kept getting worse and worse. So I fired him too. And found another family doctor that I knew has ADHD kids. She prescribed Adderall maxing it at 40mg / day. I got worse. Damn.

Back to the web. I discovered that 20mg at a shot is too much for me. And that is why 5 10mg spread out over the course of the day worked so well. Beginners luck. I called the second shrink that I fired for an appointment. We hashed it out. When I said two 20mg Rit isn't enough he interpreted that to mean that 40 mg does not control my ADHD symptoms. He understood me that way because that is what I meant. I wasn't able to distinguish between lack of efficacy and a depressive reaction. Now that he understood, he knew what to do - prescribe Concerta. Well, at that time financially I am doing better but just barely making ends meet. So we went with 3 20mg generic cut in half taken every 1.5 hours or so. Works but is a pain taking 6 doses per day and frequently I screw up on the timing.

I am calling tommorow to request a Concerta script. I can afford the Concerta now and could have afforded it three years ago if I only knew then the direct relationship between a meds efficacy and my ability to function.

Goody,

Don't let that college psychiatric Nurse Practioner over-ride Amen's recommendations. Someone just posted how important it is to get - not just a shrink - but an ADHD specialist shrink. Dr. Daniel Amen is the preeminent ADHD specialist. All other shrinks need to catch up. Anyway I felt the details I provided were necessary for substantiating my "don't do that recommendation."

Bob

[goody2shuz]

<removed>

I understand what you are saying regarding Dr. Amen....from what I see we are going by his recommendations being that the next step suggested was to add an antidepressant to help my daughter through that "getting stuck" periods. The NP received an entire copy of Dr. Amen's findings and treatment recommendations and even had my daughter sign a release form in order to obtain any copies of her medical records. I am glad because I really don't know what my daughter handed over to her and what she didn't.

Anyway the way I see it the NP's adding the Wellbutrin doesn't go against Dr. Amen's suggestion for treatment now that I have learned that it is used not only as an AD but also to treat ADD. It may even eliminate the need for the Daytrana patch which would be the next step so we will see if the Wellbutrin does the thing and if not re-evaluate.

Also ~ We are entitled to one followup appointment with the pdoc at the AMEN clinic and he suggested that we line up a conference call with me, himself and my daughter and her pdoc which I think that I am going to do when my daughter next meets with the NP. That way the NP should have the medical records in hand and we all can get on the same page in regard to how my daughter is doing and if he agrees with the treatment.

I checked in with my daughter today and she said that the Wellbutrin seems to be making her more tired. I know that there is an adjustment period and told her to hang in there and we would give it a few weeks and if it still posed a problem we would call the NP. I told her if things got worse to call me and that I would in the meantime be checking in with her since this is a new med we are trying.

I so appreciate everybody's input and will keep you all posted with how things are going.

Thanks again for your wonderful support.

~ Goody

[goody2shuz]

Well when they say it's too good to be true it probably is....right??? I noticed the past few times by phone that my daughter was back to her jumping from subject to subject. One day she had admitted (as I had guessed ) that she had forgotten to take her Lamictal.

Well the other day when we spoke and was only on the Wellbutrin for less than a week she started telling me that her roommate told her that she was on it and it made her all emotional. I told her that everybody is different and that it was too soon to tell what the med could do. Well today when we were talking she said that she had already tried increasing the Wellbutrin (which is before the NP told her too) and that it wasn't working like the Adderall did. I told her that she should give it a chance and even the NP would agree that it was too soon to consider another med before giving this one a fighting chance. She went on to say that she knows what she is doing and that she should be able to do what she wants to do regarding meds and that she went to get her own doctor because she didn't want me interfering with her. I was hearing all the same argumentiveness and the "getting stuck hardheadedness" all over again that seemed to be better when she wasn't on the Wellbutrin. It is difficult to tell how things are going while she is away but I couldn't help but be concerned about her playing with the meds and not taking them as prescribed and thinking that she knows what is best for her. Everything I told her she cut down and she said that she new that the Adderall worked and that nothing else would...I told her that by Dr. Amen's treatment plan that it was decided to do the anticonvulsant (Lamictal) and then try to add an antidepressant and then the Daytrana. She said that she knew that Adderall was the #1 ADD med and that was what she should be on....I told her that I had my concerns because it was addictive and that with her use of alcohol and drugs that I had my concerns about that and that there were just as effective meds such as the recommended Daytrana patch. She said that she needed the Adderall and I told her that since she was 14 she used caffeine and any stimulant that she could get her hands on such as Ephedra(diet pills).....she said that was what worked for her and that she needed it. I told her to talk to her NP and that she probably would agree with me, that she knew more than her roommate and wouldn't be pleased that she was not following her prescribed instructions. She said that she didn't care, that she knew what was best for her and that she wasn't going to tell me anything anymore and didn't have to. This was a complete turn around than before she started the Wellbutrin and it is almost as if it is making her worse in terms of behavior. I could tell by how argumentative she was being on the phone.

Any advice...she is 19 now and pointed that out.....I was about to schedule an appointment with the doctor from the AMEN clinic to conference in with the NP, my daughter and myself as a followup and was discussing this with my daughter when she brought this all up.

I am open to any suggestions.....

Thanks for listening ~ Goody

[addprogrammer]

Goody,

Don't even think about Adderall. Amen recommended Daytrana for very good reasons.

Bob