Changing meds: Strattera to Wellbutrin

[STEM_Dad]

TL;DR - I asked my doctor to do a trial of treatment with bupropion (Wellbutrin). I'm hoping that it treats my Inattentive traits as well as atomoxetine (Strattera) and that it also helps me with motivation.

I've been on generic Strattera (atomoxetine) for three years. It helps with most of my Inattentive ADHD traits very well, and I'm tremendously grateful for the change, since my untreated ADHD was so debilitating.

(The first medication that I was put on was Adderall XR, at various dosages over about a 6 month period. The best it did to treat my ADHD was half of what atomoxetine does for me.)

The biggest struggles that I still have with my ADHD are all related to motivation and execution. From task initiation, to persistence, to follow-through.

I'm hoping that increasing dopamine as well as norepinephrine will help me more.

~~~~~

Today is my second day on bupropion (generic Wellbutrin).

So far, my mind seems about as clear as it does on atomoxetine (generic Strattera). I feel slightly more motivated than usual (just barely), but I can't be sure if that's the medication, my anticipation, or just placebo effect.

I'm aware that, similarly to Strattera and to SSRI antidepressants, it might take days, weeks, or even months to realize the full effects of bupropion.

I've had a mild headache for the last couple of hours. I took the medication three hours ago.

[Cocacola2]

Buproprion was great for the first week I took it (this was about 6 years ago). I was getting everything done and life seemed like it was going to be okay. But quickly after, I guess the medicine accumulated in my system, I started to panic and get confused. Two months after first taking it I ended up in an e.r psych ward. I guess that despite the horrible side effects I was always trying to go back to that first week This was a nurse psychiatrist that gave me this medicine.

I changed my doctor as soon as I could.

I would say please make sure your doctor knows how to handle this drug. This drug isn't just like any antidepressants out there. It can really screw you up. I would say to please keep in touch with your doctor about how you are feeling.

[STEM_Dad in reply to Cocacola2]

It sounds like what you went through was terrible. Thanks for the word of caution.

I know that it carries some serious risks.

Someone that I'm close to was prescribed bupropion for depression. I don't know if they were getting much benefit from it, since they weren't taking it regularly, but at least they didn't have a reaction like you did.

My doctor and I agreed that I should try it for a month. But because of your warning, I'll be sure to let him know about any negative side effects.

So far, the only side effect that I've had was a mild headache that lasted a few hours.

[PinkPanda23]

I'm interested and hope you have good results. Wellbutrin is one of the drugs I tried that still gave me the tardive diskenesia movements and didn't really alleviate my ADHD symptoms. It seems to be very helpful for a number of mental conditions.

[STEM_Dad in reply to PinkPanda23]

I've heard it referred to as an "unconventional" antidepressant, since it acts on dopamine and norepinephrine instead of on serotonin. While it's mainly used to treat depression (MDD or SAD) or for weight management, there are indeed a number of other conditions (including ADHD) that it is prescribed off-label to treat.

Probably the reason why it works on so many conditions is because dopamine and norepinephrine are used in the nervous system for more things than mood regulation.

Too bad that it didn't work for you. I hope that you've found a treatment that does.

[FocusAndFlow]

STEM_Dad - I hope the change works for you. I see a number of your posts, which leads me to conclude that you have done a lot of research on this before switching, so I'm not concerned at all with your thoroughness from that perspective.

I assume you do all this as well, but it's worth asking to give you a refresher and a different perspective by way of asking some questions: Have you changed any other habits / routines since the switch? Yes, here it comes.... Are you exercising? Is your diet relatively high in healthy protein, lower in carbs (and complex carbs at that, but you do need them for energy). How is your sleep? Etc.

The reason I ask is because I've used myself as a bit of a guinea pig with these things and I have notes on what helps me feel better or not, how many days I can go without exercising and/or meditating before I start feeling the anxiety/depressive symptoms start to creep up again, even with the Ritalin, mind you (About 2-4 days, if you must know). Those symptoms then set off inattention, struggles to complete tasks, or manage time properly, and all the rest of it. Here comes that old familiar tune...

So, I would just encourage you to ensure you are either journaling, keeping a checklist of your behavioral tools and patterns to ensure that you are collaborating as well as possible with the Rx, regardless of what it is.

I hope this makes sense, as I notice that when I just take my Ritalin but go a few days without doing these things, it still helps, but it feels somehow a bit hollow/forced, and I end up having moody/irritable days and signs of negative symptoms as mentioned above. If I do all those other things, conversely, but accidentally skip a dose of Ritalin (I forget the late afternoon one about twice per week as a pattern because I hyper-focus in the afternoons), I am in a good mood, but I simply cannot execute as well, and I simply cannot finish a task. I'll move the needle greatly on a few, but I've taught myself to leave it there for tomorrow. I can't take the Ritalin past 6:00pm, so I have learned to make do on those days with 'partial credit', if you will.

Anyway, I hope this example is of some use and that you find the right mix that works for you.

As a parting gift, I leave you with this: I just started taking Vitamin B6 a couple of days ago, and it is really helping me on the task completion side. I don't know if you're already taking it, and of course, you have to do your own research, etc. That said, I am very, very hopeful that my productivity will double over the next couple of weeks. I came across this in Dr. Amen's book Change Your Brain Change Your Life - Highly recommended. I'd never heard of the effects of Vitamin B6 for Adult ADHD before. I checked my multivitamin and my B complex and they had a whopping 5mg combined. I got some 50mgs Pure Encapsulations in P5P form (most bioavailable form, according to Examine.com), and I'm on day 3 taking it twice per day so as to not exceed 100mgs (do your own research before trying, of course) daily, and it's really 'dialing me in' much better, taking out some remaining ADHD rough edges, specifically on time management, task completion and motivation/energy. 60 capsules were $20 on AMZ, so it happens to be very cost efficient as well! Bonus.

Every bit helps. I hope this does too.

Be well. Godspeed.

[STEM_Dad]

UPDATE:After a week on bupropion (generic Wellbutrin), I find that it treats my inattentive symptoms about as much as atomoxetine did.

I asked to switch meds because I have struggled tremendously to be motivated to do things that I know I need to do.

It seems to be helping with motivation. I didn't feel any different this morning, but I was able to get out of bed easily...5 minutes before my first alarm went off!

I also washed a sink-full of dishes, which is something that I've never had the motivation to do at breakfast time again.

I also was able to get into the shower earlier, took a faster shower than usual, got myself dressed and ready quicker than usual, and almost got out the door in time.

...I was 15 minutes late to work. Typically, I'm 30-60 minutes late, and then stay late to make to the time.

~~~~~

I started off my day feeling better than usual. I started the day feeling better than I usually do.

However, all this new capability seems to have tapered off since lunch, and now I'm floundering as I normally do.

Maybe I hit my limit. I'll have to continue to track how I'm doing on this new medication.

.....

I don't feel any differently, but I think that I was doing better at a lot of things this morning.

[STEM_Dad]

Update on how bupropion (generic Wellbutrin) is working for me.

It seems to help my ADHD symptoms about as well as atomoxetine (generic Strattera) did for the last 3 years.

I think it also helps me out a little with mood. My mood hasn't seemed to feel as "low" or as "rough" as it used to. It's not that I don't experience low moods, but they just aren't quite as bad as before.

It's like going camping where the ground is rough and bumpy, and sleeping on top of a one inch thick foam pad. The ground will still be bumpy; I would still feel every bump and dip, but I would be slightly raised and the roughness of the turf would be smoothed out, I wouldn't feel every little pebble.

However, I'm wondering if my emotions are a little blunted...just a little. I don't know if it's a reaction to the medication or a reaction to life circumstances, but I seen to be a little more distant from other people. (Just a little, not to a point that it's detrimental. I still feel a lot of empathy for others, but it feels like that might be a little padded, too. That might be a good thing, since I tend to be affected by others' emotions too easily.)

I'll continue the medication trial. (My doctor prescribed a 90 day supply for the 30 day trial that I requested.)