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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by toodlebug on July 1, 2003, at 18:43:30
I started taking Wellbutrin (for mild depression and ADD) 2.5 weeks ago. So far I have worked up from 100 mg. to 300 mg. with the goal of 400 mg. At first I noticed good improvement in my mood as well as reduced appetite, but as the dose goes up I have not noticed any more improvement. (I am hoping the Wellbutrin will help me lose the 40 pounds I gained on Effexor & Prozac.) Do I just need to give the Wellbutrin more time to work, or is this going to be all it does for me, or should I take a higher dose? If this is all the improvement I am going to see, I won't complain too much because it has done some good things and so far I have not had any problems with it at all.
I am also wondering about adding Adderall or some other stimulant to the Wellbutrin. My doctor said that was fine, but I wanted to hear more people's experiences with that. I have taken Adderall in the past, but not on a regular basis because it caused insomnia/early waking at first. I now think that was due to some Prozac still being in my system because I was very sensitive to any kind of sleep disturbance at the time. I now sleep better.
By the way, I have also tried Celexa, Paxil, Effexor, and Prozac. Celexa and Paxil were awful for me. Effexor was fantastic for the first 6 months or so but then caused some hypomania and the withdrawal was hellish. Prozac didn't seem to have much effect, but I think my body had "pooped-out" on the SSRI's by that point.)
Thanks!
Posted by craig getty on July 2, 2003, at 8:23:14
In reply to Wellbutrin dosage/adding Adderall?, posted by toodlebug on July 1, 2003, at 18:43:30
I was on 400 mg of Wellbutrin for dysthymia and added Ritalin (extended release). For the first couple of weeks ritalin gave me the additional energy boost I needed, but my tolerance to it increased rapidly. My pdoc increased the dose, and soon it wasn't giving me positive, focusing energy, but just made me feel "awake-tired", jumpy and irritable. Then I switched to Provigil (while still on Wellbutrin). The good news is that Provigil is a lot subtler, and I do not experience any speed-like crashes. The bad news is that Provigil can be too subtle, and sometimes I think it does not much more than a cup of strong coffee. I started on 100 mg of Provigil, then went up to 200 mg. My doctor told me it was o.k. to go to 400 mg - which I occassionally do - but it doesn't necessarily do anything else except mess with my stomach.
For the past month I've switched from Wellbutrin to Nardil (while still on Provigil). As far as energy goes, Nardil is a bit too much of drain for Provigil to handle so I plan on asking my doc for something to replace the Provigil. What that will be, I do not know. Open to anecdotal recommendations about Adderall or anything else.
P.S. I think that you really haven't given the Wellbutrin a chance. When I started I was on 150 mg. for about 3 weeks, then 300 for about a month until it pooped, then finally 400. The 2.5 week period you have seems too short to give the lower dosages a chance.
> I started taking Wellbutrin (for mild depression and ADD) 2.5 weeks ago. So far I have worked up from 100 mg. to 300 mg. with the goal of 400 mg. At first I noticed good improvement in my mood as well as reduced appetite, but as the dose goes up I have not noticed any more improvement. (I am hoping the Wellbutrin will help me lose the 40 pounds I gained on Effexor & Prozac.) Do I just need to give the Wellbutrin more time to work, or is this going to be all it does for me, or should I take a higher dose? If this is all the improvement I am going to see, I won't complain too much because it has done some good things and so far I have not had any problems with it at all.
>
> I am also wondering about adding Adderall or some other stimulant to the Wellbutrin. My doctor said that was fine, but I wanted to hear more people's experiences with that. I have taken Adderall in the past, but not on a regular basis because it caused insomnia/early waking at first. I now think that was due to some Prozac still being in my system because I was very sensitive to any kind of sleep disturbance at the time. I now sleep better.
>
> By the way, I have also tried Celexa, Paxil, Effexor, and Prozac. Celexa and Paxil were awful for me. Effexor was fantastic for the first 6 months or so but then caused some hypomania and the withdrawal was hellish. Prozac didn't seem to have much effect, but I think my body had "pooped-out" on the SSRI's by that point.)
>
> Thanks!
Posted by Penny on July 2, 2003, at 8:31:20
In reply to Wellbutrin dosage/adding Adderall?, posted by toodlebug on July 1, 2003, at 18:43:30
> I started taking Wellbutrin (for mild depression and ADD) 2.5 weeks ago. So far I have worked up from 100 mg. to 300 mg. with the goal of 400 mg. At first I noticed good improvement in my mood as well as reduced appetite, but as the dose goes up I have not noticed any more improvement. (I am hoping the Wellbutrin will help me lose the 40 pounds I gained on Effexor & Prozac.) Do I just need to give the Wellbutrin more time to work, or is this going to be all it does for me, or should I take a higher dose? If this is all the improvement I am going to see, I won't complain too much because it has done some good things and so far I have not had any problems with it at all.
Might be all it does, but I would give it a little more time and an increased dose to be sure. If you are satisfied with that, then keep going. If not, perhaps your doc can augment with something, like an antipsychotic with antidepressant qualities (I take Geodon).
>
> I am also wondering about adding Adderall or some other stimulant to the Wellbutrin. My doctor said that was fine, but I wanted to hear more people's experiences with that. I have taken Adderall in the past, but not on a regular basis because it caused insomnia/early waking at first. I now think that was due to some Prozac still being in my system because I was very sensitive to any kind of sleep disturbance at the time. I now sleep better.Any particular reason you want to add a stimulant? I have been having a lot of trouble staying awake and concentrating (I take a Zoloft-Wellbutrin-Geodon-Lamictal combo), but my mood had been stable for a good while - several months - so my doc agreed to take me off the Geodon and start me on Adderall, with the understanding that a possible side effect is depressed mood. I was only on Adderall for a week when my mood dropped drastically. Not to mention that it made me SLEEPY!!! Wasn't a stimulant for me at all. Needless to say, doc took me off of Adderall immediately and started me back on Geodon, and increased my Zoloft, but now my mood is highly unstable and I am once again in a depressive state. Not fun... Doc had tried me on Provigil first for the sleepiness, and it was great for a while, but then pooped out.
>
> By the way, I have also tried Celexa, Paxil, Effexor, and Prozac. Celexa and Paxil were awful for me. Effexor was fantastic for the first 6 months or so but then caused some hypomania and the withdrawal was hellish. Prozac didn't seem to have much effect, but I think my body had "pooped-out" on the SSRI's by that point.)
Yeah, I have been on Celexa, Paxil (which was horrible for me), Effexor (which worked but flattened my mood tremendously, then was TERRIBLE coming off of!) and Lexapro - and now Zoloft. Never did try Prozac, but I don't respond well to the straight SSRIs either - they have to be augmented with something.Good luck!
Posted by toodlebug on July 2, 2003, at 10:23:05
In reply to Re: Wellbutrin dosage/adding Adderall? » toodlebug, posted by Penny on July 2, 2003, at 8:31:20
>Any particular reason you want to add a stimulant?
For the ADD-- to help me focus and to further improve mood and energy. I had been taking it on the weekends only the past few months (so I could be a "weekend warrior") and it has been great. I quit taking it when I started on the Wellbutrin because I have been a little concerned about taking it with the Wellbutrin despite my doctor's ok. All the talk of seizures, etc. freaked me out.
Posted by the blue professor on July 7, 2003, at 1:25:17
In reply to Re: Wellbutrin dosage/adding Adderall?, posted by toodlebug on July 2, 2003, at 10:23:05
I take 400mg Wellbutring (200mg BID), 20mg Lexapro and 20mg dexadrine. The lexapro & WB are for depression and the dex for ADD.
It is a pretty good combo. The dexadrine helps the ADD symptoms a little, but makes me drowsy. I seem to be a little strange responding to the stimulants as most people tell me that that much dexadrine would keep them up for 24 hours.
Posted by toodlebug on July 7, 2003, at 15:08:08
In reply to Re: Wellbutrin dosage/adding Adderall?, posted by the blue professor on July 7, 2003, at 1:25:17
Well I tried 20 mg. Adderall with the Wellbutrin this weekend and it was fine. It helps more with the ADD than the Wellbutrin alone. I need the additional activation and focus that Adderall provides. I don't take it every day, though, because after several days it starts to interfere with my sleep, so I only take it on the weekends and on a few weekdays.
I find it sort of interesting that unlike most people my big problem with ADD is on the weekends. I have tons of household chores and without Adderall I get nothing done at all. I just sit around like a lump and end up getting depressed at my inactivity. When I do get started on a task, I feel overwhelmed by it and either don't do it, get bogged down in some detail and make no progress on the project, or get distracted by something else and do that instead. Or I try to do much and end up with half a dozen half-finished projects and my house looks worse than it did to start with. Then I don't want to let anyone into my house because I am so embarassed by its disorder which then adds to my isolation and depression. With the Adderall I am a regular Weekend Warrior! I am sometimes too busy with chores to socialize, but at least I am doing something and at least once in a while have people over. At my job, there is enough structure that I am able to get enough done to please my boss without any chemical help. But then, I have always been sort of a work/school focused person. Kind of an atypical ADD sufferer. It took me a long time to get diagnosed.
Posted by Craig Getty on July 9, 2003, at 0:37:03
In reply to Re: Wellbutrin dosage/adding Adderall?, posted by toodlebug on July 7, 2003, at 15:08:08
Thanks for sharing your experience. I can relate to what you're saying about needing additional focus and feeling overwhelmed - I believe that I, too, have (limbic) ADD symptoms. I had added Ritalin to my Wellbutrin, but the benefits didn't last that long and just made me moody. I then added Provigil, which seemed to work though not completely satisfactorily.
Eventually Wellbutrin pooped out for my dysthymia so now I am on Nardil, which the jury is still out on. The Provigil has become less effective so maybe I'll take your example and ask my pdoc about Adderall.
> Well I tried 20 mg. Adderall with the Wellbutrin this weekend and it was fine. It helps more with the ADD than the Wellbutrin alone. I need the additional activation and focus that Adderall provides. I don't take it every day, though, because after several days it starts to interfere with my sleep, so I only take it on the weekends and on a few weekdays.
>
> I find it sort of interesting that unlike most people my big problem with ADD is on the weekends. I have tons of household chores and without Adderall I get nothing done at all. I just sit around like a lump and end up getting depressed at my inactivity. When I do get started on a task, I feel overwhelmed by it and either don't do it, get bogged down in some detail and make no progress on the project, or get distracted by something else and do that instead. Or I try to do much and end up with half a dozen half-finished projects and my house looks worse than it did to start with. Then I don't want to let anyone into my house because I am so embarassed by its disorder which then adds to my isolation and depression. With the Adderall I am a regular Weekend Warrior! I am sometimes too busy with chores to socialize, but at least I am doing something and at least once in a while have people over. At my job, there is enough structure that I am able to get enough done to please my boss without any chemical help. But then, I have always been sort of a work/school focused person. Kind of an atypical ADD sufferer. It took me a long time to get diagnosed.
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