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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by jode on August 17, 2006, at 8:15:52
I've been on Wellbutrin XL 450mg (depression) for about 6 months and my dr just added Concerta 54mg (ADD - finally!). I take the Wellbutrin when I wake up around 6-7 but he says I have to wait till around noon to take the Concerta. I've been on it for a week and I'm already forgetting to take it. If I take it after lunch time I'm up till well past midnight, have to take sleeping pills to get to sleep then I don't want to get out of bed in the morning.
I called Jannsen-Ortho, the makers of Concerta and they don't have any information on why Wellbutrin would interact with Concerta. Wellbutrin isn't tryciclic or an MAOI which will interact. I've talked to two pharmacists and neither of them know "why" to wait, just that it's recommended. I did read on one site that taking them together may increase the effects of the Wellbutrin. In my case I don't think that's a bad thing.
Does anyone else take these medications and can answer my questions? ANY responses would be very helpful!!
Jode
Posted by SLS on August 17, 2006, at 8:36:45
In reply to Can I take Concerta and Wellbutrin at once?, posted by jode on August 17, 2006, at 8:15:52
> I've been on Wellbutrin XL 450mg (depression) for about 6 months and my dr just added Concerta 54mg (ADD - finally!). I take the Wellbutrin when I wake up around 6-7 but he says I have to wait till around noon to take the Concerta. I've been on it for a week and I'm already forgetting to take it. If I take it after lunch time I'm up till well past midnight, have to take sleeping pills to get to sleep then I don't want to get out of bed in the morning.
> I called Jannsen-Ortho, the makers of Concerta and they don't have any information on why Wellbutrin would interact with Concerta. Wellbutrin isn't tryciclic or an MAOI which will interact. I've talked to two pharmacists and neither of them know "why" to wait, just that it's recommended. I did read on one site that taking them together may increase the effects of the Wellbutrin. In my case I don't think that's a bad thing.
> Does anyone else take these medications and can answer my questions? ANY responses would be very helpful!!
> Jode
Hi Jode.If you decide to take the Concerta in the morning, you might want to shift 150mg of Wellbutrin to the afternoon to reduce the risk of seizure, even though the risk of seizure with Concerta alone in non-epileptics has not been well established. It is probably a good practice to split the 450mg dosage anyway.
- Scott
Posted by jode on August 17, 2006, at 9:26:03
In reply to Re: Can I take Concerta and Wellbutrin at once?, posted by SLS on August 17, 2006, at 8:36:45
> > I've been on Wellbutrin XL 450mg (depression) for about 6 months and my dr just added Concerta 54mg (ADD - finally!). I take the Wellbutrin when I wake up around 6-7 but he says I have to wait till around noon to take the Concerta. I've been on it for a week and I'm already forgetting to take it. If I take it after lunch time I'm up till well past midnight, have to take sleeping pills to get to sleep then I don't want to get out of bed in the morning.
> > I called Jannsen-Ortho, the makers of Concerta and they don't have any information on why Wellbutrin would interact with Concerta. Wellbutrin isn't tryciclic or an MAOI which will interact. I've talked to two pharmacists and neither of them know "why" to wait, just that it's recommended. I did read on one site that taking them together may increase the effects of the Wellbutrin. In my case I don't think that's a bad thing.
> > Does anyone else take these medications and can answer my questions? ANY responses would be very helpful!!
> > Jode
>
>
> Hi Jode.
>
> If you decide to take the Concerta in the morning, you might want to shift 150mg of Wellbutrin to the afternoon to reduce the risk of seizure, even though the risk of seizure with Concerta alone in non-epileptics has not been well established. It is probably a good practice to split the 450mg dosage anyway.
>
>
> - Scottthis morning I took the Concerta first (almost an hour ago) and I'll take the Wellbutrin shortly. I take 3-150mg pills at once. I used to take 150mg in the morning and 150mg at lunch but like the Concerta, I was always forgetting the second pill so the doctor said to take it all at once. I babysit during the day so things here are hectic to begin with. I have no risk of seizure so I'm not really concerned in that aspect. I just have NO memory so splitting up the pills doesn't work for me. I think I'm going to call GlaxoSmithKline and see what they have to say about interactions.
Jode
Posted by SLS on August 17, 2006, at 9:38:02
In reply to Re: Can I take Concerta and Wellbutrin at once? » SLS, posted by jode on August 17, 2006, at 9:26:03
> I think I'm going to call GlaxoSmithKline and see what they have to say about interactions.
Please let us know what they have to say.
- Scott
Posted by llrrrpp on August 17, 2006, at 9:42:59
In reply to Re: Can I take Concerta and Wellbutrin at once? » SLS, posted by jode on August 17, 2006, at 9:26:03
Hey Jode,
Can you set the alarm on your cell phone to have a daily reminder at noon?Or, can you put it in your lunch bag?
Or, can you put it in your purse/wallet- so that you when you have to buy lunch or a cold drink or something around noon it will be a reminder to take your pill/s?
I think you can probably incorporate some kind of fairly minor change to help remind you. And given what SLS wrote about seizures, I definitely think that some behavioural change is probably better than chancing it with a large dose of an activating AD + a stimulant.
Just a thought, from a perenially disorganized person. I finally figured out how not to lose my keys and wallet in my house- I just leave it in my backpack!
And another thing I do is that I keep all my electronic stuff plugged into one power cord, that way I never lose my cell-phone charger, my camera battery charger, my ipod charger, my computer charger, etc.
good luck- and I'm so happy that the meds are helping you :o)
-ll
Posted by jode on August 17, 2006, at 10:04:19
In reply to Re: Can I take Concerta and Wellbutrin at once?, posted by SLS on August 17, 2006, at 9:38:02
I just got off the phone with GSK and his suggestion is to call my dr asap because the 2 meds shouldn't be taken together (even if I wait a few hours) because they both work on the same two neurotransmitters. ie - one counteracts the other. I'm medically challenged when it comes to terminology but he did refer to dopamine and 'methylphindate'?(or somthing like that) He also said both of them carry the risk of seizures so I'm doubleing/tripleing my chance of having one.
That sucks because I like the fact that Concerta keeps me awake during the day and the Wellbutrin gives me the boost I need to want to get up each day.
I think I'll do a bit more research then call my dr. this afternoon.
Jode
Posted by jode on August 17, 2006, at 10:10:08
In reply to Re: Can I take Concerta and Wellbutrin at once? » jode, posted by llrrrpp on August 17, 2006, at 9:42:59
those are very good ideas but...
1 - I don't have a cell phone, ipod, charger, none of it. I'm from the dark ages and besides, I'd lose it or just not use it.
2 - since I babysit I'm so busy making lunches for everyone else that my needs come last. Quiet time is around 2pm (nap time!!) so that's when I get my break and by then it's too late.
I know it sounds like I'm just making excuses but from what I wrote in my last thread I just may not be taking both the meds anyway.
Jode
Posted by silvercoin on August 17, 2006, at 12:46:03
In reply to Can I take Concerta and Wellbutrin at once?, posted by jode on August 17, 2006, at 8:15:52
> I've been on Wellbutrin XL 450mg (depression) for about 6 months and my dr just added Concerta 54mg (ADD - finally!). I take the Wellbutrin when I wake up around 6-7 but he says I have to wait till around noon to take the Concerta. I've been on it for a week and I'm already forgetting to take it. If I take it after lunch time I'm up till well past midnight, have to take sleeping pills to get to sleep then I don't want to get out of bed in the morning.
> I called Jannsen-Ortho, the makers of Concerta and they don't have any information on why Wellbutrin would interact with Concerta. Wellbutrin isn't tryciclic or an MAOI which will interact. I've talked to two pharmacists and neither of them know "why" to wait, just that it's recommended. I did read on one site that taking them together may increase the effects of the Wellbutrin. In my case I don't think that's a bad thing.
> Does anyone else take these medications and can answer my questions? ANY responses would be very helpful!!
> Jode
The Wellbutrin XL is a very slow release formulation, and I don't think it particularly matters when you take it in relation to the Concerta. The larger question is whether it was a prudent decision to prescribe these drugs simultaneously, and I think that it is open to question. I guess I would personally take a dim view of the combination, but no doubt there are people for whom it has worked and who haven't suffered any ill effects from it.Todd
Posted by Phillipa on August 17, 2006, at 18:21:35
In reply to Re: Can I take Concerta and Wellbutrin at once?, posted by silvercoin on August 17, 2006, at 12:46:03
Did a pdoc prescribe them for you? If so have you called and told him what Glasco Kline said. Love Phillipa
Posted by jode on August 17, 2006, at 18:59:03
In reply to Re: Can I take Concerta and Wellbutrin at once?, posted by Phillipa on August 17, 2006, at 18:21:35
the dr I've been seeing for the past year prescribed them both. Over the last 5 years I've been on Celexa, Zoloft, Wellbutrin and now Concerta. I did more research online after I talked to GSK and from what I can tell, it's not the fact that they work on the same neurotransmitters, it's that they can both bring on seizures that's the big problem. I KNOW they work when I take them both because I took the Concerta first thing this morning but only took 300mg of Wellbutrin this afternoon. Right now I'm agitated but at the same time I'm so restless I can't get anything done. I'm crying over tv commercials and I can't remember the last time I cried. I'm going to call the dr in the morning to see what he says.
Jode
Posted by Racer on August 17, 2006, at 21:25:54
In reply to Re: Can I take Concerta and Wellbutrin at once? » Phillipa, posted by jode on August 17, 2006, at 18:59:03
My pdoc had me reduce the Wellbutrin XL to 300 when I started the methylphenidate, but she told me to take the WB in the morning, along with one Ritalin (changed to Concerta later), and then another Ritalin at noon or thereabouts. (Concerta is long acting Ritalin, by the way.)
For what it's worth, I'm curious about why your pdoc would suggest taking a long lasting stimulant at noon. That seems like a good way to induce sleep problems... But, I didn't go to med school...
That's all anecdotal, but I hope it helps. Good luck, and do let us know what your doctor says.
Posted by alohashirt on August 20, 2006, at 21:01:46
In reply to Re: Can I take Concerta and Wellbutrin at once? » Phillipa, posted by jode on August 17, 2006, at 18:59:03
Many years ago I tried a friend's Concerta when on Wellbutring for ADHD. When my pdoc later prescribed Concerta I was no longer on Wellbutrin. Two points - timing and combinations:
1. I always took Concerta as soon as I awoke - one of the disadvantages of Concerta, that Focalin XR improves on is that Concerta has greater concentration of methylphenidate (the active ingredient) in the second burst. I work very long hours an dteh nine hour effect of Concerta was never enough. I would take Concerta at 7.00am then another Metadate CD, which is a five hour "medium term" methylphenidate at 2.00pm.
2. For a long time I combined Concerta with Dexedrine which was very helpful. I couldn' be on a full dose of Dexedrine because it induced hypertension in me.I have always found it hard to get a straight answer as to whether two ADHD meds would compete, be linearly additive or be complementary/synergistic. This field of psychiatry/psychopharmacology still seems very primitive and the accepted wisdom seems rarely to be evidience based or reliable. Maybe in 400 years there will be no need for a psycho-babble because we will all have the brain equivalent of a pacemaker that autotunes our wiring for us?
This is the end of the thread.
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