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

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:angel: :wave:

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