Wellbutrin XL: Some Benefits So Far

I have been taking Wellbutrin XL for a little over two weeks now, and I've been feeling much better. While taking the Strattera, I was quite angry and nervous a lot of the time, and my blood pressure was high. Lately I've been feeling really good-- relaxed and more confident, and my blood pressure is at a more normal level. However, I am aware that it is difficult to say how much this has to do with the medication exactly.

Interestingly, I've read anecdotal accounts online of people who felt the way I did taking Strattera when they were taking Wellbutrin. Both drugs act on the dopamine pathway, so I'm guessing there might be a connection. I think that the Wellbutrin XL, since it is extended-release, might not have this "angering" effect-- that is, since the drug is released from the capsule very gradually, your system is dealing with just a little at any one time. It could also help that I'm taking a somewhat low dose. Another, perhaps even more likely, possibility is just that different medications affect different people differently, and some trial-and-error is unavoidable. I think there is a lot of research going on about Wellbutrin and ADD, and it would be good to have more scientific information. (Please, again, see my disclaimer about how you should see a doctor for any health problem. Don't rely on the Internet, including this site!)

As far as the treatment of my ADD goes, it is a little hard to say at this early point if the Wellbutrin XL has helped. I've noticed that I've spaced out more, but I can't yet say if I've been noticing it more or it has been happening more. I think that I am becoming better aware when I lose track, and it is going to take some mental exercise to utilize that improved awareness. My doctor and I are still early on with figuring out what medications would work best for me, but I continue to do the best I can.

From Strattera to Wellbutrin XR

There are two main classes of ADD medications: stimulants and antidepressants. I haven't taken neurology yet, but it appears that both drugs have the same net effect in the end: they act on neurotransmitters and/or their receptors. "Stimulants" may sound like an odd choice, but the way I understand it, they stimulate (activate) your brain's "braking" mechanisms. Stimulants have shown to be more effective than antidepressants for treating ADD, although this is a trend and there is variation person-to-person.

As a medical student, there is a perceived career risk to taking stimulants, which are subject to special legal restrictions beyond those for other prescription drugs. To be honest, I don't understand how it can be that taking legally prescribed stimulants for legitimate conditions could be risky when applying for residency, etc., but health care workers with ADD often prefer non-stimulants to be avoid such issues.

The only non-stimulant FDA-approved for ADD is Strattera. Dr. Hallowell in his new edition of Driven to Distraction (or maybe Delivered from Distraction, another book of his) went from being very hopeful that Strattera would replace stimulants, to being hopeful that Strattera would show its promise once the dosing was fine-tuned, to recommending Wellbutrin (an antidepressant) instead.

There is a lot of information online about individuals' disappointments and success stories with various drugs. With medications for mental health, it is sometimes difficult to gauge if a medication is causing a problem or if it is the complexity of life.

While taking Strattera, my emotions were all over the place, but yet some things in my personal life were also. I experienced the common side effect of queasiness, but I was generally more productive. I was still very distractable, but a decreased appetite and a reduction in feelings of anxiety helped with efficiency. However, I did not take the Strattera on a consistent schedule: I was to take it twice a day, 12 hours apart, and I frequently disturbed the schedule. Like for any drug, consistency is very important (and is a notoriously big problem for people with ADD).

There has been promising research that once-a-day Wellbutrin XR is an effective treatment for adults with ADD, and this fits with Dr. Hallowell's experience. However, Wellbutrin is not FDA-approved for treating ADD and is so prescribed "off label."

Like other antidepressants, it can take weeks before Wellbutrin (or Strattera, for that matter) makes its full effect. My physician decided with me to switch to Wellbutrin XR from Strattera instead of adjusting the Strattera dosing schedule to take it once a day. I've been very consistent taking Wellbutrin, and I feel much better emotionally. Interestingly, Wellbutrin acts an inhibitor for the enzyme that metabolizes Strattera, so the two drugs should not be taken together (or the Strattera should at least be decreased).

It is too soon to tell if the Wellbutrin XR will help me with my ADD, but I am keeping my fingers crossed. I already feel more like myself again, which makes me think that the Strattera was not working for me, at least not as I was taking it.