View Full Version : SSRIs vs Wellbutrin for co-morbid ADD

09-29-13, 01:01 PM
A little bit of background (TL;DR at the very bottom)

I started treating my ADD about a year ago though I've had it since a child (I'm 21 now) I never believed it was real until I started becoming more self aware. I got started off on 10mg Adderall XR, I lost a lot of weight and it was causing me a lot of anxiety so I ended up switching to 10mg Dexedrine XR which I asked for since I read it's not so edgy. It was a lot better but the 12 hour commitment was hell so I switched to the 10mg IR tablets which seem to be the best stimulant for me. I like knowing I have the option of only being medicated for 4 hours as opposed to 10-12. Dexedrine has been a god send in my life, though it's extremely taxing on my body and my mental health. Some days it will go smoothly, other days it will give me terrible anxiety, headaches, and body aches from being tense all day. Messes with my appetite still, too. I take it as little as possible, 2 a day for school, one tablet split into 2 doses for work, and not at all on my off days. I love what it does for me, absolutely HATE the side effects.

I have what I identify with as seasonal depression, though I live in Hawaii so it has nothing to do with the weather, but every time around fall and winter my life seems to get moldy, my anxiety gets worse and I start to get a little depressed. About this time last year I was just starting one of the worst bouts of depression of my life, and now I'm starting to feel it again. I'm just looking for something to help me knuckle down and get through this. I don't want to turn to drugs and alcohol. I work out, eat as a second job, take a protein, L-glutamine, and amino supplement, and 100-200mg of 5-htp about twice a week.

I talked to my Psychiatrist about starting on some kind of anti-depressant, he never diagnosed me with depression but he told me that people with ADD often suffer from depression and anxiety and that it's common for them to take something for it. He gave me the option to start with an SSRI, SNRI, or Wellbutrin. I had done my research previously and thought an SNRI would be perfect, but he made a very convincing argument for me to try an SSRI first, since it's the standard first line of treatment. I've been on Lexapro for 4 days now, and I really don't like it. It makes my ADD symptoms worse, I can't focus on anything, can't get engaged with anything. I feel very spaced out, I don't really care about anything. while I don't necessarily feel bad, I don't feel good either. I feel very detached, and in a weird way it actually makes me feel worse because of that. I feel like I'm trapped or something, everything seems very plastic and bland. I want to say it's terrible but like I said, technically I don't feel terrible. I feel existentially bad. Keeps me up at night or makes me sleep very lightly, messes with my stomach and bowel movements, sexual dysfunction.

My questions
I'm going to talk to my psychiatrist again soon, but I'm just curious as to what's worked for people before. I've read that Wellbutrin works great for a lot of people for treating their co-morbid ADD symptoms, so I'm going to ask for it. What does it feel like? How has it helped you? What are some of the pros and cons for you? How is it by itself without a stimulant? Would the Wellbutrin work better alongside the SSRI or just replace it? Sorry, I don't know how to ask what I want to know, so anything helps.

In your experience, is an SSRI or Wellbutrin better for your co-morbid symptoms? What are some of the pros and cons of both? Do you take both? How do they feel alongside a stimulant like Dexedrine or Adderall?

09-30-13, 12:57 PM
I know that Adderall and Wellbutrin is a good mix for one of my friends. just, to answer your last question. Another thing I would say is one, good that you're on top of this, and two primary care physicians are not the best at dealing with medicines. Specialists might get you to a better combo more quickly. But, maybe not, it depends on the doctor. :)

01-07-14, 12:49 AM
Ok standard SSRI antidepressants, can activate various negative acting serotonin subreceptors. For example activation of 5-HT2c or 5-HT7 is associated with reduced functioning in the prefrontal cortex area (probably Medial part? Areas that govern emotional regulation).

Caution with SNRI and stimulant. I did this on Ritalin and felt profoundly agitated with this combination. Stimulants have powerful effects on Noradrenalin, potential interaction.

If you are suffering from anxiety from stimulants, I mean standard treatment is Clonidine?

Clonidine reduces most, if not all of the physical and anxiety side effects of stimulants in most people, though the dose must be very gradually worked up. IT can also FURTHER help treat ADHD symptoms (improving outcome).

In regards to the SSRI side effects. In general though, your brain will down regulate the serotonin receptors and typically neutralize most side effects within a couple to a few weeks.