Hope you experienced souls can help us out!

My teen daughter with adhd is doing pretty well on Wellbutrin XL 300mg at 9am plus Strattera 40mg at 9am and 7pm (taking all the Strattera at once made her zone out).

Her doctor is now trying to help her fine-tune, to alleviate two key problems:
1 - she's having trouble functioning in the morning before her a.m. meds kick in (note, she can't take them any earlier than 9am because she can't stomach breakfast before 8:30)
2 - in the early afternoon she can get overly driven, less social, and easily stressed/anxious

Because she's doing well academically, no one wants to make too drastic a change unless we have to, so the first "baby step" the doctor is suggesting is to switch the once-a-day XL 300mg to twice-a-day 150mg SR OR XL. I know the XL is not usually taken twice a day, but the thought is that it might be slightly less agitating and at the same time, let her wake up with some still in her system.

(BTW, I know not everyone does well on the Wellbutrin/Strattera combo because they both act on noripenephrine; if adjusting the Wellbutrin does not pan out, the next step will be to begin adjusting the Strattera)

Anyone have experiences that could shed light on this particular twice-a-day SR vs. XL question?

Some people take Welbutrin XL in the PM and find it is very beneficial for them the next day, when waking.

If you tried this once and it caused wakefulness (insomnia) check to see if you were using the generic (Teva) Wellbutrin. The generic releases more in the first few hours and so it causes a different response. The non-generic is released more evenly over time.

I take the SR in the AM, just once per day. I feel it take effect after about 45 minutes and it builds over the next few hours. The "peak" seems to be between hours 3 and 6, then it subsides. So I think the twice a day SR may be about the same as the once a day AM XR, in terms of onset, but maybe its a bit sooner.

My assessment is that it would have an impact more in the afternoon than in the AM. That may be a plus there though. If falling asleep was a problem, because of the mild stimulant effect, it may return under that scenario. But she could take the PM dose early in the PM.

She my also tolerate taking the Wellburtin prior to breakfast (as soon as she wakes). Then she could take the Strattera with breakfast. Wellbutrin is usually easier to tolerate on an empty stomach and isn't an appetite suppressant. The second dose of Wellbutrin SR can be taken eight hours later. That may help both the AM and the afternoon.

The other thing you may want to do is to add is a very low dose of Dexedrine in the AM. The onset would be within 30 minutes and it may be just the thing to trigger a better AM experience. It could be a very low dosage.

I am not a Dr., but I am more or less facing the same challenges and have been looking ahead with regard to my own choices.

It seems it will come down to experimenting a bit. You may find the best approach is an AM IR followed by an afternoon SR dose. Those two could be just six hours apart, I believe, maybe even less. If you switched to an AM IR you may even drop that dose to 100 mg., as it seems it may be more easily absorbed.

Good luck:)