Meh. What to do?

[PolkaDotCom]

Just another update: I went back to the doc last night and told him I'm really pleased with the Wellbutrin for the ADHD-related depression, especially since all of the side effects have finally worn off. He asked about concentration and I told him I'm not doing so well with it and that the Wellbutrin really wasn't doing anything for it. He reminded me he knew I didn't like Strattera, and in order to prescribe a stimulant I'd have to have a whole cardiovascular workup because he says they can seriously affect your heart rate, etc. He also said that they will not work with the Wellbutrin so I would have to stop taking it. He then prescribed me Buspar for my irritability.

I'm beginning to think I don't really have ADHD, or maybe that this guy is a crock. I'm not really into asking for certain drugs, because he's supposed to be the expert, but why would he say that Wellbutrin is incompatible? I wanted to ask for Vyvanse, because it's supposedly the less-stigmatic of the stims, good for adult ADHD, and is on the right tier of my prescription policy. I know my brain doesn't work right, and I don't want to be one of those people who insist they have ADHD because they meet symptom A, B, and D and want to know what to expect at the doctor or how to tell him they have ADHD because they want Adderall or Ritalin or Concerta, or because they can't concentrate or read or whatever so they think going to doctor will give them magic pills. So I am beginning to think I really don't have it. Sure, I meet the diagnostic criteria, but what would you guys do? I want to keep taking my Wellbutrin because I feel it works well for me, but I also want a medication that will take away my mind's sporadic thought processes, my subconscious leg shaking, fidgeting and jaw clenching. I want there to be something that will help me to eagerly read my schoolbooks, to be excited to learn, to be passionate about what I am learning about. I want to be able to write with the emotion I feel and with my brain following suit. I want to be able to carry on a conversation with someone without the thought of what's for dinner tonight popping into my head or whether or not I have something on my face. I want to actually finish a sentence or thought when I'm offering my sister advice on her boy troubles. I'm willing to do anything to fix this situation so my brain works normally and I can be the thoughtful, intelligent, and smart person my soul most certainly is but my brain chemistry prevents from shining through.

It's taking me a while to write this because I'm not exactly sure I know what I want to say or how I want to say it; and my mind keeps getting pulled away to do other things. Text messages keep coming in, emails are coming to my phone "What is the plan for tonight," the radio is on and my mind is singing along and my knees are moving sideways to the beat; more and more internet tasks come into my mind. This is what I want to be able to accomplish. I want to sit down to write a thoughtful, intelligent post about how I feel and what I want to do and just finish it, from start to finish, without stopping to do unrelated tasks. I am willing to do anythning to have this kind of task become part of my everyday life, and I will take whatever medication I need to take, see whatever doctor I need to see, and read whatver book I need to read. I don't want to feel like I'm oppressed or my abilities (or disorders) doubted.

I'm sorry for the rant (vent). I came here because I know a lot of you guys on here are smart and will be able to offer me decent advice. What would you do? Seek a 2nd opinion? Take the drugs prescribed and just continue treatment as prescribed by the doc? Read more books?

[Coldhandedman]

When you mix a stimulant with a antidepressant, you can get whats called Seratonin Syndrome. Which, can be fatal.

I can't take an antidepressant like Citalopram with Adderall, or that would happen.

It is always a good idea to research drug interactions and take the advice of a doctor.

Serotonin Syndrome is a potentially life-threatening adverse drug reaction that may occur following therapeutic drug use, inadvertent interactions between drugs, or the recreational use of certain drugs. It is most commonly referred to as serotonin syndrome, but the terms serotonin toxicity or serotonin toxidrome are more accurate as they reflect the fact that it is a form of poisoning.^[1][2] Rarely it may also be called serotonin storm, hyperserotonemia, or serotonergic syndrome.
Serotonin syndrome is not a spontaneous drug reaction; it is a consequence of excess serotonergic activity at central nervous system (CNS) and peripheral serotonin receptors. This excess serotonin activity produces a specific spectrum of clinical findings which may range from barely perceptible to fatal.^[3]

[PolkaDotCom]

I don't take Citalopram. I take Wellbutrin, and Wellbutrin doesn't affect serotonin.

Not to be rude, but I'm looking for advice on what to do about my situation involving diagnosis and doctor, and maybe to see if anyone else feels the same way.

Thanks for your reply, CHM. It is most appreciated.

[Coldhandedman]

Originally Posted by PolkaDotCom

I don't take Citalopram. I take Wellbutrin, and Wellbutrin doesn't affect serotonin.

Not to be rude, but I'm looking for advice on what to do about my situation involving diagnosis and doctor, and maybe to see if anyone else feels the same way.

Thanks for your reply, CHM. It is most appreciated.

My bad.

[wifeandmom]

Find another doctor with more experience treating AD/HD. Lots of people on the boards take Wellbutrin with a stimulant. My 17 yr old DD is on 40 mg Adderall XR am, 10 mg Adderall IR pm booster and just started Wellbutrin 150 mg this month (about 2 weeks ago). It has definetly evened out her moodiness. We haven't seen any adverse reaction, nor has she reported any to us.

She took Vyvanse this past year and it made her very pleasant and mellow, but she really needs the stimulation of the PNS that the left (levo) isomer in Adderall provides. On Vyvanse, she was dreamy and Winnie the Poo; she needs a little more Tigger. : D

[PolkaDotCom]

Originally Posted by wifeandmom

Find another doctor with more experience treating AD/HD. Lots of people on the boards take Wellbutrin with a stimulant. My 17 yr old DD is on 40 mg Adderall XR am, 10 mg Adderall IR pm booster and just started Wellbutrin 150 mg this month (about 2 weeks ago). It has definetly evened out her moodiness. We haven't seen any adverse reaction, nor has she reported any to us.

She took Vyvanse this past year and it made her very pleasant and mellow, but she really needs the stimulation of the PNS that the left (levo) isomer in Adderall provides. On Vyvanse, she was dreamy and Winnie the Poo; she needs a little more Tigger. : D

Thanks for your input! I was leaning towards finding another doctor but don't want to get caught up in any kind of mess. Thanks again!

[griwei]

I think it's important for us to recall a basic premise of pharmacology: individuals react differently to medications. Yes, some people may suffer from serotonin syndrome if they ingest too much Citalopram and Adderall (or very much at all). By contrast, I currently take 40 mg of both daily, plus 150 mg of Buproprion - all properly prescribed and monitored.

As it turns out, in my individual case, Adderall is the most effective for me to improve focus (treating my ADHD) and reduce impulsiveness, in addition to the Buproprion (again, treating my ADHD). The Citalopram is taken profilactically - to prevent the dysthymia that Adderall creates. Without it, I could not stand more than 15 mg of Adderall per day, which had far too little impact upon my ADHD symptoms. With it, I can at least reach the lower range for a normal therapeutic dose (i.e. 40 mg).

And no, I have not exhibited any symptoms of serotonin syndrome!

[Captain Sanity]

Originally Posted by Coldhandedman

When you mix a stimulant with a antidepressant, you can get whats called Seratonin Syndrome. Which, can be fatal.

I can't take an antidepressant like Citalopram with Adderall, or that would happen.

It is always a good idea to research drug interactions and take the advice of a doctor.

Serotonin Syndrome is a potentially life-threatening adverse drug reaction that may occur following therapeutic drug use, inadvertent interactions between drugs, or the recreational use of certain drugs. It is most commonly referred to as serotonin syndrome, but the terms serotonin toxicity or serotonin toxidrome are more accurate as they reflect the fact that it is a form of poisoning.^[1][2] Rarely it may also be called serotonin storm, hyperserotonemia, or serotonergic syndrome.
Serotonin syndrome is not a spontaneous drug reaction; it is a consequence of excess serotonergic activity at central nervous system (CNS) and peripheral serotonin receptors. This excess serotonin activity produces a specific spectrum of clinical findings which may range from barely perceptible to fatal.^[3]

Not really, that's incredibly unlikely even at large doses. You will go manicky through the ceiling and stop long before you get serotonin syndrome.

[ikgbixcal]

wellbutrin and adderall work wonders for me no more depression at all and add symptoms have ceased

[chowmix]

I'm on celexa, wellbutrin, and concerta as prescribed by a doctor and have been having wonderful results reducing my GAD/OCD/ADD symptoms.

Still adjusting dosages, but I think these things usually need adjusting over time.