Wellbutrin and Dexedrine

[magdelaine]

I'm posting this in the hope that it will help someone else, as reading everyone else's posts have been helpful to me.

I was dx with ADD in April of this year (inattentive with hyperfocus). Because of some depression and anxiety, the doc prescribed Wellbutrin 150XL to see if that would help. Pretty much right away, I noticed a big difference. For the first time that I could remember I had a quiet moment in my mind, one that wasn't filled the voice I could never silence. The depression went away, and once the hyperfocus voices were quieted my anxiety went way down.

I was able to concentrate enough to make more progress on various projects than I've been able to in a long time. Part of it was being able to see the whole thing rather than just parts, part of it was the result of silencing the voices...which could be very critical. I didn't need to be perfectionist, I could just work on a job.

Another thing that improved a lot on the Wellbutrin was the social anxiety that I didn't realize I had until it wasn't there any more. It actually had a very big impact on my life and made many aspects of it difficult, like responding to student emails (I teach online), or grading, or simply leaving the house to shop. That is pretty much gone when I'm on WB.

After being on the 150 for about 6 weeks, I felt like the WB wasn't doing as much as it was in the beginning. And although I felt a lot better in many areas on the Wellbutrin, it didn't improve my focus as much as I'd hoped. After researching, I decided to ask my doc for Dexedrine in addition to the WB and he agree.

When I first started taking the Dexedrine with the WB, it was a complete disaster. I took 10mg Dex with my 150 at the same time, in the morning, and after the first few days it gave me a terrible headache that made me feel like I had an iron pot on my head. My peripheral vision was non-existent and my hyperfocus came back with a vengeance. Forget working on the computer. That was impossible. But I sure could clean and organize! Whew.

Anyway, I stopped trying to take the Dexedrine. I still needed something more, though, I could feel it. Since I knew that the therapeutic dose of WB for ADD is 300mg, I started taking that in the morning instead of the 150mg. That improved things a lot; it brought back how I felt on WB when I first started it but it didn't really do any more for focus.

I then started to experiment with the Dexedrine, and through a lot of trial and error I discovered that taking with Dexedrine by itself made my ADD much better, but after a couple of days the depression and social anxiety would come back. I then tried something I read here on the forum about taking the Dexedrine hours before the Wellbutrin, and success!

I now have the benefits of focus and an "awake" brain along with reduced hyperfocus, depression, and social anxiety. Wow! So this is what it feels like to be normal, whatever that is. I still have ADD, but it doesn't impair me much any more (even if it does give my family plenty to tease me about).

I take 10mg Dexedrine in the morning with my decaf coffee, 300mg WB at lunch, and if I need to work into the evening I'll take another 10mg at around 3 or 4. It doesn't seem to interfere with sleep, even if I take it as late as 6pm. Some days I will forgo the Dexedrine altogether and just be my fuzzy self.

In any case I just wanted to let people know that sometimes it takes a lot of patience and some experimentation to get things figured out, even if you know you are on the "right" medication.

[Mincan]

You have it backwards, hyperfocus is how our brain is supposed to be, it's obvious you will run into depression and anxiety if you go against how you are supposed to be.

[magdelaine]

You can only say that by having not been in my head during hyperfocus!! It's the difference between being driven (hyperfocus) and being the driver. I'd rather be the driver.

[hollywood]

mag,

are you using the term peripheral vision as an analogy in this example. Meaning when you first were on the combo of dex and wellbutrin you had no ability to shift tasks and all you could do was simply hone in on whats in front of you and super focus on it just like being absorbed in a video game? ie " hyperfocusing" . I think it's common with adhd as we all know but the goal just as you stated is to trial and error and find a med combo that helps reduce the behavior and enables us a more universal form of focusing or normal focus, ie " the ability to focus but when in task have the ability to know what your doing , know the time that you need to execute one task and move to another and then shift from either task is something of a larger or more important demand comes along during the day enabling us with adhd to focus better and not be totally absorbed in one task when you need to do several to make a successful day. This is probably the most common problem I see with all of us with adhd. That is finding to med and the combo where we can focus but not be totally absorbed in one task and shift from one thing to another with little problems.

[Kiddder]

magdelaine,

Glad you found what works for you......just another example that we should never give up experimenting with different meds, doses, how and when we take them. I am on WB 300mg and take in the morning now. I will start Friday on Ritilin or similar and have already learned here that I may need to stagger how I take them....your post is just another confermation....thanks!

[hollywood]

Yes you must stagger the dose while taking wellbutrin and a stimulant, when the wellbutrin reaches consistent blood levels in your body you are reuptaking dopamine at that point and when you wake will have some already in your system , then when you take your stim dose you will not need the wellbutrin right away. I find it best for me if you take your wellbutrin around noon -2pm or so-

[magdelaine]

Hollywood, that is exactly it...it's almost like the gears inside your head that allow you to shift from one task or competitor for your attention and another have rusted shut (how's that for an analogy?). I was amazed that medication (Wellbutrin) helped with this problem. I mean, I guess I didn't know what to expect, but when I thought about it you could almost say that gear oil had been applied to my locked-up brain.

As far as the peripheral vision thing goes, however, that was real. The hyperfocus was so bad, so intense, I literally could not see what my kids were doing three feet away when I was working on the computer. It was like sitting in a tunnel; very strange.

After all that, it's such an amazing thing to have control of my head back. A miracle if ya think about it.

[magdelaine]

Originally Posted by hollywood

Yes you must stagger the dose while taking wellbutrin and a stimulant, when the wellbutrin reaches consistent blood levels in your body you are reuptaking dopamine at that point and when you wake will have some already in your system , then when you take your stim dose you will not need the wellbutrin right away. I find it best for me if you take your wellbutrin around noon -2pm or so-

This is how it works for me too. I can still feel the WB in the background when I wake up and I feel best if I take the stimulant first thing as if I was having my morning coffee. It does everything you hope coffee would do, but better.

FWIW, this combination and timing doesn't work so well on lower doses of Wellbutrin.

[magdelaine]

Originally Posted by Mincan

You have it backwards, hyperfocus is how our brain is supposed to be, it's obvious you will run into depression and anxiety if you go against how you are supposed to be.

I've been thinking about this statement, and I thought I would point out something that you probably know; that there is reasonable depression and unreasonable depression. If I was experiencing depression because I was going against how I'm supposed to be, that would be a reasonable reaction, right? Like when I went through a nasty divorce and child custody battle with my verbally abusive ex, I experienced clinical depression. That was a reasonable reaction, even though I needed medication to pull my poor brain back from the brink.

However, the depression I referenced in my initial post is not a reasonable reaction. It was cyclic, here one day and gone the next. It was not triggered by any outside event or person or even behavior on my part. The only thing I could trace it to were my overly negative thought patterns. I had tried to control these patterns for years using cognitive therapy techniques with some success, but sometimes it would get so exhausting...and then things would get the better of me.

I found out that there is a certain kind of ADD that leads to negative thought pattern loops, and that Wellbutrin helps relieve them. It's a chemical imbalance problem, not a reasonable reaction to life's stresses, whether internally or externally caused.

[hollywood]

mag,

I'm not sure why lower doses of wellbutrin really don't help by taking wellbutrin later in the day but what's true is true and your definitely on the money regarding that statement. I would say that wellbutrin timing it like I stated and many others doing the same with success is basically priming your adhd meds and boosting them as well. So you wake with more energy and they last longer as well. I think that the NE increase is a big reason as to why it helps increase focus and brings back the desire that alot of those of us with adhd have even after a long time on stims.. It basically pushes you forward to where you used to be and puts you back into living your life instead of just taking up space.

[mensa99]

Hollywood and Magdelaine - I liked reading your posts. Very interesting. So happy for you Magdelaine, bupropion and dexedrine is a certain type of calm "wow." Like being a child again sometimes, that feeling in your stomach? Ya know? And Hollywood, I have been reading your posts for about 2 years (I just registered just a few days ago) - you always have very precise information about what you are thinking and taking. Wish you both well...look forward to future posts.

Oh and Hollywood - I see from some other posts that you seem to sometimes not feel how you "really" should with Wellbutrin XL, right? Question it a bit as far as efficacy right?

I see you take Pristiq at times too, sorry I am off with my memory a bit right now, but have you ever tried instant release Wellbutrin at 75 mg. because I think I have seen you oscillate between 300 and 150 XLs I think. Well you know that with IR Wellbutrin you can take just (3) 75 mg. IR tabs for a non-talked about target dose of 225 mg. which worked wonders for me when I could NOT seem to find 150 and 300 feeling "just right". I took each one spaced out 4 hours each for about 2 weeks and it totally tweaked and solved the FINAL need for 300 mgs.

Just a thought man.

Peace. Mensa99