cymbalta and apathy | ADHD Information
Hi Katastrophee,Well, I finally made it to a new doctor who is in my insurance network, and not far from my home. We sat while I described my past use of various stimulants and anti-depressants to control my ADHD symptoms. I told him that I was currently on Cymbalta 20mgs and welbutrin 150XL. He asked me how stimulants worked, and I told him that they exacerbated my anxiety. I explained that my need to keep shaking my legs and get up from my desk at work was not resolved. As I had mentioned on a previous post, I thought that Buspar would be an interesting addition to alleviate the anxiety I feel. Going forward, he prescribed 15mgs and suggested I cut them in half and take it twice daily. He mentioned that it was possible that I would experience the opposite symptom, anxiety, which could happen. Guess what, it did happen. I even went so far as to cut the pills into thirds since the pills are structured to do so. I stopped taking the pills after the second day. I was told by my colleagues that even my glances were very intense. It's too bad, I'm back to square one. Now I don't see the doctor until August 27th, since I'm flying to Turkey to be a best man this Tuesday, and I won't be back for two weeks. I was hoping that I would have the anxiety issue solved so that I could be a lot more relaxed on this trip. Unfortunately it doesn't look like it's going to happen.
I did mention my interest in Zoloft and Welbutrin, and the doctor didn't seem to think it was a good idea to go on Zoloft. He thought that the Cymbalta and Zoloft were similar and he did not think that the Zoloft would benefit me more than the Cymbalta for Anxiety.
Oh well, back to square one when I get back. I will also let you know how it goes after my next visit and pill after Buspar.
Mr. B
Hi Mr B,
That's too bad about the Buspar. Figures that it would go the other way.... What about something like Provigil? Might be a better alternative to a stimulant since those aggravate your anxiety? I also read in Delivered From Distraction that Amantadine works very well for ADHD. It is an anti-viral med used to treat Parkinson's (a Dopamine agonist). However, it apparently needs to be given at a lower dose for ADHD (starting at 25mg). This can be done with a liquid form of the med.
I don't know that either could be used with your current cocktail, but might be something to consider? Both should be easier on your anxiety, anyway. Hopefully.
Could you just add a small dose of a stimulant like I am doing?
I am on day 4 of methyphenidate. I starting with 2.5mg 3x/daily and will slowly work up towards 20mg 3x/daily. I am at 5mg now, and can feel some effect. I am calmer, my head is quieter and I can follow my thoughts more easily. I can also focus well enough to stick with longer tasks that I might normally hurry through. Absolutely no side effects otherwise! We'll see what happens as I increase the dose. Right now I have no rebound and can't really even tell when it wears off. I assume that is because it is a teeny dose. Maybe Wellbutrin has something to do with that.
Have a safe trip!
katastrophee39292.835462963
Well, I went to a Psychiatrist today. I did some research and decided to go to one that is highly rated. I had not expected that he answer his own phone calls at the office, and when he did, I asked if he took Guardian and he said no. He went on to say that he wasn't in the network. He further mentioned that they didn't pay much. After breifly speaking to me on the phone, he understood that I was looking for a consultation. I asked him how much a consultation was and he said 0.00. At this point, I bit the bullet and decided to book the appointment. He asked that I bring a list of meds with me that I took, and what the pros and cons were with each of them.
I should mention that he answered some calls during the session. I don't know about that one. Nonetheless, I thought he had a quick grasp of how I was.
He made an interesting comment. He said that stimulants work for people who are 18 and under. Once 18 is surpassed, there are hormonal changes and stimulants no longer calm a person down, but instead, exaccerbate the systoms. I asked if I should stop taking the Cymabalta and try Zoloft and Welbutrin. He felt that I should not stop the Cymbalta. It's been too effective for me. He was starting to suggest Buspar, but that does not address my drive amd focus issues.
The session ended with him asking if I wanted to schedule another session, or if I wanted to think about it. He made it clear that I wasn't going ot walk out with a perscription. I don't know. The only thing that made a diffence with my libido is welbutrin. Maybe I will cut the 300 in half and try that again. Maybe I didn't give it enough time. I need to relax as well. Sleep isn't good either. There is definately a need to go on more visits to someone who knows their meds. Hopefully another reputable doctor that is in my network. I am not comfortable spending 0 per week.
In the mean time, I will cut and try the 150 welbutrin again.
I've learned that I'm more complicated than I originally thought. The process continues.
Mr. B.
Mr. B39241.8283912037
Hey Mr B,
If you are using Wellbutrin XL, you can't cut it in half. It has three chambers that dissolve and release medicine over the course of the day. If you are using SR, be aware that the milligram efficacy decreases 15% 40 minutes after being cut. So your second half will lose potency. That is what my doc said anyway....
You could give the 300mg more time. Like I said above, it took about a month for the Wellbutrin to ramp up enough where I could see a difference in effect.
I tend to agree that you should keep Cymbalta if it works so well for you. Dunno about the rest of what he said.... I suppose it could be possible that stimulants work differently in adults than in kids, but so many people here say that hey work brilliantly and DO calm them down.
I have my next appointment in a week and a half. Might be adding a stimulant to my Prozac/Wellbutrin mix. If so, I will let you know how it goes (or if we try something different). My doc kind of wants to switch Wellbutrin for a stimulant, but I don't want to do that.
Good luck!
I have been cutting the 300 welbutrin XL as best that I can over the weekend, and found myself better able to stay focused all day. Perhaps my body has better adjusted to it. Because of this positive result, I ended up filling a script that I had for the 150 XLs. I think this combination is not bad afterall. I still have the great results of the Cymbalta. The only thing missing was the vigor and sex drive. The welbutrin definitely takes care of that. I am shopping for a good head doctor to see if he will suggest something very light like Buspar to take the edge off, perhaps in the evening time. Buspar is supposed to be very clean, non toxic, and non addictive at low doses. The doctor I consulted with the other day felt very good about this drug for me. A very small dose could give me the added calmness to relax.I'll keep you posted.
Mr. B
Hey Katastrophee,
I would be interested in what your doctor goes with in your case. I had to go for cutting the pill as best I could, because I do not have a source at the moment anymore to get a perscription filled. Nonetheless, although I noticed that I wasted the second half of the pill because it doesn't cut well, I am at least getting enough vigor to get some things done. My issue with the welbutrin is that it's not solving the uptightness that I have, or the anxiety. My issue is a mix of anxiety (Hyperactivity) and focusing. The welbutrin helps with drive and focus but does not help on the anxiety side. The 300XL just locks me up too much. I'm better off with the 150 XL. I will try a doctor in network near my residence and see If I can alter the combo to get a more even result.
I'll keep you posted as to what the next Doctor thinks. I heard that Buspar for OCD and anxiety is excellent, clean, not toxic at all on low doses, and not addictive. Furthermore, it takes effect right away.
Mr. B
Hi Mr B,
This is my third day with a second dose of Wellbutrin and so far, so good! No negative side effects, which is great. It will probably be a few days or maybe a couple of weeks before I know whether this boost will do much for my focus. Maybe after some time I can switch back to Wellbutrin XL 300mg without being nauseated. That way I won't have to remember to take my second 150mg dose of SR. I set an alarm on my cell phone but it isn't always with me....
It sure gave me another boost in the libido department! Holy moly....
I can't take Ambien. I took it a few times a while back and I was one of those people who would get up and wander around and generally act like an idiot. It freaked out my husband. I would wake up feeling groggy too. I try to avoid sleep aids. The best thing for me was Wellbutrin XL. I always felt great in the morning. That is not the case as much with the SR. The second dose does not seem to have made much of a difference in that respect. It is not keeping me awake, though.
My aunt took Buspar and it did help her anxiety. It is defeinitely an option. I hope things work out for you. Let me know how it goes!
katastrophee39256.6307407407Hey Katastrophee,I think you have been right. After having negative side affects taking strattera with my cocktail of Cymbolta and Welbutrin, I sampled Aderral 10mgs for a week now. This may be the best combination so far. I'm taking 10mgs in the morning. I don't need more than that because the combination of the other two drugs keeps my levels of Aderral in my blood all throughout the day. I might even have to go to 5mgs, because I feel perhaps that I maybe too focused. I have two days before I see the doctor. I'll try 5mgs for the next two days so I can give a proper update to my doctor.
This may be a very good combination for me. So far I feel quite please, and I'm not experiencing any side affects. "NO ANXIETY":)
I'll keep you posted....
Cheers,
Mr. B
Hey Katastrophee,
I returned from my two week trip from Turkey, and it was quite good for recharging my batteries. First things first, I went to see my doctor. After I told him that I experienced anxiety, he suggested that I try Strattera, since I had experienced anxiety with stimulants in the past. He started me on 40 mgs and told me to move up to 80 mgs within a week. After three days of getting up every 15 minutes at work, I decided to go to the higher dose sooner. Strattera is strictly a norepinephrine reuptake inhibitor. I couldn't believe it, th doctor's hunch was right. I became very focused and I didn't have any anxiety, and I actually woke up rested. I even spent six consecutive hours sorting through three milk crates filled with sensitive documents, bought a shredder, and cleared my my home of all that unnecessary junk.
The same evening, I went to a late movie showing, and I didn't fidget at all.
Here's the bad news: For the first time, I started having very unpleasant sexual side effects that I consider intolerable. For that reason, I had to discontinue taking the drug. At least I sorted through paperwork that I just could not get to before. Additionally, I learned that the anxiety is just due to not being able to control the core symptoms of ADHD. Well, back to square one. I see the doc on the 17th when he returns.
Thanks for the information I'll ask him about the drug you mentioned.
Cheers,
Mr. B
Mr. B39329.8941435185P. S. the only concern I have about the methyphenidate you're taking is the dosing schedule. I would find it difficult to keep track of a drug that I would have to take three times a day.
I'll keep you posted on what my doc suggests as to what I should do next.
Mr. B
Hi Mr B,
That's great! I am glad that Adderall is helping. My husband takes Straterra and had some minor sexual dysfunction when he started it. In his case, it got better, thankfully.
The methylphenidate family has been great for me.
After playing around with dosage on the short-acting methylphenidate, I switched to Focalin XR. I liked it a lot because it was nice and smooth, but after about the 4th day, it quit working. I am sure the dose just needed to be adjusted, but when I went back to see my doctor, we switched to Concerta since my co-pay is lower for Concerta vs Focalin. So far, so good, although the dose may be a teensy bit on the high side. I may adjust. I am taking the 54mg. 36mg will probably not be enough so I will see how I do with this. I would have thought that I would only need a small dose of a stimulant since I have Wellbutrin on board, but I guess I am just one of those people who tends to run on the higher end dosage-wise.
I haven't had any anxiety either. I thought for sure I would since I have panic disorder. In fact, I seem calmer and less fearful than I am without the stimulant.
I am changing jobs and so I will be without insurance for a month (unless I want to pay a frightening amount of $$ for COBRA). When I DO get my new insurance, neither my regular doc or my P-doc accept it.... I think I will probably continue to see my P-doc and just pay the full fee because I don't want to play the "find-a-new-psychiatrist" game....
Also had to take a drug test for this new job and I am praying that it comes out OK. I hope that if it DOES come out positive, I will get a chance to show proof of my prescriptions before they try to kick my butt out the door. I am actually pretty stressed about it. Should hear from someone in the next couple of days if it comes back positive....
Glad things are going so well for you!
Hi, I just wanted to thank you all for sharing your experiences with different meds here. My son is ADHD/ODD. We have tried several meds. I find your posts to be extemely interesting, because I find it interesting to understand what neurotransmitters do what, and how the meds help different issues. It's hard to get this info from the Psychiatrists that we've seen, due to time, etc. My son is 14, on Concerta 54, and Wellbutrin SR 150. Since he went on Wellbutrin, he's changed (positive) so much!!! He was on Risperdal 1.5, which was helping but his impulses were out of control, plus weight gain. He stole money from home, and other stuff, was very oppositional. That has disappeared for the most part. He talks about the stealing as "the old me". This is interesting how a med change can make such a HUGE difference. He's going into high school this fall, and I really would like to get him off the Concerta. I'm hoping the doc can find a good combination. Interesting, his back up med was Effexor if my son had side effects on Wellbutrin.
Can someone please explain the use of Cymbalta to me? Is it used to treat ADHD directly or the depression that can be associated with feeling like life is out of control when one suffers from ADHD? My partner's doctor prescribed this to her, and we are unclear on whether this will help her core ADHD symptoms (inability to focus, impulsivity, etc) or not. Please help!Hello everyone,I have not written a follow up to my success announcement to having started with Cymbalta in some time now. I have noticed for some months now, that for a male my age, my sex drive is quite non-existent. So I was googling to see what people might be saying about Cymbalta and ADHD, and I stumbled across a response to my first announcement from a member of this forum called "open your eyes".
I am copying and pasting his comments below because what he says is absolutely right on the money. Starting next week, I will try to mix Welbutrin with Cymbalta, and if that doesn't work, I'm going to try the combination of Zoloft and Welbutrin. The Cymbalta alone is not the answer, but it has been the best out of all single medications I've taken in the past. What "open your eyes" describes below is exactly the experience I'm having right now with the lack of drive.
Here is what open your eyes posted in the past:
Cymbalta aka duloxetine, should be a huge upgrade from the SSRI's because of it's effect on norepinephrine. Norepinephrine is a vital transmitter for mental energy, motivation and drive. NE inhibitors also block Dopamine in the executive prefrontal cortex, the part of the brain implicated in ADD. Cymbalt should be like other NE inhibitors like Desimpramine and Bupropion that have been proven to be effective on ADD core symptoms. You could also add Tyrosine for Dopamine to equal out the transmitters. I'll be glad when they come out with a med tha increases all three equally. For now I'm taking zolft (serotonin + dopamine) and wellbutrin (norepinephrine + dopamine), which is working well.
How have your core ADD symptoms improved? How has your working memory improved? Are you able to remember phone numbers and menial things better? How is youre planning going? Are you more prompt for work and appointments...do you have a better awareness of time?
Opent your eyes,
I'm experimenting with different medications that will increase Serotonin, Dopamine, and Norepenephrine together. I have classic signs of low serotonin and therefore need to take something that will raise it. The problem with SSRI's is that they only increase serotonin. When Serotonin is increased, Dopamine is decreased, which causes apathy, decreased vigilance and amotivation. Zoloft, which increases Dopamine as well as Serotonin is the only SSRI that doesn't reduce vigilance. A core symptom of ADD is decreased vigilance, which is why taking SSRI's alone is not good for people with ADD, excluding Zoloft.
Another good thing about Zoloft is that it is relatively non-toxic, and very easy on the liver. But, Zolft alone doesn't increase dopamine or norepinephrine enough, the two chemicals implicated in ADD, nearly enough. I was using Reboxetine, which is a selective NE blocker, but the sexual side effects were too much. The only NE stimulator that does not reduce sex drive or vigilance is Wellbutrin, because of it's effect on Dopamine. I've been taking only 150mg of XR / day.
Dopamine is important for sex drive, vigilance, and the prevention of apathy. People who fall in love have low serotonin and high dopamine. Cymbalta does potently increase dopamine where it is needed to treat ADD, the prefrontal cortex, but not in other places in the brain. You could see some loss in interest in things, such as sex and other normal things that you are normally passionate about, a condition known as anadonia, by not keeping the dopamine levels high. Wellbutrin is one of the only treatments for Adenonia, because of its ability to increase dopamine.
If it becomes a problem you can lower your dosage of cymbalta, or add a small dose of stimulant or wellbutrin, or if you want to do it natural you can take 500mg L-Tyrosine 3 times a day on an empty stomach. Exercise is also a good way to increasing dopamine. L-Tyrosine is a precurser to Dopamine. The good thing about taking medications for ADD is that smaller doses seem to be more effective than the same dosage of medication used for other problems such as depression.
OpenYourEyes38377.8969791667
I want to thank Open Your Eyes for writing this post from the past. I tried to do a search on this forum name and it did not come up. I want to thank open your eyes for the post. I can now do something different to offset the lack of drive problem.
Mr. B
Again, this message is for "Open Your Eyes". I will try to add Welbutrin to the mix and see how it works. I do know that on Cymbalta, i've had no need to drink alcohol, or the occassional ciguarette I used to have when I drank. I have not drank or smoked in three years since taking the Cymbalta. My sleep in not restful, i'm apathetic, and I could be more motivated for longer periods of time. I'm still getting up from my work desk when the moments are not stimulating enough. Does this sound like the Welbutrin is going to take care of it, or the combination that you're on. Something is telling me that the combination that you're taking is going to work better. Nonetheless, I think I'm just going to try the Welbutrin for a few days since it's effectiveness is quickly apparent.
Mr. B.
Mr B,
I am currently taking Prozac and Wellbutrin. The Prozac is for my OCD-like obsessiveness - Wellbutrin for the ADHD. I started with Prozac first, and so I can definitely say that what libido Prozac took away from me got restored and THEN some with the addition of Wellbutrin. Wellbutrin has also curbed my impulses - including eating (kind of a big impulse issue) and drinking alcohol (which I never did much of anyway). I sleep less (I typically can sleep 10 hours and then take a 3 hour nap in the afternoon and not feel rested) now and feel more rested and alert. 7 hours is enough for me.
Hope things go well for you - good luck!
I am curious if you all think this combination is BETTER than Desiprimine. My 12 year old daughter cannot tolerate stimulants at all. she has taken Zoloft and Wellbutrin (not together) in the past and can tolerate both at low doses. She did take Nortriptyline for over a year, but couldnt tolerate the side effects there either (sleepy). So our next adventure is to be Desiprimine. I am wondering if low dose Zoloft and Wellbutrin is t worth a try first...............seems like it will work quicker and she is already on 12.5 mg of zoloft. Any thoughts anyone?Hey katastrophee,I think sex addiction was more like it at the time..lol. Interesting, I can have my mind stuck in one gear as well, and not have the fluidity of thinking when not on meds. I think the Cymbalta has helped in that regard, as it does elevate serotonine levels. I'm not quite sure of what would be considered normal in that regard. I do know that it has made a remarkable difference in my life. Impulse being a major one, and having more clarity of thought. Now on the 300 XL 6 days in, I think I may be feeling a tiny bit of that anxiety in the background, but it does not appear to be much of an issue, at least not yet for now. I most definitely now feel the vigor, and also the libido, that's nice. I will definitely not give up the Cymbalta as I mentioned before, since it's been the cleanest and most even feeling med till now.
I wouldn't be able to make any claims with respect to the difference between Prozac and Cymbalta, because I've never been on it. I think Lexapro maybe the closest and that didn't calm me down, nor help enough with impulse control.
Mr. B
Hey Mr B,
Maybe part of your ADHD was impulsiveness concerning sex? Now that you are on meds that is curbed and you have more of a "normal" libido? Just a thought. I had MAJOR impulse issues concerning sex in college, but not really anymore - mostly because my tendency to end up in my ex-boyfriend's bed (several times)really hurt the guy I dated for three years and I felt awful about it later...he found out at the end and broke up with me. I could never do that to my husband.
Prozac did totally kill what libido I had though....I wonder if the doc REALLY doesn't want me to take Wellbutrin AND a stimulant if Cymbalta and a stimulant would work better concerning libido.....? Hmmmm......will have to keep that in the back of my mind. The major concern with that is whether Cymbalta will work for OCD as well as Prozac does....
Still want to stay on Wellbutrin....just considering my options.
katastrophee39234.8448148148 Hey Katastrophee,Today is day five on 300 XL generic and I think this is working very well so far. The extra 150 seems to have finally given me a calming affect and I feel even all the way around. Typically, when I sit down, I need to shake my leg or legs. I'm not doing that right now, and seem to have more patience than I do normally. That was encouraging when you said to go for the 300XL, and it was a good choice. My impulse control is even better now. I don't know if I could feel any more normal than this, it really seems quite helpful.
Regarding your situation, I had read that nausea, insomnia, as well as headaches eventually go away. These can be short term side affects. With the Cymbalta 20mgs and the Welbutrin, there doesn't seem to be any side affects for me at all nor any sort of anxiety. I wouldn't have found this better solution if I hadn't googled cymbalta and sex drive, which had brought me back to what open your eyes had said about Cymbalta and apathy. I would like to see what this combo does for that drive in the short term.
Good luck with the cocktail.
Cheers,
Mr. B
Mr. B39233.2877546296
Katastrophee,
I would also like to mention with the Cymbalta, the functional aspect of my masculinity is much more pronounced. I believe with an SSRI, there is some less feeling down there which is not there with Cymbalta. Actually I find it better or lets say I feel like I have an advantage functionally. Lower drive and apathy had kicked in on Cymbalta alone. I don't know how much of a Dopomine increase I have gotten with the Welbutrin now that I'm on 300 mgs, but perhaps without meds, I was so obsessed with sex that I may have unrealistic expectations or that I maybe more normal and cooled off in that regard on meds period. At least I'm less Hyper and less fidgety on this new combination. I almost feel that if it wasn't unadviseable to even increase the welbutrin more I would, but I know the max is 300 per day, and I will not exceed that. I will see how it goes over the next few weeks.
Mr. B
Hey Mr B,
Well, it sounds like you have some options:
1) Give the combo more time - I am just now getting the best effects from Wellbutrin 5 weeks out. I had to go through a lot of ups and downs along the way. I was more anxious for a time, apethetic for a time, completely spacey and then finally more able to focus. Also, for whatever reason, the SR form seems to help my focus more than the XL. Could just be me. You certainly have to give it some time if you are willing to wait it out.
2) Switch from Cymbalta to Zoloft - although I am a bit concerned about how they both affect dopamine. I would check with your father/brother for an OK before doing this since I don't know how much is too much. Yes, it seems logical that more dopamine would have more of an effect like a stimulant, but I don't know that for sure.
3) For me, Prozac with the Wellbutrin works great. It curbs the anxiety and slows my obsessions. It helps keep me from fixating on things. It may not work as well as Cymbalta for you, but it certinly is a possibility.
I finally feel more in control of my mind. On Friday, something turned around and switched on my motivation. It has not gone away, which is good, but I am exhausted from doing so much this weekend that I put off for so long....
Good luck!
Hey Katastrophee,I don't know about the 300 mgs of Welbutrin anymore. Yeah, perhaps my legs were shaking less, but I felt a little locked in place. I have some obsessive qualities which I do not believe are addressed when I go for this combination. Granted, there appears to be more narrow minded channeling, less distraction, but I'm not feeling right. It felt too much, like it didn't feel normal, and I wasn't relaxed. What I'm looking for is to be less fidgety, with better focus, and more drive. I'm a little afraid to leave the Cymbalta. The only thing was the apathy issue which is an important one. Perhaps If I try 50 mgs of Zoloft, it will calm me down more and perhaps allow me to sit around long enough and not be impulsive. From what I read before Zoloft it ncreases the dopomine too, and it might eleviate my hyperactivity and impulse control more. I don't know. It sucks that I paid for a months supply of 300 which aren't even breakable. In case I wanted to try and go back down to the 150 mgs. I don't know.
Mr. B.
Yeah, I had the same problem on day 2. I was worried too since I felt so great the day before.....also had to take an afternoon nap! For me, it got better over the next few days. So far, you and I are having pretty much the same experience. Hopefully for you, you will not get the thrice daily brain buzz I had for a week that started on day 3....Thanks for the follow up. I'm giving the combination more time, but I still feel that if I was more relaxed, I would have more patience to want to sit for longer periods of time, or read etc.. I think the welbutrin is effective for focus without the kind of anxiety that a stimulant presents, however, my sleep patterns are still poor. If I can wake up rested and have more patience I think I would be at my best state of mind.
I've been taking AmbienCR in the evenings, and with that, I'm still waking up groggy and unrested. Good luck with your dosing. Something tells me that adding something lite like a Buspar in the evening, will ultimately solve the issue, but I will wait till I find a doctor that I like.
Good luck,
Mr. B
Hi Mr B,
Glad things are going well for you. I had my follow-up with the doc this afternoon. I told him that the Wellbutrin SR seems to be gentler on me than the XL but it kind of wears off later in the day. This makes me sleepy in the evening and groggy in the morning. I am going to try taking another dose in the afternoon. Hopefully two doses of 150mg SR will work out better than one dose of 300mg XL did. I am starting tomorrow and will let you know how it goes. The doc agreed with me that it would be optimal for us to get a desired effect from Wellbutrin vs using a stimulant.
Here's hoping!
Well, I've been taking the combo Cymbalta 20mgs and Welbutrin 150 xls. It's been quite good to me for work. I still need something to ease me up or relax me at night time so that I can get tired enough to think of sleep and stop thinking about my work life. The focus and drive is much better now.I'm looking for a doctor in the network. So far this combination is pretty good.
Mr. B.
Hey Katastrophee,
I tried provigial but that drug being a Dopomine Reuptake Inhiptor, did not give me the wakefullness, or clarity and focus I was looking for. I do not need existing dopomine to remain there longer, I need higher levels of it to round off the serotonine and Norepinephrin success. Since I am not a pychiatrist and neither is any of my family members, I believe I am close to treatment, but I want to now consult with someone trained in this area, so as to waste less time in getting the right mix.
It will be less time spent, and less expensive in the long run in many ways. I have a feeling the zoloft and Welbutrin are going to be the closet thing, but I don't know if the docter is going to ask me to wean off the Cymbalta or am I going to be allowed to swap out right away. Since I do not know the ideal answer, I would rather confirm with a doctor who knows their Neuropharmacology.
I am a little concerned because the Cymbalta was working best for me, with the exception of course of much better focus and Drive. Once that part is adjusted, I think I will have further success in an already growing business.
Thanks for taking an interest.
Mr. B
Hi Katastrophee,
I tried something different. I decided that since I felt somewhat anxious or uptight over the weekend, having taken the usual 150 XL in the morning, and not having the fast paced work environment of the weekday, I decided to try going into work on Monday without taking the Webutrin that day. I took my usual dose of Cymbalta only. When I woke up this morning, I felt down as soon as I opened my eyes. This really helped me to compare myself to how I feel when I do take Welbutrin. So I took both the Cymbalta and the Welbutrin today, and felt a lot more evened out, and of course focused. The feeling of being down went away. After seeing how 300 XL felt compared to the 150 XL, I don't think I can see myself going back to the 300 XL. It was too much, and I think it just made me more uptight and locked me up more emotionally. Perhaps you're motivated to take the higer dose because the Prozac is a lot more effective in raising your Serotonine levels as compared to Norempinephrine, and therefore prompting you to want to even it out with a higher dose of Welbutrin.
Katastophree, you said that your Aunt took Buspar, past tense. If she doesn't take it anymore, what is she taking now, or is she not taking anything at all? If she's still taking Buspar, I was wondering if she would agree if it could be taken as needed. From what I understand it goes to work quickly, and it doesn't build in the blood stream which means you need to take it everyday, unlike antidepressants where you can take the weekend off, and still have it in your system to benefit from it.
I like the idea of XL over SR because I like the consistancy of it's effects and I like to know I can watch a movie or do work without passing out.
Ambien doesn't make me get up and walk around, but it ensures that I only wake up once in the middle of the night instead of repeatly.
Sounds like you're doing pretty well on your cocktail. Let me know if there is anything new you can share... continued success to you:)
Mr. B
Hey Mr B,
Glad it is working well for you!! That is awesome that it isn't causing side effects for you.
Yeah, I would have just toughed out the nausea since I know it probably would have gone away, but it was bad enough that I could not sleep at night. I asked my doc if there was another way I could try to increase it (like alternating 150mg and 300mg/day), but he said to just stay on the lower dose. I am not normally a big baby about side effects, but I can't just miss a week of work because I can't sleep/eat. I would just go ahead and alternate days, but I don't know if that is OK to do with Wellbutrin.....it seems to be a "touchy" drug (fiddling around or stopping cold turkey can trigger seizures). Since I drive 1000 miles/week, I can't risk doing something like that without my doc's blessing. I like being alive and having full use of my arms and legs.... I am sure the people driving around me feel the same way.
Wellbutrin SR seems to have more of a peak/valley kind of thing during the day than the XL. Not dramatic, but it does not seem quite as even. I also noticed it is a lot harder to get my butt moving in the morning and I am getting to bed a lot later. Not insomnia, just not really tired. When I do lay down I go right to sleep as usual. I may just switch back to the brand name XL and cough up the bucks.... I don't mind. I am just slightly concerned that if I call my doc complaining about the SR and asking for a script for XL, he may just tell me to wean off and we'll try a stimulant at next visit.
I don't want to stop the Wellbutrin....
I hope things continue so well for you!
Katastophee,I hear you loud and clear. I thought that I'd never take that Welbutrin drug ever again in my life when I used to take it alone with nothing else. I was aggressive, with plenty of anxiety, with a need to occassionally grub a cigarette or drink, just to relax. After taking at least 8 diferent adhd meds over 8 years, I found the Cymbalta combo with the Welbutrin the best. I would not be courageous to take Welbutrin alone. It is the mix of the two that has stabilized me in many ways. I'm lucky and have Internists in my family dad and brother, who have been given me the scripts as I need to try them. I frequently get my blood tested typically every six months to see how i'm doing. Stimulants also gave me great anxiety and rebound effect. So, the only thing I think this cocktail is very effecitve for Adhd with Anxiety, I feel the mix I'm taking is great. Of course it really depends on each individual of course and how they react. I did this all without a Psychiatrist. I've done it with my own research and introspectivenesss.
It's not my place to make suggestions as I am not an MD. Perhaps you may want to ask about the Cymbalta. It's an SNRI. Very clean, and has no side effects for me. Taking that drug with the Welbutrin is helping me tolerate the welbutrin I suspect. I must say though, I am like a tank when in comes to these types of things, I have strong tolerance.
I bought the Generic Welbutrin 300 XL which was quite cheaper with the Insurance I have. You may want to ask your doctor about this combination.
Good luck,
Mr. B.
Mr. B39233.8496643519
Yeah, maybe I will ask him about Cymbalta. I am taking Prozac with it, which I think helps keep the anxiety at bay. It also works very well for my obsessiveness. It helps shut my brain off since I fret and fixate on EVERYTHING.
I would never take Wellbutrin by itself, I bet I would go through the roof!!
I have some of the generic 300mg XL from my failed attempt to increase the dose. I am so tempted to try it again. We'll see. Normally I am not the type of person who has a lot of side effects from meds.
Let me know how things are going!
Hi Mr B,
XL feels "stronger" than SR. I don't know if that is because you get a full "dose" of the XL three times a day (basically 3 doses of Wellbutrin IR in 1 tablet) vs. having a slow release in your bloodstream like the SR.
Things seem to be improving with the second dose of SR. I am having very minimal to no side effects. I would be interested to see whether I can switch back to the XL since it is more "even" than the SR and seems to be more potent.
Yes, I feel like I need more of the Wellbutrin to counter the Prozac serotonin boost. When I went from 20 to 40mg, I got sleepier and a bit of a libido decrease.
I'll give this schedule another week and then try the 300mg XL. If that is too much or doesn't get me the effect I want it may be time to talk stimulants. I am very intrigued by Vyvanse. It appears to be smoother than the other stimulants.
I don't honestly know what my aunt is currently taking. I know she did take Buspar every day, but I don't know if she had to. She has taken everything under the sun. I don't keep as close contact with her since I moved out of the state. If I can find out about it, I'll let you know.
Take care!
Interesting... you and I are built somewhat different. I have hyperactivity, so I can't sit still. By nature I have some anxiety, which is where the hyperactivity is coming from. The Cymablta has been a god send because it's very clean and it has made a difference in my work life. I don't drink or smoke anything anymore because of it. However, again, my focus and vigilance isn't there as open your eyes mentioned. Welbutrin had made me sleepless, but now that I have the Cymbalta in me, I'd like to see how the combination works. If it makes me too anxious, I will try the Zoloft and Welbutrin combo perhaps. This no sex drive thing has to be taken care of. I mean I do look around, but I'm just too passive.
Mr. B.
Hello Kastastrophe,
I am intregued by the idea now of the ssri combo with Welbutrin. Cymbalta is the only drug that actually stopped my interest all together in Drinking and or grubbing cigarettes at all since three years now. I'm missing drive on the sexual side, I can't sit still. My impulsivity is controlled with Cymbalta, which makes me much better in business. I had taken Welbutin alone years ago. I had anxiety and aggressiveness on this drug. I had plenty of drive though. I also had dry mouth, and couldn't sleep. Since the side affects were noticeable, I was just concerned about side effects of mixing Cymbalta and Welbutrin.
If i'm too much over the top, I could then try the Zoloft and Welbutrin, since it was mentioned by open your eyes that it does not lessen the libido.
Mr. B
Hey Mr B,
I had panic disorder many years ago and took Prozac (and Klonopin). Back then I had no idea that all my problems were being caused by ADHD. Prozac definitely calms me down and shuts off most of the worrying & obsessing that I tend to do non-stop. When I first went to my PDoc with a concern about ADHD (about a month and a half ago) he wanted me to start with Prozac first and see what that did for my concentration. I felt better, and had somewhat less mind-racing obsessions, but it did not improve anything else. I did not expect that it would.
He recommended adding Wellbutrin at that point because of the dopamine boost. He thought I was sleeping too much (have ALWAYS been a big sleeper as I mentioned above). It certainly does exacerbate my anxiety somewhat, but not to an intolerable level. Especially considering that I have panic disorder, it is surprising that I haven't had major issues with that. My PDoc warned me that it might trigger panic attacks, but I didn't worry much about that. He was concerned, but panic attacks became such second nature to me years ago that I can manage them OK. I rarely have them anymore, but did have one shortly after starting Wellbutrin. I wonder if Prozac (or some other SSRI) helps counteract the anxiety that Wellbutrin can trigger? It does seem to be a good combo, at least for me. I really, really like what the Wellbutrin has done for me. My new problem seems to be that I cannot take 300mg of Wellbutrin without feeling severely nauseated, and my PDoc said to just stay on the 150mg. 150mg is not enough to manage my ADHD symptoms so I don't know what I will end up doing. I have a follow-up appointment with my PDoc next week so we'll see....
..day two on Welbutrin, suprisingly, it's made me sleepy to the point that I had to take a two hour knap in the late afternoon. I'm assuming that the body is adjusting. I guess you can consider this a calming effect, but this is a little over the top.Mr. B
Hey Mr B,
Yeah, I noticed a difference within 20 minutes of taking my first dose of Wellbutrin. I was much calmer and able to focus. All the "white noise" in my head went away. The second day I was sleepy, then the side effects started on the third day ("brain buzz" about every 5 hours went I would get a "dose" of the extended release tab and some mild nausea off and on). Side effects went away after a week. It has been about three weeks now and the positive effect on my focus is slowly coming back.
Glad to hear things are going well. Let us know how you are doing!
so far the effects are awsome taking the welbutrin with the Cymbalta. I know I only started welbutrin this afternoon, but I know from the past that Welbutrin acts quickly. Before this evening, I couldn't sit still without shaking my leg. Now all of a sudden with the combo, it appears that I've calmed down, and my leg isn't even active on it's own. With the welbutrin added, I still feel the positive benefits of the Cymbalta, and it feels like that this extra effectI needed to stay more focused is already there. Let me see how it feels on day three. In any event, I'm very pleased at the moment. I was even yawning a couple of times.In the past, with Welbutrin alone, I was very obssessive, aggressive, and had lots of axiety on it, which made me want to drink, smoke cigarettes, and even pot. Now I'm feeling calm believe it or not. Very interesting so far.
I'll write a follow up for any one interested in a three days or so.
Mr. B
Mr. B39221.7735300926
Wellbutrin will aggrevate your anxiety. It did elevate my levels a bit when I added it to my lexapro dosage, but it was manageable. I don't recommend taking it alone if you have an anxiety problem. Btw, it works from day one, the side effects just takes 2 weeks to dissipate. Another thing is, you might have trouble falling asleep the first few days if taken alone. Luckily this time around I was already on lexapro, and that helped me fall asleep when I started it back up.
thanks, I'm going to try the welbutrin 150 tomorrow. I should know pretty fast if its ok, since welbutrin doesn't have to build in the blood stream for that long. Three to four days tops. If it begins to give me the kind of anxiety it did when I took it with nothing else, I will try mixing with Zoloft. If that doesn't work, I'll go to zoloft and welbutrin. Unfortunately, all this stuff is trial and error.I'll keep everyone posted if there is interest.
Thx,
Mr. B
Hey Mr B,
That's great that Cymbalta works so well for you. I just wonder whether it is OK to take with Wellbutrin since they both act on norepinephrine? I honestly have no idea. Yeah, I understand about the sex drive thing. I was moping after starting Prozac....was SO happy that Wellbutrin reversed that issue. I also did not know that Zoloft works on dopamine in addition to serotonin as stated in the post above? I thought it was just a straight SSRI.....that's what the website says anyways. That also makes me wonder if OK with Wellbutrin since they would BOTH be acting on dopamine. I tried taking Zoloft years ago and it gave me nasty headaches....
Good luck!
Hey guys,Second day on Welbutrin on 300mgs. I don't know. I was hoping the the focus would be better. Perhaps I have to give it a little more time.
I'll keep you posted.....
Cheers,
Mr. B
Mr B,
Glad that 300mgs at least SEEMS to help some. My understanding about Wellbutrin in general is that it is not as effective for focus as a stimulant for MOST people. It has certainly helped me, but the area where it has made the most profound difference is in my sleep. It seems a little easier for me to control my impulses (especially eating) and take care of some tasks that I consider tedious, but otherwise not much help on the focus. That was why I was hoping I could tolerate 300mg. The higher dose did not make me anxious, just nauseous.
In an effort to save me some money in prescription costs (his suggestion), last week my doc wrote me a script for generic Wellbutrin SR (Wellbutrin XL 150mg has no generic). I have my reservations about this, and the jury is still out. I don't notice a huge difference, but it may be that I do feel a tad bit more alert on the XL. He told me that if there was a major issue I could come get a script for the XL.
You will need to give it more time. After the initial decrease in effect that I had, it took about 4 weeks to start to really kick in. I have heard from others that this is typical. But I know it can be so frustrating when it makes such a difference the first day!
Best wishes!
Katastrophe,Well, today is day six now on Welbutriin 150 X once a day. I must be an ox or something. It's like my body quickly adjusted, and I must say although there is an improvement, that calming feeling the day I needed to knap is not quite there anymore. Today at work, I kept getting up consistently. I'm lucky that I have a job that allows me to do that, but in terms of being calm enough to want to read for long periods of time, that is not there. My impulse control is definitely stronger. My mind feels clearer, but still I would like to be calmer. I don't know. Perhaps I should go up to 300 mgs. I don't know.
Any ideas. As far as tolerating the 150, I have no issues.
Mr. B
Keep in mind that increasing to 300mgs might elevate anxiety levels. What about adding a small dosage of stimulant. I take 10-20mgs of Adderall with wellbutrin xl and lexapro.
Mr B,
I'd go to 300mg since that is technically the therapeutic dose (although everyone is different). I also noticed that the wonderful effects I had from Wellbutrin the first day dwindled over the first week. I tried to take 300mg but it made me too nauseous which really bites.... Anyway, now that I am 4 weeks in, I do notice that it seems to be "kicking in" more. It is not aggravating my anxiety at all and I do seem to be able to get some things done and forget less. It isn't dramatic, but I'll take it. You could definitely add a small dose of a stimulant to "sharpen" your focus more.
Johnnyboi,
Because I can't seem to tolerate 300mg of Wellbutrin I am increasing my Prozac dose for a month to see what that does for me (mostly to control obsessions). My doc is concerned about adding a stimulant to Wellbutrin because I have panic disorder (although I rarely have panic attacks anymore). Did adding Adderall to your Wellbutrin elevate anxiety? At my next follow-up he is strongly considering ditching the Wellbutrin for a stimulant. I really love Wellbutrin and am concerned that just using a stimulant will cause a bunch of ups and downs....besides the fact that Wellbutrin does wonders to counteract the Prozac libido elimination.....and I can sleep less and stay awake during the day....
If you ditch the wellbutrin, your libido problems will return. In addition to that, you will once again sleep more, and possibly struggle to stay awake during the day, as a result of elevated serotonin levels. This is because wellbutrin affects dopamine and norepinephrine. In your case, dopamine mainly affects your sleep, and sex drive. I would stay on the wellbutrin, especially since you are trying an increased dosage of prozac. Ask your doctor if you could try a low dosage of Adderall, 10mgs, and see how it works for you. If you can tolerate it fine, I'd give 20mgs a shot, but anymore than that could aggrevate anxiety. In retrospect, the SSRI's really does wonders with the induced anxiety caused by the stimulants. The stimulants alone will not impact your sleep, or libido as well as wellbutrin.Johnnyboi,
Thanks for the words of advice. Yeah, that is what I figured would happen.... Now that I am so much more awake I really, REALLY don't want to go back to the way it was before. I feel so much better that if given the choice between taking something that will probably work much better for focus during the day and Wellbutrin (which is not really enough to really manage my symptoms) I am tempted to choose the Wellbutrin. I don't want to be a slug again or be on a rollercoaster when the stimulant wears off. I have such a problem getting out of bed in the morning and Wellbutrin has made it much easier to wake up. If I stop it I will go back to literally dragging myself up every morning and then having to wait until the med "kicks in".... Not my first choice. Besides, I have enough problems WITHOUT the Prozac killing my libido, so anything that helps me there is most welcome!!!
I'll tell him I don't want to stop it and want to try a low dose of Adderall. I think he is mostly concerned I will start having panic attacks again. He was worried about that when I started Wellbutrin, but I told him I didn't care if it triggered a few while adjusting. It did actually make me have one. No biggee. I am not concerned about that since I know what they are when they happen. Besides, if it DOES cause a problem, it will wear off by the end of the day and then I can just stop taking it. Seems pretty low-risk to me.
Thanks again!
Hey guys, you know what, I have nothing to lose. I was a little worried that 300 would be too much. However, even at work yesterday, the 7th day, I was still staring at the papers on my work desk, wanting to finally organize it and get it out of my hair, I just couldn't get to do it. I found myself still getting up frequently. As far as anxiety, I absolutely have none with this Cymbalta Welbutrin combination, not that I did without the welbutrin. Cymbalta is excellent in that sense. I do have bad memories when on Welbutrin alone, which was high anxiety ridden for me, prompting me to drink, smoke, and whatever to relax. The benefits of the 150 mgs of welbutrin is not as pronounced anymore now since yesterday. I just woke up and took both cymbalta and Welbutrin 150mgs. Perhaps now I will just pop another 150 welbutrin and see what happens. It's going to where off anyway later. I just hope that I won't adjust to that too and need more or something. Let's hope not. Additionally, no matter what I do, my brain just doesn't seem to shut down when I sleep, and I wake up and toss frequently at night. I can wake up in the morning, but not very well rested.
I'll keep you posted as to now what happens with the 300 welbutrin combo. FYI.. I think Cymbalta 20mgs is great in a lot of other respects. I'm much less impulsive. I feel much more under control and in a lot of ways much more independent and confident to employ my naturual talents. The only issue with that drug is that it doesn't help with focus enough and my Libido is compromised. However, it doesn't make you sleepy at all. I never get tired on the stuff unless I have to drive long distances or something, where I have to focus for long periods of time. It makes me not want to drink or smoke or anything. As a matter of fact I stopped drinking alcohol and grubbing cigarettes in 2004 right after starting with Cymbalta. 20mgs is perfect. Anything more than that felt too much.
Mr. B
Hey guys,
I don't know if I should talk so soon since it's my first day on 300 mgs of Welbutrin with the 20mgs of Cymbalta. It appears to be better. My focus his more intense and the duration much longer. My leg barely shakes when I sit if at all. I seem to have more viger and less needful to take the path of least resistance. I hope that it only gets better. Again, I really think the Cymbalta is a main stay, and do not see myself abandoning it. As an SNRI, it handles the seritonin and NE evenly, and it's very clean. I don't have any side affects on this drug. When I used to take effexor, I had to go in the 300 plus range on the dosing, and the side effects were horrible. The Cymbalta is clean, and I need only the lowest dose. I hope the Welbutrin doesn't wear off in days to come. Will give an update on this.
Mr. B
Hey Mr B,
Well, the second dose of Wellbutrin helped me a bit, but at 300mg a day, it is still not doing an adequate job of helping my focus. I saw my p-doc this afternoon, and after showing him a list of issues and telling him how my husband is on the verge of leaving me because I forget everything etc, he decided to add a stimulant. I will be trying short-acting methyphenidate in addition to the other meds. I have never taken a stimulant before and so I don't really know what to expect. I also don't know whether this one will be the "right" one, but we'll see. My pharmacy had to order it and so it will be Wednesday when I go pick it up.
I'll let you know how it goes. I hope all is well with you!
I take 10mgs of lexapro, and 150mg of wellbutrin. Alone the 10mgs of lexapro made me really hyperactive, and the addition of wellbutrin calmed me down. It hasn't done wonders for concentration, but it could be that I'm just so used to the effects of stimulants. I take Adderall on top of this when I go to school, otherwise I'm fine at home, can eat, sleep, stay calm with no problems. The first day that I added wellbutrin was a little challenging to fall asleep, but since I take lexapro at night, I was eventually able to fall asleep.interesting, I'd love to hear more on all this too. We just went with the Desiprimine. Started today and will wean her off the Zoloft....................