All ADD drugs suck.

February 12, 2007 8:35 AM

I am taking Wellbutrin for ADD, and (like other posters here) I've noticed that my personality seems to be flatlining.

Basically, my capacity for feeling any real elation seems to be reduced, and when I start going off it I am capable of feeling a wider range of emotions. I've been taking it for about two years.

I've taken concerta (SR ritalin) but thought it was giving me a tic, so I freaked and quit.

Otherwise I was digging the concerta. The wellbutrin keeps me from being impulsive as it simultaneously decreases my enthusiasm and energy levels somewhat.

I'm afraid if I taper off the wellbutrin (generic SR, 150mg) that a raft of unpleasant behaviors associated with ADD (distraction, lack of productivity, snapping at spouse, barking at kids) will return. On the other hand, I am older and mellower.

I am going to see a clinical psychiatrist, but my previous experiences have been hardly educational, and I wanted to ping ask.mefi before embarking.

Is there a drug that will let me retain my personality, won't have a crash effect, and let me focus enough to get some work done? Or should I become Mr. Natural and start taking folates and exercising two hours a day and hope for the best?

Thanks for any tips.

posted by anonymous to health (22 comments total)

Have you tried Strattera instead? Where Concerta is an amphetamine, and Wellbutrin is a SSRI, Strattera is a NRI. It's got a *lot* of annoying side effects, and I've had some serious mood swings on it, but it's let me concentrate...
posted by SpecialK at 8:41 AM on February 12, 2007

Let me play just a little devil's advocate-could you have been overly emotional and now just more "normal?"

If not, well I have been on Strattera, and it isn't that bad. If you have low blood pressure it can make you a little dizzy but otherwise I had no problem with it.
posted by konolia at 8:48 AM on February 12, 2007

Another vote for Strattera!
posted by k8t at 8:52 AM on February 12, 2007

I am on Zyban, which is basically Welbutrin and I have the same issue. I don't get annoyed as easiily, which has helped me quit smoking, but I have never been so content with watching my housemates play Final Fantasy 12 as I have while on Zyban. Usually I would get really annoyed and retreat to the bedroom.
posted by parmanparman at 8:52 AM on February 12, 2007

I recommend talking to the prescriber (presumably your psychiatrist). About seven years ago, whilst going through a messy spell of post-collegiate depression, I went through long list of different drugs including Wellbutrin, which ironically had the exact opposite effect on me to a dramatic degree (it made me mean and aggressive and unable to eat). It took months (literally) to finally find a good match. This is an experience I've heard echoed by my friends who are taking medication for adult ADD. It's still an imperfect science. And it's very rare to find the right medication right off the bat. Bottom line is, if you genuinely feel like the drug is having signicantly negative effects on your personality, it's probably a sign that it's not the right one, and could even a signal that it could cause more problems (possibly even physical) down the line.

Also, your body chemistry does change as you get older. So what worked a year ago might not work in two years.

Again talk to your psychiatrist.
posted by thivaia at 9:02 AM on February 12, 2007

As I understand it, Focalin XR is a lot like Concerta, but it's gentler. You might talk to your doctor about it.
posted by palmcorder_yajna at 9:05 AM on February 12, 2007

Obviously, not all drugs work the same way for everybody. However, strattera made me feel dead inside. Just totally flat. Like a robotic version of myself.

I tried generic wellbutrin and it made me anxious and constantly annoyed. I tried the brand name version and it was great, no side effects whatsoever. I eventually had to stop taking it because the smell of the pill put me off and I'd skip doses.

I've tried all sorts of meds throughout the years and I'm better off without the meds than with. This probably won't work for everyone, but it works best for me.
posted by necessitas at 9:11 AM on February 12, 2007

and Wellbutrin is a SSRI

Just a nitpick: Wellbutrin is not an SSRI.
posted by dilettante at 9:14 AM on February 12, 2007

Oops. Thanks dilettante, I thought it was. Wellbutrin is an NRI like Strattera, it seems. http://en.wikipedia.org/wiki/Norepinephrine_reuptake_inhibitor
posted by SpecialK at 9:20 AM on February 12, 2007

Ack. linky to NRI article
posted by SpecialK at 9:20 AM on February 12, 2007

First, one more slight nitpick: Concerta is not an amphetamine.

Wellbutrin is an NRI, but it also inhibits the reuptake of dopamine, much like other drugs usually prescribed for ADD such as Dexedrine, Ritalin, etc.

Concerta is a mix of two isomers of methylphenidate, whereas Focalin contains only one of the two. It's the same as the situation with Adderall and Dexedrine respectively. I have a friend who has tried both Adderall and Dexedrine, and found that the effects differed enough that he distinctly preferred the Dexedrine, so it's possible that Focalin will be more to your liking.

That said, you might also want to look into the extended release versions of Adderall and Dexedrine, though they ARE amphetamines, and can have some unpleasant side effects. Extended release Dexedrine seemed to work well for a different friend of mine, but he eventually stopped using it as the side effects (trouble sleeping, anxiety) seemed to get worse as he went on.
posted by benign at 9:25 AM on February 12, 2007

I've been taking Wellbutrin for several years. I see the flattening of emotion as a good thing (personally) It works to level-out the highs and lows of depressive episodes. I've found it to be the best of anything else I've tried.

And ditto on necessitas' observation about some generics. My HMO insisted on putting me on a generic bupropion. Within days I became highly agitated, depressed and angry. The HMO eventually agreed to put me back on the name brand (making me pay the out-of-formulary fee, of course) and I was much, much better. It was scary.
posted by Thorzdad at 9:29 AM on February 12, 2007

"Is there a drug that will let me retain my personality, won't have a crash effect, and let me focus enough to get some work done? Or should I become Mr. Natural and start taking folates and exercising two hours a day and hope for the best?"

Is there no middle road here? What about a nice course of therapy to help you handle the symptoms of ADD? If it works, it works. If not, you can go back on medications.

Therapy is proven effective across a wide range disorders and symptoms, as well as a wide range of severities. It does not have to take a long time. It works better than no treatment at all, and as well as medications for many disorders. Were the medications working as you wanted them too you wouldn't be asking this question. Since they aren't, and you're looking for a change, why not give therapy a try? Folate and exercise are not equivalent to therapy, which is a goal-directed, professionally-managed behavior.

The worst that happens is that you discover, in a couple of months, that you want to try medications again, but you'll have more information to add to the mix. In both cases, medications and therapy, for ADD you're addressing symptoms, anyway.
posted by OmieWise at 9:30 AM on February 12, 2007

I hate to say this, but this is what you were asking for in the first place. My mom just went on a mood stabilizer after 35 years of undiagnosed agonizing bipolar disorder. Now she's complaining of mood flattening and wants the highs back. But that's like having your cake and eat it too. Your elation was likely part of the problem.
posted by Ironmouth at 9:35 AM on February 12, 2007

A psychiatrist remarked to me that the official medical term for finding the right mood brain drug should be "crapshoot." Nobody can predict how you'll do on a given drug, even based on your history with other drugs in the same class. But I do think it's good to ask around as you're doing; it can give you an idea of the crazy range of results, and encourage you to try something new even if the package insert sounds discouraging.

Wellbutrin SR does you dome good, but it's too calming at 150 mg. How about trying 75 mg, and adding some other drug. (A little Concerta, maybe? Some people do combine them for ADHD.)

Good luck in your quest.
posted by wryly at 10:03 AM on February 12, 2007

I hate seeing people recommend specific drugs. It's straight out of the "Talk to your doctor about _______" commercials on US TV. What works for one may not work for another and it's definitely a sign of the times that people go in to doctors recommending a particular name brand. It freaks me out a little. Have a good long conversation with your psychiatrist to sort out the cost/benefit ratio of various approaches.

Anyway. I take Wellbutrin (300mg) for ADD. I've been on it since about christmastime and I'm not sure yet how I feel about it. I do think it reduced my impulsivity about getting off-task at work, but not miraculously so. My psychiatrist has mentioned possibly increasing to 450mg. I'm not sure how I feel about that, but I guess I'll try if he suggests it.

I'm also on Effexor (150mg) and dexedrine (3x5mg three times a day.) The dexedrine has been the single most helpful drug in my case. It changed everything -- I had become so overwhelmed by life that I didn't even feel I could hold down a job anymore, but immediately after starting the dexies I felt capable of facing my daily life. I had the will to DO things for once.

As for the Effexor, I tried decreasing recently because with regards to the ADD my doctor isn't convinced it's necessary (I went on it for depression before I was diagnosed with ADD) but I felt like I was getting depressed again. I'm not sure if it was life circumstances or not, but I'm back to 150mg for the time being.

But I think that Ironmouth is on to something. There is a huge shift in self-perception after you accept that you have ADD. All your ideas about who you are come into question. Everything you thought you knew about your personality suddenly seems suspect. I recommend the book Journeys Through ADDulthood by Sari Solden. It addresses that gap in self-image.

Also, the Crazy Meds site is useful, but again, don't take a personal account as a recommendation for or against a particular drug. Everyone's reaction is different.

Yesterday was a good example of the progress I've made. I had a tonne of things to accomplish yesterday that I knew I couldn't leave any longer -- vacuuming, washing dishes, laundry, a sewing project etc etc etc and I got it all done! I assure you this is a huge sign of progress for me.
posted by loiseau at 10:14 AM on February 12, 2007

As the partner of someone with ADD, I agree with Ironmouth. Of course you're not going to feel "normal" or "retain your personality" because normal for someone with ADD (or bipolar, or any other psychiatric disorder) is not conducive to functioning in the rest of the world. That's why the drugs exist, to make you feel other than what you're used to. I'm sure your spouse and kids would rather have you be elated than snapping at them, but if it's both or neither, I'll gladly take neither...
posted by desjardins at 10:25 AM on February 12, 2007

Wellbutrin just made me mad when I took it.

I did Strattera for a year or so. Sexual side effects were awful, and it kinda destroyed my will to do anything after about 6 months.

Now I'm on Provigil, which I absolutely love.
posted by Lord_Pall at 10:44 AM on February 12, 2007

Ironmouth writes...

I hate to say this, but this is what you were asking for in the first place.

There's a lot (!) of room between flat and bipolar. These drugs are meant to regulate moods, not remove the ability to feel anything at all.
posted by tkolar at 10:49 AM on February 12, 2007 [1 favorite]

First, one more slight nitpick: Concerta is not an amphetamine.

Not technically. But it is a central nervous system stimulant with similar effects.
posted by norm at 1:34 PM on February 12, 2007

There's a lot (!) of room between flat and bipolar. These drugs are meant to regulate moods, not remove the ability to feel anything at all.

That's true, but (and I'm another user of many prescription meds speaking from experience) the fact is that if you take mood-altering drugs, then they are going to alter your mood. It may be a little, it may be a lot, but that's kind of the point. And if you have learned to identify as a person who is grumpy most of the time, or overjoyed only on every other Wednesday, and then you realize suddenly that you are no longer that way, then yes, you "no longer feel like yourself." That's how it is. The point is to not make you feel like yourself. You can't stay the same way you are and still not have the problems that are caused by being the way you are, just as you can't get drunk and stay sober at the same time. You can have just one glass of wine if you like, but altering your mind is altering your mind. It has it's pluses and minuses, but that's what it is.
posted by bingo at 9:56 PM on February 12, 2007

Huh. I personally haven't found Wellbutrin to flatline my moods. In fact, my psychiatrist recommended it over an SSRI because he said that they were more likely to do so. I actually found that being on it brought back my ability to be delighted by things.

So this is, I guess, a vote for everyone reacts differently, and you should keep trying new things until you find one whose side effects you're ok with.
posted by someone else at 11:53 PM on February 13, 2007