Bupropion vs Adderall
October 20, 2011 8:10 PM   Subscribe

Should I go back on Bupropion (Wellbutrin), or give Adderall a try?

A few months ago I quit taking Bupropion (Wellbutrin), which I was taking for reasons including depression. I don't feel depressed anymore, but I'm missing the heightened focus and productivity I had on Wellbutrin. I feel like I'm perpetually struggling to stay on top of things, and that's something that could get depressing, and which at the very least is causing me some stress.

A little research taught me that both Wellbutrin and Adderall function as norepinephrine-dopamine reuptake inhibitors (NDRIs), so either should be similar in effect and give me the kick I'm looking for.

But these are different molecules with different metabolites. I've read that amphetamines like Adderall can be neurotoxic, which worries me.

So I have two specific questions, one technical and one anecdotal:

1. Which of these drugs is less dangerous?

2. For those of you who have been on both medications, what difference between the two did you experience?
posted by edguardo to Health & Fitness (15 answers total) 11 users marked this as a favorite
I am not a doctor or a psychatrist, but my lay understanding is that you do build up a tolerance to Adderall and it becomes less effective over time, while you do not build up a tolerance to Wellbutrin. If you plan to be on the medication long term, this might be something to consider.

Adderall can be, and often is, abused. I don't think - though I could be wrong - that it's possible to abuse Wellbutrin.
posted by insectosaurus at 8:16 PM on October 20, 2011

I have taken both. I have the same experience as insectosaurus of building up a tolerance with Adderall / MAS.

I find that Adderall / MAS can sometimes produce a "down-swing" as it wears off, resulting in a period of feeling depressed in the late afternoon or evening.

If Bupropion works for you I'd continue with that, personally.
posted by XMLicious at 8:51 PM on October 20, 2011

Not sure about the dangers, but in terms of #2...

1. Adderall is way more difficult to get. For one thing, there's an Adderall shortage right now; it took me two weeks to find a pharmacy in town that had any the last time I refilled, and it's only projected to get worse. For another, because Adderall is abused, asking for it tends to be met with suspicion. One clinic wouldn't prescribe it unless I'd spent at least a year trying other ADD meds under their watch, and my GP wouldn't prescribe it until I had gone to a psychologist on his approved list, taken a battery of formal ADD tests, and had the psychologist send over a detailed report specifically recommending it. Even after all that, I still have trouble; I've been asking my GP for several months now to increase my dosage a little, because I'm still on the starter dose after a year and it's not as effective anymore. He won't do it, and treats me like I'm begging on the corner for crack whenever I ask.

2. Insectosaurus is right, you do build up a tolerance. The starter dose worked great at first, but now I barely notice a difference. Even though it seems like it's not working, I realized I'm definitely addicted to it; when I couldn't get my scrip refilled, I felt like absolute ass for about four days.

3. It has some annoying side effects; food is completely unappealing and tastes bad. I've heard that part goes away after a while, but I still have to force myself to eat. It also gives me a weird tic where I click my teeth along with whatever song is in my head, which drives my husband CRAZY.

4. That said, I was on Wellbutrin before I was on Adderall, and the Adderall works SO much better. Even with the tooth-clicking and no appetite and addiction, I feel like Adderall's worth it for me to be able to get from Point A to Point B without accidentally going to points C-Z.
posted by Gianna at 8:54 PM on October 20, 2011 [1 favorite]

I contemplated writing this exact same question a few months ago.

I went on Wellbutrin for depression, and for the first few days it was A-MAYYYYY-ZING - I had focus and productivity and an attention span like I'd never had before. I remember thinking "is this how normal people feel?" and I literally cried with joy about how awesome I felt, and how I could stay on-task, and the like.

Then I started getting hives and my doctor suggested I switch to Celexa. I did, and the depression stayed at bay, but I still missed that feeling of being able to start a task and stick to it all the way through. I wondered if there was a way to get it back.

So then I did the same research as you, and found that Wellbutrin was an NDRI, just like Adderall. I talked to my doctor, explained my situation, and he gave me a prescription for Adderall. It's a very low dosage; I don't remember the exact number.

I've been on it for about two months now, give or take a week or two, and it's still wonderful. Shit gets done! My desk at work is clean! The house is tidy! I've lost weight! I'm probably addicted to it now, but at the moment, I do not care.

posted by Lucinda at 9:01 PM on October 20, 2011 [3 favorites]

It's exceedingly easy to see why Adderall gets abused. It's got a very clear 'on' state, and to say that it causes "heightened focus and productivity" is an understatement - its (ab)use as a "study drug" is well documented. Wellbutrin had a much less pronounced effect; it took a few weeks and a steady dose before I felt any effect, and the effect was much less "in your face".
posted by fragmede at 9:49 PM on October 20, 2011

I took Wellbutrin along with some other meds for a while which worked well until it didn't anymore. (Lack of energy and resolve to follow through on things is the hallmark of my depression.)

My doctor took me off Wellbutrin and put me on Vyvanse instead. I've used Adderall in the past and what I didn't like was the up and down spurts of energy depending on when I took the pills. Vyvanse is more of an extended-release med, much more of an even-keeled focus and productivity.

Only annoying thing is that like Adderall, it's heavily regulated, so you have to get a new prescription each month.
posted by book 'em dano at 10:19 PM on October 20, 2011

Well I've never had depression but I've recently gotten prescription for Adderall specifically for ADHD about a month ago. The first week and a half it was awesome but, although it greatly improved my productivity around 5pm (I took it usually around 10am) I would start to feel really emotionally blank, sometimes highly irritable and crazy. Like insane lunatic crazy and just very not myself. So I'd definitely be wearing of Adderall if you're taking it for things other than straight up ADHD.
posted by ad4pt at 11:56 PM on October 20, 2011

If Wellbutrin worked for you, then that's what you should use. I was on brand-name Wellbutrin for several years and felt is was amazing stuff. If my prescription coverage paid for brand-name meds, I'd still be happily taking it.

I would only throw my own personal-experience-based caveat...I've found that the Bupropion generics on the market vary wildly in their quality and effectiveness. Some seem to come close to the level of effectiveness of the brand version. Others, though, work so horribly as to make me wonder if they weren't actually created to act as a depression potentiator. I think the issue was that the generics don't mimic the time-release mechanism of the brand, dumping far too much bupropion into your system, causing a huge spike and then a crash.

Unfortunately, the generic that created the worst problems for us was also the cheapest one on the market and, thus, was the version most pharmacies stocked.

YMMV, of course.
posted by Thorzdad at 4:36 AM on October 21, 2011 [2 favorites]

I love Adderall, and am not on it now, and there are ways to keep from building up too much of a tolerance...

But if wellbutrin worked for you, why try something new?
posted by the young rope-rider at 6:21 AM on October 21, 2011

wellbutrin generics are definitely different from the brand. Check out crazymeds.
posted by the young rope-rider at 6:24 AM on October 21, 2011 [1 favorite]

Adderall starts working in 30 minutes and wears off in a few hours. Wellbutrin can take weeks to go on and off. Why not give Adderall a shot for a few days first and see how it is for you?
posted by SampleSize at 8:16 AM on October 21, 2011

I've taken both. I took welbutrin for depression/quit smoking, and adderall and its friendly family of amphetamine salts for studying/getting shit done.

The point of the difficulty to get scripted for it is/can be hard, but certainly isn't impossible. I know people who's primary goal was academic use and were able to get it scripted.

Adderall has diminision effects, and certainly can cause a dependency. Why? Because it feels so good, and you can get so much more done (I can't write worth a shit on it, but I can easily read a mountain of boring material lickity split). More likely than not, they would first put you on Straterra, and probably Ritalin prior towards any amphetamine salt.

If you do get scripted for it, and wish to avoid dependency issues, keep in mind the regularity of which you take it. Stagger days between using/not using and if planning on come off it after extended use to titrate the dose downwards.

It can be a safe, highly useful medication, but it can be terrible as well. The crashes can suck as well.

Best of luck, I am not a doctor/pharmacist. Just well versed in psychotropic medications.
posted by handbanana at 8:45 AM on October 21, 2011

I've never had trouble getting Adderall and it was prescribed to me first before anything else, so you might not have that problem. Of course I am not college age, and I'm so ADHD that you can tell something is up just by looking at me.

If you go in specifically asking for Adderall they might be suspicious, though.
posted by the young rope-rider at 10:00 AM on October 21, 2011 [1 favorite]

I am currently on Adderall for ADHD. This is the 2nd time I’ve been on it, as I find that I quickly build up a tolerance to the dosage. For about 3 weeks after my dosage is increased, my focus is amazing and all of my shit gets done. I’ve never tried Wellbutrin. I asked about it once but was told that one of the side effects is weight gain. That’s a deal breaker for me.
posted by Amalie-Suzette at 10:45 AM on October 21, 2011

Ha! Something I actually know about (kind of)! I have ADHD-induced depression, so I have, at various times, taken both Wellbutrin and Ritalin/Concerta at the same time. (Never Adderall, but I thought it was just another formulation of the amphetamine family?)

In my experience, after coming out of a depression episode, if I still felt like I couldn't get anything done, that was a sign that the depression wasn't truly vanquished. I've recently tried taking just the Ritalin, and for me at least, this is a non-starter. I decide to do ALL THE THINGS now that I can concentrate, and then I crash out when I metabolize it all (superfast drug metabolism here) and get depressed! I need the WB in there to mediate the response, and often, WB alone is enough to allow me to cope on my own the rest of the way. (I'll never be organized and able to behave like a responsible adult, but anything is an improvement over not being able to work on a project for even 5 minutes at a time.)

Many people hate hate hate WB, but for me and my brother, it was a lifesaver - helped the depression and anxiety (and the delusional-level panic attacks) without the flat affect of SSRIs. Only side effect I've ever had is that my hands shake a tiny bit - I assume it's the dopamine effects, and I've established that it's not permanent, at least for me.

So, assuming you weren't having problems with the WB, I'd recommend that at least, and then after you've been back on for a month, then start thinking about if you need more.

(IANAD, just a crazyperson.)
posted by dust.wind.dude at 12:05 PM on October 21, 2011 [1 favorite]

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