Wellbutrin (Buproprion) and Adult ADHD -A Non-Stimulant Option. Mechanism of action and side effects
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- čas přidán 27. 08. 2024
- Dr. Pagnani of Rittenhouse Psychiatric Associates discusses Wellbutrin (Buproprion) and its off-label use in the treatment of Adult ADHD. Wellbutrin (buproprion) is a norepinephrine and dopamine reuptake inhibitor, which is FDA approved for the treatment of depression. Unlike antidepressants such as SSRIs or SNRIs, this medication does NOT increase availability of serotonin, and therefore, does NOT treat anxiety (in fact, it can make anxiety and irritability worse). It is also used for smoking cessation (with the Trade name Zyban). Other side effects include increased risk for seizure (making it a non-ideal option for individuals with eating disorders or alcohol use disorders [as it can be dangerous for these individuals]), increased intra-ocular pressure, dry mouth, constipation, tachycardia, sweating, insomnia, upset stomach, decreased appetite (and weight loss) and others. With that said, this may be a good option for some patients, particularly as it does not have the abuse potential, of stimulants like adderall, ritalin, vyvanse and concerta.
Dr. Pagnani is the founder and medical director of Rittenhouse Psychiatric Associates, an Instructor at The Johns Hopkins Hospital for the Department of Psychiatry, he supervises psychiatric residents at Jefferson Hospital, he serves on the Young Professional Board of Uplift, the Center for Grieving Children and he maintains a private practice of Psychiatry in Philadelphia where he sees patients for one-time psychiatric evaluations and second opinions. He is a licensed physician and surgeon in NJ, PA, NY, MD, DE, FL and CA and can provide consultations to individuals via HIPAA compliant Telehealth visits living in these locations.
Rittenhouse Psychiatric Associates is a private practice of psychiatry consisting of about 25 psychiatrists, psychiatric nurse practitioners and psychotherapists with physical locations in Philadelphia and Paoli, PA and serving all of PA, NJ, NY and FL virtually via HIPAA compliant tele-psychiatry. Individuals seeking not only evaluations but long-term psychiatric care, can contact Rittenhouse Psychiatric Associates directly.
These videos aim to increase awareness and discussion of mental health topics and to encourage struggling individuals to schedule an appointment directly with a mental health provider. Mental health needs to be normalized, and simply speaking about mental health topics openly, is an important first step.
Dr. Pagnani and Rittenhouse Psychiatric Associates are NOT advocating for or against the use of any mentioned psychiatric medications for any specific individual. Additionally, any side effects mentioned are not a complete list of potential side effects or contraindications to taking any mentioned medications, and all risks and benefits of a medication should be discussed with an individual’s provider at an appointment, before starting, stopping or making changes to a medication regimen.
This video is INFORMATIVE ONLY - NOT MEDICAL ADVICE.
If you are researching a specific topic, please view our CZcams channel, click all videos and use the search function. Please also visit and follow us on instagram and FB: @RittenhousePsych.
www.RittenhousePA.com
www.ChrisPagnaniMD.com
I’ve tried most meds that are used to treat depression and anxiety primarily, but none really helped at all. I recently started bupropion and it has honestly saved my life. Also, I was recently diagnosed with adhd as well, and I completely understand now why I am the way I am.. however, before the bupropion, the depression overrode the adhd and I was in bed most of the time, just not wanting to participate in life. I am a completely different person now and I’m thankfully enjoying life again. Thanks for the video. 🙏🏼
Hi Sally, how long have you been taking it? It was a real life saver to me, but after 3 years it basically stopped working (at 300). I upped it at 450 - nothing. Any hint?
@@mantralibre1367 I’ve been taking it since February of this year. I started at 150 xl and felt a lift in my mood very quickly, but then kind of leveled out and felt that I would probably benefit from a higher dose. So I talked to my doctor about a month later and she upped me to 300 xl which has been working pretty well so far. But I agree with you, it truly saves lives and I wish I had talked to my doctor sooner. I’ve tried lexapro and escotalopram in the past with no success, and kind of just gave up on meds. I wish you the best of luck! 💜🩵
It's wonderful to hear that you are doing well, and that this medication (and proper diagnosis) has been so beneficial. Great post, and thank you for sharing! - Dr. Pagnani
@@jaxsally i was given ritalin in the end. Alive again, even though I cant Say I like the upgrade. It seems stimulants are the only thing working for me, and it's pretty easy to develop a Quick tolerance. However, feeling good again feels good🥴😂
I was giving this medication as well I’m very nervous about taking new meds that my doctors prescribed me 😅 but reading this comment makes me feel confident n trying it. Hopefully no symptoms thank you for sharing your experience.
Huh. Interesting. My experience with Buproprion and ADHD so far quite positive. It helps with anexiety, quite a bit with executive functioning, and it gives the amount of control over what my brain does i've never had before.
May i ask what your dosage is?
Thank you for sharing and I'm so glad to hear that you are having positive effects! Sincerely, - Dr. Pagnani
Do you take the XL or SR version?
That’s great! I just got it prescribed and it’s been more than a week of no noticeable change, sadly.
Still holding out though.
@@ubayyd probably just need a higher dose gotta play it safe and start with low dose though don't wanna end up overmedicated.
Nobody ever explained to me why bulimia would cause an increased seizure risk when paired with buproprion/Wellbutrin. Thanks for disseminating valuable information!
Wellbutrin has helped improve my ADHD symptoms, but it also increased my insomnia. My doctor added Neuronitin 4 times a day and this, along with therapy, significantly improved management of my condition. ADHD symptoms aren't the same for everyone and treatments aren't "one size fits all." Finding good providers that specializes in treating ADHD is imperative to success.
How is it going for you?
@@Valentininia I'm better than I've been at any other time in my life. That's not to say everyday is rainbows and cotton candy, but there's a lot more good days than before this tx regimen.
I've been using it for about 3 years. The way I describe it is that it stimulates my motivation. It doesn't help me stay on task, but it does help me actually start. And starting is sometimes the biggest challenge.
And if you're someone who tried and it didn't work, let me ask what dose? Everyone starts at 150, but everyone I know who likes it moves up to 300 while everyone who didn't like it stoped before trying 300. Everyone's experience is unique, but I suggest trying the 300 before you give up. Start on 150, move up to 300.
This is my opinion as a layman who has used it for 3 years, I'm not giving medical advice, just one patients experience.
I just started this medicine for my ADHD and IED I am feeling much better. But I am a very social person, and according to my doctor it okay to drink on weekends, like 5-7 drinks also but google says otherwise. If you are an occasional drinker can you please comment on it?
I just started this medicine for my ADHD and IED I am feeling much better. But I am a very social person, and according to my doctor it okay to drink on weekends, like 5-7 drinks also but google says otherwise. If you are an occasional drinker can you please comment on it?
@@Raunakbhalla. It is a dangerous risk, but I do drink I haven't noticable difference as of yet when I drink. Doesn't mean it's not hurting in ways that have yet to manifest, but I have not experienced the mix effecting me personally.
Also I think half the time doctors just say "don't drink and smoke with it" because they low key want you to stop drinking and smoking anyways. 😂
I turned into a fat slob when I quit.
I was trying to be more outgoing, this drug made my anxiety worse, but I miss the benefit.
I had no side effects from this drug. It worked as intended. I lost 20 pounds on this drug then gained it back when I quit.
Not the best for social anxiety, that’s why I quit. I miss the benefits.
Wellbutrin is technically an stimulant. Yes, it’s used as an antidepressant, but its mechanism of action is one of a stimulant since it blocks dopamine reuptake by inhibiting DAT via a mechanism similar to cocaine, but less addictive. It has the same end result as an amphetamine (like adderall) which is to increase synaptic dopamine.
I had great results with it, and though it was prescribed to help with my bipolar/SAD, I believe it did help me with my ADHD as well. Unfortunately, the last psychiatrist I saw didn’t want to prescribe Wellbutrin to help with my adhd (I don’t need it for the other things at the moment).
Yes it is a stimulant. It can help you lose weight, causes sleeplessness and increases energy. I take it myself for post cancer/chemotherapy induced fatigue. Guess what a more technical name for bupropion is 3-Chloro-N-tert-butyl-β-ketoamphetamine making it a cathinone/amphetamine
What was his reasoning?
Currently zoning out while watching this 😂
i'm here reading the comments
Never have related more
@@nachocor LMAOOOOOO.....
😂😂😂
No ADHD peeps made it through this video!
It’s helped me with PMDD and it happened to help with ADHD. My anxiety with PMDD was brutal and now it is very manageable.
I'm glad to hear this, and thank you for sharing. - Dr. Pagnani
@Einsd619 I also have PMDD...tried Lexapro and it was a big no for me...I had full blown depression while on it (Lexapro), all I wanted to do is sleep and eat...it was so hard to pull myself out of that.
Just out of curiosity...what dose of Welbutrin are you on?
I can't believe Ben Foster changed his name and became a doctor. Man can do anything!
As a mental health provider and a patient, I am very appreciative of your video and detail replies to comments Dr. Pagnani! Thank you so much for your service and time!
Thank you so much for the kind comment!
I have been on 150 mg welbutrin for about 2 years and i really appreciate what it has done for my energy levels. I did raise my intake to 300 for a time which I agree, it did increase my irritability, when I was fighting a lot with my boyfriend at the time. Which then, my psychiatrist prescribed me to pair with zoloft, and this combination has been the most effective for my depression !
I just started this medicine Bupropion 150mg for my ADHD and IED I am feeling much better. But I am a very social person, and according to my doctor it okay to drink on weekends, like 5-7 drinks also but google says otherwise. If you are an occasional drinker can you please comment on it?
There’s studies out there that it can actually treat anxiety, this is a common misconception
Great comment and thank you for watching. While it is not FDA approved for the treatment of anxiety and while it has increased anxiety in many patients whom I've treated for depression or smoking cessation, I HAVE had some individuals report a decrease in anxiety (which really is interesting). I will say that one group of individuals who may have this response, would be individuals who are experiencing an anxious depression (where the underlying issue is depression, as opposed to a primary anxiety disorder). Another, would be some individuals with ADHD, where difficulty being present causes increased anxiety and distress, and then an improvement in focus causes a drop in anxiety with treatment. Thank again for your comment! - Dr. Pagnani
@@RittenhousePsych This seems to be the case for me. My ADHD deeply exacorbates my feelings of anxiety. Constly misplacing things, forgetting what I'm doing, getting overwhelmed by trying to plan out multiple tasks back-to-back or deal with multiple things at once can send me into a full-blown anxiety attack. I've started taking Wellbutrin recently, and have noticed a decrease in anxiousness, increase in energy and attentiveness.
It does, but especially social anxiety. Not, say, panic attacks or GAD. This because social anxiety and the depression coming with it, or with self criticizing are basically byproducts of the adhd.
I have untreatable neurological illness pain and I’ve tried every medication and treatment out there my doctors said. I never felt a single thing from any medication until I just started Wellbutrin 4 days ago and even the first day I felt a big difference! It’s really helping my anxiety from my pain and I’ve been able to stand up longer! Sometimes I can only stand for a few mins so noticing a difference give me hope!!!
Wellbrutrin at 150mg has made my ADHD and anxiety and mood MUCH worse. I feel so low.
Sorry to hear, it doesn't work for everyone. I've been seeing a lot of negative reactions on Reddit to Wellbutrin but surprisingly, a lot of good reactions on the CZcams comment section.
How long have u been on it though? Usually takes like 1 week to 8. My NP said it should take 1 week tho LMAO we'll see.
Have you tried Straterra? I would try to go non-stimulant, cheaper and safer!
@@MC-Minorityhow is it going for you
@@Valentininia Hey what's going on, I got off Wellbutrin and switched to Ritalin. I think I was on it for roughly 2 months. The 1st month I took 150mg and then 300mg my 2nd month, maybe it could have had full effect on the 3rd month. I've also researched people sometimes combine straterra.
If you have time like if you're in middle school or high school I'd go the antidepressant route or if you're on a break from school and working, then that'll be a perfect time to try it too.
Anyways, Ritalin works way better ofc b/c it's a stimulant. How's it going for you?
Buproprion saved my life. My first 75mg buproprion pill just about blew my head off. I tried cutting them in half; then in quarters, but had to cut into 5 pieces (15mg) to be able to tolerate. In a few months I worked up to 150mg/day. I have adhd and atypical depression. I still practice my compensating behaviors, and bup helps me to do them well. Also handled the depression.
Thank you so much for sharing, and your comment. I am happy to hear that you are doing well, and that this medication has been so helpful. I also think that it's great that you discussed your experience, with slowly titrating the medication to allow your body to adjust. It is not uncommon for someone to have activation (increased anxiety), irritability, upset stomach, headaches, and other side effects when starting these medications - and those SE's often go away with a slow titration and time to allow individuals to adjust. Thank you again! - Dr. Pagnani
I just received this new rx and terrified. Could you explain what you felt with the 75mg pill?
@@RittenhousePsych it was just this intense feeling in my head, not painful or anything, just quite unpleasant. But I had hope for buproprion and wanted to give it a fair chance, so I started splitting the pill until it was comfortable for me. Don't be scared, but I suggest that you take the first pill on your day off. Many people just take the full dose and just tough it out until they get used to it. I just didn't feel like going through all that, when I knew I could taper up and have the same end result. I think a lot of rx are like that, strong at first and then you get used to it.
@@lisetteblancas9557wondering the same thing
What version were you cutting? Just an fyi cutting extended release tablets isn’t recommended and will make them immediate release into your system (in case someone reads this and is thinking about doing this)
It made my anxiety worse. I was further away from my goal.
BUT I MISS THE BENEFITS
I turned into a fat slob when I quit Wellbutrin.
I’ve gained 20 pounds in a month, lost all impulse control, have no energy.
My advice, don’t see a psychiatrist unless you are a danger to yourself or others. Don’t see one if you are just trying to be more outgoing.
I know you said this doesn’t help anxiety but my doctor said it will help me. For references I have anxiety, adhd and depression.
Without us having an evaluation, I cannot comment as to how the medication will likely affect your specific symptoms. With that said, while it does not treat primary anxiety disorders, some patients do feel less anxious if their ADHD symptoms are better managed (and wellbutrin can improve ADHD symptoms for some individuals). There are other instances where it could be helpful as well. Thank you for sharing and your comment! - Dr. Pagnani
I'm supposed to start taking this wellbutrin xl this week but after reading these comments got me not wanting to even take it seriously.. I understand that medication works totally different on every person... but my lord I don't see too many great comments about this medication at all... ppl run to the comments to see how others has reacted to taking this and I think I'm going to not take this .. I don't wanna even try it just to see if it works because I have bad anxiety as it is & just knowing the fact of taking new meds definitely increases your anxiety before even taking it ... I'll stick to taking my xanax 1mg or Goli Gummies
No don't take xanax🥺
I had a really strange experience with Wellbutrin. It was years ago back when I had MDD and I hadn't yet been diagnosed with adhd & bpd. The Wellburtin gave me really bizarre hallucinations. I would see pictures in the form of drawings (like sketches) or cartoon type images moving on the walls, floors ceilings. Not all the time but frequently. They weren't unpleasant thankfully.
Something very strange was also going on with me at the time where I basically didn't sleep for an entire week. I wanted to but couldn't. This probably contributed to having those hallucinations but not completely. I came off the Wellbutrin and my doc switched me to a different medication after I told him about this hallucinations and no sleep thing. I continued having insomnia but I didn't get the hallucinations anymore --- so I know that it was mainly the Welbutrin that caused that.
Thank you for sharing your experience, and I'm sorry to hear that you had this negative reaction to the medication. Sincerely, - Dr. Pagnani
This causes shizophrenia,Wellubrin cause trauma for your brain and when you had your first hallucination it won’t stop even if you quit ,but the doctors love you😂
Really good video. I heard everything I needed to know. Thanks.
Thank you for watching and the kind comment. Sincerely, - Dr. Pagnani
I was prescribed this today and have not taken it yet. I will get it sometime in the next week or so. I am already taking fluoxitine for anxiety and it has helped, I am just not really motivated to do anything while taking it. I look forward to seeing if this helps. Thank you for the information.
My ears were ringing LIKE NEVER BEFORE! I’m on day one of not taking it. Hoping my ears go back to normal.
How is it going?
I’ve had good and bad Wellbutrin experiences. Helps the depression by causes insomnia. Then I took seroquel at night to sleep. This caused tremors so I took anti seizure meds with it. God it’s just a snowball. I don’t know if it’s worth it.
could you explain the tremors? wondering if I have been having the same.
Before taking 450mg of Bupropion, I would suggest to combine Bupropion 150XR or so with Methylphenidate. Seems to be a good combo...
Thanks, great video! You deserve a lot more subscribers. You're gonna go far, keep it up!
I had to stop after 7 days, tinnitus, insomnia and Nightmares that were so lucid i was scared to fall asleep, it just didnt work for me
😢😢
Nightmares will go away. I never had nightmares in my life untill I started with Bupropion. I really had bad nightmares the first 3 weeks. Not only that. Dreams where so real I pissed my bed twice as an adult 🤐. After a few weeks that al went away.
@@waltersteyger1215 🤣🤣
@@waltersteyger1215good comment. Pretty informative
Now that you are off of it, what’s the update for ears ringing????? I need an answer ASAP!
Very informative. I have been taking Wellbutrin for 7 weeks now for depression. I also have ADHD which is self diagnosed. I have all the symptoms and have had my whole life. I am 61 years old, male, and in recovery as well. I am taking 150 mg a day and while it has helped with the depression, I am still experiencing the ADHD symptoms. Any suggestions will be greatly appreciated.
I' cant understand how you had medication for "selfdiagnosed, unles you are a psyciatrys docktor. Wery weard. 😅
@@katiketo1maybe he has diagnosed depression and they prescribed Wellbutrin for that
It changed my life, but i had to heart skips and weird beats on it, dont know why but i had to stop it, dident get arrytmas anymore and could train again, checked my heart with ultrasound and ecg after i stopped taking it, nothing wrong with my heart.
It sucks, it worked really well, i went from doing no gym workouts to working out 5 days a week, woke up rested, which i never do otherwise, could clean and do everything easily on wellbutrin
You should refer to your psychiatrist to add B-Blockers like propranolol your treatment. It could be helpful
I have started taking bupropion for depression but I also have been thinking I may have inattentive ADHD. While I love that bupropion makes me feel motivated and has helped with my anhedonia, at 300 mg XL, it hasn’t helped my executive function. I’ve been taking bupropion for 3 months now. It’s like I have the motivation and thought that “I can actually do this,” but I still can’t bring myself to actually DO it. Not without significant effort. I briefly mentioned this to my NP when I finally got help, but she wasn’t sure if I had ADHD, so she placed me on this medication. I don’t want to seem like a fiend, but the executive function part has had my life on pause for the last few years. Not sure how to address this without feeling like I’m overstepping.
Bupropion didn’t work for me. I have severe inattentive adhd/depression
Thank you for sharing and adding to the discussion. Best,
I’ve been on Bupropion for a few months. I felt fine. The depression went away. My anxiety has gotten very bad. I’m only on 35.7 mg. I originally was prescribed 75 mg. I couldn’t tolerate it. My nurse said to take it every other day at 37.5 mg. I have BiPolar ll. I never had a break with the disease. My nurse is constantly trying all different kinds of medications and combinations, and the anxiety always comes back very bad. I’ve had anxiety since I was seven years old. Sometimes I have panic attacks and they’re very bad along with disassociation.
I gained 14 pounds in a week after I stopped taking it…. But…. I slept better.
I am 6 days on bupropion, the effects may just be in my head right now but I already feel like I have an increased ability to remember and complete multiple tasks in a row. Previously any one thing felt like a horrible chore 😅
Effexor as a non stim works for me for adhd. I was on Vyvanse for years but doc stopped taking my insurance so had to switch to a different doc who didn’t believe adults have adhd and wouldn’t prescribe stims. But the Effexor helps.
Thank you for your comment and sharing! I'm glad to hear that a non-stimulant (Effexor) has been helpful for your symptoms. Individuals often do not realize that there are options beyond the stimulant medications. Sincerely, - Dr. Pagnani
Duloxetine would likely be a better option as it’s also an SNRI like venlafaxine however it’s more potent at increasing norepinephrine levels.
I’ve taken both when I was “depressed” before I was diagnosed with ADHD. And duloxetine was without a doubt more effective at calming my brain.
Get a new doc .
Wellbutrin helps to keep me motivated and energetic but maybe I'm not taking enough because I'm still very impulsive and I still deal with anxiety. I'm taking 150mg and wondering if 300mg or 450mg would work better.
I've thought about adding Armodifinil to the mix as I heard that will help me with focus and executive function.
What do you think about this combination or upping my dose of Wellbutrin?
Hey, I've been taking bupropion (wellbutrin) for a month now, 150mg. I'd say try upping the dose of the wellbutrin first if it isn't doing the job for you instead of adding in a new type of medication. Having one type and just at a higher dose is much better than two different types, with possible negative interplay effects between them. Try discussing upping your dose with your health provider!
Wellbutrin made me completely unable to sleep. Terrible for my brain chemistry 😑
@@michaelhogan2256 same for me but I was on another medication and I couldn't stay awake
Thank you for sharing and adding to the discussion. While I cannot give someone direct advice without an evaluation, my general approach is to optimize one medication (as long as it's tolerated) before adding a second. With that said, it's important to be sure that the first medication isn't making any symptoms worse, or causing any side effects. For adults, typical doses of wellbutrin for ADHD tend to be 300 or 450. Again, this may not be appropriate for you, but it's important to discuss all of this with your professional. Best, - Dr. Pagnani
Thank you for sharing and I'm sorry to hear. Best,
It gave me some energy but also anxiety but I'm super depressed
Thank you for sharing and I'm sorry to hear that you've been having difficulty with your mood. Please be sure to discuss with your provider, and hopefully you can find treatment that works for you quickly. I really appreciate you joining in on the discussion. Sincerely, - Dr. Pagnani
ive been taking this medication for over 1 year right after my son passed. after the first few months my dosage was raised to 300xl because there was no effect which also resulted in no change. i decided it was a waist of money and quit the medication cold turkey even though my doc told me its dangerous to just stop. its been a full week of not taking it and again i feel no change. I have two questions if you would be so kind to answer is, how long till this is out of my system and why did this medication have zero effect?
First and foremost, I am sorry to hear about your son and you and you and your family are in my thoughts. Thank you for your comment, and I'll do my best with your questions.
Without an evaluation to determine someone's diagnosis, I cannot say exactly why a medication does (or doesn't) work for an individual. However, if someone does not have a history of significant depressions, outside of the context of triggers (a death in the family, would cause substantial "normal" human sadness), then antidepressant medications may not have any effect on improving mood. They generally only improve someone's mood if there's a medical condition (like major depressive disorder) causing/ contributing to the sadness. Extreme circumstances causing sadness (with no underlying medical illness) tend to be best treated with psychotherapy, behavioral activation, support, monitoring, avoiding problematic substances etc.
With that said, when someone has a treatable medical condition (like major depressive disorder) it can take a trial or even a couple of trials, to find the right medication for that individual. There's unfortunately no blood test or lab that someone can draw, to know exactly which medication (or dose) will work best for someone's neurochemistry. Even genetic testing for one's ability to metabolize medications, still doesn't tell you if a medication will work (although, it may help a provider to understand why someone may need only a low dose, or may require a high dose, of a particular medication, based on how fast or slowly a patient's body breaks down said medications). That is an aside, and I typically do not find these tests useful, for most patients.
When a patient has a medication trial, I try to have appointments every 4-6 weeks, so if there's no improvement of symptoms (once the medication is at full effect, or close to it), we can increase, or change medications as warranted. This way, if a patient requires several trials, it does not take too long, before they ultimately feel an improved mood.
Wellbutrin should be out of someone's system within about a week (in terms of blood levels). However, it may take several weeks (or up to a month or two, if someone's been taking it for a long-period of time) to establish a new baseline RE mood, energy, etc once stopping.
I do hope that this is helpful, and I am sorry again for your loss.
Sincerely, - Dr. Pagnani
my doctor prescribed me bupropion XL 150mg, escitalopram 10mg and trazodone 50mg. I've never felt so well in my life. But sometimes I think that I'm taking to much pills a day. do you think this is healthy?
OBVIOUSLY not healthy. 3 pills to make you feel good! Imagine when you stop talking them... Or maybe you have?
I just got prescribed that also and feel the same way. Im already thinking on how can I stop this after 1-2 years of usage
If it increases the presence of dopamine and norepinephrine, then it's a stimulant, isn't it?
That's a very interesting question.
If the definition that someone is using for stimulant is a medication/ substance that increases levels or activity of dopamine in the central nervous system, and can promote wakefulness, increase heart rate, breathing rate, and/ or brain function/ activity, then you could include Wellbutrin in that category. Amphetamines, methylphenidates, modafinil (Provigil), armodafinil (Nuvigil), caffeine, cocaine, nicotine all fall into that category as well. The way that I was trained, was that the "stimulant" category contains medications that not only satisfy the above criteria, but also have a degree of abuse/ dependency risk (and wellbutrin would fall below that threshold).
This really is a great academic question. As I'm typing this, I'm thinking "well, epinephrine given to someone in cardiac arrest, is certainly a stimulant, and you don't see people abusing it."
Of note, when I talk about wellbutrin, I say that while it's not put into the stimulant category, it has "stimulant-like" effects.
Thanks for your comment!
- Dr. Pagnani
@@RittenhousePsych - Thanks for your reply. Do you think we can we prevent addiction to stimulants for ADHD by not taking higher and higher doses? Or by taking time off from the stimulants in order to rebuild damaged dopamine receptors? It seems like dependence/addiction is otherwise eventually inevitable. (Maybe this question belongs under a different video)
@@echo-trip-1 well it’s kind of irrational to say someone with ADHD is addicted/dependent on stimulants. They require them to function as they lack the normal levels of dopamine and norepinephrine. We don’t say diabetics are addicted/dependent to insulin, they need it in order to live because they lack the ability to make it.
With that said it’s important that people don’t mistake euphoria with remission of ADHD symptoms. If your dose is too high initially, you’ll get euphoric effects and once that begins to fade patients may think they need a higher dose when in reality most of the time they don’t.
Also assuming the patient is on a proper dose, there should not be significant damage/death of dopamine receptors. They only die when overstimulated.
@@johnmoore1495 - Your second paragraph is key. But how many psychiatrists tell their patients that? I’ve never heard one say it. I suspect many of them don’t even know.
@@johnmoore1495 - Likewise with the third paragraph
I’m scared of having anger issues from it
Do you currently take it
@@Jamie_Rosex0 yes I do! I do get grumpy but it’s very bearable.
How is it going for you!
@@Valentininia good! I feel a lot better but tbh miss the honey moon phase where I was very energised and switched on lol.
Same here was on 150mg for 1 month it didn't do nothing now I've been on 300mg for couple weeks it's giving me insomnia I get 4hr sleep a day n I can get a lil moody at times
Why do you say that adults need higher end like 450 mg?
As someone who takes 450mg of bupropion XL it’s quite underwhelming even compared to modafinil.
The side effects and seizure risk are also not great considering the fact that if you’re taking it for ADHD that means you’ll likely be on it in perpetuity. Personally I get horrible tremors if I take all 450mg at once. It’s as if I develop Parkinson’s after a couple hours and it lasts for 6-8 hours. I’m not saying that lightly, eating soup would be impossible, and using utensils is incredibly difficult. So I have to spread my dosage out to 150mg every 8 hours which is a pain and hard to stay consistent with. Even with spreading it out I still get a noticeable tremor.
And let me be clear it’s definitely tremors, not jitters. It’s a shakiness as if your blood sugar is low or if your muscles are physically exhausted, it’s not jitters as though you’ve had way too much caffeine.
I think some of the issue is the generics are hot garbage. There are so many complaints on bupropion XL generics having increased side effects and reduced efficacy over the name brand. Not to mention the FDA granted a waiver to generic manufactures in regards to them not having to run trials on 450mg citing it wasn’t worth the risk of increased siezers on trial patients… Yet they granted the waiver allowing them to sell us 450mg without any testing. Makes zero sense. But a month supply of 450mg of the name brand is $5251 with GoodRx, so that’s off the table for 99% of Americans.
I think it’s best to stick to immediate release (IR) and sustained release (SR.) They seem to have far less problems compared to the extended release (XL) version.
What's Ur experience with modafinil?
God dude, 5000 dollars, fpr a month of 450 wellbutrin? In Italy it's about 20 euro. 🙄
Thank you for sharing, and I am sorry to hear about your side effects. I wanted to mention that I've had some patients switch to Aplenzin (also bupropion, but a new trade name medication), when they cannot get trade name Wellbutrin at a reasonable cost. When doing so, they are getting the same medication every time (as opposed to different generics). This medication is also expensive, BUT the company that makes it does offer coupon and discount cards (many newer trade name companies will do this). They also will often give samples to providers. So, it may be something to look into, or to talk to your provider about trying to get samples. Of note, I do have many patients do well on generic wellbutrin, but I also have had patients with your same experience. I hope that this is helpful, - Dr. Pagnani
if we start to feel anxiety, should we stop the treatment or not? i’m diagnosed with borderline personality disorder, adhd and cptsd. i already take escitalopram and tranxilium, we just (a week ago) added wellbutrin. due to my borderline personality disorder, i can’t take concerta because as they told me, this is not recommended
i’m at 150mg wellbutrin for now, didn’t feel any effects, not even the side effects except this anxiety that i handle with tranxilium, but it’s a bit annoying cos i have to dose a bit more my tranxilium to feel ok on wellbutrin
i really have high hope for this, i need to treat my adhd cos it’s disabling to me.. gimme hope doctor!!! 🙏🏽 thank you for your video
Thank you so much for sharing, and your questions. I am sorry for such a delay in my response. If someone feels increased anxiety with titrating wellbutrin, it's important to first discuss with their provider. Sometimes reducing the dose or more-slowly titrating can be very helpful. With that said, if it's clear that a medication is worsening someone's symptoms (or if it's clear that instead of adjusting to a dose, side effects are getting progressively worse on that same dose), then their provider will likely want them to decrease or stop the medication. I do not know what's best for your specific situation without an evaluation, but I hope that all of this is helpful and you can discuss in more detail with your provider. Sincerely, - Dr. Pagnani
I took Wellbutrin for 4 days, 150mg twice a day… it made me crazy. I couldn’t sit down and I cried sooooooo much. No thanks. Never again.
Thank you so much for your comment and sharing your experience! - Dr. Pagnani
Why’d you start at 300mg?! That’s normally like a few years down the line in tolerance.
@@amasterofsomeexactly, how ridiculous
Is Wellbutrin/Bupropion still available in the USA? Has anybody heard anything about nitrosamines there? I'm not seeing anything about it being withdrawn. Very frustrating.
Bupropion (Wellbutrin) is still available in the US by prescription. Thank you for your comment
@@RittenhousePsych Bupropion has been withdrawn in the UK and Europe pending an investigation for nitrosamine deposits, either from manufacture or storage. These deposits are potentially carcinogenic, so surprised there's no word from the US about it. Perhaps you can find out what the manufacturers have to say about it and let us know here. Thanks.
300 mg of Wellbutrin XL and 70 mg of Vyvanse together work great together for me.
Nuclear shit
Does this medication pair well with Buspirone? So that both meds would be helping anxiety,adhd and depression?
Thanks
I have been on wellbutrin for a month and have a buzzing in my head that I don't think will go away even if I stop taking it. the medicine. is there any hope
Thanks for the video, unfortunately in my experience nothing can come even close to stimulants. I find that stimulant’s have way less side effects and also calm my anxiety. But on the other hand had a friend who could not tolerate stimulants and found this medication to be a lifeline. I guess everyone is different and I have come to the conclusion without being a medical expert just my thoughts that you ether respond better to stimulants or you respond better to non stimulants class of medication. However this medication does appear to be more energising so may be better for people who get good effects to stimulants.
Stuff doesn’t work for me. Just made my anxiety worse at higher doses.
Im about to switch to this from my ssri, mainly because adderall has been repeatedly losing effectiveness, and the possibility that some of my supposed adhd symptoms might actually be depression symptoms that my ssri isnt effectively treating
For my ADHD people: ive been continuously upping my stimulant med dosage. It helps for a few days, then it'll stop having any effect whatsoever. So i take a break for a few days, up my dosage, and repeat the cycle. This has been the pattern for over 6 months. I started out on ritalin, then went over to adderall, which ive been on for 2.5 - 3 months. The entire time, it's been the same pattern, and im now on 2 25mg per day with no sustaining effective dosage appearing to settle in. Has anyone else had this experience? Whatd u do?
How come when I went to my psychiatrist he gave me wellbutrin for anxiety?
Did it work
Thanks for your video ! I started Wellbutrin 150 XL 2 months ago. I’m concerned about increased eye pressure. Is 150XL a low dose and is increased eye pressure common?
I'm under lexapro 20 ml for anxiety. It's not helping me as it used to. I got prescribed Wellbutrin. But I get some of the side effects, some anxiety dry lips and lots of fast heart beats. I know side effects last about 2 weeks. It feels horrible. Should I keep on taking it. Today is my 3rd day.
Hello! Is Wellbutrin more effective than Strattera for ADHD?
Everyone's body is different depends on you
I just started at 100 milligrams and I don’t feel any different. Do I have to take it for a week or so until it starts working or is it supposed to work right away?
it'll take few weeks to get results. you might feel the change in mood after 3-7 days.
Very interesting to hear all these details. I’m in the UK and been trying Methylphenidate for a bit over a week. I’m not sure Wellbutrin is an option here, though some non-stimulants are, anyway for me anxiety is the sticking point so probably a no.
Thank you for the comment! I hope that you find the right medication for your symptoms. Unfortunately the increased anxiety with wellbutrin (buproprion, you likely do have it available in the UK) can occur, but it doesn't affect everyone. Some are more or less sensitive than others. Thanks again! - Dr. Pagnani
I believe gp cant prescribe but consultants in hospital can for depression in uk.
Apparently it's being reviewed and may be possible to get on prescription from gp by the end of December 2023.
I’m having anxiety right now but I have Ativan that I don’t want to take it’s afternoon can I take it now (Afternoon)?? Or would morning being best
I just had my first dose today and felt really good. I have ADHD and IED( not harming other but had major self harm issued) I am feeling much better. Im 29 years old. But I am a very social person, and according to my doctor it okay to drink on weekends, like 5-7 drinks also but google says otherwise. Can you please comment on it? Because according to the doctor even if I take half a bottle on a Saturday its alright but google says about seizures which really bummed me out and Im very confused.
I just started on it 150mg, for a couple of days I was not feeling anything, not happy not sad not anything just blunt, I read that this will be even worse when increased the dosage
Does that mean it’s not for me?
Thank you for watching our video! As mentioned, these medications tend to take a month or so to get to their full effect. I would recommend speaking directly with your provider to discuss your specific care. If you are progressively feeling worse, then absolutely discuss with your provider.
This is NOT a good option for ADD at all. I had tried it many years ago as a possible option but side effects were terrible. Plus it is a mild stimulant like drinking 3-4 coffee. I have been on Strattera for 20 years and it does help to a point. It slows down the brain so you can focus but you can feel a little slow and tired. But I have recently discovered L-Tyrosine. This helps your body produce more Dopamine which people with ADD need. This has helped quite a bit
Thank you for sharing your experiences and thoughts! Very much appreciated. Best, - Dr. Pagnani
I just got prescribed bupropion and I’m bulimic. Can seizures give long lasting effects ?
Wellbutrin saved my life - like, I found out at 30 why did people, say, liked to dance, or could do chit - chat, or why feelings were considered something. Until it stopped working. Now I'm on ritalin. It works great, true, but the side effects are many, and it's not a 24h pill, say, I gotta take 3 to get the effect I had on wellbutrin. Not ideal. And: it is basically cocaine. People will object to this, but it indeed is. The chemical structure is very similar, it binds to even more receptors than cocaine, and the effects after one hour are pretty the same. You just don't feel the rush since it takes 30 min to kick. However. Better than nothing.
Thank you for sharing your experiences and thoughts. It's important to note, that there are other options beyond wellbutrin and stimulants (like Ritalin) for ADHD. I'd highly recommend speaking to your provider about other options, particularly non-stimulants (strattera, intuniv and others). You may have already done so, but it may be helpful for others to know this. Best, - Dr. Pagnani
@@RittenhousePsych yeah, I unfortunately dont live in the states. Ritalin Is the only available treatment for ADHD here.
Why did it stop working ?
Is it safe during conceiving, pregnancy and breastfeeding though?? Thanks
Thank you for your question. This is definitely something to discuss directly with your OBGYN and mental health prescriber. Medications like wellbutrin could potentially have side effects to a developing child, BUT if a medication like wellbutrin is required to keep someone's mood stable, there may also be benefits to the baby for developing in a more stable environment. Mothers who are depressed or overly anxious, may have difficulty getting good sleep, proper nutrition, and appropriate physical activity, which could all be important for a developing baby as well. I do not know what is best for you, but this is all something to discuss directly with your providers. I hope that this is helpful. Sincerely, - Dr. Pagnani
I was prescribed bupropion as an add on medication to take with my concerta. But I feel like it's been blocking the effects of my concerta and I end up feeling tired. Is that common?
I take 300mgs against(what?) each day. I can't feel a thing.:( I hear that Wellbutrin works exactly like ritalin. Is this true?
No, it is very mild. Sometimes I quit because I am not sure it doesn't do anything. After a few weeks I am back in a black hole and exactly know why I am taking it.
@@waltersteyger1215how is it going for you
interesting. i was on wellbutrin once and all it did was make my hands tremble.
My spinal cord is hurting i had to take 3 month long resperidon be caus of be ing excited to no accept my parent as they are . So there forward i am feelibg ill in term of mentally knowing in top of my head someting is not reachable it feels like its a tumor as i think thay way the pain comes . So and my coordination is not functioning any more .it looks like my mind has been changed . Be aware of the doses anyone .
Can youbtell me how can i rewind the respiredone
As i was a child i have been dreamed days and nicht .
I keep seeing that everyone is on like 75 mg and they had problems. I’m on 300mg daily?? Is that right? I firmly believe I have adhd and I failed out of school bc of it and I’ve bought and taken Adderall and vyvanse of the street and from friends and that shit has ALWAYS helped me. Literally changed my life in how it helps me with energy, focus, and motivation but I can’t tell my dr that I’d buy it off the street bc then I’d be labeled a drug addict and would then never be prescribed what I feel I need. I don’t know what to do. I do not like the bupropion as it makes me extremely fidgety.
I mean just tell your doctor a friend gave you one or two, and you tried it since you know you have ADHD. If it's a doctor you've been going to for a while, I doubt he'd consider that abuse. It's kind of like telling your doctor a friend gave you a Cialis, and it was effective, so you'd like a prescription.
@@diegogarcia4255 I got them few months ago. She refused to put me on it and then I got a call one day saying I had a prescription ready and I thought it was my sleeping meds but it ended up being vyvanse
You mentioned, homicidal thoughts with no elaboration 😮
* DO NOT PRESCRIBE SSRI's FOR ADHD! You will likely lose you creativity and personlity in place of feeling not much of anything. You will also have the memory similar to that of a lobotomy patient. Unless being drpressed is why you can't focus, SSRI's will only cause more problems for legit ADD/ADHD.
Wellbutrin is an NDRI ..Not an ssri
Didn't work for me at all..made me tired and spaced out. Too bad, its an easy prescription to get, stimulants are a pain.
True
Getting ritalin is hard.
Why I don't feel anything from this medication. Been using it for more than two months now.. -_-
Thank you for watching our video! Just like all anti-depressants, these medications take time to work. With that said, for most individuals at 2 months, they would be at full effect. Full effect for wellbutrin tends to actually be by 3-4 weeks (it works faster for most, than SSRIs/ SNRIs). Sometimes patients do not feel ANY improvement until they are on the right dose for them. For example, let's say someone starts at wellbutrin XL 150 daily. They may not feel anything, until a couple weeks after being increased to 300. Or even a couple weeks after being increased to 450. Any medications changes that someone makes, need to be discussed directly with their provider (and should only occur if someone is tolerating the medication well). With that said, if one of my patients told me that they did not feel any improvement on a starting dose for 2 months, I would tell them there's no reason not to be optimistic, and I would make an adjustment if they are tolerating it well. - Dr. Pagnani
only made me suffer brain zaps for months....so far
got better
@@bring6not12how is it now?
@@Valentininia nearly gone to the point where i cant tell sometimes if zap or random body sensation
never nearly as bad or frequent anymore, i went from 10-100+ BAD shocks a day to 1 weak shock every few days,
its been about 8 months since quitting WB
Buprinion or Ketamine??
Wellbutrin is giving me bad diarrhea... I just started taking it. I need Imodium to stop me from going to the bathroom. Im giving myself 10 days if it continues byebye Wellbutrin !
Did it stop?
Wtf is Ben Foster doing?!?!
Is it true wellbutrin causes premature Aging skin?
No lol
I had to stop taking this as I would crush and snort it to get high. It is a very abusable drug. I have no respect for drugs.
It seems that everyone s comments here comes from a different species of human !!! 😮
Haha we are all humans but no one is the same
It sounds dangerous
i cant with these side effects
Thank you for your comment. I recommend discussing all potential risks and benefits with your provider. With that said, individuals always have the right (and should) to make their own medical decisions. I hope that you are well, - Dr. Pagnani
Tried it for 2 days. 250 mg. Terrible. No thanks
Thank you for watching and your comment. I am sorry to hear that you had a negative experience, and I hope that you are well. - Dr. Pagnani
i'm not a medical professional, but 250mg seems really high to start with? usually titrate up over the course of a week and the effects are felt best 1-2 weeks in
im allergic to wellbutrin…. turns me red. Don’t recommend it.
That's just you. You don't need to recommend or not recommend
@@jcbanbury according to who? you? no thanks
What's black and white and red all over?😅 The newspaper!
🙄 please don't just read others people work?
Doctors follow and abide what the literature and data says. As they should otherwise you'd have Doctors that believe in more than one gender and that men can have babies.
@noarelax - Thank you for your comment. I try to incorporate both evidence-based information (the work of others) and my clinical experience in these videos and my patient care. I understand that some may not agree with this approach, but it's great that there are various opinions. Best, - Dr. Pagnani
Hello! My Dr changed my medication (after my suggestion) from Concerta 36mg + 18mg, to Ritalin 20mg + 20 mg + 2mg (3 times a day) . She also increased my Voxra from 150 mg to 300mg. Its been 2 weeks and my anxiety is getting really bad. (I also have Busperon 20 mg 2 times a day, and Seroquel one half 25 mg (ca 12mg) at night.)
Im planing on asking her if I can swich back to concera. Unnsure if I should ask her to swich from voxra to Venlafaxin, or try something like Sertralin, without the noradrealin?
I ve tried many diffrent SSRI during my life, (Flouxetin, Sertralin, Citralopram are ones I remember) but combined with Metylfenidate Ive only ever tried Venlafaxin and Voxra . (sorry for my spelling / grammar, Im Swedish..:)
450mg is wild