Wellbutrin and Ritalin: No Longer Working. What do you know about this Combo?

[NeuroWoman]

Dear Dr. Gould & Fellow Forum-Goers:

I would like to hear from anyone who has personal experience and/or informed info about the mixing of the generics of Ritalin and Wellbutrin (Buproprion).

Currently, I am taking the Ritalin, extended release, 40 mg. a day and it doesn't seem to be working as well for me anymore. Also, I am craving coffee again periodically which I had stopped drinking. Now, I realize it was a subconcious attempt at an energy boost. Also, I am wearier during the day and don't sleep as well at night. I take 300 mg. a day of Buproprion.

The sleep issue wasn't so much a problem when I was on Clonozapem (Klonopin), too: I stopped the Clonzapem though and will not return to it because after a few weeks on it, I had huge memory issues when I was on it in combo with the above-mentioned drugs. Also, Seroquil was prescribed as a fourth. Again, with these 2 drugs added, I got 'tired' by 10pm each night, didn't have trouble falling asleep, and woke up alert at 6am in the morning which was ideal. That said, the other consequences, such as the memory of an infant, were way too devastating.

That said, I am back to my 'old' routine: fatigue during the day, something akin to mild depression internally, not sleeping as soundly, not waking easily. Haven't reverted to drinking tons of coffee but having read more about ADD, I understand now why I drank 2-4 cups a day before. Overall, feeling isolated and weary.

Would appreciate a response from Dr. Gould, who kindly replied to a previous question, if possible. In addition, I would also love to hear from fellow AD/HDers who have focused and informed info as well as personal experience stories about the combined intake of either the generic versions of Wellbutrin and Ritalin - or the 'brand name'' versions of these 2 drugs. It will be a couple of weeks before I see a new psychiatrist and she would like to 'get to know me' before adjusting meds, etc. In the interim, I am trying to understand more about this combo and why it's not working as well now. (Have been on it for no more thatn 3-4 months.) Thank you.

[dontpanic]

When I was put on Wellbutrin and Ritalin, I had a manic episode. Not particularly happy about that combination.

[sspryte]

My doc just changed my meds yesterday. I was taking 54mg of concerta in the am and 150mg of buproprion twice a day. I had to stop the concerta because at that dosage it was costing me $400 a month! He kept me on the welbutrin but changed me to 20mg of Ritalin twice a day an added citalopram at night because I was having problems controlling my emotions. Has anyone been on this combination before? I was on Ritalin as a child and it seemed to help then. Hope this helps now.
Michelle

[freddie526]

Thank you for you tips as well.I will definetly start taking more b complex and fish oils .I also want to share a tip to this post that I've also read about that helps the dopamine recepter.Studies have shown that An amino acid by the name of L-tyrosine with the combination of vitamin C helps the brain produce and recover more dopamine.Researchers believe also that this combination could possibly ease a persons withdraw off of amphetamine type medications/or any type of stimulant for that matter that affects the dopamine recepter.the only problem with the combination unfortenetly is that vitamin C might, and could lower the affective action of an amphetamine or any type of fruit that has citric acid .

[blabhamilton]

for those of you that are taking  Ritalin  how long have you been taking it? I am just wondering because I am a  Ritalin surviver.

[Mariadelmar]

Thanks so much for sharing this info. I am on 50 mg Ritalin and 80 mg Prozac for ADD and depression, respectively. I recently stopped taking Effexor because it made me gain weight in an abnormal way. My doc says Effexor does not cause weight gain but it does and I am not the only one reporting this. Do you have a clue why antidepressants cause weight gain? I excercise every day (45 min.), eat relatively healthy, bit within the 3 months that I took Effexor I clearly noticed l that my body changed. I have read in other forums about people gaining up to 50 pounds in no more than 4 months wiithout having changed anything in their diets. I read that these drugs can alter your thyroid gland, or mess with the way your body metabolizes fats and sugars. So I reduced the 150 mg Effexor to 75 mg and then stopped gradually (cold turkey and non-cold turkey reports are terrifying), and started taking Prozac, which I used before (40 mg daily for about 10 years) but stopped working (that is why I was put on Effexor). The 80 mg of Prozac are making me feel very tired all the time.Have you or your brother experienced these effects (weight gain, physical exhaustion) with the antidepressants you were taking? The Ritalin seems to work and helps me to concentrate and stay awake. I have a sleeping disorder and can sleep as much as 18 hours, wake up and then sleep again. That is why I was put on Ritalin. Would you suggest to diminish Prozac gradually to maybe 20 mg and also gradually add 150 mg Wellbutrin? I know I should ask my doctor, but it seems to me that patients know a lot more about side effects because we have been doing or own research, and most of all, taking these medications ourselves. My doctor has no clue as to what is going on with me, though he thinks he does. He tells me that I gained weight because I am not depressed anymore and probably found out the good things about life, like eating. By the way I read this on the internet, so he is doing his homework, but it is not enough. Well, thanks again for that long mail sharing your knowledge with all of us.

[Canadian4Life]

Been taking Ritalin instant release 60mg throughout the day for 5 years. I take 20mg in the a.m., 20mg at noon, 10mg after supper and 10mg before bed. Ritalin has been amazing for my ADHD and it calms me down so much. I have social anxiety and depression and yesterday my doctor added wellbutrin 100 SR once daily. I take it in the afternoon and it totally kills any crash, all of the ritalin "rebounds" and even though it's a dopamine-norepinephrine reuptake inhibitor like ritalin it makes me alot more sociable and less anxious in social situations. Ritalin is awesome for ADHD especially hyperactive type like me but makes me introverted and quiet whereas the wellbutrin has the total opposite effect but together are a miracle for me at this point in my life. The ritalin calms me down and helps with my hyperactivity/impulsiveness but the wellbutrin gives me motivation, drive, increased pleasure..all of which ritalin doesn't give me..or ever has! They have both made you tolerant to the boost of dopamine. These drugs downregulate dopamine receptors and norepinephrine receptors..causing you to need more dopamine (increase in meds). The same problem happens alot of times with selective serotonin reuptake inhibitors. When my brother was on celexa it helped his depression and anxiety but after 3 years it "pooped" out on him and didn't work. This is because serotonin increases overtime depletes dopamine and downregulate serotonin receptors. What's this have to do with ritalin and wellbutrin not working anymore? Well when his celexa gave out he was on 60mg. He slowly cut back to 20mg. He felt better and wellbutrin was added to his 20mg of celexa. The celexa was working again..better than before and he was only on 20mg whereas before 60mg was his effective dose. Just like the celexa depleted dopamine from the brain and lowering his dose and adding wellbutrin his dopamine levels were able to come back to normal and his med worked again for him.. but better! If this holds true for ssri poop out I know this has to be the same problem you're having but in the opposite way. Your dopamine receptors have been downregulated and they aren't as sensitive to dopamine as before. I think adding an SSRI to your current med combo might be of benefit. The ritalin and wellbutrin have depleted serotonin and although serotonin is not thought to be a major player in ADHD or ritalin/wellbutrin it does have a very significant responsibility. Adding a SSRI to your combo will boost serotonin levels again and lowering your ritalin and wellbutrin (or just one of them) will help as well. SSRI's will cause dopamine depletion and lowering your ritalin/wellbutrin dosage will help dopamine receptors become more sensitive again because there's less around so they compensate by becoming more sensitive to it. I'm not sure how much of an improvement you will see in regards to your adhd/add symptoms but in time the lowering of the ritalin/wellbutrin and addition of the ssri will upregulate your dopamine receptors. That's my view on tolerance to DNRI's and SSRI's. It's just simply your dopamine/norepinephrine receptors need time to "relax" and then they will upregulate again so you can get benefit from your wellbutrin/ritalin combo. I know adding a dopaminergic drug to an ssri when it poops out helps and the med becomes effective again..if not more in alot of cases. But adding an ssri and lowering your wellbutrin/ritalin might be very helpful to your adhd/add symptoms initially but you have to give your dopamine receptors time to relax and reupregulate. It's like a seesaw you up the dopamine via dopaminergic drugs (ritalin/wellbutrin) and thus dopamine receptors downregulate and serotonin levels get lowered and serotonin receptors then upregulate and vice versa. So upping dopamine lowers serotonin and your brain becomes more sensitive to it. You could even try adding an ssri and not lowering your wellbutrin/ritalin combo (although that would be a slower upregulation) and see how that feels. If it's what causes ssri "poop" out than it has to be the reason for DNRI (ritalin/wellbutrin) "poop" out as well. Also there have been claims and studies showing that NMDA receptor antagonists can help tolerance to ritalin and dopaminergic drugs. Magnesium and DM (found in cough syrup) are both NMDA receptor antagonists and are available over the counter. I use magnesium and I can vouch for that one. I take 1 gram of magnesium glycinate before bed everynight and it made my ritalin's effect alot more effective the next day. Alot of people say magnesium doesn't work because it's a "noncompetitive" nmda receptor antagonist but it works for me. DM is not a "noncompetitor" nmda receptor antagonist and people also vouch that helps dopaminergic tolerance. I am not a fan of nmda receptor antagonist drugs..read alot of studies showing they "may" cause damage to the brain. Probably not in the low doses that DM is sold in but I still don't want that risk. Memantine and Amantadine are both nmda receptor antagonists used for alzheimer's and are also used to prevent tolerance. I haven't tried either of the two but people say it also works. I am not a fan of nmda receptor antagonists (besides magnesium) but that's just my opinion and others use them with success. Both nmda receptor antagonists and ssri's (in time) cause an upregulation of dopamine receptors through two very different ways. But I think that upping your serotonin levels is a much better way and can help with anxiety and such. These opinions are just "my" opinions and what I have found and seen to be what's happening with this "tolerance" problem. You could always just take breaks too which would help your brain re-adjust (naturally) which is in my opinion the best way to go. Upping the ritalin and/or wellbutrin will only help for a while and increase your tolerance. Your brain needs a break and time to stabilize again. So adding an ssri, or a nmda receptor antagonist, or take breaks are three very effective ways to lower your tolerance and get the effectiveness you want back from your wellbutrin/ritalin combo. I'd go with breaks from the meds (ritalin especially), adding some magnesium (anything besides the oxide form) and if you wish add a small dose of an ssri (if you feel comfortable with that and can tolerate an ssri). Two other natural helpers also I forgot to mention are B Vitamins (a b-complex) and Omega 3 Fish oils. The b vitamins will make the meds more effective and work preperly and the omega-3 fish oils have been shown to increase dopamine levels and make the brain more sensitive to dopamine (thus it's antidepressant effects). Sorry for the long post but I just wanted to give you the heads up and details on how you can maintain effectiveness from your wellbutrin/ritalin combo. Whatever you choose to do.. I wish you luck my friend!

[golferdancer1]

Great post... That is the kind of info that is helpful to people trying to figure out their meds!

[davey777]

I take Wellbutrin and Ritalin and it was a miracle cure for my adult ADD.  It was as if someone had given me a brand new brain.  I take 150mg of Wellbutrin and 20mg of Ritalin first thing in the morning.  Then around 1 or 2, I take the same thing over again.  This lasts me the whole day.  By the time it wears off in the evening, I sleep like a baby.  BUT, if I take the second dosage much later than 3 or 4, I won't be going to bed till midnight or 1 easily.  Ritalin wears off real quickly and my body crashes fast.  That's why the Wellbutrin works great with it.  I don't feel the effects of crashing as much and I seem to be more positive in my thinking throughout the day.

[beefysupersonic]

The Seroquel is the culprit, stop taking that lobotomizing poison. It blocks all the effects of dopaminergic agents such as Ritalin and Wellbutrin.
I used to have Risperdal and even when I took only one tab it completely flattened my Ritalin buzz

[Mary0919]

Hi everyone, I would appreciate a response from anyone who can help.  I too take Wellbutrin and Focalin XR (Ritalin).  I just started taking Abilify and it worked fantastic and very quickly on my depression symptoms for about a week.  Now, I'm back to my usual depressed, irritable, angry self.  I am so discouraged and sick of trying all these meds.  Why would my doc have me on all these stimulants???  He doesn't want to try me on Adderall because I am a recovering alcoholic.  Anybody know or have experience with this combo????? Thanks, Theresa

[Tanker Chic]

Not sure, but I think because the adderall (like ritalin) is a stimulant and the wellbutrin tended to slow me down and make me tired, it did kind of neutralize the affect as you put it.  I also noticed that on ritalin and addrell, if you had any vices, it tended to highten them even more.  For example it made me drink more often and back when I smoked it made me smoke more.  The wellbutrin actually helped me quit smoking and it took away the urg to drink as often.  

Good luck to you.  

[NeuroWoman]

What impact did the Wellbutrin have? Did it neutralize the Adderall? Thanks for checking in but I am not sure how these worked against each other or why?

[Tanker Chic]

I took wellbutrin and adderall together (similar to ritalin).  Once I started taking the wellbutrin I had to almost double my dose of adderall.  Once I went off the wellbutrin, i lowered my dose of adderall back down.  

[portuguese mom]

It is winter and the weather is gloomy. Maybe it is impacting you.  Have you read about SAD? Do a google search on SAD.  Maybe you have it. Good luck.
http://www.sada.org.uk/