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Avatar universal

Treatment options for adult ADD

What are some of the treatment options for adult ADD-inattentive?  My doc put me on Wellbutrin XL 150 mg once a day but it's not really helping.  I still get very distracted and can't focus on just one thing.  

Are there any adults that have experienced success with other medications?

I already take Omega-3 fish oils, B-complex, etc. and exercise 30 min./day

Thanks!
63 Responses
189897 tn?1441126518
COMMUNITY LEADER
   This site will give you virtually all the treatment options for ADD.
http://www.healing-arts.org/children/ADHD/treatments.htm
   Wellbutrin is used to treat depression, not ADD.  If ADD is the source of your depression, than you would definitely want to find a specific treatment for that.  Kind of wonder what kind of a doc you are seeing.
   You might also want to check out this site.  Its for adults with ADD and pretty well runs through all kinds of adult ADD stuff.  Its kinda of helter-skelter, but the writer is ADD, and it tends to fit his personality I think.    
   http://jeffsaddmind.com/for-first-time-visitors
757137 tn?1347196453
I know there are behavioral treatments for children, so there must be ones for adults. See what you can find on the internet.
1512059 tn?1298296573
I was diagnosed back in 2000, while living in CA, and knowing something was not right was liberating for me. My psychiatrist told me that often, a low level depression often follows an adult with ADD and prescribed Welbutrin once a day. I was also put on Neurontin and Dexadrine.

At that point, all hell broke loose and I got worse. Rambled when talking or writing, and my ability to finish tasks got worse.

So he put me on Klonapin to moderate the affects of the speed. I was a mess.

My biggest help came from reading the stories of other adults with ADD on the internet and learning their non medicinal way of dealing.

Today I am not taking any medicine to manage my ADD. When I see myself fliting from one thing to the other I make myself finish the thing I am working on. I realize I may have a "light" case,  but that is what works for me.

I stayed on Welbutrin the entire time I was in CA. I don't think it hurt or helped either way. I know the Neurontin/Dexadrine/Klonapin cocktail didn't work for me.

Check out the websites recommended. They should be illuminating,
Avatar universal
My 'shrink' took me off Concerta and prescribed Wellbritin HCL SR (100mg 2X a day).  Doesn't work at all ... ha...didn't even stop me from smoking!!!  I already take Paxil for anxiety.  My 2 adult children take Adderall and are doing just fine.  Doc keeps telling me ADD meds are 'too addicting'.  What the heck ... I just want my ADD to be under control so I can cope with accomplishing day to day tasks !!!  I think I have anxiety because I cannot cope with the ADD symptoms ... I cannot concentrate/focus/complete tasks/etc.  Example:  every room in my house is always half cleaned !!!!  I have appointment this week with 'shrink' ... it might be my LAST one with him!!!
189897 tn?1441126518
COMMUNITY LEADER
    ADD meds are not addictive to someone who has ADD and takes the prescribed dosage.  This has been proven numerous times.  I'm guessing that he feels you do not have ADD and is afraid you will abuse the med.  Which is kind of a weird assumption to make since both your children have it.  Where does he think they got the ADD from?   Either that or he is not really up on whats going on.
      Can you go to see whoever is treating your adult kids?
Avatar universal
Thanks for your response :)

My oldest daughter lives in South Carolina.  Other daughter's office does not take Medicaid .... which I am unfortunately on ... so I cannot afford to go there either.

I made a few phone calls today to Medicaid who told me to call my 'Medicaid' insurance provider about the pre-authorization.  Well....after spending all day doing my research....I seem to think the doc is faxing the pre-auth info to the wrong place.  At this point I have no idea where the info went to.  I will discuss this with him on Friday.  ARGHHH...wish I had a real job with normal insurance ... not this Medicaid crap.
Avatar universal
PS>>>>>  This doc has me so confused ... I am not looking forward to my Friday appointment :(
189897 tn?1441126518
COMMUNITY LEADER
   What happened when you were on concerta (how did it effect you).   How much was the dose.  How many different times did he change the dose - in other words, how did he step you up dosage wise.  I take it he is a psychiatrist?  
Avatar universal
My primary care doc first prescribed Concerta in February ... 18mg 1X day.  Then I was 'assigned' to the shrink in March.  He upped dose to 27mg 1X day.  Did nothing for me.....wanted to sleep all day.  Follow-up with shrink later in March ... took me off Concerta and did the  Wellbritin HCL SR (100mg 2X a day) thing.  Both meds are generic. Like I said in my first post, I already take Paxil for anxiety....I think I have anxiety because I can't focus/complete tasks/concentrate/etc. because of the ADD.  I hope I can convince the shrink when I see him tomorrow that he is treating me for the wrong thing!!!  BTW...I saw a video on YouTube about a woman that had what was called 'age-something ADD'....damn I can't remember the name of it.....but anyway.....IT WAS EXACTLY THE WAY I AM!!!  I couldn't believe it!!
189897 tn?1441126518
COMMUNITY LEADER
     27mg's of concerta is a fairly low dose.  Surprised he didn't go one higher if you said it was not working.  However, you said it made you sleepy (which can be an indication of an overdose).  The fact it made you sleepy is a pretty good sign you could have ADD as that amount would wire most people.   What surprises me the most was that he only tried it once.  Standard is to start low and keep going until something happens.
    How did the 18mg effect you?
    Make sure the doc knows you are taking both Wellbritin and Paxil (not sure thats a good thing, but I need to research that).
     Yes, Anxiety is a definite side effect of ADD.  In fact, that and depression are pretty classic symptoms.
     I assume your doc is a psychiatrist, not a psychologist, since he is doing the prescribing?
      The following is an adult ADD site that has a ton of information.  I think you will find it very helpful.  http://jeffsaddmind.com/for-first-time-visitors
       Here is a site that is easier to read - http://www.webmd.com/add-adhd/guide/adhd-adults     This site you could print out page - check off all the things that apply to you and take it to your doc.
        Let me know how it goes and if you need any more info!
      
Avatar universal
Doc is an MD that 'specializes' in psychiatry.  18mg did nothing ... sleeepy was all.  The first time I went to the 'shrink' I showed him 3 different "tests' I took from online places ... I answered them 100% honestly.....well, he kind of pushed them back to me on the desk ... didn't even look at them ... WTH.
He gave me a 6 answer sheet that I had seen online to fill in.  My first question to him during my appointment today is going to be "What condition are you treating me for"?  If he tells me 'anxiety' I will tell him that he is incorrect ... he knows I am already taking Paxil for anxiety.  If I do not get the results I need/want today, I am never going to this dude again.  None of the meds he prescribed so far have even came close to making me feel 'wired'.  I have had it with this guy...I need to get my ADD/life in order.
189897 tn?1441126518
COMMUNITY LEADER
   I did some more research and discovered that there can be a significant reaction between paxil (and to a lesser extent, wellburitin) and stimulant meds.  When I mentioned the sleepy feeling you had sounded more like an overdose - that now makes sense.
   Here is a link to info on the interactions - http://www.corepsychblog.com/2006/11/adderall-prozac-and-paxil-problem-not-solution/
   and its easy to google to find more info.

    From reading this I get the feeling that  if you want to try stimulant meds you need to be off paxil.
     Also, since - "Paxil is a selective serotonin reuptake inhibitor, or SSRI. This type of antidepressant treats depression by increasing serotonin levels in the brain. . Wellbutrin is a norepinephrine and dopamine reuptake inhibitor, and is the only U.S. Food and Drug Administration approved drug in its class. It does not affect serotonin at all, and instead inhibits the reuptake of norepinephrine and dopamine, therefore, increasing the levels of these two neurotransmitters in the brain."  I imagine that is why he may have you on these two drugs.  I am guessing that he put you on Wellbutrin due to the interaction between Paxil and the stim. med.   If so - this is something he should have explained to you.

Avatar universal
Here is the latest scoop:

Went to shrink appointment yesterday.

First...he reamed me out for discussing how long the wait time is in his office.  My appt. was for 11:45...the gentlemen next to me was scheduled for the same time (WTH).  The waiting room was filled and everyone was talking about how long the wait time is/was for them.  Jeepers Cats....we we not talking very loud about the issue....don't know how he new about the waiting room conversations.

Second...people that went in before me came out looking/acting very 'po'd'.  Hmmmm...maybe he reamed them out too and/or treated them like he did me as you will see below.

Third...when I asked him what condition he was treating me for....he said anxiety and ADD.  I told him that I already take paxil for anxiety and that the Wellbutrin is NOT for ADD.  He went off on a tiraid about how he was helping me with non-addicting medication.  Whatever!!

Fourth....I told him the Wellbutrin was not working at all and since it is also a med to help you stop smoking, that was not any help either.  I am smoking more than I was without Wellbutrin.

Fifth...I asked to see the Concerta pre-authorization fax he suposedly sent.  He said NO...you cannot see that.....WTH....all I wanted to do is verify that he sent it to the correct fax number..  Can't believe he would not let me see something in my file that pertains to "me".

Sixth...he said I was a "non-compliant patient" ...  gave me a script for Wellbutin HCL XL (AGAIN) 15 tabs of 300mg to be taken 1X a day...and told me to go somewhere else.  HOLY CRAP !!!  Do you believe this stuff????

My pharmacist gave me a sheet of info that comes with their bottle of Wellbutrin and high-lighted a few things on it.  Indications And Usage:  Major Depressive Disorder and Seasonal Affective Disorder.  Their was no indication for anxiety or ADD and a side effect is "Anxiety".  Here we go again with the Wellbutrin Confusion Senario.  This seems to be totally stupid already.

Took the 300mg today....no difference.  Vacuum cleaner still in middle of living room since LAST Friday....not used  yet...yeah...I will get to it. Dining room half-cleaned...dishwasher not emptied....can hardly walk in my den without stepping on papers all over the floor that need to be filed...money in bank but bills not paid .... etc...etc...etc.  HA HA

The whole time I was in his office he kept saying things about 'you don't know what it is like to be on this (his) side of the desk'.....yeah....it was "all about him"  ya know?

Glad I am done with this dude.  Now I have to find somewhere else to go for help.  
189897 tn?1441126518
COMMUNITY LEADER
   Well, at least he did you one favor by telling you to go somewhere else.
Did more research on Welbutrin and it is one of the suggested meds for ADHD, but does not seem to be as effective.  Pretty good comments on people who have used it here - http://****.com/forum/topic.php?id=1369
    Probably wouldn't hurt to try it for a bit longer.  If or when you decide to stop it, make sure you read up on how to do so!
     When you do find a new doc - make sure he knows all of the meds you are on.  I would definitely look for a psychiatrist who has a specialty in ADHD.
    And do take the time to check out the sites I mentioned - plus the link above is from ****.com which is also quite good.  
   Keep us posted and let me know if there are any more resources you need.  Best Wishes.
Avatar universal
Hi ... what are the letters for ****.com in your link?  Looking forward to checking it out.  Thanks.
189897 tn?1441126518
COMMUNITY LEADER
  weird, they normally let the link to that site go through.  Guess, I'll have to recheck the policies as you can't get the information found at that totallyadd site anywhere in medhelp.   But you now have the info you need.
Avatar universal
Went to new shrink yesterday.  The 'intake coordinator' asked me a ton of questions about my health/family/etc. No tests were given to me to check for ADD.  Shrink said I don't have ADD since I did well in high school and have two college degrees.  Concluded that I need a MOOD STABILIZER ... WTH !!!  Told me to reduce Paxil from 60mg to 40mg a day.  Gave me script for LAMICTAL 25mg once a day in the morning and we would increase dosage as time goes on if needed. I have appointment at end of May. I have been searching online about this med and from what I found, it is NOT what I need or should have to get my concentration/focus/etc. corrected.  He seemed to think that my "racing thoughts" (yes...I have them...they are all about how I will get all my daily tasks in order and completed ... but at the end of the day nothing is done...damn it) are the reason I need a MOOD STABILIZER.  These people are driving me nuts with their 'conclusions' and the meds they give me.  I took a Lamictal this morning and slept most of the day (AGAIN).  Don't feel any different ... maybe it takes a few weeks ... who knows !!!  I actually paid someone $40 to mow my lawn today because I couldn't get my 'focus' outside to do it !!!!  BTW...$40 was not in the budget for lawnwork.  I am at my wtts end with what seems to be total silliness.
189897 tn?1441126518
COMMUNITY LEADER
    Well, I do like the idea that he has reduced the Paxil.  A number of the effects you mention as having are also listed as side effects for Paxil.  And Paxil is a med that you want to slowly withdraw from.  Lamictal is probably worth trying and certainly has less side effects then Paxil.
    People with ADD do get college degrees, but typically they have to work very hard, suffer a lot of stress, and many times are squeaking through.  Hopefully, he asked you more about your college experience then just noting you have two degrees.  If you did have problems going through college, he needs to know this.  And, I guess, if you are highly intelligent and loved the subject area - you might of had very few problems.
    Anyway, I do wonder how much of your "focus" problems might be due to the paxil and will be curious to see if he tries to slowly reduce the paxil some more while increasing the lamictal.  Hang in there!
Avatar universal
Actually, I graduated 'with honors' from college.  I really loved college ... wish I could go back for a degree in something else.  It was tough ... I went to school evenings/weekends + worked full-time + raised my two daughters.  I would study after everyone went to bed ... ahhhhh ... we are talking after midnight !!!  

****And, I guess, if you are highly intelligent and loved the subject area - you might of had very few problems****  Sandman2 you are 100% right on this comment :)

Ok....back to the meds issue.  I am just soooo confused as to what these people are trying to do to 'cure me'.  From what I have read about  Lamictal, it is for "seizures" and "bipolar disorder"!!!  I do not have either of these problems.  I have been on the Lamictal for almost a week now and feel NO different.  Seems like a waste of money and the weird RASH side-effect I read about is creeping me out ... haven't had any rashes yet.  I don't seem to have any side effects at all ... maybe these pills don't have any medication in them !?!?!?

Guess I will just keep taking the Lamictal until my next appointment at the end of May.  Appointment is actually with someone who just determines if meds should be increased and writes the scripts.  If things don't turn around somewhat by the appointment, who knows what they will give me next !!!!

I wish I could go someplace that actually gives you the whole ADD testing.  Then I would know for sure if I do have it or not, even though know I have the symptoms.  

PS>>>How do you know so much about this stuff?  I like reading your responses :)

189897 tn?1441126518
COMMUNITY LEADER
  Hey Misty,
   sorry I took so long in getting back to you!  On a family vacation and let things slip for awhile.
   A lot of my experience comes from many years on this site.  A lot comes from working with ADHD kids as a teacher/administrator.  And a lot comes from just doing a lot of research on line.  And you have certainly caused me to take a look at a lot of medications that I don't normally have to deal with - so realize that I really don't have a lot of expertise in what you are going through.
    My first thought is that I think you certainly have enough ability to get deeply into this stuff (if it interests you - and it should).  Unfortunately you have two or three things going against you.  
   The first is that you really appear to have problems focusing on the kind of boring stuff that this is about - even if its about you.  And more about that problem later.  Second is that your doctors are either not telling you what is going on - or somehow their message is not coming through to you?   Third, they are not treating for ADD, and not telling you why.  And finally - this is about you - which does tend to filter any message they may be sending.
   lacmital does have many uses.  One of which is a mood stabilizer.  If you can use that and get off the paxil - I think - that would be a good thing.  The question in my mind is if the paxil is the reason for you being unable to concentrate.  There is only one way to find out.  But its really important to slowly withdraw.  So yes, keep doing what you are doing, but at the next meeting, see if you can drop the dose of paxil.  
    Actually, go back to my earlier post on the interaction between paxil and stimulant meds.  Specifically, ask the doctor about that.  In fact, when you saw your latest doc - did you give him your medical history of which drugs you took and your responses to them?
    And keep reading up on adult ADD.  the more you know the more you can inform the doc.
    Finally, you are really trying to take charge of your life.  Keep it going.  Force your self to get out and exercise, even if its only a long walk.  Make sure you are getting enough sleep.  Get a white board.  Write a schedule on it and keep to it (well, that could take some trial and error).  Main thing is to try and get into a rhythm and keep to it.
   Lots of stuff here- sorry - take some time to digest it.  Peace
Avatar universal
Hope you had a wonderful vacation :)

I spend soooo much time online researching ADULT ADD and the meds I have been prescribed + my daughter is a pharmacy tech, I think I know more than the shrinks!!!

Bottom line is the shrinks keep telling me that Adderal/Concerta/etc are "too addicting".  I know that they can be addicting, but I will only take them as prescribed ... and I DID tell them that.  Seems strange that I should have to 'inform the doc' about ADD ... that is what 'they' are supposed to know all about.

Actually, my appointment on May 31st is not with the shrink....just some girl that will supposedly up the Lacmital and write the script.

As for Paxil....I take that before I go to bed ... second shrink said to take the Lacmital when I wake up.  

I did inform both shrinks of all my meds and my responses to them.

As for the 'white board' ... I have one + 'post-it notes' all over the place ... even have post-its in my car (LOL).  Also have paper lists of things to be done ...  have a list of my lists LOL..  It is not boring stuff that I have an issue with ... it is concentrating/focusing/etc. on COMPLETING every day tasks.  I have so many things started but keep moving on to something else and something else (and on and on) ... but nothing gets finished.  I feel kind of 'scatter-brained' and it ***** when at the end of the day, I realize that nothing is completed.  It is very annoying.

I have to find a place that actually does the ADD tests ... not just paper response kind ... and see what happens with that.  I have to get my life in order ya know?

Talk to ya soon :)

189897 tn?1441126518
COMMUNITY LEADER
   "Bottom line is the shrinks keep telling me that Adderal/Concerta/etc are "too addicting". "   BS - unless you don't have AD/HD.  All of the literature states that the stim meds doses are too small to be addicting.  
   By the way, found a good site on Paxil - don't be put off by the title.  Its about the only site I have found that gives its half life and mentions taking it at night.  The site is - http://www.crazymeds.us/pmwiki/pmwiki.php/Meds/Paxil#.T7GOdb_evNo
     It looks like you are going to somehow try and find a psychiatrist that specializes in adult ADHD.  The point is that you are not being treated for ADD, but for anxiety which the ADD could be causing (very common).  The problem is - as "Crazy meds" points out - Paxil is difficult to stop.  So you will definitely need someone who can help you in slowly cutting down.   Heck, I have said this all before.  The problem is the possibility of an interaction between the stim meds and the Paxil.  Thus, I think you will need to be off the Paxil before you try anything and thats gonna be not easy.  However - hopefully, the  Lacmital will allow that - so maybe this new dr. knows whats going on (just not explaining it real well).  I hope they up the Lacmital and cut back the Paxil.  
    Good Luck!
Avatar universal
Adderall worked for me...started at age 55 and haven't looked back. It really does the job
189897 tn?1441126518
COMMUNITY LEADER
   Nice to get a comment from somebody who has been there.  Please feel free to keep posting :)
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