[libsg1]

I have several questions and chose this site so that I can get real advice from real people who know what I'm going through (before I go back to my doctor). I am bi-polar with rapid-cycling mood shifts, ADHD, have Fibromyalgia, and Lupus.
First, I have been on Effexor since March (after being on Paxil for years). I take Effexor (150 mg/day), Lithium (400 mg/day); I was taking Adderall before I got on Effexor and I want to get back on it but having trouble finding doctors who will prescribe it; and Loratab. My previous doctor stopped treating patients with ADHD and will no longer prescribe Adderall. The Effexor has made me gain too much weight, plus I'm still depressed and extremely unmotivated. I sweat at night and have terrible dreams. Overall, my mood is better and I certainly have an appetite; however, those positive results are minimal and I am still suffering from deep depression.

I would like to get off the Effexor and start on either Wellbutrin or Cymbalta. I don't know if I need to
stay on Effexor but add Wellbutrin
get off of Effexor and take something in place of it plus Wellbutrin
just take Wellbutrin

I am having a lot of trouble finding doctors who will prescribe Adderall; however, it worked wonders for me. Any suggestions? I also believe that it helped my bi-polar disorder.

I have tried numerous pain medications over the years but Loratab works the best. The problem is the same problem as with Adderall. Doctors don't want to prescribe it because of the "street abuse". I don't understand why patients with real pain should have to suffer and not be able to get the meds they need, that work for them.

I don't know that much about Cymbalta but have heard good things. I have taken Wellbutrin before and it helped (plus I know it will help me cut back on smoking). Both Adderall and Wellbutrin helped me lose a little weight when I was taking them before.

I know this is confusing but that's why I'm posting these questions. I am so tired of trying new things and trying to figure out what works. I want to be able to go into my doctor's office and tell him what I would like to try.
Thank you in advance for any advice you can offer.
Libby

[erinkj]

Originally Posted by libsg1

I have several questions and chose this site so that I can get real advice from real people who know what I'm going through (before I go back to my doctor). I am bi-polar with rapid-cycling mood shifts, ADHD, have Fibromyalgia, and Lupus.
First, I have been on Effexor since March (after being on Paxil for years). I take Effexor (150 mg/day), Lithium (400 mg/day); I was taking Adderall before I got on Effexor and I want to get back on it but having trouble finding doctors who will prescribe it; and Loratab. My previous doctor stopped treating patients with ADHD and will no longer prescribe Adderall. The Effexor has made me gain too much weight, plus I'm still depressed and extremely unmotivated. I sweat at night and have terrible dreams. Overall, my mood is better and I certainly have an appetite; however, those positive results are minimal and I am still suffering from deep depression.

I would like to get off the Effexor and start on either Wellbutrin or Cymbalta. I don't know if I need to
stay on Effexor but add Wellbutrin
get off of Effexor and take something in place of it plus Wellbutrin
just take Wellbutrin

I am having a lot of trouble finding doctors who will prescribe Adderall; however, it worked wonders for me. Any suggestions? I also believe that it helped my bi-polar disorder.

I have tried numerous pain medications over the years but Loratab works the best. The problem is the same problem as with Adderall. Doctors don't want to prescribe it because of the "street abuse". I don't understand why patients with real pain should have to suffer and not be able to get the meds they need, that work for them.

I don't know that much about Cymbalta but have heard good things. I have taken Wellbutrin before and it helped (plus I know it will help me cut back on smoking). Both Adderall and Wellbutrin helped me lose a little weight when I was taking them before.

I know this is confusing but that's why I'm posting these questions. I am so tired of trying new things and trying to figure out what works. I want to be able to go into my doctor's office and tell him what I would like to try.
Thank you in advance for any advice you can offer.
Libby

If you have had success with wellbutrin in the past then, I think you should try going back on that first to see if it helps before trying something new ie:cymbalta. For the ADHD you can add stratera instead of adderal. Stratera is for the treatment of ADHD but is NOT an amphetamine therefore your dr should have no prob giving that to you. It is worth a try. I must confess that I am rather surprised that you were ever given adderall or any amphetamine to treat ADHD if you have bi-polar with rapid cycling...I would think that that the stimulant would induce mania. Of course, people are complex and so are our conditions so, typical treatments don't work for everyone. There is a possability that cymbalta could be beneficial to you if you have chronic pain as studies have shown it helpful with pain conditions, however those studies are not without controversy. I am not a doctor but, the best advice I or anyone else can give you is to re-search ALL of your med's individualy as well as in combination to each other. It has been my experience that the more med's thrown in to the cocktail, the more problems I have had! Hope that helps some....Good luck...Peace....Erin

[libsg1]

Erin,
Thank you so much for your advice. I never thought about Stratera but I will definitely inquire about it. I think you're right about the Wellbutrin as well. I appreciate your response.
Libby

[COpharmD]

Hope I am not too late: I am definitely not trying to discourage you from talking to your doctor about these drug combinations since the 2 of you obviously know your needs better than anyone else can, but when looking at the drug combinations of Adderall with either Cymbalta/Wellbutrin, Wellbutrin with Cymbalta, as well as the drug combination of Cymbalta and Adderall, there are some concerning drug-drug interactions that you might want to keep in mind when choosing what therapies you are willing to consider.

Drug-Drug Interaction of Adderall & Wellbutrin The use of bupropion (Wellbutrin) is associated with an increase risk of dose-related seizures. Ufortunately, Adderall is similar. Since both of these drugs are often individually epileptogenic (increase the risk/probability of seizures while decreasing the seizure threshold) they can have additive effects when combined. Extreme caution is advised if Wellbutrin is administered with any substance that can reduce the seizure threshold (ie-Adderall).

Drug-Drug Interaction of Wellbutrin & Cymbalta See above interaction since this one is the same.

Drug-Drug Interaction of Adderall & Cymbalta It is suggested that patients treated with serotonin reuptake inhibitors (SRIs, example is Cymbalta) may exhibit an increased sensitivity to sympathomimetic agents (Adderall, amphetamines, & other similar stimulants). Additionally, Adderall should not generally be administered with SRIs because of the additive risk of serotonin syndrome, which is a rare but serious (and potentially fatal condition) which probably results from hyperstimulation of certain receptors in the brainstem.

Good Luck!! Keep fighting...hope you find a combination that works for you very soon!

Kirstin