[Melissa_1287]

I'm a 21-year-old college student who was diagnosed with OCD (Obsessive-Compulsive-Disorder) at age 12. Immediately, I began treatment (meds in conjunction with cognitive-behavioral-therapy) and started to see results almost instantly. To this day I'm pretty much on an even keel as far as my OCD is concerned, but now there are other issues on the table. I have a great deal of difficulty holding my concentration for extended periods of time and thinking in a straight line. I feel like my brain is a scrambled TV set and I am unable to think on my feet. Information that is already inside of my brain is extremely hard for me to retrieve, and I find myself fumbling for the right words, and thinking in circles all of the time. In short, my mind is all jumbled up, and although I have always felt this way somewhat, I am just now starting to realize how problematic it is (being that I'm at the tail-end of my youth, and I'll be graduating and entering the workforce in the not-too-distant-future) in my life. I've always managed to get by in school, but I feel that the integration of facts and ideas never really set in when it was supposed to. For example, I'd be introduced to a concept, I'd understand it (sometimes after much struggling), but then quickly forget it. It's been that way all throughout High School for me, and although I did do well, I knew that I wouldn't be able to retain even 50% of what I had learned. Does it sound like possible ADD could be at play here? I've done some research on it, and after looking over the symptoms and reading other peoples' stories, I truly believe that I am a prime candidate for this disorder.

Now, here is where I run into a brick wall...as I already mentioned, I have clinical OCD, and am on medication for it (250 mg of Zoloft daily). The problem here rests in the fact that most of the medications typically prescribed for ADD patients (amphetamine-derived stimulants) have the potential to aggravate OCD symptoms. So, my doctor started me on Wellbutrin (selective seretonin reuptake inhibitor) about a month ago, and I started to see some positive results--I felt my brain was operating on a somewhat quicker level than usual, and my concentration and verbal fluency had both increased substantially. Then I started school again, and all of the aforementioned struggles flaired up again. I don't know if the progress I was seeing in the beginning was just a false dawn, or if the fact that I went up another 100 mg on the Wellbutrin could have something to do with it...I don't see why it would. So, I spoke to my doctor, and he told me to go back to 300 mg daily. I think I should also mention the fact that I did some research on Wellbutrin, and much to my dismay, found out that a majority of people were experiencing the exact opposite effect that I was--decreased level of concentration, poor memory, and lack of verbal fluency. This made me believe that the results I thought I was seeing were a "mind over matter" sort of thing.

I explained all of this to my doctor, and he insisted that I give the Wellbutrin a bit more time to run its course. I can tell that he is against putting me on one of the amphetamine-derived stimulants because of my OCD, but in all honesty, having my OCD marginally increase is a price that I am willing to pay at this point if it means being able to focus better and actually stay on task. That is all I have wanted over the past few years, and so that is a risk that I am willing to take. In particular, I looked up the ADD medication Adderall, and found that it had helped an overwhelmingly large number of people who had a story similar to mine get back on their feet. I believe this is the medication for me, and I really want to give it a spin...but admittedly, I am a little worried about the effect it could have on my OCD. What I'm wondering is...since I am already on a medication that keeps my OCD symptoms in check, shouldn't that decrease the chances of them resurfacing exponentially (especially if I am only taking the lowest dose of Adderall)? Unless the medication is so strong that it can counter the effects of another one, even at the lowest possible dose prescribed...

I apologize for the long-winded post, but can anybody offer some advice? Personal stories similar to mine, or someone who has even a cursory understanding of how these medications work...I'd greatly appreciate it.

[Psyched]

Melissa,
I'd say stick with what the doc says. However, if you are set on Adderall, simply ask your doctor why he's against you having it. You and your doctor should be working together to get these issues in check. I'm sure if you ask him why he's against you having Adderall, he'll tell you. You said you've been taking the Wellbutrin for about a month right? It usually takes about 4-6 weeks to see a real change with it...why not give it a little more time? Just a thought. Good luck!

[MaisieC]

Hi Melissa,

I too think you should stick with what your doctor is recommending. Not because doctors are always right, but because this is a pretty complicated situation, in lots of different ways. Hang in with the Wellbutrin for a while longer. If you're still feeling messed up, then I agree with Psyched that you should have a frank discussion with your doctor. You're a smart person, and good doctors generally like to talk with smart patients and should engage in an intelligent discussion of what they're doing. (At least, I hope your doctor is good that way.)

I don't have your same issues, but I do have your same proclivity to doing research and try to figure out my own medications. Sometimes I'm right, and sometimes I'm wrong. I always talk it over with my doctor. My doctor ALWAYS knows more than I've been able to glean on the Web!

I wouldn't be overly concerned about having an atypical response to the Wellbutrin, and I wouldn't conclude that it's wishful thinking on your part. People's brains are different. Your brain is already doing its own thing, plus you're on a pretty high dose of Zoloft. The Wellbutrin probably is helping you. I'm guessing that the beginning of school has brought a lot of stress, so that may be playing a role.

I don't know for sure...but I'm not clear why you assume that an amphetamine-based medication would increase your OCD only "marginally." These symptoms have been pretty well controlled for a long time, right? It might not be all that OK if they flared up. I know you're eager to feel better, but it's wise to be cautious.

Just browsing around the Web, all I see are people saying NOT to combine Adderall with SSRIs. Again, this is not my line of country, but it's what I'm reading. I really think the best thing to do is to work closely with your doctor.

Hang in there, and good luck!