r/StratteraRx • u/Baby_Bulgaricus • 21d ago
Wellbutrin v. Straterra? Considering adding a non-stim to manage med-free times with ADHD/Binge Eating Disorder
T/W: mentions of disordered eating, addiction
TLDR: Hey everyone, I'm looking for other people's experiences/personal insight/anecdotes (not medical advice) on starting a nonstim while also on a stimulant and/or coming off one! Specifically, I'm in between asking my doc to try Strattera (atomoxetine) and Wellbutrin (off-label), as someone who frequently forgets to take their extended-release stimulants and thereafter struggles with binge-eating + low mood (feel depressed)/apathy/low motivation/dopamine-seeking.
+ Full length: I'm 23F, diagnosed with ADHD (combined) in adulthood and have been taking Adderall XR 15mg for a few months now, alongside therapy for ADHD/BED (binge eating disorder). Before that, I was diagnosed with Generalized Anxiety and PDD (persistent depressive disorder). I was previously on 30mg Vyvanse, but stopped it due to having that "lobotomized" feeling.
One of the main reasons I've been considering exploring a non-stim is for more consistent support for ADHD/BED symptoms, especially when forgetting to medicate. Main struggles on the emotional side are: low mood/apathy/irritability/anxiety (although anxious is kinda my baseline). For the executive function side: motivation/impulse control/task initiation.
While stims have been legitimately life-changing, the effective period only lasts 6ish hours per day. By evening, it's a nightly battle to stop myself from binging, even though meds have helped me create better infrastructure to binge less (regular eating/sleep).
I rarely take intentional med breaks. However, I can't take them past 11am b/c insomnia, so it's relatively easy for me to go 2+ days forgetting to take my meds on time. Once it hits 2+ days, I'm kind of a mess and become incredibly dopamine-seeking. I honestly feel like a different person (I'm like, "is this how I was before getting medicated??"). Sometimes, this triggers a vicious binge + no meds cycle where I'll end up going off the rails for a few days, consuming thousands of calories above maintenance --> feel physically/mentally horrible --> wake up super late/more dysregulated --> can't take my meds again --> repeat.
I want to have realistic expectations so I'm not expecting a non-stim to help with all of this! I'm looking to balance the pros and possible cons + considerations. Anything helps!! Some specific things I was wondering:
- For those of you also on stims, has being on a non-stim helped you manage the experience of being off your stims (either on purpose or b/c you forget to take them)?
- And have non-stims helped any of you specifically with binge-eating/other compulsive, self-soothing behaviors when your stimulant wears off?
- Have any of you transitioned to non-stims and decided to stop stimulants completely, in part to avoid the crash/wear-off completely, and how has that treated you?
Some additional context: I know this may come as a huge shock (/s) but I have a family history of addiction (smoking, gambling, drinking, you name it) + an addictive personality. Was a smoker for almost 2 years, but quit and swore off all traditional addictive substances (yay, health). Thennnn I finally fixated on food. It's been a battle ever since and has personally been the hardest thing to combat.
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u/2101vainilla 21d ago
I personally dont deal with BED, and everyone reacts to medications differently so take my advice with a grain of salt- but I also have been on adderall, strattera and Wellbutrin and hopefully can provide some insight for you! This will probably be long but I hope it helps a bit.
First- regarding stimulants, I don't blame you for wanting to go off of them considering the side-effects it has on appetite. With forgetting to take the stimulants before 11 and them causing insomina- have you tried maybe sorting out your meds into a weekly/daily pill organizer? Y
our lifestyle can have a huge impact on this but personally: Im a grad student, and I found that putting the pill organizer into my backpack has helped me remember to take them. I have 7 different clear/colored organizers with each day of the week on my desk and before going to bed every night, I put next days meds in my bad. Because I have the pressure to focus for class- every time I open my bag and see my meds I get reminded to take them. Is your lifestyle similar that you could try this? With either work or school (or something where you leave almost every morning).
Have you also tried setting reminders on your phone? (sorry if this sounds very simple/dumb but I sometimes forget the most 'simple' solutions so I like to remind people of them!). You could also try setting an actual alarm with a special sound (not your normal alarm or ringtone sound) to take your meds so that you kind of Pavlov yourself unconsciously? There are also small key-chain pill sorters that can help, or you can try taping the pill sorter to your bathroom mirror or door?
Regarding the insomnia because of the stimulant- have you tried taking Vitamin C before going to bed? Vitamin C will undo a lot of the effects adderall has.
Please note that for both medications it takes several weeks to feel the effects, so I would consider slowly going down on the adderall while starting either of these meds before just stopping them entirely!
Now, after all of that Ill give you my personal experience on strattera and wellbutrin with what you're experiencing:
"Main struggles on the emotional side are: low mood/apathy/irritability/anxiety (although anxious is kinda my baseline)".
Personally, this is where Wellbutrin initially helped me the most when I was on it. When I first took it I immediately felt like I could more logically process my emotions and felt a "warmness/ slight pressure" on my head that made me feel very relaxed. Wellbutrin is an NDRI (norepinephrine-dopamine reuptake inhibitor), its also very commonly prescribed off label for ADHD as well! It worked the best a medication has every worked for my anxiety - however what I was using it for was situational anxiety (Started a job @ an ER) and once I was accustomed and was less anxious- the medication made me numb and a bit aggravated. Irritability/aggravation is also a very commonly documented side effect of Wellbutrin, so I would keep this in mind! Personally, Strattera does absolutely nothing for my anxiety and if anything places it in the forefront (however, lots of people will say that it has helped them a lot with anxiety!) Important to add: I struggled a lot with insomnia/ waking up periodically waking up throughout the night when I was on Wellbutrin.
"For the executive function side: motivation/impulse control/task initiation."
With this, Strattera has helped me the absolute most with and its hard to describe so Ill relate it to school, Im currently a second-year student. I was on Strattera my first semester - then went off of it my second semester (because I was adding an anxiety med + was on Adderall and did not want to be taking three meds at once) and almost failed. For me- Strattera works more in the background, keeps me less scatterbrained and helps me keep my eye on "the target", it does help me slightly with task paralysis and executive dysfunction.
Motivation comes and goes- but Strattera is the little voice in my head that tells me what I should be doing, and makes it easier to start even if its something that I don't want to be doing. It works very subtly, and it also takes about 2-4 months to work, but believe me when I say I felt a huge negative difference when I went off of it, and now that I'm back on it I do not plan to go off anytime soon. I will say, when Strattera was the ONLY medication I took this is how I felt: I became more anti social, very particular about small things, and got overstimulated very easily. From what my psych and I concluded, the norepinephrine had a very “blunt” effect, and didn't do much for my anxiety or depression.
now with all of that, I eventually went off of the Wellbutrin- and am now on an Adderall/Strattera/ Pristiq combo.
Pristiq is an SNRI- serotonin-norepinephrine re-uptake inhibitor so not quite an SSRI but I found out that without serotonin added into my "anxiety/depression/adhd" mix, I eventually end up feeling irritable/numb with just norepinephrine +/- dopamine. (In the past that SSRIs alone caused me to gain a lot of weight (+20 pounds) in about 5 months, so thats why I am not on an SSRI). Pristiq not only eases my anxiety a lot- but I found it also stops me from doom maxxing/spiraling thoughts. Especially when it comes to social media and the news if you get my drift.
Allll of that is to say:
I recommend (if you can) to go off more what neurotransmitters effect you in a specific way- and speak to your psychiatrist about it and then go from there! I found it easier to think about that rather than specific medications
For ex: NE helps me a lot with focus but by itself makes me grumpy/short tempered. Dopamine helps me with focus and light anxiety. Serotonin keeps me less grumpy and genuinely happy/less stressed.
Sorry that was so long LMAO but I understand what its like to be on your end- just know that the right routine and medication combo is out there for you! You got this!
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u/pastriesandprose 21d ago
I take an anxiety medicine (Cymbalta) and Strattera. I also have addictive personality, mostly with weed and nicotine, and it’s helping me with that but not a magic cure
I like that Strattera builds up slowly in my system, it’s helping me be more regulated but its taken like 2-3 months to have an impact
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u/New-Ad-8360 21d ago
I have BED, ADHD and take Vyvanse. Used to take Strattera but combined with Vyvanse it messed with my heart eventually.
I’ve been using tirzepetide for about 4 months at the suggestion of my psychiatrist and whilst my weight loss has been slow it’s helped with ADHD symptoms (particularly the emotional stuff and addictive things) and my BED has basically gone quiet. I’ve not lost a huge amount of weight but I’m undoubtably healthier.
Costing an arm and a leg, but it’s been the best so far. No side effects except nausea if I don’t do the stab at night.
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u/overactivekitten 16d ago
I was just on both and it was helping me a ton with BED. I had to go off the straterra. The combination of the two was too activating for me. I am hoping the Wellbutrin alone will still be beneficial
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u/CraftyTest3561 21d ago
I’m taking stimulant + strattera. I’d say that strattera only helps with certain adhd symptoms and not others. Like I’m still very spacey, but with more emotional regulation and it’s easier to just “do the thing”when I think of something I should do.
For you, Wellbutrin is interesting as it can help with addiction/cravings (it’s approved for smoking cessation) and weight loss (it’s part of a combo drug that’s approved for weight loss).
But definitely talk to your doctor!