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ADHD

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Vyvanse and Wellbutrin: can you take them together?

Written by Klarity Editorial Team

Published: Oct 31, 2022

Medically Reviewed by Dr. Zoe Russell

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People with attention deficit hyperactivity disorder (ADHD) are almost three times more likely to develop depression than the general population. Treating both conditions is important, but are there effective treatment options that can simultaneously help treat ADHD and depression?

Vyvanse and Wellbutrin are two different medications that can work synergistically to treat symptoms of ADHD and other comorbid mood disorders, like depression. If you have ADHD and experience depression, this combination of medications might be right for you.

However, taking Vyvanse and Wellbutrin, either singly or together, isn’t recommended for everyone. In this post, Klarity discusses Vyvanse and Wellbutrin and how both can work together to help people with comorbid ADHD and depression symptoms. We also address situations where Vyvanse or Wellbutrin might not be right for you. 

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This article discusses suicide, suicidal ideation, and self-harm. If you or someone you know is experiencing suicidal thoughts or is in crisis, contact the Suicide Prevention Lifeline immediately at 800-273-8255.

What is Vyvanse?

Vyvanse is a central nervous system stimulant. The main ingredient in Vyvanse is lisdexamfetamine dimesylate. Once it hits your body’s GI tract, it is converted to an active ingredient—dextroamphetamine, a type of amphetamine used to treat attention deficit hyperactivity disorder.

As a stimulant medication, Vyvanse increases the amount of norepinephrine and dopamine in the brain. Norepinephrine is a neurotransmitter that stimulates the central nervous system, improving alertness, concentration, and cognition. Dopamine is a neurotransmitter whose function is crucial to the brain’s reward center. It is the “feel good” neurotransmitter.

As a result, Vyvanse produces feelings of euphoria and well-being in addition to helping improve concentration and attention span and reduce hyperactivity and impulsive behaviors. Because of Vyvanse’s effect on impulsive behavior, it is FDA-approved to treat binge-eating disorder.

However, as a stimulant medication, Vyvanse is a federally-controlled substance due to its addictive nature and risk of dependence, among other side effects. Sharing your prescription of Vyvanse or other medications of the same class with another person is illegal. 

Forms and dosages

Vyvanse is available in oral capsules and chewable tablets. It is mostly prescribed in oral tablet form. Usually, patients start on a daily dose of 10mg by mouth and gradually increase the dosage if no interactions or reactions occur.

Vyvanse oral capsules are available in:

  • 10 milligrams
  • 20 milligrams
  • 30 milligrams
  • 40 milligrams
  • 50 milligrams
  • 60 milligrams
  • 70 milligrams

Vyvanse chewable tablets come in the following dosages:

  • 10 milligrams 
  • 20 milligrams
  • 30 milligrams
  • 40 milligrams
  • 50 milligrams 
  • 60 milligrams

Conditions treated

Vyvanse treats symptoms of ADHD and moderate-to-mild binge eating disorder in patients older than six years of age. It is sometimes prescribed “off-label” for treatment-resistant depression.

Symptoms of ADHD Vyvanse treats

The core symptoms of attention deficit hyperactivity disorder are inattention, hyperactivity, and impulsivity. For adults with ADHD, hyperactivity symptoms are less severe than inattentive or impulsive symptoms.

Inattentive Symptoms Include:

  • Difficulty paying attention to tasks and conversations
  • Difficulty organizing and prioritizing tasks and activities
  • Difficulty following through/completing directions, duties, responsibilities, and obligations
  • Often loses important items like keys, wallets, phones, etc.
  • Easily distracted, even by one’s own thoughts
  • Often misses appointments, fails to return calls or pay bills 

Impulsivity Symptoms Include:

  • Has difficulty sitting still when doing so is expected
  • Has difficulty being quiet when doing so is expected
  • Fidgets often, tapping hands and feet
  • Often squirms in seat and leaves seat when inappropriate
  • Talks excessively and often interjects in conversations
  • Interrupts and intrudes on others

Because Vyvanse helps control symptoms of impulsivity, it is FDA-approved to treat binge-eating disorder (BED). 

Cost

The cost of Vyvanse will depend on your dosage, pharmacy, and insurance. On average, a 30-day supply of 70 mg capsules without insurance or a product coupon is roughly $15 a pill, or $460.55 a month. There are no less-expensive, generic versions of Vyvanse. However, like with other medications, manufacturer’s coupons are available for people without insurance, reducing costs.

Side effects and drug warnings

Here are the common side effects drugs like Vyvanse have on the central nervous system.  

  • Insomnia (trouble falling and staying asleep) 
  • Decreased appetite 
  • Weight loss
  • Abdominal (belly) pain 
  • Constipation
  • Headache 
  • Nausea and vomiting 
  • Irritability 
  • Anxiety
  • Crashing (some patients might experience increased tiredness and irritability as the medication wears off)

Taking Vyvanse comes with the risk of more serious side effects, which are less common. These include:

Cardiovascular problems

  • Increased heartbeat
  • Increased blood pressure
  • Heart attack
  • Chest pain (angina) 
  • Sudden weakness/numbness in the arm 
  • Chest tightness with pain radiating to the neck, jaw, and throat 

Worsening mental health symptoms

  • Developing or worsening psychotic symptoms, including visual and auditory hallucinations and delusions
  • Developing or worsening bipolar symptoms
  • Developing or worsening manic symptoms
  • Developing or worsening negative thought patterns and behavior

Circulatory symptoms 

  • “Raynaud’s syndrome” (problems with blood circulation in your fingers and toes)
  • Due to lack of circulation, patients will notice their fingers look pale with blue, purple, red, or white discoloration.
  • Fingers and toes might feel numb and cold 
  • Unexplained injuries, bruises, and cuts to fingers and toes

Serotonin Syndrome

Serotonin syndrome is a toxic build-up of serotonin that can be fatal. It occurs most often when starting a new medication that elevates serotonin levels or as a drug interaction between two medications that boost serotonin levels.

This condition occurs hours after taking a new medication or increasing the dose of your current medication. Symptoms include: 

  • Seizures 
  • Muscle twitching and tremors
  • Stiff muscles
  • Fast heartbeat 
  • Loss of coordination
  • Diarrhea 
  • Flushing (warmth, redness, and swelling of the face)
  • Confusion 

Warnings and drug interactions

Vyvanse is classified as a Schedule II drug under the Controlled Substances Act due to its stimulant properties, potential for misuse, and very high risk for dependency. This is because it belongs to the amphetamine class of medications. Long-term use, misuse, or high dosage may increase this risk, so it’s crucial to take Vyvanse as prescribed and under close medical supervision. 

Additionally, if Vyvanse is discontinued suddenly, withdrawal symptoms can occur. Symptoms may vary in severity depending on the dosage and duration of use. The best way to stop taking Vyvanse is under the guidance of a healthcare provider. 

Common withdrawal symptoms include:

  • Fatigue 
  • Depression or anxiety 
  • Irritability 
  • Difficulty sleeping 
  • Increased appetite 
  • Headaches
  • Difficulty concentrating 
  • Flu-like symptoms such as muscle aches and sweating

Other medications frequently used to treat ADHD are also classified as Schedule II stimulants. The most frequently prescribed medications include:

  • Methylphenidate (Ritalin, Concerta): Stimulant medications chemically different from amphetamines but have similar effects.
  • Dextroamphetamine (Dexedrine): An amphetamine medication used for ADHD and narcolepsy.
  • Lisdexamfetamine (Vyvanse): A prodrug that remains inactive until metabolized in the body, prescribed for ADHD and binge eating disorder.
  • Methamphetamine (Desoxyn): A potent central nervous system stimulant used in rare instances to treat ADHD and obesity.

It’s important to note that Vyvanse should always be taken under the guidance and supervision of a healthcare professional. Understanding the potential risks and side effects associated with this and similar medications can help individuals make informed decisions about their treatment options.

Serotonin syndrome

Serotonin syndrome is a rare but potentially fatal condition that occurs when there is too much serotonin in your body. Usually, serotonin toxicity occurs when patients increase their dose of medication or start a new medication that affects serotonin levels. 

Serotonin syndrome usually occurs within a few hours of taking a higher dose of medication or starting other medications that elevate serotonin. Symptoms of serotonin include:

  • Insomnia
  • Confusion
  • Agitation
  • Restlessness
  • Rapid heart rate and high blood pressure
  • High blood pressure
  • Muscle rigidity
  • Dilated pupils
  • Loss of muscle coordination or twitching muscles

To prevent serotonin syndrome, patients prescribed Vyvanse should stop taking an monoamine oxidase inhibitor (MAOI) 14 days before starting stimulant medications like Vyvanse. 

Common MAOIs are:

  • Isocarboxazid 
  • Linezolid
  • Methylene blue injection 
  • Phenelzine 
  • Rasagiline 
  • Selegiline 
  • Tranylcypromine 

Always talk to your medical provider when stopping or starting other medications to avoid drug interactions.

Vyvanse and alcohol

Though there are no specific studies on Vyvanse and alcohol’s combined use, there have been studies on amphetamines, a similar drug, and alcohol. Mixing amphetamines and alcohol raises heart rate and blood pressure.

CNS stimulants can mask the effects of alcohol intoxication, which leads to people drinking more than they should — taking Vyvanse while drinking alcohol can lead to alcohol poisoning and injuries associated with drunkenness, like falling.

Licensed providers on Klarity provide personalized treatment. Find a provider that matches your needs and preferences.

What is Wellbutrin?

Wellbutrin (bupropion) is a unique antidepressant medication. It is an NDRI or norepinephrine-dopamine reuptake inhibitor. Like other antidepressant medication, this medication is FDA-approved to treat major depressive disorder (MDD) and seasonal affective disorder (SAD) and is prescribed to help with smoking cessation and weight loss.

Like Vyvanse, taking Wellbutrin elevates levels of dopamine and norepinephrine. Dopamine is responsible for feelings of well-being and is a vital part of the brain’s reward center. Norepinephrine excites the central nervous system and affects attention, concentration, and cognition. 

Forms and dosages

Wellbutrin is available in two types of modified-release oral tablets—controlled release (Wellbutrin XL) or sustained release (Wellbutrin SR). Both Wellbutrin XL and Wellbutrin SR are considered “extended release.” Both are intended as a daily dose.

  • Controlled Release: The medication is slowly released constantly over time.
  • Sustained Release: The medication is slowly released over time, but not constantly. 

When you speak with your Klarity medical provider, they’ll help determine which form and dosage are best for you. 

Oral tablet, sustained release (Wellbutrin SR):

  • 100 milligrams 
  • 150 milligrams 
  • 200 milligrams 

Oral tablet, controlled-release (Wellbutrin XL):

  • 150 milligrams 
  • 300 milligrams 

Conditions treated

Wellbutrin, Wellbutrin XL, and Wellbutrin SR are primarily prescribed to treat depression symptoms. In addition to treating depressive disorders, Wellbutrin is FDA-approved as a smoking cessation aid. 

Depression symptoms Wellbutrin can treat

  • Sadness
  • Feeling empty and hopeless
  • Outbursts of anger, frustration, and irritability
  • Reduced or lack of interest in hobbies and activities that used to bring joy
  • Sleep disturbances: insomnia, oversleeping sleeping
  • Feeling tired, lethargic, and “heavy” or weighed down
  • Changes in appetite: eating too much or too little
  • Increased anxiety, restlessness, and agitation
  • Speaking and moving as if in slow motion
  • Difficulty thinking, concentrating, remembering, and making decisions
  • Unexplained pains and aches
  • Feelings of worthlessness, ruminating on past mistakes and failures
  • Unnatural guilt or shame
  • Thoughts of death, suicide, and feeling like you’d be better off if not alive.

Cost

The cost of Wellbutrin XL and Wellbutrin SR will depend on your dosage, pharmacy, and insurance. A 30-day supply of Wellbutrin — 30 tablets — costs about $86.62, or $2.89 per pill. Health insurance will drastically reduce the cost of Wellbutrin. If you do not have health insurance, there are coupons and copay assistance programs available to reduce the costs of Wellbutrin.

Side effects

All antidepressants carry some risk of side effects. Common side effects of Wellbutrin XL and SR include:

  • Anxiety
  • Abnormal or unusual dreams
  • Tachycardia (fast heartbeat)
  • Hyperventilation 
  • Excessive sweating 
  • Blurred vision 
  • Irritability
  • Migraine
  • Dry mouth
  • Constipation
  • Insomnia (trouble sleeping) 
  • Skin rash 
  • Confusion 
  • Dizziness and fainting
  • Nausea and vomiting
  • Tremors
  • Excessive energy (excessive talking, hyperactivity, and fidgeting)
  • Hair loss

These side effects are often minor and disappear after a few days or weeks. However, if the above side effects persist over a few weeks, worsen, and interfere with your daily functioning, then talk to your medical provider about stopping or reducing the dosage.

Wellbutrin XL and SR can cause more serious side effects in a small percentage of Wellbutrin users. If prescribed Wellbutrin, monitor for the following side effects:

Mental health side effects

  • Panic attacks
  • Changes in mood
  • Increased impulsiveness
  • Increased depression
  • Increased anxiety 

Other serious side effects

  • Hypertension
  • Vision Issues
  • Seizures 

Warnings and drug interactions

People prone to seizures, whether due to medication, a seizure disorder, or injury, must disclose this to their medical providers before taking Wellbutrin. 0.1% – 0.4% of Wellbutrin users experience seizures or an increased risk of having a seizure. This is especially true with alcohol use.

Unlike SSRIs, Wellbutrin does not have widely reported sexual side effects. 

Wellbutrin can affect your weight and appetite, causing weight loss or weight gain. Be sure to disclose any history of eating disorders with your medical provider before taking Wellbutrin.

Wellbutrin might not be right for people with liver and kidney issues due to the increased strain on these organs when metabolizing Wellbutrin. People with diabetes and bipolar mood disorder should also not take Wellbutrin.

Also, Wellbutrin should not be prescribed to those with bipolar disorder or schizophrenia, and it has a small risk of causing psychosis in some patients.

Serotonin Syndrome

Though Wellbutrin primarily prevents the reuptake of norepinephrine and dopamine, which elevates the base levels of the two neurotransmitters, it also boosts serotonin to a lesser extent.

Because of this, Wellbutrin should not be taken with other medications that increase serotonin levels, including SSRIs and MAOIs.

Common MAOIs include:

  • Isocarboxazid 
  • Linezolid
  • Methylene blue injection 
  • Phenelzine 
  • Rasagiline 
  • Selegiline 
  • Tranylcypromine 

Common SSRIs include:

  • Fluoxetine (Prozac)
  • Paroxetine (Paxil, Pexeva)
  • Sertraline (Zoloft)
  • Citalopram (Celexa)
  • Escitalopram (Lexapro)

Boxed warning

All antidepressants come with a black box warning from the FDA. In placebo-controlled trials of antidepressants, researchers saw an increase in suicidal thoughts and ideation among children and adolescents taking antidepressants compared to the placebo group.

These findings have not been replicated in adults. However, it’s important for people taking antidepressants to monitor for sudden mood, thoughts, and behavior changes. If these are experienced, contact your healthcare provider immediately.

How do Vyvanse and Wellbutrin work together?

Though they use different mechanisms, Vyvanse and Wellbutrin increase the available amounts of norepinephrine and dopamine in the brain. Because of this, Vyvanse and Wellbutrin have a synergistic effect when used to treat ADHD and depression. 

Attention deficit hyperactivity disorder is often comorbid with other mental health conditions, including many varieties of depression, like seasonal affective disorder. These medications might be suitable for people with ADHD who have comorbid depression. However, taking the two medicines together increases the risk of certain side effects, such as seizures or negative drug interactions.

Here’s a breakdown of the potential benefits and drawbacks:

Benefits

  • Vyvanse and Wellbutrin may be prescribed together to help treat ADHD and treat depression in people who have both conditions.
  • Vyvanse and Wellbutrin may have complementary effects, as Vyvanse can help improve focus and attention, while Wellbutrin can help improve mood and reduce symptoms of depression.

Risks

  • Combining Wellbutrin with Vyvanse may increase the risk of side effects, such as high blood pressure, heart palpitations, and insomnia.
  • Both medications can increase the risk of seizures, and combining them may further increase this risk.
  • Taking Vyvanse and Wellbutrin together may increase the risk of drug dependence and abuse.
  • Some people may experience an increased risk of suicidal thoughts or behaviors when taking Wellbutrin.

Klarity helps you discover the right ADHD medication

Klarity has helped more than 30,000 people find diagnoses and treatment for various mental health issues — including ADHD and depression. Our novel telehealth service marketplace makes finding online ADHD and depression treatment affordable, fast, and convenient. 

So, if you are curious about trying Vyvanse and Wellbutrin together to manage ADHD and depression symptoms, book an appointment on Klarity. Here’s why:

Klarity is fast: We will get you a virtual appointment with a licensed healthcare provider in your state within 48 hours.

Klarity is convenient: Meet with a provider anywhere you have cell service or WiFi — we put the doctor’s office in your pocket.

Schedule an appointment today to get started.

Sources

Carl Sherman. “Is It ADHD, Depression, or Both?” ADDitude. https://www.additudemag.com/adhd-and-depression-symptoms-treatment/

“Drug interactions between bupropion/naltrexone and Vyvanse.” Drugs. https://www.drugs.com/drug-interactions/bupropion-naltrexone-with-vyvanse-3559-0-1475-2533.html

“Bupropion (Oral Route) – Mayo Clinic” 

https://www.mayoclinic.org,https://www.mayoclinic.org/drugs-supplements/bupropion-oral-route/precautions/drg-20062478 

Jacqueline Sinfield. “Using Wellbutrin for ADHD.” Very Well Mind. https://www.verywellmind.com/using-wellbutrin-for-adhd-4137671

Janice Rodden. “Wellbutrin.” ADDitude. https://www.additudemag.com/medication/wellbutrin/#:~:text=When%20prescribed%20for%20ADHD%20treatment,like%20Vyvanse%20or%20Adderall%20XR.

Renato P. Munhoz. “Serotonin syndrome induced by a combination of bupropion and SSRIs.” National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/15602102/

“Vyvanse: Dosage, side effects, alternatives and more – Medical News Today.” 

https://www.medicalnewstoday.com,https://www.medicalnewstoday.com/articles/vyvanse#side-effects 

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