Expert: Dr Billy Levin - 12/30/2009

Question
Hi Dr.
I am 50.
I was diagnosed with adult ADD in my early 40's and prescribed wellbutrin.
It was a huge relief to find out what was wrong with me, and the wellbutrin has helped.
On two occasions I went off the medication in concern for its side effects and thinking I could do without it, but my wife was firm in advising me to keep taking it.
I am currently on 100 mg. SR once a day.
In the last year I have noticed an increase in certain shealth issues for which I can only implicate the wellbutrin, having ruled out eveything else and doing an elimination diet.
These are:
*extreme abdominal distension and inability to lose weight despite a low calorie diet and lots of exercise.
*narrow pale stools
* itchy skin which becomes hives in hot weather.
Two questions please:
1.Are there now any alternatives, including natural supplements, to the wellbutrin?
2.When I went back on the medication it took a couple weeks to notice improvement-I assume this meant it had to build up.
Since it has now buit up, can I cut the pills in half ot take on alternate days.
My digestive issues are the price I pay for domestic harmony but I wish the price wasnt so high!
Thanks and happy new year!

Answer
In my medical practice I never use Wellbutrin for ADD/ADHD on its own. However I often use it as an "add-on" for depression complicating ADHD. The most suggested medications for ADHD are the stimulants  (with few exceptions the first choice)and an optimal dose has to be evaluated using rating scales on a regular basis. As I have not examined you my only suggestion is to see your doctor as any treatment to be acceptable, must  have no problamatic side effects and must over all work! As ADHD is not a part time condition the treatment is on a regular every day with no exceptions.