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Bupropion for ADHD


From: adeptus+ <adeptus@vnet.net> (Anthony C. Patterson, MD)
Subject: Bupropion for ADHD
Date: Thu, 27 Jul 1995 17:13:35 -0500 (EST)

I am wondering what your experience has been in treating ADHD with bupropion in general and specifically regarding differences between adults and children.

--Stephen Cheshire

My child psychiatrist partner recently handed me a copy of a well-controlled study comparing bupropion against methylphenidate against placebo. Both drugs were significantly more effective than placebo against ADHD in children, yet *no* significant differences were found between response rates. Now, the study was not set up for rejecting a type II error, but it seems to suggest the most certain conclusions regarding effectiveness of the two agents so far. I have not seen a study of adults with equal controls or strength of conclusions.


Date: Thu, 27 Jul 1995 08:03:51 -0700 (PDT)
From: Thomas Lewis <tblewis@itsa.ucsf.EDU>
Subject: Bupropion for ADHD

Bupropion appears to be a useful agent in some, but not all, patients with ADHD. The references below may be of interest.

Wender PH, Reimherr FW. Bupropion treatment of attention-deficit hyperactivity disorder in adults. American Journal of Psychiatry, 1990 Aug, 147 (8): 1018-20. The authors treated 19 adults with attention-deficit hyperactivity disorder with an open trial of bupropion. These patients had received maintenance stimulant medication or monoamine oxidase inhibitors for an average of 3.7 years. Fourteen of the patients experienced moderate to marked benefit from bupropion; ten of these patients chose to continue bupropion rather than their former medication.

Barrickman LL, Perry PJ, Allen AJ, Kuperman S, Arndt SV, Herrmann KJ, Schumacher E. Bupropion versus methylphenidate in the treatment of attention-deficit hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 1995 May, 34 (5): 649-57. In this double-blind, crossover trial, bupropion and methylphenidate were both effective and did not differ in their overall efficacy as treatments for ADHD.


From: "Schweickert, Lori" <LSCHWEIC@npih.medsch.ucla.edu>
Subject: Bupropion for ADHD
Date: Wed, 06 Dec 95 09:09:00 PST

In my clinical experience using Wellbutrin for childhood ADHD (3 kids), both kids and parents note improvement, but attention seems to improve less than hyperactivity or impulsivity. Teachers note the same thing. All of the parents thought methylphenidate worked better, so I ended up switching 2/3 back already. I'm maximizing the dose on the third.


From: MKomrad@aol.com
Date: Thu, 23 May 1996 23:15:10 -0400
Subject: Bupropion for ADHD

I have tried Wellbutrin a couple of times and found it useless in this condition.


Date: Fri, 24 May 1996 23:00:09 -0500
From: talmadge@onramp.net (John M. Talmadge, M.D.)
Subject: Bupropion for ADHD

I have had moderate success using Wellbutrin with adult ADD.


Date: Fri, 12 Jan 1996 21:18:12 EST
From: HRudMD@aol.com (Howard Rudominer, M.D.)
Subject: Bupropion for ADHD

I have been very happy with buproprion so far with ADHD. I have gotten very nice results with a minimum of side effects.


Date: Thu, 31 Oct 1996 22:58:44 -0500
From: Ivan Goldberg <Psydoc@psycom.net>
Subject: Bupropion for ADHD

Paul Wender, MD, sent me the following message and asked me to post it to the list:

We have conducted trials of bupropion (Wender and Reimherr, 1990). It is worth trying. Details and additional material may be found in my book.

I look forward to hearing from my colleagues about their success with the various pharmacological regimens we have employed.

References

Wender, P.H. and Reimherr, F.W. Bupropion treatment of attention-deficit hyperactivity disorder in adults. Am J Psychiatry, 147, 1018-1020 (1990).

Wender, P.H. Attention-Deficit Hyperactivity Disorder in Adults. New York: Oxford University Press, 1995.


From: CWangTSA@aol.com
Date: Tue, 17 Dec 1996 03:22:41 -0500
Subject: Bupropion for ADHD

I have heard good things about bupropion. In fact my son takes it for his ADD. It works well for him.


Date: Tue, 17 Dec 1996 01:11:49 -0800
From: "Deborah Pines, MD" <deborahp@erols.com>
Subject: Bupropion for ADHD

I use buproprion for ADHD with very good results.


Date: Tue, 4 Feb 97 00:01 PST
From: Charlene Sabin <sabin@hevanet.com>
Subject: Bupropion and methylphenidate for ADHD

I have tried combining bupropion and methylphenidate in the treatment of ADHD a few times and found it helpful. The bupropion does not seem to be as effective in assisting concentration as the stimulant medications in general, but the addition of the methylphenidate, even in a slightly smaller dose than usual, seems to help. Some children get depression as a side effect of the methylphenidate treatment, so this combination actually seems reasonable clinically for approximately the 5 clients whom I have treated this way. Theoretically it might lower the seizure threshold further, but I haven't tried it in anyone where that seemed like a particular danger.


Date: Tue, 4 Feb 1997 20:10:51 -0500
From: bret burquest <bret@vnet.net>
Subject: Bupropion for ADHD

I've used bupropion many times with generally good results, so much so that it's now my drug of first choice in the absence of seizures and bulimia. When it isn't enough alone, add methylphenidate.


Date: Tue, 04 Feb 1997 21:32:21 -0800
From: John Rose <JOHNROSE@pol.net>
Subject: Bupropion and methylphenidate for ADHD

In my "n" of 2 patients the combination of bupropion and methylphenidate is well tolerated and the two appear to work better on the core symptoms than either alone. In these patients sleep and appetite are not affected. I do ask frequently about psychotic and manic symptoms both to check for side effects as well as a missed diagnosis of cyclothymia or bipolar II. Both patients are adults. I would be more reluctant in children due to developmental issues.


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[dr. bob] Dr. Bob is Robert Hsiung, MD, dr-bob@uchicago.edu

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