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How can forgetfulness and confusion be managed despite taking Wellbutrin?

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General & Family Physician
Practicing since : 1991
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I feel like I’m going To lose my job if I don’t get some help. I’ve talk to my doctor, I’ve always been scatterbrained and forgetful but the last nine months it’s been worse! My doctor added Wellbutrin To my antidepressant in hopes that it would help me focus better. I’ve noticed no change, I called the doctor and they’re upping the Wellbutrin prescription:
I am a flight attendant for 30 years, I’ve had coworkers talk to me because of my lack of focus and ability to finish a task and not get distracted. I’m getting worried
Sat, 10 Mar 2018 in Mental Health
Answered by Dr. Bonnie Berger-Durnbaugh 3 hours later
Brief Answer:

Detailed Answer:
Hello and welcome,

I don't know all of your health problems or mental health history so I can't advise whether this is a good idea or not. But I can provide some information in general here.

1. Poor sleep quality: Do you sleep well? Do you snore or have apnea? Also, were there any changes in sleep after starting the Cymbalta (which I assume you have been on for a long time, perhaps prior to the forgetfulness?) or after starting the Wellbutrin? Poor sleep or inadequate number of hours of sleep can affect concentration, focus, and memory. So this is something to consider evaluating or treating if necessary.

2. Have you had your thyroid checked? I recommend getting blood work for TSH, thyroxine (T4), if you have not had this checked recently, and also a CBC (complete blood count) to check for anemia and red blood cell size, and a complete chemistry panel (checks glucose, liver function, kidney function, electrolytes). In addition, blood tests for B12 and folate (two B-vitamins) should be done.

3. It takes about 4 weeks for a new antidepressant to work. You've been on the Wellbutrin for 4 weeks. If you haven't been on a therapeutic dose (we often start people on lower doses for a few weeks to get them past initial side effects), then it would be ok to increase the dose to see. But I'd ask the doctor exactly what he thinks the Wellbutrin will be treating here. If it is depression that he is trying to treat by increasing the Wellbutrin, and if depression is not the issue behind your symptoms, then I would not think this is the best option.

4. Have you consulted with a psychiatrist to evaluate your difficulty? It's possible that you have adult ADD and need a medication more specific for that.

5. A "neuropsych" evaluation can test the specific problems that you may be having trouble with and shed light on what might be going on. This is a battery of tests done by psychologists who are trained in this specific type of testing. It includes in depth memory recall, speed of processing tests, etc.

So these are some things to think on. And I can understand your need for expediency. Please let me know if I can clarify or provide further information.
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