krazzy, I think it is good to add one med at a time, see how you react on that, and then progress to the next "tweak" by adding or removing meds, changing doses, etc. Unfortunately, you don't really know how you do on Wellbutrin, as you haven't given it a fair chance by taking it regularly. When people are on SSRIs, like Paxil, it is not uncommon to give Wellbutrin to help them be more "up", as some people experience a kind of numb/zombie effect with SSRIs, and that is not what most people are seeking. Another bit of info--according to my PNP, people usually do not have the same difficulties stopping Wellbutrin as they do stopping SSRIs.

I started on Wellbutrin for ADHD symptoms, as it is effective for this in some people. It did help me a lot, but I felt it wasn't enough, so I added the stimulant Vyvanse. At the time of starting Vyvanse, my PNP decreased my dose of Wellbutrin from 300 mg to 150. She said I wouldn't need as much since I was adding the stimulant (they both act on the dopamine pathway). I've done fine on this combination.

I also have anxiety, and my PNP told me neither Wellbutrin nor Vyvanse would help with that, and could make it worse. But I was more concerned about dealing with my ADHD symptoms than the anxiety, so I made this trade-off. I use non-medical approaches (deep breathing, etc.) to handle my anxiety, as well as psychotherapy. (I have xanax I can use in a pinch if I really need it, but I rarely take it.)

I think you should have a good talk with your doc about all your concerns about these meds. Ask questions about why you are taking each one, how you will know if you should give up any of them or decrease their dosages, etc. Good suggestion from Simcha--write down all your questions before your doctor visit.

One last question--is it the same doctor who is prescribing you Paxil, Wellbutrin, and Concerta? Some of your comments made me think you originally got the Paxil from a different doc. It would be very helpful if the same doctor was prescribing all of your psychoactive meds. You need a unified treatment plan.

Good luck.