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d-amphetamine vs. l-amphetamine?

Posted by MB on March 18, 2002, at 16:10:17

OK, I need some advice. I am currently taking Adderall, Neurontin, Klonopin, and Serzone.

--Started with Gabitril then Trileptal as mood stabablizers, couldn't tolorate (especially when Prozac was added to Trileptal) so switched to Neurontin which seemed fine.

--Akathisia and anxiety on Prozac was so bad that added Klonopin.

--Never could tolorate akathisia on Prozac (even at 5-10mg/day) so switched to Serzone by my request (figured 5HT-2a blockade = less akathisia), but have yet to be able to get up to the 400mg requested by doc (stuck at 200mg: postural hypotension and akathisia).

--Titrated up to 45mg Adderall a day. This seems to be the only med of the bunch that has helped mood any.

P-doc's recomended dosing schedule screwed me up and I was left to titrate doing times and sizes of those doses for the past month as I only speak with him monthly (this sparse assistence with med management will change shortly).

Anyway, during the day, I sometimes come down with horrible sympathetic overstimulation (chills, cold sweats, goosebumbps, creepy/crawly scalp, etc). It seems that when the Adderall first "kicks in" it is nothing like this, yet later in the day, the stimulation becomes more "ephedrine-like", then gets better. Along with the "ephedrine-like" stage is usually a mood swing in the negative direction (irritability or start crying over nothing or feel completely dead inside).

Could this be the action of the l-amphetamine? I've been told that the pharmacokinetics of the four different Adderall salts is unknown (true?). The Dr's Assistent recommended Concerta. Methylphenidate, I've been told is even *more* peripherally active than Amphetamine. Am I wrong? Am I barking up the wrong tree if I ask tomorrow (my consultation) to be switched to dextroamphetamine?

--also, I'm wondering if Serzone could be increasing norepinephrine at such a low dose (i.e., exacerbating Adderall's sympathamimetic side effects).

I feel like the Doctor should have the answer, but instead it seems up to me to figure this out. Everything he's tried so far has made me sicker.

MB


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poster:MB thread:98610
URL: http://www.dr-bob.org/babble/20020318/msgs/98610.html