Posted by Ritch on March 27, 2002, at 9:57:01
In reply to time to taper adderall and add lithium-DARN!, posted by Peter on March 27, 2002, at 2:41:56
> Hi everyone:
> Well, I've been on Neurontin (300mg tid), adderall (20mgXR in a.m. + 10mg regular early p.m.), and klonopin(1.5mg daily), all for a few months. Because of some emotional instability and a desire to simplify my medication regime, my pdoc and I have decided that I taper off adderall and start lithium (Eskalith) 300mg each night, rising up to 600mg in 3 days. After I'm stable on eskalith, I might also taper off the neurontin, or keep using a small amount of it with the lithium. To tell you the truth, I'm freaked out (what else is new?). I find that I really like the adderall; I'm so used to feeling motivated and focused with the first dose, and my evening 10mg dose makes me feel calm, focused, and often a bit euphoric. Even though I'm tapering off slowly, I'm just not looking forward to coming off of it. I never went over my prescribed dose, so I haven't abused it, but I guess I'm addicted by this time. On the other hand, my more sensible half tells me that it's alot better for me, with my addiction background, to be on a less 'psychoactive' medication (eskalith) that I can take once-daily to stabilize me. In doing this I can pay more attention to the important things in life-my relationships, spirituality, etc...but I'm just apprehensive about stopping the adderall! My p-doc was even going to up my dose of the stimulant, but we decided to try the lithium. He's diagnosed me with mild bipolar II/SP/possible ADD. Though I love the adderall, it sometimes creates a bit of instability & irritability in me, and my high heart rate would have required the addition of a beta-blocker, which I wouldn't have felt comfortable with. I'm hoping that the Lithium will finally be the one drug that can keep me stable. I've tried just about everything else, and I want to just settle on something and stay, and it sounds like Lithium's the best bet. But I'm nervous. Sorry-I just needed to vent.
Why can't your pdoc just start up the lithium and get you stabilized at a low therapeutic blood level *first*-then start an Adderall taper (or switch pstims)? I mean, how is he going to be able to tell what's working for you if he changes two things at once?