Posted by Ritch on December 23, 2002, at 9:26:42
In reply to Re: do anti-psychotics make ADD worse??, posted by cybercafe on December 22, 2002, at 21:24:52
> > > i was taking zyprexa+clonazepam for bp II, then when we threw in
> > > 30 mg of ritalin sr it seemed to do little
> > >
> > > do anti-psychotics make ADD worse, or make stimulants less effective?
> > >
> > >
> >
> >
> > They make stimulants less effective. If you are taking enough of an AP, your D2 receptors are all pretty much going to be blocked and a stimulant would likely have little effect. They can make ADD symptoms worse, too. I remember when I was trying low-dose Seroquel at bedtime, I would have a rebound super-attentive effect about 16 hrs. post-dosing, when the D2 receptors were becoming unoccupied.
> >
>
> damn... actually i was reading an article on the journal of clinical psychiatry that implicated D4 receptors ...
>
> and apparently olanzapine binds strongly to D4 receptors
>
> but then i thought norepenephrine was also important in
> ADD....
>
> what is the mechanism of action of ritalin, just
> inhibition on the dopamine re uptake transporter?
Ritalin also blocks the NE reuptake pumps and releases NE as well. Do you think your pdoc would be willing to reduce the olanzapine a bit? It almost sounds like your DA receptors generally are fully occupied, and there just isn't any wiggle room to activate them.
poster:Ritch
thread:132899
URL: http://www.dr-bob.org/babble/20021223/msgs/132973.html