Posted by fachad on February 12, 2003, at 20:52:04
In reply to how do you handle stimulant rebound depression?, posted by cybercafe on February 12, 2003, at 20:24:39
A couple of suggestions:
First, find out which of the stimulants causes the least rebound depression for you. For me, immediate release methylphenidate causes by far the worst rebound depression, and Adderall causes far too many somatic side effects like racing heart and dry mouth; so dextrostat is the logical choice. It causes a little rebound depression for me, but not much.
Next, consider an extended release preparation like Concerta, Adderall XR, or Dexedrine Spansules. The slow onset/slow wear off will make the rebound much less dramatic.
If you cannot afford the extended release meds (they are all brand only and often not covered by insurance), consider splitting your doses to create a "virtual extended release" effect. For example, if you take three 10mg methylphenidate tablets at 8 AM, 12PM, and 4PM, break those scored tablets into halves or even quarters and take 1/2 tablet every 2 hours instead of a whole tablet every 4 hours, etc.
Finally, for me a very low dose of a tricyclic AD like doxepin or trimipramine makes me feel warm and fuzzy and smoothes the stimulant wear off. Just a small dose, like 10 mg or 25 mg is sufficient.
poster:fachad
thread:140767
URL: http://www.dr-bob.org/babble/20030208/msgs/140771.html