Posted by Peter on August 18, 2003, at 20:16:07
In reply to Re: AGH! This is too much!! » wingedcat, posted by Jasmine Neroli on August 17, 2003, at 17:06:13
Ok. Here's the situation. One day of adderall 20mg, and, even after calming down for 4 days on 3.75mg klonopin, I experienced extreme mood lability and the obsessional worrying seems to have increased. The adderall had it's beneficial points (drive, focus, mood-lift, calm), but I would say the resultant mopiness, comatose spaciness, and exacerbation of obsessional thinking far outweighed the benefits.
I realize this is only after ONE day of the adderall, but I am quite familiar with the drug, as I've taken it on and off for 1-2 years, and, if I were to be brutally honest with myself, I can say that each time I fell into a callous, detached, hyperfocused haze that I was too sucked into to notice and too afraid to change even if I to some degree did notice. But, having been off it for a few weeks and having started it up again today, I can perceive more clearly the detrimental effects, and I believe I do not want to get deeper into that mess by continuing the adderall. I just don't understand why my pdoc suggested that i resume it rather than start an AD.
It is OBVIOUS to me, and evident in my posts (as some of you have noted), that my main difficulty now that is destroying me is my obsessional anxiety and resultant depression.
I have tried all SSRI's in the past. They all worked well in this particular area, though they might have exacerbated other areas of my diagnosis. My pdoc has concurred with me that I've reaped benefits for my anxiety from SSRI's, but he is more of the 'cutting edge,' 'experimental type' (great at first, but I've since come to desire a doc that sticks by more 'tride and true' methodology), and would probably in the end want to try out strattera or Welbutrin again on me (both of which agitated me first time around), believing somehow that a large part of my comorbid disorder stems from low dopamine levels. I'm not mocking him; I highly respect his genius, truly. But I get tired of being the gineau pig.
Here's the question: He won't be back until Sept.2, and not available for a session until Sept.9. He answered 'no, not the right time' on that last phone call when I asked if I could start up an SSRI. But With this much klonopin, I would think that whatever pre-therapeutic acute side-effects an SSRI would cause would be at least lessened.
So, I can either:
a) continue the adderall with the possibility (improbable, says my 'gut') that it will be different this time and I'll feel better after multiple days on it.
b) switch to adderall XR (I found a two year old unopened script from when I used to take XR, but we decided, as it doesn't have a steady pulse mechanism like strattera, that it really doesn't offer much improvement in terms of 'smoothness.'). Then again, that was then, this is now. The XR, from what I remember, does seem to pack less of a punch, which might be a benefit for me at this point (that is, if it;s not too old a script to be effective).
b) STOP the adderall; do not continue it for a second day, and just stick with the higher-than-usual klonopin dose and nothing else; this will undoubtedly render me extremely tired and probably depressed, but is a simpler regime to take until doc returns.
c) Take out my 10mg prozac stash, and just start taking 5mg every other day, and deal with the difficult side-effects for a few weeks before it starts to work, knowing that when it does start to work, it will most probably be the best solution now with the widest therapeutic range for various anxieties and depression. In addition, any anxiety side-effects, etc. could be helped by my current high-dose klonopin. Of course, though, there is a chance that this in fact would not be a right move for reasons that I, not a doctor, cannot understand.
As for my doc's long-term plans with strattera or wellbutrin, or any new drug on the block, he's a great guy (REALLY great), but as many of u have said, albeit in different words, this is MY body/mind, not his; and I'm in no mood for further experimentation. It's time to function in life, and if the SSRI's have proved conducive to those ends in the past, i can deal with possible overactivaion/alcohol cravings if and when it comes to that as it did a few times in the past after a few months of SSRI therapy.
I'm sorry for going on like this - honestly, I've never had such an intense streak of obsessional anxiety. As for why such a high dose of klonopin isn't helping, I don't know - I guess it isn't efficacious for OBSESSIONAL type of anxiety?
Anyway, I really took to heart what some of you said that sometimes we just need to take matters into our own hands in emergency situations, but I don't know if that is wise in this specific situation with the prozac, especially with it's extra long half-life (if it begins to really agitate me, it'll take a while to get out of my system). But who knows - at this point I'm talking out of my ___, and it's 3a.m here.
But I'd really appreciate your thoughts given this new info and the 3 possible steps I can take.
Thank you so much again,
Peter
poster:Peter
thread:251194
URL: http://www.dr-bob.org/babble/20030818/msgs/251967.html