Posted by KaraS on July 15, 2004, at 1:19:09
In reply to Re: Zeugma, ADD diagnosis » KaraS, posted by zeugma on July 12, 2004, at 13:37:49
> sorry it's so long for me to reply to your post, I had to sleep upwards of 12 hours to recover from the weekend's insomnia, and also there are some posting problems that interfere with the 'include previous post' option.
Hi Zeugma,
I'm glad you got a chance to catch up on your sleep. (Even though you needed it, don't you feel really depressed after you've slept that long?) I almost missed responding to you entirely. I thought I owed you a response but couldn't find the thread. I gave up figuring that I must not owe you a reply. I could have sworn that I did a search on your name and everything. Then this evening I saw it quite by accident. Maybe I do have ADD! OTOH, maybe it's the rhodiola that I've been trying. I think it's have the opposite effect on me that it's supposed to. But that's another story.At any rate, let me now respond to your comments.
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> It has been a mixed blessing having the ADHD diagnosis from an early age. At 12 I was hardly able to process it other than to think 'oh no, there's something wrong with my brain.' also my parents do not understand psychiatric illness, and essentially ignored the recommendations that were made, which was not helpful in terms of my subsequent academic career. they did put me in psychotherapy, but i will save the disasters this produced for PB Psychology, if i ever do choose to publicize them.
>It is so difficult to deal with a situation like yours or mine when the parents don't understand. It's hard enough to deal with the problem itself and then to have them compound it - especially since you were so young. You really weren't old enough to be your own advocate which is what the situation called for. As I'm sure you know, both fields of psychiatry and psychology are rife with treatment horror stories. Many years into the future they will probably look back on our methods the same way that we look at using leeches to cure illnesses.
> yes I've found some things that worked or work. Strattera unquestionably did work on some aspects of my ADHD. Once I went on it I started moving up in my profession, and it had a powerful motivating effect that was great. Unfortuantely two problems:
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> i used it concurrently with nortriptyline, and this was pharmacological redundancy, which amplified the s/e of each;
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> and Strattera has a fatiguing effect that is hard to explain on a pharmacological basis. This did not manifest in me immediately, rather it slowly intensified until my already severe lethargy became unbearable. Also, while it addresses such ADHD/depression issues such as brain fog and motivation, it fails to have the 'slowing' effect that Provigil and the stims I tried long ago had, and which is probably better suited to most types of ADHD, and which I prefer to the enforced 'alertness' of Strattera. Oh, and Provigil is calming, and I am one of those ultra-nervous types.
>I don't really have any interest in trying Strattera right now. I need more energizing activity at the moment. I have been extremely nervous at times in the past but right now my depression is very clinically atypical. I couldn't stand anything that would make me more listless or tired. (If I'm reading your message correctly, you have an unusual combination of lethargy with anxiety. That must make it harder to treat you.) Provigil made my limbs feel too heavy and I haven't tried the stimulants yet other than Ritalin at 5 mg. which made me sleepy. I've been afraid to increase the dosage in case it would knock me out entirely. Did I ask you yet if you've had any problem with stimulant tolerance? Is that why you're not taking them currently?
I feel like I may have told you/asked you all of this previously. If so, please excuse me. I'm not feeling terribly sharp right now.
> I never tried Remeron, and am rather disturbed by its ability to increase triglycerides- I have cholesterol problems already. Also I would want to put Remeron in place of my AD if I was going to do it at all, and I have seen no evidence that Remeron is a more potent AD than nortriptyline. I would probably benefit from remeron's alpha-2 antagonism, but I already get that from buspirone. I would rather stick with what I have and use Ambien.
>I wasn't aware of Remeron's cholesterol connection. I wouldn't be interested because of the sedation or the weight gain anyway which is why I never looked into it further.
> I also have an order for Ritalin LA at my local pharmacy and should be getting it by the weekend. My pdoc encouraged me to 'mix and match' as needed, so I have other options besides the Provigil.
>I guess that makes sense. You know what you need at the time and can benefit by varying what you take.
> The insomnia was not nearly as bad last night, so perhaps it was the pot of coffee I had Saturday evening that worsened the insomnia (normally coffeedosn't cause that unless it's Starbuck's),or maybe it's the normal 'startup' of a new med (nortrip had plenty of those too).
>I'm either having insomnia or I can't stop sleeping. I seem to rotate phases of both. Makes it harder to treat me as well.
> I know you tried nortrip and had tachycardia problems. I was kept on a very low dose of nortrip by my pdoc because of bp problems. Eventually my body adjusted and I have been able to increase dosage without recurrence of the problem. Reactions are idiosyncratic of course, but a retrial of nortrip might be something to try, plus it has some efficacy in ADHD if you do have that.
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Take care,
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> zEncouraging that your body did adjust. Did your heart race also or was it just your blood pressure? I may someday retry nortriptyline. Maybe start with a really, really small dose.
Thanks so much for all of your info and feedback!
Kara
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poster:KaraS
thread:364549
URL: http://www.dr-bob.org/babble/20040714/msgs/366360.html