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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Libby on June 30, 2000, at 12:07:17
Today I traded in my Depakote and Effexor XR for a lower dose of Effexor XR (possibly changing to
Prozac at some point) and Ritalin. I just took my first dose of Ritalin this morning and I feel so good! My mood is good. I feel calm. I can actually read! I even want to MOVE occasionally. Augmentation with Depakote and other "mood stablizers" made me feel fatigued and overwhelmed constantly. With the Ritalin, I have both mental and physical energy!YAY Ritalin! I sure hope it keeps working.
Posted by Janice on June 30, 2000, at 12:24:39
In reply to Ritalin augmentation - looks like it's working!, posted by Libby on June 30, 2000, at 12:07:17
hi Libby,
Fantastic! I hope this feeling lasts (sometimes the initial effects of stimulants are almost like highs).
Feeling calm and being able to read are GREAT signs!!!!!!!! and could most definately be indicative of ADD - yeah!
I just sent a post to you last night in reply to your last posting, but I see the batch has turned over. I was hoping you would be able to try a stimulant -depending on the Tova testing.
Very, very happy for you
Gotta go, at work, Janice
Posted by KarenB on June 30, 2000, at 13:21:24
In reply to Re: Ritalin augmentation - looks like it's working, posted by Janice on June 30, 2000, at 12:24:39
Libby,
Great news - I hope it continues for you.
If you find yourself crashing from the Ritalin when the dose wears off, Ritalin SR is an alternative... or Adderall, which I have come to prefer. Or, note when the crash occurs and do your second dosing 1/2 hour earlier than that.
Just some tips.
Glad you are feeling better. What were the results of the TOVA? I think I missed that.
Karen
Posted by noa on June 30, 2000, at 14:48:50
In reply to Re: Ritalin augmentation - looks like it's working, posted by KarenB on June 30, 2000, at 13:21:24
> Libby,
That is good news. Hope it lasts, but even if there is some inconsistency in it, at least now you know you respond well to a stimulant, and you are reminded of what it is to feel better.
Posted by Libby on June 30, 2000, at 14:51:01
In reply to Re: Ritalin augmentation - looks like it's working, posted by KarenB on June 30, 2000, at 13:21:24
>What were the results of the TOVA? I think I >missed that.
Karen, I take the TOVA on Monday (unmedicated) but he did a long interview today and says he's convinced enough to give it a trial over the weekend. Says even if I'm not officially ADD, if the Ritalin improves my concentration and helps me perform in this new job, he will likely keep me on it or another stimulant. Right now, just being able to *think* feels pretty good.
The Bipolar meds flopped with me. He finally agreed NO MORE "MOOD STABLIZERS"! They just
made my mood swings worse, never better, plus
I felt like a zombie all the time. Lethargy
and wild mood swings make for a really icky
feeling...
I like this much better, but more importantly,
I can function!!!
Posted by Noa on July 1, 2000, at 13:26:46
In reply to Re: Ritalin augmentation - looks like it's working, posted by Libby on June 30, 2000, at 14:51:01
The thing about the Tova is that it doesn't measure all aspects of attention deficit disorder.
Posted by Libby on July 3, 2000, at 11:44:30
In reply to Re: Ritalin augmentation - looks like it's working, posted by Noa on July 1, 2000, at 13:26:46
Noa said...
> The thing about the Tova is that it doesn't measure all aspects of attention deficit disorder.<Is it pretty reliable for identifying problems with inattention? I have an hour and a half with a Clinical Psychologist... The TOVA is roughly a half hour long... I was expecting a lengthy interview... Am I likely to get more tests?
Also, I'm taking it this afternoon instead of early morning... Will that really make a significant difference?Thanks...
L.
Posted by noa on July 3, 2000, at 13:20:10
In reply to Noa TOVA Question, posted by Libby on July 3, 2000, at 11:44:30
Well, it sounds like the psychologist is going to do a thorough interview and not rely on just the TOVA, which is a visual test of attention, so if you have difficulty with auditory tasks, it won't show up on the TOVA.
They might do some other tests, too, but probably will do a structured questionnaire that can be scored, and is normed, so it will give you an idea of whether you are more likely than the average person to have attention problems of various types (difficulty initiating focus, difficulty sustaining focus, difficulty screening out irrelevant stimuli in order to remain focused, difficulty with working memory, difficulty sustaining attention because of intruding emotions, etc.). But these questionnaires are not tests, they are based on self report. Sometimes, you can get a second report from a friend, spouse, etc.
Posted by noa on July 3, 2000, at 13:22:25
In reply to Noa TOVA Question, posted by Libby on July 3, 2000, at 11:44:30
I don't know about the timing of the TOVA. I guess it depends on your particular rhythms of alertness, mood, attention, etc.
Posted by Libby on July 7, 2000, at 11:58:39
In reply to Re: Noa TOVA Question, posted by noa on July 3, 2000, at 13:20:10
The final process was:
- TOVA unmedicated (ON my anti-depressant, but OFF the Ritalin
- Self-reported history
- Questionaires for my mother and daughter
- TOVA medicated (ON both AD & Ritalin)All these tests were done by a Adult ADD specialist. I don't have the specifics for all types of attention, but my doc says my diagnosis is clearly ADD. My overall attention span on the TOVA without Ritalin was around 2nd percentile. With Ritalin, it was around 65th percentile, so there was a HUGE difference. I think they are going to increase my dose in a couple of weeks to see if we can do even better.
I am very excited about these results. They kick off a process that I hope will discourage future depressive episodes and they explain a lot of the problems I have had to deal with my whole life. I have always been very intelligent (IQ of 150 and a Ph.D.) but I have always FELT dumber than the average bear. Now I know why.
We would NEVER have figured this out if it hadn't been for people like Janice, Karen, and Noa, who posted about augmentation with stimulants, their ADD symptoms, etc. Also to people like JohnL & ChrisK who posted about the need to be involved in your own recovery process (even the meds)...
I thought I was doomed to a life of chronic depression. Now I feel there's a chance I may never have to be depressed again.
Gratefully...
L.
Posted by noa on July 7, 2000, at 14:22:40
In reply to Karen, Noa, etc. TOVA results, posted by Libby on July 7, 2000, at 11:58:39
That is great! You sound SO relieved to have gotten some confirmation of your suspicions, and now that you can address the ADD, you are probably going to tackle the depression. Afterall, it can be depressing to go through life not knowing why everything is so hard for you when all indicators are saying things should be easy!
Great news. Have a great weekend.
Posted by KarenB on July 7, 2000, at 16:36:02
In reply to Karen, Noa, etc. TOVA results, posted by Libby on July 7, 2000, at 11:58:39
Libby,
Wow, that is such good news! I mean, not that you HAVE ADD but at least now you know what is wrong. It's not an excuse, a writer once said...but it certainly is an explanation.
I also tested, at age 12, with 150...and proceeded to get mediocre grades through school, couldn't learn how to read music and almost failed 8th grade Algebra. At the same time that I got the "D" grade, I was also attending classes for gifted children. Go figure. And, I was not diagnosed until I started reading this board a few months ago. I began to notice how much the ADD people sounded like me and went to CHADD and a few other websites and took some tests. I scored 19 out of 20 on the first one I took. This has resulted in a change of medication and I now feel I am closer to being well than I have ever been, despite some med setbacks I have had. I was diagnosed for years with major depression and then bipolar disorder.
To me, ADD explains so much... Like the way I can have a conversation with someone in whom I am truly interested and my mind can completely leave the room without warning. When I "return," I am still gazing intently into the person's eyes, thinking, "Oh no, WHAT are they talking about?!!" And the way I can spin around my own home, from one unfinished task to the next, because something will grab my attention and I impulsively start something new, when I was in the middle of another project. I can have four or five things going all at once and I will stop myself, breathe and regroup. My husband always has to tell me not to forget the original reason I was going to the store. He has always said I have no concept of time - now I know that's a common symptom of ADD. Basically, I'm an airhead with a high I.Q.;)
I too am grateful for this board. It was some postings by someone named Sarah and others that first got me going on the ADD possibility.
I have to tell you, I was overseas for a while and on two medications that worked beautifully for me: Sulpiride and Amineptine (no longer available). I have spent months looking for something to replace that combination and have just started a trial of Adrafinil. I plan to try it with amisulpride, a drug very similar to Sulpiride. For me, the psychostimulant gave energy and focus (I have hypoactivity with my ADD) and the Sulpiride aided in the symptoms of physical sluggishness, fatigue and social anxiety. It really did help to stabilize my moods, which is a BIG problem for me.
Just out of curiosity: Do you suffer also from any chronic pain or PMS?
Sorry this is so long. I'm excited for you that you have finally gotten some answers. That, in itself, was a huge relief to me.
One last thing: You said,
> "I thought I was doomed to a life of chronic depression. Now I feel there's a chance I may never have to be
depressed again."I wanted to comment on this statement: Don't get discouraged if the first few (or several) med trials for ADD don't get you exactly where you need to be. The great thing is, at least you now know what you are fighting.
Karen
Posted by Libby on July 7, 2000, at 18:11:21
In reply to Re: TOVA results » Libby, posted by KarenB on July 7, 2000, at 16:36:02
Karen said...
>I was diagnosed for years with major depression >and then bipolar disorder.My psychiatrist pretty much insisted on a trial of Depakote before he'd entertain the possibility of undiagnosed ADD. I never felt so low in my entire life. I sat on the sofa for two weeks and didn't move. With the little energy & focus I could muster during the day, I read about augmentation with stimulants. Frankly, that interested me just because I was so exhausted, but the more I read about ADD, the more I said, "That's me!" It's good to have the experts confirm that.
>Basically, I'm an airhead with a high I.Q.;)
Exactly! When my doc finally got around to considering ADD, he asked how my family and friends would describe me and without even thinking I told him they'd all say I was the smartest *flake* they knew! :)
>For me, the psychostimulant gave energy and focus (I have hypoactivity with my ADD) and the Sulpiride aided in the symptoms of physical sluggishness, fatigue and social anxiety. It really did help to stabilize my moods, which is a BIG problem for me. Just out of curiosity: Do you suffer also from any chronic pain or PMS? Sorry this is so long. I'm excited for you that you have finally gotten some answers. That, in itself, was a huge relief to me.Don't get discouraged if the first few (or several) med trials for ADD don't get you exactly where you need to be. The great thing is, at least you now know what you are fighting.<I'm just relieved to know (and have someone else know) that I'm not stupid or an emotional cripple (which is what I had begun to think)... It's just that my brain works a little differently and I've become a basketcase BECAUSE of that... *laughter*
Just kidding. What a joy it is to be able to think!Thanks again...
L.
Posted by Cass on July 7, 2000, at 19:39:14
In reply to Re: TOVA results - Relief, posted by Libby on July 7, 2000, at 18:11:21
When my doc finally got around to considering ADD, he asked how my family and friends would describe me and without even thinking I told him they'd all say I was the smartest *flake* they knew! :)
Libby, I think my friends would describe me as the smartest "space case" they know.
> >For me, the psychostimulant gave energy and focus (I have hypoactivity with my ADD) and the Sulpiride aided in the symptoms of physical sluggishness, fatigue and social anxiety. It really did help to stabilize my moods, which is a BIG problem for me. Just out of curiosity: Do you suffer also from any chronic pain or PMS?
> I'm just relieved to know (and have someone else know) that I'm not stupid or an emotional cripple (which is what I had begun to think)...Libby, I also have sluggishness, fatigue and social anxiety. However, the physical problems are also in part due to a serious medical problem I have. I have a great deal of pain sometimes because of the chonic medical problem, and I have dysmenorhea (sp?) and PMS. Your posts have been making me feel less alone, too. I am so glad you are getting to the root of your problems. Just out of curiousity, is your method of completing tasks often inconsistent? My method of doing things, cleaning, organizing (which I am terrible at), grooming, changes every time I do the task. In college, my method of taking notes always varied, yet I had very high grades. Some people notice my inconsistent methods and get really irritated. I don't know why some people find it disturbing. I guess they just want things to be predictable, and they want to see a set pattern, but that's not what they get with me.
Here is my history of psychostimulants. The first one I tried was Adderall. That made me very agitated. Then I tried Ritalin which was helpful, but I also wanted the benefit of an appetite suppressant, and Ritalin did not help me in that way. Now I am on Dexedrine which does have the appetite suppressant quality. It seems to be helping me with my other ADD symptoms, and it is only slightly agitating.
I hope things continue going well with you. Good wishes.Cass
Posted by Angela5 on July 7, 2000, at 20:37:56
In reply to Re: TOVA results - Relief, posted by Cass on July 7, 2000, at 19:39:14
> When my doc finally got around to considering ADD, he asked how my family and friends would describe me and without even thinking I told him they'd all say I was the smartest *flake* they knew! :)
>
> Libby, I think my friends would describe me as the smartest "space case" they know.
>
>I know exactly what all of you are saying. I, too, have been described that way many times. I like Karen's comment about "an airhead with a high IQ!" ;)
I understand the school issues, too. For me, that really became apparent with concentration and focus at work. It is so hard sometimes to feel like you have the cognitive ability to do something, but somehow your brain just won't let you.
Posted by Janice on July 7, 2000, at 23:46:41
In reply to Karen, Noa, etc. TOVA results, posted by Libby on July 7, 2000, at 11:58:39
very happy to hear it's ADD and not bipolar Libby. you didn't need that IQ test to tell you how smart you were, I could have done that :>)
2 University degrees and rarely attended a lecture,
Another superflake, Janice
This is the end of the thread.
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