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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Lethan on January 11, 2001, at 13:57:12
I am a 28 year old male with ADHD and seemingly no comorbid diseases such as OCD or bipolarity. I have potential for minor seizures, so Wellbutrin is out. I tried it previously and it seemed to have no effect. Recently I had panic attacks, which had never happened before. The neurologist put me on Effexor and Xanax. The panic attacks subsided, and now I'm back to looking for daily management of the ADHD. The latest neurologist and psychiatrist are replacing the Effexor with Celexa and the Xanax with Klonopin. These are all basically anxiety and depression medications. The SSRIs seem like the way to go, but I wonder about the stimulants. I'm kind of leary of them. Anyone in a similar situation that could offer an anectdote or advice? Specifically, Celexa in combination with other drugs for 'typical' ADHD.
Posted by SLS on January 11, 2001, at 18:55:17
In reply to Adult ADHD Medicatiom, posted by Lethan on January 11, 2001, at 13:57:12
> I am a 28 year old male with ADHD and seemingly no comorbid diseases such as OCD or bipolarity. I have potential for minor seizures, so Wellbutrin is out. I tried it previously and it seemed to have no effect. Recently I had panic attacks, which had never happened before. The neurologist put me on Effexor and Xanax. The panic attacks subsided, and now I'm back to looking for daily management of the ADHD. The latest neurologist and psychiatrist are replacing the Effexor with Celexa and the Xanax with Klonopin. These are all basically anxiety and depression medications. The SSRIs seem like the way to go, but I wonder about the stimulants. I'm kind of leary of them. Anyone in a similar situation that could offer an anectdote or advice? Specifically, Celexa in combination with other drugs for 'typical' ADHD.
What aspects of AD/HD do you feel most in need of remedying? Attention? Kinetic? Emotional/behavioral?Tofranil (imipramine) is a tricyclic antidepressant that has been used successfully to treat adult ADD. It is effective for much of the behavioral aspects, but does little for the attentional aspects.
- Scott
Posted by Lethan on January 12, 2001, at 9:53:51
In reply to Re: Adult ADHD Medicatiom, posted by SLS on January 11, 2001, at 18:55:17
> > I am a 28 year old male with ADHD and seemingly no comorbid diseases such as OCD or bipolarity. I have potential for minor seizures, so Wellbutrin is out. I tried it previously and it seemed to have no effect. Recently I had panic attacks, which had never happened before. The neurologist put me on Effexor and Xanax. The panic attacks subsided, and now I'm back to looking for daily management of the ADHD. The latest neurologist and psychiatrist are replacing the Effexor with Celexa and the Xanax with Klonopin. These are all basically anxiety and depression medications. The SSRIs seem like the way to go, but I wonder about the stimulants. I'm kind of leary of them. Anyone in a similar situation that could offer an anectdote or advice? Specifically, Celexa in combination with other drugs for 'typical' ADHD.
>
>
> What aspects of AD/HD do you feel most in need of remedying? Attention? Kinetic? Emotional/behavioral?
>
> Tofranil (imipramine) is a tricyclic antidepressant that has been used successfully to treat adult ADD. It is effective for much of the behavioral aspects, but does little for the attentional aspects.
>
>
> - ScottPhysical anxiety,always needing to keep moving; motivation/attention/concentration at work, I need to be challenged but not overwhelmed; I always need to be entertained; my emotions are very nondemonstrative, they seem flat, almost anti-bipolar; I get angry/upset easily, but it manifests itself internally, then passes; I'm an INTP personality. So all these things. I want to be a better husband and soon-to-be father and not have my family think I'm nuts or neurotic.
Posted by SLS on January 12, 2001, at 12:12:28
In reply to Re: Adult ADHD Medicatiom, posted by Lethan on January 12, 2001, at 9:53:51
> > What aspects of AD/HD do you feel most in need of remedying? Attention? Kinetic? Emotional/behavioral?
> >
> > Tofranil (imipramine) is a tricyclic antidepressant that has been used successfully to treat adult ADD. It is effective for much of the behavioral aspects, but does little for the attentional aspects.> Physical anxiety,always needing to keep moving; motivation/attention/concentration at work, I need to be challenged but not overwhelmed; I always need to be entertained; my emotions are very nondemonstrative, they seem flat, almost anti-bipolar; I get angry/upset easily, but it manifests itself internally, then passes; I'm an INTP personality. So all these things. I want to be a better husband and soon-to-be father and not have my family think I'm nuts or neurotic.
Dear LethanFrom what little I have read on the subject, as a layman, I want to emphasize that much of the attentional and concentration components of AD/HD are not addressed by antidepressants. The more traditionally thought of psychostimulant drugs are necessary to remedy this; e.g. Ritalin, Dexedrine, and Adderal. For the behavioral, emotional, mood, and motivational aspects, antidepressants are helpful. The two I know of specifically that help are Tofranil (imipramine) and Effexor (venlafaxine). There has also been some reported success using Wellbutrin (bupropion), but I am not as impressed with the stuff I have come across regarding this drug.
Just ask your doctor about these things. Of course, all of this is dependant upon an accurate diagnosis. From what I'm told, it is not so easy.
I'm sure you'll make a fine Daddy.
Sincerely
Scott
Posted by stjames on January 12, 2001, at 12:19:51
In reply to Re: Adult ADHD Medicatiom » Lethan, posted by SLS on January 12, 2001, at 12:12:28
Dear Lethan
>
> From what little I have read on the subject, as a layman, I want to emphasize that much of the attentional and concentration components of AD/HD are not addressed by antidepressants. The more traditionally thought of psychostimulant drugs are necessary to remedy this; e.g. Ritalin, Dexedrine, and Adderal. For the behavioral, emotional, mood, and motivational aspects, antidepressants are helpful. The two I know of specifically that help are Tofranil (imipramine) and Effexor (venlafaxine). There has also been some reported success using Wellbutrin (bupropion), but I am not as impressed with the stuff I have come across regarding this drug.
>
James here.....Highly agree with Scott. I have ADD and never found Wellburtin to do anything for me. Tofranil and Doxipin worked well on my depression and stopped my thoughts from racing very, very fast.
Did nothing for attention. Effexor worked better than any other AD for my depression and helped a little with attention. The stims were the only meds that inproved attention, the difference was major. I'm sure when you get you ADD under control
you will find you will make a fine parent.james
Posted by Cam W. on January 12, 2001, at 17:48:08
In reply to Re: Adult ADHD Medicatiom, posted by Lethan on January 12, 2001, at 9:53:51
Lethan - Stimulants (Dexedrine, Adderal and Ritalin) are also used for adult ADHD. True ADHD should be diagnosed by age 8 years. It is very seldom that true ADHD begins after puberty.
Hope this helps - Cam
Posted by maribeth on January 12, 2001, at 17:53:51
In reply to Re: Adult ADHD Medicatiom, posted by stjames on January 12, 2001, at 12:19:51
> Dear Lethan
> >
> > From what little I have read on the subject, as a layman, I want to emphasize that much of the attentional and concentration components of AD/HD are not addressed by antidepressants. The more traditionally thought of psychostimulant drugs are necessary to remedy this; e.g. Ritalin, Dexedrine, and Adderal. For the behavioral, emotional, mood, and motivational aspects, antidepressants are helpful. The two I know of specifically that help are Tofranil (imipramine) and Effexor (venlafaxine). There has also been some reported success using Wellbutrin (bupropion), but I am not as impressed with the stuff I have come across regarding this drug.
> >
>
>
> James here.....
>
> Highly agree with Scott. I have ADD and never found Wellburtin to do anything for me. Tofranil and Doxipin worked well on my depression and stopped my thoughts from racing very, very fast.
> Did nothing for attention. Effexor worked better than any other AD for my depression and helped a little with attention. The stims were the only meds that inproved attention, the difference was major. I'm sure when you get you ADD under control
> you will find you will make a fine parent.
>
> jamesLethan, James, et al ...
Ritalin 40mgm, 20 in the AM, 20mgm in the mid PM, and 40 mgm of Prozac did wonders for both my depression and attention stuff.(I also went on Ritalin SR for a time,
Then a year or so later my family doc and my pdoc switched me to Wellbutrin. (I forget the dose),to take the place of the Ritalin, but cut my Prozac to 20 qd. Within two
weeks I became very delusional, began experiencing auditory and visual hallucinations the "whole" 9 yards. I wound up in the "rubber room". (I remember none of this) the pdocs there put me
Effexor eventually getting me to the 300mgm that I now take each morning. I worked almost from day one!! I also take 300mgm Seroquel over the day and 200 Topamax and I am
finally back in the human race. (Oh,forgot to say that the Wellbutrin really worked wonderfully right up until the day it zorked me.) I think all of my current meds are working
well, but the Effexor gets most of the glory in my book!! Marybeth
Posted by Shell on January 13, 2001, at 13:24:46
In reply to Re: Adult ADHD Medicatiom » Lethan, posted by Cam W. on January 12, 2001, at 17:48:08
> Lethan - Stimulants (Dexedrine, Adderal and Ritalin) are also used for adult ADHD. True ADHD should be diagnosed by age 8 years. It is very seldom that true ADHD begins after puberty.
>
> Hope this helps - CamMust it have been diagnosed by age eight? I was diagnosed at thirty, but the diagnosis was based on behaviors/problems/symptoms that were there since very early childhood. I was told by my psychologist that the diganosis may be missed in childhood (especially in women with the non-attentive type like me who didn't cause classroom disruptions), but that the true test is that the symptoms were PRESENT early.
Shell
Posted by buffalo1 on January 13, 2001, at 14:45:48
In reply to Re: Adult ADHD Medicatiom, posted by Shell on January 13, 2001, at 13:24:46
My girlfriend (age 25) just started taking Concerta 2 months ago with great results.
Posted by Cam W. on January 13, 2001, at 15:52:40
In reply to Re: Adult ADHD Medicatiom, posted by Shell on January 13, 2001, at 13:24:46
> > Lethan - Stimulants (Dexedrine, Adderal and Ritalin) are also used for adult ADHD. True ADHD should be diagnosed by age 8 years. It is very seldom that true ADHD begins after puberty.
> >
> > Hope this helps - Cam
>
> Must it have been diagnosed by age eight? I was diagnosed at thirty, but the diagnosis was based on behaviors/problems/symptoms that were there since very early childhood. I was told by my psychologist that the diganosis may be missed in childhood (especially in women with the non-attentive type like me who didn't cause classroom disruptions), but that the true test is that the symptoms were PRESENT early.
>
> ShellShell - Sorry about the wrong choice of words. You are correct about symptoms being "present" and not necessarily "diagnosed" by 8 years. I believe these are DSM-IV standards (if I am not mistaken). - Cam
Posted by Shell on January 13, 2001, at 20:23:26
In reply to Re: Adult ADHD Medicatiom, posted by Cam W. on January 13, 2001, at 15:52:40
> > > Lethan - Stimulants (Dexedrine, Adderal and Ritalin) are also used for adult ADHD. True ADHD should be diagnosed by age 8 years. It is very seldom that true ADHD begins after puberty.
> > >
> > > Hope this helps - Cam
> >
> > Must it have been diagnosed by age eight? I was diagnosed at thirty, but the diagnosis was based on behaviors/problems/symptoms that were there since very early childhood. I was told by my psychologist that the diganosis may be missed in childhood (especially in women with the non-attentive type like me who didn't cause classroom disruptions), but that the true test is that the symptoms were PRESENT early.
> >
> > Shell
>
> Shell - Sorry about the wrong choice of words. You are correct about symptoms being "present" and not necessarily "diagnosed" by 8 years. I believe these are DSM-IV standards (if I am not mistaken). - CamNo problem. You had me confused there for a while; I was wondering if I had understood my doctor correctly. Thanks for the explanation.
Shell
Posted by Lethan on January 15, 2001, at 8:40:02
In reply to Re: Adult ADHD Medicatiom, posted by Shell on January 13, 2001, at 20:23:26
Thanks for all the helpful information. I think it is the Effexor that is causing my sleep problems. As I am weaning off of that, I still wonder if anyone has had experience specifically with Celexa (or Paxil or a similar SSRI), maybe in conjunction with Klonopin (or similar). I want to give these a chance before I think about stimulants w/ tricyclics. And my symptoms do extend back to childhood.
Posted by aazospiro on August 7, 2004, at 22:31:05
In reply to Re: Adult ADHD Medicatiom, posted by buffalo1 on January 13, 2001, at 14:45:48
can TCA's at low dose be used with ritalin concerta etc? like 10 mgs morning and after noon??
I heard that add a small TCA dose amplifies the stimulant response in that its lot more calming an lasts longer
Posted by sofarsogood on August 8, 2004, at 2:36:13
In reply to Re: Adult ADHD Medicatiom, posted by aazospiro on August 7, 2004, at 22:31:05
I am 29 now . I t was suggested to my mom at an early age that I be put on medication for add.(I just found this out recentley) I was the bad kid in elementary school. My mother did not agree I guess. I had many inner struggles as a teen and a adult .ie drug abuse ,gettting into trouble,relationships. To this day no one ever seemed to notice. To most people I had it together. I recentley quit doing drugs. I have been seeing a shrink. I said nothing to him about ADD or any other issues. The shrink brought it up to me . Im fidgety quick to answere before the question is finished being asked . At first I was thrown back by his ideas . After taking a test for ADD I am sure this was something Ive been dealing with all my life. I think medicatin at an earlier age would have helped . Now I think I have developed coping mechanisms that work . It may have prevented me from taking the path that I did. Although since Ive been drug free I think mabey I might need meds . I dont know. It seems the only thing that works with relatively low side effects is stimulants. With my history of drug abuse I am skeptical. I have been offerd strattera or welbutrin by doc. Turned both down . He has mentioned the stims but I dont know if I wanna go that route. I just wanna feel normal. Its been a few months now drug free. I dont want to use . I want to be at peace in my skin.Im not. Drugs gave me that . . Im always thinking of stuff to do but I dont do it . Any advice would be appreciated >
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