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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by memma on October 9, 2003, at 16:05:16
Hi everyone... Like many people here, I'm having a great deal of difficulty in finding out what is really wrong with me, and I've been through a number of different medicines to treat ADHD and Bipolar II.
Here's some history- I'm a 23 year old female with early onset ADHD, but I went undiagnosed until college. I had excellant grades and wonderful social skills, and although teachers recommended to my parents yearly... They thought it was unnecessay.
The University pdoc gave me an initial Ritalin prescription, then moved to Adderrall. I was prescribed 40-60 mg/ day, and I usually took 20 mg 2xday). I later stopped taking Adderall because after 1.5 years, I dropped from 120 lbs to 103 lbs (btw I'm five eight- looked anorexic). Pdoc didn't care, just told me to eat more.I had 1 year unmedicated, then started to develop serious anxiety. I would not leave my house for days (I was a very social person before: Served 2 years on Panhell (sorority) and in U. student govt). There was no real reason for me to be anxious - no outside stimulus. This escalated to deep depression and I began to lose many friends because my behavior was so awful and I would get mad at them. I was always irrational, hurtful attacking on my part towards these people. I attempted suicide, and wound up in hospital with a new pdoc and new meds.
I was diagnosed as depressed, put on Zoloft (started at 50mgd, up to 150mgd) and Dexedrine for ADHD (Spansules- can't remember dose, I think it was 40mgd). Things were very nice, but never "right"... then...the cycling begun. I started sleeping less, or more, and exhibiting very typical Bipolar 2 symptoms....
So after upping Zoloft ocne, pdoc diagnosed me as Bipolar 2 (after about four months on Dex and Zoloft). He stopped the Dexedrine cold, and begun Depakote and Zyprexa. This is my five months of hell: I was constantly either hypomanic or depressed, with very little time between the up or down changes. The times I was depressed were significantly harder to deal with than the hypomania. I couldn't hold down a job, so I begun volunteering. The problem was that over this five months, my pdoc would not change the meds, only increase my dosage. I begged him to take me off the Zoloft to maybe decrease the cycles (I had been increased to final dosage of 250 mpd). The Zyprexa only seemed to make me shake and twitch all over (dosage from 15 mpd to 40 mpd) and I could not tolerate Depakote doasges over 2500 mg (extreme, immediate nausea-tried for a long time to add Sprinkles...never worked, I would violently vomit almost an hour after taking, even if dosages were separated into AM and PM).
I know in hindsight that this was the ABSOLUTE WORST THING TO DO (please please don't do this anyone, consult another pdoc!!!!)...but after the 5 months, I stopped taking all meds (Zoloft, Zyprexa, Depakote). I know it was stupid and dangerous, but I couldn't take the constant rapid cycling.
I immediately felt better. I also stopped seeing my therapist as he was in same office as pdoc, and encouraged the Zoloft cocktail.
I quickly found a new therapist, who helped me interview and find a new pdoc I really like. I was off medication totally for about three months, and had no episodes or hypomania or depression, but I have had typical ADHD symptoms and increasing anxiety, which I would describe as irrational worrying. New Pdoc gave me trials of Concerta (headaches), then put me back on Adderall. New dosage is Adderall XR 30mg in am, then reg Adderall 10 mg at 4pm. Going well for almost two months, until: (and this is my final question, thank you so much for reading this!!): Two nights ago I couldn't fall asleep at all (took normal Adderall XR and Adderall schedule), I was agitated and worrisome all through yesterday, and awake. I called pdoc and took no Adderall or Add XR yesterday, and still didn't sleep. I have an appointment with him tomorrow and he called in Ambien for me to take tonight.
I'm very concerned that this is Adderall induced mania. I've never stayed up for two nights in a row due to any medicine. I've taken Adderall at similar dosages before, what would make this different? Plus, I've been so worried, almost compulsive type worrying about really irrational and minute things, and I previously did not react that way to stimulants. And I still have no clue if the 5 months of hypomania and depression were just a cause of the Zoloft, or if I truly am Bipolar 2.
Thank you so much for your support in reading this. It's so helpful to vent...!! I just often feel like nothing helps...and every new med causes some new bizarre behavior. (and I know there are about a million typos - bear with me, no sleep!!!)
Anyway, thanks again,
memma
Posted by blondegirl47 on October 10, 2003, at 14:13:31
In reply to Adderall induced mania? Or...? Please help..., posted by memma on October 9, 2003, at 16:05:16
If eat too soon berore or after taking Adderall xr or adderall short acting it will delay the on set of your medication...for me it has delayed it a couple hours. I have this problem too. I try not to eat anything a couple hour before/after taking adderall. Try having a big glass of orange juice an hour or so before bed. Citric acid lowers the absorption of adderall. Heavy exerice also helps you excrete your medication faster.
Hope this helps
Blondegirl
Posted by DayByDay on October 13, 2003, at 10:31:29
In reply to Adderall induced mania? Or...? Please help..., posted by memma on October 9, 2003, at 16:05:16
Hello there.
(My post is possibly even longer than yours, I hope it wonīt discourage you from reading it)Amphetamine (which is in adderal) itself is considered by researchers
(high recreational doses at least - I donīt know about small doses medical doses) to have effects similar to the symptoms of mania. I read that researchers, as I remember it, are actually giving it to rats to mimic mania to then experiment on them, poor rats.From my own experience I used to have SSRI-induced (Prozac, Zoloft, Lexapro, Paxil)BP mixed states only when I was on medications - i took them for a long time without being aware of it - I told my doc about how I fellt and she didnīt say anything about med-induced BP (BPIII) although
she knew I had BP in the family. Later a doc
told me that not all docs knows about this - bad luck for me. If I knew about this I would have stayed away from amphetamine because I knew how it worked on people. Here comes the nasty part - I had tried it a couple of times in rather small amounts to help me with my homework at the University and even though I had nasty comedowns it actually did help me, the first times at least, at those critical moments when I had a lot of stuff to do - I never got any problems from it afterwards. Then one time got some really strong stuff from a friend that i took much of and I got a very strong rush which truly fellt manic - I had rushing thoughts, fellt
very smart and creative, like a crazy genius - I didnīt get my homework done but wandered around
for several and wrote down all my "brilliant" ideas in a notebook. I didnīt sleep for three days. But this time I noticed that this rushing thought and manic creativity remained for a couple days afterwards - I thought it was some
remaining effect from the A so I didnīt bother. I had some left in the bag and used it for homework
a couple of more times. To make a long story short several months later I realised that the A
had triggered a Mixed BP state in me that lasted to time I became aware of it - then I had the worst depression of my life. Iīve read in the
DSM IV about amphetamine and it said, as I remember it that amphetamine use (both medical and illegal) can induce mania, if it last for up to 2 weeks after you stop taking the drug itīs directly related to the amphetamine if it last longer than that one might suspect that it had triggered a real phychiatric disorder which it did
in me. I guess this maybe makes me more than med-induced BP only, I havenīt spoke about this with my doctor mostly because I have a hard time accepting it but Iīll do it on my next visit.
Naturally i wonīt take anymore amphetamine in my life and I regret that I ever took it, more than I regret anything else in my life.Now me and my new doc, the first really good one(Iīve had some bad docs too) and I have are trying new meds to help me with my depression. Depakote + SSRI didnīt work for me and now Iīm are trying lithium and lamictal without any SSRI at all. So far I donīt know were Iīm heading I guess Iīm in a medicine experimentation phase like you are but Iīm hoping for the best for both of us.
One more thing I just noticed in your text
"Plus, I've been so worried, almost compulsive type worrying about really irrational and minute things, and I previously did not react that way to stimulants."
I know that amphetamine can have this effect in
me, during the high and especially during the comedown. I also have OCD so my symptoms get worse. Although iīve heard Amphtetamine can be
used to treat OCD, iīve also read that amphetamine
can cause OCD in some of the children that use it for ADHD. I think they gave the children a daily dose of 250mg vitamine B6 to reduce it.By the way I have a link about ADHD where a dutch commision claiming that ADHD is not a brain disorder, itīs one of those anti-medicine sites,
I donīt believe medicines are all bad - they do help a lot of people, still they can be bad itīs good that there are people focusing on that since
the pharm-companies and many docs often have a one-sided picture aswell.http://www.prozactruth.com/add_adhd.htm#top
Hope Iīve been of some help. If you like to, post an update and tell me how your situation develops
it would be interesting to know since iīm in this
"experimenting with meds to help me without causing BP" situation aswell
DbD
Posted by yabba on October 13, 2003, at 17:13:03
In reply to Adderall induced mania? Or...? Please help..., posted by memma on October 9, 2003, at 16:05:16
> Here's some history- I'm a 23 year old female with early onset ADHD, but I went undiagnosed until college. I had excellant grades and wonderful social skills, and although teachers recommended to my parents yearly... They thought it was unnecessay.
Why did you decide that it became necessary to medicate your ADHD? Maybe you could get by without medication and just some counseling for tips on how to deal with it.
This is the end of the thread.
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