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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by laura777 on January 16, 2004, at 10:41:01
Hey everyone , I haven't posted in a while and I finally was put on proper meds and it has changed my life in that instead of just pushing through a day just surviving I now have a quality life .. I have ADHD and was put on Adderall xr ..
But what I have noticed is that sometimes when the adderall is wearing off at night i get anxious and an edginess and it is not a good feeling at all .. It does not happen all the time just at certain times and it may have to do with my hormones ..
My question is can a person take ativan for this symptom ?
And is it the mildest of the benzo's .
The reason I ask is because I do not care for benzos like xanex valumes and such because of the hangover and the fact they last too long ,..
Is there a benzo that is fast acting but short duration ? I have been told that adivan was such a drug ..Also is it unusual for someone that is on Adderall xr to use or request Adivan for this purpose ??
Thanks for all your responses and your time ..
Laura
Posted by Asian Girl on January 17, 2004, at 6:13:50
In reply to adderall edginess is Atavin good for this ?, posted by laura777 on January 16, 2004, at 10:41:01
Laura
I took my addrall 20mg XR about 6:30am, and I also took o.25 mg Klonopin every 3-4 hours a day. ( totally 1.5mg per day)
I don't know this is the best combo, but it does help me reduce the addrall wear off crash ( that yaky feeling ).
I'm looking forward to hear if others has better sugestions too.
Asian girl
Posted by laura777 on January 17, 2004, at 9:10:42
In reply to Re: adderall edginess is Atavin good for this ?, posted by Asian Girl on January 17, 2004, at 6:13:50
> Laura
> I took my addrall 20mg XR about 6:30am, and I also took o.25 mg Klonopin every 3-4 hours a day. ( totally 1.5mg per day)
> I don't know this is the best combo, but it does help me reduce the addrall wear off crash ( that yaky feeling ).
> I'm looking forward to hear if others has better sugestions too.
> Asian girl
Hey lady , thanks for responding and I also hope that others reply as well .. laura
Posted by jerrympls on January 17, 2004, at 22:44:00
In reply to adderall edginess is Atavin good for this ?, posted by laura777 on January 16, 2004, at 10:41:01
HI
Whenever I've been prescribed a stimulant, the doctors I've seen usually prescibe a benzo along with it for the edginess, etc. Or if they don't - and I ask, they have been willing to add it. They work very well for when a stimulant wears off and irritability, etc set in.
As for the half-life of the benzos, I think it goes like this (1 being shortest acting and 4 being longest acting):
1) Xanax
2) Ativan
3) Valium
4) KlonopinDocs usually like to prescribe Klonopin because it lasts longer and is "smooth" compared to Xanax where the half-life is short and can cause ups and downs.
Hope this helps....
Jerry
Posted by laura777 on January 19, 2004, at 6:30:15
In reply to Re: adderall edginess is Atavin good for this ? » laura777, posted by jerrympls on January 17, 2004, at 22:44:00
Thanks Jerry , Adderall has done wonders for me , it just took me a long time to figure out why at night i would want to drink 2 glasses of wine ..
I have finally figured it out ! I truly do not want to drink because in the past I would use that at time to self medicate prior to being diagnosed and I do not like the way it makes me feel .. I will be phoneing my p-doc today .. thanks again , laura
Posted by mtdew on January 19, 2004, at 15:39:49
In reply to Re: adderall edginess is Atavin good for this ? » laura777, posted by jerrympls on January 17, 2004, at 22:44:00
According to Dr. Bob's benzo chart, you have Klonopin and Valium reversed. Valium is about the longest lasting benzo there is.
> HI
>
> Whenever I've been prescribed a stimulant, the doctors I've seen usually prescibe a benzo along with it for the edginess, etc. Or if they don't - and I ask, they have been willing to add it. They work very well for when a stimulant wears off and irritability, etc set in.
>
> As for the half-life of the benzos, I think it goes like this (1 being shortest acting and 4 being longest acting):
>
> 1) Xanax
> 2) Ativan
> 3) Valium
> 4) Klonopin
>
> Docs usually like to prescribe Klonopin because it lasts longer and is "smooth" compared to Xanax where the half-life is short and can cause ups and downs.
>
> Hope this helps....
>
> Jerry
>
Posted by scott-d-o on January 20, 2004, at 3:28:34
In reply to Re: adderall edginess is Atavin good for this ?, posted by mtdew on January 19, 2004, at 15:39:49
> According to Dr. Bob's benzo chart, you have Klonopin and Valium reversed. Valium is about the longest lasting benzo there is.
I'm not sure which chart you are referring to; but it is incorrect. Valium's half-life ranges from around 20 to 25 hrs; where as Klonopin's half-life is generally anywhere from 30 up to 50 hrs. This also correlates well with my personal experiences with the two medications. Klonopin is the longest acting benzodiazepine available.
Posted by mtdew on January 20, 2004, at 17:45:45
In reply to Re: adderall edginess is Atavin good for this ?, posted by scott-d-o on January 20, 2004, at 3:28:34
The chart is here:
http://www.dr-bob.org/tips/bzd.html
It lists diazepam's half-life as 30-200 hrs (including active metabolites). This chart is consistent with others I've seen.
> > According to Dr. Bob's benzo chart, you have Klonopin and Valium reversed. Valium is about the longest lasting benzo there is.
>
> I'm not sure which chart you are referring to; but it is incorrect. Valium's half-life ranges from around 20 to 25 hrs; where as Klonopin's half-life is generally anywhere from 30 up to 50 hrs. This also correlates well with my personal experiences with the two medications. Klonopin is the longest acting benzodiazepine available.
Posted by Cee6 on February 10, 2004, at 20:43:42
In reply to adderall edginess is Atavin good for this ?, posted by laura777 on January 16, 2004, at 10:41:01
Hi all, I'm new here but I've been reading posts for a while. Now seems a good time to jump in so I'll tell you a little about my situation while I respond to this post. This may be lenghty.......
Wow.. This thread describes exactly what I've been experiencing with adderall as well. I've been taking it for about 7 months. I'm prescribed 20mg 3x daily but rarely take that much, usually 20mg x 2 is enough. It has really made a tremendous difference in my life. Lots of benefits, but also has introduced some emotional instability which I had never before experienced. I pretty much know the routine with my dosing now but my ability to anticipate the transient side effects doesnt seem to be very consistent. During the day I am pretty happy with the overall experience. The ability to focus is a wonderful thing, especially when it took 22 years and the majority of my academically subaverage college experience to figure it out. My only complaints are these gradually intensifying anxious/self concious thoughts and feelings that seem to come and go. I think those have always been there to some extent but seem to be slightly more apparent now. I dont mind dealing with this, as its not constant or extremely intense. I also notice transient shakyness/jitteryness. Ive always had shaky hands and have told my physican about it but it was found not to be serious. Stimulants do seem to make it more prevalent, but again this is something I can accept.
The night time is another story. When its time to relax at night, when the adderall is fading away, thats when the irritability and nervous/anxious feelings set in. This is also accompanied by lingering muscle tension, slightly irregular heartbeat (as in mild palpatations, increased rate), and transient insomnia which was part of my inital reason for going to see a Pdoc in the first place (sleepwalking being the main issue).I brought these issues to my PDocs attention last session and he asked if I would mind taking something that he felt could be benficial. I of course agreed after he told me how this would help me sleep along with calming the anxiety a bit so he gives me a script for Amyltriptyline of which I knew nothing about. I filled it, went home and did a lot of research. While it sounded like this might be something that would work for me there was also a lot of negative aspects. I have no desire to be on a AntiDep of any kind, much less a TCA. I dont even care to take the adderall very much and wish there was no need for it having importance in my life. So I wrote my doc a letter and explained my position. He responded with all of the meds benefits again and commented on the low dose situation, as I knew he would, but of course it was up to me. So I decided to give him the benefit of the doubt and give it a try. Bad Idea All Round. I wont go in to detail but Emotionally Unstable sums up that week of my life. The 10mg/night dose also served to completely negate any beneficial aspect to the adderall in the daytime as well, which is reason enough to throw that horrible stuff in the garbage. It did MAKE me fall asleep and sleep well but falling asleep was a STRANGE and somewhat uncomfortable experience (body temp regulation, drifting in and out, and worse of all either much more prevalent irrythmias or just greater anxiety over their occurances). So, I stopped it all at once and wont take it again. I know these things are supposed to go away over time, but Im not willing to find out how long it'll take especially since this was just 10mg.
So now we've come to my present situation. I am learning to deal with my irritability (without alcohol, which was my inital solution at first as well) Everything else still remains though. Sleep issues are probably the worst of all the negative aspects. OTC sleep aids and me DO NOT AGREE! .25mg melatonin puts be down for a LOOOONG time and makes me very groggy. This holds true for most other things too. When its really bad I go have a swig of nyquil which seems to be the best of all the evil OTC's yet still isnt a very attractive option. I've also been using 5HTP as of late, and that has been a mixed experience. At its worst it sedates me but makes me "daydream" to the point where I cant sleep because my mind is so consumed with the story, if that makes any sense. Its like sleeping with your eyes wide open... Not restful at all...Its getting to the point where I am considering asking about switching Pstim meds in hopes of beneficial reduction of these side effects. In any case I am probably going to give the XR a try in hopes that my body will be able to get used to its consistent method of administration in a more favorable manner, thus providing additional stability. After researching them quite a bit I think I could probably find a place for a benzo in my routine, perhaps not as a daily additive but there for when I feel its appropriate. I am not comfortable bringing this to my docs attention mainly due to my age (22) and the fact that I live in a university college town and negative stigmas are all too prevalent concerning such substances. I feel I have a good, trusting relationship with my doc but have a hard time going in to Benzo territory with him if it wasnt his inital recommendation even though substance responsibility is not at all an issue in my case. Perhaps I'm just being over analyitical about the whole thing, but who has that ever hurt? I dont want to create any questionable situations that could make him not trust me. This experience has been far too beneficial thus far for me to want to go out on a limb only to have him see me as college kid lookin to score some benzos even though everything indicates that I could probably experience specific benefits. So, I sorta feel like I am stuck, at least until my next appointment over a month from now.
I'm not disappointed with the adderall at all. Its been beneficial in many aspects of my life. I'm in good shape and live a healthy lifestyle, so I know thats not an issue concerning my problems. This drug has certainly added some complication to my personal life while smoothing out and clarifying other aspects of my daily life. Balancing the trade off is the problem.
I appreciate the advice you all offer! Just searching through the topics youve covered I've had many questions answered. Its SOOO important to be informed!
Thanks...
Posted by laura777 on February 11, 2004, at 0:49:10
In reply to NewToTheBoard .. Adderall edginess My story, posted by Cee6 on February 10, 2004, at 20:43:42
hey , I was given klonipin .05 mgs , it is a very long acting benzo .. I am very sensitive to benzo's so i take just half of that and sometimes 1/4 .. This seem to help greatly .. because of the long acting properties , I take it at night and it smooths my day out with the Adderall XR .. hope this helps ..
Posted by katalina on February 13, 2004, at 10:26:08
In reply to Re: NewToTheBoard .. Adderall edginess My story, posted by laura777 on February 11, 2004, at 0:49:10
I take between 30 - 50 mgs. of Adderall XR each day (have been on for 2.5 years, started out lower and worked up to this dosage about a year ago. Anyway, I was having the same inconsistent anxious episodes and poor sleep. After reading some positive Adderal and Klonopin combo stories on this board, I asked my dr. for klonopin for sleep and he ended up giving me 1.5 per day to be taken how I chose. Adding the klonopin really helped take the residual edginess from the Adderall off and actually enhanced the positive effects from the Adderall which I was so sadly getting used to and didn't appreciate so much anymore.
Anyway, if you go into your dr.'s office and have some good data and sources and insinuate the evil motives of the pharmaceutical biz and how they (think they) dictate med scrips to the docs and the patheticness of it, etc. and reference how they think of the patent before the patient, blah, blah, blah, and that usually gets docs in a rant about HMO's and the ruination of patient care, blah, blah, blah and you will have him right where you want him . . . not wanting to look like a schumuck that doesn't have any critical thinking skills to call his own, and saying to himself, I'm not buying into some pharm. rep convincing me ssri's are as effective as benzos (they're not even close) and he'll give you what you want (are entitled to).
Of course YMMV depending on your doc (age/ego) and going in (hoping to be) more educated about the topic than s/he is and s/he will be more apt to being receptive to your response.
I think klonopin/clonzapam would help you and is a very safe and beneficial drug for the majority of people who take it. It seems to have a clearly synergestic effect for many who combine it with Adderall (my nerologist agreed after I stated it was according to the ___________ ("enter respected source here").
p.s., I just smoked a little cannibas (infrequently imbibe) am probably being very superflous and verbose, but I am serious about the two working well together) . . . good luck and remember to tell them what to write without them knowing it wasn't their own idea in the first place. Most docs enjoy talking to educated patients instead of the majority of people who take their words like they came straight from God's mouth - you might be surprised).
Katie
Posted by laura777 on February 13, 2004, at 13:31:18
In reply to Re: NewToTheBoard .. Adderall edginess My story, posted by katalina on February 13, 2004, at 10:26:08
Hey Katie, You seem like you are a gem ! truly love your thread , it speaks volumes ..
Laura
Posted by micro on February 13, 2004, at 15:23:29
In reply to NewToTheBoard .. Adderall edginess My story, posted by Cee6 on February 10, 2004, at 20:43:42
> Hi all, I'm new here but I've been reading posts for a while. Now seems a good time to jump in so I'll tell you a little about my situation while I respond to this post. This may be lenghty.......
>
>
>
> Wow.. This thread describes exactly what I've been experiencing with adderall as well. I've been taking it for about 7 months. I'm prescribed 20mg 3x daily but rarely take that much, usually 20mg x 2 is enough. It has really made a tremendous difference in my life. Lots of benefits, but also has introduced some emotional instability which I had never before experienced. I pretty much know the routine with my dosing now but my ability to anticipate the transient side effects doesnt seem to be very consistent. During the day I am pretty happy with the overall experience. The ability to focus is a wonderful thing, especially when it took 22 years and the majority of my academically subaverage college experience to figure it out. My only complaints are these gradually intensifying anxious/self concious thoughts and feelings that seem to come and go. I think those have always been there to some extent but seem to be slightly more apparent now. I dont mind dealing with this, as its not constant or extremely intense. I also notice transient shakyness/jitteryness. Ive always had shaky hands and have told my physican about it but it was found not to be serious. Stimulants do seem to make it more prevalent, but again this is something I can accept.
> The night time is another story. When its time to relax at night, when the adderall is fading away, thats when the irritability and nervous/anxious feelings set in. This is also accompanied by lingering muscle tension, slightly irregular heartbeat (as in mild palpatations, increased rate), and transient insomnia which was part of my inital reason for going to see a Pdoc in the first place (sleepwalking being the main issue).
>
> I brought these issues to my PDocs attention last session and he asked if I would mind taking something that he felt could be benficial. I of course agreed after he told me how this would help me sleep along with calming the anxiety a bit so he gives me a script for Amyltriptyline of which I knew nothing about. I filled it, went home and did a lot of research. While it sounded like this might be something that would work for me there was also a lot of negative aspects. I have no desire to be on a AntiDep of any kind, much less a TCA. I dont even care to take the adderall very much and wish there was no need for it having importance in my life. So I wrote my doc a letter and explained my position. He responded with all of the meds benefits again and commented on the low dose situation, as I knew he would, but of course it was up to me. So I decided to give him the benefit of the doubt and give it a try. Bad Idea All Round. I wont go in to detail but Emotionally Unstable sums up that week of my life. The 10mg/night dose also served to completely negate any beneficial aspect to the adderall in the daytime as well, which is reason enough to throw that horrible stuff in the garbage. It did MAKE me fall asleep and sleep well but falling asleep was a STRANGE and somewhat uncomfortable experience (body temp regulation, drifting in and out, and worse of all either much more prevalent irrythmias or just greater anxiety over their occurances). So, I stopped it all at once and wont take it again. I know these things are supposed to go away over time, but Im not willing to find out how long it'll take especially since this was just 10mg.
> So now we've come to my present situation. I am learning to deal with my irritability (without alcohol, which was my inital solution at first as well) Everything else still remains though. Sleep issues are probably the worst of all the negative aspects. OTC sleep aids and me DO NOT AGREE! .25mg melatonin puts be down for a LOOOONG time and makes me very groggy. This holds true for most other things too. When its really bad I go have a swig of nyquil which seems to be the best of all the evil OTC's yet still isnt a very attractive option. I've also been using 5HTP as of late, and that has been a mixed experience. At its worst it sedates me but makes me "daydream" to the point where I cant sleep because my mind is so consumed with the story, if that makes any sense. Its like sleeping with your eyes wide open... Not restful at all...
>
> Its getting to the point where I am considering asking about switching Pstim meds in hopes of beneficial reduction of these side effects. In any case I am probably going to give the XR a try in hopes that my body will be able to get used to its consistent method of administration in a more favorable manner, thus providing additional stability. After researching them quite a bit I think I could probably find a place for a benzo in my routine, perhaps not as a daily additive but there for when I feel its appropriate. I am not comfortable bringing this to my docs attention mainly due to my age (22) and the fact that I live in a university college town and negative stigmas are all too prevalent concerning such substances. I feel I have a good, trusting relationship with my doc but have a hard time going in to Benzo territory with him if it wasnt his inital recommendation even though substance responsibility is not at all an issue in my case. Perhaps I'm just being over analyitical about the whole thing, but who has that ever hurt? I dont want to create any questionable situations that could make him not trust me. This experience has been far too beneficial thus far for me to want to go out on a limb only to have him see me as college kid lookin to score some benzos even though everything indicates that I could probably experience specific benefits. So, I sorta feel like I am stuck, at least until my next appointment over a month from now.
>
> I'm not disappointed with the adderall at all. Its been beneficial in many aspects of my life. I'm in good shape and live a healthy lifestyle, so I know thats not an issue concerning my problems. This drug has certainly added some complication to my personal life while smoothing out and clarifying other aspects of my daily life. Balancing the trade off is the problem.
>
> I appreciate the advice you all offer! Just searching through the topics youve covered I've had many questions answered. Its SOOO important to be informed!
> Thanks...Hello, Would you consider your alcohol problem [a problem or an addiction]? Alcoholism? If so, the drug of choice for alcohol related anxiety is Librium that is not to say Ativan won't work. However, shorter acting benzo's are more difficult to discontinue.
You should also be closely monitored by your pdoc if you have had an issue with alcohol/
Best of wishes, Micro
Posted by Cee6 on February 13, 2004, at 15:43:50
In reply to Re: NewToTheBoard .. Adderall edginess My story, posted by micro on February 13, 2004, at 15:23:29
Oh I dont have a problem with alcohol at all, it was just that it felt a little more appropriate on those nights where the medication gave me that notable edgy/unable to fully rest feeling. Other than that, alcohol is something that I dont really enjoy having in even moderate quantites very often.
Thanks for the info guys. I'll probably bring up Clonazepam next appointment.
Posted by Interject79 on February 13, 2004, at 23:01:03
In reply to Re: NewToTheBoard .. Adderall edginess My story, posted by Cee6 on February 13, 2004, at 15:43:50
Clonidine is sometimes helpful for evening irritability while on stimulants (and for AD/HDers in general). It also helps with sleep and doesn't have a terribly long half-life, which I think is important when taking sedating agents if you have AD/HD. Clonidine has an added benefit of not being a benzodiazepine.
Sonata is a short-acting sedative just for sleep. I've taken it on ocassion the help me fall asleep easier with no extra morning slowness.
The best thing for me, though many will not like it or be able to do it, is to deprive myself of sound (earplugs), use absolute minimal lighting or none at all, and meditate...very soothing.
Best wishes,
interject
This is the end of the thread.
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