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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 29. This is the beginning of the thread.
Posted by Bowtie Bob on September 16, 2005, at 5:13:01
I have been on a stimulant, very successfully, for almost 2 months for ADD and have done extremely well. This past week, I had an extremely long and stressful day where I felt flushed, and my blood pressure was actually way up--my normal BP is about 112/75...went to 135/83. Does anyone have any experience with this being a transient thing, especially if the long and stressful days are rare?
Posted by Paulbwell on September 16, 2005, at 7:47:02
In reply to ADHD Meds, Stress, Feeling Bad, posted by Bowtie Bob on September 16, 2005, at 5:13:01
> I have been on a stimulant, very successfully, for almost 2 months for ADD and have done extremely well. This past week, I had an extremely long and stressful day where I felt flushed, and my blood pressure was actually way up--my normal BP is about 112/75...went to 135/83. Does anyone have any experience with this being a transient thing, especially if the long and stressful days are rare?
What Stimulant are you on?
Dosage?
Were you drinking alot of Tea, Coffee, little water intake? ALL these thinks can play a MAJOR issue on your situation, job issues etc. ok?My PcDoc took my BP and weight EVERY time i saw him the first few months i took Ritalin.
Cheers
Posted by Bowtie Bob on September 16, 2005, at 12:31:57
In reply to Re: ADHD Meds, Stress, Feeling Bad » Bowtie Bob, posted by Paulbwell on September 16, 2005, at 7:47:02
> > I have been on a stimulant, very successfully, for almost 2 months for ADD and have done extremely well. This past week, I had an extremely long and stressful day where I felt flushed, and my blood pressure was actually way up--my normal BP is about 112/75...went to 135/83. Does anyone have any experience with this being a transient thing, especially if the long and stressful days are rare?
>
> What Stimulant are you on?
> Dosage?
> Were you drinking alot of Tea, Coffee, little water intake? ALL these thinks can play a MAJOR issue on your situation, job issues etc. ok?
>
> My PcDoc took my BP and weight EVERY time i saw him the first few months i took Ritalin.
>
> CheersI am on Focalin XR 10mg and usually do very well. Consequently, I gave up all coffee, tea, etc. that has caffeine in anticipation of an additive effect. My weight, eating, etc. have remained the same; I sleep very soundly as well. It may have been a stressful day that compounded it....
Posted by Sarah T. on September 16, 2005, at 18:46:43
In reply to Re: ADHD Meds, Stress, Feeling Bad, posted by Bowtie Bob on September 16, 2005, at 12:31:57
Hi.
How many hours does the Focalin XR 10mg last? I mean, how many hours does it last for you?
The blood pressure you mentioned, 135/83, isn't terrible. It is higher than usual for you, but it's not bad, unless you felt bad on it. Did you have a headache or stiff neck? Did you take your BP regularly before you were on Focalin? If so, did you notice fluctuations throughout the day?
Posted by alohashirt on September 16, 2005, at 21:24:17
In reply to Re: ADHD Meds, Stress, Feeling Bad » Bowtie Bob, posted by Sarah T. on September 16, 2005, at 18:46:43
> Hi.
>
> How many hours does the Focalin XR 10mg last? I mean, how many hours does it last for you?
>
> The blood pressure you mentioned, 135/83, isn't terrible. It is higher than usual for you, but it's not bad, unless you felt bad on it. Did you have a headache or stiff neck? Did you take your BP regularly before you were on Focalin? If so, did you notice fluctuations throughout the day?
When I started on Concerta my BP moved very slightly (from 120/70 to 128/78). When I tried Adderall XR 30mg it went to 140/110 with headache. I returned to the Concerta and slowly began increasing a supplementary dose of dexedrine from 5mg to 30mg. At 15mg I started 50mg of Toprol XR, at 30mg I increased it to 100mg of Toprol XR. I have now swapped eth Concerta for Focalin XR and am reducing the dexedrine, which is lowering my BP such that I don't seem to need the Toprol any more.So for me, amphetamines cause hypertension and Concerta/Focalin doesn't (much).
Posted by Sarah T. on September 16, 2005, at 22:21:11
In reply to Re: ADHD Meds, Stress, Feeling Bad, posted by alohashirt on September 16, 2005, at 21:24:17
Hi alohashirt,
What an intriguing screen name! Thanks for your reply. I was interested to see that you were able to combine Dexedrine with Concerta! I don't know whether I could do that. I have such trouble with med combos. I guess the Toprol enabled you to do that. Is Toprol the same as Metoprolol? I know someone who is on that. It's supposed to be a very good medicine. It's an ACE inhibitor, right? I think they are supposed to have fewer side effects than the older BP meds.
Do you take any other medications, such as an antidepressant?
Posted by alohashirt on September 17, 2005, at 7:46:09
In reply to Re: ADHD Meds, Stress, Feeling Bad » alohashirt, posted by Sarah T. on September 16, 2005, at 22:21:11
> Hi alohashirt,
>
> What an intriguing screen name! Thanks for your reply. I was interested to see that you were able to combine Dexedrine with Concerta! I don't know whether I could do that. I have such trouble with med combos. I guess the Toprol enabled you to do that. Is Toprol the same as Metoprolol? I know someone who is on that. It's supposed to be a very good medicine. It's an ACE inhibitor, right? I think they are supposed to have fewer side effects than the older BP meds.
>
> Do you take any other medications, such as an antidepressant?I also take Strattera, which works on the distraction when the stimulants wear off. No antidepressants or anything else. I take fish oil, magnesium, zinc, vitamin B, though I suspect these are an expensive placebo.
Posted by Sarah T. on September 17, 2005, at 15:49:29
In reply to Re: ADHD Meds, Stress, Feeling Bad, posted by alohashirt on September 17, 2005, at 7:46:09
Hi. Thanks for your reply. Does Strattera have any antidepressant benefits for you? I took it for a while, but I thought Reboxetine, which is not available in the U.S., was a much better antidepressant. The trouble with Reboxetine is that it was such a hassle to import it from overseas, and I made the mistake of starting at too high a dose.
Posted by alohashirt on September 17, 2005, at 16:11:14
In reply to Re: ADHD Meds, Stress, Feeling Bad » alohashirt, posted by Sarah T. on September 17, 2005, at 15:49:29
> Hi. Thanks for your reply. Does Strattera have any antidepressant benefits for you? I took it for a while, but I thought Reboxetine, which is not available in the U.S., was a much better antidepressant. The trouble with Reboxetine is that it was such a hassle to import it from overseas, and I made the mistake of starting at too high a dose.
I don't know. I'm not depressed.
Posted by Bowtie Bob on September 17, 2005, at 17:55:01
In reply to Re: ADHD Meds, Stress, Feeling Bad » Bowtie Bob, posted by Sarah T. on September 16, 2005, at 18:46:43
> Hi.
>
> How many hours does the Focalin XR 10mg last? I mean, how many hours does it last for you?
>
> The blood pressure you mentioned, 135/83, isn't terrible. It is higher than usual for you, but it's not bad, unless you felt bad on it. Did you have a headache or stiff neck? Did you take your BP regularly before you were on Focalin? If so, did you notice fluctuations throughout the day?Hi Sarah T,
I am taking Focalin XR 10mg/day. No stiff neck, etc., just some facial flushing. Interestingly, I have not taken anything for almost 3 days now and am really paying the price with my family. I guess the trade-off is being very careful on days that I know will be extremely full. I use the Focalin XR because it is on board faster than the Concerta. Overall, it will last me about 9 hours. Because I am at my desk between 5-5:30 AM I usually start with short acting Focalin and take the XR about 5 hours later to cover the entire day.
Posted by Sarah T. on September 17, 2005, at 19:16:06
In reply to Re: ADHD Meds, Stress, Feeling Bad, posted by alohashirt on September 17, 2005, at 16:11:14
> > > I don't know. I'm not depressed.
Not depressed??!!! Lucky you. How many milligrams of Strattera do you take per day?
Posted by Sarah T. on September 17, 2005, at 19:26:10
In reply to Re: ADHD Meds, Stress, Feeling Bad, posted by Bowtie Bob on September 17, 2005, at 17:55:01
Hi Bowtie Bob,
I was interested to read that the Focalin XR kicks in faster than Concerta for you. I thought that, for me, Concerta was a really good medicine in theory but not in practice, primarily because it took so long to kick in. Although it does start working right away, it just wasn't enough for me. I would wait hours to feel right. Then, that feeling right would last an hour and a half or two hours, and then I'd feel awful again. I took Metadate for a while because that kicked in faster, but it also wore off after about 5-6 hours. My doctor suggested taking more after about five hours, but for some reason that didn't work. I didn't feel well when I took more. Perhaps I should have tried immediate release for a few hours and when that wore I off, I should have tried the Metadate. I rarely hear or read about Metadate these days.
You certainly have a long day. Starting off at 5:30! Wow! What time do you wake up? Do you get any sleep? I know someone who has to appear on T.V. at 5 a.m. every weekday morning. She gets up at 1:00 a.m. I think she goes to bed at 6 or 7 p.m. I'm not sure what you'd call that shift!
Posted by theo on September 17, 2005, at 23:10:28
In reply to Re: ADHD Meds, Stress, Feeling Bad, posted by alohashirt on September 16, 2005, at 21:24:17
How are you liking the Focalin XR? Does one dose last you through the day as Concerta? I'm definitly going to try one or the other next and am curious about the Focalin XR versus Concerta.
Posted by Bowtie Bob on September 18, 2005, at 11:41:46
In reply to Re: ADHD Meds, Stress, Feeling Bad » alohashirt, posted by theo on September 17, 2005, at 23:10:28
> How are you liking the Focalin XR? Does one dose last you through the day as Concerta? I'm definitly going to try one or the other next and am curious about the Focalin XR versus Concerta.
The big difference between Concerta and Focalin XR is that the latter kicks in much faster...50% of the total dose up front, with the remainder spread out. Concerta only kicks in about 20% up front. Hope it helps.
Posted by Bowtie Bob on September 18, 2005, at 11:44:35
In reply to Re: ADHD Meds, Stress, Feeling Bad » Bowtie Bob, posted by Sarah T. on September 17, 2005, at 19:26:10
> Hi Bowtie Bob,
>
> I was interested to read that the Focalin XR kicks in faster than Concerta for you. I thought that, for me, Concerta was a really good medicine in theory but not in practice, primarily because it took so long to kick in. Although it does start working right away, it just wasn't enough for me. I would wait hours to feel right. Then, that feeling right would last an hour and a half or two hours, and then I'd feel awful again. I took Metadate for a while because that kicked in faster, but it also wore off after about 5-6 hours. My doctor suggested taking more after about five hours, but for some reason that didn't work. I didn't feel well when I took more. Perhaps I should have tried immediate release for a few hours and when that wore I off, I should have tried the Metadate. I rarely hear or read about Metadate these days.
>
> You certainly have a long day. Starting off at 5:30! Wow! What time do you wake up? Do you get any sleep? I know someone who has to appear on T.V. at 5 a.m. every weekday morning. She gets up at 1:00 a.m. I think she goes to bed at 6 or 7 p.m. I'm not sure what you'd call that shift!
>
>Sarah T,
I am up at about 4:30AM and am at my desk a little after 5:00. This is the only time to get my computer work, e-mails, etc. done before I get the rest of the family up and moving around 6:15. I am out the door by 7:15 for my youngest daughter to get to school. For long days, I have to supplement with short-acting Focalin, but with these changes, I may have to change something...
Posted by alohashirt on September 18, 2005, at 20:53:40
In reply to Re: ADHD Meds, Stress, Feeling Bad » alohashirt, posted by Sarah T. on September 17, 2005, at 19:16:06
> > > > I don't know. I'm not depressed.
>
> Not depressed??!!! Lucky you. How many milligrams of Strattera do you take per day?
>In theory 50mg. If I'm stuck in meetings at work or forgetful I sometimes forget one or even both doses.
Posted by alohashirt on September 18, 2005, at 20:56:23
In reply to Re: ADHD Meds, Stress, Feeling Bad » alohashirt, posted by theo on September 17, 2005, at 23:10:28
> How are you liking the Focalin XR? Does one dose last you through the day as Concerta? I'm definitly going to try one or the other next and am curious about the Focalin XR versus Concerta.
I prefer Focalin XR. Concerta worked well but was a little "tunnel-like" at times. The Focalin seems sharper/better (subjectively) I wish there were some kind of electronic tuning machine that my doc could plug me into that would allow him to tweak blood chemistry for an afternoon and determine a "perfect combination" of meds that would work for me.
Posted by alohashirt on September 18, 2005, at 21:01:25
In reply to Re: ADHD Meds, Stress, Feeling Bad » alohashirt, posted by Sarah T. on September 17, 2005, at 19:16:06
> > > > I don't know. I'm not depressed.
>
> Not depressed??!!! Lucky you. How many milligrams of Strattera do you take per day?
>
Just to be clear - I'm not saying I have serenity. I am still bad tempered, moody, self-pitying, arrogant, competitive, self-centred, disorganized, prone to melodrama, self-absorption, compulsive spending, too lazy/hyper-focused/busy to eat dinner, drink fluids, go to sleep, go to bathjroom, compulsive internet using, carrying an extra 20lbs, losing hair except for nose and ear-hair, losing memory, and have combination skin.Not cured yet.
Posted by theo on September 18, 2005, at 22:46:57
In reply to Re: ADHD Meds, Stress, Feeling Bad, posted by alohashirt on September 18, 2005, at 20:56:23
> I prefer Focalin XR. Concerta worked well but was a little "tunnel-like" at times. The Focalin seems sharper/better (subjectively)
How about wearing off. Does Focalin XR wear off pretty smooth like Concerta? Does it last long enough for once a day dosing?
Posted by Bowtie Bob on September 19, 2005, at 5:25:37
In reply to Re: ADHD Meds, Stress, Feeling Bad » alohashirt, posted by theo on September 18, 2005, at 22:46:57
> > I prefer Focalin XR. Concerta worked well but was a little "tunnel-like" at times. The Focalin seems sharper/better (subjectively)
>
> How about wearing off. Does Focalin XR wear off pretty smooth like Concerta? Does it last long enough for once a day dosing?
>
I think this depends on how long your day is. Mine is over 12 hours. A short acting at the end may be needed.
Posted by alohashirt on September 19, 2005, at 22:35:58
In reply to Re: ADHD Meds, Stress, Feeling Bad » alohashirt, posted by theo on September 18, 2005, at 22:46:57
> > I prefer Focalin XR. Concerta worked well but was a little "tunnel-like" at times. The Focalin seems sharper/better (subjectively)
>
> How about wearing off. Does Focalin XR wear off pretty smooth like Concerta? Does it last long enough for once a day dosing?
>wears off sooner (say 7 hrs cf 9 hrs for Concerta ) and has a noticeable drop at lunchtime
Posted by Paulbwell on September 23, 2005, at 4:38:52
In reply to Re: ADHD Meds, Stress, Feeling Bad, posted by alohashirt on September 19, 2005, at 22:35:58
> > > I prefer Focalin XR. Concerta worked well but was a little "tunnel-like" at times. The Focalin seems sharper/better (subjectively)
> >
> > How about wearing off. Does Focalin XR wear off pretty smooth like Concerta? Does it last long enough for once a day dosing?
> >
>
> wears off sooner (say 7 hrs cf 9 hrs for Concerta ) and has a noticeable drop at lunchtime
I have the opportunity of a Month free trial on Concerta, (After which i would have to pay for) (by the drug company) after having been scripted 70-80mgs Methylphenidate daily for one and one half years, i am somewhat comfortable with tailouring the IR effects IR Methylphenidate. I would like SR sometimes and not have to concern myself with the constant dosage reminders of the IR-which althought has its benefits, ISN'T A MED YOU CAN TAKE IN THE MORNING AND FORGET ABOUT IT, the way Dexedrine Spansules seem to be, or the mighty Desoxyn Gradumet 5, 10,15mg were, or Biphetamine where: with their 12 hour action. The REAL Amphetamines sem to be superior from what i have read anyways-Monoamine output+reuptake, as opposed to straight Reuptake like Methyphenidate, The REAL Amphetamines seem to help and benefit far more people.I have an opportunity to trial Dextroamphetamine 5mg IR if i present right, so maybe that would be smoother and less 'Caffeinated' feeling?
Cheers all
Posted by vbAgent on September 25, 2005, at 0:48:05
In reply to Re: ADHD Meds, Stress, Feeling Bad, posted by Paulbwell on September 23, 2005, at 4:38:52
> > > > I prefer Focalin XR. Concerta worked well but was a little "tunnel-like" at times. The Focalin seems sharper/better (subjectively)
> > > >
I haven't had the opportunity to sample Focalin XR, but I've read that it may have fewer cardiac related side-effecs than racemic methylphenidate. Continue taking it if it works.
> > > > I have the opportunity of a Month free trial on Concerta, (After which i would have to pay for) (by the drug company)...
> > > >
Wow, what good fortune that you were given a month free trial of Concerta - without insurance that med is $$$$. Nicely done.
> > > > ... after having been scripted 70-80mgs Methylphenidate daily for one and one half years,
> > > >
That's a high daily dosage for the IR. The most I was ever prescribed was 20mg tid. Presently, I'm prescribed either Ritalin LA 20mg or 30mg taken once a day.
> > > > i am somewhat comfortable with tailouring the IR effects IR Methylphenidate. I would like SR sometimes and not have to concern myself with the constant dosage reminders of the IR-which althought has its benefits, ISN'T A MED YOU CAN TAKE IN THE MORNING AND FORGET ABOUT IT, the way Dexedrine Spansules seem to be, or the mighty Desoxyn Gradumet 5, 10,15mg were, or Biphetamine where: with their 12 hour action. The REAL Amphetamines sem to be superior from what i have read anyways-Monoamine output+reuptake, as opposed to straight Reuptake like Methyphenidate, The REAL Amphetamines seem to help and benefit far more people.
> > > >
Everyone is different. If someone fails at Ritalin then Adderall might be tried, and vice versa. As as aside, the amphetamines don't necessarily help and benefit more people. They're more potent cerebral stimulants, and consequently have a higher abuse potential.
> > > > I have an opportunity to trial Dextroamphetamine 5mg IR if i present right, so maybe that would be smoother and less 'Caffeinated' feeling?
> > > >
Are you discontinuing the Focalin XR and switching to Dexedrine? If so, let us know the results!
I was placed on Catapres (clonidine) last Monday for hypertension. My pcp measured my BP at 170/112...not good. Unfortunately, Catapress at the starting regimen of 0.1mg bid wipes me out! I feel very sedated and depressed. I'm thinking of taking half of a 0.1mg tablet in the morning and the rest, 0.15mg, before bedtime. I will check with my doctor on Monday before making any changes...but I can't tolerate this sedated-depressive feeling much longer!!!
Do any participants of this forum have experience with Catapres (clonidine)? If so, please share...
Thanks! :-) Peace ya'll...
Posted by gromit on September 26, 2005, at 9:05:56
In reply to Re: ADHD Meds, Stress, Feeling Bad, posted by Paulbwell on September 23, 2005, at 4:38:52
> I have an opportunity to trial Dextroamphetamine 5mg IR if i present right, so maybe that would be smoother and less 'Caffeinated' feeling?
Possibly, I get no stimulation at all from ritalin, it's more like I just bought the latest video card and my frame rate is increased so the game seems to slow down. I'm really starting to despise the caffeine like feeling from the adderall I'm taking now. For me it's more a physical thing but when my heart is pounding it does start to make me nervous. A lot of people seem to find the reverse to be the case though, ritalin = dirty stimulant amphetamines = calm focus.
My doctor also said I could try d-amphetamine if I can't adjust to the mixed stuff. She didn't seem to buy that l-amphetamine might cause more side effects but she listened and is willing to let me try it. I'm really hoping dex will do the trick but from past experience I'm afraid at this point in my life amphetamines might release too much NE for me to handle.
Do you post on an add forum under a slightly different name?
Rick
Posted by KaraS on September 26, 2005, at 9:33:16
In reply to Re: ADHD Meds, Stress, Feeling Bad » Paulbwell, posted by gromit on September 26, 2005, at 9:05:56
> > I have an opportunity to trial Dextroamphetamine 5mg IR if i present right, so maybe that would be smoother and less 'Caffeinated' feeling?
>
> Possibly, I get no stimulation at all from ritalin, it's more like I just bought the latest video card and my frame rate is increased so the game seems to slow down. I'm really starting to despise the caffeine like feeling from the adderall I'm taking now. For me it's more a physical thing but when my heart is pounding it does start to make me nervous. A lot of people seem to find the reverse to be the case though, ritalin = dirty stimulant amphetamines = calm focus.
>
> My doctor also said I could try d-amphetamine if I can't adjust to the mixed stuff. She didn't seem to buy that l-amphetamine might cause more side effects but she listened and is willing to let me try it. I'm really hoping dex will do the trick but from past experience I'm afraid at this point in my life amphetamines might release too much NE for me to handle.
>
> Do you post on an add forum under a slightly different name?
>
>
> Rick
>
Have you ever thought about adding a beta blocker? That might just do the trick.k
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