Psycho-Babble Medication Thread 16376

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Adderall queries(excuse any redundancy)&emoting

Posted by CarolAnn(and the trouble I seen...) on December 7, 1999, at 10:43:14

First, thank you for all the valuable advice I have found on this board so-far. I never want to be a bother with my HEAVY emotional times, but here goes:
I've been so far down the past couple months that it's something of a miracle to be here to tell the tale. Have spent as much time in bed as my 19 month old daughter's needs can spare. Am so overwhelmed by even the simplest of tasks that it is a huge achievement(for the whole day!) to get the brkfast dishes into washer! Even "fun" holiday events seem like major chores that I wish I could get out of. And the worse thing, the thing that makes me feel like an absolute monster in human disguise: My widowed father-in-law is coming for a two and 1/2 week visit over Xmas & New Year's, and I find myself actually(truly!) wishing he would die, so I won't have to deal with all the work involved(he's elderly & pretty helpless). Okay, all done emoting for now, moving on...

Saw Pdoc today. Due to almost "suicidal" levels of fatigue, he has taken me off Serzone(well, have to taper off next few days). He wants me to give the 400mgs per day Wellbutrin some more time to judge effectiveness. We discussed possibilty of my having "atypical Add"(description in previous thread for 'newbies'). He agreed it was possible and started me on 10mgs Adderall twice daily.
Now Questions(no time to ask him due to "managed care's" 15 minute limit for "medication management" appt.) :(
So:
Does this seem like enough dosage to be helpful stimulant-wise?
Should I feel some immediate results(like with each dose?), or does it build up to results?
How long should I give this dosage before seeking a possible increase?
Considering I haven't yet gotten any stimulant effect from the Wellbutrin, do you think adding the Adderall will make a difference there?
Anyone have any other information that would be helpful?
CarolAnn

 

Re: Adderall queries

Posted by Judy on December 7, 1999, at 17:53:36

In reply to Adderall queries(excuse any redundancy)&emoting, posted by CarolAnn(and the trouble I seen...) on December 7, 1999, at 10:43:14

CarolAnn,

You can and should emote all you want! Nobody should have to attempt the rigors of caring for a 19-month-old feeling the way you do.

While I can't give you any info on Adderall, I CAN tell you to hang in there for several more days after stopping Serzone and see how you feel. Your description of "suicidal" levels of fatigue on Serzone sounds TOO familiar - it is by far the most dangerous drug I ever took in terms of the way it made me feel. Most mornings, my brain would wake up (if you could call it that) and I would have to lie there for several minutes until my body caught up with it. It was like coming out of anesthesia! The rest of the day didn't get much better - I was near-catatonic until I could go back to sleep again.

The Wellbutrin might give you what you're looking for stimulation-wise once the Serzone is out of your system. Maybe you won't even have to worry about when and how much to increase the Adderall. I hope so.

Judy

 

Re: Adderall queries

Posted by Noa on December 7, 1999, at 20:38:02

In reply to Re: Adderall queries, posted by Judy on December 7, 1999, at 17:53:36

> CarolAnn,
I read somewhere that mothers of toddlers represent one of the largest groups of people with depression. I guess the only good thing about this is that hopefully, it gets better, as the kids grow up.

 

Re: Adderall queries(excuse any redundancy)&emoting

Posted by Zeke on December 8, 1999, at 5:02:22

In reply to Adderall queries(excuse any redundancy)&emoting, posted by CarolAnn(and the trouble I seen...) on December 7, 1999, at 10:43:14

First, I keep wondering about the 'atypical ADD' dx which I've never heard before. (I've read your previous posts.) However, 'atypical depression' is used and may be what he means. Or as Noa commented, it may be the w/o hyperactivity form (primarily inattentive) or 'not otherwise specified'.

How long do you give it? Well the doc meant the Wellbutrin. How long have you been at 400mg/day? You shouldn't go much higher on Wellbutrin because of the risk of seizures. For Adderal, its own effect should be immediate, but a positive interaction with the Wellbutrin (potentiation) may be delayed -- but then Wellbutrin may even block the some of the actions of amphetamine (ie, in limbic areas).

If you don't get any effect from the Wellbutrin at this dose of Adderall, why not ask about dumping the Wellbutrin and trying a SSRI + Adderall?

 

CA: What about this?

Posted by Zeke on December 8, 1999, at 6:20:41

In reply to Adderall queries(excuse any redundancy)&emoting, posted by CarolAnn(and the trouble I seen...) on December 7, 1999, at 10:43:14

A few questions to consider...

Was there any med that seemed to help your mom? or helped for other family members with depression? (If so, mention this to the doc.)

If other relatives suffered with depression, was it primarily female relatives?

Did you or your mom suffer from postpartum depression, or if already depressed, did it make you feel worse?

During your pregnancy, did you feel better depression-wise? (Estrogen levels increase during pregnancy)

If you have been on estrogen (say for birth control) did you feel better?

Research is uncovering important and diverse activity by estrogen in the brain. I have read about an estrogen-serotonin connection -- the effect of estrogen on MAO. Also that estrogen plays a protective function -- important because the hippocampus seems to shrink during depression and severe stress. (But fret not, as even these physical changes are reversible via neurogenesis.)

see:
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=10511016&form=6&db=m&Dopt=b
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=9807636&form=6&db=m&Dopt=b

(about half way down -- "4. Hormonal therapies")
http://mblcommunications.com/CNS198_Brambilla.html

 

Re: Adderall queries(excuse any redundancy)&emoting

Posted by Noa on December 8, 1999, at 7:11:49

In reply to Adderall queries(excuse any redundancy)&emoting, posted by CarolAnn(and the trouble I seen...) on December 7, 1999, at 10:43:14

Carol Ann,
You describe the following:
Have spent as much time in bed as my 19 month old daughter's needs can spare.
and
almost "suicidal" levels of fatigue.

As Zeke suggested, it is likely that the doctor is talking about atypical depression, or major depression with atypical features, based on your level of fatigue.

It seems to me that you have to divide your difficulties into two categories: acute and chronic. The issue of ADD is more of a chronic one, and in my humble opinion, should take a back seat to the more acute problem, which is your depression. You are extremely fatigued, cannot feel pleasure in holiday events, even find them to be a burden or chore, have no motivation, and are feeling so taxed by your father in law's visit that you have wishes that he would die. This SCREAMS DEPRESSION. Sure, you may also have ADD, and it may in part be the cause of feeling overwhelmed, but I believe you are overwhelmed primarily because of the depression. Deal with that first.
I agree with the doc that if you are going to try a med like wellbutrin, you need to give it a chance. How long did you give it before adding the adderall?
With atypical depression, sometimes stimulants are used to augment ADs. It could help with the fatigue. And it could boost the effects of the Wellbutrin.
BTW, how long were you on Serzone? When I first startd it, it made me very emotional, agitated, tearful. That wore off after a few weeks. But as I recently increased the dose, I do find myself more tired.

 

Re: back to you, Noa...

Posted by CarolAnn on December 8, 1999, at 17:51:29

In reply to Re: Adderall queries(excuse any redundancy)&emoting, posted by Noa on December 8, 1999, at 7:11:49

Noa, I was on Serzone for over four wks, with no response at all except much, much, worse fatigue *and* depression.

My Pdoc added the Adderall because I had been on Wellbutrin for eight weeks, and never had any stimulant effect at all. Actually, I was the one who asked for a stimulant, because my depression always gets worse when I get too overwhelmed with daily responsibilities and am too tired to get anything done(always!). What with the holidays and my father-in-law's visit, I knew that if I did not find some energy somewhere(even in a pill), by next week I would have been in a verrry bad place. The place where I never get out of bed, and when I'm not sleeping, I am composing suicide notes!
The main agenda with the Adderall is to see if it will give the Wellbutrin a kick in the pants so it will start working. My Pdoc just does not want to give up on the Wellbutrin until I have been on at least 12 wks. Which is fine with me as long as I have enough energy to "deal" in the meantime. Thanx for all the feedback!CarolAnn

 

Re: Reply to Zeke &one last Adderall query to all.

Posted by CarolAnn on December 8, 1999, at 18:17:24

In reply to Re: Adderall queries(excuse any redundancy)&emoting, posted by Zeke on December 8, 1999, at 5:02:22

Hi Zeke. First, the phrase "atypical ADD" is just my description of the form I think I have. I have never been hyper-active, quite the opposite. I don't remember a time in my life when I was not tired. But, on reflecting back to school days, I can remember the teachers having to almost yell in order to jar me from daydreaming. I have always been very imaginative and able to use my daydreams to escape any circumstances I did not want to be in(ie: school ,dentist appts, ect.). Anyway, I always thought that ADD meant being too hyper-active to pay attention. That's why I started the "atypical" ADD thread, in hopes of finding out if this might be part of my depression problem.
Actually when I asked, how long I should give it? I misspoke. I was talking about the Adderall, I want to know if the effects are just dose by dose, or if there is a cumulative effect or both. For example, if I forget to take them a few days, will I just notice a difference on those days or will there be a negative effect on my longterm treatment? Sorry this reply is so long, I'm not very articulate.Thanx for all the helpful info!CarolAnn

 

CarolAnn

Posted by Janice on December 8, 1999, at 19:48:07

In reply to Re: Reply to Zeke &one last Adderall query to all., posted by CarolAnn on December 8, 1999, at 18:17:24


Hi CarolAnn,
I'll share with you my experiences on Dexedrine (a stimulant like Adderall). I notice the effects immediately, within an hour. stimulants are not cumulative - the longer lasting ones last me about 12 hours; and the shorter lasting ones about 4 hours. I don't take them past 2pm to ensure I sleep well.

They don't improve my mood; what drastically improves my mood is the effect of the stimulants. On them, I am able to do things I have never done in my life (get out of bed, fold clothes, make grocery lists, do housework). Through the help of the stimulants, I have been able to drastically change my life; and the repercusions of this makes me feel good physically and mentally.

There is a book called 'Women and ADD', which goes into detail about ADD without hyperactivity. Hypo-activity is a symptom of this disorder, so is daydreaming. Daydreaming is an internal way of being distracted (you know how they say ADD people are easily distracted). Anyway, I'd recommend the book. If you're interested I'll get the authors name from the library for you.

One way I've heard to tell the difference between depression and ADD (hyper or not) is that ADD is chronic (beginning in childhood) and depression is episodic. Although most people with ADD also have depression as a consequence of the ADD. I've also heard that people with ADD generally don't have self-pity (which depressed people often have).

So the stimulants may not make you feel that different on the inside, but watch what you are able to 'do' and accomplish. janice.

I'm having one hell of a time trying to get more Dexedrine out of my new doctor. I'm very angry about it. I don't know what exactly is up with this drug, but I feel like suing the shit out of someone. Yesterday, I got too angry to even talk about it. Like I plan to start spending 18 hours in bed a day so this idiot can find a drug that he likes. gggrrrrrrr! You're lucky this doctor would give you some. Hope you feel better shortly.

 

Re: CarolAnn

Posted by Noa on December 8, 1999, at 20:51:26

In reply to CarolAnn, posted by Janice on December 8, 1999, at 19:48:07

Janice, what is the problem with getting dexedrine? Why are you seeing a new doctor?

 

CarolAnn CarolAnn CarolAnn

Posted by zeke on December 9, 1999, at 0:57:47

In reply to Re: CarolAnn, posted by Noa on December 8, 1999, at 20:51:26

CarolAnn --

I feel very concerned because you said your mother committed suicide -- and I assume she was severely depressed. And now you mention writing a suicide note. And the final red flag is the holidays coming up.

I think I hear you saying that your baby is the main thing keeping you battling on. I admire you for battling. But I hear you being overwhelmed. Please keep talking to us but please find someone there you can talk to and confide in.

I want you to know, that if things get really bad you aren't going to lose your child by getting special help.

Did you look at my post "CA, What about this?" I was really curious about your mood during your pregnancy and afterwards. This represents high and low estrogen levels. Now this may all sound off the wall, but as estrogen drop, the brain releases more and more monoamine oxidase and you're left with low neurotransmitter levels: serotonin, norepinephrine, dopamine and several others. I sounds like your mom suffered her final depression when you were young and that parallel makes this something to look into. (I also think of this as a friend of a past girlfriend said she 'only felt best when she was pregnant'. Or if you don't believe me, look at those medline links.) Estrogen could be something that really helps you.

Re ADD and Adderall -- Hyperactivity isn't a necessary part of ADHD, it typically is absent in girls, and it tends to resolve into adulthood anyway. But the attentional and temperament issues often persist.

Nonetheless, Noa is absolutely right: You need to focus on the Depression. Janice is right that you should feel the Adderall immediately, but over a week or two it may cause you to feel the Wellbutrin start to work. But for technical reasons the Wellbutrin may block some of the Adderall effects.

So do you feel any effect from the Adderall? Are you feeling any better or worse today?

 

Re: CarolAnn CarolAnn CarolAnn

Posted by noa on December 9, 1999, at 6:34:16

In reply to CarolAnn CarolAnn CarolAnn, posted by zeke on December 9, 1999, at 0:57:47

Zeke, you are good at putting the puzzle together. I am glad you wrote your post. I am concerned about CA, too.

 

Re: CarolAnn

Posted by Phil on December 9, 1999, at 6:56:41

In reply to CarolAnn CarolAnn CarolAnn, posted by zeke on December 9, 1999, at 0:57:47

I think I read on Goldberg's site that Canadian shrinks...sounds like a hockey team, don't even prescribe Serzone anymore although some GP's do.
I think Ser. has been available there for a while and they realized it just ain't a very good AD.
It was worthless for my depression and gave me a hair-trigger temper. Does your Father-in-Law have any other options? My brother was in town recently and stayed with his ex-girlfriend while he was here. I was too stressed to deal with it and he understood. TAKE CARE OF YOU FIRST.
Phil
PS...These holidays will pass! I HATE THIS TIME OF YEAR!!!!!!!

 

Re: a note to Janice

Posted by CarolAnn on December 9, 1999, at 6:58:30

In reply to CarolAnn, posted by Janice on December 8, 1999, at 19:48:07

Janice, if your Doc won't give more dexedrine, maybe you can get him to switch to Adderall. My Pdoc presribed it, because it is supposed to be better then dexedrine or ritalin. He said Adderall is like a combination of dex. and rit., also, some insurances require generic drugs where available, and since there is no generic Adderall, there is no worry that you will get something inferior, which my Pdoc said is possible with generic forms even though they are supposed to be regulated as the exact same thing as name brands! Hope this helps!CarolAnn

 

Re: note to Zeke

Posted by CarolAnn on December 9, 1999, at 7:08:57

In reply to CarolAnn CarolAnn CarolAnn, posted by zeke on December 9, 1999, at 0:57:47

Zeke, I'm so sorry to have inadvertantly mislead you, when I talked about mom's and suicide, I was not refering to my mom(who is alive and in denial), I was talking about *not* wanting to subject *my* child to the experience of having her mom commit suicide.
As far as pregnancy goes, I did not feel any better then usual, but since I could not take drugs, I self-medicated with food. I gained sixty pounds, on an already overweight body! Luckily, that "sixty" has come off, but I still need to drop quite a bit of weight.
As far as post-prenancy, Oh my god, I know I had the worst post-partum depression possible. Let me say this, you know your post-partum depression has been *bad*, when your husband gets a vasectomy just so that neither of you ever have to go through that again! 'Nuff said!
Thanx for all your support and helpful words! Oh yeah, I am feeling a bit better on the Adderall, especially with the Serzone getting out of my system. Thanx so much for your concern, it means alot!CarolAnn

 

Re: note to Noa

Posted by CarolAnn on December 9, 1999, at 7:16:29

In reply to Re: CarolAnn CarolAnn CarolAnn, posted by noa on December 9, 1999, at 6:34:16

Noa, you don't know how good it makes me feel to have people so concerned about me! It really is a comfort to know that others truly understand and care about my problems.
Please read my note to Zeke, you will see that I am not as bad off as things seem!
Thank you again!CarolAnn

 

Re: Adderall queries(excuse any redundancy)&emoting

Posted by S. Suggs on December 9, 1999, at 7:37:03

In reply to Adderall queries(excuse any redundancy)&emoting, posted by CarolAnn(and the trouble I seen...) on December 7, 1999, at 10:43:14

CarolAnn:

I agree with Zeke's suggestion for a ssir + stim. I am a male with a diagnosis of dysthymia and ADD-H. Take Parnate 50mg/day, lithium 900mg/day with excellent results. I ended up on Parnate after years of searching and trying all of the others. He (your doc) should have no problem working in an ssri. Wellbutrin is a good drug, but works weakly on dopamine, and from what I understand, that is about all. It's quirky and to tell the truth, they do not completely understand what it does (like a lot of drugs). Adderall is a combo of dextroamphetamine and amphetamine (I think), I know it is not a combo of dextro and ritalin. I'd push hard for a ssri or another catagory such as Effexor etc...

What have you taken in the past other than the current meds? For how long? And how is your doc open to YOUR suggestons?

Hang in there, it will get better, too many people on this forum will veryfy this.

Blessings,

S. Suggs

 

Noa...

Posted by Janice on December 9, 1999, at 15:27:11

In reply to Re: CarolAnn, posted by Noa on December 8, 1999, at 20:51:26

hi,

I've been travelling recently and have just moved to a new city. It seems to me the healthcare system in this province is more bureaucratic than the one in the last province I was in.

I'm having troubles (I believe) because doctors in this province are very accountable for the amount of stimulants they prescribe (I heard it can be used as a recreational drug - but I imagine most drug uses are probably just trying to feel normal. So none of the doctors seem to want to prescribe the stimulants. So now I have to be officially diagnosed as having ADHD. My doctor in Toronto never gave me any official diagnosis, and I liked his style. I mean, I KNOW what i experience. It seems bureaucratic to me and I'm probably over-reacting. I don't want to have to convince anyone of having these disorders, but I don't function without the medication; plus I have a strong aversion to anyone having any power over me. I feel like I have to 'hustle' for Dexedrine, and this pisses me off. Like Dove, I want to scream and yell at them, Janice.

 

Re: a note to S.Suggs

Posted by CarolAnn on December 9, 1999, at 15:37:42

In reply to Re: Adderall queries(excuse any redundancy)&emoting, posted by S. Suggs on December 9, 1999, at 7:37:03

Dear S.Suggs
Thank you for your reply!
First, I must have misspoken about the contents of Adderall. You are right, I meant to say that my Dr. said that Adderall "works" like a combo of dexedrine and ritalin.
I also think you may be right about my needing an ssri. But, I just came off Serzone(which affects serotonin, in a different way then ssri), and I don't want to add anything right away until I find out how the Wellbutrin and Adderall work out. I actually have taken quite a few ssri's with no results: Zoloft, Prozac, Effexor, Prozac again at higher doses, also have experience with the tricyclic Elavil.
My Dr. is pretty open to suggestions, actually I was the one who suggested a stimulant and he decided on Adderall. CarolAnn

 

Re: Noa...Janice

Posted by Noa on December 9, 1999, at 17:10:49

In reply to Noa..., posted by Janice on December 9, 1999, at 15:27:11

Can you have your Toronto doc call your new doc?

 

Re: a note to S.Suggs

Posted by S. Suggs on December 9, 1999, at 22:22:41

In reply to Re: a note to S.Suggs, posted by CarolAnn on December 9, 1999, at 15:37:42

CarolAnn: You are very welcome. I really enjoy doing all I can to help others out if possible with what limited information that I have. Pharmacy is a love of mine, so I really get a kick out of this site. One question, it's a long shot, but have you considered a new stim drug, schedule IV, called Provigil? It is indicated for narcolepsy as other schedule II narcs. From what I understand, it just makes you feel like you are awake, not driven to paint the outside of your house in an afternoon. Just a thought, hope it helps, Blessings,

S. Suggs

 

Re: Noa...

Posted by zeke on December 11, 1999, at 3:55:51

In reply to Noa..., posted by Janice on December 9, 1999, at 15:27:11

What metro area do you live in now?

Someone suggested getting your medical records forwarded and a MD-MD phone call, and I agree. Also seek a physician who treats ADD in Adults, and isn't bound by unjustified morality re stimulants. Among other places, try the local university med school -- psychiatry, child psychiatry and behavioral neurology departments.

While Dexedrine certainly has therapeutic potential for many, IT IS amphetamine and has high potential for abuse (especially if used IV). Try to understand the difficulty doctors have distinguishing folks like you from those abusing it ("drug seeking behavior"). Further, by law they have to document your ADD in prescribing controlled drugs.

I agree with you that its frustrating!


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