Psycho-Babble Medication Thread 17617

Shown: posts 1 to 7 of 7. This is the beginning of the thread.

 

ADD and Anxiety... how do you tell the difference?

Posted by Janice on December 28, 1999, at 8:21:22

When I first started taking anti-depressants and anti-anxiety medication 6 years ago, most of my anxiety, hyperchondria, panic attacks and most of my phobias dissapated.

All I was left with was an intense fear of flying and driving. 2 months ago, I took a trip to Hawaii. Now instead of knocking myself out with anti-anxiety pills (like I usually do), I took an extra Dexedrine instead. And it worked. I was, for the first time in my life, a rational, sane person on the plane. Even better I didn't have to recover from the Ativan hangover.

Last night I had a sleepless night (2 in 2 weeks) and had to call in sick to my new job today. All my 'anxiety' was about this new job and my lack of confidence, and how the whole scene is scaring the crap out of me. I took 1.5mg of Ativan, and it did nothing.

In the past, whenever I can't sleep I take .5 mg of Ativan. This has always worked up till the past 2 weeks...so I am suspecting that it is the mental, out-of-control, part of the ADD that has been keeping me up lately. And that this mental, out-of-control part of ADD is not biologically related to anxiety although they manifest themselves similarly (if that sentence does not give it away, I'm not a scientist.)

Next time this happens, I'm going to try a Dexedrine instead of an Ativan.

so my questions are;

anyone else get confused between ADD and anxiety, or have a similar experience? and how is it you can differentiate between the two disorders?

Could anyone explain to me (in layman's terms) why these 2 disorders manifest themselves so similarly and yet are treated with medication from opposite families?

I hope i have explained myself half decently, it's now 6:22 and I am finally beginning to feel sleepy. thanks Janice.

 

update: I fell asleep after taking 20mg Dexedrine

Posted by Janice on December 28, 1999, at 15:18:49

In reply to ADD and Anxiety... how do you tell the difference?, posted by Janice on December 28, 1999, at 8:21:22

With the exception of the plane ride I mentioned in my previous post, I've always felt that Dexedrine increases, then steadies the energy I do have, then spreads it evenly throughout the day.I was not completely surprised this 'attack' needed a stimulant to recede.

So is anxiety mostly physical, sweating, tightening of muscles, feeling like your having difficulities breathing?

and is ADD the mental, can't stop thinking/worrying about something, part of anxiety?

I'd love to hear from others how you experience anxiety or their ADD symptoms that seems very much like anxiety. Thanks. I'm finding this whole experience rather odd. janice. Peace.

 

sleepiness and amphetamine

Posted by Zeke on December 30, 1999, at 2:23:18

In reply to update: I fell asleep after taking 20mg Dexedrine, posted by Janice on December 28, 1999, at 15:18:49

Rather than answer your questions, I'll make some comments...

The first is to note the reported comorbidity of anxiety (and dysthymia) and ADD. This at least suggests some biological relation. I have been diagnosed with ADD and in the past, an anxiety disorder. And I take Dexedrine and in the past Ativan. Both were helpful but the Dexedrine much more so. Personally, I found Ativan much superior to Xanax, which tended to make me sleepy.

The fact that Dexedrine makes you sleepy is something that Dr. Paul Wender -- certainly an primary expert in ADD -- has commented on. In his book "Attention Deficit Hyperactivity Disorder in Adults" he refers to reports by Adults w/ ADD who indeed that stimulants make them feel sleepy. (Unfortunately I've loaned out my copy of the book so I can't give better reference but take a look at the book if you can.)

I did find one reference to the amphetamine/sleepiness connection where boys with ADD reported the sleepiness effect, but men w/o ADD did not. see: http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=7406657&form=6&db=m&Dopt=b In particular it says, "The men reported euphoria, while the boys reported only feeling "tired# or "different# after taking the stimulant." However Wender (above) seems to feel this sleepiness effect may be a marker for ADD (and as I have said, he notes this in adults). I have experienced this effect occasionally but moreover a more general calming effect.

There are psychiatrists that report on efficacy of amphetamine in relieving OCD and mania*, but the common perception is that amphetamine cause or exasperate anxiety and thus would be contraindicated with anxiety. I think this has soem truth but is largely tied to fear of controlled substances and especially of untoward reactions in naive users as well as extreme anxiety and paranoia seen in chronic abuse and overdose with amphetamine (and other stimulants). But IMHO this is describes on the behavioral differences of amphetamine effects at mederate and high doses, just like moderate doses relieve hyperactivity but high doses will cause hyperactivity. Also, while amphetamine acts primarily on dopamine and penylethylamine, there is evidence that it will elevate synaptic serotonin levels in conjunction with substances that act on serotonin (eg, SSRIs or Xanax, which has an antidepressant effect beyond its anxiolotic effect). There is also evidence of a direct dopamine/serotonin connection: "Evidence that serotonin3 (5-hydroxytryptamine3, 5-HT3) antagonists attenuate behavioral responses to D-amphetamine and cocaine suggests that 5-HT3 receptors modulate brain dopamine." (see: http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=8888359&form=6&db=m&Dopt=b note too a possible connection of euphoria and anxiety implied there -- since moderate doses used in ADD tend not to cause euphoria does this also speak to the non-anxiety response therein?)

Another study, suggests that amphetamine has effects on GABA, the transmitter system that benzodiazepines effect and one attributed to anxiety: "GABAergic drugs are potentiated by enhanced dopaminergic neurotransmission with regard to their actions on ambulatory activity and rearing." (see: http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=9443561&form=6&db=m&Dopt=b )

Interestingly, phobias may be preciptated by amphetamine withdrawl: "d-amphetamine ... when discontinued by our patient, was followed by the full syndrome of agoraphobia." (see: http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=7085580&form=6&db=m&Dopt=b )

*see Psychopharmacology Tips (also, http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=1680885&form=6&db=m&Dopt=b , http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=7751261&form=6&db=m&Dopt=b , http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=3429704&form=6&db=m&Dopt=b , http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=3312177&form=6&db=m&Dopt=b )

 

sleepiness and amphetamine

Posted by Zeke on December 30, 1999, at 2:57:25

In reply to update: I fell asleep after taking 20mg Dexedrine, posted by Janice on December 28, 1999, at 15:18:49

Rather than answer your questions, I'll make some comments...

The first is to note the reported comorbidity of anxiety (and dysthymia) and ADD. This at least suggests some biological relation. I have been diagnosed with ADD and in the past, an anxiety disorder. And I take Dexedrine and in the past Ativan. Both were helpful but the Dexedrine much more so. Personally, I found Ativan much superior to Xanax, which tended to make me sleepy.

The fact that Dexedrine makes you sleepy is something that Dr. Paul Wender -- certainly an primary expert in ADD -- has commented on. In his book "Attention Deficit Hyperactivity Disorder in Adults" he refers to reports by Adults w/ ADD who indeed that stimulants make them feel sleepy. (Unfortunately I've loaned out my copy of the book so I can't give better reference but take a look at the book if you can.)

I did find one reference to the amphetamine/sleepiness connection where boys with ADD reported the sleepiness effect, but men w/o ADD did not. see: http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=7406657&form=6&db=m&Dopt=b In particular it says, "The men reported euphoria, while the boys reported only feeling "tired# or "different# after taking the stimulant." However Wender (above) seems to feel this sleepiness effect may be a marker for ADD (and as I have said, he notes this in adults). I have experienced this effect occasionally but moreover a more general calming effect.

There are psychiatrists that report on efficacy of amphetamine in relieving OCD and mania*, but the common perception is that amphetamine cause or exasperate anxiety and thus would be contraindicated with anxiety. I think this has soem truth but is largely tied to fear of controlled substances and especially of untoward reactions in naive users as well as extreme anxiety and paranoia seen in chronic abuse and overdose with amphetamine (and other stimulants). But IMHO this is describes on the behavioral differences of amphetamine effects at mederate and high doses, just like moderate doses relieve hyperactivity but high doses will cause hyperactivity. Also, while amphetamine acts primarily on dopamine and penylethylamine, there is evidence that it will elevate synaptic serotonin levels in conjunction with substances that act on serotonin (eg, SSRIs or Xanax, which has an antidepressant effect beyond its anxiolotic effect). There is also evidence of a direct dopamine/serotonin connection: "Evidence that serotonin3 (5-hydroxytryptamine3, 5-HT3) antagonists attenuate behavioral responses to D-amphetamine and cocaine suggests that 5-HT3 receptors modulate brain dopamine." (see: http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=8888359&form=6&db=m&Dopt=b note too a possible connection of euphoria and anxiety implied there -- since moderate doses used in ADD tend not to cause euphoria does this also speak to the non-anxiety response therein?)

Another study, suggests that amphetamine has effects on GABA, the transmitter system that benzodiazepines effect and one attributed to anxiety: "GABAergic drugs are potentiated by enhanced dopaminergic neurotransmission with regard to their actions on ambulatory activity and rearing." (see: http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=9443561&form=6&db=m&Dopt=b )

Interestingly, phobias may be preciptated by amphetamine withdrawl: "d-amphetamine ... when discontinued by our patient, was followed by the full syndrome of agoraphobia." (see: http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=7085580&form=6&db=m&Dopt=b )

*see Psychopharmacology Tips (also, http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=1680885&form=6&db=m&Dopt=b , http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=7751261&form=6&db=m&Dopt=b , http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=3429704&form=6&db=m&Dopt=b , http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=3312177&form=6&db=m&Dopt=b )

 

sleepiness and amphetamine

Posted by Zeke on December 30, 1999, at 2:57:26

In reply to update: I fell asleep after taking 20mg Dexedrine, posted by Janice on December 28, 1999, at 15:18:49

Rather than answer your questions, I'll make some comments...

The first is to note the reported comorbidity of anxiety (and dysthymia) and ADD. This at least suggests some biological relation. I have been diagnosed with ADD and in the past, an anxiety disorder. And I take Dexedrine and in the past Ativan. Both were helpful but the Dexedrine much more so. Personally, I found Ativan much superior to Xanax, which tended to make me sleepy.

The fact that Dexedrine makes you sleepy is something that Dr. Paul Wender -- certainly an primary expert in ADD -- has commented on. In his book "Attention Deficit Hyperactivity Disorder in Adults" he refers to reports by Adults w/ ADD who indeed that stimulants make them feel sleepy. (Unfortunately I've loaned out my copy of the book so I can't give better reference but take a look at the book if you can.)

I did find one reference to the amphetamine/sleepiness connection where boys with ADD reported the sleepiness effect, but men w/o ADD did not. see: http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=7406657&form=6&db=m&Dopt=b In particular it says, "The men reported euphoria, while the boys reported only feeling "tired# or "different# after taking the stimulant." However Wender (above) seems to feel this sleepiness effect may be a marker for ADD (and as I have said, he notes this in adults). I have experienced this effect occasionally but moreover a more general calming effect.

There are psychiatrists that report on efficacy of amphetamine in relieving OCD and mania*, but the common perception is that amphetamine cause or exasperate anxiety and thus would be contraindicated with anxiety. I think this has soem truth but is largely tied to fear of controlled substances and especially of untoward reactions in naive users as well as extreme anxiety and paranoia seen in chronic abuse and overdose with amphetamine (and other stimulants). But IMHO this is describes on the behavioral differences of amphetamine effects at mederate and high doses, just like moderate doses relieve hyperactivity but high doses will cause hyperactivity. Also, while amphetamine acts primarily on dopamine and penylethylamine, there is evidence that it will elevate synaptic serotonin levels in conjunction with substances that act on serotonin (eg, SSRIs or Xanax, which has an antidepressant effect beyond its anxiolotic effect). There is also evidence of a direct dopamine/serotonin connection: "Evidence that serotonin3 (5-hydroxytryptamine3, 5-HT3) antagonists attenuate behavioral responses to D-amphetamine and cocaine suggests that 5-HT3 receptors modulate brain dopamine." (see: http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=8888359&form=6&db=m&Dopt=b note too a possible connection of euphoria and anxiety implied there -- since moderate doses used in ADD tend not to cause euphoria does this also speak to the non-anxiety response therein?)

Another study, suggests that amphetamine has effects on GABA, the transmitter system that benzodiazepines effect and one attributed to anxiety: "GABAergic drugs are potentiated by enhanced dopaminergic neurotransmission with regard to their actions on ambulatory activity and rearing." (see: http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=9443561&form=6&db=m&Dopt=b )

Interestingly, phobias may be preciptated by amphetamine withdrawl: "d-amphetamine ... when discontinued by our patient, was followed by the full syndrome of agoraphobia." (see: http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=7085580&form=6&db=m&Dopt=b )

*see Psychopharmacology Tips (also, http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=1680885&form=6&db=m&Dopt=b , http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=7751261&form=6&db=m&Dopt=b , http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=3429704&form=6&db=m&Dopt=b , http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=3312177&form=6&db=m&Dopt=b )

 

Re: ADD and Anxiety... how do you tell the difference?

Posted by anna on December 30, 1999, at 14:33:21

In reply to ADD and Anxiety... how do you tell the difference?, posted by Janice on December 28, 1999, at 8:21:22

If you are asking how to tell if what you are feeling at a given time is due to anxiety or ADD--I have been wondering the same thing myself. But, I try not to drive myself crazy about it. I think I read in "driven to distraction" that panic, aniety, depression, add, etc are all related. While I went off daily Klonipin immediately when I began Adderal (I just did it on my own--like something snapped), I do find some situations where I still take a klonipin--ones that hisotrically caused me anxiety--airplanes, job interviews and, rarely, when I have taken the adderall and after an hour still feel that...anxious-jumpy thing. (I still will not go on a boat or a propeller plane--no drug or therapy will get me to do either of those--holdovers from panic disorder I cannot shake!)

Adderall doesn't make me sleepy, BUT, I can take 20 mg of adderall when I get up and then go right back to sleep. ( FYI--I began taking benzos, ssris, etc many years ago for panic, aniety, depression. Also recently stopped buspar and now just on adderal, wellbruitrin and zoloft--trying to stop latter.

Bottom line--I don't knwo how old you are, but I've been dealing with all this, treated or not, since I was a kid (the pediatrician had me on Miltowns --a "'60" tranquelizer--at age 8...) I don't think I can just say "if all my former anxiety was really add", why do I still get anxious?--it's not that clear cut, and I think it's different for all of us. Maybe I've always had them all together--or close to together-- maybe the add came first, and I was frustrated so I became anxious--and then no kid would play with me (not true, I had the best Barbies) so I became depressed. Or, maybe the anxiety came on because mom made me a wreck about something or another and the ADD appeared at the same time due to my brain chemistry....What am I trying to say, and trying to accept myself, is that some how my wiring is not what is deemed "normal", but I take stuff to regulate it and jsut try to get on with things. I try not to obsess on which "disorder" is causing which syptom. Maybe not medically right, but it's a practical approach

> When I first started taking anti-depressants and anti-anxiety medication 6 years ago, most of my anxiety, hyperchondria, panic attacks and most of my phobias dissapated.
>
> All I was left with was an intense fear of flying and driving. 2 months ago, I took a trip to Hawaii. Now instead of knocking myself out with anti-anxiety pills (like I usually do), I took an extra Dexedrine instead. And it worked. I was, for the first time in my life, a rational, sane person on the plane. Even better I didn't have to recover from the Ativan hangover.
>
> Last night I had a sleepless night (2 in 2 weeks) and had to call in sick to my new job today. All my 'anxiety' was about this new job and my lack of confidence, and how the whole scene is scaring the crap out of me. I took 1.5mg of Ativan, and it did nothing.
>
> In the past, whenever I can't sleep I take .5 mg of Ativan. This has always worked up till the past 2 weeks...so I am suspecting that it is the mental, out-of-control, part of the ADD that has been keeping me up lately. And that this mental, out-of-control part of ADD is not biologically related to anxiety although they manifest themselves similarly (if that sentence does not give it away, I'm not a scientist.)
>
> Next time this happens, I'm going to try a Dexedrine instead of an Ativan.
>
> so my questions are;
>
> anyone else get confused between ADD and anxiety, or have a similar experience? and how is it you can differentiate between the two disorders?
>
> Could anyone explain to me (in layman's terms) why these 2 disorders manifest themselves so similarly and yet are treated with medication from opposite families?
>
> I hope i have explained myself half decently, it's now 6:22 and I am finally beginning to feel sleepy. thanks Janice.

 

Re: ADD and Anxiety... how do you tell the difference?

Posted by dove on December 30, 1999, at 15:50:19

In reply to ADD and Anxiety... how do you tell the difference?, posted by Janice on December 28, 1999, at 8:21:22

Hi Janice :-)

I must say, we have the same dx's and the same symptoms. I too have a severe fear of flying and driving. When I was younger it wasn't a problem, the older I've gotten the worse it gets. Riding in the car with my husband I hold the armrest white-knuckled, my heart-rate over 130 and my teeth grinding, I last maybe 10 minutes and then order him to let me drive or take me home. I did make a 1-hour journey around Thanksgiving, Adderall and Prozac both in my system at the time, but that was the most relaxed I'd been in at least 3 years.

I too am interested in the connection of these disorders and symptoms, and how to go about treating them, especially since they often require polar solutions. Also, I can take 20 mgs. of Adderall and go right back to sleep, although I think my sleep isn't as healthy, I don't feel "rested" afterwards.

In thought,
dove


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