Psycho-Babble Medication Thread 16036

Shown: posts 1 to 25 of 44. This is the beginning of the thread.

 

Addiction to Dexedrine

Posted by Tracy on December 1, 1999, at 3:11:35

I was diagnosed with adult onset add about 3 years ago. My doctor started me on Ritalin and after 8 months my tolerance increased so much that I was switched to Dexedrine. I've been taking Dexedrine for the past two years now. My initial dose was 30 mg. per day (2 5mg tabs 3x a day). Now I can barely feel the effects of 100+mg per day. I know that I am severely addicted yet at the same time I feel powerless to do anything about it. On the medication I can work 60 hour weeks and still have plenty of energy. I'm afraid
of how my life will change if I discontinue its use but I know it is impossible to continue on in this pattern. Dexedrine has also helped control my appetite and stay at a desirable weight. Are there any others out there who share my problem?

 

Re: Addiction to Dexedrine

Posted by Zeke on December 1, 1999, at 21:20:23

In reply to Addiction to Dexedrine, posted by Tracy on December 1, 1999, at 3:11:35

Hi Tracy --

I have ADD and take Dexedrine but only about half your dosage.

Since you take Dexedrine for a medical reason (ADD) I think it would be better to say you are dependent on rather than addicted to Dexedrine. (Are you increasing the dose yourself? I'd say that would be a sign of addiction. But I doubt you're doing that or you'd run out occasionally)

Tolerance to stimulants in ADD is supposedly rare (after some initial adjustment).

I do remember Dr. Paul Wender writing about a ADD patient who experienced tolerance to both Ritalin and Dexedrine. Wender's clever solution was to continue to swithch the patient between the stimulants periodically as the tolerance occurred. (It has since been discovered that Ritalin and the amphetamines effect different dopamine pools in the brain and (at clinical doses) they are not cross tolerant.)

So you might speak with your doctor about giving Ritalin a try again, building the dose as the tolerance builds. Then switch back, etc... Besides, if your doc writes much higher a dosage he'll soon get unwanted attention from the DEA or Medical Board!

Finally I wonder if the tolerance isn't so much in re your ADD, but to the superwoman and supermodel effects you mention. After a 60 hour week you should be slowing down a bit, and diet & exercise can help with the weight.

 

Re: Addiction to Dexedrine

Posted by Noa on December 2, 1999, at 21:05:10

In reply to Re: Addiction to Dexedrine, posted by Zeke on December 1, 1999, at 21:20:23

The term "adult onset ADD" is unusual. By definition, as currently written, the DSM diagnosis of ADD includes the criterion of onset before age 7.

 

Re: Addiction to Dexedrine

Posted by saint james on December 5, 1999, at 0:18:39

In reply to Re: Addiction to Dexedrine, posted by Noa on December 2, 1999, at 21:05:10

Have you tried AD's. I take Dex and Effexor and find the AD's decrease the amount of Dex I have to take. It seems the AD make stims more effective. Also if I just take Dex and no AD's it takes alot to bring my mood up, where as taking the AD's solves this so I just take enough Dex to focus. I have found all the AD's that work for mood in me also help some with focus, esp. Effexor. To me, because you are having to increase the dose to have same effect indicates you are not properly medicated. Something is not right. Dexadrine is not addressing all your problems. The best and most common, tried and true cocktail for adult ADD is stim + AD. Discuss some AD's with you doc, if you have not gone this route. It does not count if you have tried 2 AD's, trust me !

j

 

Re: Addiction to Dexedrine

Posted by Zeke on December 6, 1999, at 8:39:44

In reply to Re: Addiction to Dexedrine, posted by saint james on December 5, 1999, at 0:18:39

An antidepressant might help, and Effexor or the SSRIs would also supplement the weight control issue. However if she is BiPolar the AD might induce mania.

saint james, you said,"The best and most common, tried and true cocktail for adult ADD is stim + AD." Are you sure of that? I know where you're coming from: Anxiety and dysthymia are frequenly coexist in adults with ADD and so these meds are often given. Yet I haven't read any studies saying that this combination (AD + stim) is "the rule" in adult ADD (excepting individual physicians' own preferences, eg, J Beiderman).

I'm curious, does Effexor interact with amphetamine as the tricyclics do, ie, does it increase amphetamine levels in the brain? SSRIs -- probably the most common ADs -- don't have this effect.

Lastly, Noa made a good comment. Likely she was just meant adult diagnosed rather than adult onset. The prevailing belief about ADD until recently was that it disappeared in adulthood. I remember being told this is by one psychiatrist and told by another to try taking caffeine. This later fellow told me didn't know much about it, that he vaguely remembered one lecture that touched on it in his med schooling/residency. Sadly, both these chaps were CMHS psychiatrists, the only resource available to folks in that area.

 

Re: Addiction to Dexedrine

Posted by saint james on December 6, 1999, at 20:28:34

In reply to Re: Addiction to Dexedrine, posted by Zeke on December 6, 1999, at 8:39:44

>
> saint james, you said,"The best and most common, tried and true cocktail for adult ADD is stim + AD." Are you sure of that? I know where you're coming from: Anxiety and dysthymia are frequenly coexist in adults with ADD and so these meds are often given. Yet I haven't read any studies saying that this combination (AD + stim) is "the rule" in adult ADD (excepting individual physicians' own preferences, eg, J Beiderman).
>
> I'm curious, does Effexor interact with amphetamine as the tricyclics do, ie, does it increase amphetamine levels in the brain? SSRIs -- probably the most common ADs -- don't have this effect.
>


James here....

On the adult ADD lists most are on AD + stim. Depression is often comorbid in ADD. Even if it is not many ADD'ers find AD reduce brain clutter.

I can't speak for SSRI's and stims, SSRI's are of no use in me because I am an nor-e person. The TCA's and Effexor do increase effectiveness and levels of stims and vice versa. I have to account for this fact when choosing doses of each. (Effexor and Dexadrine) However in general most of the psyco meds will increase levels and sometimes effectivness. This is one reason why polydrug treatment works.

j

 

Re: Addiction to Dexedrine

Posted by greg on January 16, 2000, at 0:26:52

In reply to Addiction to Dexedrine, posted by Tracy on December 1, 1999, at 3:11:35

> I was diagnosed with adult onset add about 3 years ago. My doctor started me on Ritalin and after 8 months my tolerance increased so much that I was switched to Dexedrine. I've been taking Dexedrine for the past two years now. My initial dose was 30 mg. per day (2 5mg tabs 3x a day). Now I can barely feel the effects of 100+mg per day. I know that I am severely addicted yet at the same time I feel powerless to do anything about it. On the medication I can work 60 hour weeks and still have plenty of energy. I'm afraid
> of how my life will change if I discontinue its use but I know it is impossible to continue on in this pattern. Dexedrine has also helped control my appetite and stay at a desirable weight. Are there any others out there who share my problem?

100 mg seem way too high of a dose for add. Im not a Doctor but i wouldnt go any higher with your dose.I am a 31 year old male with add. I have been taking Dexedrine for 2 weeks. It has really helped me with day to day tasks.I think there is a lot of positive things if it is used at a safe dose. I take 30mg a day and it is working fine for me . Even if my body adjusts to that level i wont take the mg any higher. As a part business owner over 25 employees I also work long hours but i find time 5 days a week to get to the gym for 1 hour and 15 minutes. I work hard at keeping fit at 5-10 180lb. I dont rely on dexedrine to maintain my weight. Please take time to get on a exercise program and nutritious diet.
This will help you feel a lot better mentally and
physically!

 

Re: Addiction to Dexedrine

Posted by Scott L. Schofield on January 16, 2000, at 20:51:17

In reply to Re: Addiction to Dexedrine, posted by saint james on December 6, 1999, at 20:28:34


> > saint james, you said,"The best and most common, tried and true cocktail for adult ADD is stim + AD." Are you sure of that? I know where you're coming from: Anxiety and dysthymia are frequenly coexist in adults with ADD and so these meds are often given. Yet I haven't read any studies saying that this combination (AD + stim) is "the rule" in adult ADD (excepting individual physicians' own preferences, eg, J Beiderman).

> > I'm curious, does Effexor interact with amphetamine as the tricyclics do, ie, does it increase amphetamine levels in the brain? SSRIs -- probably the most common ADs -- don't have this effect.

> On the adult ADD lists most are on AD + stim. Depression is often comorbid in ADD. Even if it is not many ADD'ers find AD reduce brain clutter.

> I can't speak for SSRI's and stims, SSRI's are of no use in me because I am an nor-e person. The TCA's and Effexor do increase effectiveness and levels of stims and vice versa. I have to account for this fact when choosing doses of each. (Effexor and Dexadrine) However in general most of the psyco meds will increase levels and sometimes effectivness. This is one reason why polydrug treatment works.

About 15 years or so ago, I knew of someone (adult) for whom imipramine (Trofranil) monotherapy seemed effective. I have come across a few posts suggesting that bupropion (Wellbutrin) can also be effective.

What are the current thoughts regarding these two drugs and their use in drug combinations?


- Scott

 

Scott -- Desipramine, Wellbutrin

Posted by Zeke on January 17, 2000, at 15:37:30

In reply to Re: Addiction to Dexedrine, posted by Scott L. Schofield on January 16, 2000, at 20:51:17

> About 15 years or so ago, I knew of someone (adult) for whom imipramine (Trofranil) monotherapy seemed effective. I have come across a few posts suggesting that bupropion (Wellbutrin) can also be effective.

There is some logic to that since desipramine is said to be sometimes effective for ADD and imipramine is metabolized to desipramine. Neither did much for my ADD though. Imipramine/desipramine effect norepinephrine but not dopamine -- probably why it's not quite as effective as the psychostimulants. However, Adderral contains levo isomers of amphetamine (25%) which only effect norepinephrine. Dextro isomers (ergo 'Dex'-edrine) effect both dopamine and norepinephrine. So there is probably some role for norepinephrine in ADD.

Wellbutrin (bupropion) is related to the stimulant diethylpropion, and does effect dopamine in a stimulant like manner (although its mechanism is debated) so that's likely the reason for its greater efficacy in ADD. For me all it did was create headaches and a rash (and an unhappy doctor who had amphetamine paranoia).

Tricyclic ADs (eg, desipramine) also increase blood/brain levels of amphetamine(eg, Dexedrine). For what its worth you can also increase the effect of amphetamine by taking a little sodium bicarbonate (Baking Soda/ingredient of AlkaSeltzer) with it. That increases absorbtion and decreases the kidneys' removal of amphetamine. (But don't do this often as it [baking soda] will mess up your electrolytes!)

 

Questions about depression

Posted by household06 on February 14, 2002, at 13:44:26

In reply to Scott -- Desipramine, Wellbutrin, posted by Zeke on January 17, 2000, at 15:37:30

I have been diagnosed with depression, and have tried so many AD's that I am getting frustrated. I have been on celexa, trazodone, effexor, celexa & trazodone, and now all three. They seem to work for a little while, but then I am back at square one. I have heard good things about dexadrine, as far as helping with the energy level during the day. I would like to hear from anyone that has been prescribed dexadrine to help with depression. Also, what dosage, and any adverse reactions.

 

amphetamine for depression household06

Posted by Elizabeth on February 15, 2002, at 8:54:57

In reply to Questions about depression, posted by household06 on February 14, 2002, at 13:44:26

I tried taking Dexedrine once briefly. I was also taking Parnate at the time, and the Dexedrine caused my blood pressure to go up a lot so I didn't continue taking it, but this shouldn't happen if you're not taking a MAOI (if you haven't tried MAOIs, you should consider it). A lot of people find that amphetamine helps them feel more motivated and improves their concentration as well as giving them more energy. Some people with depression have symptoms suggestive of ADD, and for them stimulants are often helpful.

10-20 mg/day would be a typical starting dose. How to divide it depends on which formulation you're taking (immediate-release or sustained-release).

-elizabeth

 

Re: amphetamine for depression

Posted by BLPBart on February 15, 2002, at 9:28:23

In reply to amphetamine for depression household06, posted by Elizabeth on February 15, 2002, at 8:54:57

> I tried taking Dexedrine once briefly. I was also taking Parnate at the time, and the Dexedrine caused my blood pressure to go up a lot so I didn't continue taking it, but this shouldn't happen if you're not taking a MAOI (if you haven't tried MAOIs, you should consider it). A lot of people find that amphetamine helps them feel more motivated and improves their concentration as well as giving them more energy. Some people with depression have symptoms suggestive of ADD, and for them stimulants are often helpful.
>
> 10-20 mg/day would be a typical starting dose. How to divide it depends on which formulation you're taking (immediate-release or sustained-release).
>
> -elizabeth


I originally started on celexa and prozac and had bad side effects. The prozac especially caused me to be extremely lethargic and unmotivated. I switched to wellbutrin which helped a lot but then my dr and I decided to add dexedrine SR just this past monday because I show definite signs of inattentive ADD. I am definitely feeling more motivated- I come home from work and actually still have the energy to make dinner, take care of bills, etc. where before I'd come home exhausted from work and then everything else would pile up just adding to my frustration and stress level. I'm starting on 10 mg/day and am going to titrate up by 10 mg/day each week until my dr and I feel the dosage is right. I'm also getting back into my running routine which I had completely stopped while on the prozac.

 

Re: Questions about depression

Posted by manowar on February 15, 2002, at 17:53:18

In reply to Questions about depression, posted by household06 on February 14, 2002, at 13:44:26

Hello,
I know how you feel. Hang in there, and learn as much as you can about this disorder.
I think many on this BB are the type of depressives that DON'T do well on serotonergic type meds. I certainly don't.

Unfortunately, typical pstims like Dexedrine can help depression for a little while, but the effect soon wears off, and we're back to square one again. That's why no pdocs that I know of in this area of the country prescribe typical pstims like Dexedrine for people with depression.

The good news is that if an antidepressant is not working, some pdocs will augment an antidepressant with a pstim and sometimes the combo works wonders. I personally don't know of any doctors around here that will do that, but it seems to be commonplace in other areas around the country and world.

Try the non-serotonergic, non-tricyclic drugs like Wellbutrin. Wellbutrin has a very benign side effect profile and is very stimulating for most people. Another avenue to take is to try Modafinil (Provigil). Provigil is a drug indicated to treat people for Narcolepsy, but many people, including myself, experience a huge increase in energy and vigilance. It also has a powerful anti-depressant effect. Its very expensive, but for me it works wonders with a side effect profile of zero. It is considered a pstim, but fortunately its not a controlled drug like other pstims.

Keep the faith, and get better soon,

Tim


> I have been diagnosed with depression, and have tried so many AD's that I am getting frustrated. I have been on celexa, trazodone, effexor, celexa & trazodone, and now all three. They seem to work for a little while, but then I am back at square one. I have heard good things about dexadrine, as far as helping with the energy level during the day. I would like to hear from anyone that has been prescribed dexadrine to help with depression. Also, what dosage, and any adverse reactions.

 

Re: Questions about depression

Posted by Elizabeth on February 16, 2002, at 11:50:47

In reply to Re: Questions about depression, posted by manowar on February 15, 2002, at 17:53:18

> Unfortunately, typical pstims like Dexedrine can help depression for a little while, but the effect soon wears off, and we're back to square one again. That's why no pdocs that I know of in this area of the country prescribe typical pstims like Dexedrine for people with depression.

That's the reputation of stimulants. I don't know if it's really true. It certainly isn't true for everyone; amphetamine was a standard treatment for depression before MAOIs and TCAs were discovered. A relative of mine who died a couple years ago took it for years with no tolerance developing. I think it's more likely that the doctors in your area who never prescribe Dexedrine for depression are simply very conservative, because stimulants can be very effective for some depressed people who need catecholaminergic drugs rather than serotonergic ones.

> The good news is that if an antidepressant is not working, some pdocs will augment an antidepressant with a pstim and sometimes the combo works wonders.

If tolerance really were an inevitable consequence of taking stimulants for depression, people would become tolerant regardless of whether they were also taking an antidepressant or not. Also, I think that in most cases, if an antidepressant really isn't working, switching to something else is a better idea than augmenting. My guess is that people who have sudden miraculous responses when a stimulant is added to an ineffective antidepressant are responding to the stimulant and that discontinuing the antidepressant would probably make little or no difference (except for causing fewer side effects and saving the patient some money).

> Try the non-serotonergic, non-tricyclic drugs like Wellbutrin. Wellbutrin has a very benign side effect profile and is very stimulating for most people.

I haven't been too impressed by what I've heard about Wellbutrin. It seems to work well for some people, but most people who take it are using it for augmentation or to counteract SSRI (or, occasionally, MAOI) side effects. If someone needs a catecholaminergic drug rather than a serotonergic one, I would expect a stimulant (Dexedrine, Adderall, Ritalin/Concerta, Cylert, Provigil) to be more effective than Wellbutrin.

> Another avenue to take is to try Modafinil (Provigil).

This seems like a better idea than Wellbutrin. I've heard many positive stories about modafinil. The main complaint people seem to have is that it costs too much. It really isn't a great antinarcoleptic since it doesn't treat cataplexy; it's better for depression and ADD, IMO. The risk of tolerance to modafinil is probably not that different from the risk of tolerance to Dexedrine.

> It is considered a pstim, but fortunately its not a controlled drug like other pstims.

It is a controlled substance, but like Cylert, it's only C-IV.

-elizabeth

 

Dexedrine/Provigil Tolerance? Elizabeth

Posted by IsoM on February 16, 2002, at 19:53:29

In reply to Re: Questions about depression, posted by Elizabeth on February 16, 2002, at 11:50:47

> > "...I've heard many positive stories about modafinil. The main complaint people seem to have is that it costs too much. It really isn't a great antinarcoleptic since it doesn't treat cataplexy; it's better for depression and ADD, IMO. The risk of tolerance to modafinil is probably not that different from the risk of tolerance to Dexedrine."

Elizabeth, most people with narcolepsy don't experience cataplexy that often or as severe as it's sometimes dramatisised. Most of us just experience muscle weakness & trouble standing (tend to collapse unless sitting, then we keel over in the laughter or tears). Most of us find the most troubling aspect of narcolepsy is fighting the constant all-day sleepiness. That's why modafinil & adrafinil is so good. We can finally be productive without spending enormous effort at trying to stay awake & alert.

The review I read of adrafinil done by CNS Reviews by a team at Toronto, said that even after 3 years or more of use, tolerance to adrafinil wasn't seen.
http://www.nevapress.com/cnsdr/full/5/3/193.pdf

I do know I could build tolerance to Dexedrine fairly quick when used continuously. I would give myself frequent drug holidays as what would once keep me alert soon lost its effect & would instead need an increase - something I wouldn't do, hence the drug holidays.

 

Re: Dexedrine/Provigil Tolerance? IsoM

Posted by Ritch on February 16, 2002, at 21:35:59

In reply to Dexedrine/Provigil Tolerance? Elizabeth, posted by IsoM on February 16, 2002, at 19:53:29

> > > "...I've heard many positive stories about modafinil. The main complaint people seem to have is that it costs too much. It really isn't a great antinarcoleptic since it doesn't treat cataplexy; it's better for depression and ADD, IMO. The risk of tolerance to modafinil is probably not that different from the risk of tolerance to Dexedrine."
>
> Elizabeth, most people with narcolepsy don't experience cataplexy that often or as severe as it's sometimes dramatisised. Most of us just experience muscle weakness & trouble standing (tend to collapse unless sitting, then we keel over in the laughter or tears). Most of us find the most troubling aspect of narcolepsy is fighting the constant all-day sleepiness. That's why modafinil & adrafinil is so good. We can finally be productive without spending enormous effort at trying to stay awake & alert.
>
> The review I read of adrafinil done by CNS Reviews by a team at Toronto, said that even after 3 years or more of use, tolerance to adrafinil wasn't seen.
> http://www.nevapress.com/cnsdr/full/5/3/193.pdf
>
> I do know I could build tolerance to Dexedrine fairly quick when used continuously. I would give myself frequent drug holidays as what would once keep me alert soon lost its effect & would instead need an increase - something I wouldn't do, hence the drug holidays.


Hi IsoM,

When I increase dosages of SSri's I get the most hypomanic, but the weird thing is...I tend to have spells of laughter. Sometimes the laughter spells involve loss of consciousness (a few seconds). For example, if someone tells me a really good joke and I respond with some laughter I will see *spots* in my eyes and I will sometimes fall to the floor. Does this not sound like the *cataplexy* involved with narcolepsy??

Mitch

 

Cataplexy? Ritch

Posted by IsoM on February 16, 2002, at 22:17:30

In reply to Re: Dexedrine/Provigil Tolerance? IsoM, posted by Ritch on February 16, 2002, at 21:35:59

> > "...I tend to have spells of laughter. Sometimes the laughter spells involve loss of consciousness (a few seconds). For example, if someone tells me a really good joke and I respond with some laughter I will see *spots* in my eyes and I will sometimes fall to the floor. Does this not sound like the *cataplexy* involved with narcolepsy??"

Not really. I'm definitely no expert on narcolepsy but if symptoms are characteristc, I'd think it's a good chance that whoever had them would also have narcolepsy. But this doesn't sound like it. It's not so much as falling unconscious as sudden, unexpected emotion (a shock, crying, laughter can trigger the cataplexy part causing muscle weakness ranging from just wobbly muscles to complete loss of control (fall down, lose consciousness)

There's generally a tetrad of symptoms with narcolepsy. Here's a site on it, one of the best, I think:
http://www.sleepdisorderchannel.net/narcolepsy/

Even if it doesn't sound like cataplexy to me (like I said - I'm no expert), check out to see if anything else related to your sleep sounds like it. If it does, you might want to check it out with a doctor who really recognises narcolepsy. Too many still think you have to fall over into an immediate sleep to qualify. Otherwise, I'm sorry to tell you but I'm baffled - haven't heard anything like this of yours.

 

Re: Questions about depression Elizabeth

Posted by manowar on February 19, 2002, at 15:57:04

In reply to Re: Questions about depression, posted by Elizabeth on February 16, 2002, at 11:50:47

Hello Elizabeth,

You make some very good points as usual. I've got a few questions for you:

> This seems like a better idea than Wellbutrin. I've heard many positive stories about modafinil. The main complaint people seem to have is that it costs too much. It really isn't a great antinarcoleptic since it doesn't treat cataplexy; it's better for depression and ADD, IMO. The risk of tolerance to modafinil is probably not that different from the risk of tolerance to Dexedrine.

What is cataplexy?
What does IMO mean?

>
> > It is considered a pstim, but fortunately its not a controlled drug like other pstims.
>
> It is a controlled substance, but like Cylert, it's only C-IV.

What's the difference between a regular drug and C-IV drug?

Thanks,
Tim

 

Stimulant Monotherapy for Depression Elizabeth

Posted by fachad on February 19, 2002, at 20:45:12

In reply to Re: Questions about depression, posted by Elizabeth on February 16, 2002, at 11:50:47

Elizabeth wrote:

"My guess is that people who have sudden miraculous responses when a stimulant is added to an ineffective antidepressant are responding to the stimulant and that discontinuing the antidepressant would probably make little or no difference (except for causing fewer side effects and saving the patient some money)."

That's exactly how it worked for me - after a long trail of ineffective ADs, my pdoc added Ritalin. Later, I discontinued all ADs and just took Ritalin, and it's remained effective against my depression at the same dose for years.

I did switch to Concerta, so you can forget about that "saving some money" part.

> > Unfortunately, typical pstims like Dexedrine can help depression for a little while, but the effect soon wears off, and we're back to square one again. That's why no pdocs that I know of in this area of the country prescribe typical pstims like Dexedrine for people with depression.
>
> That's the reputation of stimulants. I don't know if it's really true. It certainly isn't true for everyone; amphetamine was a standard treatment for depression before MAOIs and TCAs were discovered. A relative of mine who died a couple years ago took it for years with no tolerance developing. I think it's more likely that the doctors in your area who never prescribe Dexedrine for depression are simply very conservative, because stimulants can be very effective for some depressed people who need catecholaminergic drugs rather than serotonergic ones.
>
> > The good news is that if an antidepressant is not working, some pdocs will augment an antidepressant with a pstim and sometimes the combo works wonders.
>
> If tolerance really were an inevitable consequence of taking stimulants for depression, people would become tolerant regardless of whether they were also taking an antidepressant or not. Also, I think that in most cases, if an antidepressant really isn't working, switching to something else is a better idea than augmenting. My guess is that people who have sudden miraculous responses when a stimulant is added to an ineffective antidepressant are responding to the stimulant and that discontinuing the antidepressant would probably make little or no difference (except for causing fewer side effects and saving the patient some money).
>
> > Try the non-serotonergic, non-tricyclic drugs like Wellbutrin. Wellbutrin has a very benign side effect profile and is very stimulating for most people.
>
> I haven't been too impressed by what I've heard about Wellbutrin. It seems to work well for some people, but most people who take it are using it for augmentation or to counteract SSRI (or, occasionally, MAOI) side effects. If someone needs a catecholaminergic drug rather than a serotonergic one, I would expect a stimulant (Dexedrine, Adderall, Ritalin/Concerta, Cylert, Provigil) to be more effective than Wellbutrin.
>
> > Another avenue to take is to try Modafinil (Provigil).
>
> This seems like a better idea than Wellbutrin. I've heard many positive stories about modafinil. The main complaint people seem to have is that it costs too much. It really isn't a great antinarcoleptic since it doesn't treat cataplexy; it's better for depression and ADD, IMO. The risk of tolerance to modafinil is probably not that different from the risk of tolerance to Dexedrine.
>
> > It is considered a pstim, but fortunately its not a controlled drug like other pstims.
>
> It is a controlled substance, but like Cylert, it's only C-IV.
>
> -elizabeth

 

Re: Dexedrine Tolerance?

Posted by Zo on February 20, 2002, at 0:48:04

In reply to Dexedrine/Provigil Tolerance? Elizabeth, posted by IsoM on February 16, 2002, at 19:53:29

Sorry, you could build up a tolerance for Dex, or you have?

I've not heard of same, not in weeny Rx amounts. I can only stand 15mg on special days. . . And I am going to be on Dex rest of this life.

Best,
Zo

 

Re: Dexedrine Tolerance? Zo

Posted by IsoM on February 20, 2002, at 2:22:33

In reply to Re: Dexedrine Tolerance?, posted by Zo on February 20, 2002, at 0:48:04

Not sure if your question is meant for me, but I can (& have) developed a certain tolerance for Dexedrine before. I no longer take it but use adrafinil instead which is supposed to have a record of no tolerance build-up.

 

Re: Dexedrine Tolerance?

Posted by Geezer on February 20, 2002, at 10:12:05

In reply to Re: Dexedrine Tolerance?, posted by Zo on February 20, 2002, at 0:48:04

Can anyone tell me why one person would develope tolerance to Dex. while someone else would not? I can completely agree with Elizabeth's post - when a stim. is added to an ineffective AD, probably the effect felt is from the stim. and has nothing to do with the AD. Every time I used Dex. I experienced EUPHORIA (at any dose), Tolerance developed quickly and abuse went like a rocket.

I have tried 2 doses of Provigil 100mg. (now, after the fact, I understand this drug requires some time to work). Provigil felt like the bumbed-out rebound depression I used to get when the Dex. wore off.

I am not looking for a way to take pstims again - God knows I have paid the price for that. I would like to understand WHY a drug that could mean death for one can be helpful to another. I guess that is the purpose of this board.

All comments welcome......Thank you

Geezer

 

Re: Dexedrine Tolerance? A Theory Geezer

Posted by fachad on February 21, 2002, at 8:21:28

In reply to Re: Dexedrine Tolerance?, posted by Geezer on February 20, 2002, at 10:12:05

Geezer,

As I posted in response to Elizabeth, I responded to a pstim (Ritalin) and was able to drop the AD (Serzone) without any loss of response.

In answer to your question about how some develop tolerance and some do not, I think it can be predicted by how a person perceives the initial drug effects.

If the initial "zap" that you experience from a pstim is experienced as euphoric, and you develop a liking for that feeling of euphoria, you will have to constantly increase the dose to get that same level of euphoria.

On the other hand, in my case, the initial "zap" was moderately disphoric - I felt edgy and uncomfortable - BUT my depression lifted.

I actually looked forward to developing "tolerance" to the zap so I could just enjoy not being depressed without being edgy.

After about a month of daily Ritalin, the "unsettled" feeling went away and it has worked for my depression for 7 years.

I think a valid analogy would be if someone really got off on the sedation an OTC antihistamine like Benadryl vs. someone whose allergies are relived by Benadryl.

The first person would find the drowsiness to wear off after a few days of constant use, and would have to increase the dose to get the same effect.

But the other person would find his allergies relived at the same dose for years, because histamine is still blocked, even though the subjective drowsiness is no longer perceived.

Just a guess, but it makes sense to me.

> Can anyone tell me why one person would develope tolerance to Dex. while someone else would not? I can completely agree with Elizabeth's post - when a stim. is added to an ineffective AD, probably the effect felt is from the stim. and has nothing to do with the AD. Every time I used Dex. I experienced EUPHORIA (at any dose), Tolerance developed quickly and abuse went like a rocket.
>
> I have tried 2 doses of Provigil 100mg. (now, after the fact, I understand this drug requires some time to work). Provigil felt like the bumbed-out rebound depression I used to get when the Dex. wore off.
>
> I am not looking for a way to take pstims again - God knows I have paid the price for that. I would like to understand WHY a drug that could mean death for one can be helpful to another. I guess that is the purpose of this board.
>
> All comments welcome......Thank you
>
> Geezer

 

Re: Dexedrine Tolerance? A Theory

Posted by Geezer on February 21, 2002, at 11:08:54

In reply to Re: Dexedrine Tolerance? A Theory Geezer, posted by fachad on February 21, 2002, at 8:21:28

fachad,

Thank you so very much for your response RE: pstims. You have answered a question that goes far beyond casual interest in terms of importance.

The key factor you mentioned - "zap" = EURPHORIA, I believe and agree, is the predictor to good therapeutic treatment OR tolerance, abuse and serious consequences. My last experience with Dex. was 1985 (had abuse going back to 1962-intermittent). I started with 15mg. in AM, 4 months later I had increased the dose to 150mg. per day (honest). This episode required my full attention all day every day. I had 5 different docs writing scripts-had them filled at 5 different drug stores.

What ended the run? A pharmacist recognized my abuse and confronted me. He made it clear - detox. or else!

Here is what I have learned:

1) One size does not fit all. Pstims can be a blessing for some folks with depression and add but a potential death sentence for others with unstable mood disorders (I have Bipolar II-DXed in 2001).
2) The "zap theory". Any thing that makes you feel like Super Man with the first dose is no good for you.
3) Self medication based on my own subjective and flawed knowledge of psyc. meds. may result in a poor outcome.
4) A CORRECT DX is essential for treatment (never trust a pdoc that won't share the DX with you).
5) Modern day Mood Specialists (Psychopharmacologists) and contemporary psyc. drugs offer me a much better chance at survival (IMHO and yes I do men survival) than I had 30 years ago.

Thanks fachad.....I take your post as much more than "just a guess". Important stuff to a "Geezer" looking for answers.

 

Re: Dexedrine Tolerance? A Theory fachad

Posted by IsoM on February 21, 2002, at 13:01:23

In reply to Re: Dexedrine Tolerance? A Theory Geezer, posted by fachad on February 21, 2002, at 8:21:28

I think it sounds like a pretty good guess but...

I can develop a tolerance to Dexedrine & I do experience that inital euphoria. But my 26 yr old son can also develop a tolerance to it & feels no euphoria on it at all. I was surprised he didn't - I assumed everyone would & questioned him about it. It only serves to keep him awake & focused. No euphoria whatsoever.


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