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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by julepp on February 18, 2000, at 9:09:15
I've been on Adderal for about 10 months or so now - am up to 30mgs three times daily.
I've not been on any AD for just about a month(been on just about all of them but Prozac and discontinued due to unpleasant side effects).
I am constantly tired(even with the above dose of Adderal), experiencing mood swings, bouts of crying for no reason and insomnia.
Does anyone have any suggestions?
My current meds are Adderal, Estrace 2mg daily(HRT due to hysterectomy 19 yrs. ago), Soma 350mg up to three times daily(if needed, for old back injury) and Ambien 10 mgs at bedtime if needed(most times I do).
Any suggestions would be appreciated!!
julepp
Posted by JohnL on February 19, 2000, at 4:24:40
In reply to HELP!!!, posted by julepp on February 18, 2000, at 9:09:15
It's not uncommon for a drug to destabilize. Were you doing well with Adderall at one time? If so, then you may need to take something to restabilize it. If not, then it may be the wrong drug altogether. If it never did well with you, trying 2 or 3 others within the same class would make sense at this point. Though they are all similar, they are also quite different. A patient will usually respond much better to one over the others.
If the Adderall worked well at one point, the two most straightforward approaches to restore stability are, first, add a low dose antipsychotic (may have to briefly try two or three to discover a favorite); and second, add a chemical/electrical stabilizer like Lithium, Tegretal, or Depakote. Newer ones like Lamictal or Neurontin are fine choices too.
Sometimes a stimulant will overcompensate NE/dopamine in parts of the brain where it isn't needed, while normalizing other parts where it is needed. A small dose antipsychotic will counter the overcompensation in certain parts of the brain. A stimulant with an antipsychotic or a mood stabilizer can be a wonderful combination.
On the other hand, if the Adderall never worked well anyway, then it makes sense to try 2 or 3 other stimulants instead, before considering other options. Trials can be done in time frames of 1 week each for quick exploration.
Posted by julepp on February 19, 2000, at 10:26:12
In reply to Re: HELP!!!, posted by JohnL on February 19, 2000, at 4:24:40
Thanks John!
The Adderal worked great until about a month ago.
That's when the overwhelming fatigue started.
I've been thinkinking about asking my psych doc to try something with it(I see her in 2 weeks).
Yesterday I found out I have gallstones(one the size of a nickel) and kidney stones in both kidneys(I went in for an x-ray of my thoracic spine).
If a stone is blocking the bile duct(either partial or total obstruction) it could cause or contribute to the fatigue(I've had some back pain on the upper right side off and on for a few months, but not much gastric distress).
Hopefully, when I get the gallbladder out(liver enzymes back to normal level), and get something added to help the mood swings, I'll get lined out
Thanks again for your input
This is the end of the thread.
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