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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by MarkG on March 29, 2001, at 15:02:41
Hello,
I have struggled with depression for years (I am 28). I have tried Prozac, Zoloft, Effexor, Remeron, and Wellbutrin without a whole lot of success. About 5 weeks ago I started Parnate- I have been feeling less depressed but still having continued difficulties concentrating, organizing, comprehending reading, etc. I noticed for the first two weeks I took Parnate I felt so NORMAL! I was very focused, could get work done, and so everything else seemed to fall in place. Unfortunately this did not last.
I talked with my doc and he said that it sounds like I responded to the amphetamine properties of Parnate and that I might respond favorably to stimulants. After he said this, I looked into the uses for stimulants and discovered that they are commmonly used to treat ADHD. I then discovered that the criteria for ADHD, inattentive type seems to really explain the way I have been and felt since childhood.
I am really wondering if my depression is a result in part to ADD probs? Does anyone have any long-term experience with stimulants with similar kinds of situations/conditions? I am especially interested in the effects of Adderall use long term- decreased efficacy, tolerance build up, side effects, etc.
Other peoples experiences or info re: this would be much appreciated, THANKS!
MarkG
Posted by Dubya on March 29, 2001, at 17:09:05
In reply to Depression, ADHD (Inattentive), and stimulants, posted by MarkG on March 29, 2001, at 15:02:41
In a sense, ADD/ADHD can cause depression also, they can exist together and make ADD/ADHD/depression even more severe. I think ADD/ADHD has to do with the DOPAMINE levels in the brain thus, you seem to react "favourably" to stimulants.
Posted by MarkinBoston on March 29, 2001, at 17:20:41
In reply to Depression, ADHD (Inattentive), and stimulants, posted by MarkG on March 29, 2001, at 15:02:41
Recently (through reading here), my condition also seems to be ADD, inattentive or depressive type. Effexor has helped for major episodes, but eventually sapped my motivation and I'd go off it. This go round, I tried stimulants for the first time. They did not take the place of Effexor, but sure helped with mood, concentration, memory, and sociability. I started on Ritalin, grew tolarant to it over a few months, switched to Adderall, and after a few months, I'm tolarant of it so that 40mg in the AM affects me about as much as a cup of coffee except the blood pressure and heart rate increase is greater and of concern.
I see my doc tomorrow to discuss this and ADD. It may be time to switch to another stimulant. There are a number of them to go yet.
Posted by SalArmy4me on March 31, 2001, at 10:20:58
In reply to Depression, ADHD (Inattentive), and stimulants, posted by MarkG on March 29, 2001, at 15:02:41
Your doc couldn't expand his horizons and prescribe MAOI + Stimulants? Its mentioned prominently in the Tips, and I used that combination without incident.
> Hello,
>
> I have struggled with depression for years (I am 28). I have tried Prozac, Zoloft, Effexor, Remeron, and Wellbutrin without a whole lot of success. About 5 weeks ago I started Parnate- I have been feeling less depressed but still having continued difficulties concentrating, organizing, comprehending reading, etc. I noticed for the first two weeks I took Parnate I felt so NORMAL! I was very focused, could get work done, and so everything else seemed to fall in place. Unfortunately this did not last.
>
> I talked with my doc and he said that it sounds like I responded to the amphetamine properties of Parnate and that I might respond favorably to stimulants. After he said this, I looked into the uses for stimulants and discovered that they are commmonly used to treat ADHD. I then discovered that the criteria for ADHD, inattentive type seems to really explain the way I have been and felt since childhood.
>
> I am really wondering if my depression is a result in part to ADD probs? Does anyone have any long-term experience with stimulants with similar kinds of situations/conditions? I am especially interested in the effects of Adderall use long term- decreased efficacy, tolerance build up, side effects, etc.
>
> Other peoples experiences or info re: this would be much appreciated, THANKS!
>
> MarkG
Posted by MarkG on March 31, 2001, at 14:34:08
In reply to Re: Depression, ADHD (Inattentive), and stimulants, posted by SalArmy4me on March 31, 2001, at 10:20:58
Hi Sal,
When I had a rise and fall on the Parnate, my doc said that it sounds like stimulants might be an option- maybe with a "more traditional" type of antidepressant. He seems really reluctant to add on a stimulant to the Parnate though, saying it's "really dicey." Overall, I feel slightly better with Parnate, I don't feel irritable and I don't have that sinking depressed feeling. But I have a lot of fatigue, lack of motivation, and continued anhedonia, inattention, and head fog. So, what MAOI were you taking and with what stimulant? Was it effective? How long have you been or were you on that combo? Sorry so long. Just trying to figure all of this out. Thanks! MarkG
> Your doc couldn't expand his horizons and prescribe MAOI + Stimulants? Its mentioned prominently in the Tips, and I used that combination without incident.
>
> > Hello,
> >
> > I have struggled with depression for years (I am 28). I have tried Prozac, Zoloft, Effexor, Remeron, and Wellbutrin without a whole lot of success. About 5 weeks ago I started Parnate- I have been feeling less depressed but still having continued difficulties concentrating, organizing, comprehending reading, etc. I noticed for the first two weeks I took Parnate I felt so NORMAL! I was very focused, could get work done, and so everything else seemed to fall in place. Unfortunately this did not last.
> >
> > I talked with my doc and he said that it sounds like I responded to the amphetamine properties of Parnate and that I might respond favorably to stimulants. After he said this, I looked into the uses for stimulants and discovered that they are commmonly used to treat ADHD. I then discovered that the criteria for ADHD, inattentive type seems to really explain the way I have been and felt since childhood.
> >
> > I am really wondering if my depression is a result in part to ADD probs? Does anyone have any long-term experience with stimulants with similar kinds of situations/conditions? I am especially interested in the effects of Adderall use long term- decreased efficacy, tolerance build up, side effects, etc.
> >
> > Other peoples experiences or info re: this would be much appreciated, THANKS!
> >
> > MarkG
Posted by SalArmy4me on April 1, 2001, at 18:35:52
In reply to Re: Depression, ADHD (Inattentive), and stimulants » SalArmy4me, posted by MarkG on March 31, 2001, at 14:34:08
I took Nardil with Ritalin; Parnate with dextroamphetamine. They didn't wake me up, though.
I think the reason that Parnate was so good for you is that it works on many chemicals in the brain. But you can get that same effect with something that isn't so old and incompatibile with every other medication known to mankind.
Here are some good ones: venlafaxine (it can work on 3 chemicals at a high dose), mirtazapine, desipramine
Or, you can do a combo to hit every chemical like venlafaxine + mirtazapine + buproprion
Posted by Sulpicia on April 1, 2001, at 21:48:19
In reply to Depression, ADHD (Inattentive), and stimulants, posted by MarkG on March 29, 2001, at 15:02:41
>Hi Mark
Depression is ADD/HD's favorite comorbid! To think of it, I've never met or corresponded
with an ADDult who didn't have depression either once or twice, or chronically.
I've suffered from depression for a dog's age -- OK at times, on meds, off meds yada yada.
I also had what I thought were some weird learning disability things, difficulty in concentrating,
reading, retention etc. A real *pleasure* to have while doing a doctorate, let me tell you.
Any way, my son was tested for ADD [inattentive, no hyper stuff], he flunked, but I passed.
I wish I could say I lived happily ever after but it's true only to a certain extent.
Yes it was fabulous to realize what was wrong, yes adderall relieved the symptoms extremely well
but when I started the pstim it disagreed with the AD I was on. Hence a very ugly speedy switch to tofranil
which is working quite well.
Suggestions: go to the ADD site at About.com and read up.
Not many pdocs have experience with adults. Under ideal circumstances it's a pain in the a$$ to get
the pstim dose right, or the med. You'll have to educate yourself.
My depression is relieved, but it was also relieved by the AD meds. I still need therapy -- but that's
just me. :):)
Questions?
good luck.
S.
Posted by MarkG on April 2, 2001, at 1:31:09
In reply to Re: Depression, ADHD (Inattentive), and stimulants, posted by SalArmy4me on April 1, 2001, at 18:35:52
Hi Sal,Thanks for the response. I have tried venflaxine (Effexor) and mirtazapine (Remeron). Effexor was mildly effective for awhile, preventing me from any bottom out periods. Remeron for me was like being in a dark cloud for several months. Good sleep but no emotion, extreme depression. Actually, I'm beginning to wonder if increasing serotonin levels, in my case, is such a good thing. What makes me believe that a stimulant might be effective is that the Parnate was most effective from day 1 (within an hour or two of the first pill) until the end of the first week and a half. Since then, I haven't had the feeling of swimming in a bottomless cup of depression but still feeling blah, very slow, and fatigued- and still having concentration probs.
If my doc is unwilling to add a stim to Parnate, I'm wondering if going back to Wellbutrin w/a stimulant might help. Oh, as far as combos hitting the big 3 NTs, I tried Wellbutrin + Remeron. This seemed to reduce the extreme mental fog and emotional blocking of Remeron for me, and gave me quite a boost, but didn't lift my mood.
What was your Parnate + dex experience like? What combo are you on now?
Mark
> I took Nardil with Ritalin; Parnate with dextroamphetamine. They didn't wake me up, though.
>
> I think the reason that Parnate was so good for you is that it works on many chemicals in the brain. But you can get that same effect with something that isn't so old and incompatibile with every other medication known to mankind.
>
> Here are some good ones: venlafaxine (it can work on 3 chemicals at a high dose), mirtazapine, desipramine
>
> Or, you can do a combo to hit every chemical like venlafaxine + mirtazapine + buproprion
Posted by MarkG on April 2, 2001, at 1:39:53
In reply to Re: Depression, ADHD (Inattentive), and stimulants » MarkG, posted by Sulpicia on April 1, 2001, at 21:48:19
Hi S.,
Thanks for your story. Yes, yes, I too can relate to the "pleasure" of struggling while in a doctoral program. I've always said that I love a challenge!
So what exactly is Tofranil, an AD? I haven't heard of that before. Also, you mentioned that adding the stim was a real pain- did you have to try a lot of different things before finding the right med/dose?
Mark
(P.S.- I'll check out the ABout.com site).> >Hi Mark
> Depression is ADD/HD's favorite comorbid! To think of it, I've never met or corresponded
> with an ADDult who didn't have depression either once or twice, or chronically.
> I've suffered from depression for a dog's age -- OK at times, on meds, off meds yada yada.
> I also had what I thought were some weird learning disability things, difficulty in concentrating,
> reading, retention etc. A real *pleasure* to have while doing a doctorate, let me tell you.
> Any way, my son was tested for ADD [inattentive, no hyper stuff], he flunked, but I passed.
> I wish I could say I lived happily ever after but it's true only to a certain extent.
> Yes it was fabulous to realize what was wrong, yes adderall relieved the symptoms extremely well
> but when I started the pstim it disagreed with the AD I was on. Hence a very ugly speedy switch to tofranil
> which is working quite well.
> Suggestions: go to the ADD site at About.com and read up.
> Not many pdocs have experience with adults. Under ideal circumstances it's a pain in the a$$ to get
> the pstim dose right, or the med. You'll have to educate yourself.
> My depression is relieved, but it was also relieved by the AD meds. I still need therapy -- but that's
> just me. :):)
> Questions?
> good luck.
> S.
Posted by Sulpicia on April 2, 2001, at 20:19:44
In reply to Re: Depression, ADHD (Inattentive), and stimulants » Sulpicia, posted by MarkG on April 2, 2001, at 1:39:53
> Hi S.,
>
> Thanks for your story. Yes, yes, I too can relate to the "pleasure" of struggling while in a doctoral program. I've always said that I love a challenge!
>
> So what exactly is Tofranil, an AD? I haven't heard of that before. Also, you mentioned that adding the stim was a real pain- did you have to try a lot of different things before finding the right med/dose?
>
> Mark
> (P.S.- I'll check out the ABout.com site).
>
> Tofranil is a tricyclic AD. We don't hear about them because they've been around for a while. They are also not the recipient of the all advertising the SSRIs now have.
The tricyclics [IMHO] work quite well if you meet the criteria -- like no heart problems inter alia.
The adderall was added to the paxil that I was on. Over several weeks the two drugs potentiated each other
AND made me depressed at the same time. Don't ask. My pdoc said it's all individual.
I had taken tofranil in the past with good results and so went back to it.
The adderall was my first ADD/HD prescription so there wasn't a great deal of fooling around.
This is probably totally subjective but I found paxil to be energizing, so with the adderall I was
sort of energized to the limits of my sanity. Tofranil is slightly sedating [to me] so it's a good mix
with the adderall.
What can be a pain is figuring out the adderall dose. The manufacturer says 8 hours. Experience says closer
to 4to 6. Some need 5mgs 3x a day, others need 20mgs 3x a day. Just to confuse the issue even more, I need
4 10mg doses because I need those 4 hours of reading after dinner. This can be a pain with some docs because
they get fussy about increasing the dosage -- despite the fact that they know this is necessary.
The other important thing is to take the meds to bolster your own daily cycles of alertness. Don't try to fight
them. If I tried to interfere with my post-lunch coma, I could take a whole bottle of adderall and still be
sleepy.
Happy to answer any other questions.
S.
>
> > >Hi Mark
> > Depression is ADD/HD's favorite comorbid! To think of it, I've never met or corresponded
> > with an ADDult who didn't have depression either once or twice, or chronically.
> > I've suffered from depression for a dog's age -- OK at times, on meds, off meds yada yada.
> > I also had what I thought were some weird learning disability things, difficulty in concentrating,
> > reading, retention etc. A real *pleasure* to have while doing a doctorate, let me tell you.
> > Any way, my son was tested for ADD [inattentive, no hyper stuff], he flunked, but I passed.
> > I wish I could say I lived happily ever after but it's true only to a certain extent.
> > Yes it was fabulous to realize what was wrong, yes adderall relieved the symptoms extremely well
> > but when I started the pstim it disagreed with the AD I was on. Hence a very ugly speedy switch to tofranil
> > which is working quite well.
> > Suggestions: go to the ADD site at About.com and read up.
> > Not many pdocs have experience with adults. Under ideal circumstances it's a pain in the a$$ to get
> > the pstim dose right, or the med. You'll have to educate yourself.
> > My depression is relieved, but it was also relieved by the AD meds. I still need therapy -- but that's
> > just me. :):)
> > Questions?
> > good luck.
> > S.
This is the end of the thread.
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