Psycho-Babble Medication Thread 63904

Shown: posts 1 to 10 of 10. This is the beginning of the thread.

 

Amphetamines/Ritalin/Depression

Posted by Mr.Scott on May 22, 2001, at 12:28:58

There are many threads on this in various forms, but I want to know specifically if any of you can weigh in on experiences you may have had or are currently having regarding the usage of Ritalin, Adderall, Dexedrine, and other stimulants alone or in combination with other meds for the treatment of resistant depression. Sorry for the long sentence..

I am currently trying stims in combination with Prozac for a treatment resistant depression that has been with me since I can remember. I feel a little improved on a tiny dose of Adderall with the Prozac.

Problem is.. I used to abuse a lot of Cocaine about 5 years ago, and I am scared something bad will happen. I will not abuse the meds in any way, but I just remember the pain my cocaine problem caused up and down and up and down. My doc seems to think I was actually on to something by going after the cocaine. He thinks a trial of longer acting stims is warranted..

I am trusting him, but hope to get some feedback from the people who are actually in the trenches day in and day out and don't just theorize about, but actually experience the problem of mental illness.

All comments and opinions welcome.

mr.scott

 

Re: Amphetamines/Ritalin/Depression

Posted by stjames on May 22, 2001, at 12:41:58

In reply to Amphetamines/Ritalin/Depression , posted by Mr.Scott on May 22, 2001, at 12:28:58

Ask your doc to give small scripts, like a week or 2, till you and he are comfortable that you are not inclined to abuse stims.

James

 

Re: Amphetamines/Ritalin/Depression

Posted by Noa on May 22, 2001, at 12:42:40

In reply to Amphetamines/Ritalin/Depression , posted by Mr.Scott on May 22, 2001, at 12:28:58

I have no experience with cocaine or being addicted to stims (except caffeine), but my initial reaction is "Wow. That is an unusual doctor!" So many doctors will not use stims if there is even a hint of a history of addiction.

If you have a good relationship with this doctor, and see him frequently, perhaps you really can develop the kind of communication and self-monitoring that will help you feel in control with using this medicine appropriately. If you will feel better about it, perhaps you can ask him to write two week scrips, instead of one month scrips. You might also want to work out with him a sort of self-monitoring scale to keep track of how you feel as the med wears off, or whether you are experiencing cravings for more of the med, etc.

 

Re: Amphetamines/Ritalin/Depression » Mr.Scott

Posted by Marie1 on May 22, 2001, at 14:23:41

In reply to Amphetamines/Ritalin/Depression , posted by Mr.Scott on May 22, 2001, at 12:28:58

Mr. Scott,
I use phentermine with prozac and have for many years. This is not sanctioned by my pdoc; he sees it as substance abuse because I obtain the phentermine for weight loss, not depression. It makes me feel much better because I think it restores motivation, initiative, enthusiasm and to a lesser extent, energy.

Marie

 

Re: Amphetamines/Ritalin/Depression » Mr.Scott

Posted by SalArmy4me on May 22, 2001, at 14:24:07

In reply to Amphetamines/Ritalin/Depression , posted by Mr.Scott on May 22, 2001, at 12:28:58

Perhaps you can ask your doctor for relatively non-addicting stimulants like modafinil or pemoline.

 

Re: Amphetamines/Ritalin/Depression

Posted by cole on May 22, 2001, at 15:37:01

In reply to Amphetamines/Ritalin/Depression , posted by Mr.Scott on May 22, 2001, at 12:28:58

I'm taking remeron and ritalin. I was tx resistant to everything but the remeron, and I still have some low periods on the remeron. I've found that low doses of ritalin keep me focused and motivated during those low points, and recently I've switched to taking it daily, instead of PRN. I don't care for the rebound after a dose wears off, and I often worry about what long term stim use may do to my health, but I'm going to stick to it as long as I am in school, because it keeps me on top of my work. I do need to take trazodone at night sometimes because the ritalin may have worn off enough to make me feel tired, but not enough to let me fall asleep. I can't say anything about the abuse potential, but I really dislike the feeling I get when it's washing out of my system. I get keyed up, and if I don't get to the gym fast (or take a dose) I'm liable to punch a wall, and this is coming from a relatively chill, quiet girl.
cole

 

Re: Amphetamines/Ritalin/Depression » Mr.Scott

Posted by Sulpicia on May 22, 2001, at 18:39:41

In reply to Amphetamines/Ritalin/Depression , posted by Mr.Scott on May 22, 2001, at 12:28:58

>
>
> Hi--
My situation is slightly different but perhaps of interest.
First, so you understand my perspective: 10 years of sobriety from drugs and alcohol, mainly the latter,
chronic depression, and mild ADD.
I take a tricyclic AD and adderall. Abuse and addiction need not be the same phenomena, so please realize
that my comments are based on personal experience with addiction.
It's very good that you are scared, and this makes it less likely you'll be tempted to abuse adderall.
Lots of people with ADD have substance abuse issues so getting medication is a minefield, but the adults I've
met have done very well -- no reappearance of abuse stuff.
One thing you should consider is that successful treatment of your depression makes it much less likely that
you'll feel the need to return to coke.

As for self-medication, I think your doc is right on target. The wonderful pdoc who
treats my teenager spent several hours asking about her drug abuse: what were her favorites, why,
and what did the various drugs make you feel like. He clearly saw this as self-medication and used
the info to help decide which AD to start with.

I personally feel OK taking adderall for ADD. Addiction hasn't been an issue for me for a long while
and I still maintain contact with recovering people. Tho it's not everyone's choice or need, AA or similar
models can be very helpful, especially for relapse prevention. It's almost educational in a strange way --
you can see the signs of relapse in another person much more readily than in yourself. In time you learn to
understand your own patterns of behavior. What I learned in AA keeps me comfortable about taking adderall.
Short version: I know when I'm in trouble. And I was scared too when adderall was suggested.

If you believe that you have good self-awareness and understanding of what was going on with you when you
abused coke, you're probably in good shape.
You should also commit to absolute honesty with your pdoc: if you need to change a dosage, ask first.
And don't panic if you find that you need an increase or decrease. It happens, sometimes from other meds,
changes in lifestyle or diet, etc. Just tell the pdoc and you'll work it out.

I think the most important thing is to get your depression relieved -- being wretched constantly will get you
into more trouble over time.

If you recognize a problematic response to the adderall, talking to others in the same position is very useful.
I hesitate to suggest a drug counselor because some are very dogmatic in their insistance on no drugs at all....
but perhaps with the right individual this would be an option.

Have you had any responses to adderall that scare you?
I wish you the best.
S.

 

Re: Amphetamines/Ritalin/Depression

Posted by sl on May 23, 2001, at 13:42:43

In reply to Amphetamines/Ritalin/Depression , posted by Mr.Scott on May 22, 2001, at 12:28:58

>stimulants alone or in combination with other meds for the treatment of resistant depression. Sorry for the long sentence..

No need to apologize, you just made yourself understood. :)
I'll just mention off the bat, I'm not sure what the official definition of "resistant depression" is. Heh, I suspect it might be ME. :P

>doc seems to think I was actually on to something by going after the cocaine. He thinks a trial of longer acting stims is warranted..

It's called "self-medication", I believe. My biggest things are anxiety and lack of energy. So I drank, cuz when you're drinking, you don't worry and you have a jolt of sugar/calories. (actually, I still drink occasionally for the above reasons, just not nearly so often)

Anyway, I agree with him.

BUT. Personally I'd suggest trying a stimulating antidepressant before a straight stimulant. Like Wellbutrin or high-dose Effexor. It might just be that a stimulant might make you twitchy and restless and still in a lousy mood.

> All comments and opinions welcome.

Thanks! I hope you get it worked out. :)

sl

 

Re: Amphetamines/Ritalin/Depression » Mr.Scott

Posted by tresni on May 24, 2001, at 13:04:43

In reply to Amphetamines/Ritalin/Depression , posted by Mr.Scott on May 22, 2001, at 12:28:58

Mr. Scott,
I can relate to what you're going through. I have lived with a nagging depression since I was a kid. I, too, had abused cocaine in the 1980s & then methamphetamine in the 1990s (up until about 7 months ago, in fact.) At that time I finally sought medical attention and was put on Concerta & Ritalin. They help with ADD and depression. At first I wrestled with the guilt, fear & other unsure feelings about taking stimulant meds in my situation. It was scary. Especially the short acting Ritalin because I had to take it every few hours and that reminded me of my old patterns of drug use. I can tell you now though, I have no doubt that this medication is helping me. It's a shame I didn't get help sooner. I finally feel like my brain is working correctly which enables me to make changes to make my life better. For me, some key differences I noticed between doing cocaine & meth versus taking stimulant medications were:
1. When I used cocaine/meth, I was not only addicted to the drug, but the ritual involved.
2. When I used cocaine/meth, I was snorting or smoking it, so it all reaches your brain at once, therefore causing you to experience "the high"
I read something in a book called "Addiction or Self Medication? The Truth" by Manijeh Nikakhtar and Louis F. Markert that was very enlightening. It said,
"Medications make abnormal brain function normal. Drugs make normal function abnormal."
This really shed some light on my internal debate. In fact, I'll quote the whole paragraph since it helped me put the whole thing in perspective so much.

"We need to raise our awareness of how drugs affect us biologically. What, for instance, is the difference between medication (psychotropic medications) and drugs (psychoactive substances)? If we are experiencing abnormal feelings, we are undergoing abnormal brain biochemical functioning. Either some neuronal chemistry is less than normal or some is over-produced. Medication, when used under a physician's recommendation, can normalize such chemical imbalances and stabilize mood. On the other hand, when people are under the influence of drugs or psychoactive substances, their normal brain functioning becomes altered to an abnormal state. When there is a pre-existing chemical imbalance causing emotional disturbances, drugs further exacerbate this abnormality over a period of time and psychiatric symtoms worsen."

I hope this sheds some light for you too. I am just so thankful that there is a legal, safer way to get the help I needed. I now see the difference, personally, between self-medicating with drugs & getting professional help. I suppose both ways were trying to correct a common problem, but one caused more harm in the long run and one is actually helping.
Hang in there, it's worth it!
Tresni


> There are many threads on this in various forms, but I want to know specifically if any of you can weigh in on experiences you may have had or are currently having regarding the usage of Ritalin, Adderall, Dexedrine, and other stimulants alone or in combination with other meds for the treatment of resistant depression. Sorry for the long sentence..
>
> I am currently trying stims in combination with Prozac for a treatment resistant depression that has been with me since I can remember. I feel a little improved on a tiny dose of Adderall with the Prozac.
>
> Problem is.. I used to abuse a lot of Cocaine about 5 years ago, and I am scared something bad will happen. I will not abuse the meds in any way, but I just remember the pain my cocaine problem caused up and down and up and down. My doc seems to think I was actually on to something by going after the cocaine. He thinks a trial of longer acting stims is warranted..
>
> I am trusting him, but hope to get some feedback from the people who are actually in the trenches day in and day out and don't just theorize about, but actually experience the problem of mental illness.
>
> All comments and opinions welcome.
>
> mr.scott

 

Re: Amphetamines/Ritalin/Depression

Posted by Mr.Scott on May 28, 2001, at 19:45:04

In reply to Amphetamines/Ritalin/Depression , posted by Mr.Scott on May 22, 2001, at 12:28:58

Thank You all for posting posting follow-ups. I greatly appreciate your input and consider it highly valuable.


This is the end of the thread.


Show another thread

URL of post in thread:


Psycho-Babble Medication | Extras | FAQ


[dr. bob] Dr. Bob is Robert Hsiung, MD, bob@dr-bob.org

Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.