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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by Ed on August 24, 2000, at 16:56:29
How is your Adderal trial going? What else are you taking with it?
Posted by AndrewB on August 24, 2000, at 18:02:08
In reply to Adderall -- AndrewB, posted by Ed on August 24, 2000, at 16:56:29
> How is your Adderal trial going? What else are you taking with it?
Hi Ed,
Thanks for asking about me. How are things with you.
Adderall has been fantastic. I am now on Amisulpride, Selegiline (low dose) and Adderall. As you can see, these meds are all dopaminergics. (I also sometimes take a low dose of Klonopin 2 hours before bedtime for a more restful sleep.)
They seem to work synergistically, one making the other work better. It is an idea of mine that selegiline make amisulpride work more robustly. You see, when I was taking amisulpride alone, its effects used to wilt in high stress situations. Selegiline seems to make less of a dose of adderall necessary. Amisulpride may prevent the agitation and anxiety that can sometimes accompany selegiline and adderall use.
I now feel happy, friendly, motivated, energetic, sharp and quite confident. In short, I'm loving life. It is an amazing change that has come over me.
I am of course concerned that adderall will lose its effectiveness overtime. Tolerance developing to it is not unusual. Fortunately I was feeling pretty good on just the amisulpride and selegiline, so I won't be devastated if it happens to give out. I have absolutely no side effects.
I hope this is an inspiration to others who think they may have dopaminergic dysfunction. If you do indeed have it, correcting it can make a big difference in your life. The first dopaminergic drug that you try though isn't necessarily going to work for you. You may have to be patient and try different meds and med combos.
Andrew
Posted by JohnL on August 25, 2000, at 6:14:37
In reply to Adderall -- AndrewB, posted by Ed on August 24, 2000, at 16:56:29
Andrew,
So glad to hear things are going well with your current meds! I got my fingers crossed that it stays good!
John
Posted by Ed on August 25, 2000, at 12:33:52
In reply to Adderall -- AndrewB, posted by Ed on August 24, 2000, at 16:56:29
BRAVO! Me, I am just starting Amisulpride. I will give it a few more days, then maybe add Adderall. I'll keep you posted.
Posted by JohnL on August 26, 2000, at 5:15:13
In reply to Adderall -- AndrewB, posted by Ed on August 24, 2000, at 16:56:29
Andrew,
I'm just curious, what dosages are you taking of each med?
John
Posted by SLS on August 26, 2000, at 16:40:45
In reply to Re: Adderall --Ed, posted by AndrewB on August 24, 2000, at 18:02:08
> Adderall has been fantastic. I am now on Amisulpride, Selegiline (low dose) and Adderall.
Nice choice.I hope things work out long-term. Good luck.
- Scott
Posted by AndrewB on August 28, 2000, at 12:31:08
In reply to Re: Adderall » AndrewB, posted by SLS on August 26, 2000, at 16:40:45
I've quit the adderall. Started showing signs of tolerance and decreased effect or side effects. Reminded me of amineptine, nice while the ride lasts........Anyway not for me. I'm tired today but I should recover and stabilize again soon. Now on amisulpride (50mg/day) and selegiline (5mg/day).
AndrewB
Posted by JohnL on August 29, 2000, at 4:48:02
In reply to Re: Adderall, posted by AndrewB on August 28, 2000, at 12:31:08
> I've quit the adderall. Started showing signs of tolerance and decreased effect or side effects. Reminded me of amineptine, nice while the ride lasts........Anyway not for me. I'm tired today but I should recover and stabilize again soon. Now on amisulpride (50mg/day) and selegiline (5mg/day).
>
> AndrewBAndrewB,
I don't remember, have you tried Amisulpride+Adrafinil combo? I know you are focusing on dopamine, but if you haven't tried this combo, I think it's worth a looksee.The reason I think so is because:
To me, Amisulpride alone is OK. Nothing spectacular, but OK. Better than SSRIs and stuff, that's for sure. But still, there is room for improvement.
To me, Adrafinil alone also is OK, but nothing spectacular. There is a little room for improvement.
But combined the end result is dramatically enhanced. I used to think, well, Adrafinil makes me feel this way, and Amisulpride makes me feel that way, so the two combined should be a mixture of those two feelings. But that's actually not the case at all. The end result is a completely different hybrid, not resembling either alone. And not just the sum of the two combined, but more than that. Hard to explain.Anyway, just thought I'd mention it in case you or anyone else is interested. If anyone has tried either Adrafinil or Amisulpride alone, don't let those trials be predicters of how the two combined would be. The end result of the combo is not what could be predicted. It is a lot better than one might expect. At least, for me anyway. I think it's worth a look.
This combo can start to work in one week, have some ups and downs and rocky roads in week two, and by week three be stabilized feeling very good.
John
Posted by AndrewB on August 29, 2000, at 12:03:57
In reply to Re: Adderall, posted by JohnL on August 29, 2000, at 4:48:02
John,
Tried the adrafinil for 3 or 4 days. I had a big headache and inner tension. Will try again sometime in the near future at a lower dose, half a pill. How about lamotrigine as an arousal agent?
AndrewB
Posted by JohnL on August 30, 2000, at 4:04:01
In reply to Re: Adderall, posted by AndrewB on August 29, 2000, at 12:03:57
> John,
>
> Tried the adrafinil for 3 or 4 days. I had a big headache and inner tension. Will try again sometime in the near future at a lower dose, half a pill. How about lamotrigine as an arousal agent?
>
> AndrewBDid you try Adrafinil alone, or in combination with Amisulpride? Was Reboxetine involved at that time?
Lamictal...to me it was a non-sedating med that definitely made life 'smoother'. Good mood stabilizer, and a good med to quiet my tinnitus. It wasn't really alerting or stimulating in anyway. It's hard to say. On a scale with 0 being neutral, -5 being very sedated, and +5 being very stimulated, I would rate Lamictal about a +1. But who knows. Some people don't feel much effect from it, while others experience magic.
I kind of miss the smoothness and the quiet ears, so I sometimes think about starting it again. But since I'm already taking an antipsychotic (Amisulpride) and a stimulant/antidepressant (Adrafinil), I'm hesitant to add another med. There have been times in the past where I was taking 5 or 7 meds at the same time. It feels good to be doing pretty good with just two.
One more thing about Lamictal...I had a pdoc at the time who was a wiz with drugs. I mean, he knew every little intricacy about everything. He knew astounding details that I couldn't find in literature or on the net anywhere. Concerning Lamictal, he said it has some boosting effect on dopamine. He explained that is why I had a boost in sex drive, slight insomnia, and a boost in work productivity at the time. So, since you are focusing on dopamine, Lamictal might be the link in the chain you're looking for. But is it an arousal agent? I would call Adrafinil, Amisulpride, Ritalin, and Adderall arousal agents. I wouldn't put Lamictal on that same level, though I have to say it was in no way dulling or sedating. It could be a slightly arousing agent. I think its best potential may be in combination with other dopinergic drugs, so they work on dopamine in synergy from different angles.
The bummer about it is the time it takes to give it a trial. Since you can only increase dose by 25mg a week to be on the safe side, it takes a while to get up into the 100mg to 200mg range to see what the effect is. But overall, I liked it much better than a whole lot of other drugs. If I had to choose my favorite Top 5 drugs out of say 20 or 30, Lamictal would be one of them. I liked Lamictal. Hhmmmm....
But in your shoes, I think I would do like you said...try 1/2 Adrafinil with Amisulpride. After much tweaking, I've found my best level is 25mg Amisulpride + 600 Adrafinil. This is definitely an arousal combination. But I had to work up to that level. I couldn't have started at 600mg Adrafinil. Too much too soon for me. 300mg Adrafinil isn't quite enough, while 600mg is almost to the point of inner tension, but just shy of it.
John
Posted by AndrewB on August 30, 2000, at 11:45:16
In reply to Re: Adderall-Andrew, posted by JohnL on August 30, 2000, at 4:04:01
John,
Good info John, thanks.
AndrewB
Posted by Laszlo on August 21, 2001, at 1:50:57
In reply to Adderall -- AndrewB, posted by Ed on August 24, 2000, at 16:56:29
Andrew,
What exactly are you taking these meds for? Scizophrenia?
Laszlo
Posted by AndrewB on August 22, 2001, at 3:10:36
In reply to Re: Adderall -- AndrewB, posted by Laszlo on August 21, 2001, at 1:50:57
Laszlo,
Those posts you've responded to are quite old. Since then I've added memantine to the adderall/selegiline/amisulpride along with klonopin at night. I take these med.s for dysthymia whose symptoms include low energy, low motivation, anhedonia, and low self esteem with constant negative thoughts. I also have comormid social aviodant personality (loosely related to social anxiety) where the world is viewed as a hostile place and I therefore want to withdraw from it. My current combo has eliminated all my symptoms.
No I don't have schizophrenia, though amisulpride is known mainly as neuroleptic for schizophrenia. However I take amisulpride at low doses. At these doses it has a different, most simply put, opposite mode of action than the higher doses taken for schizophrenia. Study after study has shown amisulpride to be effective for many in taking away dysthymia when used at low doses. Many people who occassion this board have given first hand accounts of it being effective for their dysthymia and/or social anxiety.
AndrewB
Posted by Laszlo on September 5, 2001, at 22:43:20
In reply to Re: Adderall -- AndrewB, posted by AndrewB on August 22, 2001, at 3:10:36
Andrew,
A friend of mine asked his doctor for Adderall for ADD. His doctor told him that Adderall gives diminishing returns in adults and warned that he would have to take more and more and would end up abusing. Instead, he put him on Wellbutrin. Any thoughts?
Laszlo
Posted by Zo on September 6, 2001, at 1:00:19
In reply to Re: Adderall -- AndrewB, posted by Laszlo on September 5, 2001, at 22:43:20
I have thoughts. That doctor is full of shit.
Best,
Zo
Posted by Laszlo on September 6, 2001, at 6:53:13
In reply to Re: Adderall -- AndrewB » Laszlo, posted by Zo on September 6, 2001, at 1:00:19
Thanks, Zo. You are a man of few words, but what words!
The doctor also told him that he would crash big time every few days.
Do you know your Enneagram personality type? I wonder about the correlation between dysthymia and the type 5.
Best,
Laszlo
Posted by Mitch on September 6, 2001, at 13:15:54
In reply to Re: Adderall -- AndrewB, posted by Laszlo on September 5, 2001, at 22:43:20
> Andrew,
>
> A friend of mine asked his doctor for Adderall for ADD. His doctor told him that Adderall gives diminishing returns in adults and warned that he would have to take more and more and would end up abusing. Instead, he put him on Wellbutrin. Any thoughts?
>
> LaszloProbably what the doctor is saying parenthetically is (let's try something that is not a controlled substance first because it makes me uptight to prescribe Schedule II hand carried prescriptions. The Adderall might work fine, but the reputation will get around and I will have people in here that are faking it to get the drugs and then I will wind up with a lawsuit or worse)
Posted by Cindylou on September 6, 2001, at 14:21:37
In reply to Re: Adderall -- AndrewB, posted by Laszlo on September 6, 2001, at 6:53:13
>
> The doctor also told him that he would crash big time every few days.
>Just a note -- I recently tried Adderall, and wasn't warned about this "crashing" effect. But in my case, your friend's doctor was right! I felt great for about 4 or 5 days, then crashed HARD. Felt like @#$%#. I tried it again, felt good for about 3 days, then crashed again. It sucked. I guess this doesn't happen to most people, but according to some smart people on this board, it is pretty common.
-cindy
Posted by Zo on September 6, 2001, at 14:50:14
In reply to Re: Adderall -- AndrewB, posted by Laszlo on September 6, 2001, at 6:53:13
> Do you know your Enneagram personality type? I wonder about the correlation between dysthymia and the type 5.
>I am a Four. Have you read Don Richard Riso's Personality Types (rev.) ? He integrates the DSM with Enneagram numbers, from healthiest to nuttiest. Ab-fab!
Zo
Posted by SLS on September 6, 2001, at 21:47:14
In reply to Re: Adderall -- » Laszlo, posted by Cindylou on September 6, 2001, at 14:21:37
> >
> > The doctor also told him that he would crash big time every few days.
> >
>
> Just a note -- I recently tried Adderall, and wasn't warned about this "crashing" effect. But in my case, your friend's doctor was right! I felt great for about 4 or 5 days, then crashed HARD. Felt like @#$%#. I tried it again, felt good for about 3 days, then crashed again. It sucked. I guess this doesn't happen to most people, but according to some smart people on this board, it is pretty common.
> -cindy
This may be far fetched.AndrewB has reported that memantine, an experimental drug, has enabled him to continue to respond to Adderall when he had previously experienced poop-out after 3 days.
Memantine is currently in phase III trials (just one step short of approval) for treating Alzheimer's Dementia. Andrew feels that memantine might prevent poop-out by blocking a specific glutamate receptor known as the NMDA receptor. It reduces glutamate stimulation.
Lamictal (lamotrigine) also reduces glutamate stimulation, but in a different way. I'm wondering if Lamictal can help prevent amphetamine poop-out.
It's just a thought.
- Scott
Posted by Mitch on October 3, 2001, at 0:08:00
In reply to Re: Adderall --, posted by gardengal on October 2, 2001, at 23:19:21
> > > >
> > > > The doctor also told him that he would crash big time every few days.
> > > >
> > >
> > > Just a note -- I recently tried Adderall, and wasn't warned about this "crashing" effect. But in my case, your friend's doctor was right! I felt great for about 4 or 5 days, then crashed HARD. Felt like @#$%#. I tried it again, felt good for about 3 days, then crashed again. It sucked. I guess this doesn't happen to most people, but according to some smart people on this board, it is pretty common.
> > > -cindy
> >
> >
> > This may be far fetched.
> >
> > AndrewB has reported that memantine, an experimental drug, has enabled him to continue to respond to Adderall when he had previously experienced poop-out after 3 days.
> >
> > Memantine is currently in phase III trials (just one step short of approval) for treating Alzheimer's Dementia. Andrew feels that memantine might prevent poop-out by blocking a specific glutamate receptor known as the NMDA receptor. It reduces glutamate stimulation.
> >
> > Lamictal (lamotrigine) also reduces glutamate stimulation, but in a different way. I'm wondering if Lamictal can help prevent amphetamine poop-out.
> >
> > It's just a thought.
> >
> >
> > - ScottThanks for that info, Alzheimer's demnentia, huh? Lamictal is a last try (because of the rash) on my pdoc's list. Perhaps memantine would be more of a mood stabilizer rather than an antidepressant?
As far as Adderall goes-it proved to be one of the best mood *stabilizing* agents I have ever taken. I felt a *mild* euphoria and insomnia for about three or four days which yielded to a quite euthymic mood with consistent sleep/wake cycles and circadian rhythyms. I just had trouble with the anxiety it provoked due to being newly hyperaware of non-verbal social communications.
This is the end of the thread.
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