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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 26. This is the beginning of the thread.
Posted by geno on June 12, 2002, at 20:29:58
Hello, im going to a reg general practiioner, new to the game. What do i tell him. I need xanax, and Esp Adderal or dexadrine? should i say i have a hard time concentrating or shomething like that?>
geno
Posted by Xevious on June 12, 2002, at 23:02:39
In reply to Going to doc, need adderal, posted by geno on June 12, 2002, at 20:29:58
If you suspect that you have ADD, then you should go to a specialist and be properly tested. If you are given a diagnosis of ADD, then that specialist will refer you to a doctor who will prescribe the proper medication for you. (Unless of course that specialist is a psychiatrist)
If you already have been diagnosed with ADD, then you've been through this and know what to do already. Note that these are tightly controlled drugs; you will not be able to simply walk into a doctor's office and ask for them.
For a listing of ADD-aware practitioners capable of accurately diagnosing and treating the disorder, visit http://www.chadd.org
> Hello, im going to a reg general practiioner, new to the game. What do i tell him. I need xanax, and Esp Adderal or dexadrine? should i say i have a hard time concentrating or shomething like that?>
> geno
Posted by fachad on June 12, 2002, at 23:14:31
In reply to Going to doc, need adderal, posted by geno on June 12, 2002, at 20:29:58
GPs usually will not write scrips for Adderall, Dex, Ritalin.
They tend to view them as drugs of abuse, and they are afraid their patiens will sue them for "hooking" them and they are afraid that the State Board of Medical Examiners will crack down on them, which they very well might.
If you want a Schedule II pstim like Adderall, Dex, or Ritalin, you need to go to a pdoc or possibly a neurologist.
A GP may write for a few days worth of Xanax, maybe, with the same concerns as above, but they will be very leary of anyone who asks for Xanax, and they will not want to write for it as an ongoing maintanece med - only as a short term emergency band-aid.
Again, you need to go to a pdoc.
> Hello, im going to a reg general practiioner, new to the game. What do i tell him. I need xanax, and Esp Adderal or dexadrine? should i say i have a hard time concentrating or shomething like that?>
> geno
Posted by 3 Beer Effect on June 12, 2002, at 23:57:48
In reply to Going to doc, need adderal, posted by geno on June 12, 2002, at 20:29:58
I don't think you have to go to a psychiatrist or neurologist in order to be treated with Ritalin, Dexedrine, or Adderall for ADD. Family Practitioners are actually quite knowlegeable about ADD since they see so many "ADD kids".
As an adult though, it is harder obtain an ADD medication, because the doctor will fear abuse. I began ADD Medication though, with my regular Family doctor with Ritalin SR 20 mg, which didn't work, then he switched me to Ritalin IR 20 mg 2x per day which worked very well.
Usually, the doctor will go through a whole routine about how you should take Wellbutrin SR even though it has a four-fold seizure rate compared to other anti-depressants, shows some indications of being hepatotoxic, & makes those with anxiety worse, & has limited efficacy in Adult ADD (~30% or so). This Wellbutrin SR routine seems to be universal among doctors- it must be all those free pens & refigerator magnets they are getting.
Provided you can fend off the Wellbutrin SR the doctor will inevitably push on you, he is definitely NOT going to give you anything at all if you ask for Xanax at the same time. Deserved or not, Xanax has quite a bad reputation in doctors circles & they are quite careful to whom they prescribe it to since it seems to easily be the most abused benzo (+ there was all the negative publicity a few months ago with the President's niece being arrested for writing a fake Xanax prescription). I would avoid asking for Xanax at all, & also ask for the stimulant first (after explaining all your Adult ADD symptoms from the CHADD website), then tentatively ask for Klonopin.
As far as an ADD stimulant, I wouldn't ask for anything except Adderall or Ritalin. Asking for Dexedrine/Dextrostat (which is one of the best ADD medicines, but is one of the slowest selling) or Focalin or anything else might make him think you researched this whole ADD thing which he would probably take as a sign of drug seeking behavior.
According to the traditional parent-childlike doctor-patient relationship, patients are supposed to be ignorant & dumb, not informed about all the medications available for their condition.
Provided you get turned down, the tricyclic Norpramin (desipramine) in adequate anti-depressant dosages has turned out in studies to be a better medication for Adult ADD than Wellbutrin SR.
Avoid Provigil, studies show no efficacy for ADD in what was once thought to be a 5$ wonder pill. Turns out, its not all that much more effective than Caffeine, even in military sleep deprivation studies. To me, it felt like a glorified version of extended release caffeine & pooped out after 2.5 months.
3 Beers........
Posted by beardedlady on June 13, 2002, at 8:32:46
In reply to Family Practitioners often treat ADD children, posted by 3 Beer Effect on June 12, 2002, at 23:57:48
When I got my sudden attack of chronic insomnia, I called several doctors. Only my gynecologist would see me right away. She immediately wrote me a script for Xanax and called a therapist to ask for an emergency session that same day. The following week, I was prescribed Zoloft by a psychiatrist, who also wrote a Xanax script for night use. I thought it had to be the standard anxiety med. Shows what I know!
beardy : )>
Posted by katekite on June 13, 2002, at 11:56:34
In reply to Re: Xanax » 3 Beer Effect, posted by beardedlady on June 13, 2002, at 8:32:46
It seems to be very regional. At a university clinic no one would consider benzos... there was one private pdoc I went to in town that was reasonable about it. Then moved, new city all the pdocs had no problem with it. Moved across the country, new city all the pdocs raised their eyebrows and I had to shop. Next city over one was just way too happy to get me on twice daily dosing. I'm not sure if its regional or something inculcated in med school: definitely an interesting phenomenon.
kate
Posted by geno on June 13, 2002, at 14:35:10
In reply to Re: Xanax, posted by katekite on June 13, 2002, at 11:56:34
3 beers,
So if i go to a general practioner and tell him that my "former doctor" where i resided in florida, had me on a combo of zoloft, adderal, xanax, and would like to get this again? Maybe if not, ill have to find 2 docs, because my pdoc wants to cut my xanax out, due to my drug history, and probably wont give me adderal. UNLESS, i tell him that ok i dont need xanax anymore, but i cannot concentrate and would like to try adderal with my zoloft/remeron. Then go to a general doctor and get the xanax?
Boy lucky for this board! HEHE i hope my doc isnt on psycobabble LOL
geno
Posted by JohnQ on June 13, 2002, at 18:07:20
In reply to Re: Xanax, posted by geno on June 13, 2002, at 14:35:10
Geno, try not to mention your past GHB use/abuse to your new doctor. It'll be tough enough to get these meds as it is.
Posted by fachad on June 13, 2002, at 19:23:45
In reply to Re: Xanax, posted by katekite on June 13, 2002, at 11:56:34
My experience is that some docs are just benzo-phobic, while others are OK with benzos in general but not with Xanax.
Even my current pdoc, who is extremely easy going, does not like Xanax. He has been very forthcoming with RXs for other benzos: temazepam, lorazepam, estazolam, klonopin, have all been no problem.
But when I asked about Xanax, his usual relaxed manner changed, and he told me that this particular med was "inherently more problematic" than other benzos, and quickly changed the subject. I did not even use the "X" word; I asked about "alprazolam".
Since he is not a benzo-phobic, and is very open to experimental combos, I am inclined to think that there really is something to the bad reputation of Xanax.
> It seems to be very regional. At a university clinic no one would consider benzos... there was one private pdoc I went to in town that was reasonable about it. Then moved, new city all the pdocs had no problem with it. Moved across the country, new city all the pdocs raised their eyebrows and I had to shop. Next city over one was just way too happy to get me on twice daily dosing. I'm not sure if its regional or something inculcated in med school: definitely an interesting phenomenon.
>
> kate
Posted by fachad on June 13, 2002, at 19:30:28
In reply to Re: Xanax, posted by geno on June 13, 2002, at 14:35:10
geno,
docs are wise to the "former doctor" story - it is a very old line among drug seekers.
another old one is being on a trip and forgetting to bring your pills.
Why do you need Xanax?
Could some other benzo work just as well?
If you have had a drug problem, maybe the docs are really protecting you from harm by denying the Xanax.
> 3 beers,
> So if i go to a general practioner and tell him that my "former doctor" where i resided in florida, had me on a combo of zoloft, adderal, xanax, and would like to get this again? Maybe if not, ill have to find 2 docs, because my pdoc wants to cut my xanax out, due to my drug history, and probably wont give me adderal. UNLESS, i tell him that ok i dont need xanax anymore, but i cannot concentrate and would like to try adderal with my zoloft/remeron. Then go to a general doctor and get the xanax?
> Boy lucky for this board! HEHE i hope my doc isnt on psycobabble LOL
> geno
Posted by geno on June 13, 2002, at 20:51:42
In reply to Re: Xanax » geno, posted by fachad on June 13, 2002, at 19:30:28
my main concern is getting a script of adderal. What should i tell my new doc?
Posted by fachad on June 13, 2002, at 22:16:17
In reply to Re: Xanax, posted by geno on June 13, 2002, at 20:51:42
Why do you want the Adderall? What would be better (truthfully) if you were taking Adderall vs. not taking Adderall?
That is what you should tell your new doc.
Posted by Seamus2 on June 13, 2002, at 22:56:44
In reply to Re: Going to doc, need adderal, posted by Xevious on June 12, 2002, at 23:02:39
If you don't already have ADD, that chadd website might well be able to induce it. Whew!
Posted by 3 Beer Effect on June 14, 2002, at 0:22:39
In reply to Going to doc, need adderal, posted by geno on June 12, 2002, at 20:29:58
Posted by Angel Girl on June 14, 2002, at 1:37:46
In reply to pdoc attitudes on benzos in general vs on Xanax » katekite, posted by fachad on June 13, 2002, at 19:23:45
Hi Kate
I noticed that you mentioned that Xanax has a bad reputation and sometimes doctors avoid prescribing it. It was actually the first med my dr prescribed to me and he seems to have no problems renewing my prescription whenever I want it.
What's the bad rep????
Thanks,
Angel Girl
Posted by IsoM on June 14, 2002, at 2:04:24
In reply to Re: Going to doc, need adderal » Xevious, posted by Seamus2 on June 13, 2002, at 22:56:44
Very true words, Seamus. I was directed to their site a couple of years ago & couldn't go through it. It's very poorly designed for any one with ADD - the information may be good but it's easy to get bogged down there. The colours are a bit much too, especially for any one with Irlen syndrome too. (It's one reason I like Dr. Bob's site - easy on the eyes & well-laid out.)
Posted by katekite on June 14, 2002, at 8:58:40
In reply to pdoc attitudes on benzos in general vs on Xanax » katekite, posted by fachad on June 13, 2002, at 19:23:45
I agree. For me its been valium that was in question. Klonopin is always ok and valium is never ok. Ativan is always fine. I have no experience asking or recieving other benzos, I've never tried xanax.
I'm now 'addicted' or at least dependent on klonopin, something that never would have happened with a shorter half-life drug. Really lame result of half-baked opinions. It was great for a couple weeks, then I acclimated to it and now its 9 months later.
kate
Posted by Seamus2 on June 14, 2002, at 9:53:01
In reply to CHADD Web Site » Seamus2, posted by IsoM on June 14, 2002, at 2:04:24
I gave up too. Yikes, what WERE they thinking?!?
Posted by 3 Beer Effect on June 14, 2002, at 11:41:40
In reply to Re: bad reputation of Xanax - fachad, posted by Angel Girl on June 14, 2002, at 1:37:46
Posted by Phil on June 14, 2002, at 12:36:18
In reply to Re: pdoc attitudes on benzos in general vs on Xanax, posted by katekite on June 14, 2002, at 8:58:40
Are you saying that it's not helping now? I've been at the same dose for years and think it's a great drug. Are you getting anxiety again?
I thought, I may be wrong, that shorter half-life benzos were a greater addiction problem. Maybe I'm thinking abuse potential. Kind of the same thing. I would feel vulnerable if I took Valium; used to love it during partying years. But Clonazepam is much better in my case.
Very, very scatter brained Phil
Posted by joy on June 14, 2002, at 14:16:52
In reply to Re: pdoc attitudes on benzos in general vs on Xanax » katekite, posted by Phil on June 14, 2002, at 12:36:18
I've been taking Alazopram [generic Xanax] over 2 years, especially for insomnia. I have not increased my dose, and in fact use it a lot less than I used to. I think the benzo/Xanax hysteria is very overdone. Just my humble opion, but I've had no problems.
Joy
Posted by katekite on June 14, 2002, at 20:12:44
In reply to Re: pdoc attitudes on benzos in general vs on Xanax » katekite, posted by Phil on June 14, 2002, at 12:36:18
I think there's a couple kinds of dependence.
One would be with short acting ones: you find it helpful, then it wears off and you feel the need for it again, you start to take it all the time just to feel relaxed and keep increasing the dose. I think this is the kind of addiction pdocs worry about.
My kind of addiction is that I took klonopin for anxiety and it really helped. Then I got diagnosed with ADD and started those meds and that helped even more. So I want to try life without the klonopin. I'm down to .25 mg per day and feel just like I did before I ever started klonopin (my body is acclimated and thinks that's normal now). When I try to go off completely I get this rebound anxiety and insomnia that is worse than anything I experienced before and I about go nuts and can't do it. So I consider myself addicted. But I don't want the feeling and never consider increasing the dose. I'm not sure what to call this kind of addiction. I think this type of addiction would be more common with the longer acting ones like klonopin because it is so easy to get a blood level going that doesn't change. I would rather have just used the short acting ones as needed than have to go through this. Since the short acting ones get mostly out of your system before you take the next one (if careful) then I should have been able to prevent dependence with them.
So yes, I feel like klonopin lost its effectiveness at the dose of .25 mg per day, for me. I'm sure if I went back to 1 mg a day I would really be able to tell though.
sorry this is so long.
kate
Posted by Alan on June 14, 2002, at 22:36:45
In reply to addiction vs dependence? » Phil, posted by katekite on June 14, 2002, at 20:12:44
http://panicdisorder.about.com/library/weekly/aa031997.htm
Addiction is not the appropriate usage given to legitimate BZD usage of any kind in the "in the know" medical community that treats anxiety disordrs.
Alan
Posted by Phil on June 15, 2002, at 7:10:01
In reply to addiction vs dependence? » Phil, posted by katekite on June 14, 2002, at 20:12:44
There was someone on this board quite a while back that would use sandpaper to make the dose smaller. Scrape off a little and very slowly wean the rest of the way. Hey, you've got time.
Posted by katekite on June 15, 2002, at 15:49:06
In reply to Re: addiction vs dependence? » katekite, posted by Phil on June 15, 2002, at 7:10:01
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