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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by cybercafe on January 13, 2003, at 13:57:47
i am bp 2 + ADD and looking for a good stimulant
i'm wondering why my doc chose ritalin sr, is it the least likely to precipitate a hypomanic episode?
from limited reading, everyone seems to prefer adderall xr for effectiveness and duration or dexederine if they cannot tolerate adderall (tics? pain? blood pressure?)
is this right?
Posted by Ritch on January 13, 2003, at 23:54:07
In reply to some stimulants more/less likely to cause mania?, posted by cybercafe on January 13, 2003, at 13:57:47
> i am bp 2 + ADD and looking for a good stimulant
>
> i'm wondering why my doc chose ritalin sr, is it the least likely to precipitate a hypomanic episode?
>
> from limited reading, everyone seems to prefer adderall xr for effectiveness and duration or dexederine if they cannot tolerate adderall (tics? pain? blood pressure?)
> is this right?
Cyber, the next time you see your pdoc you need to bring this issue up directly and get some answers. Do I truly have a comorbid dx of BPII and ADHD in your opinion or are you trying meds just to test that hypothesis? There are times when it is helpful to pick your doctor's brains instead of the other way around. It could simply be that Ritalin is the "first-line" medication that is prescribed for ADHD, and your doc is doing an experiment. It is kind of nice to be let in on the experiment, however.
Posted by cybercafe on January 15, 2003, at 11:27:53
In reply to Re: some stimulants more/less likely to cause mania? » cybercafe, posted by Ritch on January 13, 2003, at 23:54:07
> > i am bp 2 + ADD and looking for a good stimulant
> >
> > i'm wondering why my doc chose ritalin sr, is it the least likely to precipitate a hypomanic episode?
> >
> > from limited reading, everyone seems to prefer adderall xr for effectiveness and duration or dexederine if they cannot tolerate adderall (tics? pain? blood pressure?)
> > is this right?
>
>
> Cyber, the next time you see your pdoc you need to bring this issue up directly and get some answers. Do I truly have a comorbid dx of BPII and ADHD in your opinion or are you trying meds just to test that hypothesis? There are times when it is helpful to pick your doctor's brains instead of the other way around. It could simply be that Ritalin is the "first-line" medication that is prescribed for ADHD, and your doc is doing an experiment. It is kind of nice to be let in on the experiment, however.
>mitch, i have an IQ of 155+, graduated from the finest undergrad program in the country, have an active social life, appear normal and NO ONE can understand why i'm working a shit parttime job, working my butt off for low pay, and living in poverty
i need to start off my saying that i love my doc for seeing me so frequently (visits are free up here) and he is certainly brilliant
i asked my doc to put me on adderall or dexedrine instead of ritalin today and he said "never" ... because they are amphetamines, cause the release of catecolamines, and bring on a manic episode or cycling
this seems to make sense to me, since zyprexa is an antagonist and provides stability
nonetheless i feel fine on caffeine, and i can't believe psychiatry/technology/research has not come up with something better
anyways i really have no idea where to take my life now - pharmacy college? (cause pharmacists can work part time) .... move to europe and maybe find IT contracts?
i just can't decide whether i should take action now, or hope my doc prescribes different meds or hope ADD spontaneously remits
hell maybe i could take abilify and have it lower dopamine in my neocortex (=mood stability?) while increasing dopamine in my nucleus accumbens (=relieve ADD)as always your comments are greatly appreciated
Posted by Ritch on January 15, 2003, at 13:19:23
In reply to Re: some stimulants more/less likely to cause mania?, posted by cybercafe on January 15, 2003, at 11:27:53
> > > i am bp 2 + ADD and looking for a good stimulant
> > >
> > > i'm wondering why my doc chose ritalin sr, is it the least likely to precipitate a hypomanic episode?
> > >
> > > from limited reading, everyone seems to prefer adderall xr for effectiveness and duration or dexederine if they cannot tolerate adderall (tics? pain? blood pressure?)
> > > is this right?
> >
> >
> > Cyber, the next time you see your pdoc you need to bring this issue up directly and get some answers. Do I truly have a comorbid dx of BPII and ADHD in your opinion or are you trying meds just to test that hypothesis? There are times when it is helpful to pick your doctor's brains instead of the other way around. It could simply be that Ritalin is the "first-line" medication that is prescribed for ADHD, and your doc is doing an experiment. It is kind of nice to be let in on the experiment, however.
> >
>
> mitch, i have an IQ of 155+, graduated from the finest undergrad program in the country, have an active social life, appear normal and NO ONE can understand why i'm working a shit parttime job, working my butt off for low pay, and living in poverty
>
> i need to start off my saying that i love my doc for seeing me so frequently (visits are free up here) and he is certainly brilliant
>
> i asked my doc to put me on adderall or dexedrine instead of ritalin today and he said "never" ... because they are amphetamines, cause the release of catecolamines, and bring on a manic episode or cycling
>
> this seems to make sense to me, since zyprexa is an antagonist and provides stability
>
> nonetheless i feel fine on caffeine, and i can't believe psychiatry/technology/research has not come up with something better
>
> anyways i really have no idea where to take my life now - pharmacy college? (cause pharmacists can work part time) .... move to europe and maybe find IT contracts?
>
> i just can't decide whether i should take action now, or hope my doc prescribes different meds or hope ADD spontaneously remits
>
>
> hell maybe i could take abilify and have it lower dopamine in my neocortex (=mood stability?) while increasing dopamine in my nucleus accumbens (=relieve ADD)
>
> as always your comments are greatly appreciated
Cyber, I know what you are talking about. It took three tries for me to finish college over an eighteen year period and wound up with about 50% more hours than required to graduate due to dropping out, changing my mind, changing degree programs, getting horrifically bored, angry with a particular professor(s), being depressed/unmotivated, etc.,etc. I don't like to work with a lot of rules and regimentation, I don't like being told what to do. If I felt like one particular course sucked, then the *entire degree program* sucked. That's how I treat lots of things. If something is wrong with my car-the whole car is crap and needs to be replaced. I just can't seem to get down to the "nuts and bolts" level of reality and deal with one particular item at a time, and follow the directions and then go to the next task. As far as the meds go, I did notice *some* mood elevation with the amps, and ZERO mood elevation with the mph. So, it is possible that mph is much less likely to trigger hypomania. But, I generally disagree with that, because I really noticed the anticycling effect of Adderall and Dexedrine. However, the anxiety builds and builds while I am taking them. I don't get hypomanic, I don't get depressed, just an increasingly jittery blahness. Maybe I am so accustomed to being absent-minded, trapped in the moment, that the "detaily" part of existence really looks pretty damn ugly to me! ;)
Posted by cybercafe on January 16, 2003, at 12:33:36
In reply to Re: some stimulants more/less likely to cause mania? » cybercafe, posted by Ritch on January 15, 2003, at 13:19:23
>
>
> Cyber, I know what you are talking about. It took three tries for me to finish college over an eighteen year period and wound up with about 50% more hours than required to graduate due to dropping out, changing my mind, changing degree programs, getting horrifically bored, angry with a particular professor(s), being depressed/unmotivated, etc.,etc. I don't like to work with a lot of rules and regimentation, I don't like being told what to do. If I felt like one particular course sucked, then the *entire degree program* sucked. That's how I treat lots of things. If something is wrong with my car-the whole car is crap and needs to be replaced. I just can't seem to get down to the "nuts and bolts" level of reality and deal with one particular item at a time, and follow the directions and then go to the next task. As far as the meds go, I did notice *some* mood elevation with the amps, and ZERO mood elevation with the mph. So, it is possible that mph is much less likely to trigger hypomania. But, I generally disagree with that, because I really noticed the anticycling effect of Adderall and Dexedrine. However, the anxiety builds and builds while I am taking them. I don't get hypomanic, I don't get depressed, just an increasingly jittery blahness. Maybe I am so accustomed to being absent-minded, trapped in the moment, that the "detaily" part of existence really looks pretty damn ugly to me! ;)what is your history of diagnosis? i was diagnosed depressed at 22, bipolar at 24, and ADD now at 27
generally it has taken me about 2 years to get diagnosed with an obvious condition from the moment i pick up on it myselfi found mph had mood elevating effects when i first took it ..
so i guess its wise not to risk amphetamines ....i just have these feeling that i will be feeling great, after the best years of my life have passed me by..... and it seems like such a waste to me ...
maybe i should move to a country with a more consumer based health care system (france? germany?) i don't knowug... to tell you the truth my doc (an excellent doc btw) contradicts himself a bit, so hopefully next week he'll change his mind and decide to up the mph sr
so... what is your biggest problem right now... or are you able to work at all?
Posted by Ritch on January 16, 2003, at 22:08:06
In reply to Re: some stimulants more/less likely to cause mania?, posted by cybercafe on January 16, 2003, at 12:33:36
> >
> >
> > Cyber, I know what you are talking about. It took three tries for me to finish college over an eighteen year period and wound up with about 50% more hours than required to graduate due to dropping out, changing my mind, changing degree programs, getting horrifically bored, angry with a particular professor(s), being depressed/unmotivated, etc.,etc. I don't like to work with a lot of rules and regimentation, I don't like being told what to do. If I felt like one particular course sucked, then the *entire degree program* sucked. That's how I treat lots of things. If something is wrong with my car-the whole car is crap and needs to be replaced. I just can't seem to get down to the "nuts and bolts" level of reality and deal with one particular item at a time, and follow the directions and then go to the next task. As far as the meds go, I did notice *some* mood elevation with the amps, and ZERO mood elevation with the mph. So, it is possible that mph is much less likely to trigger hypomania. But, I generally disagree with that, because I really noticed the anticycling effect of Adderall and Dexedrine. However, the anxiety builds and builds while I am taking them. I don't get hypomanic, I don't get depressed, just an increasingly jittery blahness. Maybe I am so accustomed to being absent-minded, trapped in the moment, that the "detaily" part of existence really looks pretty damn ugly to me! ;)
>
> what is your history of diagnosis? i was diagnosed depressed at 22, bipolar at 24, and ADD now at 27
> generally it has taken me about 2 years to get diagnosed with an obvious condition from the moment i pick up on it myself
>
> i found mph had mood elevating effects when i first took it ..
> so i guess its wise not to risk amphetamines ....
>
> i just have these feeling that i will be feeling great, after the best years of my life have passed me by..... and it seems like such a waste to me ...
> maybe i should move to a country with a more consumer based health care system (france? germany?) i don't know
>
> ug... to tell you the truth my doc (an excellent doc btw) contradicts himself a bit, so hopefully next week he'll change his mind and decide to up the mph sr
>
> so... what is your biggest problem right now... or are you able to work at all?
>
>Hi Cyber, History of dx: manic-depressive illness right from the get-go at age 19 (before there was any "bipolar" terminology or distinctions between "I" and "II" or "III", etc.). I saw about three or four shrinks pretty rapid fire within a year at the beginning and they all agreed with that diagnosis, I never disputed it either. Howevever, they all differed on what meds to prescribe (except for lithium of course). One doc wanted doxepin with lithium, the other wanted diazepam with lithium, the other wanted thioridazine with lithium. Recently, I have had ADHD diagnosed as a comorbid condition, and after seeing a neurologist the possibility of frontal and/or temporal lobe partial seizure disorder of some kind has been mentioned.---Mitch
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