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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by cybercafe on March 23, 2003, at 16:15:17
i find ritalin makes me want to sit still and watch tv
whereas SSRIs made me happy, want to go out and do things
(i thought dopamine was better for anhedonia than SSRIs.. i find the opposite)
Posted by utopizen on March 23, 2003, at 17:37:38
In reply to do stims make you lazy?, posted by cybercafe on March 23, 2003, at 16:15:17
> i find ritalin makes me want to sit still and watch tv
>
> whereas SSRIs made me happy, want to go out and do things
>
> (i thought dopamine was better for anhedonia than SSRIs.. i find the opposite)
>Um, no, they're suppose to make your room very clean and your class notes very detailed. I still have to force myself to walk to the library, but once I'm there, I do work. Try that. It'll have you focus on whatever you're doing at the time-- taking notes, watching tv, or sitting in class. Change your setting, not your dose, and you'll do fine.
Posted by Viridis on March 24, 2003, at 3:33:58
In reply to do stims make you lazy?, posted by cybercafe on March 23, 2003, at 16:15:17
They shouldn't, but they can make you very focused, and if TV is what's available, then I guess that might become your focus. You can change your focus, though, as Utopizen suggested.
But if SSRIs work better for you, then why not go with those?
Posted by cybercafe on March 24, 2003, at 20:47:42
In reply to Re: do stims make you lazy?, posted by utopizen on March 23, 2003, at 17:37:38
> > i find ritalin makes me want to sit still and watch tv
> >
> > whereas SSRIs made me happy, want to go out and do things
> >
> > (i thought dopamine was better for anhedonia than SSRIs.. i find the opposite)
> >
>
> Um, no, they're suppose to make your room very clean and your class notes very detailed. I still have to force myself to walk to the library, but once I'm there, I do work. Try that. It'll have you focus on whatever you're doing at the time-- taking notes, watching tv, or sitting in class. Change your setting, not your dose, and you'll do fine.hmmm... i don't feel motivated to clean my room at all.. (or get out of bed, dress, shower, cook, etc)
it does seem to improve focus but i don't get a real sense of pleasure ... not like SSRIs
i thought SSRIs were supposed to cause apathy, not stimulants ... ??
Posted by cybercafe on March 24, 2003, at 21:00:39
In reply to Re: do stims make you lazy? » cybercafe, posted by Viridis on March 24, 2003, at 3:33:58
> They shouldn't, but they can make you very focused, and if TV is what's available, then I guess that might become your focus. You can change your focus, though, as Utopizen suggested.
umm... yeah, at work i couldn't concentrate and generally found things unpleasant... and had to quit... but hobbies i'm able to concentrate on better.... if i have to wait for a bus i don't go quite as insane
>
> But if SSRIs work better for you, then why not go with those?SSRIs, or better yet MAOIs, make me a lot happier but i can't hold down a job ........ or wait at a red light!
stimulants make me concentrate a little better and make me a little bit happier ... but since stopping parnate (an antidepressant) it's been getting harder and harder to get out of bed, shower, cook, get dressed, etc and i'm thinking there is a lot of room for improvement .. like i used to have hopes and plans for the future, now everyday living just seems like a struggle
okay i think i'm going to print out this message and hope my pdoc takes the time to read it
Posted by utopizen on March 24, 2003, at 21:30:48
In reply to Re: do stims make you lazy?, posted by cybercafe on March 24, 2003, at 21:00:39
Cyber,
I suggest you consider switching to another med. Let's see, there's quite a few left before you should blame all stims for not working! =)
Adderall (d+l amphetamine salts, 4 of 'em)
Not particularly good if you have anxiety,
at least not for me. This may be because of the
l-amphetamine. Dexederine replaced Benzedrine
by isolating benzedrine's d-isomer, the isomer
responsible for the most effect and fewest side effectsFor me, the part that worked was the d-isomer, and the l-parts just stayed in my system after the d part had run out, causing me to remain jittery and have insomnia but remain inattentive.
I think this is over-rated in general, especially if all you have is inattentive ADHD like me. I mean, it makes me do work, but lasts too long, like I said, in a bad way.
Dexederine (d-amphetamine)
lasts a few hours, also available in time-release form. I'd say it's better than Adderall, but everyone has a preference.
Desoxyn (methamphetamine)
I'm on this now. Hurts my tummy when it's done it's thing, but I've been using baking soda for that. It lasts a few hours. No time-release and no generic (no generic wants to bother with the regulations!) You'll feel super-smart though, because you get to stump the pharmacist when he has to special order a drug he's never heard of before! =)
Suppose to be of special signifigance to inattentives.
Posted by cybercafe on March 24, 2003, at 23:10:28
In reply to Re: do stims make you lazy? » cybercafe, posted by utopizen on March 24, 2003, at 21:30:48
> Cyber,
>
> I suggest you consider switching to another med. Let's see, there's quite a few left before you should blame all stims for not working! =)
>
> I think this is over-rated in general, especially if all you have is inattentive ADHD like me. I mean, it makes me do work, but lasts too long, like I said, in a bad way.sorry for not being clear dude, i have ADHD + bipolar II + anxiety ... and because of the bipolar, my doc won't let me touch amphetamines (adderall, dexedrine)
regulations!) You'll feel super-smart though, because you get to stump the pharmacist when he has to special order a drug he's never heard of before! =)
> Suppose to be of special signifigance to inattentives.the drug or stumping the pharmacist?
yeah i would love to stump a pharmacist...
reminds me of the fun i had with GPs when i was taking MAOIs, oh i suppose that must be narcissistic personality disorder :)
Posted by utopizen on March 25, 2003, at 9:08:27
In reply to Re: do stims make you lazy?, posted by cybercafe on March 24, 2003, at 23:10:28
Why don't you try Straterra? You can stay on the Ritalin while you're trying it out, and maybe drop it if it works well enough.
It's not a stimulant.
Never heard of the bipolar issue. I have social anxiety, though, and Desoxyn is good for this because it's less of a slave driver for my head, but it still lets me focus and gives me the energy to get things done. I can see why others say it's good for us inattentive types, and how Adderall is good for hyperactivity types. Adderall would literally make me enter a room sometimes, and people would remark how I "looked like I was on a mission" as I entered.
Posted by Ellen S. on March 25, 2003, at 23:09:39
In reply to Re: do stims make you lazy?, posted by utopizen on March 25, 2003, at 9:08:27
I'm wondering how common it is for stimulants to make people anxious, or to contribute to anxiety.
Several months ago, my teenage son's pdoc prescribed Adderall to help him wake up in the morning -- to overcome the severe sedation he was experiencing due to his various medications (Celexa, Eskalith, and Geodon) for anxiety and depression. For a long time he took the Adderall only when he was having serious difficulty waking up to get to school, but on the doctor's advice he started taking it every day. Now his anxiety is out of control (he can wake up in the morning OK, but he is often too anxious to leave the house or even to get out of bed), and we suspect that the Adderall may be contributing to the anxiety. Have others had this experience?
Posted by cybercafe on March 26, 2003, at 1:33:23
In reply to Re: do stims make you lazy?, posted by utopizen on March 25, 2003, at 9:08:27
> Why don't you try Straterra? You can stay on the Ritalin while you're trying it out, and maybe drop it if it works well enough.
not available in canada :(
maybe i should ask my doc about reboxetine, though i havn't heard much good about it
>
> It's not a stimulant.
>
> Never heard of the bipolar issue. I have social anxiety, though, and Desoxyn is good for this because it's less of a slave driver for my head, but it still lets me focus and gives me the energy to get things done. I can see why others say it's good for us inattentive types, and how Adderall is good for hyperactivity types. Adderall would literally make me enter a room sometimes, and people would remark how I "looked like I was on a mission" as I entered.yeah i get the man on a mission thing without meds, when i finally find something that actually interests me, i'll hyperfocus
Posted by cybercafe on March 26, 2003, at 1:34:33
In reply to Re: do stims make you lazy?, posted by Ellen S. on March 25, 2003, at 23:09:39
> I'm wondering how common it is for stimulants to make people anxious, or to contribute to anxiety.
>
> Several months ago, my teenage son's pdoc prescribed Adderall to help him wake up in the morning -- to overcome the severe sedation he was experiencing due to his various medications (Celexa, Eskalith, and Geodon) for anxiety and depression. For a long time he took the Adderall only when he was having serious difficulty waking up to get to school, but on the doctor's advice he started taking it every day. Now his anxiety is out of control (he can wake up in the morning OK, but he is often too anxious to leave the house or even to get out of bed), and we suspect that the Adderall may be contributing to the anxiety. Have others had this experience?ritalin definately makes me anxious
i hear the amphetamines aren't as bad
Posted by Ritch on March 26, 2003, at 9:00:55
In reply to Re: do stims make you lazy?, posted by Ellen S. on March 25, 2003, at 23:09:39
> I'm wondering how common it is for stimulants to make people anxious, or to contribute to anxiety.
>
> Several months ago, my teenage son's pdoc prescribed Adderall to help him wake up in the morning -- to overcome the severe sedation he was experiencing due to his various medications (Celexa, Eskalith, and Geodon) for anxiety and depression. For a long time he took the Adderall only when he was having serious difficulty waking up to get to school, but on the doctor's advice he started taking it every day. Now his anxiety is out of control (he can wake up in the morning OK, but he is often too anxious to leave the house or even to get out of bed), and we suspect that the Adderall may be contributing to the anxiety. Have others had this experience?If you already have a pre-existing anxiety disorder they definitely *can* make it worse. You might try a switch from Adderall to dexedrine to see if that rids him of most of the residual anxiety. If that doesn't work I would look at stopping the stimulant and focus on the other three meds and see if those might be causing most of the trouble with somnolence (esp. Geodon and Celexa). Antipsychotics can create a lot of sleepiness, Celexa can cause drowsiness and both of them could cause some insomnia at night making it tough to get up in the morning. He is taking Eskalith? Is he also dx'ed as bipolar?
Posted by Ellen S. on March 26, 2003, at 11:01:00
In reply to Re: do stims make you lazy? » Ellen S., posted by Ritch on March 26, 2003, at 9:00:55
> > I'm wondering how common it is for stimulants to make people anxious, or to contribute to anxiety.
> >
> > Several months ago, my teenage son's pdoc prescribed Adderall to help him wake up in the morning -- to overcome the severe sedation he was experiencing due to his various medications (Celexa, Eskalith, and Geodon) for anxiety and depression. For a long time he took the Adderall only when he was having serious difficulty waking up to get to school, but on the doctor's advice he started taking it every day. Now his anxiety is out of control (he can wake up in the morning OK, but he is often too anxious to leave the house or even to get out of bed), and we suspect that the Adderall may be contributing to the anxiety. Have others had this experience?
>
> If you already have a pre-existing anxiety disorder they definitely *can* make it worse. You might try a switch from Adderall to dexedrine to see if that rids him of most of the residual anxiety.Thanks, Ritch. Is there really a big difference between Adderall and dexedrine with respect to anxiety? I didn't know dexedrine was still available, but I see it at http://www.rxlist.com/cgi/generic/dextroamphetamine.htm .
> If that doesn't work I would look at stopping the stimulant and focus on the other three meds and see if those might be causing most of the trouble with somnolence (esp. Geodon and Celexa). Antipsychotics can create a lot of sleepiness, Celexa can cause drowsiness and both of them could cause some insomnia at night making it tough to get up in the morning.
We definitely would like to get him off the stimulant and address his sedation by reducing the medication(s) that cause it. We had expressed concerns about the sedation for a long time and wanted to see if his meds could be adjusted to reduce the sedation effect, but the pdoc strongly prefers to add meds to deal with side effects (rather than adjusting other meds to deal with the cause of the side effects), so he prescribed the Adderall.
We suspect that the Geodon is the biggest contributor to the sedation effect, but on the couple of occasions when he has skipped his 20 mg/day of Geodon to see how things go without it, he feels the difference (he is more easily upset by "stuff" that happens) and we notice a difference in his behavior. Thus, the Geodon is an important part of his treatment. He's just (today) started a trial of Abilify, which I am hoping might do the same things for him that the Geodon does but without the sedation effect, but for now the Abilify has been added to the mix, instead of replacing something else.
>He is taking Eskalith? Is he also dx'ed as bipolar?
>Interesting question. He was started on the Eskalith to augment the SSRI he was taking for depression. The effect was dramatic. He had been on an SSRI for about a year with no more than a limited effect that we could see -- although the pdoc he had been seeing during that time was convinced it was working -- but within a week after adding lithium he pulled out of a suicidal state and was feeling and acting pretty good.
The professionals who have worked with him most closely and on a continuing basis (including 24/7 hospitalization) have given him a dx of GAD plus mood disorder NOS. His psychologist-therapist strongly believes the anxiety is the main issue, with the depression secondary (due to my son's feeling that his life was out of control due to his inability to function normally), and we think he has a good understanding of the situation. However, the current pdoc is convinced that he is bipolar (mostly based on a pencil-and-paper questionnaire and the fact that lithium has been helpful) and keeps trying to add additional medications as "mood stabilizers." (Abilify is the latest in the list. Previously he has tried increasing the Geodon -- which was originally prescribed by an out-of-town specialist *not* as a mood stabilizer, but that was abandoned due to too many side effects. Also, my son took a fairly large dose of Lamictal for several months without any sense that it was doing anything other than mildly fogging up his head.)
We've taken the attitude that we seriously doubt the BP diagnosis (there's no family history, and the various other professionals he's worked with say he's nothing like a BP kid in his behavior), but we have agreed to cooperate with treatment that would help with *either* BP or the dx's that we believe.
Posted by utopizen on March 26, 2003, at 11:13:01
In reply to Re: do stims make you lazy / anxious? » Ritch, posted by Ellen S. on March 26, 2003, at 11:01:00
Provigil is suggested these days for somnolence (fatigue from meds). It shouldn't aggravate the anxiety. It's not a stimulant, it'll just wake him up.
Posted by blondegirl47 on March 26, 2003, at 12:19:21
In reply to Re: do stims make you lazy?, posted by utopizen on March 25, 2003, at 9:08:27
I have read about Desoxyn, but I can't get my doc to write a prescription for it. I have noticed short acting adderall seems to make me kind of tense.
Posted by Ritch on March 26, 2003, at 13:53:26
In reply to Re: do stims make you lazy / anxious? » Ritch, posted by Ellen S. on March 26, 2003, at 11:01:00
Yes, dexedrine is available and it is VERY cheap as well. The trouble is he would probably have to take it 3x daily, or perhaps 2x daily with the time-released spansules. I've been on both and the dexedrine causes much less anxiety. Also, it produced even less anxiety than Ritalin. Good luck with the med trials. Really sounds like bipolar, but he and myself and many others here have this weird mix of GAD+bipolaroid symptoms+ADHD probs. I wonder if it is a "fourth" illness all its own, not just uncomplicated/untreated BPII.
Posted by utopizen on March 26, 2003, at 15:47:16
In reply to Re: do stims make you lazy? » utopizen, posted by blondegirl47 on March 26, 2003, at 12:19:21
> I have read about Desoxyn, but I can't get my doc to write a prescription for it. I have noticed short acting adderall seems to make me kind of tense.
>It's in the same drug class (Schedule II), but some docs are tense about it. It's not anything that will addict someone when it's not abused. It's not capable of being injected or snorted, unlike Adderall or other stimulants, so in that way it's a bit safer actually. The shell is impossible to break for snorting or burn up for injection.
You can try Dexedrine, which lacks the l-isomer that is often the reason for anxiety in Adderall. Or Straterra, which is a non-stimulant. Trying a time-release version of Dexedrine may even be better, as some fine the speed of onset is the cause of the anxiety.
Posted by blondegirl47 on March 26, 2003, at 16:04:53
In reply to Re: do stims make you lazy?, posted by utopizen on March 26, 2003, at 15:47:16
I have tried regular Dexedrine, I didn't like it at all. Infact I think it made me more tired. It certainly made me grouchy. adderall xr works better for me than regular, so maybe down the road I will try time release dexedrine. Thanks for you input. :)
Posted by cybercafe on March 26, 2003, at 23:41:44
In reply to Re: do stims make you lazy / anxious? » Ellen S., posted by Ritch on March 26, 2003, at 13:53:26
> Yes, dexedrine is available and it is VERY cheap as well. The trouble is he would probably have to take it 3x daily, or perhaps 2x daily with the time-released spansules. I've been on both and the dexedrine causes much less anxiety. Also, it produced even less anxiety than Ritalin. Good luck with the med trials. Really sounds like bipolar, but he and myself and many others here have this weird mix of GAD+bipolaroid symptoms+ADHD probs. I wonder if it is a "fourth" illness all its own, not just uncomplicated/untreated BPII.
hmmm... GAD + bipolar + ADHD ... i'd just like to know what the cure is
Mitch have you ever discussed Abilify with your doc as a mood stabilizer, treatment for ADHD, or both?
i am wondering if it might be the one mood stabilizer that doesn't make ADHD worse
thoughts/comments?
Posted by Ritch on March 27, 2003, at 8:39:03
In reply to Re: do stims make you lazy / anxious?, posted by cybercafe on March 26, 2003, at 23:41:44
> > Yes, dexedrine is available and it is VERY cheap as well. The trouble is he would probably have to take it 3x daily, or perhaps 2x daily with the time-released spansules. I've been on both and the dexedrine causes much less anxiety. Also, it produced even less anxiety than Ritalin. Good luck with the med trials. Really sounds like bipolar, but he and myself and many others here have this weird mix of GAD+bipolaroid symptoms+ADHD probs. I wonder if it is a "fourth" illness all its own, not just uncomplicated/untreated BPII.
>
> hmmm... GAD + bipolar + ADHD ... i'd just like to know what the cure is
>
> Mitch have you ever discussed Abilify with your doc as a mood stabilizer, treatment for ADHD, or both?
>
> i am wondering if it might be the one mood stabilizer that doesn't make ADHD worse
>
> thoughts/comments?Hi, my last pdoc visit Abilify was practically marketed to me, but I won't take any AP's-period. Every AP I have taken caused cognitive dulling-this one might be an exception, but I do not want another dystonic reaction (as I had with Risperdal) or akathisia (which I am told Abilify seems to be worse for than the others). I quit the tiny bit of Effexor I had been taking and my cycling has gotten much smoother as a result. I then added WB back in. YES, the WB did cause some fairly fierce anxiety for a while, but the Depakote increase (250>375) took care of it. I was on WB 37.5 for about a week, then doubled it to 75mg for about 10 days, then bumped it to 100mg for about five days, then the last five days have been at 150mg. Anxiety is fading-I am quite surprised. My focus has been improving since I made the jump from 100>150 of WB. I couldn't tolerate this dosage previously, but am having little problems with it now. The Depakote causes cognitive problems, but they seem to be more "elastic" than the fogginess I had with Trileptal or the dazed feeling on lithium. They seem to be a little worse for a few days, but I seem to adjust to them more rapidly. I'm sure many will find Abilify to work wonders for them, but it sure is pricey. One thing about looking at the insert that had me concerned was its moderate affinity for the serotonin transporter. Good news if you have OCD perhaps, but SSRI activity = enhanced cycling for me.
Posted by Ellen S. on March 27, 2003, at 21:39:27
In reply to Re: do stims make you lazy / anxious?, posted by utopizen on March 26, 2003, at 11:13:01
> Provigil is suggested these days for somnolence (fatigue from meds). It shouldn't aggravate the anxiety. It's not a stimulant, it'll just wake him up.
Thanks for the suggestion. Provigil is very interesting medication, but it didn't work for us.
My son's main sedation problem seems to be mostly in waking up, not in maintaining wakefulness later in the day. For a brief period he was given Provigil to supplement a relatively low dose of Adderall without increasing anxiety. The Provigil didn't seem to help him wake up.
Posted by cybercafe on March 28, 2003, at 17:02:01
In reply to Re: do stims make you lazy / anxious? » cybercafe, posted by Ritch on March 27, 2003, at 8:39:03
Thanks for your comments Mitch.
Your comments are, as always, greatly appreciated.
Be well :)
This is the end of the thread.
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