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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Luthien on April 4, 2005, at 9:26:57
My husband has had difficulty with being able to concentrate at work, and he (and I) want to tackle this. He's lost 3 jobs in the last 4 years, at an age when he should be really getting ahead in his profession (high tech). He's very intelligent and knowledgeable about his field. He's always seemed to have a bit of adult ADD: procrastination, fidgeting, insomnia (can't turn brain off), poor listening skills (frequently things I tell him go "in one ear and out the other"). With the stresses in his life over the last 5 or 6 years (the death of a sibling, job strains, having a high-needs toddler in the house, and more), the depression (or ADD?) has not improved. Our family doctor dx'd him as having depression 5 years ago and put him on Prozac. This seemed to help, but the stresses kept adding over the years: another child, a layoff, a move for a new job, another layoff, a new job out of state which didn't work out, a long period without work...
After a couple years on Prozac his doc switched him to Lexapro. Both Prozac and Lexapro seemed to have helped, but not as much as they should have and they just killed his libido. His symptoms are very much like adult ADD (plus stress), but his new doctor is so far reluctant to dx ADD. His doctor seems to be pretty open to suggestions, but seems to want to focus on ADs before trying any ADD meds. My husband recently got off Lexapro and took Effexor for 5 weeks, which helped with concentration but which left him frighteningly, emotionally neutralized and did not help his libido. He had an awful time getting off Effexor with body and brain zaps, and finally I had him titrate off reducing the number of pellets each day. (I've been reading this board a while now, having been dx as dysthymic myself.) Wellbutrin might help with the concentration and libido, but with his insomnia problems I'm not sure how well that would work out. He exercises twice a week, but I've been trying to get him to increase that to five and he's not been able to find the time. He has one or two alcoholic drinks in the evening to destress. I once gave him an Ativan when he was really stressed out and he said it worked wonderfully, but he has never asked his doc for this or mentioned that he has tried it.
So, can anyone suggest meds that we can research and suggest to his doc? He's very anxious right now as he is having starting to have some difficulty concentrating at work.
Posted by Phillipa on April 4, 2005, at 17:45:10
In reply to Depression or Adult ADD? Need advice on meds!, posted by Luthien on April 4, 2005, at 9:26:57
I'm sorry he's having such a hard time right now, but i think you answered your own question. The ativan calmed him. That would be the suggestion I would give to the doc. It would calm down his mind, let him sleep, and wouldn't add to the sexual problems. I hate AD's, I've never seen them work for anxiety, just make you apathetic. It's good he excercises. Hope this helps. Fondly, Phillipa
Posted by Bill LL on April 5, 2005, at 9:55:24
In reply to Depression or Adult ADD? Need advice on meds!, posted by Luthien on April 4, 2005, at 9:26:57
When I switched from Lexapro to Cymbalta, my concentration was helped. He might want to try Cymbalta. It affects norepinephrine and that can help with ADD symptoms.
Otherwise, he needs to try an ADD drug such as Ritalin. If the doc says no, go to a different doc. Psychiatrists are generally more willing to prescribe ADD drugs than are internists.
Posted by Luthien on April 5, 2005, at 17:49:03
In reply to Re: Depression or Adult ADD? Need advice on meds! » Luthien, posted by Phillipa on April 4, 2005, at 17:45:10
Thanks, Phillipa. He's most keen on something that will help with concentration. The inability to turn his brain off at night often leads to him to read until 3 a.m., which means he goes to work on 3 hours of sleep which, of course, doesn't help with concentration. Occasionally he will take a half a Trazadone around 9 at night, but he said the Ativan just took away all the stress and left him feeling normal, whereas the Trazadone leaves him feeling drugged. How does he ask his doctor for Ativan? Doctors are notoriously hesitant to prescribe sedatives, from what I've read on here. Our family doc (MD/PhD Psych) in our old city was reluctant to ever prescribe Ativan. I've had a bottle (which my ENT prescribed for me without hesitation, LOL) that have lasted me about 2 years.
Cheers,
Luthien
Posted by Luthien on April 5, 2005, at 17:52:59
In reply to Re: Depression or Adult ADD? Need advice on meds!, posted by Bill LL on April 5, 2005, at 9:55:24
> When I switched from Lexapro to Cymbalta, my concentration was helped. He might want to try Cymbalta. It affects norepinephrine and that can help with ADD symptoms.
>
> Otherwise, he needs to try an ADD drug such as Ritalin. If the doc says no, go to a different doc. Psychiatrists are generally more willing to prescribe ADD drugs than are internists.
>
>
with ADD symptoms.
Thank you so much. We will look into Cymbalta. Around here there's usually a 3-month waiting list to see a Psychiatrist. Yikes.
This is the end of the thread.
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