![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2 to 26 of 42. Go back in thread:
Posted by Dinah on July 7, 2006, at 2:15:57
In reply to Doc won't treat ADD, posted by curtm on July 6, 2006, at 9:19:55
Is she particularly good in any way? I'm all for changing pdocs if you aren't happy.
I'm not happy, but only because he's so cold and formal. He gives me the meds that have proved helpful in the past, though, and doesn't press ones that have been harmful to me. So I keep him.
Are you getting enough sleep? There was an article in Psychology Today I think about sleep disorders, or not enough sleep, and ADD symptoms.
Posted by curtm on July 7, 2006, at 2:15:57
In reply to Re: Doc won't treat ADD » curtm, posted by Dinah on July 6, 2006, at 9:29:47
I don't care anymore if she's cold and formal. I can be the same way with her if I need to. She works for me and I expect results. I have lost my patience with her (it is not one of my virtues.) I can be open and warm with my T and vice versa.
I don't have any trouble sleeping ever. But being "tranquilized" is causing more harm than good. What I need is more trouble sleeping, but she just doesn't get it I guess.
I just got back from the doc. I gave back the seroquel and she gave me abilify. So I'll try that one tonight.
Posted by MidnightBlue on July 7, 2006, at 2:15:58
In reply to Re: Doc won't treat ADD » Dinah, posted by curtm on July 6, 2006, at 13:37:10
Curt,
I don't remember if you have tried Wellbutrin, but it is used in ADD and depression and will help focus your thoughts. Not sure why you are on the meds you are on. I think your meds are muddling your mind. Just my opinion....MB
Posted by Racer on July 7, 2006, at 2:15:58
In reply to Doc won't treat ADD, posted by curtm on July 6, 2006, at 9:19:55
I won't comment on any of this, because I have Opinions. It's a terrible burden, you know, having Opinions...
What I will ask is whether you've tried Strattera? It did seem to help me, and I would probably try it again.
Hope that helps, and good luck. If hope if it doesn't help, you will consider firing your pdoc in favor of one who, oh, I don't know -- maybe listens to your concerns?
Take care.
Posted by curtm on July 7, 2006, at 8:28:11
In reply to Re: Doc won't treat ADD » curtm, posted by Racer on July 7, 2006, at 1:30:39
>> I won't comment on any of this, because I have Opinions. It's a terrible burden, you know, having Opinions...
You can always Babble-mail me your opinions. I like both Babble-mail and opinions.
Posted by pseudoname on July 7, 2006, at 9:46:31
In reply to Doc won't treat ADD, posted by curtm on July 6, 2006, at 9:19:55
…if it were *ME* in the situation you describe (all else being equal). Things have never gotten better for me with a pdoc when they've refused a reasonable alternative for arbitrary reasons. Who put her in charge of saying what order your problems should be addressed? Besides, ADHD drugs can profoundly improve depression (as threads just above this one show).
The point of getting a psychiatrist for me has never been having a good relationship with them, it's getting an effective med. In my opinion, this pdoc is obstructing that goal and things will only get more frustrating.
Good luck, Curt.
Posted by llrrrpp on July 7, 2006, at 12:02:11
In reply to I would dump her… » curtm, posted by pseudoname on July 7, 2006, at 9:46:31
curtm,
is her reason for avoiding stimulants because of your history of stimulant addiction? OR is it for some other reason? If she cannot give you a reason that seems satisfactory, dump her.I am doing well on seroquel 25 mg at night and provigil 200 mg in the daytime. It's a stimulant, but not in the same category as amphetamine (PLEASE correct me if I'm mistaken!) I'm not on my own computer and don't have access to my research materials
cheers and best of luck to you. TGIF :)
-ll
Posted by med_empowered on July 7, 2006, at 12:44:46
In reply to Re: I would dump her…, posted by llrrrpp on July 7, 2006, at 12:02:11
For whatever reasons, shrinks sometimes go on power trips. I had a doc similar to yours once: I'd say "hey, I can't focus, and the drugs I'm on seem to be making things worse" and she'd be like "hmmm..interesting. Keep taking them (plus drug XXX, also sedating) and things will probably get better". I ditched her and go with a different doc.
I don't know your situation, but I don't think tranquilizing someone is the same as helping someone. I also think a doctor who is being paid to deliver reasonable results--improved focus, better quality of life--should do their best to achieve the patient's goals. If your doc fails to deliver for whatever reason--be it a refusal to help, an over-emphasis on other issues you find less important, or just plain incompetence--then I think its perfectly reasonable to move on and find a doctor who will work with you.
As for ADD meds...there are lots of things that can help. There are stimulating ADs (Wellbutrin, Pamelor, high-dose Effexor), conventional stimulants, Provigil, so on and so forth. There's no good reason for your doc to treat you like this, and there's also no good reason for you to stand for it. I say move on to someone else.
Posted by saturn on July 7, 2006, at 12:58:48
In reply to Re: I would dump her…, posted by llrrrpp on July 7, 2006, at 12:02:11
> I am doing well on seroquel 25 mg at night and provigil 200 mg in the daytime.Hi ll,
Do you mind if I jump in here and ask if you'retaking the provigil for ADHD, and if so how it works and/or side effects? Thanks. Peace. Saturn.
Posted by Phillipa on July 7, 2006, at 22:52:59
In reply to Re: Doc won't treat ADD » Dinah, posted by curtm on July 6, 2006, at 13:37:10
Curtn abilify is supposed to be stimulating. Good luck!!!!Love Phillipa
Posted by gardenergirl on July 8, 2006, at 11:02:28
In reply to Re: Doc won't treat ADD » curtm, posted by Phillipa on July 7, 2006, at 22:52:59
Curt,
I have atypical depression and mild inattentive ADHD. I take Nardil and Lamictal for the depression and provigil for the ADHD. The provigil helps with any residual depression and has helped me regulate my sleeping (usually sleep too much). Now I just need to work on behavioral interventions for ADHD to really see some improvement. Structure, structure, structure! :)I hope you and your pdoc can work together to target all of your symptoms.
Good luck,
gg
Posted by rjlockhart on July 8, 2006, at 21:55:09
In reply to Doc won't treat ADD, posted by curtm on July 6, 2006, at 9:19:55
First of all, i dont know what you situation is with you thoughts. I take Xanax at a high dose. That freaking quiets my body not my mind.
Anyways are you talking about a stimulant, tell her that you are having difficulty concentrating. Is there any thing that can help?
Dexedrine and Adderall, well i dont know if she would prescribe it. Be percistant! thats what pays off.
Take care
RJ
Posted by rjlockhart on July 8, 2006, at 21:56:48
In reply to Re: Doc won't treat ADD, posted by rjlockhart on July 8, 2006, at 21:55:09
whoa i just read my post, i think im a little manic right now, sometimes i get a little not myself. Forgive me if that post seemed provative.
But be be persistant!
Rj
Posted by Phillipa on July 8, 2006, at 22:00:32
In reply to Re: Doc won't treat ADD, posted by rjlockhart on July 8, 2006, at 21:56:48
Matt did you know there's a self-esteem board now? Check it out. Love Phillipa
Posted by rjlockhart on July 8, 2006, at 23:06:14
In reply to Re: Doc won't treat ADD » rjlockhart, posted by Phillipa on July 8, 2006, at 22:00:32
thanks i posted here.
Take care
RJ
Posted by llrrrpp on July 10, 2006, at 13:31:27
In reply to re provigil » llrrrpp, posted by saturn on July 7, 2006, at 12:58:48
>
> > I am doing well on seroquel 25 mg at night and provigil 200 mg in the daytime.
>
> Hi ll,
>
> Do you mind if I jump in here and ask if you'retaking the provigil for ADHD, and if so how it works and/or side effects? Thanks. Peace. Saturn.
>
Hi Saturn,
I take the provigil because I have a lot of daytime sleepiness due to AD (cymbalta, 90 mg) I was odosing on caffeine and feeling like crap. even on the provigil I can still get in 2 good naps a day. but the difference is that I don't NEED them :) who knows, maybe I have ADHD. More likely I'm just disorganized and slacking.
-ll
Posted by laima on July 19, 2006, at 10:42:07
In reply to Doc won't treat ADD, posted by curtm on July 6, 2006, at 9:19:55
Personally, I wonder if you might want to consider a new doctor, even for "a second opionion". Why so reluctant to treat ADD? Also, the drugs such as zyprexa can be complicated, themselves. Not to mention that the right benzodiazepine might be another helpful to "quiet" your brain while leaving you more "natural feeling" and functional. (I'm no doctor- this was just how it went iin my case.) When I tried zyprexa, it actualy made my attention much worse because I entered an almost hallucinogenic fog-state, and became very sedentary and strange, floaty feeling-save for persistently obsessing over eating and running out to buy more icecream. I am on my second doctor now- and he's radically different and smarter than the first one who I had. The first one was eager to prescribe in a way that sounds like what yours is doing- but the second addressed my ADD immediately. Personally, I think part of my depression and anxieties have stemmed from the utter frustration of not being able to concentrate on anything, complete tasks, and so on. I was in constant state of panic over what was't getting done, sliding away, and not working out. With ritalin, I am completing tasks, able to read books, etc. This has been an enourmous morale boost. While I am still not exactly the picture of model mental health, the ADD treatment has been very important to get me on my way. I do understand that many doctors are reluctant to prescribe for ADD because many of those drugs have a high addiction and abuse potential- perhaps that is part of the problem? They can also make an anxious person feel much more "wired". (I've experienced that, too.)
As for provigel- I even tried that. It did keep me awake and helped me focus- with absolutely no "wiredness"! Ultimately, in my case, ritalin worked out best. But, provigel, if you can get it, might be a good one.
I wish you good luck.
> I took an ADD test at T's and show results of ADD, but pdoc won't treat it because she thinks my mood disorder needs to be addressed first. In the meantime, I can't concentrate at work (or anywhere for that matter) and she keeps giving me stuff to "quiet my brain" like Zyprexa or Seroquel. Those have done nothing but tranquilize me for at least a dozen hours at a time. Can't get much done that way now can I? Not sure what I should do next. Should I fire her and find a new doc or go through all the AP's that she keeps bringing up as options. I know they will all do the same thing (knock me out.) I am not very happy right now about this situation. Grrrr
Posted by laima on July 19, 2006, at 10:51:29
In reply to re provigil » llrrrpp, posted by saturn on July 7, 2006, at 12:58:48
I took provigel for awhile because I have ADD as well as a sleep disorder and an anxiety problem. It indeed kept me awake and modestly helped me with concentration. I didn't notice any side effects, though my doctor did say it interacts with many diffferent drugs. What- I still don't know. I didn't have any trouble falling asleep at night while using it, either.My doctor said no one knows exactly how it works, but that it is very, very specific as to where it acts in the brain. I also heard it was originally developed to be used by pilots and military personell who need to be alert but not "wired".
Ritalin works well for me now- but a tiny amount dexedrine once made me feel that I was about to completely freak out. I think we might not all react the same to these drugs.
>
> > I am doing well on seroquel 25 mg at night and provigil 200 mg in the daytime.
>
> Hi ll,
>
> Do you mind if I jump in here and ask if you'retaking the provigil for ADHD, and if so how it works and/or side effects? Thanks. Peace. Saturn.
>
Posted by cloudydaze on July 19, 2006, at 17:52:03
In reply to Doc won't treat ADD, posted by curtm on July 6, 2006, at 9:19:55
Do you have bipolar? You said "mood disorder" - so i wasnt sure.
I have bipolar, and for years i was medicated for ADD. I really am not sure if i ever had ADD. The problem is, symptoms of bipolar (and sometimes depression & other disorders) cross over with the symptoms of ADD.
I always thought that my trouble concentrating was ADD, but then I learned about the "racing thoughts/disorganized thoughts" symptom of bipolar...and i think that's my problem. It even affects my sleep (can't turn off my mind...)
Maybe your doc thinks you really don't have ADD, but you have similar symptoms caused by your mood disorder?
I wasn't aware there was a test for ADD. Unless it's a new thing...the research I did on ADD always said that there is no actual test, just evaluation of symptoms combined with family history of the illness (several people in my family have ADD, but i seem to be the only one with bipolar..).
If there is a test, it would be interesting to know if i actually ever had ADD...or if i was just taking ritalin for nothing!
I've taken both Zyprexa and serequel...felt like a zombie. I didnt like it.
> I took an ADD test at T's and show results of ADD, but pdoc won't treat it because she thinks my mood disorder needs to be addressed first. In the meantime, I can't concentrate at work (or anywhere for that matter) and she keeps giving me stuff to "quiet my brain" like Zyprexa or Seroquel. Those have done nothing but tranquilize me for at least a dozen hours at a time. Can't get much done that way now can I? Not sure what I should do next. Should I fire her and find a new doc or go through all the AP's that she keeps bringing up as options. I know they will all do the same thing (knock me out.) I am not very happy right now about this situation. Grrrr
Posted by curtm on July 20, 2006, at 8:34:26
In reply to Re: Doc won't treat ADD, posted by cloudydaze on July 19, 2006, at 17:52:03
The ADD test was simple. I took it on a computer
The screen was black with a 2" x 3" square in the middle. The computer would either display the number 1 or 2 in the box. The computer will sound a number 1 or 2 also. Each time you hear or see the number 1, you click the left mouse button. Somehow base on your reaction and accuracy it evaluates your "symptoms." My psychologist ran this test for me.
Posted by pseudoname on July 20, 2006, at 8:58:12
In reply to Re: Doc won't treat ADD » cloudydaze, posted by curtm on July 20, 2006, at 8:34:26
> I took it on a computer
> My psychologist ran this test for me.If you don't mind my asking, how much did he/she charge for it?
Thanks.
Posted by laima on July 20, 2006, at 9:54:04
In reply to Re: Doc won't treat ADD » cloudydaze, posted by curtm on July 20, 2006, at 8:34:26
I was going to say, I've seen questionaires about ADD just as I've seen questionaires about anxiety disorders, depression scales, psychosis evaluations, etc. But the test you took sounds even more "official" or "unbiased" somehow than those. I do agree with the person who said that questionaires and tests alone are perhaps not the best way to make a definitive diagnosis, and also agree that it is important to consider factors such as how the disorder affects daily life functioning, etc.
A lot of "healthy" people might score high on the tests when in a poor mood, for example. (I imagine you know, as likely we all do, "feeling blue" or "disracted" once in awhile, doesn't make a clinical mood disorder. I get so irritated when happy, well-adjusted people say stuff like "I'm so depressed that there is nothing good on tv tonight", "I can't pay attention to this boring lecture- must be my add". etc., but I digress...) And then there is a lot of potential for overlap, as in the very unfortunate story shared by cloudydaze.But, is it true that adult add usually lacks "hyperactive or "racing" elements? Or am I wrong in thinking this? My own add is more spaciness, inability to concentrate, pay attention, or stick to tasks, easy distraction, etc.
I was thinking about your predicament, and it occurred to me that every psychiatrist I've ever met seemed to have a philosophy of "one thing at a time so we know what is affecting what".
Perhaps, plausabley, your doctor is understandabley reluctant to prescribe a stimulant to a person who expresses troubeling agitation, racing thoughts, and the like? A stimulant might make such symptoms much worse by increasing anxiety and agitation. Also, in my own experience as a patient, I noticed that there is often a mood lull or slight fall as they (stimulants) wear off. (Provigel the exception-but while not sure again, I think it is better for sleep and wakefulness troubles rather than ADD. (At least in my case.) And again, my doctor claims it can interact with many other substances, limiting overall treatment options.) Maybe that's why this talk of first "quieting" your mind came up?I'm still sorry your doctor seems so insistent on anti-psychotics.
What if you proposed that you wished to try something like klonopin or even one of those "mood stabilizers" like lamictal?
I myself found lamictal didn't agree with me, but it sure was a massive improvement over zyprexa. (And again, I know zyprexa works great for many people- and I envy those who can tolerate it- for it sure does seem to help with mood and anxiety!)I hope I didn't step on any slippery slope here with my thoughts or words in this post-I know we are all different and went through different trials and have had different experiences.
I'm no medical expert, I'm just speculating based upon my own experiences as a patient who over the years tried many different drugs, and and am sincerely wishing to be helpful and supportive. (diagnosed and being treated for mood disorder- resistant unipolar depression and anxiety-and add)> The ADD test was simple. I took it on a computer
> The screen was black with a 2" x 3" square in the middle. The computer would either display the number 1 or 2 in the box. The computer will sound a number 1 or 2 also. Each time you hear or see the number 1, you click the left mouse button. Somehow base on your reaction and accuracy it evaluates your "symptoms." My psychologist ran this test for me.
Posted by curtm on July 20, 2006, at 10:33:13
In reply to cost of test? » curtm, posted by pseudoname on July 20, 2006, at 8:58:12
> > I took it on a computer
> > My psychologist ran this test for me.
>
> If you don't mind my asking, how much did he/she charge for it?
>
> Thanks.
Hmmmm. I hope it didn't cost anything. I never asked. I assumed that it was just part of my therapy at his hourly rate. Oh well. I do have insurance anyway. I will ask next Monday when I go. (If I remember)
Posted by pseudoname on July 20, 2006, at 11:28:56
In reply to Re: cost of test? » pseudoname, posted by curtm on July 20, 2006, at 10:33:13
> I hope it didn't cost anything.
Hey, Curt.
I was only curious because computer-based ADHD tests were one the things marketed at the APA convention. The salesguy told me I could use it to increase my billing (he thought I was a pdoc) by about $200 per patient intake with virtually no clock time by the doc. The suggested bill for the test itself (if given once) was $45, I think.
Posted by curtm on July 20, 2006, at 12:06:08
In reply to Re: cost of test? » curtm, posted by pseudoname on July 20, 2006, at 11:28:56
>> he thought I was a pdoc
You should be. You would be very good I'm sure.
Thanks for the info. I would think they should disclose additional costs beforehand. Watch me get pissed if he didn't. Funny.
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.