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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by sondico24 on February 21, 2008, at 13:26:55
I'm a 2 tour veteran of the Iraq war, and was diagnosed with PTSD. I recently started college and told the doc I couldn't concentrate. I didn't know I would be diagnosed with ADHD. Maybe the PTSD caused ADHD? I don't know, but I started taking methylphenidate 20mg morning and 20mg noon. I went back and said that helped a little, but wore off too quick, so switched to 10mg, and 20mg slow release, but haven't had any success, so I called doc and said to switch to 20mg morning with 20mg slow release, and again in the afternoon. I tried this once, and it made me feel stupid, so I went back to 10mg with 20mg slow release. It seems to make me talkative, jittery, increased heart rate, and kind of zoned out, instead of in, and a little depressed/out of energy in the afternoon. I don't really know what to do, so I came here hoping someone could give me some advice. Should I try adderall, or some other medicine? Ever since I got back from Iraq I've been searching for something it seems like; to make me whole again, feels like something is missing. Any help would be appreciated.
Posted by gardenergirl on February 21, 2008, at 13:55:48
In reply to recently diagnosed with adhd and need your advice, posted by sondico24 on February 21, 2008, at 13:26:55
First, thank you for your service, and welcome back home. Also, welcome to Babble!
Did whoever diagnosed you with ADHD do any testing? It can be very tricky to diagnose this in adults, particularly with a comorbid disorder like PTSD or others. Did you show any signs of ADHD in childhood? I ask this because if your symptoms are ADHD-like but are more related to the PTSD, I'm not sure you'll get the best benefit from a stimulant.
I have ADHD, diagnosed finally as an adult. I don't take stimulants because they are contraindicated with another med I take for depression, Nardil. So I can't offer any advice about your meds. I'd just highly recommend seeing a specialist for a thorough diagnosis if you didn't already.
Good luck.
gg
Posted by Racer on February 21, 2008, at 14:12:54
In reply to Re: recently diagnosed with adhd and need your adv » sondico24, posted by gardenergirl on February 21, 2008, at 13:55:48
First, I agree with GG that an inability to concentrate isn't necessarily ADHD, and your reactions to methylphenidate don't sound as though they support that diagnosis. Also, the long acting forms of methylphenidate should be taken once a day -- that's the point, that they are slower release, and you don't get the highs and lows that the immediate release produces.
For what it's worth, I take Concerta -- a long acting form of methylphenidate -- and I know when I've hit the right dose because I feel more focused, but I can't really feel the medication. (That doesn't sound right, but what I mean is that there's no speediness -- I don't have trouble sleeping, don't feel extra talkative, don't have any sort of let down when it's wearing off, etc.) If you're experiences ups and downs throughout the day, that sounds as though there's a problem with either dosage or dosing schedule.
Since you've recently experienced something so profoundly life-altering, I wonder if you've considered trying psychotherapy? That's certainly not a suggestion that there's anything "wrong" with you, only a suggestion that it might help to be able to discuss your experiences, process some of the emotional turmoil they must have caused, and maybe learn some new coping skills that might help with the PTSD symptoms. I'm a big believer in therapy, and see a therapist myself, but I know that there are some people who are more suspicious of it, or believe that it's only for people who are "crazy," or have other negative views of it. I have very positive views of therapy, and really want to make that clear, as well as making clear that what works for me does not always work for others...
(Dear me, I guess I'm feeling worried about how my words are taken by others. I really mean well, but I'm terribly afraid that I'm inadvertently offending others.)
I, too, would like to thank you for your service to your country. I wish you all the best in adjusting to your return.
Posted by Dopamine123 on February 21, 2008, at 15:11:30
In reply to I agree with GG on this, and..., posted by Racer on February 21, 2008, at 14:12:54
I have ADD problems and I tried ritalin/concerta to start out with. I really didn't like it at all. It made me feel really weird and out of it, even though my concentration was improved. It didn't help my mood at all. So now I take adderall, which for me is a much better drug. I don't feel as weird on it as I did on ritalin and the adderall has much more of an antidepressant effect for me. I think its best to take the adderall in combination with an antidepressant, otherwise the withdrawal is much harder.
If you don't want to go into withdrawal, you could try the antidepressant Wellbutrin. It is similar in effect to ritalin but has a much longer half-life. It increases dopamine/norepinephrine, though to a lesser extent than ritalin.
Visit my blog on neuroscience/neurotechnology:
http://brainstimulant.blogspot.com
Posted by Dopamine123 on February 21, 2008, at 15:16:32
In reply to recently diagnosed with adhd and need your advice, posted by sondico24 on February 21, 2008, at 13:26:55
Oh, and by the way. Attention problems are common to almost every psychiatric disorder. So it doesn't necessarily mean you have ADD/ADHD if you can't concentrate. Depression, Bipolar disorder, Schizophrenia and PTSD are all associated with poorer concentration. Sometimes all you need is an antidepressant to improve your concentration, but often you need to combine an antidepressant with a stimulant to get a better cognitive effect.
I take mirtazapine with adderall which is a good combination for anxiety/depression/concentration/sleep.
Posted by eric wagner on February 21, 2008, at 15:38:48
In reply to Re: recently diagnosed with adhd and need your advice, posted by Dopamine123 on February 21, 2008, at 15:16:32
hi
i take daytrana (methylphenidate patch)
it takes me 1 - 2 weeks for side effects to wear off
for me - the first week is pretty tough (irritability, bad mood, etc.)
u may want to give it a little time
i find medication excellent for concentration, creativity, organization, etc.
the 4th - 9th day, i have a better mood, but then changes
i just recently got a prescription for a higher dose, so hopefully this will help mood
(i have tried many antidepressants in all classes w/ no positive results whotsoever)
godd luck
good luck
Posted by Phillipa on February 21, 2008, at 19:05:59
In reply to Re: recently diagnosed with adhd and need your advice, posted by eric wagner on February 21, 2008, at 15:38:48
Just my 2 cents Son was in Iraq and has PTSD he denied it for years and finally went on zoloft and is off it now and has prn ativan. Might want to get the PTSD testing. Do you jump with noises? Welcome home. Love Phillipa
Posted by Phillipa on February 21, 2008, at 19:08:21
In reply to recently diagnosed with adhd and need your advice, posted by sondico24 on February 21, 2008, at 13:26:55
And also a warm welcome to babble as I see you're new lots of great people here some you've already met. Love Phillipa
Posted by sondico24 on February 21, 2008, at 20:01:17
In reply to Re: recently diagnosed with adhd and need your advice » eric wagner, posted by Phillipa on February 21, 2008, at 19:05:59
Thank you all for your advice, I didn't expect such a warm welcome, I really appreciate it. Well, I am also irritable a lot of times, for no apparent reason, impulsive most times, and worry I will become abusive towards my girlfriend/future children. Maybe I do need an antidepressant... I was on salexa, but I didn't like that because of sexual side effects. I switched to mirtazapine, and I slept most of the day, but I only took it twice, so maybe I didn't give it enough time for my body to adjust. Sometimes I still think I need one though. I did cognitive therapy for 12 weeks after being diagnosed with PTSD, and now I'm going to do some other type of therapy in the coming weeks. I told the therapist I get my feelings confused, sometimes I really just don't know how to interpret what I'm feeling. Thank you all again...
Posted by bleauberry on February 21, 2008, at 20:49:52
In reply to recently diagnosed with adhd and need your advice, posted by sondico24 on February 21, 2008, at 13:26:55
With your experience it would be highly likely in my opinion that your adrenal glands are fried and your HPA axis is bent out of shape badly. Medications might help, probably make it worse in a few weeks or months, and load you with strange reactions as you are already experiencing. Post traumatic stress and ADHD go hand in hand with adrenals. Start there and that could be all you need. Fix the problem causing symptoms instead of muting a cluster of symptoms.
Your history as well as description of responses to meds gives distinct clues pointing in this direction.
You might seriously want to take a look stopthethyroidmadness.com and follow links to learn about adrenal burnout and related thyroid problems. Without being sure these things are solid, medicating yourself will be like trying to build a house on soggy clay. If you want more detail, hop over to the alternative board and start a new post.
Posted by MissK on February 22, 2008, at 6:16:16
In reply to recently diagnosed with adhd and need your advice, posted by sondico24 on February 21, 2008, at 13:26:55
>Ever since I got back from Iraq I've been searching for something it seems like; to make me whole again, feels like something is missing. Any help would be appreciated.
Maybe a few sessions of therapy with a psychologist to talk about this is what is needed, and not medication. If you didn't have ADHD before your experiences in Iraq, then I wonder why you would have it now. Not being able to concentrate can be psychologically related too, and what you describe above is more of a psychological question; i.e. 'feels like something is missing'. In therapy you can explore that feeling and concern and what it may be. I am of the opinion that the least or no medication, the better.
Posted by MissK on February 22, 2008, at 6:20:25
In reply to Re: recently diagnosed with adhd and need your advice, posted by sondico24 on February 21, 2008, at 20:01:17
Oops, that will teach me for not reading the whole thread before responding! lol. Yes, sounds like some additional therapy will do you good.
>Thank you all for your advice, I didn't expect such a warm welcome, I really appreciate it. Well, I am also irritable a lot of times, for no apparent reason, impulsive most times, and worry I will become abusive towards my girlfriend/future children. Maybe I do need an antidepressant... I was on salexa, but I didn't like that because of sexual side effects. I switched to mirtazapine, and I slept most of the day, but I only took it twice, so maybe I didn't give it enough time for my body to adjust. Sometimes I still think I need one though. I did cognitive therapy for 12 weeks after being diagnosed with PTSD, and now I'm going to do some other type of therapy in the coming weeks. I told the therapist I get my feelings confused, sometimes I really just don't know how to interpret what I'm feeling. Thank you all again...
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