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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by sailboat77 on September 29, 2010, at 20:23:53
I've been suffering from Bipolar II disorder for 10 years now and haven't found a single medication that works, except for Adderall.
The only thing that brings me relief and a sense of comfort is Adderall, but the Adderall wears off after 4 hours and then I slip into depression.
Does anyone else take Adderall or some other stimulant for their Bipolar/Depression?
Posted by sailboat77 on September 29, 2010, at 20:32:17
In reply to Adderall and Bipolar II, posted by sailboat77 on September 29, 2010, at 20:23:53
I should add that I've had ECT treatments without any positive results. I'm not even sure that I have Bipolar II because I never get manic, just very depressed. The only thing I haven't tried are MAOI's because of all the side effects. My depression/bipolar is extremely treatment resistant.
Posted by morgan miller on September 29, 2010, at 22:15:21
In reply to Re: Adderall and Bipolar II, posted by sailboat77 on September 29, 2010, at 20:32:17
Have you tried TCA's like Nortriptyline? Evidently the combination of Zoloft and Nortriptyline can work quite well.
I would seriously consider an MAOI like Nardil or Parnate. The side effects are not what you might think. I'm sure there are plenty of people here that can give you feedback on their experience with MAOIs.
Is this your first post here? If so, welcome to Psycho-Babble!
Sorry if I miss that you mentioned it was your first post.
Morgan
Posted by Christ_empowered on September 29, 2010, at 23:36:49
In reply to Re: Adderall and Bipolar II, posted by morgan miller on September 29, 2010, at 22:15:21
Just based on personal experience, I'd say Tofranil (maybe the PM form, its a once-nightly capsule) plus adderall a couple times daily.
Posted by Phillipa on September 30, 2010, at 10:36:12
In reply to Re: Adderall and Bipolar II, posted by Christ_empowered on September 29, 2010, at 23:36:49
If you can take providgil with bipolar II have you tried that? Phillipa
Posted by sailboat77 on September 30, 2010, at 11:39:17
In reply to Re: Adderall and Bipolar II, posted by Phillipa on September 30, 2010, at 10:36:12
Thanks so much for your help. I'm going to talk to my doctor about some of the suggestions you guys have given me.
Posted by emilyp on September 30, 2010, at 14:27:51
In reply to Re: Adderall and Bipolar II, posted by sailboat77 on September 30, 2010, at 11:39:17
It would seem to me that before you switch medications or try any new medications, you should get your diagnosis checked - perhaps by another doctor than the one you currently see. There is a meaningful difference between bipolar and depression; if you are treating the wrong illness, it is hard to believe that you will have a successful outcome.
Posted by alchemy on September 30, 2010, at 19:56:17
In reply to Adderall and Bipolar II, posted by sailboat77 on September 29, 2010, at 20:23:53
I am sort-of bipolar II with no ups. Just different levels of depression.
How long have you tried Adderall? I'm just curious based on my own experience. When I tried it is when my "bipolar" tendencies were manifested. First week on 30mg was awesome, I thought I had found a miracle after 20 years.
Then, not so great- up and down, with deeper downs. That was about 3 years ago. (added abilify which made things worse. became so bad I tried the ect & luckily it worked). My first week on Adderall & my first week after ECT were the best week-long times of my life.
I now have the same questions as you now that I am on a stabilizer (Lamictal). I have been taking dexadrine most of the time for about 8 months. Based on my experience, I am hesitant. I don't think it has ever made a big difference, maybe because of the Lamictal. I think it has helped my motivation at times. But I can also take it and take a nap.
My dr. actually thought I should take it more regulary, and then try increasing it. I didn't take his advice for very long. It pretty much just made it hard to sleep.
I don't want to give it up because it does seem to occasionally to help a little bit with motivation. (and I admit I like the weight loss effects). But I am worried it may be having a negative effect on me, especially long term.
---> Any input from anyone if the effects of a stimulant can be blunted when on a stabilizer?
Sailboat:
- What are your experiences with stabilizers?
- Do you think the depression that comes when the adderall wears off is worse than if you wouldn't have taken it (just my curiousity for my situation)
- Ideally I would guess it would be best for you to be on a stabilizer when taking a stim.
- What about a long-acting version?
- Like mentioned earlier, Provigil is a unique med for energy, but not a stimulant.
Posted by sailboat77 on October 1, 2010, at 10:42:46
In reply to Re: Adderall and Bipolar II, posted by alchemy on September 30, 2010, at 19:56:17
Thanks for responding. It sounds like we have very similar issues with taking stimulants. I'm either unipolar or bipolar II. I've been trying Adderall/Vyvanse off and on for the past 2 years. The only time I feel positive or truly happy is when taking stimulants, though I don't get manic. Just like you, I thought Vyvanse and Adderall were my saving grace until I realized that I was getting depressed soon after they wore off.
Right now, I'm actually taking Vyvanse which is just like Adderall but it's a slower release and lasts hours longer (the Adderall only lasts 3 hours for me). My greatest problem is that Vyvanse makes me feel motivated and happy for about 5 hours but then I slip into an even deep depression for the rest of the day. My greatest hope/wish is that I can find a combination of meds that provide a longer lasting stimulant effect (i.e. Happiness/Motivation), and most importantly, a mood stabilizer or anti-depressant that prevents me from crashing.
In terms of mood stabilizers, I tried Lamictal 2 years a ago but it didn't have any effect on me. Recently, I've been taking Lithium for for the past 2 months. The Lithium seems to weaken Vyvanse's stimulant effects. But some people get improvement on Lithium because of its anti-manic properties. After talking to my doc, I think we will put the Lithium aside.
[I should it should be known that I'm Treatment-Resistant to Unipolar or Bipolar II disorder. I've almost every 3rd generation SSRI or atypical antipsychotic without any improvement. (Cymbalta. effexor, prozac, abilify, seroquel, ect...]
I'm currently taking:
30mg Vyvanse (taken every other day)
3mg Lunesta (helps take the edge off the stimulant so I can sleep)
75mg Nortriptyline (doesn't help my depression, but it makes the Vyvanse crash slightly less worse)
600mg Lithium (I recently stopped taking it though because it negated the benefits of the stimulant)
.5mg Xanax (helps alleviate sadness when I'm very depressed)I'm going to my doc today so I can ask him to change two of my medicines. Instead of nortriptyline, I want to try Tofranil (a different sort of tricyclic). Instead of Vyvanse, I want to try Provigil.
-Thanks again for posting and sharing your wisdom. Respond back if you have any other experiences that might be helpful.
Posted by Dan_MI on October 3, 2010, at 10:53:52
In reply to Re: Adderall and Bipolar II, posted by sailboat77 on October 1, 2010, at 10:42:46
I'd be careful. It's possible to have mood swings in unipolar depression and be helped greatly by stabilizers, especially lamictal.
The danger is the potential to train your brain into being bipolar with the use of stimulants, even if you had no experience with mania before. Once your manic, it becomes easier and easier to become manic again. I never had mania until I took effexor, and now I have to be extremely careful. I cannot take cough medicine with dextromethorphan or decongestants with pseudroephedrine or phenylephrine. If I accidentally take an extra prozac it has the potential to turn into a week-long hypomanic episode.
Lithium has a lot of pluses if you can stomach (no pun intended) the side effects.
Welcome to the board!
Posted by alchemy on October 3, 2010, at 12:10:21
In reply to Re: Adderall and Bipolar II, posted by sailboat77 on October 1, 2010, at 10:42:46
thank you for posting your experiences.
it sounds like Lamictal is probably also reducing the effects of dexadrine for me.i don't know. it sounds like i'm damned if i do and damned if i don't. but there really is no definite proof that it is screwing me up. i am on 400mg of lamictal.
Posted by Cece on October 4, 2010, at 14:35:00
In reply to Adderall and Bipolar II, posted by sailboat77 on September 29, 2010, at 20:23:53
Hi-
I'm BPII, and Adderall has been part of my cocktail for about 10 years. Most of my other meds have changed during that time, but the Adderall has remained constant except for the fact that I switched to Add XR a couple of years ago because I was getting an afternoon slump. The XR seemed to solve that.
My BP II proved to be extremely treatment resistant and it's taken 20 years of med tuning to get me to the place I am now (a lot of new meds have come out since I was diagnosed). I'm presently more stable and in better spirits than I've been in decades (despite the fact that I'm under massive financial stress) (knock on wood), and I've been wondering if I still need the Adderall, although I'm wary of changing anything.
Here's my cocktail:
morning- 20mg Adderall XR, 60mg Cymnbalta, 5mg Abilify, and 112mcg Levothroid (I have a thyroid disorder and do best in terms of mood when my thyroid is running on the fast side of normal).
night- 60mg Cymbalta, 200mg Lamictal, 50mg Trazodone (for sleep).What meds have you tried that didn't work? Have you tried any combos?
Best wishes,
Cece> I've been suffering from Bipolar II disorder for 10 years now and haven't found a single medication that works, except for Adderall.
>
> The only thing that brings me relief and a sense of comfort is Adderall, but the Adderall wears off after 4 hours and then I slip into depression.
>
> Does anyone else take Adderall or some other stimulant for their Bipolar/Depression?
Posted by alchemy on October 4, 2010, at 18:42:51
In reply to Re: Adderall and Bipolar II, posted by Cece on October 4, 2010, at 14:35:00
Cece, did you have any mood cycling before or after taking the Adderall?
I am 20 years of treatment resistance, miserably hanging on.thx :)
Posted by Cece on October 4, 2010, at 19:01:37
In reply to Re: Adderall and Bipolar II » Cece, posted by alchemy on October 4, 2010, at 18:42:51
I had mood cycling both before and with Adderall, I don't think it made any difference in my stability. It's only been the last year or two that my cycling has become mild enough to be almost "normal".
Keep hanging in there- if I can get stable and feeling good, then any BPII can. I've been blessed with some excellent doctors along the way, have gotten rid of the ones that were mediocre. For a number of years I went outside my HMO and paid for a private doctor out of pocket- I spent out my savings, but it was worth it.
Cece
> Cece, did you have any mood cycling before or after taking the Adderall?
> I am 20 years of treatment resistance, miserably hanging on.
>
> thx :)
Posted by Cece on October 4, 2010, at 19:12:40
In reply to Re: Adderall and Bipolar II » Cece, posted by alchemy on October 4, 2010, at 18:42:51
I forgot to mention that I've been on mood stabilizers the whole time I've been on Adderall.
Posted by alchemy on October 4, 2010, at 21:03:42
In reply to Re: Adderall and Bipolar II » alchemy, posted by Cece on October 4, 2010, at 19:01:37
thank you. I have been worried that taking dexadrine would make it worse over time. Did you notice if your cycling improved with the long-acting version?
My cycling always been every few days or during the day. It is so weird to say that I have "cycling". I just always thought I had depression. Lamictal isn't doing enough/anything for stabilizing. But I have tried every other stabilizer and they made me much worse.
But since taking dexadrine, which has been about 10 months, I occassionally get a period of quick dips: down-up...down-up (seconds or minutes in between). Sometimes they are so subtle I'm not sure if they are happening. Sometimes they are a few seconds more. I may have a week without them, and then maybe a few days the next week. And of course no pattern, just like everything else.I don't know what they are, but I am suspicious that they are from dexadrine.
I have been on Lamictal for 3 years, at increasing dosages.
Posted by Cece on October 4, 2010, at 22:00:12
In reply to Re: Adderall and Bipolar II » Cece, posted by alchemy on October 4, 2010, at 21:03:42
Not all stimulants are the same- dexedrine used to (I haven't taken it for decades) make me jumpy, Provigil made me feel totally weird, but I find Adderall to be relatively gentle and it helps with my mental clarity.
When Lamictal was my only mood stabilizer, I had to go up to 600mg to get fairly stable and it gave me some brain fog at that dose. I'm much better now all around with a lower dose of Lamictal and some Abilify. I'm also taking a different AD than I was back then.
Posted by SheilaC on October 5, 2010, at 6:38:55
In reply to Adderall and Bipolar II, posted by sailboat77 on September 29, 2010, at 20:23:53
I'm exactly the same way. I have tried all the antidepressants except for the MAOIs. I didn't want to deal with the food issues so I refused to try them.
My diagnosis has been both ADD/ADHD and BPII. And now it's just "mood disorder" since no doc can define exactly what's what with me.
But, Adderall works better than any other antidepressant I have ever tried. The thing is I have to divide my doses. I take a very small dose of 5mg in the early morning and then another 5mg at lunch. I noticed on the weekend if I skip my Adderall I become depressed.
I also take a small dose of Geodon and between the Adderall and Geodon I am doing pretty darn good.
It's not uncommon to have both a mood disorder and ADD/ADHD. Sometimes a little stimulant works wonders.
Good luck to you!
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