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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by utopizen on July 26, 2011, at 18:41:54
does anyone know anyone who has done research on AD/HD with comorbid AD/HD?
My friend had a psychotic episode, and now his doctors are convinced he can never receive treatment for his AD/HD again-- not even with Provigil! What should he do? He's very smart, and this is ruining his life and chances of completing his studies.
I can't imagine his doctors taking the instruction to forget about it if it were either completing THEIR degree or being a "good patient"...
Posted by linkadge on July 26, 2011, at 19:36:36
In reply to friend has psychosis+ADHD- please help, posted by utopizen on July 26, 2011, at 18:41:54
Atomoxetine or guanfacine might be an option for the ADHD treatment.
Linkadge
Posted by Christ_empowered on July 26, 2011, at 22:05:32
In reply to Re: friend has psychosis+ADHD- please help, posted by linkadge on July 26, 2011, at 19:36:36
Your friend just might need a new shrink. I had one shrink who was all about stimulants+antipsychotics, and another shrink who told me that stimulants were a no-go for me. Shop around.
Posted by morgan miller on July 26, 2011, at 22:47:13
In reply to Re: friend has psychosis+ADHD- please help, posted by Christ_empowered on July 26, 2011, at 22:05:32
The adhd is likely a symptom of the psychotic disorder, not an separate independent illness. I don't think many cases of adhd should be treated traditionally for this reason. ADHD diagnosis has been just another reason to hand out medicaitons and for drug companies to make money. It really is out of f*ck*ng control.
Posted by morgan miller on July 26, 2011, at 22:52:06
In reply to friend has psychosis+ADHD- please help, posted by utopizen on July 26, 2011, at 18:41:54
> does anyone know anyone who has done research on AD/HD with comorbid AD/HD?
>
> My friend had a psychotic episode, and now his doctors are convinced he can never receive treatment for his AD/HD again-- not even with Provigil! What should he do? He's very smart, and this is ruining his life and chances of completing his studies.
>
> I can't imagine his doctors taking the instruction to forget about it if it were either completing THEIR degree or being a "good patient"...So what's more important, losing one's mind over and over again, falling deeper into the rabbit hole, or getting some silly college degree? I know many people living very good lives without a college degree. This is one of many things wrong with our culture today. I am all for a good education, but let's get our priorities straight.
Also, your friend probably should not have been on those meds to begin with. I am sure, that with the right treatment, a little time, the right diet, proper exercise, a few supplements, and some hard hard work, your friend and be a productive force in the classroom again. They may not ever be the same, but they will be able to take care of business.
Posted by Phillipa on July 27, 2011, at 0:22:03
In reply to Re: friend has psychosis+ADHD- please help, posted by morgan miller on July 26, 2011, at 22:52:06
Morgan I truly think you have such a balanced approach to me it holestic yet not without a med. Phillipa
Posted by SheilaC on July 27, 2011, at 11:11:22
In reply to Re: friend has psychosis+ADHD- please help » morgan miller, posted by Phillipa on July 27, 2011, at 0:22:03
I have been diagnosed with both ADHD and BP. I KNOW for certain that any of the stimulants (Adderall, Provigil, Nuvigil, etc.) cause mania in me. And I was taking a TINY dose of only 5mg of Adderall and I tried a TINY dose of Nuvigul and Provigil and got manic on both.
In the old days before I was truly diagnosed BP, I was on antidepressants and too much coffee could make me manic.
I'm sorry for your friend, it is hard. I know when I am manic from Adderall or Nuvigil I could study my butt off and do very well. But when I wasn't focused on studying - look out - I could be a real witch.
Maybe there are some people that can take ADHD meds without becoming psychotic, but I am not one of them.
I miss them, but I have to try and trudge through without them.
Posted by utopizen on July 28, 2011, at 16:01:25
In reply to Re: friend has psychosis+ADHD- please help » morgan miller, posted by Phillipa on July 27, 2011, at 0:22:03
> Morgan I truly think you have such a balanced approach to me it holestic yet not without a med. Phillipa
>there's no holistic way to treat AD/HD; furthermore, I -do- believe exercise is going to help with the symptoms, but perhaps I'm not being more detailed by not explaining schizophrenia presents its own unique problem apart from AD/HD- in that it kills brain cells during the psychotic episode.
So if you give someone amphetamine, and since most of the brain damage occurs in the prefrontal cortex, blood flow is enhanced at that site and the cognitive deficit is nearly eliminated with the amphetamine. Moreover, the antipsychotic, once properly stabilized -first-, prevents any psychotic relapse otherwise triggered by the amphetamine.
So the problem becomes not freaking out the psychiatrist, who is the most coward kind of person in the world, I'm beginning to realize... sigh. God forbid they take on a complicated case...
psychiatrists are so touchy.
Posted by utopizen on July 28, 2011, at 16:55:00
In reply to psychiatrists are so touchy! (ADD+Psychosis) » Phillipa, posted by utopizen on July 28, 2011, at 16:01:25
my friend's in a clinic, which is so far the best option he's been able to find that's been willing to treat him at -all-.
but he also needs to get treated for his ADH/D, and since they're paid by the State, they don't care. Anyone in the Boston area, I'm begging you to help here... I can give you my email if you are in the area and know a kind doctor that is sensitive to your needs.
Posted by emmanuel98 on July 28, 2011, at 21:09:51
In reply to HELP, BOSTON! doc that rx psychosis+stimulant?, posted by utopizen on July 28, 2011, at 16:55:00
Many MA towns and cities have community mental health centers. They are still functioning, despite budget cuts, because they get $$ from private funders, Medicaid, private insurance billing. Check out your local town division of social services.
Posted by morgan miller on July 28, 2011, at 22:51:16
In reply to psychiatrists are so touchy! (ADD+Psychosis) » Phillipa, posted by utopizen on July 28, 2011, at 16:01:25
There are holistic ways to treat ADHD, people just want an easy quick fix and don't like dealing with reality. We need to think it is as simple as simply being born this way and a medication is the cure.
The schizophrenia needs to be treated, first and foremost. Also, there are plenty of things your friend can take to enhance blood flow(you realize exercise does this along with enhancing neurogenesis) and reduce damage done by psychotic breaks. I suggest you go to mindandmuscle.net and longecity.org to get some good suggestions on things your friend can take to try to save their brain and function better, without having to take amphetamine, which is known to be neurotoxic.
Believe me, there is a good chance your friend will be worse off in the long run if they continue to take amphetamine. Like I said before, college is not that important, not right now. There's no rush, they just need to get better and ease their way back into life, the right way.
Morgan
Posted by morgan miller on July 28, 2011, at 22:55:47
In reply to HELP, BOSTON! doc that rx psychosis+stimulant?, posted by utopizen on July 28, 2011, at 16:55:00
Is it really that hard to understand both that ADHD is probably a symptom of other deeper issues and not some disease of the brain that someone was simply born with. The ADHD in this case is very likely tied into the schizophrenia. Pease, folks, reality, let's start confronting it.
Posted by Phillipa on July 28, 2011, at 23:19:57
In reply to friend has psychosis+ADHD- please help, posted by utopizen on July 26, 2011, at 18:41:54
Sorry you didn't mention schizophrenia just psychotic break which can a number of things from depression to Bipolar. I agree the schizophenia must be delt with with meds. As for ad hd personally have not heard the two combined. Treat the schizophenia what's your friend on now for it? Phillipa
Posted by Christ_empowered on July 29, 2011, at 12:37:04
In reply to Re: friend has psychosis+ADHD- please help » utopizen, posted by Phillipa on July 28, 2011, at 23:19:57
I've taken neuroleptics+stimulants, and it was OK, but felt strange. In my case, it became a balancing act; keeping the neuroleptic dose high enough to control the psychosis w/o causing side effects, and then calibrating the amphetamine dose so that I got results but didn't freak out. At a certain point, it just felt strange--tranquilized, yet stimulated. It certainly didn't help me in school or work, that's for sure.
What's the cause of the psychosis? What neuroleptic is being used? If you're using an older drug, a sedating drug, or an excessively high dose, there are going to be cognitive issues, and ADHD has nothing to do with it. I take Abilify (soon I'll also be taking Lamictal), and I must say that Abilify+supplements+therapy=better concentration than using Abilify+uppers.
Posted by utopizen on July 29, 2011, at 15:28:55
In reply to neuroleptics+stimulants, posted by Christ_empowered on July 29, 2011, at 12:37:04
>
> What's the cause of the psychosis? What neuroleptic is being used? If you're using an older drug, a sedating drug, or an excessively high dose, there are going to be cognitive issues, and ADHD has nothing to do with it. I take Abilify (soon I'll also be taking Lamictal), and I must say that Abilify+supplements+therapy=better concentration than using Abilify+uppers.
>how did you find a doc willing to treat both? trial and error?
he's on Risperdal Consta injection every 2 weeks and said it with the Adderall made him feel good as new, like his old self-- and feels awful off the Adderall now.
what supplements do you take?
tim
Posted by Christ_empowered on July 30, 2011, at 16:34:08
In reply to Re: neuroleptics+stimulants, posted by utopizen on July 29, 2011, at 15:28:55
Risperdal is kind of rough. It made me really sad and twitchy when I took it.
I take: 6 grams taurine, 3grams niacinamide, 2 b-100 caps, 3 grams green tea extract, 4 grams vitamin C, 1600IU vitamin e+400micrograms selenium, 4mgs astaxanathin, soy extract.
I don't know how you find a doctor who'd be willing to try it out. Mine was an older, female doctor who'd been practicing for a while. I guess in her experience I seemed like I could benefit from that sort of treatment.
Posted by desolationrower on July 30, 2011, at 21:22:25
In reply to Re: neuroleptics+stimulants, posted by utopizen on July 29, 2011, at 15:28:55
I don't see why NRIs would be avoided. some people get manic on them, but i don't think they are notable for exacerbating psychosis.
Also, lithium. there wre some studies (admittedly, carful enpoint selection can affect things) that it helped for kids with ADHD. and of course its good for psychosis.
-d/r
Posted by floatingbridge on August 1, 2011, at 9:42:00
In reply to lithium, nri, posted by desolationrower on July 30, 2011, at 21:22:25
> I don't see why NRIs would be avoided. some people get manic on them, but i don't think they are notable for exacerbating psychosis.
>
> Also, lithium. there wre some studies (admittedly, carful enpoint selection can affect things) that it helped for kids with ADHD. and of course its good for psychosis.
>
> -d/rSegeline has shown some efficacy in treating AD(H)D, though I feel like I might be one of the few who have ever bumped into the few studies run on this....
ADHD is not necessarily related to schizophrenia except in ways beyond my comprehension. I thought the latest theories pointed to brain development and immature regions of the brain. This asymmetry of development can be
amended somewhat for some, and hence some children
outgrow some symptoms, but others do not. For some they worsen. Very much so.To have AD(H)D is a terrible experience. One's native
intelligence, IQ, talents, whatever, remain intact, but the problem seems to be in consistent expression. A real deep read into AD(H)D is very sobering. It can precipitate real
suffering and tragic loss for some.In reversal to common sense triage, some folks treat AD(H)D first, then the remaining symptoms/conditions.
Schizophrenia /psychosis and ADHD seem like such an unfairly heavy burden to bear. I hope this friend fins ways out from under this.
Posted by utopizen on August 4, 2011, at 0:26:05
In reply to Re: lithium, nri, posted by floatingbridge on August 1, 2011, at 9:42:00
thanks for the kind words and help, everyone. apparently, I was wrong, he doesn't necessarily have schitzophrenia-- he has first-contact psychosis. (That means an episode of psychosis that hasn't yet relapsed). It was for a day, and he's on Risperdal, so no one knows if he would have developed into schizophrenia if he didn't get treated.
if anyone is bored and wants to do some quick research, he's in Boston, so any sympathetic studies are perhaps more likely carried out by a Boston doctor (odds wise, anyhow)... and that would lead him to a doc sympathetic to the cause.
Keyword suggestions would be: psychosis+methylphenidate,psychosis+amphetamine,psychosis+dextroamphetamine,ADHD+psychosis, etc...
right now, he's seeing a clinic doctor, which is like seeing a substitute teacher in a college class if it'll be cool for him/her to help out with a Fulbright application...
these are not people with the monetary or any other incentive to do more than what they can slack by on.
Which is why doctors hate clinic doctors, I imagine.
anyhow, at this point I don't see the harm in just straight out asking docs over the phone,
"are you adverse to treating AD/HD and psychosis at the same time?"
(little trick in getting around the fact one might appear to present with drug-seeking behavior, given the only alternative to a stimulant for AD/HD is the brand of placebo named Strattera, so docs are hip to how to translate this to "will you script amps"). =D
well, on with the research challenge, good luck =)
just know to scroll over the plethora of studies involving amphetamine in the rat, given the way schz. is studied in the rat is to give neurotoxic doses of amphetamine...
--
man, this site is great when you feel hopeless. very empowering to know so many folks just want to support others here. I really feel like I can help him, potentially. thanks so much!
This is the end of the thread.
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