Posted by Ritch on January 28, 2002, at 10:52:23
In reply to Re: Persistent, cycling irritability... » Ritch, posted by bob on January 27, 2002, at 22:27:26
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> > Bob, You haven't mentioned a trial with a stimulant... Many folks as adults who have anger-temper probs may benefit from a stimulant to control the impulsiveness-it could be as simple as adult ADHD.
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> > Mitch
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> Mitch:
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> When I was on Depakote, I had overwhelming fatigue almost all the time. During this period, I tried Ritalin, and Dexedrine. The Ritalin made an enormous difference for a few days (looking back it was a little like a hypomanic episode) but then gradually it had less and less effect. Eventually, I actually experienced a physical lethargy on it, with very little good effects. I then switched to Dexedrine, and had the same response, except without the initial good phase, probably because my body had already adapted to the Ritalin. Of course, the stimulants were being taken to counteract the unrelenting drowsiness of Depakote, and not for any irritability or impulsiveness. That's one thing Depakote was great at, was putting a big damper on everything. I don't know how I'd respond to those stimulants now, but I'd be suprised if any beneficial effect lasted.
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> Maybe Provigil would be a good thing to try???
Bob, That is one of the options I mentioned at my last visit. When I was on Adderall I experienced a very mild euphoria and insomnia for about two days. Then I started sleeping *better* and the stuff just kept me awake during the day. Didn't feel a need to increase the dose (I was taking just 5mg Am). I brought up the Provigil because it is supposed to cause less anxiety than the other pstims (that is how my Adderall got ditched). I have got a theory about Provigil based on its clinical pharmacology. I think my increasing anxiety probs on the Adderall had to do with dopamine depletion due to its dopamine *releasing* properties. Provigil doesn't appear to *release* stored up dopamine-it just blocks the reuptake transporter and lets it build up that way. Also, it doesn't affect NE like Ritalin and the amphetamines do. Of course that is all sheer speculation. I might try it for a week and hate the stuff-who knows?Mitch
poster:Ritch
thread:91810
URL: http://www.dr-bob.org/babble/20020124/msgs/91871.html