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Re: med combination for ADD + BP ][ » cybercafe

Posted by Ritch on November 15, 2002, at 22:25:05

In reply to Re: med combination for ADD + BP ][, posted by cybercafe on November 15, 2002, at 19:03:25

> >
> > I never got any hypomania from dexedrine, Adderall, or methylphenidate. They all tended to make my personality kind of quiet and cold (which I don't like and partly why I am not on a stimulant now). Amps had a *slight* mood elevating effect, but mph had a complete zero effect on mood (if anything I felt slightly depressed at higher doses). SSRI's are what kick in the hypomania if I don't watch it.
> >
>
> what do you take now for mood stability and attention deficit mitch? ....

I am now on 125-500mg/day of Depakote on a flexible dosing schedule that fits my seasonal and chronic 3-week cycles. I will take 125mg/day every day no matter what. I adjust upwards depending on season and depending on what part of my cycle I happen to be in. I am also on Trileptal 150mg/day to help with bipolar depression and listening skills (ADD symptoms), maybe going to 300mg/day if I become immune to the nausea it provokes. I have been taking clonazepam for a while now, but found that I don't need more than .5mg per day over the long haul. I can slam hypomania by boosting the Depakote to 500mg and taking 1mg of Klonopin for just a day or two, and then reduce the dose. It is VERY effective for that.

>
> are you able to work without an ADD med? quiet and cold seems a price i'd be willing to pay to leave these poverty and get a real job, but who can say?

Yes, I can do it probably half of the year. The other half requires the "correct" AD's (in my case low-dose Effexor works the best), and *reduction* in Depakote (so that I don't sleep all day long). The Trileptal is an experiment, but thus far it seems to have a MILD 'energizing' effect, and I don't get the DUHS from it that I do from gaba meds.

>
> i find zyprexa makes me quieter, perhaps colder, but i always thought that was a sign i was becoming more normal :)

I had a good response in the past to atypicals (Risperdal/Seroquel), but I am SO sensitive to EPS problems (even liquid PAXIL caused mild EPS at 4mg/day). I just don't even want to go there...

>
> i thought dopamine agonists (stims) had the opposite effect.. i guess they make you interested and enthusiastic about boring things (work) but therefore less interested in interesting things (people)...

Psychostimulants *release* dopamine and block reuptake of NE and DA, not necessarily effect the DA receptors. I have tried Mirapex and Permax previously (DA receptor agonists) and they tended to make me very drowsy and nauseous, but I slept well on them.

> ... i think some people here used to suggest stims for SSRI apathy

I found that stims seem to make it easier to *ditch* SSRI's. You seem to forget that you are withdrawing from them and don't experience much withdrawal. Most notably was taking dexedrine and finding that I could nearly stop taking Celexa...


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poster:Ritch thread:127770
URL: http://www.dr-bob.org/babble/20021108/msgs/127877.html