Posted by jralphc on December 7, 2002, at 10:44:22
In reply to Re: Stimulants for Refractory Depression? » jralphc, posted by medlib on December 7, 2002, at 2:13:28
I'm a newcomer to this board. First off, I'd like to express my appreciation to all of you for your thoughtful responses. This seems like a great resource, and I'm really glad to hear from each of you.
All of the advice has been very helpful in one way or another. Today is the 3rd day taking Addrerall XL 20 mg. I am monitoring my BP and heart rate. So far, I've seen small increases in systolic BP and heart rate (from 77 to 82 on BP; pulse rate tends to be the same or sometimes it rises by 5 to 10 points for awhile). I don't know if it is the extended release formulation that causes this, but it seems like I have periods where I feel calm but focused, and other times when I'm more anxious/agitated.
Medlib--I've asked my cardiologist about ACE inhibitors or calcium channel blockers--mentioning to him the depression, too--but he seems pretty adamant that beta blockers are the best. I do think you are correct that they can worsen depression and make me feel fatigued. I will talk to him about Adderall when I see him (I only see him once or twice a year; I've gone 3 years now with no problems and a good result on my stress echocardiogram, plus my cholesterol is quite low--122 total, 67 LDL, but 31 HDL which isn't good so I take niacin and lipitor). Good advice about getting my 2 docs to consult--I may also need to get a 2nd opinion on my cardiac care. I think my cardiologist is good, but it is my life we are talking about so a 2nd opinion seems warranted.
Anyway, it is too early to judge things mentally I guess, but I certainly have more energy, get out of bed easily, sleep well and am not so lethargic during the day. So that's a big plus. But I will have to monitor BP and pulse closely, because I don't want to do anything to hurt my cardiovascular system. I am also trying to exercise more--the Adderall seems to help give me the extra boost I need to do that. The problem with my depression is I just don't have the desire to exercise when I'm blue, even though I know it could help a lot.
So, I'll give this a shot. I've read about modafinil/Provigil--do any of you have experience with that one? The reviews here seem pretty mixed, but I know from experience that it usually is that way with meds. As they say, "your mileage may vary." :-)
Thanks again.
poster:jralphc
thread:130779
URL: http://www.dr-bob.org/babble/20021203/msgs/130902.html