Posted by Viridis on September 21, 2003, at 23:15:11
In reply to Dexedrine is AMAZING! (but I am skeptical), posted by zarathustra on September 20, 2003, at 18:22:49
Stimulants can be good antidepressants, and used to be prescribed this way. However, now that most are Schedule II and there are so many concerns about abuse etc., very few doctors will use them except in the case of a diagnosis of ADD. My pdoc told me that very occasionally he will prescribe stimulants for severely depressed patients in the short term, while other ADs (hopefully) kick in, but says that he really has to be prepared to explain this, so is very cautious.
I'm not sure what your response means; there are so many overlapping conditions, and the diagnoses of most are pretty sketchy. Are you depressed because you have ADD, or does depression have ADD-like symptoms? It's hard to say -- I'm in a similar situation. I've been diagnosed with ADD and certainly fit the profile in many ways, yet a lot of it does seem to be related to anxiety and depression. When I treat the anxiety with benzos, I do much better, but still have some depression and problems with organization. Adderall helps this, but is it really working against ADD, depression, or both? Now I've added Strattera and it helps too, but although it's marketed for ADD, it's supposed to have antidepressant effects as well. So, this doesn't help much to answer the question.
One sign of ADD is supposed to be a "paradoxical" response to stimulants -- calmness etc. instead of activation. However, this seems to be rather controversial. Adderall does have a calming effect for me, but then, an effective AD should do that too.
Ultimately, I don't think the diagnosis matters nearly as much as your response. If you're doing well, I'd stick with the dexedrine, and maybe try adding Strattera for additional focus.
Re: tolerance/dependency etc.: I've been taking Adderall (very similar to dexedrine) for a couple of years now and just skip it for a day or two once in a while to avoid developing tolerance. This hasn't caused me any problems, and my pdoc encourages this. However, some people seem more prone to becoming dependent on stims than others. As far as I know, stimulants can be taken on an as-needed basis, since their effect is immediate and doesn't require a "break in" period like most standard ADs. However, I'm not sure how consistent the AD effect would be if you just took them occasionally. This is something to experiment with (under your doctor's supervision).
poster:Viridis
thread:262015
URL: http://www.dr-bob.org/babble/20030917/msgs/262311.html