Posted by Viridis on October 25, 2003, at 15:17:38
In reply to What could I try instead?, posted by Tom1982 on October 25, 2003, at 8:26:08
I'm not sure about the SSRIs -- I can't tolerate those at all, but everyone is different. I've found Strattera quite helpful. It seems to have some antidepressant qualities (apparently they're doing trials to see if they can market it that way) and I actually find it has kind of a mellowing effect too.
My experience with side effects was that at 25 mg I had no problems; when I went to 40 I felt slightly nauseous and achy for about a week, and then that went away; then I went to 65 mg and had a similar reaction that just lasted a couple of days; now I'm at 80 mg and it's fine. The one side effect that lasted a long time was dry mouth, but that's pretty much cleared up now, and I just had to make sure I always had water to sip on. Oh, and it can give me heartburn if I take it on an empty stomach or with coffee. But really, the side effects weren't bad with gradual titration, and at least they went away, most quite quickly.
I talked to my pdoc and he said this is very similar to what several of his other patients have described. His approach is to start with 25 mg for a week or so, move to 40 or 50, then 65, and then 80 if appropriate, at about 1-2 week intervals. He lets his patients work out the details and is quite flexible. It comes in quite a few doses (I think the lowest is 18 mg), so you might be able to tolerate that. There seem to be lots of free samples available.
Some people here have reported antidepressant effects from Provigil, and I found it increased my confidence and energy, just not my concentration. You should be able to get some samples to try. My pdoc says that it seems to help some people with ADD but is very hit-or-miss in that department.
For anxiety (and depression), I really think Klonopin (clonazepam, a benzo) is best, for me at least. Plus, it goes very well with Adderall. As for tolerance, I skip Adderall for a day or two every couple of weeks and that seems to minimize tolerance issues. I've been taking it for a couple of years and don't notice any withdrawal when I go off it.
And, there's also Serzone. I haven't tried it, but have two friends who have done very well with it for depression. It's supposed to be less activating than most of the standard antidepressants.
Finally, you might consider Neurontin. I found it wonderfully relaxing for the first couple of days, then had absolutely no effect. But some people here report sustained results. It's very safe and can be combined with almost everything. It should be available soon as a generic (already is in Canada). Its successor, Pregabalin, looks promising, and I think will be marketed in the next year or two.
Good luck!
poster:Viridis
thread:272582
URL: http://www.dr-bob.org/babble/20031025/msgs/273168.html