Posted by chemist on July 11, 2004, at 14:00:16
In reply to hi chemist can you help ? » chemist, posted by francesco on July 11, 2004, at 12:30:43
> Hi Chemist, I'm on Luvox to try to target ADHD-syntoms (I live in Italy where stimulants are not available). My impression is that is not working that much on concentration and attention, it makes me fatigued and sleepy, even if my depression and tendence to ruminate are under control. Also my short-temper has improved a lot, I have not had anger outbursts anymore since I started it, but my adhd-syntoms are still there (and they have probably worsened).
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> I'm on a low dose, 50 mg, and my psychiatrist suggested to raise the dose but I didn't do it, it doesn't make sense to me since it's not helping. I think she's more concerned with my mood while I'm more concerned with my adhd-issues. What would you do if you were in my shoese ? The only med that made wonders for my adhd was Anafranil (NE reuptake ?!) but it made me social phobic, kind of autistic, and I'm not sure I want to come back on that route.
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> I didn't have success with short trials of low doses of desipramine and imipramine and also ritalin for me was unesuful. I have tried each of the five ssri for at least a couple of months and they didn't help very much. It sounds like I've exhausted all the alternatives, what do you think of nootropics like piracetam for adhd ?
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> Thanks, pardon me for the long post !!!
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pronto....first, condolences about cipollini and petacchi.....especially super mario....now, on to business...seems to me like the issue to address in truly adhd, in which case you are going to have to be a little creative in working with your doctor, since many alternatives have failed. luvox has a very wide dosing spectrum - i think i mentioned this in another post - and 50 mg is pretty much at the low end. my first thought is to give a larger dose a try: some people go up to as much as 400 mg (i myself hover between 200 and 300 mg per day). the reason i mention this is because, as you know, switching meds is a real pain, and being patient for a few more weeks is a more attractive alternative. then, you can say (honestly) that you gave it a try and it didn't work, and then move on. keep in mind that there is plenty of room to work with on luvox in terms of dosing, and the withdrawl is trivial compared to things like effexor should you decide to dump it. now, anafranil gets pretty good press on these pages (i suggest posting for SLS, King Vultan, and Sad Panda for more info on that), but it seems to me that if the other TCAs didn't work - and your previous trial with anafranil was not to your liking - than reintroducing it (it is indicated for OCD, and hits serotonin and NE) is an unattractive option. what i have extracted from reading your post is that the other SSRIs were not satisfactory, nor were the TCAs, yet your quality of life has improved (in one or two ways, at least) while on a low dose of luvox. this says to me, luvox is doing some good. of course, adderall or dexedrine would be a logical approach, but you say you cannot get stimulants. so: try dosing the luvox in divided doses (cut your 50 mg tablet in half) to reduce the sedating effects (which should go away: luvox is pretty benign in terms of side effects that linger forever), as it is possible that you are maybe losing concentration and focus because you are sedated - just a suggestion. next is to try a slightly higher dose, keeping in mind that for many people a low dose of something works one way and a high dose works another. this may or may not work for you, but don't give up yet, as you note some positive experiences, even on your low dose. finally, please do post a thread about anafranil and adhd alternatives (non-stimulant) - and be sure to include Larry Hoover in your post, by the way - and get some extra info about those meds. as for the nootropics, there are some excellent choices, and you happen to be living in the country where many of the novel nootropics are being synthesized and tested: i have publications with authors at firenze, bari, roma, l'aquila, milano (glaxo smith kline), and ferrara. Pier Giovanni Baraldi's group in ferrara has done some work with thiophene derivatives that target adenosine receptors (he is director of pharmaceutital sciences at universita di ferrara), not all of it aimed at nootropic activity, but again, a good place to look; i have 4 pubs from Fulvio Gualtieri's group at universita di firenze (you might try the nootrpic nebracetam, which his group identified at being much more active and potent than piracetam, and his group has worked with other compounds extensively); try Angelo Carotti at universita di bari or Enrico Gavuzzo and Fernando Mazza, both who are (i believe) at the institute of structural chemistry in the CNR in rome, but may have wandered; try some folks at la sapienza in rome, but i cannot say if they are still around, as i have one pub that has several authors listed (all but one in rome, the other in milano), try il instituto di farmacologia II, see what you can find; and finally, check up on what glaxo smith kline is doing in milano, i have an old paper from their group, and do not know what they are up to, but they found that dimiracetam was 10-30 times more potent than oxiracetam (see if Mario Pinza is still there). in any event, the nootropics vary in function from being simply neuroprotective to, shall we say, more neurostimulating, and i would look into the 2 compounds i mentioned above (check with your doctor, of course).....all the best, and please let me know if this post addresses your concerns....ciao, bello, and all the best, chemist
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