Posted by Ezekiel on June 18, 2008, at 19:36:19
Greetings All,
Allow me to begin by providing a little background, I have suffered from dysthymia most of my adult life (I'm now 35) interspersed with periodic moderate-major depressive episodes (lasting from several months to several years when it hits) during the past 14 years. Back in the mid 1990s when my depression first began, I went to see a physician about for help and he began prescribing me numerous SSRI drugs one right after the other as soon as the previous one failed to help me. Well, I eventually became greatly disillusioned with pharmacotherapy when nothing helped, and determined to never go down that road again using psychiatric drugs to treat my mood issues after that pharmaceutical debacle (oh what sheer joy it was to withdraw from effexor, NOT!)
Now fast forward to the present - recently (3 months ago) I began to experience mild-moderate depressed YET AGAIN. Presently I'm a graduate student working towards a master's degree in a rigorous academic health care program and I'm nearly finished with my first year (I'm running on nothing but fumes at this point). I've literally gotten eaten alive this year by the furious demands of the curriculum, and my stress/anxiety level have been SKY HIGH for the last 9 months straight (I decided quit caffeine from any source & that helped a little with reducing anxiety). My grades dropped lower than is acceptable by my university last term, and so I was placed on academic probation and offered only 1 TERM to get my GPA up (to at least a 3.0 solid B average) or I will be dismissed from the program - well, I worked extremely hard to even get to this point, so I cannot allow academic failure to be an option! Talk about pressure & stress!!!! I've studied various depression treatements for many years (undergone treatments like cognitive therapy, naturopathic remedies, etc.) all with minimal-moderate success but never long lasting, and my dysthymia has always been lurking around the corner meanwhile, ready to pounce on me just at the point when I'm not looking - man, depression is such an EVIL BEAST!!!
Alright I'm getting wordy so let me get to the reason for this post - scientifically it is well known that there exists a strong relationship between extreme stress and the onset of a depressive episode (perhaps what triggered my latest episode), so I went to see a psychiatrist 6 weeks ago to see if the new frontier of anti-depression drugs I've been researching might succeed where the SSRIs failed me (e.g. EMSASM, tineptine, etc) because a lot has changed since the mid-90s when the SSRI's were as good as it got back then, unless you were willing to take on the risks of the older MAOIs.
The psychiatrist I'm seeing diagnosed me with ADD after our first 90 minute session, and said I most likely needed a stimulant and that that may solve much of my mood problems, needless to say I was completely shocked by his analysis (btw, he's involved in cutting edge depression research at a world eminent hospital in Boston where I live, so I have to at least consider the merit of his diagnosis, although I'm not 100% convinced YET).
The ADD thing had NEVER even gotten into my radar as playing a role in my depression, so I've never looked into it. Well I was desperate so I agreed to give stimulants a shot and see what happened. He told me we could add an AD if it was warranted down the road. So I started off with Ritalin for a few weeks but it made me tense (but did act as a mild anti-depressant & gave me focus). So our next meeting he prescribed me Adderall to for a trial run, and so I've been on it the last 7 days. It was astounding the soothing euphoria it provided the first 2 days, but that quickly subsided and now I get just extra concentration and energy (good thing it went away or I may never have wanted to stop this drug!). My side-effects have been a fast heart rate which has gone over 100 bpm at times, and also I've felt my heart contracting with greater force (evidently from the extra norepinephrine at sympathetic nerve synapses which adderall causes to be released). These adverse effects have improved the last couple days, and man, it is certainly no fun feeling fluttering/pounding sensations in your chest throughout the day as I'm sure some of you reading have also experienced!
So, FINALLY to the reason for posting (sorry I can be verbose at times), I am receiving some MUCH NEEDED motivation from Adderall, it's not a perfect drug, meaning it's not magically solving my study habit/time management difficulties or grander ones like revealing me the purpose why the universe exists, but it is helping me organize myself better (which was virtually non-existent before) and is also helping me to prioritize academic tasks and actually begin to work on them along with an improved ability to concentrate for longer spans of time (but only a modest AD effect, and that at the higher doses).
The problem though is that I'm TERRIFIED of getting physically addicted (we'll leave psychological addiction out of this, one issue at a time!) to Adderall, because this is an inevitable consequence of taking a pharmaceutical stimulant daily for extended periods of time - I believe it probably takes somewhere between 3-4 weeks of daily use until this physical dependency occurs (that may not be an exact timetable, but I'm pretty sure it's approximately correct) and whenever you do cross that threshold, you must then resign yourself to the inevitability of going through some potentially very uncomfortable withdrawal effects for a while depending on how much you were taking & for how long (as you guys already know, this phenomenon is well documented).
So then, if someone is reading this post and has already gone down this road of becoming physically dependent on Adderall, and then at some point decided to get off of Adderall, then will you please be a good samaritan and share your experience in some detail? I know that depression and lethargy are some of the possible symptoms, but how long do the withdrawal symptoms last generally speaking? How exactly did you go about getting off of Adderall? Did you carefully taper down over time, and if so did that method lessen the severity/intensity of your withdrawal symtoms? And honestly, how miserable of an experience is it getting off of Adderall when one decides too, is it within the range of tolerability? Is there something a person can take to help get them through the withdrawal period, e.g., briefly using an opiate or benzodiazapine (or some other pharmaceutical) to help offset the worst of the withdrawal period?
I'm finding that I only respond to higher doses of Adderall, and this is maybe the case with with any stimulant because I required higher doses of Ritalin as well. I've titrated up to 50mg (instant release) twice daily with my psychiatrist's approval, and at this dosage schedule I'm functioning ok, but it still takes a good deal of effort to do the things my classmates do (study for long stretches and retain everything) seemingly with minimal effort. If taking a drug like Adderall to enable me to function "somewhat" like other people do normally, then it may be a necessary and acceptable trade off to stay on it for a year or so until I have sufficient time to research a more long-term solution that will not potentially harm my cardiovascular system down the road arising from a constantly elevated pulse pressure (this results in all you major organs aging faster over the long-term).
Ok I'm done droning on, if you've read this far I thank you for doing so, and it's my hope that a kind soul (or 2 or 3 . . .) will share some insight into the above concerns I shared, because at some point VERY SOON (I've been on it daily 7 days) I'm going to have to decide to stop Adderall or continue with daily use past the point where my body/brain becomes dependent, and just have to accept the fact that somewhere down the line I'm going to have to go through the experience of withdrawing from Adderall. Taking days off was tried and is not really an option because I revert to a slugs pace with everything and will surely be dismissed from my school due to sub-standard grades if this pattern continues.
Anyways, again thank you for reading and a HUGE thank you in advance to anyone who will take the time to share their Adderall story!!
Robert
poster:Ezekiel
thread:835343
URL: http://www.dr-bob.org/babble/20080617/msgs/835343.html