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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by JohnX on February 11, 2001, at 7:01:29
I'm curious what sort of sensitization (poop-out)
issues other people on this group have had
with Adderall.I've taken it twice as a last ditch effort to
treat depression.The 1st time I took it standalone and it it would
poop out after about every 3 days.
I took it once a day in the morning with a
mean dose of ~20 mg. I would always seem to get
erratic responses. One day 10mg drove me frantic.
Another day 30 mg did nothing.Curiously, I tried Adderall again with Klonopin
to reduce fatigue. This time I always got the
same Adderall response at 20mg. I found this strange
and actually found an abstract describing how
clonazepam (Klonopin) could prevent amphetamine
sensitization. Unfortunately I got poop-out on Klonopin,
another addictive med, and everything went to *ell.I have looked at the addiction pathway of amphetamine,
and their is a simple and interesting medication in
the pipeline which may prevent tolerance issues,
without addiction to the additive medication.
(Another guru in this NG is studying it).Anyones comments on Adderall dosing issues welcomed.
I'm very curious if my sensitization is much
greater than the average joe's.-John
Posted by Sulpicia on February 11, 2001, at 18:15:44
In reply to Adderall tolerance , dosing, etc., posted by JohnX on February 11, 2001, at 7:01:29
>
> I'm curious what sort of sensitization (poop-out)
> issues other people on this group have had
> with Adderall.
>
> I've taken it twice as a last ditch effort to
> treat depression.
>
> The 1st time I took it standalone and it it would
> poop out after about every 3 days.
> I took it once a day in the morning with a
> mean dose of ~20 mg. I would always seem to get
> erratic responses. One day 10mg drove me frantic.
> Another day 30 mg did nothing.
>
In my experience this is an extremely unusual situation.
Can you be more specific about what you mean by "poop out?"
Do you mean that you became depressed again or where no longer experiencing the euphoria
that can accompany the initial doses of adderall?
Is depression an ironclad diagnosis? Can you correlate
what you ate with the days on which the adderall didn't work?
There are some food interactions.
I take adderall 40 mgs [20am,10,10] for ADD; also dx depression
for 4th time so I took paxil 30 mgs -- the paxil potentiated the effect
of the adderall. I hated what paxil did to my muscles [I run, or I used to!]
so I'm switching to old friend tofranil, which dampens the adderall.
In general, people with ADD tend not to develop a tolerance -- god knows why.
3 days must be some kind of record but I have to admit I have come
across several people who didn't respond to adderall at all.
> Curiously, I tried Adderall again with Klonopin
> to reduce fatigue.
Are you only on a benzo for depression?????This time I always got the
> same Adderall response at 20mg. I found this strange
> and actually found an abstract describing how
> clonazepam (Klonopin) could prevent amphetamine
> sensitization. Unfortunately I got poop-out on Klonopin,
> another addictive med, and everything went to *ell.
Sorry -- sounds like you were very nearly pulled in twain here.
> I have looked at the addiction pathway of amphetamine,
> and their is a simple and interesting medication in
> the pipeline which may prevent tolerance issues,
> without addiction to the additive medication.
> (Another guru in this NG is studying it).
That should be interesting, especially since the problem
with amphetamine is that simultaneously blocks dopamine reuptake
and increases the levels by shoving more of it out of the
little storage pockets in the neuron -- god I hope I'm remembering
correctly! Please forgive my flubs. It would be a neat trick
to alter secretion and blockage w/out problems.
> Anyones comments on Adderall dosing issues welcomed.
> I'm very curious if my sensitization is much
> greater than the average joe's.You react very strangely to this med -- and believe me,
I've heard a few! The only thing that can be deduced
here is that the meds were expired, you ate something
that inactivated it, or your system doesn't tolerate it
very well.
Have you tried dexedrine or could you try adderall as
an add-on with an appropriate SSRI?
I wonder about 10 mgs making you frantic; I imagine you've
tried mood stabilizers for depression like lamictal? Or lamictal
in combo with an SSRI?Sorry not to be of more help. I do hope you find something that
works for you.
>Liz
>
>
Posted by JohnX on February 12, 2001, at 1:48:02
In reply to Re: Adderall tolerance , dosing, etc. » JohnX, posted by Sulpicia on February 11, 2001, at 18:15:44
> >
> > I'm curious what sort of sensitization (poop-out)
> > issues other people on this group have had
> > with Adderall.
> >
> > I've taken it twice as a last ditch effort to
> > treat depression.
> >
> > The 1st time I took it standalone and it it would
> > poop out after about every 3 days.
> > I took it once a day in the morning with a
> > mean dose of ~20 mg. I would always seem to get
> > erratic responses. One day 10mg drove me frantic.
> > Another day 30 mg did nothing.
> >
> In my experience this is an extremely unusual situation.
> Can you be more specific about what you mean by "poop out?"
> Do you mean that you became depressed again or where no longer experiencing the euphoria
> that can accompany the initial doses of adderall?
> Is depression an ironclad diagnosis? Can you correlate
> what you ate with the days on which the adderall didn't work?
> There are some food interactions.
> I take adderall 40 mgs [20am,10,10] for ADD; also dx depression
> for 4th time so I took paxil 30 mgs -- the paxil potentiated the effect
> of the adderall. I hated what paxil did to my muscles [I run, or I used to!]
> so I'm switching to old friend tofranil, which dampens the adderall.
> In general, people with ADD tend not to develop a tolerance -- god knows why.
> 3 days must be some kind of record but I have to admit I have come
> across several people who didn't respond to adderall at all.
> > Curiously, I tried Adderall again with Klonopin
> > to reduce fatigue.
> Are you only on a benzo for depression?????
>
> This time I always got the
> > same Adderall response at 20mg. I found this strange
> > and actually found an abstract describing how
> > clonazepam (Klonopin) could prevent amphetamine
> > sensitization. Unfortunately I got poop-out on Klonopin,
> > another addictive med, and everything went to *ell.
> Sorry -- sounds like you were very nearly pulled in twain here.
> > I have looked at the addiction pathway of amphetamine,
> > and their is a simple and interesting medication in
> > the pipeline which may prevent tolerance issues,
> > without addiction to the additive medication.
> > (Another guru in this NG is studying it).
> That should be interesting, especially since the problem
> with amphetamine is that simultaneously blocks dopamine reuptake
> and increases the levels by shoving more of it out of the
> little storage pockets in the neuron -- god I hope I'm remembering
> correctly! Please forgive my flubs. It would be a neat trick
> to alter secretion and blockage w/out problems.
> > Anyones comments on Adderall dosing issues welcomed.
> > I'm very curious if my sensitization is much
> > greater than the average joe's.
>
> You react very strangely to this med -- and believe me,
> I've heard a few! The only thing that can be deduced
> here is that the meds were expired, you ate something
> that inactivated it, or your system doesn't tolerate it
> very well.
> Have you tried dexedrine or could you try adderall as
> an add-on with an appropriate SSRI?
> I wonder about 10 mgs making you frantic; I imagine you've
> tried mood stabilizers for depression like lamictal? Or lamictal
> in combo with an SSRI?
>
> Sorry not to be of more help. I do hope you find something that
> works for you.
> >Liz
> >
> >Liz,
Thanks for your comments.
By poop-out, I mean the med does nothing,
like taking a placebo.I've been on all the anti-depressants and
I tend to get very "bizarre" responses that my
doctors don't understand. If the med works I quickly
switch into a mild mania and then a variable
time will pass before my emotions go completely
numb and I get excruciating pain in my face.
After a while the facial pain also accompanied
tingling in the extremeties and restless legs
syndrome. The Klonopin cured the pain syndromes
and helped to stabilize my mood (i've since switched
to lamictal because of addiction).I am probably going to go down the path of:
anti-convulsant standalone,
anti-convulsant + antidepressant
anti-convulsant + aderrall
antipsychotic.When I took Klonopin and Adderall I felt like
a human being for many months until Klonopin
died on me. And the Adderall always gave the
same response at 20mg. I've been trying to understand
if there is any correlation to my Aderrall trials
and my anti-depressant trials.-john
Posted by Sulpicia on February 12, 2001, at 11:12:35
In reply to Re: Adderall tolerance , dosing, etc., posted by JohnX on February 12, 2001, at 1:48:02
Were I in your shoes, I would be wondering about bipolar II.
My daughter suffers from this and her only symptom was depression.
None of the ADs worked but Paxil set her off into hypomania, which
thank god, the pdoc picked up on.Mania set off by an AD seems to be one the biggies as far
as diagnostic criteria go for BP. It's also possible to be
depressed nearly all the time and still have a dx of BP.
The facial pain sounds awful; for what it's worth, several folks I
know with chronic pain use Neurotonin [sp?] for pain.My daughter's depression -- which is the real problem for her, is
controlled by lamictal and wellbutrin.I wish you the best of luck with your search.
Liz
Posted by dalukens on February 14, 2001, at 3:27:05
In reply to Re: Adderall tolerance , dosing, etc., posted by JohnX on February 12, 2001, at 1:48:02
I can't say whether it's common or not, but I've had almost exactly the same experience with Adderall: greatly diminished effect after 3-5 days, which requires that I discontinue taking it for 24-48 hours to "de-sensitize" (or should that be "re-sensitize"), during which time I'm pretty much unable to function. This, in turn, makes my sleep/wake schedule impossible to predict (which is why I'm writing this at 4:05 in the morning). I'll talk to my doctor about Klonopin; even if it only works for a few months, that's a few months I wouldn't have otherwise.
I haven't experienced any of the other things you report, except the restless leg syndrome; I've always had this occasionally, but since starting Adderall, it's become MUCH worse. Has anyone ever found anything that will help this? People (including doctors) are always telling me I should "take a walk before bedtime," or some such ****. Correct me if I'm wrong, but the sensation of RLS is not in the muscle, as I understand it, but in the brain (like phantom limb sensation); no amount of exercise will make any difference (personal experience bears this out, as well).
At any rate, I'm not sure if I qualify as an "Average Joe," but my experiences have been much like yours.
DaL
Posted by Noa on February 14, 2001, at 14:13:45
In reply to Re: Adderall tolerance , dosing, etc. » JohnX, posted by dalukens on February 14, 2001, at 3:27:05
DaL, Effexor gives me RLS and myoclonus. I take Serzone to counteract it. In the past, I also had success with a small dose of trazodone. My pdoc recently prescribed Klonopin for this, although I rarely take it now. He also mentioned that dopamine agonists (sorry--it could very well be dopamine antagonists--I am rather clueless sometimes about this stuff) also help. I cannot remember the name of the med he mentioned that falls into that category. HElp--John, Cam? Others?
Posted by Noa on February 14, 2001, at 14:16:02
In reply to Re: Adderall tolerance , dosing, etc. » JohnX, posted by dalukens on February 14, 2001, at 3:27:05
FWIW, I have also found that the RLS is not a problem since starting regular vigorous exercise.
Posted by dalukens on February 14, 2001, at 23:47:38
In reply to Re: Adderall tolerance , dosing, etc.--ps, posted by Noa on February 14, 2001, at 14:16:02
---Noa, I'm glad that works for you, but even when I was taking Karate (I eventually acheived brown belt, which takes quite a bit of work), I still had the myoclonus/RLS. BTW, I was taking a style that used the legs *a lot.*
---DaL> FWIW, I have also found that the RLS is not a problem since starting regular vigorous exercise.
Posted by JohnX on February 15, 2001, at 2:30:56
In reply to Re: Adderall tolerance , dosing, etc. » JohnX, posted by dalukens on February 14, 2001, at 3:27:05
> I can't say whether it's common or not, but I've had almost exactly the same experience with Adderall: greatly diminished effect after 3-5 days, which requires that I discontinue taking it for 24-48 hours to "de-sensitize" (or should that be "re-sensitize"), during which time I'm pretty much unable to function. This, in turn, makes my sleep/wake schedule impossible to predict (which is why I'm writing this at 4:05 in the morning). I'll talk to my doctor about Klonopin; even if it only works for a few months, that's a few months I wouldn't have otherwise.
> I haven't experienced any of the other things you report, except the restless leg syndrome; I've always had this occasionally, but since starting Adderall, it's become MUCH worse. Has anyone ever found anything that will help this? People (including doctors) are always telling me I should "take a walk before bedtime," or some such ****. Correct me if I'm wrong, but the sensation of RLS is not in the muscle, as I understand it, but in the brain (like phantom limb sensation); no amount of exercise will make any difference (personal experience bears this out, as well).
> At any rate, I'm not sure if I qualify as an "Average Joe," but my experiences have been much like yours.
> DaL
DaL,One of the reasons I started taking Klonopin was
to help my sleeping problems when I took Effexor.
Effexor gave me severe RLS and twitching. I think
this is a serotonin up = dopamine down
phenomena. I think that SSRIs in general can
cause a lot of symptoms that resemble the side
effects of older
neuroleptic drugs (like twitching, etc)
because of this effect. Thats been my
experience although the doctor says its rare.
Drugs with 5-ht2 antagonism (like serzone and
the newer antipsychotics) are much less likely
to cause the problem. Hmm
I seem to read about it alot though.When I started taking Klonopin to help my sleep,
I found that it completely relieved my RLS, tingling, twitching, etc. (I wasn't on Adderall at
the time). BEWARE, Klonopin can become extremely
addictive if taken for too many months. I am finishing the process of detoxifying myself and
I'll tell you, it is not fun!Both Klonopin and dopaminergic agents are known
to relieve RLS.I'll look around to see if there are any
other meds that are available stateside to
help your problem. (Since I may need the
solution too). I wonder if Gabapentin may
help (non-addictive)?-John
Posted by Noa on February 17, 2001, at 11:51:11
In reply to Re: Adderall tolerance , dosing, etc., posted by JohnX on February 15, 2001, at 2:30:56
My pdoc also gave me Klonopin for the RLS, twitching, etc. but I only take it once in a while, because lately, since starting regular exercise, my RLS is gone.
BTW, I think the big difference between the effexor-induced twitching is that it goes away if you lower the dose or discontinue, whereas some of these effects from older neuroleptics are permanent. I may be wrong, some one in the know please confirm or refute. Thanks.
Posted by AndrewB on February 17, 2001, at 12:21:16
In reply to Re: Adderall tolerance , dosing, etc., posted by Noa on February 17, 2001, at 11:51:11
Just a note, Mirapex is used often for RLS.
AndrewB
Posted by Noa on February 17, 2001, at 14:14:03
In reply to Re: Adderall, RLS, posted by AndrewB on February 17, 2001, at 12:21:16
Is mirapex a dopamine agonist?
Posted by AndrewB on February 18, 2001, at 9:44:36
In reply to Re: Adderall, RLS » AndrewB, posted by Noa on February 17, 2001, at 14:14:03
> Is mirapex a dopamine agonist?
Yes, D2/D3 agonist, 7 times more selective forthe D3 receptor.
AndrewB
Posted by JohnX on February 18, 2001, at 19:56:24
In reply to Re: Mirapex, RLS, posted by AndrewB on February 18, 2001, at 9:44:36
> > Is mirapex a dopamine agonist?
>
> Yes, D2/D3 agonist, 7 times more selective forthe D3 receptor.
>
> AndrewBAndrew,
off the RLS topic..
Do you believe that of the dopamine agonists
Mirapex would give a response most consistent
with Adderall? What other dopamine agonists
if any do you feel would give an adderall like
response?-John
Posted by AndrewB on February 19, 2001, at 2:59:03
In reply to Re: Mirapex, RLS, posted by JohnX on February 18, 2001, at 19:56:24
> > > Is mirapex a dopamine agonist?
> >
> > Yes, D2/D3 agonist, 7 times more selective forthe D3 receptor.
> >
> > AndrewB
>
> Andrew,
>
> off the RLS topic..
>
> Do you believe that of the dopamine agonists
> Mirapex would give a response most consistent
> with Adderall? What other dopamine agonists
> if any do you feel would give an adderall like
> response?
>
> -JohnJohn,
Very different drugs- adderall and Mirapex. Only similarity is that Mirapex may often provide an arousal effect.
AndrewB
Posted by SLS on February 19, 2001, at 7:35:21
In reply to Re: Mirapex, RLS, posted by AndrewB on February 19, 2001, at 2:59:03
Hi Andrew,
How you would you describe the difference between "activation" and "arousal".
Thanks.
- Scott
> > > > Is mirapex a dopamine agonist?
> > >
> > > Yes, D2/D3 agonist, 7 times more selective forthe D3 receptor.
> > >
> > > AndrewB
> >
> > Andrew,
> >
> > off the RLS topic..
> >
> > Do you believe that of the dopamine agonists
> > Mirapex would give a response most consistent
> > with Adderall? What other dopamine agonists
> > if any do you feel would give an adderall like
> > response?
> >
> > -John
>
> John,
>
> Very different drugs- adderall and Mirapex. Only similarity is that Mirapex may often provide an arousal effect.
>
> AndrewB
Posted by Whit on October 12, 2004, at 11:01:04
In reply to Adderall tolerance , dosing, etc., posted by JohnX on February 11, 2001, at 7:01:29
>
> I'm curious what sort of sensitization (poop-out)
> issues other people on this group have had
> with Adderall.
>
> I've taken it twice as a last ditch effort to
> treat depression.
>
> The 1st time I took it standalone and it it would
> poop out after about every 3 days.
> I took it once a day in the morning with a
> mean dose of ~20 mg. I would always seem to get
> erratic responses. One day 10mg drove me frantic.
> Another day 30 mg did nothing.
>
> Curiously, I tried Adderall again with Klonopin
> to reduce fatigue. This time I always got the
> same Adderall response at 20mg. I found this strange
> and actually found an abstract describing how
> clonazepam (Klonopin) could prevent amphetamine
> sensitization. Unfortunately I got poop-out on Klonopin,
> another addictive med, and everything went to *ell.
>
> I have looked at the addiction pathway of amphetamine,
> and their is a simple and interesting medication in
> the pipeline which may prevent tolerance issues,
> without addiction to the additive medication.
> (Another guru in this NG is studying it).
>
> Anyones comments on Adderall dosing issues welcomed.
> I'm very curious if my sensitization is much
> greater than the average joe's.
>
> -John
>
>How much Klonopin did you need to get this effect on adderall tolerance? I have the same problem and I have Klonopin but don't know how much to take.
Thanks,
Whit
Posted by LeadingZero on October 15, 2004, at 17:50:32
In reply to Adderall tolerance , dosing, etc., posted by JohnX on February 11, 2001, at 7:01:29
I had been on adderall for more than a year, 20mg 2x/day. Sure, it stopped making me smarter after a few days-- it then just kinda centered me and slowed me down a bit. That's bad and good.
After more than a year, I started to really burn out on it, and it seemed to just slow me down. At that point, I went to a the minimum dose that had an effect (7.5 mg) once per day. That seemed to reset tollerance on a daily basis. It was very consistent, but...
...adderall is really seductive-- it makes a huge noticable difference immediately. You just want to keep that going, and/or want more-- the urge is to up the dose.
But it just can't happen.
This is the end of the thread.
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