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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by 3 Beer Effect on January 13, 2002, at 19:16:49
hello, I am currently on Remeron 60 mg/day with 900 mg/day of Neurontin for Bipolar depression. I also have Attention Deficit Inattentive (non-hyperactive) disorder & Social phobia but those problems aren't being treated at this time.
Since I am going to try & finish my final year of college in the Fall, the ADD/attentional problems are more important to me to fix than the Bipolar Depression & Social Phobia problems. The Remeron/Neurontin combination i'm on seems to be doing okay but I am quite groggy in the morning and often have trouble getting out of bed & seem to have no energy to get anything done. I have a short attention span which makes studying almost impossible sometimes, & extreme procrastination (delaying) of studying until the middle of the night before an exam usually results.
I have previously been on Ritalin, Adderall, & Dexedrine for ADD. Adderall & Dexedrine made my short attention span worse but I still would get atleast some work done. Ritalin was almost 'magical' in that I could finally focus on the task at hand and get done the same amount in one hour that would take me 2 days without taking anything. (the main drawback is that it seems to make you nerdy & shy so it definitely doesn't help w/ my social phobia.).
But these 3 ADD medicines, being schedule II controlled substances are extremely annoying b/c they require once a month psychiatrist visits, triplicate prescriptions, no refills etc, and are in general a major hassle especially if your psychiatrist is in your hometown 3 hours away from where you go to college. So I am looking for an effective stimulant/dopamine agonist as a replacement for the traditional Ritalin, Adderall, or Dexedrine regimen for ADD.
The book Essential Psychopharmacology of Depression & Bipolar Disorder by Stephen M. Stahl recommends as "heroic combo #9" on page 158 that Remeron can be supplemented with a stimulant/dopamine agonist in order to "take care of" dopamine (since Remeron already takes care of Serotonin & Norepinephrine). Lack of dopamine seems to be the main problem in ADD/attentional/focus/"not getting out of bed to do your work" problems for most people.
So my question is which of these non-schedule II stimulants or dopamine agonists are best for increasing attention/focus/getting more work done?
Mirapex (Pramipexole) vs. Provigil (Modafinil) vs. Tenuate (Diethylproprion)?
Posted by Rakken on January 13, 2002, at 20:12:20
In reply to Mirapex vs. Provigil vs. Tenuate for Adult ADD?, posted by 3 Beer Effect on January 13, 2002, at 19:16:49
I don't know about Mirapex or Tenuate. But I tried Provigil and it had no effect on me. I was on 400 mg and it would often make me more sleepy. I didn't get any bad side effects though. It just wasn't effective. And it did nothing to improve focus or attention. But I've heard that it can promote wakefulness in some people very well. It has very few side effects too.
Posted by Mr. Scott on January 13, 2002, at 20:48:08
In reply to Mirapex vs. Provigil vs. Tenuate for Adult ADD?, posted by 3 Beer Effect on January 13, 2002, at 19:16:49
I'd go with Tenuate. You know it is the parent compound of wellbutrin and may have some AD effect as well. It is sort of like the bridge between AD and Stim.
Posted by ChrisK on January 14, 2002, at 3:55:32
In reply to Mirapex vs. Provigil vs. Tenuate for Adult ADD?, posted by 3 Beer Effect on January 13, 2002, at 19:16:49
My experience with Mirapex is that it will help you to enjoy things a little more and help with motivation but it is not activating. You will not get an energy boost to get you out of bed. Provigil did very little for me except give me constipation.
Posted by Hattree on January 15, 2002, at 14:27:23
In reply to Re: Mirapex vs. Provigil vs. Tenuate for Adult ADD?, posted by ChrisK on January 14, 2002, at 3:55:32
I like Teunate because its cheap. I don't find much difference among stimulants, but its as good as any except too short-acting for my taste (but no more so than Ritalin).
> My experience with Mirapex is that it will help you to enjoy things a little more and help with motivation but it is not activating. You will not get an energy boost to get you out of bed. Provigil did very little for me except give me constipation.
Posted by Lynne on February 25, 2002, at 17:30:56
In reply to Re: Mirapex vs. Provigil vs. Tenuate for Adult ADD?, posted by Hattree on January 15, 2002, at 14:27:23
Does Tenuate help with depression too?
Thanks
This is the end of the thread.
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