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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by BLPBart on January 14, 2002, at 11:19:34
I have a question. I was just recently taken off of prozac for depression because of muscle pain and fatigue as well as weight gain. I am on wellbutrin and my doctor and Ihave discussed adding a stimulant. I've been researching this site for info on the stims when I came across adderall. I didn't know what it was so I started looking for information on it. I ended up on an ADD site and just about fell over when I read the description of peopl with adult ADD. It sounded just like me. I'm curious what the relationship that depression and ADD have. Do they tend to occur together? Is depression caused by the ADD? I'm going to talk to my doctor about it on our next visit.
Posted by MB on January 14, 2002, at 16:41:45
In reply to Depression with ADD, posted by BLPBart on January 14, 2002, at 11:19:34
> I have a question. I was just recently taken off of prozac for depression because of muscle pain and fatigue as well as weight gain. I am on wellbutrin and my doctor and Ihave discussed adding a stimulant. I've been researching this site for info on the stims when I came across adderall. I didn't know what it was so I started looking for information on it. I ended up on an ADD site and just about fell over when I read the description of peopl with adult ADD. It sounded just like me. I'm curious what the relationship that depression and ADD have. Do they tend to occur together? Is depression caused by the ADD? I'm going to talk to my doctor about it on our next visit.
I've heard that ADD, OCD and Tourette's will often appear with one of the other two (I didn't say that well, but you know what I mean?). I don't know about depression, though. I would think that having one of these disorders untreated could make a person *feel* depressed, but I don't know if clinical depression is linked to ADD. Wow, a lot of rambling with no pertinent info...sorry.MB
Posted by IsoM on January 14, 2002, at 17:23:43
In reply to Re: Depression with ADD » BLPBart, posted by MB on January 14, 2002, at 16:41:45
Can't say what the statistics for ADD & depression being found together is, but I'm being treated successfully for both (actually ADHD). I've seen others with ADD who aren't depressed so it might not be anything more than a coincidence to see the two conditions together.
> > I have a question. I was just recently taken off of prozac for depression because of muscle pain and fatigue as well as weight gain. I am on wellbutrin and my doctor and Ihave discussed adding a stimulant. I've been researching this site for info on the stims when I came across adderall. I didn't know what it was so I started looking for information on it. I ended up on an ADD site and just about fell over when I read the description of peopl with adult ADD. It sounded just like me. I'm curious what the relationship that depression and ADD have. Do they tend to occur together? Is depression caused by the ADD? I'm going to talk to my doctor about it on our next visit.
>
>
> I've heard that ADD, OCD and Tourette's will often appear with one of the other two (I didn't say that well, but you know what I mean?). I don't know about depression, though. I would think that having one of these disorders untreated could make a person *feel* depressed, but I don't know if clinical depression is linked to ADD. Wow, a lot of rambling with no pertinent info...sorry.
>
> MB
Posted by alley on January 14, 2002, at 20:35:11
In reply to Re: Depression with ADD, posted by IsoM on January 14, 2002, at 17:23:43
> Can't say what the statistics for ADD & depression being found together is, but I'm being treated successfully for both (actually ADHD). I've seen others with ADD who aren't depressed so it might not be anything more than a coincidence to see the two conditions together.
>
>
I'm just curious what meds your on for your depression and ADHD...i too am being treated for depression and ADHD and to tell you the truth the combo of meds are really confusing to me..and sometimes..well a lot of the time i dont feel them working....
Posted by IsoM on January 14, 2002, at 20:48:58
In reply to Re: Depression with ADD IsoM , posted by alley on January 14, 2002, at 20:35:11
For me, what works may not work for you. Just warning, in case my wonder combo isn't yours.
I'm on Celexa & a small bit of Paxil (that's not necessary except to stop withdrawal/discontinuation symptoms), Synthroid (underactive thyroid), & adrafinil (Olmifon). I credit adrafinil for making the major difference. Dexedrine & Ritalin can't hold a candle to adrafinil for me, but not all feel the same benefits.
> > Can't say what the statistics for ADD & depression being found together is, but I'm being treated successfully for both (actually ADHD). I've seen others with ADD who aren't depressed so it might not be anything more than a coincidence to see the two conditions together.
> >
> >
> I'm just curious what meds your on for your depression and ADHD...i too am being treated for depression and ADHD and to tell you the truth the combo of meds are really confusing to me..and sometimes..well a lot of the time i dont feel them working....
Posted by Mitch on January 15, 2002, at 0:00:22
In reply to Depression with ADD, posted by BLPBart on January 14, 2002, at 11:19:34
> I have a question. I was just recently taken off of prozac for depression because of muscle pain and fatigue as well as weight gain. I am on wellbutrin and my doctor and Ihave discussed adding a stimulant. I've been researching this site for info on the stims when I came across adderall. I didn't know what it was so I started looking for information on it. I ended up on an ADD site and just about fell over when I read the description of peopl with adult ADD. It sounded just like me. I'm curious what the relationship that depression and ADD have. Do they tend to occur together? Is depression caused by the ADD? I'm going to talk to my doctor about it on our next visit.
I don't know if it will help you, but I have bipolar and ADHD and *only* antidepressants that are stimulants or act like stimulants (i.e Wellbutrin) seems to affect my depressions. It seems that they have more to do with my level of alertness than anything else.
Mitch
Posted by petters on January 15, 2002, at 1:40:59
In reply to Depression with ADD, posted by BLPBart on January 14, 2002, at 11:19:34
> I have a question. I was just recently taken off of prozac for depression because of muscle pain and fatigue as well as weight gain. I am on wellbutrin and my doctor and Ihave discussed adding a stimulant. I've been researching this site for info on the stims when I came across adderall. I didn't know what it was so I started looking for information on it. I ended up on an ADD site and just about fell over when I read the description of peopl with adult ADD. It sounded just like me. I'm curious what the relationship that depression and ADD have. Do they tend to occur together? Is depression caused by the ADD? I'm going to talk to my doctor about it on our next visit.
Hi...Depression is often cormorbid with ADHD. Many studies show this. I haven´t seen or heard if ADD also is associated with depression. But if a ADD person have many crash with jobs and studies witch often occur with ADD, depression is an emotional conseqence.
Efexor in high dosage 300 - 450 mg is very usefull in this cases. It relives the ADD as well as the depression.
Best Wishes...//Petters
Posted by BLPBart on January 15, 2002, at 9:57:14
In reply to Re: Depression with ADD, posted by petters on January 15, 2002, at 1:40:59
I need to talk to my pdoc about this. I'm currently on wb and weaning off prozac because of the fatigue and carbo cravings. I've seen that wb is one of the drugs used for ADD but it doesn't seem to have helped me with the organizational/focusing problems that I have. I've been fortunate that it's not bad enough to make me lose my job or anything-really just a frustration more than anything. My doctor and I have discussed trying effexor if my fatigue doesn't get any better. The wb has worked for the depression though so I really would have to switch. I'm wondering if I should add something like adderall or ritalin and just see what happens. BTW, I don't have any anxiety or agitation problems from the WB. I've actually complained to my doctor that I wished it was more stimulating.
> > I have a question. I was just recently taken off of prozac for depression because of muscle pain and fatigue as well as weight gain. I am on wellbutrin and my doctor and Ihave discussed adding a stimulant. I've been researching this site for info on the stims when I came across adderall. I didn't know what it was so I started looking for information on it. I ended up on an ADD site and just about fell over when I read the description of peopl with adult ADD. It sounded just like me. I'm curious what the relationship that depression and ADD have. Do they tend to occur together? Is depression caused by the ADD? I'm going to talk to my doctor about it on our next visit.
>
>
> Hi...
>
> Depression is often cormorbid with ADHD. Many studies show this. I haven´t seen or heard if ADD also is associated with depression. But if a ADD person have many crash with jobs and studies witch often occur with ADD, depression is an emotional conseqence.
>
> Efexor in high dosage 300 - 450 mg is very usefull in this cases. It relives the ADD as well as the depression.
>
> Best Wishes...//Petters
Posted by IsoM on January 15, 2002, at 13:11:46
In reply to Re: Depression with ADD, posted by BLPBart on January 15, 2002, at 9:57:14
Adrafinil (& Provigil) belongs to the same class of drugs, "good arousal" or eugeroic medication. While Dexedrine & Ritalin both helped with my drowsiness, focusing, & alertness they don't do it nearly as well as adrafinil does for me. Before I tried adrafinil, I never thought I'd feel as well on it as I did on Dexedrine or Ritalin, but to my surprise, I feel better! And with adrafinil, the level is always even - no dragging myself out of bed in the morning feeling barely awake & alive till the Dexedrine starts working. I feel alert from morning till night, yet still have no problem falling asleep like I used to.
My ADHD shows at my age as super-hyper when I'm busy doing something, but if I'm not doing something physically active, my motor's barely idling. While I'm not really "tired", I am "sleepy" & all the time. I can sleep easily half the day without stimulation.
Anyway, I've written a lot about adrafinil before on this forum & don't want to come across as if I'm pushing it. The reason it works so wonderfully for me may be due to what I have - ADHD with depression & narcolepsy (along with a very oddly functioning brain). :)
< < "...the fatigue and carbo cravings. I've seen that wb is one of the drugs used for ADD but it doesn't seem to have helped me with the organizational/focusing problems that I have."
< < "...my fatigue doesn't get any better. The wb has worked for the depression though so I really would have to switch. I'm wondering if I should add something like adderall or ritalin and just see what happens."
Posted by alley on January 15, 2002, at 14:30:38
In reply to Re: Depression with ADD » BLPBart, posted by IsoM on January 15, 2002, at 13:11:46
> Adrafinil (& Provigil) belongs to the same class of drugs, "good arousal" or eugeroic medication. While Dexedrine & Ritalin both helped with my drowsiness, focusing, & alertness they don't do it nearly as well as adrafinil does for me. Before I tried adrafinil, I never thought I'd feel as well on it as I did on Dexedrine or Ritalin, but to my surprise, I feel better! And with adrafinil, the level is always even - no dragging myself out of bed in the morning feeling barely awake & alive till the Dexedrine starts working. I feel alert from morning till night, yet still have no problem falling asleep like I used to.
>
> My ADHD shows at my age as super-hyper when I'm busy doing something, but if I'm not doing something physically active, my motor's barely idling. While I'm not really "tired", I am "sleepy" & all the time. I can sleep easily half the day without stimulation.
>
> Anyway, I've written a lot about adrafinil before on this forum & don't want to come across as if I'm pushing it. The reason it works so wonderfully for me may be due to what I have - ADHD with depression & narcolepsy (along with a very oddly functioning brain). :)
>
>
> < < "...the fatigue and carbo cravings. I've seen that wb is one of the drugs used for ADD but it doesn't seem to have helped me with the organizational/focusing problems that I have."
>
> < < "...my fatigue doesn't get any better. The wb has worked for the depression though so I really would have to switch. I'm wondering if I should add something like adderall or ritalin and just see what happens."my pdoc has me taking ritalin(20 mg) in the am and it again at lunch, and then 250 depakote and 100 topamax at night..i dont know what it is but i still cant concentrate in class i just breakdown and cry and im always up at night doing my work...he gave me sonata to knock me out but its not doing much good...if anyone knows any advice please help me..im not good at wording things as you can see and my pdoc is only around once a month and i dont like seeing my therapist too often to talk...thanks 8o)
Posted by Mitch on January 16, 2002, at 0:37:32
In reply to Re: Depression with ADD » BLPBart, posted by IsoM on January 15, 2002, at 13:11:46
> Adrafinil (& Provigil) belongs to the same class of drugs, "good arousal" or eugeroic medication. While Dexedrine & Ritalin both helped with my drowsiness, focusing, & alertness they don't do it nearly as well as adrafinil does for me. Before I tried adrafinil, I never thought I'd feel as well on it as I did on Dexedrine or Ritalin, but to my surprise, I feel better! And with adrafinil, the level is always even - no dragging myself out of bed in the morning feeling barely awake & alive till the Dexedrine starts working. I feel alert from morning till night, yet still have no problem falling asleep like I used to.
>
> My ADHD shows at my age as super-hyper when I'm busy doing something, but if I'm not doing something physically active, my motor's barely idling. While I'm not really "tired", I am "sleepy" & all the time. I can sleep easily half the day without stimulation.
>
> Anyway, I've written a lot about adrafinil before on this forum & don't want to come across as if I'm pushing it. The reason it works so wonderfully for me may be due to what I have - ADHD with depression & narcolepsy (along with a very oddly functioning brain). :)
IsoM,I see my pdoc next week and I am going to bring up low-dose adrafinil as a possible swap for my low-dose bupropion. My depressions (that get scary anyhows) only to respond to stims or stim-like AD's. The *important* question I want to ask you is this (if you don't mind)- do you have comorbid anxiety probs? Whether yes or no, does the adrafanil seem to aggravate or create unwanted anxiety? Also, do you get any hypomania from antidepressants? If yes, does adrafanil seem to provoke it or not?
Mitch
Posted by IsoM on January 16, 2002, at 2:08:04
In reply to Re: Depression with ADD » IsoM, posted by Mitch on January 16, 2002, at 0:37:32
I don't mind you asking at all. I'm not sure what would classify as anxiety for me. It seems to run in my family, yet it's not as bad as some people have who couldn't even function due to their anxiety. I know I definitely have symptoms of it but it only seems bad when my depression is bad too. That's when it turns into real fears for me.
Dexedrine more so, but Ritalin somewhat, makes me more sociable & tolerant of people & all their faults. My son with Asperger takes Dexedrine but when I questioned him whether he feels more sociable on it, he doesn't.
I actually found that after a while when the adrafinil had a chance to work (2-3 weeks), I was calmer & more relaxed. I noticed I wasn't holding my muscles tensed like I normally do until I notice the tension building in them by the pain produced.
Without the adrafinil, I tend to hold myself back & prefer to observe when I need to be around others. Dexedrine improves it immensely. But adrafinil does a far better job for me. It makes me feel more sociable but also much more relaxed. If I'm around people for long, even enjoying myself, I'll always come home with a headache from the mental stress. I learned to take pain killers at the beginning of such times to prevent the massive headache I'd have afterwards. Too often I'd forget & really pay for it. I noticed with adrafinil, I can interact around others & not build up the stress/tension level I normally do. No headache afterwards!
I'm a bad picker too. I pick the skin, or any irregularities, around my nails & other places. I'm not always aware I'm doing it till it hurts & starts bleeding. That's something else that's largely stopped now. And foot-tapping or leg swinging. I do that a lot when sitting around other people. I can actually sit still now. No shifting & fidgeting constantly. I don't mean I'm now a blob but I can be much more still. My movements sometimes bugged others - the typical kid in school who just couldn't hold still.
So, no - the adrafinil hasn't added to my anxiety at all. It's alleviated it. But then Buspar can calm many people down & it gave me the jitters. Valerian did too. Caffeine has no effect on me that I can notice either.
No, I don't get hypomanic on adrafinil. Perhaps if my dose was larger I might, but I only take 300 mg/day (normal recommended is 400- 1200 mg) but I think my other meds probably accentuate the effects. I do feel a little hypo on Dexedrine at times, but I know it's not real hypomania. I never feel like I don't have control & I can stand back & feel quiet if I wish.
>
>
> I see my pdoc next week and I am going to bring up low-dose adrafinil as a possible swap for my low-dose bupropion. My depressions (that get scary anyhows) only to respond to stims or stim-like AD's. The *important* question I want to ask you is this (if you don't mind)- do you have comorbid anxiety probs? Whether yes or no, does the adrafanil seem to aggravate or create unwanted anxiety? Also, do you get any hypomania from antidepressants? If yes, does adrafanil seem to provoke it or not?
>
> Mitch
Posted by Raga on January 16, 2002, at 22:05:00
In reply to Re: Questions and Answers » Mitch, posted by IsoM on January 16, 2002, at 2:08:04
I got a question for you IsoM about Adrafinil and Provigil? In your investigation of it, did you hear anything about additional risk of either of them precipitating psychosis, such as paranoia or delusions?
I came across 1 case where someone had a big psychotic break due to an -overdose- of Provigil. But I haven't seen anything about additional risk of psychosis on regular doses like we see with Ritalin or Dexedrine...
Anyone else can answer this too, or give me an idea of where to look or who to ask.Thanks a lot.
Posted by IsoM on January 17, 2002, at 1:22:34
In reply to Psychosis and Modafinil/Adrafinil » IsoM, posted by Raga on January 16, 2002, at 22:05:00
That's a nasty thing to have happen. No, I've never read anything like that with either. Doesn't mean it didn't or couldn't happen, just I never read it. I saw some poorly done images of the brain comparing the differences between what areas are activated with Ritalin/Dexedrine and with adrafinil/modafinil. The latter increases brain metabolism in a larger, more diffuse area than the regular stims. That may account for the psychosis from a Provigil overdose.
I've also read how methamphetamine (the original street speed) can lead to psychosis with continued use. It's related to Dexedrine but then it's used at much higher levels & more often. Some researchers believe that the psychosis is probably a pre-existing condition triggered by the stimulant.
The case you came across - did it say anything else? Did the person have mild psychosis before? Did he recover afterwards? And do you know how much Provigil he took?
The only thing I came across was a small part about one man attempting suicide on one or the other - Provigil or adrafinil, I forget which. He took 57 x the maximum dosage (where'd he get so much?) and after a couple of rough days was back to normal.
It's what I read & I'm reporting it exactly the same way, BUT whether this is accurate, I've no way of verifying. Unless the info comes with references or from very reliable sources, I don't necessarily trust what it says - but I do note it.
It's difficult to find much on adrafinil. It's not been particularily noticed in North America & most studies (what few there are) have been done in Europe. If you want to read anything on it, I can supply some links to different sites.
****************************************************************************************************
> I got a question for you IsoM about Adrafinil and Provigil? In your investigation of it, did you hear anything about additional risk of either of them precipitating psychosis, such as paranoia or delusions?
>
> I came across 1 case where someone had a big psychotic break due to an -overdose- of Provigil. But I haven't seen anything about additional risk of psychosis on regular doses like we see with Ritalin or Dexedrine...
>
>
> Anyone else can answer this too, or give me an idea of where to look or who to ask.
>
> Thanks a lot.
Posted by Raga on January 17, 2002, at 7:38:16
In reply to Re: Psychosis and Modafinil/Adrafinil » Raga, posted by IsoM on January 17, 2002, at 1:22:34
From a monograph on Provigil:
"One healthy male volunteer developed ideas of reference, paranoid delusions, and auditory hallucinations in association with multiple daily 600 mg doses of PROVIGIL and sleep deprivation. There was no evidence of psychosis 36 hours after drug discontinuation. Caution should be exercised when PROVIGIL is given to patients with a history of psychosis."
Multiple 600mg doses sounds plus sleep deprivation sounds like way too much and would probably make practically anyone psychotic!
What it seems to me is that the researchers saw this one case and said "Oh oh, we gotta put in a warning for people with a history of psychosis."
This is unlike Ritalin/Dexedrine, which shows a very significant increase in psychosis on -normal- doses. It isn't just methamphetamine on huge doses, btw. Even though I dislike Breggin, he does go on and on about this point...
I hoping that even though modafinil is a stimulant, it doesn't share this property.The reason I'm asking is that I am ADD but have been avoiding the stimulants for this reason. I have a history of some minor psychosis (which I believe is related to a history of significant psychedelic drug use...) I've had limited success on Wellbutrin, and am about to try desipramine; but then I'm hoping to try modafinil and others and if nothing is really working well enough, I'll give in and take the risk of psychosis and try dexedrine and/or ritalin... That's the source of my question about modafinil...
Posted by IsoM on January 17, 2002, at 11:28:18
In reply to Re: Psychosis and Modafinil/Adrafinil » IsoM, posted by Raga on January 17, 2002, at 7:38:16
I was an idiot when young & used many recreational drugs including LSD & mescaline fairly frequently. Other than wasting my money & time plus probably affected my DNA, the way I behaved before my few years on drugs & afterwards is/was basically the same. I think the hash/marijuana use affected my time sense for a number of years afterwards but that disappeared too.
I do remember that on the hallucogenics & hash my perceptions were definitely odd but I can't say I ever had any unpleasant experiences. I wasn't one of those who tried to self-medicate but foolishly just wanted to see what all these different mental experiences were like. At the time (over 30 years ago), while dangers were mentioned, they were so wildly overblown, they held no meaning.
My use of Dexedrine for ADHD I've purposely kept as low as possible with frequent drug holidays. Never experienced any problems on it either.
The area of the brain that's activated on Dexedrinee/Ritalin is also activated on modafinil/adrafinil but to a much less extent. BTW, adrafinil helps my ADHD far more than the other stims.
Posted by PsychoSage on February 18, 2004, at 5:07:31
In reply to Psychosis and Modafinil/Adrafinil » IsoM, posted by Raga on January 16, 2002, at 22:05:00
> I got a question for you IsoM about Adrafinil and Provigil? In your investigation of it, did you hear anything about additional risk of either of them precipitating psychosis, such as paranoia or delusions?
>
> I came across 1 case where someone had a big psychotic break due to an -overdose- of Provigil. But I haven't seen anything about additional risk of psychosis on regular doses like we see with Ritalin or Dexedrine...
>
>
> Anyone else can answer this too, or give me an idea of where to look or who to ask.
>
> Thanks a lot.I know this is an old topic, but this is where I am at since I am starting with provigil. The subsequent posts to this say it is unlikely, but my psychiatrist cautioned me explicitly.
This is the end of the thread.
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