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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by utopizen on September 8, 2002, at 20:47:28
Okay, and with a calm, friendly message to those of you who have been greatly helped by benzos are are enthused enough over them to suggest me to take them: my doc wants me to avoid the benzos so long as there's another drug to hop over to or switch or whatever.
Given the fact that there's several thousand I haven't tried yet, I have a feeling I might take awhile before giving up on this psychotropic cocktail buffet I keep eating at. So please, no benzos for me yet!
Anyway, the point is I'm on Ritalin (tried Adderall, but didn't like how it lasted in my system for 12 hours). An stimulants make me anxious. I need them for class to focus, but in class I also end up sounding like a dork, appearing uptight, and socially anxious. I feel like an anxious zombie. I know not everyone gets anxious on Ritalin, but I already have anxiety, and I heard if you already are anxious it makes you like this.
Anyway, what should I try? I'm already on Effexor for my social anxiety, been on it for 2 weeks. Waiting for result, but I doubt it could actually kill my Ritalin anxiety. Not even Neurontin can do that, which makes me calm off Ritalin.
I was thinking Clonodine or Tetrex... anyone feel calm on these? Or maybe Trofanil, which I heard kids mix with Ritalin to curb the anxiety. Gosh- my parents wouldn't even let me go on plain ritalin.
Posted by Seamus2 on September 8, 2002, at 22:38:42
In reply to Uptight on Ritalin... what should I add?, posted by utopizen on September 8, 2002, at 20:47:28
Have you tried reducing your dose of Ritalin?
Perhaps the amount which causes social anxiety and dorkiness is above and beyond that needed for clarity of thought.
Posted by Jackd on September 9, 2002, at 19:08:52
In reply to Re: Uptight on Ritalin... what should I add?, posted by Seamus2 on September 8, 2002, at 22:38:42
I have the same problem with 18mg of Concerta (time-release ritain; the equivalent of 5mg 3x a day). I took 1-2 mg of Klonopin a day to relieve the anxiousness, which worked great, but i guess for you that's not an option.
I wouldn't think any norepinephrine acting meds/stimulating meds would help ease the anxiety (Tofranil, Effexor, or others) Beta blockers could really help, but I have no experience with them.
My shrink suggested Propranolol at one time for tremor and anxiety, which is another beta blocker besides Clonidine. She stated that Propranolol didn't cross the blood brain barrier. So in other words, it blocks sympathetic nervous system responses but is less likely to cause unwanted mental side effects. I can't guarantee this is true.
Is your anxiety performance related or persistent nagging thoughts or both? Beta blockers help with "feeling" anxious, but not necessarily thought anxiety.
Look especially for meds with GABA action for help with anxiety.
Posted by utopizen on September 10, 2002, at 0:03:23
In reply to Re: Uptight on Ritalin... what should I add?, posted by Jackd on September 9, 2002, at 19:08:52
Propananol is a beta blocker, clonidine is an alpha agonist.
I can't take betas, because I take Salagen for dry mouth from all my meds, and it's not advised to mix the two. So that's why I'm thinking of Clonodine.
I think I'm "jittery" but I still don't exactly know what that means. I just feel uptight, physically, in my head, and in my thoughts. Like, I can read anything no matter how boring it is. So it's great for my schoolwork, it's like I've hired a dork to take over my body for a few hours and get some work done.
But the problem is I'm boring to others, and even to myself. I think of dorky things, things I shouldn't worry about in class, questions I should move on with instead of asking... in a word, I'm pedantic.
I had a dream last night, no joke, I went to this "dieitician doctor" and got Desoxyn written for me. Weird stuff. I will always wonder how I feel on it... obviously anxious though, if not more so. For some reason I'm enchanted about how meth can be sold so benignly and obscurely all at the same time... my p-doc does adolescent and adult psych., in a state that's known to be a ritalin state in an affluent suburb. So he must write a lot of stimulants. And he said he never heard of the stuff before. It shocked me.
Posted by Ritch on September 10, 2002, at 10:18:44
In reply to Re: Uptight on Ritalin... what should I add?, posted by utopizen on September 10, 2002, at 0:03:23
> Propananol is a beta blocker, clonidine is an alpha agonist.
>
> I can't take betas, because I take Salagen for dry mouth from all my meds, and it's not advised to mix the two. So that's why I'm thinking of Clonodine.
>
> I think I'm "jittery" but I still don't exactly know what that means. I just feel uptight, physically, in my head, and in my thoughts. Like, I can read anything no matter how boring it is. So it's great for my schoolwork, it's like I've hired a dork to take over my body for a few hours and get some work done.
>
> But the problem is I'm boring to others, and even to myself. I think of dorky things, things I shouldn't worry about in class, questions I should move on with instead of asking... in a word, I'm pedantic.
>
> I had a dream last night, no joke, I went to this "dieitician doctor" and got Desoxyn written for me. Weird stuff. I will always wonder how I feel on it... obviously anxious though, if not more so. For some reason I'm enchanted about how meth can be sold so benignly and obscurely all at the same time... my p-doc does adolescent and adult psych., in a state that's known to be a ritalin state in an affluent suburb. So he must write a lot of stimulants. And he said he never heard of the stuff before. It shocked me.
Hi,So you're taking Effexor+Ritalin right now? Stimulants have a tendency to heighten obsessiveness. That works great when you *need* to stay on a 'single' task. The trouble comes when you have to "shift gears" temporarily and do something different and then return to the task. Socializing in the midst of all of that places demands on you to "switch tasks" easily and stims make it especially tough for that. I am on low-dose Effexor+Wellbutrin and if I nudge up the WB I have similar problems at work. I tend to get hungup on my work task, and have trouble, "stopping out" and socializing without boring people with shop-talk. Sometimes, even switching to an unrelated work-task can be difficult. SRI's tend to facilitate "task-switching", but unfortunately they also tend to make me foggy-headed. Prozac was the only one of them that would leave me relatively clear headed, but I can't stand to take it. Maybe you could just reduce your Ritalin dose or increase your Effexor, or switch the Effexor to a different SRI? Probably a tiny bit of Klonopin added on, might do just fine though.
Mitch
Posted by Ms_Placed on September 10, 2002, at 22:43:44
In reply to Uptight on Ritalin... what should I add?, posted by utopizen on September 8, 2002, at 20:47:28
Effexor took a few months before it eliminated my anxiety and depression-- very effective but now I need ritalin for motivation!
Posted by utopizen on September 11, 2002, at 21:59:58
In reply to Re: Uptight on Ritalin... what should I add?, posted by Ms_Placed on September 10, 2002, at 22:43:44
Has anyone tried Dexedrine? I've only tried Adderall, Ritalin... Adderall stays in my system too long for me to eat anything, while Ritalin leaves quickly enough for me to schedule meals around it.
But 3Beers claims it's helped his social phobia "especially with klonopin." Well, yeah, of course! I suppose crack and klonopin would also work : ) I am pretty sure I'd feel just as anxious as I do on the others, but my doc has offered to switch me if it's really bothering me.
But seriously, I'm interested in knowing what appears to sound like a paradoxial effect in 3Beers... is anyone else experiencing a reduction in Dexedrine with anxiety or less stimulant-inducing anxiety than other stims they've tried?
I've also heard Dexedrine is less "dulling." That would be nice. I feel terrible on Ritalin, it makes my stomach acidic and my head "boring." Sorry, but I can't describe it any other way... when I said it gave me a "dull" feeling, my doctor looked at me like he's never heard that word before, and couldn't understand why it was doing that. Geez, this is someone who sees kids to get the stuff all the time, and a college student is producing symptoms he's never heard of! Does anyone else get these feelings?
Oh yeah, and the acidic-feeling (sour stomach?) doesn't go away with Mylanta, Tums or Pepto... weird...
Posted by Ritch on September 11, 2002, at 22:48:56
In reply to Re: Uptight on Ritalin... what should I add?, posted by utopizen on September 11, 2002, at 21:59:58
> Has anyone tried Dexedrine? I've only tried Adderall, Ritalin... Adderall stays in my system too long for me to eat anything, while Ritalin leaves quickly enough for me to schedule meals around it.
>
> But 3Beers claims it's helped his social phobia "especially with klonopin." Well, yeah, of course! I suppose crack and klonopin would also work : ) I am pretty sure I'd feel just as anxious as I do on the others, but my doc has offered to switch me if it's really bothering me.
>
> But seriously, I'm interested in knowing what appears to sound like a paradoxial effect in 3Beers... is anyone else experiencing a reduction in Dexedrine with anxiety or less stimulant-inducing anxiety than other stims they've tried?
>
> I've also heard Dexedrine is less "dulling." That would be nice. I feel terrible on Ritalin, it makes my stomach acidic and my head "boring." Sorry, but I can't describe it any other way... when I said it gave me a "dull" feeling, my doctor looked at me like he's never heard that word before, and couldn't understand why it was doing that. Geez, this is someone who sees kids to get the stuff all the time, and a college student is producing symptoms he's never heard of! Does anyone else get these feelings?
>
> Oh yeah, and the acidic-feeling (sour stomach?) doesn't go away with Mylanta, Tums or Pepto... weird...
Yes, a switch to dexedrine (from Ritalin) might be a smart first move. Dexedrine has been the only stimulant (between dexedrine, Adderall, Focalin) that seemed to make me feel *sleepy* in some ways. I was awake and alert, but my *eyes* felt kind of sleepy, my body felt relaxed and "dishrag-like" (but with better posture) and I didn't feel the "buzziness" that I experienced with Adderall and Focalin. I just didn't like the 3-4hr range of action (it beats Focalin or Ritalin's 1.5-3hr range, however). If they could make a "Concerta-like" tablet with dexedrine-it probably would be the best stimulant option. I haven't tried the dexedrine spansules. If one spansule (5mg) could span 8-10hrs reasonably consistently, that might be an option for me-for my midday through early evening drowsiness-inattentiveness spells.Mitch
Posted by utopizen on September 11, 2002, at 22:56:00
In reply to Re: Uptight on Ritalin... what should I add? » utopizen, posted by Ritch on September 11, 2002, at 22:48:56
I'm curious why this doesn't appear to be out there in clinical evidence... I'm sure, like a lot of stuff I read about anecdotal experiences on the 'net, re-telling your story would simply give my p-doc a balk, but he'd probably let me get a trial anyway...
I'm all for the short-acting Ritalin! Just long enough for studying, but short enough so you don't feel "married" to the stuff- when I'm done studying, I can actually eat food. Kind of novel.
Posted by IsoM on September 12, 2002, at 1:02:26
In reply to Re: Uptight on Ritalin... what should I add? » utopizen, posted by Ritch on September 11, 2002, at 22:48:56
Mitch, don't get the spansule caps. The way the time release works is half the dose is released immediately & then the other half 4 or 5 hours (I forget which) later. It's to make it easier to do one pill for 2 doses. It doesn't give the sustained smooth release you might think.
As for anecdotal stories of Dex being better than Ritalin, it's true. But I don't think they're just ancedotal.
I went to my doctor after even the Provigil pooped out (I'd started with adrafinil), & said I was starting to feel desperate in my quest to stay awake & alert. He believes I have narcolepsy without having to go through the long wait & trouble of a sleep lab test (he has 2 other narcoleptic patients & knows what it's about). When I asked him if he'd prescribe Dexedrine for me, I expected stubborn refusal. But he just said "I thought you didn't like it?" I told him it was Ritalin I didn't like for its quick ups & sudden drop after it wore off - that & the slightly jittery feeling on it. He said that was very normal with Ritalin & was one reason he didn't like it. So he seems to be aware of the difference between the two.
Happily, now I've finally got Dexedrine AND doing it legally. It's a bit of a nuisance to take but much, MUCH better than fighting trying to stay awake & alert. I take half my morning dose on an empty stomach when I first wake up, & then the other half about 45 minutes to an hour later. When the morning dose is wearing off, I repeat the same thing in the afternoon. It gives me the best sustained, smooth alertness. I would still love to have another dose in the later afternoon to keep me alert & stop the yawning that starts as the afternoon dose wears off, but I'm not going to push my doctor initially. I'll let him know when I go back for a followup & see what happens.
Posted by Ritch on September 12, 2002, at 10:32:51
In reply to Re: Dexedrine and spansule caps (for utopizen too) » Ritch, posted by IsoM on September 12, 2002, at 1:02:26
> Mitch, don't get the spansule caps. The way the time release works is half the dose is released immediately & then the other half 4 or 5 hours (I forget which) later. It's to make it easier to do one pill for 2 doses. It doesn't give the sustained smooth release you might think.
Hi IsoM,Thanks for responding. I'm aware of how the spansules do their release business-that's why I mentioned making a "Concerta-like" tablet would be helpful. But, in my case I think a 5mg spansule midday(or early afternoon) might be perfect. When I tried IR Dexedrine a few months ago, a 2.5mg dose (half a tab) was "just right"-5mg gave me some mild chest pain. It definitely had an anxiolytic effect. I would sit down (and sit still) and listen to music, read, etc.-I wasn't puttering about aimlessly like I normally do. I was stopping at stop lights and waiting for them to turn green *all* the time (I've got a tendency on out of the way lights to stop and look both ways for traffic and drive on through it-then DUH realize it wasn't a stop sign). The trouble with the half-tab of IR, was that it wore off *rapidly* (4 hrs later), the crash was so bad I could'nt keep my eyes together (exotropia). I don't like the idea of carrying around a half-tab and making sure to take it about an hour before the first half-tab goes away, etc.etc. I work in the evenings and I am not tired in the mornings. It is mid-afternoon through mid-evening when I can't stay AWAKE (about a six-eight hour period). And drinking stout coffee doesn't even seem to help. Wellbutrin, Adderall, Focalin, desipramine work, but they make me nervous. Dexedrine was the only one that didn't make me nervous. Dexedrine didn't help me focus as well as the others however, but I don't care as long as I can stay AWAKE during this time period. I got some mild hypomania from Focalin-Wellbutrin-desipramine, none from Dex., it makes me quiet. I know that Adderall is half-dex, and when I took it I felt calmed the first 2-4or5 hrs, then later in the day I felt buzzy and restless.
Mitch
Posted by IsoM on September 12, 2002, at 13:08:58
In reply to Re: Dexedrine and spansule caps (for utopizen too) » IsoM, posted by Ritch on September 12, 2002, at 10:32:51
You know I wasn't even aware that the Spansule caps came in 5 mg as I thought they were all 10 mg. The exotropia sounds pretty scary, especially to others who see you doing that. Can you still read or focus like that? I've done that traffic light drive through too. My son with me just about freaked.
So can you get a script for 5 mg spansule from your doctor? I can't see why you'd be refused such a low dose. He does know you're very sensitive to meds & wouldn't be abusing that little.
Dexedrine can calm me down, wake me up, get me very perky, or I can even sleep on them. It all depends on my normal mood at the time. I don't think they affect me as strongly as they do some (like you) but then I'm only at 5 mg 2x day. What it does more than anything is to keep me awake if I want to be. Oh, how I wish that Provigil hadn't pooped out. While it worked, it was ideal for me.
My doctor has seen me at times when I was naturally high & enthusiastic & wondered if I wasn't hyopmanic. But I know myself & 1/2 hour later I can be falling asleep on the couch. I remember even as a kid that my 'mania' was just me. I gesture wildly, talk excitedly & quickly, eyes aglistening when I feel good & am enthusiastic. Unfortunately, few people seem to have that outward show of verve & it can appear as hypomania to those who don't know me well. But my doctor's also starting to know there's times I have the mood of a slug - I love the word 'sluggish', it so describes my other side.
Posted by Seamus2 on September 12, 2002, at 21:00:03
In reply to Re: Dexedrine and spansule caps (for utopizen too) » IsoM, posted by Ritch on September 12, 2002, at 10:32:51
Mitch,*Is* there such a beast as 5 mg Dex spansules?
2.5 mgs IR q 4 hours is okay for me, but has its ups and downs.
I'm seriously thinking of breaking those in half and doing 1.25 mgs q 2-3 hrs.
5 mgs post-prandial is positively soporific.
Ritalin -- eeuw, gag me with a spoon. All over the map, and I can't break the 5 mg tabs well enough to adjust timings.
Posted by utopizen on September 12, 2002, at 21:06:22
In reply to Re: Dexedrine and spansule caps (for utopizen too), posted by Seamus2 on September 12, 2002, at 21:00:03
> 5 mgs post-prandial is positively soporific.This appears like it is a paradoxial effect,
since dexedrine is exclusive of the slang
"co-pilots." I imagine this means they
were favored among the meth and another
drugs truck drivers took...I've never tried dexedrine, but anything
has to be better than the inner tension,
jitteriness, edginess, and any other
adjective you can think of that relates
to anxiety. I felt like the guy in Trainspotting
during his job interview after he took speed.Maybe explaining this anxiety to my p-doc
as "speedy" was a bad thing...
Posted by Ritch on September 12, 2002, at 23:53:58
In reply to Re: Dexedrine and spansule caps » Ritch, posted by IsoM on September 12, 2002, at 13:08:58
> You know I wasn't even aware that the Spansule caps came in 5 mg as I thought they were all 10 mg. The exotropia sounds pretty scary, especially to others who see you doing that. Can you still read or focus like that? I've done that traffic light drive through too. My son with me just about freaked.
Hi, I just rechecked the monograph and 5,10, and 15mg spansules are manufactured. It appears that I would (with a 5mg spansule) get the same effect as taking half a 2.5mg dexedrine IR tablet, and then get the other half (2.5mg) spread out over "several" later hours. So any inconsistency would occur 4+hrs postdosing with the sustained release medication. If I took a 5mg spansule immediately before work and it worked like IR dexedrine until lunchtime, and then got a little "waviness", the final 4 hours I could probably tolerate it OK. I just want to avoid the "crash like a rock" situation before I can get home. I *like* the crash before bedtime because it seems to regulate my sleep cycles-like my full brain gets a full workout and I sleep better-more solid-no breaks-and I wake easily, at the "proper time", feeling rested.
>
> So can you get a script for 5 mg spansule from your doctor? I can't see why you'd be refused such a low dose. He does know you're very sensitive to meds & wouldn't be abusing that little.I am not concerned about being 'refused', more with "will it work without making me panicky or hypomanic (long-run), etc. I already KNOW FOR SURE that Adderall can completely quash my bipolar depressive episodes with just a 5mg daily dosage, no other AD combos have come close.
>
> Dexedrine can calm me down, wake me up, get me very perky, or I can even sleep on them. It all depends on my normal mood at the time. I don't think they affect me as strongly as they do some (like you) but then I'm only at 5 mg 2x day. What it does more than anything is to keep me awake if I want to be. Oh, how I wish that Provigil hadn't pooped out. While it worked, it was ideal for me.
>
> My doctor has seen me at times when I was naturally high & enthusiastic & wondered if I wasn't hyopmanic. But I know myself & 1/2 hour later I can be falling asleep on the couch. I remember even as a kid that my 'mania' was just me. I gesture wildly, talk excitedly & quickly, eyes aglistening when I feel good & am enthusiastic. Unfortunately, few people seem to have that outward show of verve & it can appear as hypomania to those who don't know me well. But my doctor's also starting to know there's times I have the mood of a slug - I love the word 'sluggish', it so describes my other side.
>
>
This is the end of the thread.
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