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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by utopizen on January 7, 2004, at 18:47:36
I've heard of it as a trend by some docs, but very rare one. Anyone take a low-dose long-acting stim in the AM and a short-acting stim of a different kind throughout the day?
Seems like the same idea behind the Adderall mixture of amphetamine salts. Like, say 5 or 10mg Dexedrine Spansules in AM, then a 10 or 20mg Adderall at noon.
Or Adderall XR 10mg or 20 mg in the day, with 5 mg of Desoxyn 2x/day. I've never tried such a thing, but I'm curious. Maybe it would level things out.
And gosh, isn't there anyone out there who's tried a stim and Straterra continiously?? I want to know what that's like.
Posted by Ame Sans Vie on January 8, 2004, at 8:51:52
In reply to Anyone combine ADD meds? , posted by utopizen on January 7, 2004, at 18:47:36
I just finished a short trial with Strattera recently -- I took it for two months along with Adderall XR 60mg. It wasn't really a necessity, but my pdoc thought it may allow me to decrease my dosage of amphetamines. Long story short, the Strattera caused horrible insomnia which ultimately resulted in my discontinuation. Apart from that, the effect was very synergistic with that of the Adderall. Fortunately, my pdoc isn't dead-set on taking me off amphetamines or anything... he explained he just wanted to see how the Strattera worked, as he'd never used it in an adult patient. So now it's 60mg Adderall XR again along with Klonopin 8mg, Prozac 20mg, chloral hydrate 0.5-1 gram, and Tuinal 200-400mg (switching between the chloral and the Tuinal each two weeks to avoid tolerance). I am very curious about the prospect of lowering my Adderall dosage back to 30mg and adding on Concerta, though... the Adderall works great, but I'd feel I weren't exploring all the options if I don't give it a try. The idea you brought up regarding extended-release combined with immediate-release formulations is also rather intriguing... I could use something to get me out of that 45-minute "slump" that always occurs about six hours after my Adderall dose, before the second 30mg kicks in. I imagine a small dose of Ritalin (7.5mg perhaps) could help me through this, as I've found that it only seems to last about two hours for me, which would be just about perfect.
Posted by mtdew on January 8, 2004, at 22:15:56
In reply to Re: Anyone combine ADD meds? » utopizen, posted by Ame Sans Vie on January 8, 2004, at 8:51:52
I didn't know they even still made Tuinal. I never heard of anyone on Chloral either. How did you come to be on these meds? Have you just stuck with them for the past 15+ years, or did they offer some advantage over newer meds?
Posted by Ame Sans Vie on January 9, 2004, at 0:42:58
In reply to Wow..., posted by mtdew on January 8, 2004, at 22:15:56
I'm not sure if they still make brand-name Tuinal -- I take the secobarbital/amobarbital generic. I use them simply because nothing else works for sleep. Not Remeron, trazodone, amitriptyline, Benadryl, Halcion, Restoril, Ambien, Sonata, phenobarbital... the only other option is Xyrem, but until Medicaid will cover the cost of it for any use other than narcoleptic cataplexy, I'm stuck with the chloral and Tuinal. No complaints though.
Posted by utopizen on January 9, 2004, at 4:49:51
In reply to Re: Wow... » mtdew, posted by Ame Sans Vie on January 9, 2004, at 0:42:58
> I'm not sure if they still make brand-name Tuinal -- I take the secobarbital/amobarbital generic. I use them simply because nothing else works for sleep. Not Remeron, trazodone, amitriptyline, Benadryl, Halcion, Restoril, Ambien, Sonata, phenobarbital... the only other option is Xyrem, but until Medicaid will cover the cost of it for any use other than narcoleptic cataplexy, I'm stuck with the chloral and Tuinal. No complaints though.
>Xyrem's over-rated for its insomnia-inducing properties, unless you're taking a very high dose at once... which I believe led me to high blood pressure (I was experimenting with a dose that could put me to sleep).
I'm off it temporarily, going to ask my p-doc for Sonata to combine with the Xyrem (the combo has been tested and safe on Xyrem's package insert).
Have you tried Soma for insomnia? It seems sedating from what I've read. Seconal, wow. Not even Seconal alone does the trick?
Posted by Kacy on January 10, 2004, at 13:30:34
In reply to Anyone combine ADD meds? , posted by utopizen on January 7, 2004, at 18:47:36
Strattera 100 mg.
Adderall 30 mg 2x a day
Effexor 75 mg (which works as well as 150 mg did before I started Strattera)Strattera isn't a stimulant for me. It quells anxiety.
Has anyone tried switching back and forth between different brands of Adderall to fight tolerance? When I switch brands, the same dose level works again after I have reached tolerance on the first brand. I don't know if it will continue.
I find a big difference in the type of response that I get from Shire's name brand Adderall and from Ranbaxy's generic version and from Barr's generic version. They work so differently. Can anyone tell me about their experience with different brands?
Posted by Viridis on January 11, 2004, at 19:55:09
In reply to Anyone combine ADD meds? , posted by utopizen on January 7, 2004, at 18:47:36
I took Strattera and Adderall together for about 6 months (along with Klonopin). Strattera was helpful at first, and the side effects (mild nausea, dry mouth, etc.) were quite manageable with gradual titration. I found it relaxing rather than stimulating. However, I quit the Strattera for three reasons:
1) Strattera stopped doing anything re: ADD or mood once I'd been on the full dose (80 mg/day) for a while. It did improve my mood and concentration at first.
2) Strattera was a tremendous appetite suppressant for me -- I had this with Adderall at first, but that stopped quickly. With Strattera, it didn't. This might be a plus for some people, but I don't think it's healthy to forget to eat for a whole day at a time.
3) Strattera had the strange effect of exaggerating any negative effects associated with lack of sleep. It didn't cause insomnia or make me tired. However, I found that the cognitive deficits that I experience if I haven't had enough sleep were made much worse by Strattera (who knows why?). Unfortunately, I've been so busy lately that I haven't been getting enough sleep, and Strattera made this worse. It was OK when I did get enough sleep, though -- but since it wasn't achieving its main goals anyway, I discontinued it.
Oh, and Strattera caused major heartburn if I took it on an empty stomach or with coffee (pretty easy to avoid unless you don't feel like eating or need some caffeine).
I think Strattera has promise, and initially it worked well together with Adderall. Ultimately, though, this just didn't seem like the right combo for me.
Posted by Ame Sans Vie on January 13, 2004, at 6:45:43
In reply to Re: Wow..., posted by utopizen on January 9, 2004, at 4:49:51
> Have you tried Soma for insomnia? It seems sedating from what I've read. Seconal, wow. Not even Seconal alone does the trick?
I used Soma for a while at quite high doses (700mg five times daily) to help with my fibromyalgia. Recently I discovered that aspartame was causing all the pain, and upon giving up Diet Coke in exchange for drinks sweetened with sucralose and acesulfame-K the pain I once had to treat with the fentanyl patch is 100% absent. I've never found Soma at all sedating, though -- if anything, I find it quite activating. The best comparison I can make is that it feels like a Quaalude, without the drowsiness/stupor, combined with a bit of codeine and a small hit of MDMA or a standard dose of MDA.
I don't know what it is with me and barbiturates -- neither Seconal nor Amytal works for me on its own, but it seems they vastly potentiate each other when taken together.
Posted by mtdew on January 13, 2004, at 14:07:35
In reply to Re: Wow... » utopizen, posted by Ame Sans Vie on January 13, 2004, at 6:45:43
That's interesting re aspartame and your fibro. I seem to tolerate aspartame just fine, but acesulfame-K is a problem for me. It took a while to figure out. If you have fibro/CFIDS/MCS/etc. it pays to examine everything you put in your body. I've also recently discovered minor allergies to whole grain oats, raw cashews, and shrimp. Food allergies can easily be mistaken for anxiety, as well as reduce your quality of sleep and life.
> > Have you tried Soma for insomnia? It seems sedating from what I've read. Seconal, wow. Not even Seconal alone does the trick?
>
> I used Soma for a while at quite high doses (700mg five times daily) to help with my fibromyalgia. Recently I discovered that aspartame was causing all the pain, and upon giving up Diet Coke in exchange for drinks sweetened with sucralose and acesulfame-K the pain I once had to treat with the fentanyl patch is 100% absent. I've never found Soma at all sedating, though -- if anything, I find it quite activating. The best comparison I can make is that it feels like a Quaalude, without the drowsiness/stupor, combined with a bit of codeine and a small hit of MDMA or a standard dose of MDA.
>
> I don't know what it is with me and barbiturates -- neither Seconal nor Amytal works for me on its own, but it seems they vastly potentiate each other when taken together.
This is the end of the thread.
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