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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by utopizen on February 24, 2004, at 18:24:02
Okay, I mentioned to my new pdoc today, "It's trendy among some psychopharmacologists these days to try augmenting Aricept for executive dysfunction associated with ADD."
He responded, "I'm not trendy, I go by the book [I imagine the PDR, since he kept opening it up to make sure my doses were in line with the averages].
Well, aside from the idea that "trendy" just means a doctor keeps up to date with trends in medicine, and if all docs were like him there would be no PDR, um, the studies I've read noted a 25% efficacy in patients with executive dysfunction associated with ADD.
I've heard some on this board go "I take 5mg of Aricept + a stimulant at X dose." Did you notice a difference once you added the Aricept, or skipped a day of it, or something????
Posted by Chairman_MAO on February 24, 2004, at 19:04:38
In reply to Aricept Users for AD/HD: Do you notice a change??, posted by utopizen on February 24, 2004, at 18:24:02
I've used galantamine (Reminyl, Nivalin) with excellent results. I was a rush courier at the time and my speed and accuracy in reading road maps increased by a subjective figure of about 50%. I also felt more adroit in my use of English in deep discussions.
If you want galantamine on the cheap, without prsecription, you can get it directly from Sopharma, A.D., Bulgaria (the first pharmaceutical firm to manufacture it to my knowledge) at www.nivalin.com. Their salespeople are friendly and responsive, their shipping takes about 10-14 days, and their product is top-notch.
Galantamine is stronger than Aricept and is less prone to build tolerance. Start low, go slow, and you shouldn't have any problems.
Posted by zeugma on February 24, 2004, at 20:10:30
In reply to Aricept Users for AD/HD: Do you notice a change??, posted by utopizen on February 24, 2004, at 18:24:02
If your diagnosis of narcolepsy is accurate, you'd want to stay as far away from something like Aricept as possible. The extremely brief REM latency that is diagnostic of the disorder is due to a hyper-activation of the cholinergic system and a corresponding weakness of the monoaminergic system. That is why narcoleptics are given antidepressants to manage the nighttime symptoms of narcolepsy. Cholinergic drugs would cause a hyper-activation of REM, exacerbating narcolepsy.
I suppose you could use Aricept or galantamine as a probe, and if it brings on a drastic worsening (chances are you'd know immediately) you could go in the other direction and try a more traditional approach to managing your sleep disorder. I can't imagine any MD worth his or her diploma advising anyone with narcolepsy to try this, however.
Posted by Chairman_MAO on February 25, 2004, at 7:41:43
In reply to Re: Aricept Users for AD/HD: Do you notice a change?? » utopizen, posted by zeugma on February 24, 2004, at 20:10:30
I did not know this. But then again, that's why we consult with doctors, isn't it? :) There would be more of an argument to try galantamine in this case. Aricept's half-life is 70 hours AND it accumulates in plasma, whereas galantamine's is 7. It could still worsen his sleep problems, but then again, it might not. There's certainly less chance of this happening than with Aricept.
Posted by TheOutsider on February 25, 2004, at 12:15:36
In reply to Re: Aricept Users for AD/HD: Do you notice a change?? » utopizen, posted by Chairman_MAO on February 24, 2004, at 19:04:38
> I've used galantamine (Reminyl, Nivalin) with excellent results. I was a rush courier at the time and my speed and accuracy in reading road maps increased by a subjective figure of about 50%. I also felt more adroit in my use of English in deep discussions.
>
> If you want galantamine on the cheap, without prsecription, you can get it directly from Sopharma, A.D., Bulgaria (the first pharmaceutical firm to manufacture it to my knowledge) at www.nivalin.com. Their salespeople are friendly and responsive, their shipping takes about 10-14 days, and their product is top-notch.
>
> Galantamine is stronger than Aricept and is less prone to build tolerance. Start low, go slow, and you shouldn't have any problems.I have inetentive type ADD and have been really interested by this discustion.
I'm looking for none stimulant meds, because stimulants are so hard to get in the UK.
May I ask what dosage of Galantamine you were on, and what you round most helpful?
Posted by B2chica on February 25, 2004, at 15:26:00
In reply to Question for Chairman_MAO, posted by TheOutsider on February 25, 2004, at 12:15:36
> I have inetentive type ADD and have been really interested by this discustion.
> I'm looking for none stimulant meds, because stimulants are so hard to get in the UK.
> May I ask what dosage of Galantamine you were on, and what you round most helpful?
>Strattera is not supposed to be a stimulant, but i don't know how they compare to the others mentioned, or if it's any easier for you to get. maybe someone who's been on it a while can chime in.
B2c.
Posted by Chairman_MAO on February 25, 2004, at 16:21:56
In reply to Question for Chairman_MAO, posted by TheOutsider on February 25, 2004, at 12:15:36
I took between 5 and 20mg/day (usually 15), depending upon how much I needed to focus and how long I was working. At 20mg I had razor-sharp cognition (even on benzos), but I was on the edge of excess anxiety, agitation, depression, and also tended to see the negative in everything. Galantamine is a potent agent; you'd do well to start with the lowest dose you can to see how it affects you. I took it with Strattera for a while, too, and that was even more effective. Unfortunately, Strattera made me completely impotent, just like desipramine.
If you can obtain both via prescription or otherwise, I'd give a serious trial of selegiline (5-10mg/day in divided doses) along with galantamine (dosage here is highly individualized). This combination was markedly better than Strattera + galantamine. If you cannot get selegiline, or you do not find it or galantamine alone satisfactory, try Strattera + galantamine or Wellbutrin + galantamine.
Posted by francesco on February 26, 2004, at 8:23:53
In reply to Re: Question for Chairman_MAO » TheOutsider, posted by Chairman_MAO on February 25, 2004, at 16:21:56
Hi again Chairman,
I have just read that desipramine made you completely impotent, and this was the same experience I had. I wasn't sure desipramine was the cause but having read you had the same problem I'm figuring out it was. Do you know WHY desipramine is supposed to give impotence ?Tomorrow I'll see my p-doc to try to find another AD and I want to be sure I won't take anything similar to desipramine under this respect. Is just related to the NE-reuptake ? And why more NE should be give impotence ? Thanks, I'm also curious, not just scared : )
Posted by PsychoSage on February 26, 2004, at 10:58:18
In reply to Aricept Users for AD/HD: Do you notice a change??, posted by utopizen on February 24, 2004, at 18:24:02
> Okay, I mentioned to my new pdoc today, "It's trendy among some psychopharmacologists these days to try augmenting Aricept for executive dysfunction associated with ADD."
>
> He responded, "I'm not trendy, I go by the book [I imagine the PDR, since he kept opening it up to make sure my doses were in line with the averages].
>
> Well, aside from the idea that "trendy" just means a doctor keeps up to date with trends in medicine, and if all docs were like him there would be no PDR, um, the studies I've read noted a 25% efficacy in patients with executive dysfunction associated with ADD.
>
> I've heard some on this board go "I take 5mg of Aricept + a stimulant at X dose." Did you notice a difference once you added the Aricept, or skipped a day of it, or something????I've mentioned Aricept in a few threads, but no one really came forward about this.
My prescriber mentioned Aricept and antiparkinsonians in place of stimulants.
Well, i am taking provigil now which is a nonamphet-stimulant, but I am interested in what aricept can do for me in the future because we all know the limits of stimulants. They can be activating but not necessarily be more helpful in accomplishing anything.
You need to find a person who has worked with children and ADD people. This is not a wild off-label prescription. For me it will be a great area to explore since methylphenidate and amphets are off my list because of past speed abuse several years ago which caused my ADD symptoms since i was totally without any symptoms as a child and teenager.
Find an ADD clinic [not a hokey one that preys on parents online]or see if a pediatric psychiatrist can treat you or refer you.
We inattention people need all the help we can get because attention and the ability to be productive are things we need every waking moment. It is worse than episodic illness in the sense that we can become frustrated at any given moment by this chronic condition. We can't hide poor results at school or work from the world.
For the person in the UK, wellbutrin, strattera, and effexor [probably reboxetine too] are non stimulant ADHD alternatives. Dopamine agonists and Alzheimer's drugs like Aricept are as well.
Reboxetine and strattera are very similar I understand. They are in the same family of strict NRI. Wellbutrin and strattera are very similar according to my prescriber in terms of what they do for ADHD patients even though wellbutrin is nt a strictly NRI. Effexor is a SNRI.
Posted by jparsell82 on February 27, 2004, at 6:33:13
In reply to Re: Aricept Users for AD/HD: Do you notice a change??, posted by PsychoSage on February 26, 2004, at 10:58:18
From what I've read over at the imminst.org's forums (section "Nootropic's"). Huperzine A is a stronger inhibitor than Aricept and Galantamine. Plus it's relatively cheap. I'd check into that.
Posted by Chairman_MAO on February 27, 2004, at 13:18:43
In reply to Re: Aricept Users for AD/HD: Do you notice a change??, posted by jparsell82 on February 27, 2004, at 6:33:13
I tried huperzine A and galantamine, and found galantamine to be far more effective. Simply because something is more potent does not mean it's more effective given equipotent doses are used. Galantamine stimulants nicotinic receptors, which aids in focus/concentration. Abbott Labs is testing a nicotinic agonist for ADHD.
Posted by jparsell82 on February 27, 2004, at 15:08:14
In reply to Re: Aricept Users for AD/HD: Do you notice a change?? » jparsell82, posted by Chairman_MAO on February 27, 2004, at 13:18:43
Yes, I know Galantamine also stimulates Nicotinic receptors. I'm just restating the word that I've received from over there. I talked with LifeMirage over there awhile back on his opinions of Galantamine and Huperzine A. He told me he noticed more of an effect from the Huperzine. I cannot say for myself, as I've never tried either.
This is the end of the thread.
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