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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 jms600 on May 2, 2004, at 15:57:23
Hello,
This may sound a funny question, but is there any type of medication out there which can help both Attention Deficit Disorder AND fairy severe anxiety (Generalised Anxiety Disorder & Social Phobia)??
If there is, I really think I need to try it!
Thanks!
Posted by BackOfClass on May 3, 2004, at 0:47:40
In reply to Anxiety and ADD medication, posted by jms600 on May 2, 2004, at 15:57:23
I think a stimulant like Adderall or Dexedrine, in addition to a Benzo, such as Klonopin, is the standard. I think that Dexedrine causes less anxiety of the stimulants. I look forward to what other people think?
Posted by Viridis on May 3, 2004, at 3:39:12
In reply to Re: Anxiety and ADD medication » jms600, posted by BackOfClass on May 3, 2004, at 0:47:40
Adderall + Klonopin works very well for me, and some others here. I'd suggest that you try this combination if you can. Also, Lamictal has been good (together with the above) in smoothing out the rough edges for me.
Posted by Keith Talent on May 3, 2004, at 6:52:44
In reply to Re: Anxiety and ADD medication » BackOfClass, posted by Viridis on May 3, 2004, at 3:39:12
Funny you should mention this - I'm about to start on clonazepam and dextroamphetamine (in addition to sertraline 200 mg per day). I'd suggest searching the archives (using the Google search of dr-bob.org) for previous posts on "dexedrine klonopin" and "adderall klonopin".
Posted by utopizen on May 3, 2004, at 14:53:09
In reply to Re: Anxiety and ADD medication, posted by Keith Talent on May 3, 2004, at 6:52:44
> Funny you should mention this - I'm about to start on clonazepam and dextroamphetamine (in addition to sertraline 200 mg per day). I'd suggest searching the archives (using the Google search of dr-bob.org) for previous posts on "dexedrine klonopin" and "adderall klonopin".
>While everyone, including myself for over a year now, has been quick to dismiss it as another trial to fail, I strongly encourage you give Straterra a shot.
I am about to likely go on it tomorrow along with Provigil, unless my pulmnologist believes I should wait a couple of weeks until finals are over.
(Thing is, stimulants seem to only help me with all nighters-- ever. I can't do work, period, during the day, it's like the writing I do in the daytime is either impossible or incomprable to the quality of ideas I get by pulling all-nighters.)
So as much "fun" feeling half-dead everytime a paper assignment has come up the past two years of college has been for me as an English major, and the risks involved in not completing it on time when I am often starting it at 1AM for a 9 or 11AM class on a 7-page research paper.... I think in retrospect, i was naive for not at least giving Straterra a shot.
Straterra has antidepressant properties, and is often combined with Provigil for ADD+depression, patients with ADD+sleepiness, or in general. The combo often works better than either one alone.
Because it works like an antidepressant, it can have a good shot at helping you reduce your need for an antidepressant on top of your ADD med for anxiety. You can always add on Klonopin to the mix, either prn or everyday.
Note that, after three months or so of continued use of Klonopin, I felt the effect wasn't the same at 1mg 3x/day, and many also report this. This went away after going off it for a few months, and then I took Klonopin as though it was the first time again.
Anyway, if you're a student, the summer's a great chance to give yourself a solid 3 months of testing Straterra out. I've heard of people combining it with stimulants, but none of the doctors I've encounted would budge on that one, which led me to not try it out.... but in retrospect, I didn't do so well on any of the stimulants either, unless "well" means doing all-nighters on them.
I want to have a normal sleep-wake cycle, feel awake all day, feel productive and organized and focused all day, and stims just don't do it enough for me, unless I temporarily confuse my circadian rythms (like last night, and wrote a brilliant paper that was 1600 words just in time to be late by 30 minute to class and hand it in).
The mere notion of writing a paper before, say, 1AM, is foreign to me. It's never happened. I've tried, believe me. I can read books, and all, but actually writing the paper, I write terribly during the day... Straterra, I've read anecdotes a lot of people claiming it makes them feel tired when they're suppose to and awake right in the morning when they're suppose to (initial adjustment aside).
By the way, my therapists have told me I may have asperger's, given I hone in on topics and stims seem to fail me a lot, and I have social anxiety and couldn't relate to kids when I was younger. I'm over the whole nonverbal cues thing that's supposedly what I didn't grasp when I was a kid, they say, because apparently benign cases like mine can improve by college.
My social anxiety is nothing compared to how I felt around peers as a little kid, but it's still enough to warrant some Klonopin to go to a party. But apparently, there's a big coorelation between ADD and it.
I bore people a lot because I focus on just certain things and learn all I can about it (like meds, for instance). I'm slowly learning, people are bored easily, and to shut up about things I'm interested in a lot more these days.
Posted by Viridis on May 4, 2004, at 2:27:36
In reply to Re: Anxiety and ADD medication, posted by utopizen on May 3, 2004, at 14:53:09
Hi Utopizen,
Adderall plus Strattera was fine for me; then Strattera got weird. But I really liked Strattera at first. Just based on my experience, I cannot emphasize gradual titration strongly enough, because it can have side effects (most of which disappeared fairly quickly for me). By "gradual", I mean going up by about 25 mg every week or two -- nothing too drastic. Dry mouth is a common side effect, plus mild nausea.
I quit it after its positive effects faded and it began to affect my speech (weird, but I started to slur my words, especially when I was tired). This stopped shortly after I discontinued it. I didn't find it the least bit activating, unlike Provigil, which was definitely an "upper" for me (but with no anxiety). Strangely, my pdoc is fine with Strattera plus amphetamines, but not Provigil plus Adderall.
Strattera can be very helpful, but take it slow with this one. Of course, that's just me. And do consider Lamictal, a real "wonder drug" for many with a broad spectrum of action. It seems to mix with almost anything except Depakote (which I haven't tried), and can be a very gentle mood stabilizer and antidepressant.
This is the end of the thread.
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