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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 11 to 35 of 44. Go back in thread:
Posted by pseudoname on September 26, 2005, at 14:33:33
In reply to Re: Adderall, tolerance, manic treatment » pseudoname, posted by barbaracat on September 26, 2005, at 12:19:23
I Googled "counterintutive amphetamine mania" and the first hit was it!
Posted by barbaracat on September 26, 2005, at 15:17:02
In reply to Adderall, tolerance, manic treatment, posted by pseudoname on September 26, 2005, at 12:00:31
Where have you been all my life, dear Adderall? Oh yeah, speed, I remember. Maybe this is why I took to it so ferociously when I was a depressed teen. It was the only time I felt happy and obviously I was self-medicating. I took to it recreationally a tad too well back then and have been terrified of it since. I'm older and wiser now and would love to keep things nice and mellow.
I took only 10mg but it's like the the lights came on in cobwebby parts of my brain. I can feel little pops of life force going off in my frontal lobes. Colors are alive. My normal low-level constant fibro pain is gone, gone, gone. Why would this be? Cause I'm havng too much fun? Is this what healthy normal people feel like? Is it really possible to do more than plod through life?
After 6 weeks of inert misery after I hurt myself from the fall, feeling like petrified sludge after increasing the Cymbalta, doing nothing but lie on the couch feeling like a failure I actually went out for a walk with a friend earlier. Sun! Air! Moving body parts! Yakked her ear off but that could be a combination of the med and the fact that I've pretty much communicated only in grunts to my husband for the past 6 weeks. A living breathing friend I actually felt like talking to was almost too much excitement. I'm skipping around and my friend kept saying 'you were pretty hurt, are you sure you're up for this?' Hell, yes! Gad, I felt like Julie Andrews coming over that mountaintop 'The hills are alive...'
I feel focused, involved, motivated and awake. If this has been the missing piece all this time, all these 30 years of one med after another, if it turns out I was really on the right track after all when I was popping bennies and white crosses in my youth, then I will be a bit miffed it took all this time, but still very grateful.
I'm still not 100% sure ADD is me. Anyone might feel this good on this med cause amphetamines are a popular street drug for good reason. But I give a rip as long as it works. It's like I've finally found the rest of me. Please God don't let this poop. With a good anti-tolerance regimen let it last. - BarbaraCat
Posted by barbaracat on September 26, 2005, at 15:26:07
In reply to Whoa! It was on Babble!! » barbaracat, posted by pseudoname on September 26, 2005, at 14:33:33
Whoa! is right! This is important stuff. I'm going to get this info to my pdoc.
I understand partially that amphetamines act somewhat differently in that they don't recycle the neurotransmitters but dump them into the synapse and cause depletion. Have you ever tried supplementing with amino acids like DL-phenylalanine or L-tyrosine to build the stores of dopamine and NE back up?
> I Googled "counterintutive amphetamine mania" and the first hit was it!
>
> http://www.dr-bob.org/babble/20000508/msgs/32818.html
Posted by Sarah T. on September 26, 2005, at 19:51:36
In reply to Adderall, tolerance, manic treatment, posted by pseudoname on September 26, 2005, at 12:00:31
Hi pseudoname,
That was a very interesting and helpful post. I benefited greatly from Dexedrine until I developed a tolerance to it. I wish that I had taken it as judiciously as you are taking Adderall. Actually, I did handle things fairly well, but it pooped out anyway. I wish I had received better guidance from my pdoc on how to stave off tolerance. I got most of my information from this site, but not until after I'd already experienced some poop out.
I believe that some of the tolerance I experienced may have been due, in part, to my unruly female hormones. Towards the end of the time that I was on Dexedrine, I had to take estrogen for a week or so for a gynecologic problem. During that brief period on estrogen, I found that I required MUCH less Dexedrine. Several years ago, I read an abstact about women requiring much lower doses of amphetamines when they were on estrogen. Nevertheless, with all the bad news about estrogen lately, I have no intention of going on it for any length of time, not even after I'm in menopause. I'm not sure how I'll manage when I reach that point.
Anyway, I admire the care and restraint with which you are using Adderall. I am bookmarking your post.
Sarah
Posted by Sarah T. on September 26, 2005, at 20:02:56
In reply to Re: Adderall and preventing tolerance? » barbaracat, posted by fairywings on September 25, 2005, at 17:20:58
> One thing i can tell you is to titrate up slowly because if you double the dose, and double, and double trying to hit the right dose, and you miss, you'll get obsessive, not want to leave the house or do anything, and get depressed. (sounds like the state of mind where you are now) that's how i got - a black hole depression, but when we backed off, we hit the right dose.
> The feeling good, wanting to feel better and better was the problem, and going beyond feeling good, you get too high a dose which is not good at all. It takes some trial and error, but sounds like you have a good p-doc.> good luck,
> fw>Hi fairlywings,
What you say is SO true. With amphetamines, there is such a fine line between too much and not enough, but I found that to be even more true for Adderall.
When I used to read other message boards, I found so many posts from people saying that stimulants make them tired and that they can go right to bed after taking stimulants. My impression of those cases is that they are either taking too much or they have developed tolerance or they are on the wrong drug. For many people, at the right dose, stimulants provide an alert yet calm focus. If you become over-focused or hyper-focused, obsessional, fatigued or just plain zombie-like, that probably means it's time to adjust the dosage or to consider trying another medicine.
Posted by Sarah T. on September 26, 2005, at 20:05:55
In reply to Re: Adderall and preventing tolerance?, posted by Sarah T. on September 26, 2005, at 20:02:56
Posted by barbaracat on September 26, 2005, at 21:19:35
In reply to Re: Adderall, tolerance, manic treatment » pseudoname, posted by Sarah T. on September 26, 2005, at 19:51:36
Hi Sarah,
Something to keep in mind when you reach 'that time' in a women's life. Those tests we all heard about were based on prempro, or conjugated horse urine estrogens and synthetic progesterones. The conjugated estrogens, i.e., horse urine, contain 7 estrogens to the 3 that we humans require. That means the liver has to do something with the other 4. Not knowing what the f*** to do, it recirculates and concentrates and eventually turns it into the most potent of estrogens, the kind that induces breast and uterine cancers. Why don't they get it? Because the pharma companies pay for the research and in this case could not find a way to get out of the evidencial truth of the matter and just blamed it on hormones carte blanche.It's really a trajedy because now most women hear about this travesty in women's hormones and don't realize there's an alternative. Bioidentical hormones based upon individual test results.
Saliva tests seem to be an accurate way to measure hormone levels and treatment should be based on these results. But does conventional medicine pay attention? Unfortunately, not. But fortunately, we do have alternatives. Check 'em out. Don't go by what your HMO OB/Gyn suggests.
Posted by fairywings on September 27, 2005, at 6:48:17
In reply to Re: Adderall and preventing tolerance?, posted by Sarah T. on September 26, 2005, at 20:02:56
hi bcat,
I did find that when I first started taking the right dose I was tired and my reflexes were slower than normal, which was a normal response. I told my p-doc, and he said the adderall was slowing me down. Now I have a calm and focus, but I agree, you don't want to get to hyperfocus or obsessesed.
fw
Posted by fairywings on September 27, 2005, at 7:01:43
In reply to Re: Adderall, tolerance, manic treatment » Sarah T., posted by barbaracat on September 26, 2005, at 21:19:35
This is true bcat and sarah, my sister is on natural bioidentical estrogen, she's a chemist and wouldn't have anything else. So I do think, as women we need to be in control. Finding a good female GYN is the first place to start, or a male who is like minded, IMO.
Also, if anyone has the tendency toward breast cancer, they might talk to the ob about, as a matter of course, having their ovaries removed after childbearing. women aren't told they're more likely to die of ovarian cancer than b.c., which i think they have the right to understand.
fw
Posted by KaraS on September 27, 2005, at 8:34:26
In reply to Adderall first use - brrrriinggg! Hello!, posted by barbaracat on September 26, 2005, at 15:17:02
> Where have you been all my life, dear Adderall? Oh yeah, speed, I remember. Maybe this is why I took to it so ferociously when I was a depressed teen. It was the only time I felt happy and obviously I was self-medicating. I took to it recreationally a tad too well back then and have been terrified of it since. I'm older and wiser now and would love to keep things nice and mellow.
>
> I took only 10mg but it's like the the lights came on in cobwebby parts of my brain. I can feel little pops of life force going off in my frontal lobes. Colors are alive. My normal low-level constant fibro pain is gone, gone, gone. Why would this be? Cause I'm havng too much fun? Is this what healthy normal people feel like? Is it really possible to do more than plod through life?
>
> After 6 weeks of inert misery after I hurt myself from the fall, feeling like petrified sludge after increasing the Cymbalta, doing nothing but lie on the couch feeling like a failure I actually went out for a walk with a friend earlier. Sun! Air! Moving body parts! Yakked her ear off but that could be a combination of the med and the fact that I've pretty much communicated only in grunts to my husband for the past 6 weeks. A living breathing friend I actually felt like talking to was almost too much excitement. I'm skipping around and my friend kept saying 'you were pretty hurt, are you sure you're up for this?' Hell, yes! Gad, I felt like Julie Andrews coming over that mountaintop 'The hills are alive...'
>
> I feel focused, involved, motivated and awake. If this has been the missing piece all this time, all these 30 years of one med after another, if it turns out I was really on the right track after all when I was popping bennies and white crosses in my youth, then I will be a bit miffed it took all this time, but still very grateful.
>
> I'm still not 100% sure ADD is me. Anyone might feel this good on this med cause amphetamines are a popular street drug for good reason. But I give a rip as long as it works. It's like I've finally found the rest of me. Please God don't let this poop. With a good anti-tolerance regimen let it last. - BarbaraCat
Hi BarbaraCat,From what I understand, the first week on a certain dosage of a stimulant can give you quite a high but that settles down to a therapeutic level that isn't as amazing. Don't want you to be too disappointed or think that it has stopped working for you when that happens.
k
Posted by pseudoname on September 27, 2005, at 9:21:30
In reply to Re: Whoa! It was on Babble!! » pseudoname, posted by barbaracat on September 26, 2005, at 15:26:07
> Have you ever tried supplementing with amino acids like DL-phenylalanine or L-tyrosine to build the stores of dopamine and NE back up?
I have not, but I'm definitely going to be looking into this. I've tried those supplements in the past to no effect, but I haven't tried them when I was also using Adderall.
Thanks for the tip!
Posted by pseudoname on September 27, 2005, at 9:45:33
In reply to Re: Adderall, tolerance, manic treatment » pseudoname, posted by Sarah T. on September 26, 2005, at 19:51:36
Sarah,
Thanks for your kind words. I think the restraint I'm showing with Adderall is partly due to the fact that the XR version has a good time lag between taking the capsule and when it kicks in. I haven't shown such restraint with, say, caffeine. Coffee hits me within minutes of drinking it with a warm, fuzzy, feeling. So I drink more. Then an hour later, I try to get that warm fuzzy feeling again with another cup. Then the next morning, even though I *KNOW* from years of experience that caffeine won't give me hardly any buzz 2 days in a row, I'll drink 4 cups trying to get it! And the next day. Yuck.
But Adderall XR takes 1-2 hours before it hits me so whatever part of the brain is responsible for dependent consumption doesn't seem to be able to make the connection between those little orange pellets and the improved feelings. I think Dexedrine and regular Adderall release more amphetamine immediately. (Is that correct?)
It sounds like you've been off Dexedrine and Adderall for a while. A drug holiday of several weeks may be enough to completely re-set your systems. Maybe you could try Adderall again -- just sure to get the XR version. ;)
Also, I don't expect Adderall to do much for me except leverage me out of the worst suicidal despair. My other significant depressive, emotional, mental problems are pretty much untouched by it.
Posted by barbaracat on September 27, 2005, at 11:59:19
In reply to Adderall and supplements » barbaracat, posted by pseudoname on September 27, 2005, at 9:21:30
Note to Dr. Bob: I eventually get back to babble meds so please don't boot me over to Alt just yet.
Before you go out and spend too much money on those supplements... I've been communicating with a guy over on the Alternative board. He recommended Macuna pruiens instead which is a south American bean, standardized to contain high amounts of pure L-dopa. We both agreed that the two amino acids were less than great for us.
I did a search for ADD+macuna and came up with loads of hits where macuna has been used successfully as an alternative to pstims for ADD. Here's a link for a source with some interesting info on the herb.
http://store.yahoo.com/herbalpowers/macunapruriens.html
BTW, sorry to hear you have those crushing despairing depressions. For what it's worth, I spent most of my life thinking I had severe unipolar depression but my depressions were very different from how I heard others describe theirs. Mine were bleak and black and filled with anguish - agitated nightmarish things. SSRIs would always poop and with every increase I'd get worse to the point where I was in constant dread.
With the help of this board, I finally recognized I might really be bipolar and asked my pdoc to try lithium. The difference has been miraculous. I'm lucky in that I respond very well to low dose lithium, in fact, refuse to take the higher 'therapeutic range' dose cause I don't need to overdo it.
I still get depressed and anxious but nowhere near those awful hellish things that were just getting worse with the years. It's clear now that what I thought were unipolar depressions were really bipolar mixed states dysphoric mania. I'd had my share of whoopie-do hypomanias and some full-blown manic episodes but it was mainly awful depression and that's why it took so long to think outside the box.
We've all been on so many meds and perhaps you've already given Lith a try, but if not it might be worth it. If it's the right drug for you it works wonders. I personally hated all the other mood stabilizers I tried, all except lithium, which is calming, soothing, and even grows new neural dendrites! Best to you, Barbara
> > Have you ever tried supplementing with amino acids like DL-phenylalanine or L-tyrosine to build the stores of dopamine and NE back up?
>
> I have not, but I'm definitely going to be looking into this. I've tried those supplements in the past to no effect, but I haven't tried them when I was also using Adderall.
>
> Thanks for the tip!
Posted by barbaracat on September 27, 2005, at 12:06:21
In reply to Re: Adderall first use - brrrriinggg! Hello! » barbaracat, posted by KaraS on September 27, 2005, at 8:34:26
Thanks for the head's up. That was almost a bit too much. Like being madly in love is wonderful and delightful but pretty wearing. When my husband got home he said my eyes were bugging out and I was still flying - on only 10mg! I'm going to back off to 5mg for a while and take things easy.>
>
> Hi BarbaraCat,
>
> From what I understand, the first week on a certain dosage of a stimulant can give you quite a high but that settles down to a therapeutic level that isn't as amazing. Don't want you to be too disappointed or think that it has stopped working for you when that happens.
>
> k
Posted by pseudoname on September 27, 2005, at 14:20:00
In reply to Re: Adderall and supplements » pseudoname, posted by barbaracat on September 27, 2005, at 11:59:19
> ...perhaps you've already given Lith a try, but if not it might be worth it.
I've tried lithium and other stabilizers like depakote quite a bit over the years to augment ADs. I've gone up to high doses and in combo with stuff like TCAs, Prozac and Ritalin.
Alas, the stabilizers never helped at all. I'm glad lith did for you, though!
Posted by fairywings on September 27, 2005, at 16:16:59
In reply to Re: Whoa! It was on Babble!! » pseudoname, posted by barbaracat on September 26, 2005, at 15:26:07
> Have you ever tried supplementing with amino acids like DL-phenylalanine or L-tyrosine to build the stores of dopamine and NE back up?
>
Tried it, didn't do a thing for me, but I suppose it's worth a try. Dr. Amen recommends it for those who can't or won't take stimulants.
fw
Posted by KaraS on September 27, 2005, at 19:09:00
In reply to Re: Adderall first use - brrrriinggg! Hello! » KaraS, posted by barbaracat on September 27, 2005, at 12:06:21
> Thanks for the head's up. That was almost a bit too much. Like being madly in love is wonderful and delightful but pretty wearing. When my husband got home he said my eyes were bugging out and I was still flying - on only 10mg! I'm going to back off to 5mg for a while and take things easy.>
Sounds great to me. I've never experienced that.K
>
> >
> > Hi BarbaraCat,
> >
> > From what I understand, the first week on a certain dosage of a stimulant can give you quite a high but that settles down to a therapeutic level that isn't as amazing. Don't want you to be too disappointed or think that it has stopped working for you when that happens.
> >
> > k
>
>
Posted by Sarah T. on September 29, 2005, at 0:10:54
In reply to Re: Adderall, tolerance, manic treatment » Sarah T., posted by barbaracat on September 26, 2005, at 21:19:35
Hi Barbaracat,
Thanks very much for that information about estrogen. I didn't know that about Prempro. Horse urine??? Eeewwwwww!
I'm glad to know that there are some alternatives out there. I'd better start educating myself about them.
S.
Posted by Sarah T. on September 29, 2005, at 0:26:51
In reply to Adderall dependency » Sarah T., posted by pseudoname on September 27, 2005, at 9:45:33
Hi pseudoname,
I'll have to take a look at one of those graphs that shows the time release of regular Adderall vs. Adderall XR. If I remember correctly, I think that 10 mg of Adderall XR is supposed to be like taking 5 mg of regular Adderall, twice a day, four hours apart. I believe that even regular Adderall has a "time release" mechanism of sorts, whereas regular Dexedrine IS released more immediately. The reason for regular Adderall's slower release is that it is made up of four salts, each of which has a different degree of solubility, so each one takes a different time to dissolve and, therefore, overall, the medicine lasts longer (or is supposed to last longer) than some other immediate-release stimulants. Immediate release Dexedrine is made of only one salt (dextroamphetamine sulfate).
I think your advice about taking the XR version of Adderall is an excellent suggestion. If I do try Adderall again, that's what I'll do. Unfortunately, I found the sustained release version of Dexedrine (the "Spansules") to be most unsatisfactory. The Dexedrine Spansules are a very old medicine and, for some reason, the manufacturer has never "upgraded" the release mechanism. Although Adderall XR's release mechanism isn't as "high tech" as Concerta's, it's still much better than the Dexedrine Spansule.
Posted by KaraS on September 29, 2005, at 5:18:09
In reply to Re: Adderall, tolerance, manic treatment » barbaracat, posted by Sarah T. on September 29, 2005, at 0:10:54
> Hi Barbaracat,
>
> Thanks very much for that information about estrogen. I didn't know that about Prempro. Horse urine??? Eeewwwwww!
>
> I'm glad to know that there are some alternatives out there. I'd better start educating myself about them.
>
> S.
That was an excellent post from BarbaraCat. I just wanted to add that I have several friends and a sister who are taking bioidentical hormones and doing very well on them. The latest treatment that is so popular, particularly for menopausal women, is to have your hormone levels tested. Then the doctor gives you a prescription that you can take to a compounding pharmacy. They make up a cream (to be used topically) with bioidentical hormones that is specifically tailored to the amounts you require.What makes me so sick about Prempro is that the knowledge has been there all along to use bioidentical hormones. The synthetic progestins and the horse urine estrogen were used because the bioidenticals were not patentable. Countless women have gotten all kinds of health problems because the drug companies couldn't make big bucks from the real thing.
Posted by barbaracat on September 29, 2005, at 11:40:56
In reply to Re: Adderall, tolerance, manic treatment » Sarah T., posted by KaraS on September 29, 2005, at 5:18:09
In addition to how dangerous conjugated horse urine estrogens are, the thing that bothers me the most is the sickeningly inhumane treatment of the horses. They just keep those horses cooped up and pregnant, take their foals away immediately and then destroy them after a few years of heavy labor (literally). It breaks my heart and it makes me furious that it doesn't seem to bother the drug manufacturer's that synthetic HRT is dangerous because our bodies have to metablolize 4 extra very potent estrogens (horses have 7, we have 3).
Synthetic progestins are no better, but for different reasons. Progesterone is broken down heavily in the liver and so you need much more when taken orally. All that extra gets metabolized into compounds that make you fat, depressed and bloated. Transdermal bioidentical creams (or sublingual drops) are really the way to go.
I don't know if I mentioned this, but you can find out your own hormone profile by saliva testing which is the method most naturopaths use. You don't need a Dr. to order them. Two labs that do good work are at www.heranswer.com/hormonetest.asp and www.salivatest.com.
Once you get a look at where you're at hormonally, it's usually a real eye-opener and things start making sense. You'll need a alternatively oriented Dr. to order the bioidentical creams from a compounding pharmacy. If you can't find one, www.womensinternational.com is a great compounding pharmacy that can give you names of health practitioners in your area who order their products. But as a last resort, there are creams available on the heranswer.com site that aren't as customized or potent as the pharmacy product, but better than nothing. You can't get a very strong over the counter estrogen but the progesterone is potent enough and most women end up just needing more progesterone anyway cause it converts to estrogens. OK, enough of Gal's Biology 101, - Barbara
> That was an excellent post from BarbaraCat. I just wanted to add that I have several friends and a sister who are taking bioidentical hormones and doing very well on them. The latest treatment that is so popular, particularly for menopausal women, is to have your hormone levels tested. Then the doctor gives you a prescription that you can take to a compounding pharmacy. They make up a cream (to be used topically) with bioidentical hormones that is specifically tailored to the amounts you require.
>
> What makes me so sick about Prempro is that the knowledge has been there all along to use bioidentical hormones. The synthetic progestins and the horse urine estrogen were used because the bioidenticals were not patentable. Countless women have gotten all kinds of health problems because the drug companies couldn't make big bucks from the real thing.
>
>
>
>
>
Posted by Phillipa on September 29, 2005, at 16:59:31
In reply to Hormones, posted by barbaracat on September 29, 2005, at 11:40:56
And I thought no one ever listened to you? Fondly,Phillipa
Posted by barbaracat on September 29, 2005, at 18:14:53
In reply to Re: Hormones » barbaracat, posted by Phillipa on September 29, 2005, at 16:59:31
Here's a link to a thread on alternative. I found a good resource for finding an alternative health practitioner in your area that uses bioidentical hormones and saliva testing:
http://www.dr-bob.org/babble/alter/20050924/msgs/560991.html
Posted by Sarah T. on September 29, 2005, at 19:29:15
In reply to Re: Adderall, tolerance, manic treatment » pseudoname, posted by Sarah T. on September 26, 2005, at 19:51:36
> > I believe that some of the tolerance I experienced may have been due, in part, to my unruly female hormones. Towards the end of the time that I was on Dexedrine, I had to take estrogen for a week or so for a gynecologic problem. During that brief period on estrogen, I found that I required MUCH less Dexedrine. Several years ago, I read an abstact about women requiring much lower doses of amphetamines when they were on estrogen. Nevertheless, with all the bad news about estrogen lately, I have no intention of going on it for any length of time, not even after I'm in menopause. I'm not sure how I'll manage when I reach that point.> > >> Sarah
**********************************************I just want to clarify something I wrote in the above post. Although I can't locate the abstract right now, I do remember that the women referred to in the above-mentioned study had already reached menopause. They were NOT pre- or peri-menopausal. They were on amphetamines and required lower doses of those amphetamines when estrogen was added. I'll try to locate that abstract.
Posted by Sarah T. on September 29, 2005, at 19:50:36
In reply to Re: Adderall, tolerance, manic treatment » Sarah T., posted by KaraS on September 29, 2005, at 5:18:09
Hi Kara,
How are you doing? I owe you a reply from a week or so ago regarding tolerance. I'm still mulling over that issue. Anyway. . .
Thank you for the information on hormone testing and the transdermal bio-identical hormones. I know I will have to do something. Although I have not yet reached menopause, I am already going through hormone hell. It really is like having PMS every day of the month, every month, for the entire year. Which hormones are tested? Estrogen, progesterone, and what else?
I have some questions about those salivary hormone tests. I have taken several salivary cortisol tests, each kit made by a different company. The instructions were different, depending on which company made up the test. Some said you could not eat or drink before the test, but you could drink water and rinse your mouth. Others said you couldn't even have water for two hours before the test. One involved spitting into a test tube. Another involved chewing on a cotton cylinder for a few minutes, and then placing the wet cotton in a test tube. I'm surprised that there is so much variation in procedure for the same test.
The problems you and Barbaracat mention regarding Prempro are sickening, inexcusable, unethical and probably illegal. I am disgusted with pharmaceutical companies. They lie, they manipulate and massage the data from clinical studies in order to make the results appear to be something other than what they really are. They exclude patients from studies who are unlikely to have the response they are looking for. I wish we could have faith in these people, but, at this point, I'm starting to think it's impossible to trust pharmaceutical companies -- or anyone -- when that much money is at stake.
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