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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by bissie66 on October 24, 2005, at 9:59:24
Hi. I've been taking Adderal for 5 days now. The last couple of days I have been feeling quite sad/very tired & lethargic/a little anxious - def having to do with Adderall, i.e. it's a mixture of feelings that is new since Adderall. I also find myself staring into space sometimes. From the first dose I found that I was just as forgetful and unable to focus as before. (I have never tested for ADD but was thinking maybe Adderall would help aforementioned symptoms.) I have mostly been taking 10 mg (15 mg a couple times) in the early A.M., 10 mg 5 hours later, and 5 mg late afternoon. The first few days I was def happier, more energetic. Not wildly so, but pleasantly. Does this new reaction sound more like too much or not enough Adderall? Thanks, Bissie
Posted by Bill LL on October 24, 2005, at 11:17:49
In reply to Adderall, posted by bissie66 on October 24, 2005, at 9:59:24
Off hand I would probably guess that you might do better with a dose increase since you felt good initially. But I don't know for sure.
What are your symptoms? What meds have you taken before and what meds and doses are you taking now?
> Hi. I've been taking Adderal for 5 days now. The last couple of days I have been feeling quite sad/very tired & lethargic/a little anxious - def having to do with Adderall, i.e. it's a mixture of feelings that is new since Adderall. I also find myself staring into space sometimes. From the first dose I found that I was just as forgetful and unable to focus as before. (I have never tested for ADD but was thinking maybe Adderall would help aforementioned symptoms.) I have mostly been taking 10 mg (15 mg a couple times) in the early A.M., 10 mg 5 hours later, and 5 mg late afternoon. The first few days I was def happier, more energetic. Not wildly so, but pleasantly. Does this new reaction sound more like too much or not enough Adderall? Thanks, Bissie
Posted by bissie66 on October 24, 2005, at 12:13:33
In reply to Re: Adderall, posted by Bill LL on October 24, 2005, at 11:17:49
Thanks for helping. My symptoms: fatigued and tired, upset stomach at times, a lot of brain fog, forgetting, staring at nothing, today abdomen & lower back (dull) cramps, depression (tearful, a little anxious, very low self-esteem, hopeless, thoughts like "i shouldn't have had kids bc they deserve a better mother"), dread of responsibilities coming up, lethargy, lack of motivation.
i've been on a lot of diff meds, like many of us. right now i'm on effexor 450 mg, lithium 900 mg, lamictal 300 mg, levoxyl .5 & cytomel .25 for hypothyroidism. also klonopin 5 mg tabs as needed. i usually take this 3 times a day but i break them in half bc it works well and doesn't make me too sleepy. if i'm doing really well on a med, i don't take the klonopin. that's how i know the med is working - i don't want the klonopin. with adderall, i am not taking much of it bc it's seems it might be counteractive. i also drink A LOT of coffee and have a pretty good tolerance to it.
in the past i've taken: zoloft (1st AD and i felt so good for so long - it was like i was a diff person, but it pooped out after a number of years), prozac, a tricyclic, wellbutrin, celexa, lexapro, neurontin (with AD), remeron alone, and remeron with effexor plus the current mood stabilizers. this last one was *incredible* for about a month, then pooped out. plus i gained the infamous weight. but that was one of the most glorious (& hypomanic) months of my life. i think about it all the time, wishing it could come back. twice when i was put on AD's alone, i had absolutely horrible terrifying mixed states. this developed about 5 years ago so now i have to take the mood stabilizer(s). there are probably other meds that i can't remember.
i'd be grateful for any comments/suggestions.
> Off hand I would probably guess that you might do better with a dose increase since you felt good initially. But I don't know for sure.
>
> What are your symptoms? What meds have you taken before and what meds and doses are you taking now?
>
> > Hi. I've been taking Adderal for 5 days now. The last couple of days I have been feeling quite sad/very tired & lethargic/a little anxious - def having to do with Adderall, i.e. it's a mixture of feelings that is new since Adderall. I also find myself staring into space sometimes. From the first dose I found that I was just as forgetful and unable to focus as before. (I have never tested for ADD but was thinking maybe Adderall would help aforementioned symptoms.) I have mostly been taking 10 mg (15 mg a couple times) in the early A.M., 10 mg 5 hours later, and 5 mg late afternoon. The first few days I was def happier, more energetic. Not wildly so, but pleasantly. Does this new reaction sound more like too much or not enough Adderall? Thanks, Bissie
>
>
Posted by Bill LL on October 25, 2005, at 13:13:27
In reply to Re: Adderall, posted by bissie66 on October 24, 2005, at 12:13:33
You are certainly correct when you say that a lot of us have been on a lot of different meds. My current meds are Lexapro 15mg, Lamictal 200mg, Provigil 400mg, and Lunesta 2mg. (Also a beta blocker, for blood pressure which helps with physical symtoms of anxiety).
I am doing the best ever with these. But I still might experiment with 1 or 2 more changes to see if I can get even more improvement.
Although you feel that Klonopin will coounteract the Adderal, do you think that you will feel better if you take some Klonopin with it? If so, it's worth trying. I don't think that adding the 2 would necessarily be a problem.
Also, you might want to try changing the dose of Adderal, but I don't really know. I guess that would be a good question for your doctor.
After that, maybe try Ritalin or Provigil.
You should of course discuss your situation with your doctor. But if you don't have full confidence in him or her, or you just want another opinion, consider seeing another doctor. A teaching hospital outpatient psychiatry clinic is a good place to try.
> Thanks for helping. My symptoms: fatigued and tired, upset stomach at times, a lot of brain fog, forgetting, staring at nothing, today abdomen & lower back (dull) cramps, depression (tearful, a little anxious, very low self-esteem, hopeless, thoughts like "i shouldn't have had kids bc they deserve a better mother"), dread of responsibilities coming up, lethargy, lack of motivation.
>
> i've been on a lot of diff meds, like many of us. right now i'm on effexor 450 mg, lithium 900 mg, lamictal 300 mg, levoxyl .5 & cytomel .25 for hypothyroidism. also klonopin 5 mg tabs as needed. i usually take this 3 times a day but i break them in half bc it works well and doesn't make me too sleepy. if i'm doing really well on a med, i don't take the klonopin. that's how i know the med is working - i don't want the klonopin. with adderall, i am not taking much of it bc it's seems it might be counteractive. i also drink A LOT of coffee and have a pretty good tolerance to it.
>
> in the past i've taken: zoloft (1st AD and i felt so good for so long - it was like i was a diff person, but it pooped out after a number of years), prozac, a tricyclic, wellbutrin, celexa, lexapro, neurontin (with AD), remeron alone, and remeron with effexor plus the current mood stabilizers. this last one was *incredible* for about a month, then pooped out. plus i gained the infamous weight. but that was one of the most glorious (& hypomanic) months of my life. i think about it all the time, wishing it could come back. twice when i was put on AD's alone, i had absolutely horrible terrifying mixed states. this developed about 5 years ago so now i have to take the mood stabilizer(s). there are probably other meds that i can't remember.
>
> i'd be grateful for any comments/suggestions.
>
> > Off hand I would probably guess that you might do better with a dose increase since you felt good initially. But I don't know for sure.
> >
> > What are your symptoms? What meds have you taken before and what meds and doses are you taking now?
> >
> > > Hi. I've been taking Adderal for 5 days now. The last couple of days I have been feeling quite sad/very tired & lethargic/a little anxious - def having to do with Adderall, i.e. it's a mixture of feelings that is new since Adderall. I also find myself staring into space sometimes. From the first dose I found that I was just as forgetful and unable to focus as before. (I have never tested for ADD but was thinking maybe Adderall would help aforementioned symptoms.) I have mostly been taking 10 mg (15 mg a couple times) in the early A.M., 10 mg 5 hours later, and 5 mg late afternoon. The first few days I was def happier, more energetic. Not wildly so, but pleasantly. Does this new reaction sound more like too much or not enough Adderall? Thanks, Bissie
> >
> >
>
>
Posted by bissie66 on October 25, 2005, at 13:30:40
In reply to Re: Adderall, posted by Bill LL on October 25, 2005, at 13:13:27
Thank you very much!
> You are certainly correct when you say that a lot of us have been on a lot of different meds. My current meds are Lexapro 15mg, Lamictal 200mg, Provigil 400mg, and Lunesta 2mg. (Also a beta blocker, for blood pressure which helps with physical symtoms of anxiety).
>
> I am doing the best ever with these. But I still might experiment with 1 or 2 more changes to see if I can get even more improvement.
>
> Although you feel that Klonopin will coounteract the Adderal, do you think that you will feel better if you take some Klonopin with it? If so, it's worth trying. I don't think that adding the 2 would necessarily be a problem.
>
> Also, you might want to try changing the dose of Adderal, but I don't really know. I guess that would be a good question for your doctor.
>
> After that, maybe try Ritalin or Provigil.
>
> You should of course discuss your situation with your doctor. But if you don't have full confidence in him or her, or you just want another opinion, consider seeing another doctor. A teaching hospital outpatient psychiatry clinic is a good place to try.
>
>
>
>
>
> > Thanks for helping. My symptoms: fatigued and tired, upset stomach at times, a lot of brain fog, forgetting, staring at nothing, today abdomen & lower back (dull) cramps, depression (tearful, a little anxious, very low self-esteem, hopeless, thoughts like "i shouldn't have had kids bc they deserve a better mother"), dread of responsibilities coming up, lethargy, lack of motivation.
> >
> > i've been on a lot of diff meds, like many of us. right now i'm on effexor 450 mg, lithium 900 mg, lamictal 300 mg, levoxyl .5 & cytomel .25 for hypothyroidism. also klonopin 5 mg tabs as needed. i usually take this 3 times a day but i break them in half bc it works well and doesn't make me too sleepy. if i'm doing really well on a med, i don't take the klonopin. that's how i know the med is working - i don't want the klonopin. with adderall, i am not taking much of it bc it's seems it might be counteractive. i also drink A LOT of coffee and have a pretty good tolerance to it.
> >
> > in the past i've taken: zoloft (1st AD and i felt so good for so long - it was like i was a diff person, but it pooped out after a number of years), prozac, a tricyclic, wellbutrin, celexa, lexapro, neurontin (with AD), remeron alone, and remeron with effexor plus the current mood stabilizers. this last one was *incredible* for about a month, then pooped out. plus i gained the infamous weight. but that was one of the most glorious (& hypomanic) months of my life. i think about it all the time, wishing it could come back. twice when i was put on AD's alone, i had absolutely horrible terrifying mixed states. this developed about 5 years ago so now i have to take the mood stabilizer(s). there are probably other meds that i can't remember.
> >
> > i'd be grateful for any comments/suggestions.
> >
> > > Off hand I would probably guess that you might do better with a dose increase since you felt good initially. But I don't know for sure.
> > >
> > > What are your symptoms? What meds have you taken before and what meds and doses are you taking now?
> > >
> > > > Hi. I've been taking Adderal for 5 days now. The last couple of days I have been feeling quite sad/very tired & lethargic/a little anxious - def having to do with Adderall, i.e. it's a mixture of feelings that is new since Adderall. I also find myself staring into space sometimes. From the first dose I found that I was just as forgetful and unable to focus as before. (I have never tested for ADD but was thinking maybe Adderall would help aforementioned symptoms.) I have mostly been taking 10 mg (15 mg a couple times) in the early A.M., 10 mg 5 hours later, and 5 mg late afternoon. The first few days I was def happier, more energetic. Not wildly so, but pleasantly. Does this new reaction sound more like too much or not enough Adderall? Thanks, Bissie
> > >
> > >
> >
> >
>
>
Posted by psychopharmaddict on October 26, 2005, at 11:09:02
In reply to Re: Adderall, posted by Bill LL on October 25, 2005, at 13:13:27
Hello, Some good imput here. I would just like to add some info, im not sure if it would help, Im taking a pretty potent combonation myself, but I have tried zoloft, remeron, up to effexor, xanax, and on a percentage scale, ( Oh I suffer from refractory depression, ADD, Def. Dopaminergic type malfunction in the reward center called reward system dyficentcy, which in turn caused me to abuse alcohol, opiates.
NOw not to get into my problem, I take 30mg of adderall 3x daily , .5mg klonopin 2x day, sometimes less or more, and 4mg of suboxone, which is a opiate detoxification , maintenance medication, basically I feel it gives my brain just enough opiates to help me not crave or use.
But the interaction with adderall is maybe a bit too good. Im not high but at well being. You may have to titrate or work with your doctor adding or subtracting meds. It took me 6 yrs and finally, even though all 3 meds are abusable , and scheduled, I DONT abuse them, and take them as perscribed, yet i cannot stop them.
I feel that way from adderall , esp If i dont take a suboxone in 24 hrs, because little to some doctors know, suboxone is a very good antidepressant (For me and others i spoke to, and it is listed in the psychopharm book for refractory depression, but doctors only perscribe it in the usa for opiate addiction. I feel it helps in alot of areas, its not abusable, because after 2-3 days, like adderall, the initial effects go by by, and if you then try to chase the high, then get off them.
I , did so much of my own research, and then found a doctor who heard me out, and actually was impressed and tried this combonation and I can say it has helped me 98 percent. The closest i ever came to feeling ok was on 100mg of zoloft and 30mg of remeron with .5mg xanax. Maybe 20 percent. Still drank and did unhealthy things.
I feel sorta for you, because i think adderall is a wonder drug, for me at least, and when i see or hear someone having negative effects , i cannot understand it, because my brain i think is so stubborn, well. Good advice from the other post , dont take too much klonopin nor too little, because as you may know, too much will block adderall, esp low doses, (.5mg works perfect for me at 30mg of adderall and im a bigger guy.) Some people I knew took 1-2mg, and there blocking it. But if adderall is causing some peripheral effects due to the One Isomer which kicks in norepinephrine , you will feel more anixety. I believe Dexro is moresoe dopaminergic and adderall has 25 percent l-isomer, mainly NE> I may be off but. Timing and dosage do matter.
good luck
Posted by med_empowered on October 27, 2005, at 8:06:02
In reply to Re: Adderall, posted by psychopharmaddict on October 26, 2005, at 11:09:02
hi! If you're taking stimulants for depression there are, unfortunately, no hard-and-fast rules. Stimulants were popular for depression and "fatigue" from the 30s-60s; after that, they were still RX'd, just usually with antidepressants (and usualy pretty quietly so both docs and patients could avoid the "valley of the dolls" stigma of rx'ing "uppers"). Basically, I'd say first you should set a goal for what exactly it is you're looking for out of adderall. I've taken it, and I can tell you it isn't great to make you feel happy, but it is good to make you more productive, more focused, more awake..which will help you do stuff to make you feel happier. See what I'm saying? So, just try to dose it so you're stimulated but not euphoric or hyped-up, and spread out the doses to avoid the infamous "amphetamine crash" (it SUCKS!). The FDA guidelines for ADHD and narcolepsy call for 40mgs/day max ADHD and 60mgs/day max narcolepsy. In my experience, only conservative, unoriginal docs actually pay attention to those, but it does kind of give you and indication of the general dosing guidelines. Klonopin+adderall is a pretty common combo; again, I don't think shrinks like to talk about it (the stigma of giving "uppers" and "downers" together, I suppose), but I've taken it, so have lots of my friends...pretty common. They can work well together, as long as you keep the doses of both low enough. Good luck!
Posted by lemon68 on October 29, 2005, at 21:30:24
In reply to Adderall, posted by bissie66 on October 24, 2005, at 9:59:24
Hi, I was curious if any of you had tried the XR version. I've been on it a few weeks ( 10 mg in the a.m.) and it has really helped a lot. I have not taken any add med in at least 8 years ( and i was diagnosed with it) as I have been concentrating more on depression/anxiety with a few different docs since then. My response to Adderall XR has been pretty dramatic, though, and I realize I probably need to take something for ADD - from here on out.
My doc also prescribed the generic, non-time-released form on a follow-up visit after I mentioned the high cost of XR ( no insurance, natch) but I haven't filled it yet.
Bissie, have you considered the XR to get a smoother response? I have also heard of people taking the XR version then, when it wears off the same day - too early, usually - taking the generic version to get thru the day.
I am still so new to this me, so I haven't really fugured out the dosage schedule yet... but the current regimen seems to be working okay...
thanx
Posted by bissie66 on October 30, 2005, at 9:22:52
In reply to Re: Adderall, posted by psychopharmaddict on October 26, 2005, at 11:09:02
thank you so much. this was really helpful. after reading your response and the one after it i felt so much less like a drug addict! (i too have abused alcohol and drugs a lot in the past and sometimes worry about becoming a pill head, which actually i wouldn't even mind if it worked and didn't have bad side effects.) i called my pdoc after reading yr posts and he said to def try increasing dose if i was feeling worse. he said if took too much i'd feel really jittery and speedy (my word), NOT like i was feeling which was tired, anxious, and depressed. so i increased to 20 mg, 20mg, 10mg. i did feel better until yesterday (started the new dosage on wed). i always am much more depressed on weekends but i was still surprised to find myself wanting to sleep all day and having NO energy, not showering, not going out, not getting dressed, all the usual stuff. this morning i took 30 mg bc i SO want and need energy (kids to care for, husband doing all the work and getting a little resentful). but after 30 mg i went right back to bed, feeling SO tired. slept for several hours and might go back again. i hate this! i can't go on like this.
btw, i am prescribed one day a week with no adderall (drug holiday). i took it tues last week and did feel better when i went back on the drug. i am wondering if after about 5 days something shifts. i start getting extremely tired, the can't stay awake kind.
also btw, what is refractory depression?
thanks so much for yr help, bisssie
> Hello, Some good imput here. I would just like to add some info, im not sure if it would help, Im taking a pretty potent combonation myself, but I have tried zoloft, remeron, up to effexor, xanax, and on a percentage scale, ( Oh I suffer from refractory depression, ADD, Def. Dopaminergic type malfunction in the reward center called reward system dyficentcy, which in turn caused me to abuse alcohol, opiates.
>
> NOw not to get into my problem, I take 30mg of adderall 3x daily , .5mg klonopin 2x day, sometimes less or more, and 4mg of suboxone, which is a opiate detoxification , maintenance medication, basically I feel it gives my brain just enough opiates to help me not crave or use.
>
> But the interaction with adderall is maybe a bit too good. Im not high but at well being. You may have to titrate or work with your doctor adding or subtracting meds. It took me 6 yrs and finally, even though all 3 meds are abusable , and scheduled, I DONT abuse them, and take them as perscribed, yet i cannot stop them.
>
> I feel that way from adderall , esp If i dont take a suboxone in 24 hrs, because little to some doctors know, suboxone is a very good antidepressant (For me and others i spoke to, and it is listed in the psychopharm book for refractory depression, but doctors only perscribe it in the usa for opiate addiction. I feel it helps in alot of areas, its not abusable, because after 2-3 days, like adderall, the initial effects go by by, and if you then try to chase the high, then get off them.
>
> I , did so much of my own research, and then found a doctor who heard me out, and actually was impressed and tried this combonation and I can say it has helped me 98 percent. The closest i ever came to feeling ok was on 100mg of zoloft and 30mg of remeron with .5mg xanax. Maybe 20 percent. Still drank and did unhealthy things.
>
> I feel sorta for you, because i think adderall is a wonder drug, for me at least, and when i see or hear someone having negative effects , i cannot understand it, because my brain i think is so stubborn, well. Good advice from the other post , dont take too much klonopin nor too little, because as you may know, too much will block adderall, esp low doses, (.5mg works perfect for me at 30mg of adderall and im a bigger guy.) Some people I knew took 1-2mg, and there blocking it. But if adderall is causing some peripheral effects due to the One Isomer which kicks in norepinephrine , you will feel more anixety. I believe Dexro is moresoe dopaminergic and adderall has 25 percent l-isomer, mainly NE> I may be off but. Timing and dosage do matter.
>
> good luck
Posted by bissie66 on October 30, 2005, at 9:37:21
In reply to Re: Adderall, posted by med_empowered on October 27, 2005, at 8:06:02
Hi, and thank you too for your information and knowledge. i am so impressed with how smart and compassionate people are on this board, as well as non-judgmental.
as far as what i want to get out of adderall, you hit the nail on the head when you said "more productive, more focused, more awake..which will help you do stuff to make you feel happier'. that is exactly what i want . . . and i know i could be much happier that way. i remember what it was like when i was productive and energetic and capable to care for my children, clean my house, go grocery shopping. these activities fill me with dread and terrible fear now except for the few short days when a new combo seems like it will work, or for the bliss of hypomania (med-induced and too short-lived). anyway, i have not gotten those things from adderall. more energy, initially. more able to have fun. less afraid of responsibility. definitely not more focused tho. still scatter-brained and all over the place at work. i am known there for losing my keys and other things, forgetting to do things, being late with everything, and being completely unorganized. it has caused me a lot of problems with my boss actually.
oh, and thanks for what you (and the post before yrs) said about the klonopin. made me feel like it was ok and even made sense to take a small dose of that with the adderall. it helps.
any thoughts you or anyone else have about the way adderall is or isn't working for me would be great. you know, when i think about what i most want from a med, it is energy and motivation. even before happiness. it is those things, i think, that would make me feel "a part of the world". being a parent, i can't hide under the covers like i want to, and it all just breaks my heart.
thanks so much. you all rock. bissie
> hi! If you're taking stimulants for depression there are, unfortunately, no hard-and-fast rules. Stimulants were popular for depression and "fatigue" from the 30s-60s; after that, they were still RX'd, just usually with antidepressants (and usualy pretty quietly so both docs and patients could avoid the "valley of the dolls" stigma of rx'ing "uppers"). Basically, I'd say first you should set a goal for what exactly it is you're looking for out of adderall. I've taken it, and I can tell you it isn't great to make you feel happy, but it is good to make you more productive, more focused, more awake..which will help you do stuff to make you feel happier. See what I'm saying? So, just try to dose it so you're stimulated but not euphoric or hyped-up, and spread out the doses to avoid the infamous "amphetamine crash" (it SUCKS!). The FDA guidelines for ADHD and narcolepsy call for 40mgs/day max ADHD and 60mgs/day max narcolepsy. In my experience, only conservative, unoriginal docs actually pay attention to those, but it does kind of give you and indication of the general dosing guidelines. Klonopin+adderall is a pretty common combo; again, I don't think shrinks like to talk about it (the stigma of giving "uppers" and "downers" together, I suppose), but I've taken it, so have lots of my friends...pretty common. They can work well together, as long as you keep the doses of both low enough. Good luck!
Posted by bissie66 on October 30, 2005, at 9:49:01
In reply to Re: Adderall, posted by lemon68 on October 29, 2005, at 21:30:24
hi there. i haven't tried the XR version although i've only been on adderall a couple weeks. my pdoc talked about XR and said we might try it later but he had some specific reason (which i can't remember) for starting with the regular (generic) kind. i wish i could say i've had a dramaic response like you did, but i haven't. one thing i've been struggling with is the dose cuz my doc said keep increasing until you feel good. i don't feel good for any sustained time (i.e. more than 5 days, then i raise my dose) but i'm already taking 50 - 60 mg a day and i've never heard of anyone taking more than that (on this board - tho i haven't read archives or anything). i do, however, have a high tolerance to drugs, even though i'm a small woman. i always end up taking the highest recommended dose of antidepressants, for example.
good luck to you . . the generic version *is* quite cheap, and unless you can afford the XR, i think that might be enough reason to at least try generic.
and yes, i would try the time released if my doc recommended it. i would try *anything* that might help. thank god i have a doc who is not afraid to try 'controversial' drugs (i.e. stims and benzos) and that's with him knowing i'm a recovering alc and also have a propensity to abuse drugs.
best to you, bissie
> Hi, I was curious if any of you had tried the XR version. I've been on it a few weeks ( 10 mg in the a.m.) and it has really helped a lot. I have not taken any add med in at least 8 years ( and i was diagnosed with it) as I have been concentrating more on depression/anxiety with a few different docs since then. My response to Adderall XR has been pretty dramatic, though, and I realize I probably need to take something for ADD - from here on out.
>
> My doc also prescribed the generic, non-time-released form on a follow-up visit after I mentioned the high cost of XR ( no insurance, natch) but I haven't filled it yet.
>
> Bissie, have you considered the XR to get a smoother response? I have also heard of people taking the XR version then, when it wears off the same day - too early, usually - taking the generic version to get thru the day.
>
> I am still so new to this me, so I haven't really fugured out the dosage schedule yet... but the current regimen seems to be working okay...
>
> thanx
This is the end of the thread.
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