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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 33. This is the beginning of the thread.
Posted by nickguy on July 6, 2006, at 19:16:13
Has anybody heard of this, or have experience with it? My pysch mentioned it and I was a little surprised because I know stimulants carry a lot of stigma. I think he would want to try this before an MAOI, but I'm not sure.
Posted by willyee on July 6, 2006, at 19:36:04
In reply to stimulants for depression?, posted by nickguy on July 6, 2006, at 19:16:13
> Has anybody heard of this, or have experience with it? My pysch mentioned it and I was a little surprised because I know stimulants carry a lot of stigma. I think he would want to try this before an MAOI, but I'm not sure.
Unless there is a strong Adhd presence,stimulants seem to work best as a augment to a exsisting drug,even if the exsisting drug is a Maoi.Personaly i dont see to much success with stims soley alone,and if i do it seems short lived,but i have seen people praise them who added them i.e provigil to a ssri or the like.
Ive been in search of a non-amphet stimulant myself,so far been settling for pure caffiene tabs,better than a lot of the stimulant over the counter garbage,and its at ur local 7 11 for a mere doller or two.
Posted by Phillipa on July 6, 2006, at 21:20:01
In reply to stimulants for depression?, posted by nickguy on July 6, 2006, at 19:16:13
Let me try and fill in. You're depressed and your doc wants to try stimulants before trying an MAOI. Is that what you mean? Love Phillipa
Posted by nickguy on July 6, 2006, at 21:21:14
In reply to Re: stimulants for depression? » nickguy, posted by Phillipa on July 6, 2006, at 21:20:01
> Let me try and fill in. You're depressed and your doc wants to try stimulants before trying an MAOI. Is that what you mean? Love Phillipa
Yes. He mentioned it as an option before an MAOI.
Posted by med_empowered on July 6, 2006, at 21:30:39
In reply to Re: stimulants for depression?, posted by nickguy on July 6, 2006, at 21:21:14
before the antidepressants gained popularity, stimulants were pretty much the treatment of choice for many types of depression. Until the 70s, the RX market was flooded with all kinds of stimulant combos--from your basic amphetamine, ritalin, and methamphetamine, to your sedative+stimulant or stimulant+stimulant combos...one pill I read about even had vitamins mixed with an amphetamine for weight loss ( I guess the tablet was supposed to be breakfast?)
Anyway, the results were sometimes good, sometimes not so good--addiction was a problem, but it doesn't seem to have caused too much concern until the 60s, when "speed freaks" started getting media attention and commiting acts of violence high on methedrine.
So...I'd say go for it, unless it really bothers you a whole lot. With amphetamines (adderall, dexedrine, desoxyn) and ritalin there will probably be some degree of dependence, but that's not the same as addiction--basically, if you're dependent, you need to keep taking the medication to continue benefits, and discontinuing the medication will cause some form of withdrawal.
From what I understand, these days docs usually use the stimulant with another drug or a couple other drugs for maximum benefit--for example, you might be RX'd and anti-depressant plus a stimulant, or a mood stabilizer plus a stimulant, so on and so forth. But...stimulants alone can help depression; in people who are old and/or sick and therefore unable to tolerate the side effects of ADs (and probably suffering fatigue, too), stimulants are used without any other meds to help with their depression.
So...there you go. Personally, I'd say that if you're struggling and you think this might help, go for it--the great thing about stimulants for depression is that they work fast, so after a couple "test doses," you should be able to see if you'll get any benefit. If so, you and your doc can work on the dosage--if not, you can move on to something else.
Good luck!
Posted by JerryPharmStudent on July 7, 2006, at 3:18:14
In reply to stimulants for depression?, posted by nickguy on July 6, 2006, at 19:16:13
> Has anybody heard of this, or have experience with it? My pysch mentioned it and I was a little surprised because I know stimulants carry a lot of stigma. I think he would want to try this before an MAOI, but I'm not sure.
Stimulants are a widely used tool for depression. Ritalin, Concerta, Adderall, Dexedrine - they all work VERY well when paired with SSRIs.
I've been on stimulants for depression for years. Doctors would rather prescribe stimulants than benzos sometimes!
There's more stigma attached to mental illness than there is to using stimulants for depression. Without Adderall - I'd not be able to get out of bed.
Jerry
Posted by willyee on July 7, 2006, at 6:39:42
In reply to Re: stimulants for depression? » nickguy, posted by JerryPharmStudent on July 7, 2006, at 3:18:14
> > Has anybody heard of this, or have experience with it? My pysch mentioned it and I was a little surprised because I know stimulants carry a lot of stigma. I think he would want to try this before an MAOI, but I'm not sure.
>
> Stimulants are a widely used tool for depression. Ritalin, Concerta, Adderall, Dexedrine - they all work VERY well when paired with SSRIs.
>
> I've been on stimulants for depression for years. Doctors would rather prescribe stimulants than benzos sometimes!
>
> There's more stigma attached to mental illness than there is to using stimulants for depression. Without Adderall - I'd not be able to get out of bed.
>
> Jerry
>
>
Dont know how much success stimulants have to show when combined with ssris and the like in treatment resistent depression before docters,not just the unconventional ones consider using them as a serious protocol.If a doc knows what they are doing stimulants can help termondously as i think we seen here alone.
Posted by dmlvt on July 7, 2006, at 8:15:50
In reply to stimulants for depression?, posted by nickguy on July 6, 2006, at 19:16:13
My pdoc initially diagnosed me with ADHD and dysthymia, and tried Ritalin alone. At first, it seemed to work just great and I was simply playing with the dosage. Even on the sustained release versions, I felt OK during the day butthe dysphoria as the med wore off was unbearable. I was always irritable in the evenings, and some days it was anger trending towards pure rage. Finally, the doc decided that I needed a depression med with Ritalin rather than just the stimulant. But, for while I was "up", there was a definite AD effect.
I was getting by OK at work on the Ritalin alone, but my family life was suffering as my family watched me come down every evening. They were all very relieved when my meds were changed.
Now, if the doctor would just call me back, maybe we could get me feeling better again, but that's a different topic.
dmlvt
Posted by pseudoname on July 7, 2006, at 9:35:37
In reply to Re: stimulants for depression? » nickguy, posted by JerryPharmStudent on July 7, 2006, at 3:18:14
> There's more stigma attached to mental illness than there is to using stimulants for depression.
Jerry, that's a great way to look at it. Although in my case, I'd have to substitute another drug for the word "stimulant", this a super frame of reference. Thanks.
> Doctors would rather prescribe stimulants than benzos sometimes!
Yeah. With the market saturation of kids taking Adderall and Ritalin for (alleged) ADHD, stimulants are pretty banal anymore.
Posted by Paulbwell on July 7, 2006, at 20:58:10
In reply to stimulants for depression?, posted by nickguy on July 6, 2006, at 19:16:13
> Has anybody heard of this, or have experience with it? My pysch mentioned it and I was a little surprised because I know stimulants carry a lot of stigma. I think he would want to try this before an MAOI, but I'm not sure.
IF YOU TRUELY WISH TO USE A PSYCHOSTIMant fOR A LOW MOOD, then plum for Desoxyn-high 5ht (Serotonin) realease+Dopamine @ Norprerine realese.-The king.
Cheers
Posted by crazy777girl on July 8, 2006, at 2:57:29
In reply to stimulants for depression?, posted by nickguy on July 6, 2006, at 19:16:13
Yes. methylphenidate has been part of my mix for quite a while. It keeps me out of bed. I take it in the morning. Once in a while I've forgotten it, and made it thru the day, later discovered it was still in the pill slot for that morning, it was then obvious that was why I was dragging myself thru the day like a slug in slow motion. So yes - it makes a positive difference. I still am not super-charged, btw. My pdoc wants me to take 3 a day - I take 1. We've agreed that on the dose he's recommended, I'd be even crazier than I normally am.
A.
> Has anybody heard of this, or have experience with it? My pysch mentioned it and I was a little surprised because I know stimulants carry a lot of stigma. I think he would want to try this before an MAOI, but I'm not sure.
Posted by ed_uk on July 8, 2006, at 16:07:43
In reply to great statement » JerryPharmStudent, posted by pseudoname on July 7, 2006, at 9:35:37
Hi!
Is it true that 4% of children in the US take a stimulant? In the UK it's about 0.3% I think.
Ed
Posted by med_empowered on July 8, 2006, at 16:36:32
In reply to Re: great statement » pseudoname, posted by ed_uk on July 8, 2006, at 16:07:43
The 4% number strikes me as a little low, actually. Part of the issue is that there's lots of variation in ADHD diagnosis, which kind of makes be doubt the ability of docs to distinguish between childish antics and actual problems.
For example: there's geographic variation in prescribing. THere's also variation amongst social classes (lower socio-ecnomic status children are dx'd more often and treated with stims more often).
Whats really creepy is tat now, I guess with some of the AD problems and problems surfacing with ritalin-induced psychosis in kids, some docs are turning to the atypicals for ADHD...kind of like the 50s, when "hyperkinetic" kids were given chlorpromazine (nothing like Thorazine to shut a kid up).
Posted by ed_uk on July 8, 2006, at 16:55:53
In reply to Re: great statement, posted by med_empowered on July 8, 2006, at 16:36:32
Hi Med
>The 4% number strikes me as a little low, actually
Low! Really? 4% is a lot! What worries me is that the effects of stimulants on the developing brain have not been properly studied.
Ed
Posted by Questionmark on July 8, 2006, at 23:36:49
In reply to Re: great statement » med_empowered, posted by ed_uk on July 8, 2006, at 16:55:53
> Hi Med
>
> >The 4% number strikes me as a little low, actually
>
> Low! Really? 4% is a lot! What worries me is that the effects of stimulants on the developing brain have not been properly studied.
>
> Ed
Yeah, I'd just like to say for the record (and as a U.S. citizen & former stimulant user) that I completely agree, Ed. It is absolutely freaking ridiculous that this many children are being force-fed uppers in our country. I've been wondering for awhile if the next generation of young adults are going to have extraordinarily high rates of psychological and social problems due to the high rate of chronic, heavy (for kids at least) stimulant use as children. I wouldn't be surprised if we have a group of people with anxiety and depressive disorders and quasi-schizoaffective traits (possibly with mild to moderate paranoid traits) in a decade or two (or more) referred to as PCSUDs-- or people with Post Childhood Stimulant Overuse Disorder. And they'll inevitably have some sort of pharmaceutical specifically marketed to that condition-- and it will of course be over-prescribed. I'll shut up now.
But yeah, it sickens me to see all of these young PRE-ADOLESCENT children (like 5 to 8 years old oftentimes!!) on doses of these powerful psychostimulants that would be too high for me to even want to be on. It really is sick in my opinion.
Posted by med_empowered on July 9, 2006, at 0:09:31
In reply to Re: great statement » ed_uk, posted by Questionmark on July 8, 2006, at 23:36:49
here's the thing: I really do think sometimes stims can help people...I mean, even if you cant prove the existence of ADHD, if you can give a kid low-dose dexedrine or something and then that helps them succeed in school and what not, then I say do it--occasionally.
I think in the US we have a situation where an EXTRAORDINARY number of kids are being labelled as "disordered" when their environments (school, home,etc) are really the problem. I think in many cases we're drugging kids into submission, not HELPING them in any real sense. Its frightening.
Plus, from personal experience, I've seen cases where kids are doped up to make the parents lives easier, or teacher's lives easier, or...just b/c. I've also noticed how sometimes middle and upper class kids end up on low dose drugs plus therapy and other treatments, while less fortunate kids end up on doses of stims that stunt their physical growth and emotional development.
Posted by paulbwell on July 9, 2006, at 0:17:20
In reply to Re: stimulants for depression? » nickguy, posted by JerryPharmStudent on July 7, 2006, at 3:18:14
> > Has anybody heard of this, or have experience with it? My pysch mentioned it and I was a little surprised because I know stimulants carry a lot of stigma. I think he would want to try this before an MAOI, but I'm not sure.
>
> Stimulants are a widely used tool for depression. Ritalin, Concerta, Adderall, Dexedrine - they all work VERY well when paired with SSRIs.
>
> I've been on stimulants for depression for years. Doctors would rather prescribe stimulants than benzos sometimes!
>
> There's more stigma attached to mental illness than there is to using stimulants for depression. Without Adderall - I'd not be able to get out of bed.
>
> Jerry
>
>Hi Ya!
I know medicine changes according to fads n fashions...I have a 1951 magazine ad here for a med called "Norodin"-Methamphetamine Hcl, 2.5 5mg tabs. This medication is being advertised for depression, and weight control~
~"Norodin"-psychomotor stimulant@antipressant, sure this was 50 tears ago.. BUT i converse with fok who taks Desoxyn (same thing) and done sofor years, i womder if infact they are 'treating' their Narcolepsy, or simply prefer the effects the pills have on them.
I'v taken 6 legal dope company AD's-and gen Ritalin is the only 1 which doesn't make me fat, and stupid-it is of course illegal to give for low moods, luckly i have an issue with concentration, and overactivity:).
Cheers
Posted by ed_uk on July 9, 2006, at 3:52:31
In reply to Re: great statement » ed_uk, posted by Questionmark on July 8, 2006, at 23:36:49
Hi QM
>Post Childhood Stimulant Overuse Disorder
Exactly. It worries me that a very large number of people may end up with permanent changes to brain function. Children's brains are still developing when they are given stimulants. I often wonder whether the administration of potent sympathomimetics to such a large proportion of America's children is wise. The cardiovascular toxicity of stimulants is also a concern.
>And they'll inevitably have some sort of pharmaceutical specifically marketed to that condition-- and it will of course be over-prescribed.
Probably an atypical antipsychotic!
Regards
Ed
Posted by ed_uk on July 9, 2006, at 3:57:16
In reply to stims for kids, posted by med_empowered on July 9, 2006, at 0:09:31
Hi Med
>I really do think sometimes stims can help people...I mean, even if you cant prove the existence of ADHD, if you can give a kid low-dose dexedrine or something and then that helps them succeed in school and what not, then I say do it--occasionally
I agree Med.
>think in the US we have a situation where an EXTRAORDINARY number of kids are being labelled as "disordered" when their environments (school, home,etc) are really the problem
I think that's probably true in many cases.
Prescribing psychiatric drugs to young children is something which requires extreme caution. The effects of long term use (years) are my main concern.
Regards
Ed
Posted by pseudoname on July 9, 2006, at 8:23:10
In reply to Re: stimulants for depression? » JerryPharmStudent, posted by paulbwell on July 9, 2006, at 0:17:20
Hi, Paul.
> I'v taken 6 legal dope company AD's-and gen Ritalin is the only 1 which doesn't make me fat, and stupid-it is of course illegal to give for low moods
It is NOT illegal in the U.S. for a doctor to prescribe Ritalin or other controlled substances off-label for depression. It is only illegal for a drug manufacturer to advertise off-label uses.
Posted by paulbwell on July 9, 2006, at 8:32:54
In reply to Ritalin as AD is not illegal » paulbwell, posted by pseudoname on July 9, 2006, at 8:23:10
> Hi, Paul.
>
> > I'v taken 6 legal dope company AD's-and gen Ritalin is the only 1 which doesn't make me fat, and stupid-it is of course illegal to give for low moods
>
> It is NOT illegal in the U.S. for a doctor to prescribe Ritalin or other controlled substances off-label for depression. It is only illegal for a drug manufacturer to advertise off-label uses.
Thanks-i thought it was illegal to script Stmulants for other thanADD/HD?-Narcolepsy. It's a good thing i hold more Gen Ritalin 10mg IR tabs, than most Pharmacies do, 15 boxes~400 tabs:) so i'm sweet for now.
Thankyou:)
Posted by pseudoname on July 9, 2006, at 8:37:33
In reply to Re: great statement » pseudoname, posted by ed_uk on July 8, 2006, at 16:07:43
Like med_empowered, I thought the 4% figure sounded low, but I can't find any actual numbers. I've just seen *lots* of kids ages 8-18, including some in my extended familiy, taking prescribed stimulants. In my 11-year-old nephew's class of 25 kids, I know there were about 4 on psych meds. It's really quite sad.
But I live in one of those high-Ritalinizing states. Even 15 years ago, the counties in my area were known among researchers as the "Ritalin arc".
In the U.S., elementary schools have cut back on recess periods. When I was a kid, we had 15 minutes in the morning, 30 minutes in the afternoon, and most of 30 minutes at lunchtime to go outside and run around and yell. Even at age 14, we had recesses! Now 10-year-old kids in my town are given only one break so teachers can fit in more state-mandated instruction. The kids naturally get fidgety and then have drugs shoved down their throats to keep them still.
It's like the school equivalent of factory farming.
Posted by paulbwell on July 9, 2006, at 9:15:55
In reply to Ritalin and recess, posted by pseudoname on July 9, 2006, at 8:37:33
> Like med_empowered, I thought the 4% figure sounded low, but I can't find any actual numbers. I've just seen *lots* of kids ages 8-18, including some in my extended familiy, taking prescribed stimulants. In my 11-year-old nephew's class of 25 kids, I know there were about 4 on psych meds. It's really quite sad.
>
> But I live in one of those high-Ritalinizing states. Even 15 years ago, the counties in my area were known among researchers as the "Ritalin arc".
>
> In the U.S., elementary schools have cut back on recess periods. When I was a kid, we had 15 minutes in the morning, 30 minutes in the afternoon, and most of 30 minutes at lunchtime to go outside and run around and yell. Even at age 14, we had recesses! Now 10-year-old kids in my town are given only one break so teachers can fit in more state-mandated instruction. The kids naturally get fidgety and then have drugs shoved down their throats to keep them still.
>
> It's like the school equivalent of factory farming.I hear ya!
I'm not 8yo!!I am in my early 30's, and have taken 6+AD with nothing but SEs, i have taken Ritalin-generic for over 2 years, an it's better tha the 6+ AD's i'v been thrown, so i'll go with it.
Ritalin, works as an:
-Anti depressant
-treats ADHD
-Narcolepsy
-AlzeheimersIt's a dopamine booster+Norephine booster@reuptake inhibiter, and seems to work ok. I may be becoming tolerant, so a change to Dex MAY be in order? (only you Yanks have Addy@Desoxyn) 5mg IR tabs-all's there is here, which my Doc said i could trial.
Cheers
Get back:)
Posted by Emme on July 9, 2006, at 9:20:09
In reply to stims for kids, posted by med_empowered on July 9, 2006, at 0:09:31
I've been a substitute teacher in the local schools. I'm not trained in special ed, but after a very short time in the primary school I was able to see differences between the kids who are fidgety and have a hard time keeping still vs. the few who are way beyond that and in a whole other realm. Sometimes if there are a few kids with problems, there's an aide in the room to help keep them focused, but it's still clearly a struggle for them.
I remember talking to a parent once who, after much consideration (and receiving much criticism) decided to give her son medication and said it made a huge differences and enabled him to learn and to start making friends. Before that, despite their best efforts to help him, he kept annoying the other kids with his hyperactivity. So my unprofessional opinion is that there are a few out there who probably really need some help from meds.
Posted by med_empowered on July 9, 2006, at 12:13:26
In reply to Re: stims for kids, posted by Emme on July 9, 2006, at 9:20:09
my whole things is I'm not opposed to careful usage of meds in kids in certain cases--I'm just concerned when we have huge numbers of kids being medicated who aren't deriving a clear benefit.
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