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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by jealibeanz on April 11, 2007, at 10:16:33
Well, I just started taking Ritalin after being off for almost 2 weeks. Surprise! More anxiety to add to my anxiety disorder.
I need stimulants to keep me functional, not sleep 18 hours a day, and to do my school work.
I hesistate to go back at all right now.
I definitely hesistate to say anything that will get me taken off medications that I need altogether. He's already taking away my anxiety medication.
He tends to lean toward extended release drugs... Concerta, Ritalin LA, Xanax XR. He just is completely confused when I tell him the Concerta and Ritalin don't last more than a few hours. Doctors have obviously been brain-washed in to thinking short-acting = drug abuser... don't give them out, even if they aren't effective.
Not all stimulants cause anxiety with me. Coffee is verrrrrry calming and relaxing. I think methyphenidate just doesn't agree with my body.
But, I don't think my doctor will go for anything besides Concerta, Ritalin LA, or Adderall XR. He may take them away anyway because I'm still complaining of anxiety.
I hate my life right now. I want a brain transplant or a doctor who doesn't think I'm a drug-seeker, just because I don't respond well to the "safer" options.
Posted by Phillipa on April 11, 2007, at 14:01:35
In reply to Least anxiety-inducing stimulant?, posted by jealibeanz on April 11, 2007, at 10:16:33
Jelly not to me mean or trite if coffee is calming why not more than and maybe your body wasn't meant for l8 hours a day? Not all are. I know mine never ever was. Love Phillipa
Posted by jealibeanz on April 11, 2007, at 14:10:18
In reply to Re: Least anxiety-inducing stimulant? » jealibeanz, posted by Phillipa on April 11, 2007, at 14:01:35
> Jelly not to me mean or trite if coffee is calming why not more than and maybe your body wasn't meant for l8 hours a day? Not all are. I know mine never ever was. Love Phillipa
No I meant I was sleeping for 18 hours a day!
Posted by psychobot5000 on April 11, 2007, at 19:15:39
In reply to Re: Least anxiety-inducing stimulant? » Phillipa, posted by jealibeanz on April 11, 2007, at 14:10:18
!
>I think it varies based on individual experience. The only thing I can offer is that I think adderall generally causes more anxiety than plain dexedrine/dexamphetamine.
Posted by Phillipa on April 11, 2007, at 19:55:19
In reply to Re: Least anxiety-inducing stimulant? » Phillipa, posted by jealibeanz on April 11, 2007, at 14:10:18
Ahhh I see. Want to share some sleep? Love Phillipa
Posted by jealibeanz on April 11, 2007, at 20:06:43
In reply to Re: Least anxiety-inducing stimulant? » jealibeanz, posted by Phillipa on April 11, 2007, at 19:55:19
> Ahhh I see. Want to share some sleep? Love Phillipa
I workout everyday. It helps immensely with sleep, energy, and anxiety reduction.
Posted by jealibeanz on April 11, 2007, at 20:13:32
In reply to Re: Least anxiety-inducing stimulant?, posted by psychobot5000 on April 11, 2007, at 19:15:39
> I think it varies based on individual experience. The only thing I can offer is that I think adderall generally causes more anxiety than plain dexedrine/dexamphetamine.
>
>I agree. Adderall wreaked havoc on my brain.
Is dexedrine or dexamphetamine available in a brand name formulation or as extended release? If not, I won't get it. Then again, I won't get it if I don't ask for it. I won't ask for it b/c I won't see my doctor.
Haha... ohhh there was no point to this question I suppose.
Maybe I will be offered non-stimulant Straterra to try again. Yum.
I should keep a journal of my reactions to drugs. I do remember it helping. I also remember being very nauseuous and slightly dulled and depressed. Maybe it helped with energy. I don't know. I think the concentration benefits lessened after a time, but I never titrated up past the first 2 weeks.
Posted by jonathanupr on April 11, 2007, at 20:53:13
In reply to Re: Least anxiety-inducing stimulant? » psychobot5000, posted by jealibeanz on April 11, 2007, at 20:13:32
one thing i've learned in regards to stims is that everyone reacts differently to them, but one thing that does seem to be steady across the board is that mixing Caffiene with CNS stims causes a lot of tight neck and back muscles. Anxiety to say the least.
Dexedrine is made in an XR tab (though it doesn't last as long as the Adderall XR dose).
I've had more success avoiding anxiety with CNS stims by taking the IR (instant release/standard release) forms than the XR versions (the XR versions are a bit quirky, take the Adderall XR version for instance... it release 50% of the dose immediately, and then four hours later it releases 25% of the dose, then another 25% 2 hours later.... reason this was a bit wrong for my regimen is due to not needing as much of the stim in the first four hours, and needing more of the stims throughout the next 8 to 10 hours of the day).
here's what I know of the stims I've tried:
Dex pretty much affects dopamine (and some down-stream nor-epinephrine). I was in a piss and vinegar mood on this stuff, irritable and rageful but I could control my actions, just pissed for no reason.
Adderall (shire brand) affects both dopamine and nor-epinephrine equally
Generic Adderall (Barr brand) seemingly to me affects more of the nor-epinephrine than dopamine, as my OCD was lit up by the Shire brand, and isn't hot at all on the Shire brand....interesting.
Concerta seems to be more of a reuptake inhibitor of dopamine and nor-ep, not much of a catecholamine releaser as the amphetamines above. This stim made me more irritable and through my OCD out of whack more than Adderall did.
Focalin was much better than Concerta, didn't make me as irritable, nor did it strike my anxiety as much as the Concerta did. This is the isomer of Ritalin, thus supposed to have the benefits and reduction of negatives with Ritalin....and I did see this when comparing it to Concerta. This may be a good med to try.
Desoxyn (you probably won't be able to get this med) was great until the evening, as I became irritable and for heaven's sake i couldn't sleep at night. I definitely could taste the ephedrine effect in this stuff hours after the effective dose to help my ADHD had worn off (meaning I was wide-eyed and restless without relief). And on the negative side, this stuff is very habit forming (addictive in laymens terms), and I definitely could feel that if I kept on it I wouldn't be coming off it very easily, both physiologically and mentally wanting.
If you have previous anxiety issues, you definitely need a buffer before going on a CNS stim (my opinion of course, though shared by many a psychiatrist). The approach I've taken is to start up on a SSRI, then added the CNS stim, needed some more padding thus added a drug to help with irritability, Gabitril at a low dose was a god-send, added Klonopin at a very low dose for sleep that was screwed up by the SSRI. Then, here comes the positive part of my med regimen: after I found an effective buffering, I have been lowering the SSRI, the Gabitril, and the Klon to doses where I find my day to be bearable. Example of my present regimen: down from 10 mg of Lexapro to 3.5 mg, down from 6 mg of Gabitril to 3 mg, down from 1 mg of Klon to .25 mg of Klon.... and take about 25mg to 35mg of SR release Generic Adderall. So far so good, though the withdrawals of the SSRI the last two weeks have sucked.
hope things work out
Posted by jealibeanz on April 12, 2007, at 0:03:21
In reply to Re: Least anxiety-inducing stimulant?, posted by jonathanupr on April 11, 2007, at 20:53:13
> one thing i've learned in regards to stims is that everyone reacts differently to them, but one thing that does seem to be steady across the board is that mixing Caffiene with CNS stims causes a lot of tight neck and back muscles. Anxiety to say the least.
>
> Dexedrine is made in an XR tab (though it doesn't last as long as the Adderall XR dose).
>
> I've had more success avoiding anxiety with CNS stims by taking the IR (instant release/standard release) forms than the XR versions (the XR versions are a bit quirky, take the Adderall XR version for instance... it release 50% of the dose immediately, and then four hours later it releases 25% of the dose, then another 25% 2 hours later.... reason this was a bit wrong for my regimen is due to not needing as much of the stim in the first four hours, and needing more of the stims throughout the next 8 to 10 hours of the day).
>
> here's what I know of the stims I've tried:
>
> Dex pretty much affects dopamine (and some down-stream nor-epinephrine). I was in a piss and vinegar mood on this stuff, irritable and rageful but I could control my actions, just pissed for no reason.
>
> Adderall (shire brand) affects both dopamine and nor-epinephrine equally
>
> Generic Adderall (Barr brand) seemingly to me affects more of the nor-epinephrine than dopamine, as my OCD was lit up by the Shire brand, and isn't hot at all on the Shire brand....interesting.
>
> Concerta seems to be more of a reuptake inhibitor of dopamine and nor-ep, not much of a catecholamine releaser as the amphetamines above. This stim made me more irritable and through my OCD out of whack more than Adderall did.
>
> Focalin was much better than Concerta, didn't make me as irritable, nor did it strike my anxiety as much as the Concerta did. This is the isomer of Ritalin, thus supposed to have the benefits and reduction of negatives with Ritalin....and I did see this when comparing it to Concerta. This may be a good med to try.
>
> Desoxyn (you probably won't be able to get this med) was great until the evening, as I became irritable and for heaven's sake i couldn't sleep at night. I definitely could taste the ephedrine effect in this stuff hours after the effective dose to help my ADHD had worn off (meaning I was wide-eyed and restless without relief). And on the negative side, this stuff is very habit forming (addictive in laymens terms), and I definitely could feel that if I kept on it I wouldn't be coming off it very easily, both physiologically and mentally wanting.
>
> If you have previous anxiety issues, you definitely need a buffer before going on a CNS stim (my opinion of course, though shared by many a psychiatrist). The approach I've taken is to start up on a SSRI, then added the CNS stim, needed some more padding thus added a drug to help with irritability, Gabitril at a low dose was a god-send, added Klonopin at a very low dose for sleep that was screwed up by the SSRI. Then, here comes the positive part of my med regimen: after I found an effective buffering, I have been lowering the SSRI, the Gabitril, and the Klon to doses where I find my day to be bearable. Example of my present regimen: down from 10 mg of Lexapro to 3.5 mg, down from 6 mg of Gabitril to 3 mg, down from 1 mg of Klon to .25 mg of Klon.... and take about 25mg to 35mg of SR release Generic Adderall. So far so good, though the withdrawals of the SSRI the last two weeks have sucked.
>
> hope things work outFocalin does seem like a good choice, since the side effects may be reduced. There's an XR version, right? Not that I feel the extended release works for me, but my doc loves them. I don't want to be the annoying know it all patient anymore and ask by name, because I get the feeling my doc is getting really annoyed and tired of dealing with me.
Posted by UgottaHaveHope on April 14, 2007, at 0:34:24
In reply to Re: Least anxiety-inducing stimulant?, posted by jealibeanz on April 12, 2007, at 0:03:21
You can read the other posts below on Provigil and its appears that is not a stimulant and does a great job of helping you stay awake. I know one thing: It is the official drug of the US military, which has its pilots etc take to remain sharp during long hours on the battlefield.
Posted by jealibeanz on April 14, 2007, at 4:33:53
In reply to Apparently Provigil, from what others in here say » jealibeanz, posted by UgottaHaveHope on April 14, 2007, at 0:34:24
> You can read the other posts below on Provigil and its appears that is not a stimulant and does a great job of helping you stay awake. I know one thing: It is the official drug of the US military, which has its pilots etc take to remain sharp during long hours on the battlefield.
I actually already take Provigil. It's good for "promoting wakefulness", as the company says, but not great as ADHD treatment.I am one of those who posted below on Provigil:)
Thanks for the suggestion though. Obviously you were thinking in the right direction!
Posted by psychobot5000 on April 15, 2007, at 1:49:06
In reply to Apparently Provigil, from what others in here say » jealibeanz, posted by UgottaHaveHope on April 14, 2007, at 0:34:24
> You can read the other posts below on Provigil and its appears that is not a stimulant and does a great job of helping you stay awake. I know one thing: It is the official drug of the US military, which has its pilots etc take to remain sharp during long hours on the battlefield.
Well, the US military does not use stimulants on the battlefield, per se. They use them for pilots, as 'go pills' on long missions. Their drug of choice for this purpose, since world war two has been dexamphetamine, though there has been lots of press about US defense department -study- of modafinil to replace it. Now this may have taken place by now--I haven't been keeping up--but we shouldn't assume that it's necessarily because it works better for that purpose--possiby just the normal concerns of abusability and bad press that come with ther older stims.
All that said, I personally find modafinil to be the most anxiety-creating of any stimulant--results vary, of course.
Best, all,
P-bot
Posted by jealibeanz on April 15, 2007, at 5:57:44
In reply to Re: provigil, military, and others, posted by psychobot5000 on April 15, 2007, at 1:49:06
> > You can read the other posts below on Provigil and its appears that is not a stimulant and does a great job of helping you stay awake. I know one thing: It is the official drug of the US military, which has its pilots etc take to remain sharp during long hours on the battlefield.
>
> Well, the US military does not use stimulants on the battlefield, per se. They use them for pilots, as 'go pills' on long missions. Their drug of choice for this purpose, since world war two has been dexamphetamine, though there has been lots of press about US defense department -study- of modafinil to replace it. Now this may have taken place by now--I haven't been keeping up--but we shouldn't assume that it's necessarily because it works better for that purpose--possiby just the normal concerns of abusability and bad press that come with ther older stims.
>
> All that said, I personally find modafinil to be the most anxiety-creating of any stimulant--results vary, of course.
>
> Best, all,
> P-bot
>
>Is this all hear-say, or are there credible sources that report such things? I too have read about Provigil's use by ER docs (hmmm... it's pretty convenient to have your own prescription pad!), pilots, and the US military. I've also read that Hitler constantly took some sort of amphetamine.
These were all in newspaper articles and magazines, which were either bashing the abuse of the drug or for some reason wanted to point out to the public that it exits... probably because they think this use is considered inappropriate, but didn't want to come out directly and say it.
I've also read articles that suggest that although it seems somewhat controversial to be giving employees meds so they can work long hours without being groggy, that it might not be such a bad idea for truck drivers, pilots, milary and ER docs... since them falling asleep on the job is NOT good for anyone!
I hate these articles. They demonize medications that are useful to those with disease/disorders to the public, which causes a precaution by doctors when prescribing the "pop-culture drugs". (Like mine... Provigil, Xanax, Ritalin LA, Lunesta). I don't even like TV or magazine ads which promote their medications... Cymbalta, Zolft, Abilify, Lunesta, Requip, Singulair, etc. It's nice that some who may be suffering get the message that they might have an untreated condition, and can be help. But for the most part, I think it just causes a lot of annoyance and frustration with primary care docs who have patients coming in with a self-diagnosis and demands a certain drug.
I'm just wondering if any hard proof exists. I doubt it, because I don't think any of these groups would release a state about handing out medications.
I honestly don't think it's a horrible idea for some people to take it in order to be functional on the job. I just wish that it comes on an individual basis, where someone seeks treatment, instead of beging suggested/demanded by the agency. Drugs shouldn't just be given out to the masses without a second thought. I don't know if this truly happenes or not, but I certainly hope not.
Posted by Phillipa on April 15, 2007, at 18:38:22
In reply to Re: provigil, military, and others » psychobot5000, posted by jealibeanz on April 15, 2007, at 5:57:44
I know an old poster here and I will e-mail him and ask as he is a resident. Love Phillipa
Posted by jealibeanz on April 15, 2007, at 19:21:13
In reply to Re: provigil, military, and others » jealibeanz, posted by Phillipa on April 15, 2007, at 18:38:22
> I know an old poster here and I will e-mail him and ask as he is a resident. Love Phillipa
Thanks!
Posted by Phillipa on April 15, 2007, at 19:39:19
In reply to Re: provigil, military, and others, posted by jealibeanz on April 15, 2007, at 19:21:13
I did but doubt a reply over a year. Love Phillipa
Posted by jealibeanz on April 15, 2007, at 20:41:37
In reply to Re: provigil, military, and others » jealibeanz, posted by Phillipa on April 15, 2007, at 19:39:19
> I did but doubt a reply over a year. Love Phillipa
That's alright. No big deal.
Posted by KayeBaby on April 16, 2007, at 0:07:08
In reply to Re: provigil, military, and others, posted by jealibeanz on April 15, 2007, at 20:41:37
To the best of my knowlege the common use of provigil in the US military is officially unconfirmed. However, I have read many first hand references of soldiers in Iraq having free access to it.
I will double check but a classmate of mine, recently returned from Baghdad, said something about provigil being standard issue. I will ask him to clarify.
Pilots puportedly use ambien and provigil, referring to the two drugs as "go" and "no go" pills.
The Gaurdian reported in 2004 that the UK's MOD purchased 24,000 of the pills and it is reported that the French soldiers took modafinil in the first Gulf War.
Peace,
kaye
Posted by FredPotter on April 16, 2007, at 13:35:31
In reply to Re: provigil, military, and others, posted by KayeBaby on April 16, 2007, at 0:07:08
. . . at least it is here in New Zealand, and overseas supplies look expensive too. Can anyone suggest where I can get it a bit cheaper? Thanks Fred
Posted by jealibeanz on April 16, 2007, at 13:44:13
In reply to Re: provigil, military, and others, posted by KayeBaby on April 16, 2007, at 0:07:08
> To the best of my knowlege the common use of provigil in the US military is officially unconfirmed. However, I have read many first hand references of soldiers in Iraq having free access to it.
>
> I will double check but a classmate of mine, recently returned from Baghdad, said something about provigil being standard issue. I will ask him to clarify.
>
> Pilots puportedly use ambien and provigil, referring to the two drugs as "go" and "no go" pills.
>
> The Gaurdian reported in 2004 that the UK's MOD purchased 24,000 of the pills and it is reported that the French soldiers took modafinil in the first Gulf War.
>
> Peace,
> kayePrescription drugs are standard issue in the US government? That's disturbing to me.
Posted by psychobot5000 on April 16, 2007, at 17:32:19
In reply to Re: provigil, military, and others, posted by jealibeanz on April 16, 2007, at 13:44:13
As for the question concerning whether 'go pills' are used in the US military, yes, it's well-documented and the USA has been open about using dexamphetamine since WWII, and doing extensive experimentation with modafinil use. Despite all the press, it's really nothing new.
Aviat Space Environ Med. 2005 Jul;76(7 Suppl):C39-51. Links
Fatigue in military aviation: an overview of US military-approved pharmacological countermeasures."Various components of the U.S. military have authorized the use of specific compounds for this purpose. Hypnotics such as temazepam, zolpidem, or zaleplon can mitigate the fatigue associated with insufficient or disturbed sleep. Alertness-enhancing compounds such as caffeine, modafinil, or dextroamphetamine can temporarily bridge the gap between widely spaced sleep periods. Each of these medications has a role in sustaining the safety and effectiveness of military aircrews."
___I am not aware of any official use of wakefulness-promoting drugs, in military fields other than aviation and special forces, though military doctors might prescribe them to (perhaps a large number of) individuals in their units.
However, these drugs are not 'standard issue' to regular soldiers/airmen/whatever from the US armef forces.
Some news articles seem to suggest the UK military has used modafinil as the equivalent of a 'go pill' for several years.
Posted by Phillipa on April 16, 2007, at 18:41:11
In reply to Re: 'go pills', posted by psychobot5000 on April 16, 2007, at 17:32:19
I will have to ask my Son who was in Desert Storm and was behind the French Foreign Legion as a member of the 82 Airbourne and they were in Iraq two weeks before CNN reported it and the war began. I know he was thin as a rail and of course blind minus two finger tips result of blasting cap incident. He may not tell as they were all swore to privacy. Love Phillipa ps and debriefed him at Walter Reed Hospital where he was medivaced after his injuries.
Posted by rina on April 17, 2007, at 0:10:54
In reply to Re: provigil, military, and others, posted by psychobot5000 on April 15, 2007, at 1:49:06
I'm so very frustrated!! I feel as if I've taken every medication, ever prescribed. Seriously!! I suffer, as many of you know, from Bipolar 2, ADD, Rapid Cycling/Mood Disorder and Chronic Depression. My pdoc thought we had a winner with the Lyrica at 600mg, especially since it was working wonderfully for the first two weeks. All of a sudden Bam!! Down the drain as if it never entered my system. Can someone say Lyrica who? The only thing she left was 20lbs of swelling and weight gain. So now we added Risperdal to the picture. Ask me is she working yet? It's been since Saturday and I'm hearing a few voices, irritated, yelling at the kids, hubby and the cat, eating everything in sight, agitated, annoyed at any and everything and I'm moving in slow motion all day. That can't possibly be a good thing. So now my cocktail includes: Risperdal,Topamax,Lyrica and Provigil.
Posted by rina on April 17, 2007, at 0:11:30
In reply to Re: provigil, military, and others, posted by psychobot5000 on April 15, 2007, at 1:49:06
I'm so very frustrated!! I feel as if I've taken every medication, ever prescribed. Seriously!! I suffer, as many of you know, from Bipolar 2, ADD, Rapid Cycling/Mood Disorder and Chronic Depression. My pdoc thought we had a winner with the Lyrica at 600mg, especially since it was working wonderfully for the first two weeks. All of a sudden Bam!! Down the drain as if it never entered my system. Can someone say Lyrica who? The only thing she left was 20lbs of swelling and weight gain. So now we added Risperdal to the picture. Ask me is she working yet? It's been since Saturday and I'm hearing a few voices, irritated, yelling at the kids, hubby and the cat, eating everything in sight, agitated, annoyed at any and everything and I'm moving in slow motion all day. That can't possibly be a good thing. So now my cocktail includes: Risperdal,Topamax,Lyrica and Provigil.
This is the end of the thread.
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