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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by sometimesblue on October 23, 2007, at 11:40:12
For a while I have known i have ADD symtoms, i don't really know if it is full blown ADD [if there even is a difference]....attention & focus have always been very difficult to maintain, unless I'm truly intrigued. In school I'd sometimes have to read something over & over because i just didn't absorb the information, and i have always been all over the place with work & school. Like starting one thing and never finishing before going on to the next thing.
My doc said all that was due to my depression and that if i had ADD someone would have picked it up sooner, like in school or my parents. But I'm not depressed anymore, since on Wellbutrin, and still i have the same problems. So what do i say to my doctor? Can i push her to give me some kind of ADD med? I don't see why i should have to make things harder on myself if can help it.
Any advice out there?
-SB
Posted by Racer on October 23, 2007, at 12:42:37
In reply to How can i get my doctor to understand?, posted by sometimesblue on October 23, 2007, at 11:40:12
Hm... If you hadn't already said that your doctor thinks it's related to your depression, I would have said that, myself. I'm not necessarily in favor of medication for what you describe. For one thing, Wellbutrin should control a lot of that if it really is ADD. Before going to meds, I'd advise working on behavioral techniques to address the concentration and completion issues.
Psychostimulants are not necessarily the most user friendly medications out there. If you read over the archives here with a bit of skepticism and an eye for what maybe isn't said, you'll see that they're "fun" for a lot of people, and therefore desirable for a fair number of people who maybe shouldn't be on them. Asking for a stimulant is often a warning sign to a doctor that there's a risk of abuse, especially if your doctor is more conservative.
Here's my advice, if you're determined that you want to convince your pdoc to prescribe a stimulant: try behavior modification, to show that you're serious about working on the issue, and then ask for help with any residual symptoms.
Good luck.
Posted by sometimesblue on October 23, 2007, at 12:50:18
In reply to Re: How can i get my doctor to understand?, posted by Racer on October 23, 2007, at 12:42:37
The Wellbutrin was great at first! But I was having a lot of mood swings so my doc prescribed Prozac...and ever since then it's been downhill. And the anorgasmia has returned. But, my moods have stablized a great deal. So i'm back to square one, without depression [which is a blessing, but at what price]. My work is starting to suffer, or at least they are noticing that it's taking me forever to finish my work. And i can't even follow a conversation, i just zone out and have to ask "i'm sorry, what was that last part you said"...which will only take you but so far. I'm so frustrated. Most days at home, i have no motivation to do anything. It feels like if it's not one thing it's another keeping me from feeling normal.
:(
Posted by Netch on October 23, 2007, at 13:46:09
In reply to Re: How can i get my doctor to understand? » Racer, posted by sometimesblue on October 23, 2007, at 12:50:18
sometimesblue, I had the same experience with SSRI.
You should consider alternative diagnoses like bipolar or schizoaffective disorder.
Maybe adding neuroleptics could help you out./Netch
Posted by Racer on October 23, 2007, at 13:53:13
In reply to Re: How can i get my doctor to understand? » Racer, posted by sometimesblue on October 23, 2007, at 12:50:18
AHA! What you're describing doesn't sound like ADD -- it sounds like the apathy/amotivation SSRIs can cause for many people.
My guess -- based largely on my own experience, by the way -- is that a stimulant isn't going to help much. Changing to an SNRI might help, so Cymbalta or Effexor might be good options, or adding Wellbutrin to the Prozac. Another option might be to explore another class of antidepressants, such as Remeron, which also hits both serotonin and norepinephrine. A TCA might also be an option, in which case desipramine is said to be the friendliest in terms of side effects.
For what it's worth, adding a stimulant to an SSRI for me led only to being both revved up -- and amotivated. I had too much energy to lie on the sofa, but that's about all I had the motivation to do...
I hope that helps.
Posted by sometimesblue on October 23, 2007, at 14:00:06
In reply to Re: How can i get my doctor to understand?, posted by Racer on October 23, 2007, at 13:53:13
I'm on Wellbutrin & Prozac...but i think it's time for cymbalta. That was my docs first choice, but it had to be preapproved by my ins. co...I think they'll approve it considering i've been on numerous other meds that haven't worked.
Does Cymbalta have sexual side effects?
Posted by sometimesblue on October 23, 2007, at 14:26:45
In reply to Re: How can i get my doctor to understand? » sometimesblue, posted by Netch on October 23, 2007, at 13:46:09
***"Schizoaffective disorder is a psychiatric diagnosis describing a condition where both the symptoms of mood disorder and schizophrenia are present. A person may manifest impairments in the perception or expression of reality, most commonly manifesting as auditory hallucinations, paranoid or bizarre delusions or disorganized speech and thinking, as well as discrete manic and/or depressive episodes in the context of significant social or occupational dysfunction..."***
According to this definition found in Wikipedia I don't think it's schizoaffective disorder...although, i did have auditory hallucinations when i first got on Wellbutrin? But that eventually went away.
Bipolar has come up several times on this board [from other babblers]...but...i dont have coverage for mental health so i dont know what to do. I only see my physician and it's been a trial & error with her to see what will help me.
Posted by Netch on October 23, 2007, at 14:41:48
In reply to Re: How can i get my doctor to understand?, posted by sometimesblue on October 23, 2007, at 14:26:45
Please be aware you only need two symptoms of schizofrenia to be diagnosed schizoaffective. So you don't have to have hallucinations to be schizoaffective.
Some mistaken their paranoid delusions with social fobia. I'm not saying you are... just trying to give you more options if treatment fails.
/Netch
Posted by sometimesblue on October 23, 2007, at 14:58:03
In reply to Re: How can i get my doctor to understand? » sometimesblue, posted by Netch on October 23, 2007, at 14:41:48
Posted by Phillipa on October 23, 2007, at 17:43:13
In reply to Re: How can i get my doctor to understand?, posted by sometimesblue on October 23, 2007, at 14:26:45
Cymbalta is really good for pain in my case back pain but didn't have the stimulation for me as wellbutrin did. Isn't wellbutrin dopamine. And then cymbalta is serotonin with more norepenephrine than effexor xr. That's my understanding anyway. Anyway cymbalta at 60mg for three months did nothing for depression or anxiety. But when I stopped it had back pain so it must have gotten rid of that for me. Good luck in what you decide to do. phillipa
Posted by Mathia on October 25, 2007, at 15:40:01
In reply to How can i get my doctor to understand?, posted by sometimesblue on October 23, 2007, at 11:40:12
I would say find a different doc, maybe a psychiatrist if possible money wise. If you happen to live in Houston let me know cause I know a psychiatrist who is really cool as far as
letting you try ADD meds even if you just think you may be ADD type. She'll let you try them to see if they help no questions asked.
Posted by sometimesblue on October 25, 2007, at 16:03:51
In reply to Re: How can i get my doctor to understand?, posted by Mathia on October 25, 2007, at 15:40:01
Damn, i wish i lived there! But, i figure I'm going to be honest and upfront with her. I'm going to say "I've been down this road with my other doctor who thought it was attributed to the depression...well, i'm not depressed anymore and haven't been for the past 3 months or more...and still i feel the SAME!!I would like for you to try to treat me for ADD and see how that goes..."
And if that doesn't work, I'll just have to switch doctors...i just can't keep on like this. I have no motivation at home, and no focus or attention at work [which, by the way, people are starting to notice...big problem there!]...i need help, not someone having preconceived notions about me and what-could-be-a-habit...meanwhile i get no relief from this fog in my head...
Thanks for your support,
SB
Posted by Racer on October 25, 2007, at 17:17:05
In reply to Re: How can i get my doctor to understand? » Mathia, posted by sometimesblue on October 25, 2007, at 16:03:51
>
> And if that doesn't work, I'll just have to switch doctors...i just can't keep on like this. I have no motivation at home, and no focus or attention at work [which, by the way, people are starting to notice...big problem there!]...i need help, not someone having preconceived notions about me and what-could-be-a-habit...meanwhile i get no relief from this fog in my head...I hate to sound like a broken record, but what you're saying presupposes that you're experiencing symptoms of ADD -- and not having an effect from an SSRI. If what you're going through really is ADD, then it's likely enough that a psychostimulant really will help. The problem is, if you're experiencing the apathy that SSRIs can cause for a lot of people, then the stimulant alone isn't likely to fix the problem.
The reason I'm repeating myself, by the way, is that I've had the apathy, and been put on stimulants -- which wasn't a great choice for me. Yes, I had more energy -- but more energy didn't translate into any more motivation, nor into accomplishing anything more. I just don't want you to be too disappointed if it doesn't work out.
I'll shut up now and crawl back into my cave.
Posted by Phillipa on October 25, 2007, at 19:43:39
In reply to Re: How can i get my doctor to understand? » sometimesblue, posted by Racer on October 25, 2007, at 17:17:05
Just wierd I guess as never apathy on any ad just stimulation so I usually stopped the med. After my three months of getting used to only l0mg of paxil and then feeling better only luvox does nothing in side effect arena neither negative or positive just neutral. Benzos are the only meds that affect me at all now and not much anymore so basically unmedicated. Phillipa
Posted by msanjelpie on October 26, 2007, at 4:23:38
In reply to How can i get my doctor to understand?, posted by sometimesblue on October 23, 2007, at 11:40:12
Doctor's don't like to hear self diagnoses. They like to hear symptoms. Symptoms they can diagnose themselves. Don't say you've always had it... Tell him specifically what the problem is and ask for help with that. If he is unwilling, find a new doc...
Posted by sometimesblue on October 26, 2007, at 8:49:34
In reply to Re: How can i get my doctor to understand? » sometimesblue, posted by Racer on October 25, 2007, at 17:17:05
LOL! I appreciate the broken record...the reason why i think it's ADD as opposed to the SSRI effects is that a stimulant, like ephedra, has helped in the past. Although, i guess the motivation has been lacking since they added Prozac to my wellbutrin? But the focus and attention have never been helped. My doc originally thought i was having those affects because of my depression, but i haven't been depressed in 2+ months, and still i find no relief. And it's not like i was depressed 24/7...i would just have "episodes" of depression, so why did i feel like that all the time? Scattered, unfocused, couldn't pay attention to one thing for too long before being distract by something else, unable to retain information [verbal or written], and always going off on tangens? And, i don't know if it's me, but i feel like it's getting worse and less manageable.
It's so frustrating.
-SB
Posted by Zyprexa on October 27, 2007, at 17:08:04
In reply to How can i get my doctor to understand?, posted by sometimesblue on October 23, 2007, at 11:40:12
Sounds a little like me. Thats when he put me on Strattera, for ADD. Maybe you should tell your doctor what you said. I've always be very slow at reading, often read it over several times till I fully comprehend everything. Never knew this was ADD before.
Posted by Zyprexa on October 27, 2007, at 17:10:31
In reply to Re: How can i get my doctor to understand? » Racer, posted by sometimesblue on October 26, 2007, at 8:49:34
One things for certain, I'm alot more alert since starting the strattera. Noticing things more, better attention.
Posted by Mathia on October 27, 2007, at 19:19:29
In reply to Re: How can i get my doctor to understand? » Mathia, posted by sometimesblue on October 25, 2007, at 16:03:51
SB,
No problem. Ill give you my experience taking add meds, actually never prescribed directly but got them from others to try. I, personally didnt like them. I dont like the speed feeling I got from them. Yeah, gave me more energy and I got alot done but just dont like the feeling. Now my sister is on them from the psychiatrist and they seem to be helping her, but have to tell you there are some nights where she is talking to me for like 2 hours straight and doesnt even know she's speeding her a** off. Plus, if she misses a dose for like a day and a half she goes into a major tailspin. So she's dependent on them now.
GOOD LUCK
M
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