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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Mr.Scott on March 3, 2005, at 18:48:56
Huh...
I started Adderall xr about 4 weeks ago due to extreme lethargy and fatigue 20-30mg although I guess 30 seems too much. It was added to 25mg of zoloft and .5mg of klonopin. I also use 100mg neurontin on occassion. In the last 4 weeks I have felt decent (obviously). In that time Irekindled an old flame, but other than that I don't know what to attribute my once again dwindling mental health. I'm experiencing lots of muscle aches and trouble sleeping. More depression and anxiety again too. I hope my reprieve is not over..
I'm wondering if the Adderall is at fault here? Any thoughts? Tolerance?
My Dx is all over the place. I'm not sure it matters as I've been on almost every med there is. Mostly atypical depression/anxiety/bpII. I have episodes of Major Depression here and there and have experienced destabilization and mild euphoria from antidepressants along with akathisia and parkinsons like reactions from SSRI's.
I'm so unconvinced by psychiatry. Docs have told me I have BPII and should take this or that mood stabilizer. Aside from side effects and sedation however, I'm not sure I get any benefit??
I'm going to sleep with the hope that upon waking someone here has some good insight for me.
Yuck!
Scott
Posted by med_empowered on March 3, 2005, at 20:12:46
In reply to I Feel Awful! Any help appreciated..., posted by Mr.Scott on March 3, 2005, at 18:48:56
hey! it sounds like your first need to get a thorough physical examination...if your primary complaints are physical, then step 1 should involve checking to see if you're dealing with a physical ailment. But...you could be having emotional issues as well. In terms of mood-stabilizers...I have a BP NOS diagnosis, and I'm doiong reasonably well without a mood-stabilizer...most of them (except Lamictal) are really more "anti-manic" than anything else, although if you have depression with psychotic features or treatment-resistant depression, mood-stabilizers are supposed to help. Anyway, the only thing I could recommend for you would be to see about a temporary sleep aid, maybe up your klonopin a little bit, and adjust your adderall. How often do you take it? My shrink would never do the once a day thing with stimulants; I've always had a morning pill and an afternoon pill. She said that not having a "booster" pill caused a definite crash; also, some people I know take adderall 3 or so times a day and have found that its important to divide the doses up reasonably evenly...so if you take a lot more in the morning than you do later, for instance, evening out the difference a little may help. Good luck!
Posted by Phillipa on March 3, 2005, at 20:31:02
In reply to Re: I Feel Awful! Any help appreciated..., posted by med_empowered on March 3, 2005, at 20:12:46
How's the rekindling going? Could there be something to that theory? Otherwise, why would you have brought it up. I'm also in the process of deciding whether to contact an ex-husband of mine who was wonderful that I was rotten to and divorced. Found him on a web search, and after thinking he is living in Belgium, find out he is only in VA. That alone is driving me nuts. Do I leave well enough alone, or go after the person who changed my life for the better the most. I'm remarried and my husband is the one who found him. Maybe he is trying to tell me something. Anyway I hope you sleep well, and I don't have a magic pill for you or me. Sorry. Fondly, Phillipa
Posted by banga on March 3, 2005, at 22:10:35
In reply to Re: I Feel Awful! Any help appreciated..., posted by Phillipa on March 3, 2005, at 20:31:02
I could say I am in a similar boat...Major Depression (?or BPII), GAD, ADHD sxs. I also started Adderall a little over a month ago, at 25mgs (approximately---I try to pour off a little of a 30mg capsule). also on:
desipramine 75mg
abilify 2.5 mg
Lamictal 100mg
Luvox 50mg.
I too feel achy and fatigued. I believe Adderall is a mixed bag--gives more energy, but it also through the stimulation exhausts the body. I get dead tired by night and wake up achy. I have contemplated weaning off--or at least to a lesser amount, and upping the desipramine instead. I get a little down when I feel especially tired, but otherwise doing quite well.
Posted by Phillipa on March 3, 2005, at 22:35:05
In reply to Re: I Feel Awful! Any help appreciated..., posted by Phillipa on March 3, 2005, at 20:31:02
Glad you're feeling better Banga. Fondly, Phillipa
Posted by Mr.Scott on March 3, 2005, at 23:19:36
In reply to I Feel Awful! Any help appreciated..., posted by Mr.Scott on March 3, 2005, at 18:48:56
Thanks for your support. I'm sure the old flame has a lot to do with it, but I'm so obsessed with myself and my pills I hardly notice!
She's nuttier than I am! I mean I'm prone to the insecure walk all over me thing where I then build a nasty resentment and explode, wheras she is just an outright nasty bitch with a desire to control the world! But ah...loneliness and lust take us to the strangest of places sometimes! Since I'm either totally preocupied with and catastophizing about my internal workings or obsessing about how many milligrams of zoloft I'm taking this week I fail to pay attention to the obvious. Thanks!
As for the muscle aches and sleep problems. I bet it's from this last month of unusual productiveness spawned by Adderall.
Scott
Posted by Ritch on March 4, 2005, at 0:06:32
In reply to Re: I Feel Awful! Any help appreciated..., posted by Mr.Scott on March 3, 2005, at 23:19:36
> Thanks for your support. I'm sure the old flame has a lot to do with it, but I'm so obsessed with myself and my pills I hardly notice!
>
> She's nuttier than I am! I mean I'm prone to the insecure walk all over me thing where I then build a nasty resentment and explode, wheras she is just an outright nasty bitch with a desire to control the world! But ah...loneliness and lust take us to the strangest of places sometimes! Since I'm either totally preocupied with and catastophizing about my internal workings or obsessing about how many milligrams of zoloft I'm taking this week I fail to pay attention to the obvious. Thanks!
>
> As for the muscle aches and sleep problems. I bet it's from this last month of unusual productiveness spawned by Adderall.
>
> Scott
>That was great comic relief.. thanks for writing that! I've got to print that and save it.. :)
Anyhow, you said earlier:>I'm wondering if the Adderall is at fault here? Any thoughts? Tolerance?
Yep, my guess is that maybe a reduction might be in order. I get a great initial response to stims, then a degradation with time. Perhaps try two days on and one day off or some other sort of poop-out prevention routine... where's the stimulant poop-out prevention tips when you need 'em?
Posted by SLS on March 4, 2005, at 4:30:33
In reply to Re: I Feel Awful! Any help appreciated... » Mr.Scott, posted by Ritch on March 4, 2005, at 0:06:32
Hi.
> where's the stimulant poop-out prevention tips when you need 'em?
I believe they are still sitting in a heavenly vault waiting to be released for general use.
I find that stimulants can be mildly effective for about three days. I would be very interested to see how someone does when combining Adderall with 10-20mg of memantine (Namenda). We keep hearing talk about this strategy as if it were fact. We still have yet to see one of "our own" actually try it.
- Scott
Posted by ed_uk on March 4, 2005, at 8:57:22
In reply to Re: I Feel Awful! Any help appreciated..., posted by SLS on March 4, 2005, at 4:30:33
Hi Scott!
>I believe they are still sitting in a heavenly vault waiting to be released for general use.
LOL, you're funny Scott!
>I would be very interested to see how someone does when combining Adderall with 10-20mg of memantine (Namenda). We keep hearing talk about this strategy as if it were fact.
I know, I only know of one person (AndrewB) who has tried this and had apparant success. I wonder if the memantine might have worked on its own though.
Ed.
Posted by Ritch on March 4, 2005, at 9:59:55
In reply to Re: I Feel Awful! Any help appreciated..., posted by SLS on March 4, 2005, at 4:30:33
> Hi.
>
> > where's the stimulant poop-out prevention tips when you need 'em?
>
> I believe they are still sitting in a heavenly vault waiting to be released for general use.
>
> I find that stimulants can be mildly effective for about three days. I would be very interested to see how someone does when combining Adderall with 10-20mg of memantine (Namenda). We keep hearing talk about this strategy as if it were fact. We still have yet to see one of "our own" actually try it.
>
>
> - Scott
Hmmm. Now you've got me thinking about this one... I'm taking a low dose of Depakote and I read an article (can't find it now of course) that it's mode of action has as much to do with NMDA "effects" as that of GABA transaminase inhibition. ... Anyhow during the several trials of different stimulants that I've been on.. when I was on "higher" dose of Depakote 500mg and using methylphenidate or dexedrine, I didn't really notice any "poop-out" as far as an intended antidepressant or ADHD effect, just a lingering anxiety that I always get with stims and didn't like... and it didn't seem to get worse with time like the trials w/o Depakote..
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