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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by Frustratedmama on May 15, 2009, at 21:52:03
Hi everyone!
First, I want to thank everyone who has responded so far! It really does help to have a sounding board.
Now for the problem: I have been taking the Buspar for 8 days now and am up to 10 mg 2 times a day. I still am not feeling any better and if anything am a bit more anxious than I was before. I still am irritable, depressed, unmotivated, and have these episodic "rage attacks". I am running out of options! I am now thinking maybe there isn't hope- maybe the Vyvanse is making the mood worse even though I can focus. What should I do next? If I can't focus and I am in a bad mood then I am left with nothing (I need to work). So, should I keep going with the Buspar? Try Pristiq? Ask for Klonopin? Change ADD meds? Anyone else here have experience with ADD, depression, and generalized anxiety?
Posted by Phillipa on May 15, 2009, at 22:52:32
In reply to ADD, Depression, Generalized Anxiety -what's left?, posted by Frustratedmama on May 15, 2009, at 21:52:03
I don't have knowledge of add but sounds like a push and pull kind of effect between the add med and benzos. Even though some say no. I just don't get how the two work together. Phillipa sorry you having such a hard time.
Posted by Phillipa on May 15, 2009, at 22:53:28
In reply to ADD, Depression, Generalized Anxiety -what's left?, posted by Frustratedmama on May 15, 2009, at 21:52:03
Sorry not benzos buspar. Maybe the buspar isn't strong enough? Phillipa
Posted by ricker on May 15, 2009, at 23:30:58
In reply to ADD, Depression, Generalized Anxiety -what's left?, posted by Frustratedmama on May 15, 2009, at 21:52:03
I'd be inclined to get the depression/anxiety under control... then focus on the ADD?
I started on clonazepam when I was 28 so I've been taking it for 22 years - 0.5 tid. No side effects, works good for the anxiety and has a week mood stabilizer property. I 've stopped 3 or 4 times over the years with no addictive problems but I keep going back to it... cause it work! for me anyway.
I was always leery of the A/P's but when I exhausted most of my options, Seroquel at 100mg works great for sleep, anger issues and even helps with the depression. I'm also taking low dose lamictal 50mg and the two go great together. I have lowered my clonazepam down to twice a day as the seroquel is working on the anxiety issues. Zoloft 50 mg is my A/D.
I hope you can find the right combo, I know you will so hang in there, one day at a time. :)
Regards, Rick
Posted by linkadge on May 16, 2009, at 17:02:52
In reply to ADD, Depression, Generalized Anxiety -what's left?, posted by Frustratedmama on May 15, 2009, at 21:52:03
Effexor would be a good thing to try.
Linkadge
Posted by Frustratedmama on May 16, 2009, at 20:05:01
In reply to Re: ADD, Depression, Generalized Anxiety -what's left?, posted by linkadge on May 16, 2009, at 17:02:52
Thanks for the replies! I see the pdoc Friday and will continue with the Buspar til then to see if it works.... I am also feeling a bit of withdrawal I think between doses (is this possible?) Seems like I get more agitated now between doses than I did without the Buspar. Argh! Also the vyvanse doesnt seem to be working anymore which leads me to beleive that somehow the Buspar is counteracting it!
Posted by desolationrower on May 16, 2009, at 21:44:59
In reply to Buspar counteracting ADD meds?, posted by Frustratedmama on May 16, 2009, at 20:05:01
i think you had more history in another thread, probably same thing i'd still recommend, i think guanfacine and some other things several threads ago
if busprione is making things worse, maybe stop it and see if they go back
-d/r
Posted by Frustratedmama on May 17, 2009, at 9:04:10
In reply to Re: Buspar counteracting ADD meds?, posted by desolationrower on May 16, 2009, at 21:44:59
Ok,today I took my 10 mg of Buspar this AM and now I am feeling like I did on the antipsychotics! I felt the same way on pot! Feels like what I would only assume is a "bad trip"- paranoid, jittery, like my head is tingling, out of control! Anyone? I am calling pdoc tomorrow- cant wait til friday now! Think it's time to ask for tenex, valium, or klonopin. But I still need something for the depression! Is there something out there for depression too?
Posted by floatingbridge on May 17, 2009, at 16:31:30
In reply to Re: ADD, Depression, Generalized Anxiety -what's left?, posted by linkadge on May 16, 2009, at 17:02:52
> Effexor would be a good thing to try.
>
> Linkadgepersonally, I'd skip Effexor, if one was inclined to try it and go to Pristiq (if one can afford it!). I don't have those terrible side effects I had on Effexor.
IMHO
Candace
(and good luck to you!)
Posted by Lebrada on May 21, 2009, at 19:54:58
In reply to ADD, Depression, Generalized Anxiety -what's left?, posted by Frustratedmama on May 15, 2009, at 21:52:03
> Hi everyone!
> First, I want to thank everyone who has responded so far! It really does help to have a sounding board.
> Now for the problem: I have been taking the Buspar for 8 days now and am up to 10 mg 2 times a day. I still am not feeling any better and if anything am a bit more anxious than I was before. I still am irritable, depressed, unmotivated, and have these episodic "rage attacks". I am running out of options! I am now thinking maybe there isn't hope- maybe the Vyvanse is making the mood worse even though I can focus. What should I do next? If I can't focus and I am in a bad mood then I am left with nothing (I need to work). So, should I keep going with the Buspar? Try Pristiq? Ask for Klonopin? Change ADD meds? Anyone else here have experience with ADD, depression, and generalized anxiety?I have all the above also, try throwing in Generalized Social Anxiety/Phobia as well - then your talking, as for a solution...
I tried BUSPAR (Buspirone) to 60mg for months, what a let-down, I think a placebo pill would be more effective (IMO this is useless and a waste ot time and money)!
For Depression IMO - nothing works like Lexapro!
For Anxiety - again Lexapro reduces anxiety - but not to the extent that it quashes Depression!
For ADD - Definately Dexamphetamine (with a few provisos)
As for SOCIAL ANXIETY - if you know then pass it on - remission has proven elusive here - although Lexapro does help but doesn't have a pro-social effect.
Ideally you should try:
DEXAMPHETAMINE + MOCLOBEMIDE + 2.5/5MG LEXAPRO.Anyone taking Dexamphetamine (for ADD, increased motivation, appetite suppressant etc) should IMO 'ALWAYS' add Moclobemide (the Moclobemide also helps with depression and anxiety in its own right although IMO not to the extent of Lexapro/Zoloft however on a positive note it is an activating Anti-depressant unlike most).
Add in low dose Lexapro to lift the depression - any more and it can cause head-aches because too much Serotonin from the Moclobemide...low dose Lexapro I find fine and very effective with much fewer side-effects than most combinations!
The addition of Moclobemmide prolongs the half-life of the Dex while also increasing its impact to a sig degree.
Try to have two days a week off the Dex (not Moclo) to stave off tolerance.
This is a great combination (Moclobemide is a Reversible MAO unlike Nardil and Parnate and is in my experience a very safe option as well as being an activating AD which makes for a nice complement to the effects of Dex).
Good Luck!
Posted by desolationrower on May 22, 2009, at 0:22:26
In reply to Re: ADD, Depression, Generalized Anxiety -what's left? » Frustratedmama, posted by Lebrada on May 21, 2009, at 19:54:58
hm howd you get a doc to do maoi+ssri+amp
amp is a reversable MAOI anyway
-d/r
Posted by Lebrada on May 22, 2009, at 6:36:09
In reply to Re: ADD, Depression, Generalized Anxiety -what's left?, posted by desolationrower on May 22, 2009, at 0:22:26
> hm howd you get a doc to do maoi+ssri+amp
>
> amp is a reversable MAOI anyway
>
> -d/rHi,
(Dex-Amp is not a RIMA or reversable MAO but Moclobemide is and potentiates the effects of the Dex markedly)!
Yeah, that's the tricky part, patients played a big part here.
I went to see a Dr who specialised in ADHD to get the Dexamphetamine on script - I was deemed/tested as strongly ADD inattentive. This one is great if you can get this Rx'ed. Dex certainly is pro-social and works much better if you take two days a week off to satve off tolerance.
Then through my regular GP here in NZ I got Moclobemide scripted (is v safe - and if your patient you can work your Doc so you can have 900mg a day - especially for SAD). I had bulk of this left over when I asked to try the Lexapro (Moclobemide did squat for Depression but great for Depression, ADD, motivation and for avoiding SSRI induced apathy when in combination with the Dex) which is perfect for Depression. I combined this with 'low dose' Lexapro
This 'MOCLOBEMIDE + DEXAMPHETAMINE + low dose LEXAPRO' works wonders!
Hope this helps some :)
Posted by desolationrower on May 22, 2009, at 17:58:09
In reply to Re: ADD, Depression, Generalized Anxiety -what's left? » desolationrower, posted by Lebrada on May 22, 2009, at 6:36:09
> > hm howd you get a doc to do maoi+ssri+amp
> >
> > amp is a reversable MAOI anyway
> >
> > -d/r
>
> Hi,
>
> (Dex-Amp is not a RIMA or reversable MAO but Moclobemide is and potentiates the effects of the Dex markedly)!mao binds to amp because its close to phenelethylamine's structure but it isn't metabolized by it. its not a 'RIMA' as per drug company marketing 'science'
-d/r
Posted by Lebrada on May 22, 2009, at 21:14:02
In reply to Re: ADD, Depression, Generalized Anxiety -what's left?, posted by desolationrower on May 22, 2009, at 17:58:09
> > > hm howd you get a doc to do maoi+ssri+amp
> > >
> > > amp is a reversable MAOI anyway
> > >
> > > -d/r
> >
> > Hi,
> >
> > (Dex-Amp is not a RIMA or reversable MAO but Moclobemide is and potentiates the effects of the Dex markedly)!
>
> mao binds to amp because its close to phenelethylamine's structure but it isn't metabolized by it. its not a 'RIMA' as per drug company marketing 'science'
>
> -d/rwt?
Posted by Lebrada on May 23, 2009, at 7:54:38
In reply to Re: ADD, Depression, Generalized Anxiety -what's left?, posted by desolationrower on May 22, 2009, at 0:22:26
> hm howd you get a doc to do maoi+ssri+amp
>
> amp is a reversable MAOI anyway
>
> -d/rHi Mate,
The IC50 of amphetamine for occupancy of MAO-A is >12 uM, so unless one is taking grams a day, the MAO inhibitor properties of d-amphetamine never come into play. And if you are taking grams of amphetamine a day, you've got some big problems, far bigger than just the possibility of pissing off your monoamine oxidase enzyme.
All said and done - try Moclobemide & Dex together - and then you'll see what I mean ;)
Cheers
Posted by Frustratedmama on May 23, 2009, at 15:08:55
In reply to Re: ADD, Depression, Generalized Anxiety -what's left? » Frustratedmama, posted by Lebrada on May 21, 2009, at 19:54:58
> I have all the above also, try throwing in Generalized Social Anxiety/Phobia as well - then your talking, as for a solution...I do have GAD as well (guess i forgot to add that one; however, not phobias)
> I tried BUSPAR (Buspirone) to 60mg for months, what a let-down, I think a placebo pill would be more effective (IMO this is useless and a waste ot time and money)!AGREED!
> For Depression IMO - nothing works like Lexapro!
>
> For Anxiety - again Lexapro reduces anxiety - but not to the extent that it quashes Depression!
>
> For ADD - Definately Dexamphetamine (with a few provisos)
>
> As for SOCIAL ANXIETY - if you know then pass it on - remission has proven elusive here - although Lexapro does help but doesn't have a pro-social effect.
>
> Ideally you should try:
> DEXAMPHETAMINE + MOCLOBEMIDE + 2.5/5MG LEXAPRO.
>
> Anyone taking Dexamphetamine (for ADD, increased motivation, appetite suppressant etc) should IMO 'ALWAYS' add Moclobemide (the Moclobemide also helps with depression and anxiety in its own right although IMO not to the extent of Lexapro/Zoloft however on a positive note it is an activating Anti-depressant unlike most).
>
> Add in low dose Lexapro to lift the depression - any more and it can cause head-aches because too much Serotonin from the Moclobemide...low dose Lexapro I find fine and very effective with much fewer side-effects than most combinations!
>
> The addition of Moclobemmide prolongs the half-life of the Dex while also increasing its impact to a sig degree.
>
> Try to have two days a week off the Dex (not Moclo) to stave off tolerance.
>
> This is a great combination (Moclobemide is a Reversible MAO unlike Nardil and Parnate and is in my experience a very safe option as well as being an activating AD which makes for a nice complement to the effects of Dex).
>
> Good Luck!Not sure what moclobemide is or if it is available in US? But, Lexapro made things incredibly worse for me :( Now on librium and ready to punch holes in walls!
Posted by floatingbridge on May 23, 2009, at 16:32:30
In reply to Re: ADD, Depression, Generalized Anxiety -what's left?, posted by Frustratedmama on May 23, 2009, at 15:08:55
>
> Not sure what moclobemide is or if it is available in US? But, Lexapro made things incredibly worse for me :( Now on librium and ready to punch holes in walls!Dear FM,
I can't comment on above exchange about moclobemide; just wanted to add that my recent experience with librium was a failure--I found it irritating--restless legs and more--and not much for anxiety. Am now on klonopin (again) despite it's tendency in me to depress (and feeling better).
Candace
Posted by Frustratedmama on May 23, 2009, at 16:47:21
In reply to Re: ADD, Depression, Generalized Anxiety -what's l, posted by floatingbridge on May 23, 2009, at 16:32:30
>
> Dear FM,
>
> I can't comment on above exchange about moclobemide; just wanted to add that my recent experience with librium was a failure--I found it irritating--restless legs and more--and not much for anxiety. Am now on klonopin (again) despite it's tendency in me to depress (and feeling better).
>
> Candace
>
>
I am thinking of calling and asking for klonopin! Candace, are you the one taking Pristiq too?
Posted by floatingbridge on May 23, 2009, at 17:01:38
In reply to Re: ADD, Depression, Generalized Anxiety -what's l, posted by Frustratedmama on May 23, 2009, at 16:47:21
>
> >
> > Dear FM,
> >
> > I can't comment on above exchange about moclobemide; just wanted to add that my recent experience with librium was a failure--I found it irritating--restless legs and more--and not much for anxiety. Am now on klonopin (again) despite it's tendency in me to depress (and feeling better).
> >
> > Candace
> >
> >
> I am thinking of calling and asking for klonopin! Candace, are you the one taking Pristiq too?
>Yes I am, and it seems to be working, though took a long time to kick in. Also, if I skip a dose (which I try never to do) I begin to feel sick. I expect withdrawal to be as bad as Effexor despite what some docs may say.
I think I've written somewhere that I take klonopin 3x per day on a schedule for a total of 1.5 mg. Xanax .25-.5 as emergency med.
I don't have rage affect. Major depression, anxiety (!) and SP.
Candace
Posted by Frustratedmama on May 23, 2009, at 17:07:05
In reply to Re: ADD, Depression, Generalized Anxiety -what's l, posted by floatingbridge on May 23, 2009, at 17:01:38
Thanks Candace (again)! I am not sure what the rage attacks are but man are they causing distress! It's like someone takes over my brain and I just snap! WOndering if anyone else has experienced this?
Posted by floatingbridge on May 23, 2009, at 17:19:29
In reply to Re: ADD, Depression, Generalized Anxiety -what's l, posted by Frustratedmama on May 23, 2009, at 17:07:05
> Thanks Candace (again)! I am not sure what the rage attacks are but man are they causing distress! It's like someone takes over my brain and I just snap! WOndering if anyone else has experienced this?
FM,
Maybe start a new thread about rage attacks and anger. You aren't alone.
C
This is the end of the thread.
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