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Re: ADD/Anxiety/OCD - Stimulants-Mitch DN

Posted by Mitch on August 3, 2001, at 0:57:31

In reply to Re: ADD/Anxiety/OCD - Stimulants-Mitch, posted by DN on August 2, 2001, at 14:41:59

> > > > > My symptoms seem to be Anxiety/OCD/ADD. Is there any stimulants or other medication(other than welbutrin) that I could take for ADD that would not aggrevate the anxiety or OCD part of my disorder.
> > > >
> > > > You sound like a good candidate for Prozac (that is if it doesn't make you too anxious).
> > >
> > > >Mitch: any particular reason for prozac over any other SSRI. Currently I'm at 225mg of effexor for about 5 weeks. If makes my ADD worse. Any particular reason that may be happening
> >
> >
> > Prozac (and Effexor) *usually* help ADD, however, they can make some people drowsy and indifferent. I knew one guy at work that was practically asleep at work all day from Prozac (I found that mind-boggling). You may be one of those folks that has that kind of reaction(to serotonergic meds-including Effexor), so now I am a little skeptical about a Prozac trial (it might improve OCD symptoms without any worsening of attention, though, so it might be worth trying).
> >
> > It sounds like the Effexor is helping your anxiety and ruminations but is worsening your ability to focus. I am curious, you said you are at 225mg after five weeks. Just what exactly has your doc diagnosed you with? It kind of sounds like you are being treated for generalized anxiety and you have some *traits* of ADD and OCD. Can you clarify?
> >
> > You said "not Wellbutrin". I am guessing that it made your anxiety a lot worse, right? Well, if SSRI's et al, make your ADD worse and Wellbutrin made you too anxious, the only other thing that both of them effectively could be..Parnate (tranylcypromine), but it is an MAOI, and there are diet restrictions, you would have to wash out the Effexor, etc. etc., and your pdoc might not be willing to prescribe.
> >
> > good luck
> > Mitch
> Mitch:
> I've been diagnosed with a mixed bag. Social Anxiety, GAD, OCD. Each equally painful. The ADD is my own self diagnosis because of my inabiltiy to concentrate, read or learn. I also take zyprexa which does seem to help a bit with ruminating thoughts and anxiety. Wellbutrin put me into a 9 hour panic attack. I've tried nardil with little success, but i really only gave it a 4 week trial. Do you think that parnate is worth a shot even though i had a poor response to nardil? Do you think there is a stimulant that wouldn't aggravate my anxiety? Would clomipranine be worth a shot? I appreciate the help you have already given me.
> Dave

Yes, I would still consider the Parnate (further down the road-not just yet), it is also been shown to be quite efficacious for social anxiety. I am a little concerned about the Zyprexa. I know that some people have had miraculous results for SP, but if you are still searching for something, that tells me that it probably isn't contributing that much, so why take something that isn't helping?? I have a lot of squawks about "off-label" use of antipsychotics (of any kind) for anything other than obvious psychosis. Given that all your diagnoses have been for anxiety disorders that helps a lot. You just need something for your mixed bag of anxiety that doesn't worsen your attention.

I would try getting rid of the Zyprexa first (because of the prominent antihistamine effects on your attention), if you can handle that and your attention improves, then you might be able to stay with the Effexor (as monotherapy) for your anxiety "mixed-bag". Yes, see about tapering away the Zyprexa and see if your Effexor is good enough (alone) for your symptoms. You may have adjusted to any adverse effects of the Effexor that prompted any addition of Zyprexa to control. I am guessing that the Zyprexa was added AFTER the Effexor got started right? (see here is yet another complication that needs to get straightened out!).





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