Posted by medlib on March 8, 2000, at 2:41:33
In reply to Re: The effect on the brain: ADs vs. ADD drugs, posted by JohnL on March 8, 2000, at 2:14:11
Another incredibly useful post--THANKS, JohnL
BTW, my pdoc agreed to a more speeded-up trial of alternatives; your posts provided the impetus I needed to discuss this with him.
Much appreciation,
medlib
> > I've been thinking a lot about ADD and whether or not I might have it. I know that ADD drugs are stimulants, and something about that concerns me. When I was on a stimulating AD, specifically, Wellbutrin, I became paranoid and I believe, psychotic, as well. It was nightmarish and something I would never want to experience again. Do the chemicals in ADD drugs such as Adderall and Ritalin work on the same part of the brain as a stimulating antidepressant such as Wellbutrin? Any information would be appreciated.
>
> From what I've read, stimulants vary quite a bit within their class. It takes a very specific match between the drug and the person's chemisitry to achieve wellness without addiction/abuse. Several people here felt abusive with Ritalin, but then found Adderall to be a better choice.
>
> While common choices are Ritalin, Adderall, Dexedrine, and sometimes Cyclert, other overlooked choices are Ionamin or Tenuate. Tenuate is a diet med that resembles Wellbutrin, but sometimes works great when Wellbutrin didn't. Ionamin is also a diet med. It resembles Dexedrine but sometimes is a better choice.
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> A book I was reading described stimulants as NE/dopamine replacement, to correct NE/dopamine failure. They all have various effects, ranging from stimulating release of neurotransmitters, reuptake inhibition, stimulating receptor sites, increasing blood flow into poorly circulated parts of the brain, and actually replacing failed NE/dopamine due to their molecular structures that resemble NE/dopamine. Very interesting way to interpret it. But just as it is with antidepressants, one may be a perfect match while the others aren't, depending on the person's unique chemistry.
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> When psychosis occurs on a stimulant, the book I was reading says it is because the stimulant is overcorrecting NE/dopamine in certain patchy parts of the brain, and that a small dose of an antipsychotic will rebalance things. I've heard great reports of stimulant+antipsychotic combinations when antidepressants alone were disappointing.
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> This is actually the route I will be trying at my pdoc appointment next Monday. My pdoc is going to give me a 4 day prescription each of Adderall, Dexedrine, Tenuate, and Ionamin. The purpose is to probe for the best match before continuing. The best match he says will be evident anywhere from 24 to 72 hours, but often the very first day. I already know I responded robustly to Ritalin...TOO robust. Need something a little tamer. Short trials of the other choices should identify a superior match, if indeed this is the correct treatment for me. We'll see. But according to my pdoc, he has used stimulants as monotherapy and as augmentations to treat depression for decades, with or without any symptoms of ADD or ADHD. He says a person does not need to qualify as ADHD to be treated successfully with a stimulant for depression.
poster:medlib
thread:26198
URL: http://www.dr-bob.org/babble/20000302/msgs/26337.html