Posted by Ritch on May 29, 2002, at 0:09:51
In reply to ADD and Comorbid Disorders; Expert Advice PLZ!, posted by azurebay on May 28, 2002, at 19:58:40
> Hi All,
>
> Serious subject, yet I think a lot of us experience it. This is where I definitely would appreciate some expert (as in "experienced") advice from those of you who have posted here much longer than I.
>
> Here is my in-a-nutshell-bio/history:
>
> 1. Diagnosed with ADD/ADHD as an adult in my 30's. Neurostimulant meds helped tremendously as did therapy. Honestly guys, there's no question about this Dx cause it's saved my life with neurostimulant meds!
>
> 2. As I became more in touch with the more inner things, feelings, and the whole of what had transpired over the years, I realized (over the course of 3 years with a good pdoc) that comorbid disorders were also a part of ME - just the biochemical, flesh and bones package, so to speak.
>
> 3. It became self-evident that a deeply rooted anxiety disorder, then subsequent depression was a distinct characteristic of my life since... OMG...say 9 years old! Which came first, the chicken or the egg, who knows lol.
>
> 4. The psychiatrist began exploring various medical/therapeutic alteratives to these newly emerging discoveries. At first we tried SSRI's, that were by in large a huge disappointment for the depressive aspect... with the exeption of Celexa and Effexor. Having done my research on both, it's not difficult to see why these, particularly Effexor, would work in an ADD/ADHD case.
>
> 5. For the past six months, however, I've felt as if I'm dying inside again (sigh)... panic, anxiety, sincerely working through life's crazy stuff, long story. We have literally exhausted the benzo's including Klonopin, Atavan, Valium, Librium, Serax (blah blah blah)... oh, and let's not forget the beloved Xanax *smiles*. The best of these were Klonopin and Xanax, with best results using Xanax at higher doses.
>
> 6. Despite all this bio-chemistry crap, I have been mostly functional, yet still off my game - a freelance writer, into good nutrition, solid research, yoga, mediation, etc. - doing pretty well overall, just still not exactly whole or healing.
>
> 7. Today the doc (an older doc with an open mind and lots of experience) suggests we try something different: Zyprexa. He bases this upon results with patients who have a chronic, low-level anxiety, and research supporting this class of drugs use for at least a trial at low doses.
>
> So, does this sort of scenerio ring a bell for any of you? Any thoughts, advice, alternatives, ideas?
>
> I'll certainly try the Zyprexa beginning tonight because frankly I have nothing to lose, and I rarely have serious side-effects from medications.
>
> Your thoughts and posts are deeply appreciated!!!
>
> Azure
Hello,Got a question: Just what meds are you currently taking right now? That is very important when you are asking us about experiences with med combinations (vis a vis your current symptoms). It *sounds* like you tried stimulants for ADHD and they helped you focus and pay attention to your environment and other people. BUT, after a time you had unresolved mixed anxiety/depression problems? Then you tried Celexa and Effexor and they helped your depression? Then your docs have added benzos to help with residual anxiety problems/panic? So, you are now at this place where you could see an "all-in-one" medication like Zyprexa taking the place of all of your other meds? Atypical (newer) antipsychotics are very helpful for many (and for multiple symptoms like you mention), but if you don't have *psychosis* you may be taking unnecessary risks that you may not need to take, such as irreversible movement disorders like tardive dystonia and tardive dyskinesia. Many will pooh-pooh that risk, but it is definitely there and very real. Not only that, if you have a primary mood disorder (anxiety, depression, bipolar) those risks are greater than for the general population. I got dystonic reactions from Risperdal and Seroquel that took several *months* to fade, and that was at very tiny doses. Zyprexa and *all* medications that block dopamine receptors also effect various hormone levels resulting in weight gain, sleep changes, blood sugar changes, etc. You may easily wind up with the side effects of several meds in one pill as well! Zyprexa is the most sedative of the newer antipsychotics and has a very long half-life of elimination. It will tend to reduce the effectiveness of any psychostimulant you may be taking for ADD. Antipsychotics generally are poor antipanic agents as well. It sounds like you might be better off with an antidepressant that helps your ADD (like the Celexa or Effexor you mentioned), and reduces panic as well. Maybe the psychostimulants you are taking could be reduced or eliminated as a result-possibly reducing anxiety further.
Mitch
poster:Ritch
thread:107891
URL: http://www.dr-bob.org/babble/20020525/msgs/107911.html