Posted by Ritch on August 26, 2002, at 13:54:21
In reply to NEED ADVICE - changing doses without doc, posted by Peter on August 26, 2002, at 3:17:01
> Hi everyone:
> My current med combo is 87.5mg zoloft, 750mg depakote, 2mg klonopin, 5-10mg ambien, and adderall. The reason I didn't specify my adderall dose is because I've been altering it without my pdoc's instructions-he's away for vacation. Here's basically what happened: I have mild bipolar/possible ADD/SP; I've been on just about every combo out there. There was a very special reason for combining zoloft with adderall: every time I've been on an SSRI, I've started drinking and drugging heavily and had to be take off of it. My pdoc and I surmised that this was due to an SSRI-induced dopamine deficiency. Adderall had already proven to agree with me in the past except for sometimes exacerbating my anxiety. So we decided that, in combining the two, the zoloft would help my SP and any anxiety caused by the adderall, and the adderall would help ADD/motivation and any 'craving' side-effects caused by the zoloft. Well, I've been on up to 30mg adderall in the past(20mgXR plus evening 10mgIR boost). But before starting zoloft, we tapered the adderall down to one 10mgXR daily. As the zoloft began to take effect, my anxieties improved, but I started to crave stimulation, drink too much, and get lethargic/anxious. My pdoc's last instructions before leaving for vacation was to titrate the zoloft up to 100mg. This is when I took the whole ordeal into my own hands: last Sunday (8 days ago), feeling unmotivated and miserable, I augmented my 10mg adderall XR with three 5mg IR tablets, each 4 hours apart. I noticed a dramatic improvement in my mood/sociability/productivity. The next day I decided to call in a script to th doc's assistant for 10mg immediate-release adderalls, 2-3 a day. Every day since then, I take 3-4 doses a day of immediate release, up to 35mg total. I feel better on the whole, more laid-back yet stimulated. I have some waves of anxiety which a little more klonopin helps. But, the most disturbing thing is that I don't know if what I'm doing is wrong-if I'm abusing the drug or damaging my brain, or, since my pdoc and I have agreed together on a number of 'experimental' med combos in the past, if upping the adderall might be beneficial in the long run, instead of further upping the zoloft to 100mg which might just increase cravings. He has a sub while he's away, but, you know how it is-I don't know the guy & he doesn't know me like my normal pdoc does. I'm really sorry for the lengthiness, but I'd very much appreciate any feedback anyone can give me. Thank you.Peter,
I hope you get through all of the hassles you are currently experiencing. I read one of your posts earlier about L-tyrosine. I was taking it at the beginning of the month for awhile and felt a lot better. Then I stopped it for a week or so, and felt more tired and fatigued. I started it back up a couple of days ago and feel better again. That might be worth a go. Another thing: You mentioned booze cravings and you need the stimulant to make those go away. Have you read any of the posts about Ondansentron? It is pretty expensive, and short-acting (4-6hrs I think). Maybe when you pdoc gets back, you can run it by him. If you get your cravings in the evenings close to bedtime, it might be useful to take one of those instead of taking stims close to bedtime and then getting insomnia. Just some ideas,
Mitch
poster:Ritch
thread:117776
URL: http://www.dr-bob.org/babble/20020821/msgs/117803.html