Posted by med_empowered on July 12, 2005, at 4:40:40
In reply to Re: Anti psycotic with Stimulant?, posted by rjlockhart98 on July 11, 2005, at 22:40:25
hey! The antipsychotic+stimulant combination is used now and then. I used to take Abilify @ 15mgs with Adderall, 60mgs. The combo wasn't great, but I did OK before I changed it. Stelazine is commonly used for anxiety, but on a time-limited basis. The rule seems to be to use as little Stelazine as possible (always under 6mgs) and use it for as little time as possible (the accepted practice is 4months MAXIMUM). The problem is that drugs like Stelazine have LOTS of side effects, even at low doses. Tremors, akathisia (intense feelings of unease and restlessness) are common; neuroleptic malignancy disorder is a problem with all antipsychotics, and tardive dyskinesia is an issue with ALL antipsychotics, including the new atypicals and the old drugs. Low-dose antipsychotics seem to carry a reduced risk of tardive dyskinesia, but the disorder can occur at any dosage level after chronic administration of the antipsychotic. With old antipsychotics, the risks overall (for ALL conventional antipsychotics) were something like this: 3% TD per year of treatment *baseline risk*--the very young, the old, females, and those on multiple medications and those with mood-disorders have a higher risk; at the end of 5 years, at least 20% of patients have moderate to severe tardive dyskinesia. Some estimates put this number closer to 30%; if you factor in "minor" cases of tardive dyskinesia, the numbers could be even higher. At "end-point," or the end of long term (10years+) therapy, the number of patients with tardive dyskinesia is over 50%. I guess my point is that I think using an antipsychotic in someone who isnt psychotic, especially for the purposes of controlling the effects of another medication, is unjustifiably risky. I later used Klonopin for anxiety and to cushion the Adderall a bit; it worked fine, I also used propranolol in low doses strictly on an as-needed basis, and this also helped tremendously. Some other options: meprobamate (supposedly its making a comeback), propranolol, buspar (helped me tremendously), reducing the adderall dosage, using Provigil in place of the Adderall, combining Adderall and provigil or possibly cylert or a stimulating antidepressant, such as Wellbutrin or high-dose effexor/cymbalta, or combining something like Straterra with reduced dosage adderall. Using an anticonvulsant mood-stabilizer, like Trileptal, with the Adderall can also smooth things out. Good luck!
poster:med_empowered
thread:526470
URL: http://www.dr-bob.org/babble/20050708/msgs/526591.html