Posted by jealibeanz on February 28, 2007, at 4:36:06
In reply to Re: My latest cocktail... » jealibeanz, posted by Phillipa on February 27, 2007, at 21:17:14
> I heard the long acting xanax doesn't release properly from my pdoc and she has to let people take the regular xanax in between doses. Doesn't make sense does it. But how does an ADD med and A downer like xanax work? Don't they counter each other? Love Phillipa I just don't understand the psychopharcology of these meds together.
Good question. I have seen a few doctors who thought it was ridiculous for my to be taking a stimulant (Provigil and Straterra), a benzo (Klonopin... yuck!), and a sleep aid (Lunesta). If you're a doc who actually treats ADHD patients, you wouldn't be shocked to hear this or to prescribe the medications.In actuality, it's quite common. I had a classmate with ADHD. Anxiety and insomnia are very common comorbities with adults.
The medications work on different parts of the brains. For some people, these combs would be ridiculous and "cancel each other out", for others they work like a charm.
ADHD meds are stimulating. The amphetemine-like stims tend stimulate dopamine from the frontal cortex, some work in other areas. Straterra also is a norepinephrine reuptake inhibitor. Provigil is one of those "unknown mechanism" drugs. At one point that came out saying they had a theory, then retracted it. It does however promote wakefulness (and in my case, it increased anxiety, and I increased Xanax!).
But the fact that the ADHD meds may cause an increase in anxiety doesn't mean that they cancel out in meds, in just means that it's a side effect or that they are possibly uncovering an unlying anxiety disorder.
Benzo's, as I'm sure you know cause more GABA to stick around in the brain. They are anxiolytic and I believe target all regions of the brain.
In some very anxious people they may help concentration because the patient is no longer focusing on the nervous/racing thoughts. In others they may be counter-productive. I think Klonopin would be counter productive with me, because it just knocks me out cold, no matter the dose, and I feel "dumb".
Also, stimulants don't always last long enough for the to effect sleep. In my case, and in the case of many others, we "crash" in the late afternoon/evening when the stim wears off. Sleep aids are common because the patient suffers from anxiety-related insomnia and racing thoughts (probably for that unorganized ADHD brain that bolts around from idea to idea). But in my opinion, the insomnia is rarely caused by the stimulant.
Does this make sense and help?!
poster:jealibeanz
thread:736818
URL: http://www.dr-bob.org/babble/20070224/msgs/736980.html