Posted by mtdewcmu on April 30, 2011, at 22:06:29
In reply to Re: Strattera for ADD-I? » mtdewcmu, posted by CaffeinePoet on April 30, 2011, at 19:55:28
> Yes, it's been confirmed with blood value tests and positive results from tests for antibodies against the thyroid. When I said it was treated with T3, I said _added_ T3, as in addition to the levothyroxine. The T3 that I took was actually synthetic T3 (Cytomel), not Armour. T3 (lioothyronine) is available as a synthetic. When I took it in addition to the levothyroxine, the symptoms of lethargy, low motivation, low attention greatly improved, but my thyroid value zig-zagged and I developed dizziness, fatigue, migraines, and finally the thyroid eye disease -- all onset within 2 months of starting the Cytomel, improved off the Cytomel. I would not have had Thyroid Eye Disease, btw, unless I had antithyroid antibodies in my system -- it's the same bugger.
>I didn't mean to jump to conclusions. Cytomel is not the usual treatment for hypothyroidism (my mom is hypothyroid). It sounds like it made you hyperthyroid, so it must have been some kind of experiment gone awry. Do you think your doctor misdiagnosed your lethargy and inattention as residual hypothyroidism?
> > > My biggest problem is low motivation. But I am also not getting anywhere in my career because of being late to meetings, interrupting, and procrastination. I feel that I have been overlooked as a possible ADD-I diagnosis in the past because I am fairly smart, and it took several years of failures (job loss, course failures, etc.) after reaching more complex work, for me to seek help.
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> > If your attention problems were already prominent in childhood, then it could be ADD. My life followed a similar track to what you are describing, with problems already apparent in elementary school, that I was able to compensate for more or less, but becoming more intractable later in life.
>
> They were there in childhood. My therapists have trouble piecing out whether they were there in childhood due to untreated hypothyroidism or existed as a separate entity. However, I learn very quickly and was bored in school as a child. "Absentminded professor" was a term that came up a lot.So your therapists think you were hypothyroid all through your childhood? I'm pretty sure that would have stunted your growth or caused some sort of tell-tale deformity.
I was also a bright child but had problems getting work done. A lot of excuses were made on my behalf.
> >
> > > Oh yes, and I have anxiety.
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> > Anxiety and mood disorders can conspire to cause attention difficulties even in the absence of ADD. But the presence of such disorders by no means rules out ADD. In fact, untreated ADD strongly predisposes one to develop secondary anxiety, mood, and substance abuse disorders. I had to suffer through years of having only my anxiety and mood disorder treated, before I got a doctor to take seriously my complaints of longstanding, severe attention problems.
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> I'm glad to hear that this worked out for you! I have had anxiety treated, both with low-dose benzos and SSRI's in the past. Frankly, they did help my anxiety but utterly masked any motivation I had. SSRI's make me feel zombie-like. Knowing that the anxiety has been treated and I still have these symptoms, I realize, gives me a clue about where to go.
>You can go around and around in circles for a long time trying to decide if a little better anxiety control or a little better antidepressant response might finally correct your attention issues. My story is not all that successful; it took about 8 years and a progression of doctors to get to one that let me try treating the inattention with the strongest available meds. I convinced myself for a lot of that time that the occupational problems and chronic inability to get my stuff together was a burden I simply had to bear, and was tied up with intractable depression and irrevocable damage done in childhood. There is never anything you can point to as proof that you have ADD, like a blood test, and many people including psychiatrists will be extremely obliging with stories that attribute your problems to anything other than a disorder that demands stimulants for effective control. It would have been easier to get ADD meds prescribed had you been brought in by a parent when you were a child and could not be guilty of drug seeking. Back when I had insurance, like 6-7 years ago, I raised the question of ADD and was given some computerized test to do where you had to stare at dots and push a button; apparently I did too well to have ADD. I also went to an ADD gathering on meetup.com years ago; I could not see myself in the people I met there, so I convinced myself I must have something different. In reality it is pointless to question if you have "true" ADD as there is no definitive criterion that defines true ADD; I think it would be more helpfully called Amphetamine Deficit Disorder, because it is a disorder in which you are more functional when given amphetamines. It's as simple as that. It finally got to the point with me where I realized that I would never be employed and independent unless something changed, so I put it to my current pdoc in stark terms, and by the grace of god this pdoc was willing to try bringing in the heavy artillery med-wise. My previous doc laughed at me when I suggested Dexedrine.
Of course I've only had the prescription for a few weeks and it is still unproven that I will be able to hold a job and manage an independent existence on this medication. But I believe this is the most promising thing yet tried and has the potential to effect a transformative change.
> > > Now, after a final failure, I am moving on to medication. What do you all think about Strattera? Would you try that first, or would you try to go straight for the stimulants?
> >
> > Strattera benefits fewer people with ADD than either Ritalin or amphetamine. That's not to say that it doesn't work well for those it helps (I assume), but overall it's considered much less effective than stimulants. I have heard that Adderall or Dexedrine (or Vyvanse) are most effective in adult ADD. My experience is that Dexedrine blows all the other ones away for my symptoms.
> >
> > I recommend trying Wellbutrin before Strattera. All Strattera did for me was cause me to sweat more, and cause a mild subjective effect that at the end of the day didn't amount to anything. If your doctor tries to put you on Strattera before stimulants, that usually means that he either A) doesn't trust you with a controlled substance and wants to avoid it at all costs, or B) is susceptible to Lilly's marketing, because the studies have all shown that Strattera is less effective, and therefore should be a second-line treatment for ADD.
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> I think the doctors will hesitate to put me on stimulants because of the anxiety diagnosis -- at least that's how it seems to work in the group I'm working with. And my therapist has been focused on my finding work that 'truly motivates' me, as opposed to the in-demand technical work that I have been doing. However, despite her competence (she has a PhD & seems to really be with it), I don't think she's fully realistic about what it takes to pay the bills -- people might have been able to follow their passions with a degree in anything in the 1970's, but we're not living in that world anymore and only certain things truly pay.
>This is what I meant about people, including doctors and therapists, being willing to invent all manner of rationalizations for why you fail at this or that, other than ADD. A lot of people will consider attributing your problems to a neurological cause as a failure. I actually changed careers 5 years ago, from something technical like you, to something in a health care setting where there was more adrenaline and was far from a dull office cubicle. Unfortunately, my problems followed me to the new career, and it turned out that being unproductive and unaccountable wasn't any more desirable in health care than it was in technology. There comes a time in any career when the initial novelty wears off and it intermittently becomes a chore. I have had people tell me recently that I need to keep looking for the "right" job. Well, normal people are able to do something just because they need to, it doesn't have to also be exciting. Do you suppose that 300 years ago everyone that farmed did it because they were thrilled to be farmers? I doubt it. I'm sure they adapted to it because they needed to.
poster:mtdewcmu
thread:984158
URL: http://www.dr-bob.org/babble/20110418/msgs/984230.html