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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Bill on October 4, 1999, at 18:07:13
I know someone currently using Adderol initially prescribed to help severe lethargy (low energy) and general motivation. After a year of use the individual experiences frequent mood swings, agitation, irritability, etc. Also suffering depressing, some have said he should be 'weaned off' Adderol completely in exchange for a more effective anti-depressant (i.e. Prozac). Does anyone have any experience similar to this problem and ultimate remedy? Any information would be helpful. Thanks.
Posted by dove on October 4, 1999, at 18:29:19
In reply to Adderal / Adderol, posted by Bill on October 4, 1999, at 18:07:13
I am currently on Adderall, not long enough to give you any personal examples though. I do have some knowledge about this CNS Stimulant. My Doc believes that it can be combined with SSRI's (Prozac, Paxil ect..) with very positive and stable effects. It can be abused and the outcome can be addiction, along with tolerance. My Doc recommends 40 mgs per day for mild Attention-deficit disorder and if depression accompanies, add a TCA or SSRI.
How much does he take? Is it balanced throughout the day? When is he experiencing the symptoms (i.e. is the worst when the med's wearing off/a.m. or p.m.)? How long has he been taking Adderall (I believe you said one year) and have the amounts remained unchanged during this time period? Was he moody, agitated or depressed before the meds? Has he been diagnosed with any disorders besides Motivation or Lethargy problems?
I know that it is possible for tolerance to build, especially if he has abused the medication but sometimes the meds just need a boost from elsewhere. Maybe he could consider a SSRI or another type of Anti-Depressant and lower the amount of Adderall (or even remove it for a time). This can sometimes cause the CNS Stimulant (Adderall) to get it's "kick" back. So it can work effectively, again. Another idea would be to switch from Adderall to Dexedrine or maybe a stimulating Anti-Depressant.
dove~
Posted by Noa on October 4, 1999, at 18:48:26
In reply to Re: Adderal / Adderol (Adderall), posted by dove on October 4, 1999, at 18:29:19
I wonder about the original scrip for adderall for lethargy. Was inquiry done to figure out why the lethargy? Adderall might address the sleepiness, but probably not the underlying problems. If it is an affective disorder, I don't think adderall is the right med. Is your friend depressed? Does he have a sleep disorder? What is causing the lethargy?
Posted by bill on October 4, 1999, at 18:58:40
In reply to Re: Adderal / Adderol (Adderall), posted by dove on October 4, 1999, at 18:29:19
Thanks for getting back to this issue so soon. I have some of the answers to the more specific questions you mentioned regarding my friend. He takes two pills daily (am and pm), and I'm not sure of the dosage (20 mg. ea.?). The 'moods' have gotten more frequent lately and last longer, but have been at all times, moreso the afternoons and evenings. I believe he has been taking Adderall for about a year now, and I also believe the amounts have not unchanged (I don't believe he is taking more than two, daily). I have only known him for several months and the 'moods', as I said, are more frequent. It gets to the point that he goes into total seclusion and then emerges a totally different person...for a while. Thanks again for the input.
Posted by Bill on October 4, 1999, at 19:02:36
In reply to Re: Adderal / Adderol (Adderall), posted by Noa on October 4, 1999, at 18:48:26
As a follow up to my friend...he has been diagnosed with depression, but is taking no 'anti depressants' in conjunction with the Adderall.
Posted by dove on October 4, 1999, at 19:27:22
In reply to Re: Adderal / Adderol (Adderall), posted by Bill on October 4, 1999, at 19:02:36
20 mgs. twice a day is not too much, that's the 2nd step up from Adderall initiation. I take a bit more and it should be taken a.m., noon and early evening (3x per day) that is the preferable maintenance timing. I am amazed that he has done well on that amount taken only twice a day for so long. We are talking about an Adult? I am bipolar (manic-depressive) and am familiar with mood-swings :-) Introducing an anti-depressant is not ruled out, as the depression could be the guilty party in regard to his mood-swings.
I wish I could offer more. He needs to be honest with his care-giver, even though he may fear the elimination of the Adderall and a quick return to lethargy. Maybe he'll be surprised by the augmentation of the right Anti-depressant (or mood-stabilizer?).
dove~
Posted by Noa on October 5, 1999, at 4:22:39
In reply to Re: Adderal / Adderol (Adderall), posted by dove on October 4, 1999, at 19:27:22
It is surprising to me that the doctor would choose adderall to address the depression. He might want to ask the doctor to explain the choice and share his thought process with him, or even to get a consult from another doctore just to compare approaches.
Posted by saint james on October 6, 1999, at 0:02:24
In reply to Re: Adderal / Adderol (Adderall), posted by Bill on October 4, 1999, at 19:02:36
> As a follow up to my friend...he has been diagnosed with depression, but is taking no 'anti depressants' in conjunction with the Adderall.
James here....
Although stims can be effective AD's they are generally not first or second line meds for depression for a number of reasons. I find it odd
that this doc is starting with a stim, but probably we are not getting the full story.
If is is depression that needs treating an AD, alone or with Adderal, would be a good choice.Stims for the most part are very effective at first in treating depression, but tend to make depression worse in the long run. AD's dam up existing NT's while stims make more avalible, so it can be thought that stims and AD work oppsite
each other, if fact there is evidence that stims deplete AD's if taken together, although the dose of stim is far above the normal used, to cause this depletion.Reguardless of all this armchair psycobabble, the med you riend is taking is not working and something else needs to be tried.
james
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