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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Santander on June 20, 2006, at 17:20:32
Hello, I am a new poster who has been lurking for a while and I have a question regarding which ADs work best in concert with stimulants. In particular I am taking dexedrine 20mg BID for ADD and have had great success with improved focus, concentration, and motivation - better than MPH formulations, Adderall, or strattera.
As a little background, I have underlying depression, and have for years which has been treated with varying results with countless SSRIs, SNRIs, and TCAs; as well as CBT and talk therapy. I was treated for the depression BEFORE the ADD and gave up on ADs prior to starting the stims. This depression is definately endogenous, and it is there with or without stimulant treatment.
In the past I have also been on benzos for anxiety (both GAD and SAD) and I did get some relief. I do also get a bit of anxiety when the Dex levels in my system are decreasing (time release formulations have no impact on this btw) which benzos worked for as well. However, after much thought I would like to try to stablize all of my comorbid conditions without benzos, as due to my profession, I cant afford to have any negative effects to my memory/judgement/cognition.
So, in short, what ADs have worked well with Dex or other stims for you folks? Which ADs function well in their antidepressant role in the presence of a stimulant and "smooth out" the overall stimulant action/rebound anxiety? Any insight or experiences are greatly appreciated!
Thanks
Posted by Ripley Snell on June 20, 2006, at 20:55:01
In reply to ADs that compliment stimulants?, posted by Santander on June 20, 2006, at 17:20:32
Oooh, I could go on and on on this topic! Being bipolar, I need mood elevation . . . yet in a stable way; I need stimulation . . . yet in a calm way.
I have found that the most calming ("sedating" isn't the word) ADs--this is just me speaking--are Remeron (mirtazapine), Paxil (paroxetine), and Lamictal (lamotrigine).
The antimanic (and, it's seeming, antidepressant, though I don't get that effect) Seroquel is good for "taking the rough edge off" a stimulant that might make me too (hypo)manic.
There's a nickname for Remeron and Effexor together, by the way: "Rocket Fuel." But those are just antidepressants; it would seem that maybe three agents would be good--the stimulant you're taking, an AD, and a mood stabilizer that has AD action, such as Lamictal.
The other approach is to see if you can get the effect you're getting from the stimulants instead from another agent. If it's activation you need, you might stop (slowly) the stimulants and take an "activating" AD--the combination of Remeron and Effexor I spoke of earlier, or EMSAM, or another MAOI, or even Paxil (with or without Effexor).
Best of luck!
Posted by PsychoPharmaFiender on June 21, 2006, at 0:51:57
In reply to Re: ADs that compliment stimulants?, posted by Ripley Snell on June 20, 2006, at 20:55:01
Lamictal is definitely the best AD to mix with a stimulant
Posted by santander on June 28, 2006, at 15:26:34
In reply to Re: ADs that compliment stimulants?, posted by PsychoPharmaFiender on June 21, 2006, at 0:51:57
> Lamictal is definitely the best AD to mix with a stimulant
Thanks for the replies. I will look into Remeron.
Lamictal gave me profound tremors, as well as bouts of uncontrollable rage. I can't imagine how much worse those would be on Dex+Lamictal lol.How are Zoloft or Prozac with stimulants?
This is the end of the thread.
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