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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by sac on May 20, 2005, at 5:41:08
Hi, I'm currently on Cymbalta and Lithium to manage bipolar II. I am pretty stable lately but my remaining problem is lack of focus/difficulty concentrating. I struggle to complete a task from start to finish because my brain feels confused thus I have numerous piles of papers, bills, etc. around the house that I feel too overwhelmed to go through and sort out. I used to be very sharp mentally so I don't know how this attention problem crept up on me..I'm only 37 so it shouldn't be old age. Anyhow, my question is does anyone know if stimulants can be used "as needed"? I really don't want to take a stimulant every day but feel that at times, it's really important for me to be able to focus. What is the best stimulant to try? Thanks. -Stacey
Posted by Maxime on May 20, 2005, at 6:40:19
In reply to Can stimulants be used on an as needed basis?, posted by sac on May 20, 2005, at 5:41:08
Hi Stacey. I used to take Adderall XR and I found I could NOT miss a day without getting dizzy and feeling like CRAP. However, since it's no longer available in my country, I take Dexedrine tablets as needed with no problem. I do crash after the last dose, but that would happen anyway. Maybe the Adderall Tablets would act the same way.
That was my experience. Adderall helped me focus more than the Dexedrine does. The dexedrine just helps me with my fatigue. I have tried Ritalin in all forms and it made me cranky and irritable and when it wore off I would even become suicidal.
Maxime
> Hi, I'm currently on Cymbalta and Lithium to manage bipolar II. I am pretty stable lately but my remaining problem is lack of focus/difficulty concentrating. I struggle to complete a task from start to finish because my brain feels confused thus I have numerous piles of papers, bills, etc. around the house that I feel too overwhelmed to go through and sort out. I used to be very sharp mentally so I don't know how this attention problem crept up on me..I'm only 37 so it shouldn't be old age. Anyhow, my question is does anyone know if stimulants can be used "as needed"? I really don't want to take a stimulant every day but feel that at times, it's really important for me to be able to focus. What is the best stimulant to try? Thanks. -Stacey
Posted by Paulbwell on May 20, 2005, at 7:53:33
In reply to Re: Can stimulants be used on an as needed basis? » sac, posted by Maxime on May 20, 2005, at 6:40:19
Yes they can. I started this way with ritalin, but now use it every day, unless i run out (often) when i often become depressed and sluggish, it just kinda progresses, occasional use becomes more frequent until things seem better while on them.
if you want to do this, only have a small amount to use.
Posted by Nickengland on May 20, 2005, at 8:45:57
In reply to Re: Can stimulants be used on an as needed basis? » Maxime, posted by Paulbwell on May 20, 2005, at 7:53:33
Im interested in this subject too.
I thought stimulants should only be used in ADD ~ in the case of adult ADD, is it not the case that to have ADD, unlike other mental disorders which seem to appear in the late teens early 20's....To get an adult ADD diagnosis you need to be able to trace your history that your ADD symtoms started before the age of 7 to warrent first the diagnosis of ADD, and second the use of stimualants?
I guess what I mean is, is it the fact that you don't get ADD in adult life, this is something thats starts in your childhood with the typical hyperactive, restless and disruptive child behaviour?
Also being bipolar too, and yes I sometimes i have problems concentrating..but I thought most bipolars do, seeing as they spend alot of time feeling depressed and difficuly concentrating is a symtom of depression...is it not a case of over-medicating with stimulants for a "concentration" problem which is not clinically ADD?
One of my concerns is also, does taking an amphetamine based stimulant in the case of a bipolar risk a swtich to mania?..therefore making your bipolar condition worse overall?
Like Maxine, you mentioned that you "crash" when your tablets wore off?
Kind regards
Nick
Posted by The Resistance on May 20, 2005, at 11:46:34
In reply to Can stimulants be used on an as needed basis?, posted by sac on May 20, 2005, at 5:41:08
Yes absolutely
In my personal experience using Dexedrine 'on an as needed basis' was prefferable totaking it every day, because tolerance didn't have a chance to build up, and there was less chance of addiction/tolerance.
Having said that I seem not to be prone to addiction.
I was able to dscontinue Dexedrine no problem (Effexor is another story.....)
Some people do find stimulants very addictive, and if your one of them think carefully about your usage.For Nickengland
There is a real stimulant phobia in the UK, and this makes me angry (sorry I can't prettend to be unbiased :)
I certainly think that stimulants should be used with caution, but they can be worth the risk.I was constantly told Dexedrine was addictive, but was able to discontinue it no problem.
No doctor told me Effexor was addictive, but when I stopped taking that I felt very ill!
Posted by Maxime on May 20, 2005, at 12:53:29
In reply to Re: Can stimulants be used on an as needed basis?, posted by Nickengland on May 20, 2005, at 8:45:57
Stimulants are used for various reasons. Sometimes they are use until a new anti-depressant kicks in. Sometime they are used as an anti-depressant. Sometimes they are use to treat the sedation that some AD cause. I use them for fatigue that I still don't know the source of yet.
As for crashing, on Adderall XR I didn't crash. It was smooth. I am sure everyone on PB is tired of hearing me lament about how I can't Adderall anymore. But you have no idea how much it helped ... or more importantly, how it didn't make me worse afterwards.
MAxime
> Im interested in this subject too.
>
> I thought stimulants should only be used in ADD ~ in the case of adult ADD, is it not the case that to have ADD, unlike other mental disorders which seem to appear in the late teens early 20's....To get an adult ADD diagnosis you need to be able to trace your history that your ADD symtoms started before the age of 7 to warrent first the diagnosis of ADD, and second the use of stimualants?
>
> I guess what I mean is, is it the fact that you don't get ADD in adult life, this is something thats starts in your childhood with the typical hyperactive, restless and disruptive child behaviour?
>
> Also being bipolar too, and yes I sometimes i have problems concentrating..but I thought most bipolars do, seeing as they spend alot of time feeling depressed and difficuly concentrating is a symtom of depression...is it not a case of over-medicating with stimulants for a "concentration" problem which is not clinically ADD?
>
> One of my concerns is also, does taking an amphetamine based stimulant in the case of a bipolar risk a swtich to mania?..therefore making your bipolar condition worse overall?
>
> Like Maxine, you mentioned that you "crash" when your tablets wore off?
>
> Kind regards
>
> Nick
Posted by Phillipa on May 20, 2005, at 18:39:15
In reply to Re: Can stimulants be used on an as needed basis?, posted by Maxime on May 20, 2005, at 12:53:29
Isn't wellbutrin used as a stimulant for depression? I too have always been under the impression that to be ADD in adulthood you had to have been in childhood. My son-in-law just went back on ritalin and now he isn't abusing other meds and illegal durgs. At least I think he stopped. Fondly, Phillipa
Posted by Paulbwell on May 21, 2005, at 16:45:28
In reply to Re: Can stimulants be used on an as needed basis?, posted by Phillipa on May 20, 2005, at 18:39:15
> Isn't wellbutrin used as a stimulant for depression? I too have always been under the impression that to be ADD in adulthood you had to have been in childhood. My son-in-law just went back on ritalin and now he isn't abusing other meds and illegal durgs. At least I think he stopped. Fondly, Phillipa
I was diagnosed at 31, many are as adults
Posted by alohashirt on May 21, 2005, at 21:21:34
In reply to Can stimulants be used on an as needed basis?, posted by sac on May 20, 2005, at 5:41:08
I have a good friend JJ.
We are same age, both have ADHD, both married with kids,
similar physical health, both do same line of work and both
don't drug or drink for many years.JJ takes stimulants on an as needed basis, using them depending
on the type of work he has to do. I prefer take them same time each day. If I don't then I would always forget and I'm pretty poor at knowing when I need or don't need. B oth approaches seem to work for us.
Posted by Paulbwell on May 21, 2005, at 23:38:55
In reply to Re: Can stimulants be used on an as needed basis?, posted by alohashirt on May 21, 2005, at 21:21:34
> I have a good friend JJ.
> We are same age, both have ADHD, both married with kids,
> similar physical health, both do same line of work and both
> don't drug or drink for many years.
>
> JJ takes stimulants on an as needed basis, using them depending
> on the type of work he has to do. I prefer take them same time each day. If I don't then I would always forget and I'm pretty poor at knowing when I need or don't need. B oth approaches seem to work for us.
>Hi Ya!
I also need stims, Ritalin everyday, or else are non functional, brain asleep even if my body is awake, which has cost me jobs. It didn't start off this way, but this is how things are now, I fell asleep at work at tea break last week cos i hadn't had my meds since morning, and was late back by 30 mins, luckly it went unnoticed. I am scared i am evolving into a narcoleptic! I get so blasey and tired when off my med.
Heaven help me
Posted by alohashirt on May 22, 2005, at 14:57:48
In reply to Re: Can stimulants be used on an as needed basis? » alohashirt, posted by Paulbwell on May 21, 2005, at 23:38:55
Do you have any concerns that long term med effects (less sleep, for example) might also contribute to your symptoms? I walk around feeling great that I am medicating my ADHD but my work performance and life organization doesn't seem to match my subjective confidence that I can get stuff done. My wife thinks I'm getting worse, not better.
Complicating this is that when I take objective ADHD symptom tests my scores are much higher now, and my life itself is much harder (parent of two toddlers) than it was a few years ago.
So am I getting better or worse? Sometimes I just don't know.
If I don't take meds for a couple of days then I struggle to get out of bed and get going. But is that really an objective test of teh efficcacy of the meds? I don't take them to get out of med, I take them to reduce ADHD symptoms.
I think that what I really need is a butler / man friday who can run around and organize my life.
Thoughts?
Posted by Paulbwell on May 22, 2005, at 16:09:47
In reply to Re: Can stimulants be used on an as needed basis? » Paulbwell, posted by alohashirt on May 22, 2005, at 14:57:48
> Do you have any concerns that long term med effects (less sleep, for example) might also contribute to your symptoms? I walk around feeling great that I am medicating my ADHD but my work performance and life organization doesn't seem to match my subjective confidence that I can get stuff done. My wife thinks I'm getting worse, not better.
>
> Complicating this is that when I take objective ADHD symptom tests my scores are much higher now, and my life itself is much harder (parent of two toddlers) than it was a few years ago.
>
> So am I getting better or worse? Sometimes I just don't know.
>
> If I don't take meds for a couple of days then I struggle to get out of bed and get going. But is that really an objective test of teh efficcacy of the meds? I don't take them to get out of med, I take them to reduce ADHD symptoms.
>
> I think that what I really need is a butler / man friday who can run around and organize my life.
>
> Thoughts?I know what you mean, but i sleep fine-usually, but i get very tired head-sleepy empty, which Ritalin helps, when off it i return to my pre-level, no worse i dont think, The Rit doesn't always work satisfactorily, so we are talking about trying Dextroamphetamine, i envy people who can be alert and brain active all work day. as my sleeptness has often been construed as job-non interest.
Cheers
Posted by alohashirt on May 22, 2005, at 22:06:04
In reply to Re: Can stimulants be used on an as needed basis?, posted by Paulbwell on May 22, 2005, at 16:09:47
Are you in the U.S.? I had heard about Adrafinil, a French medication related to Provigil that can reduce daytime sleepines without stimulation. Apparently the results with ADHD adults
are mixed, but positive for children.
Posted by Paulbwell on May 23, 2005, at 0:29:21
In reply to Re: Can stimulants be used on an as needed basis?, posted by alohashirt on May 22, 2005, at 22:06:04
> Are you in the U.S.? I had heard about Adrafinil, a French medication related to Provigil that can reduce daytime sleepines without stimulation. Apparently the results with ADHD adults
> are mixed, but positive for children.In live in downunder and modafinil is available but expensive,most pharms never have it. we'll see how Dex dose if i hopefully get it or an increase of rit.
Posted by Declan on May 23, 2005, at 20:27:16
In reply to Re: Can stimulants be used on an as needed basis? » Paulbwell, posted by alohashirt on May 22, 2005, at 14:57:48
Edmund White, talking of his mother,said that the cure for mental illness was room service, provided by attractive bell boys with time on their hands.
Posted by alohashirt on May 25, 2005, at 7:10:42
In reply to Re: Can stimulants be used on an as needed basis?, posted by Paulbwell on May 23, 2005, at 0:29:21
In AUstralia is it typical for a psychiatrist to treat ADHD (vs a GP) ?
If you were in the US you'd find modafinil is schedule 4. In Australia you should be able to get Adrafinil, which is 1/6 the cost of modafinil. Look for Biogenesis.
Why so many Australians with ADHD?
I grew up n Perth and am astounded by the number of Perth people on ADHD forums and boards.> > Are you in the U.S.? I had heard about Adrafinil, a French medication related to Provigil that can reduce daytime sleepines without stimulation. Apparently the results with ADHD adults
> > are mixed, but positive for children.
>
> In live in downunder and modafinil is available but expensive,most pharms never have it. we'll see how Dex dose if i hopefully get it or an increase of rit.
This is the end of the thread.
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