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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by jealibeanz on April 21, 2007, at 0:12:19
So, right now, my medications include:
Provigil, 200mg b.i.d. - fatigue
Ritalin LA, 30 mg b.i.d. - ADHD
Lunesta, 3mg - insomnia
Xanax XR, 3mg - GAD!!!!
Reactions:
I have no major complaints with the Lunesta or Provigil. The Lunesta has almost always worked well for the past year and a half. The Provigil gently wakes me up in the morning and keeps me going at noon.
I tried Ritalin LA after Concerta, 54 mg, because oddly enough, it only lasted 3-4 hours. I never thought Ritalin LA worked well. I started with 20 mg b.i.d. It only worked for about 2-3 hours, then quit. My dosage was increased to 30 mg b.i.d. There was no benefit. The only reason why I'm not going back and complaining that it's not working is because Provigil was added. So now, I don't even know how much the Ritalin help, and I'm no longer crashing from it because Provigil masks that effect.
I do think that Ritalin LA increases my anxiety. I stopped recently for 2 weeks, then went back on. Last week was absolute hell. I'm much better now. Hitting my body hard with a strong stimulant dose was a shock to the system!
I hate hate hate Xanax XR. Xanax works, XR doesn't. Not at all. Continuing to take it is pointless.
My proposal:
I've begun to consider asking to try Strattera again, in exchange for Ritalin LA. Strattera used to help a decent amount with concentration in the first few months, then faded off to nothing by month 6. I was on 60 mg. I know it initially made me tired for a day or two, but wore off. After that, I think it increased energy, at least for a few months.
Maybe I should have increased to 80 or 100 mg. I may ask about this med.
I am slightly afraid of giving up the stimulant because I need to be alert and functional, but he doesn't have a problem prescribing them, so I guess I could try Strattera and then switch back if I need to.
I thiiiink Strattera was slightly depressing/dulling. I remember after d/c'ing, that I felt like I'd lost my real personality. Hmm... won't be able to remember til I try again.
Annnnd of course I'd love to have Xanax back instead of XR. That's probably a pipe dream. I hardly see the point in suggesting it. I do however, see a point in just stopping the ridiculous XR, even if it means no other anxiety med.
Posted by rjlockhart on April 21, 2007, at 1:03:16
In reply to Thinking of a med swap, posted by jealibeanz on April 21, 2007, at 0:12:19
Tell your doctor Xanax XR polietly is not working, i need something that works quick and effiencint.
Dont go on strattera, i hated it, i still hate it. I have been on
Adderall 60mg - with wellbutrin 450mg that was a living hell.
then Switch to
Dexedrine 40 and prozac - much betterNow only on Prozac - helps some with personality.
My posting days are up.
Rj
Posted by crenshaw387 on April 21, 2007, at 2:14:29
In reply to Thinking of a med swap, posted by jealibeanz on April 21, 2007, at 0:12:19
have you tried klonopin instead of xanax? it was much better for me as i have the same problem my body metabolizes everything super fast... ive done the methylphenidate thing and the mixed salts ampetamines and then i tried dexedrine spansules and they are far superior... much smoother and a lot less jangly...
Posted by jealibeanz on April 21, 2007, at 3:45:39
In reply to Re: Thinking of a med swap, posted by rjlockhart on April 21, 2007, at 1:03:16
> Tell your doctor Xanax XR polietly is not working, i need something that works quick and effiencint.
>
> Dont go on strattera, i hated it, i still hate it. I have been on
>
> Adderall 60mg - with wellbutrin 450mg that was a living hell.
> then Switch to
> Dexedrine 40 and prozac - much better
>
> Now only on Prozac - helps some with personality.
>
> My posting days are up.
>
> Rj
>Your posting days are up? Was that directed at me? You certainly can make the choice to not repsonse to mine or anyone else's threads.
- I've told my doctor before that the Xanax XR doesn't work. I will again. It's not the short on-set that I miss, it's the lack of on-set that I hate with XR. I'm not sure it's in my best interest to ask for immediate gratification, since he seems to be looking toward tapering me off.
- I've been on Straterra before. I didn't hate it. I remember being very impressed after a few days with my productivity.
- I'm not sure what you mean by "Prozac helps some with personality." People who don't like their personality should try this drug? I'm fine with the one I have.
Posted by jealibeanz on April 21, 2007, at 4:16:51
In reply to Re: Thinking of a med swap, posted by crenshaw387 on April 21, 2007, at 2:14:29
> have you tried klonopin instead of xanax? it was much better for me as i have the same problem my body metabolizes everything super fast... ive done the methylphenidate thing and the mixed salts ampetamines and then i tried dexedrine spansules and they are far superior... much smoother and a lot less jangly... <
Yeah, I've tried Klonopin twice. I never liked it. It was very dulling and sedating. I had trouble with coordination. It lowered my mood. I was prescribed 2 mg/day, but nevvver could take more than .25-.5 mg. I'm sure I could handle more now since I've been taking Xanax for a year.
Adderall made me hot, cold, nauseous, shaky, and aggitated.
The combination of Klonopin + Adderall threw me hard and fast into crying spells and a horrible depression. The thought of either drug makes me very uneasy. It never happened when taking them separately, but I don't want to try again!
I don't think that methylphenidate is terrible with me, but I don't love the way Concerta and Ritalin LA metabolize. The forms I've tried were very short is their duration. I think the controlled release mechanisms don't always work as smoothly as they should. Concerta has 3 different releases. For all I know, only 1 or 2 "compartments" were opening. It would sure explain some things.
I too metabolize medications quickly. I need to take fairly high amounts of alprozolam, modafinil, and methyfenadate for them to be effective. That's too bad since they're all controlled drugs and nobody really wants to push the dose in to the upper limits, especially with a small female.
Are dexedrine spanules a controlled release formation? I have no idea what a spanule is!
Posted by Phillipa on April 21, 2007, at 10:14:38
In reply to Re: Thinking of a med swap » crenshaw387, posted by jealibeanz on April 21, 2007, at 4:16:51
Spanule? I think it's a capsule you open up and sprinkle little beads on your food. I'm not sure if you have to open them and sprinkle may be able to take in the capsule. Have you considered valium? Just a thought. Love Phillipa
Posted by jealibeanz on April 21, 2007, at 12:13:06
In reply to Re: Thinking of a med swap » jealibeanz, posted by Phillipa on April 21, 2007, at 10:14:38
> Spanule? I think it's a capsule you open up and sprinkle little beads on your food. I'm not sure if you have to open them and sprinkle may be able to take in the capsule. Have you considered valium? Just a thought. Love Phillipa
I haven't considered Valium. I don't know... I'm just not sure I'd ever want to ask about it. Although I know that all benzo's are fairly similar, I also know that Valium is known as a "sedative" by the medical community... much more so than the others. I don't think the stigma that was created around it has really gone away.Many newer docs are reluctant to prescribe benzo's, but if they did, it seems like Klonopin, Xanax, and Ativan are their drugs of choice.
Posted by lymom3 on April 21, 2007, at 22:41:18
In reply to Re: Thinking of a med swap, posted by jealibeanz on April 21, 2007, at 12:13:06
Dexedrine spansules kicked my insomnia into high gear. Adderall worked the best for me but made me really mean. Focalin XR worked well too but made me depressed. I didn't like Metadate or Daytrana and take 60mg of Ritalin LA. It works ok but not great. I really wish the Adderall didn't make me such a total crab. Dexedrine does work well, it is related to Adderall but my body just can't tolerate it for whatever reason. I tried Strattera but it made me throw up every morning. I stuck with it for about a month and truly that is the only thing that I remember about it is how bad I felt every day. Good luck to you. How abour Ativan, have you tried that?
Posted by crenshaw387 on April 21, 2007, at 22:57:47
In reply to Re: Thinking of a med swap » crenshaw387, posted by jealibeanz on April 21, 2007, at 4:16:51
> > have you tried klonopin instead of xanax? it was much better for me as i have the same problem my body metabolizes everything super fast... ive done the methylphenidate thing and the mixed salts ampetamines and then i tried dexedrine spansules and they are far superior... much smoother and a lot less jangly... <
>
> Yeah, I've tried Klonopin twice. I never liked it. It was very dulling and sedating. I had trouble with coordination. It lowered my mood. I was prescribed 2 mg/day, but nevvver could take more than .25-.5 mg. I'm sure I could handle more now since I've been taking Xanax for a year.
>
> Adderall made me hot, cold, nauseous, shaky, and aggitated.
>
> The combination of Klonopin + Adderall threw me hard and fast into crying spells and a horrible depression. The thought of either drug makes me very uneasy. It never happened when taking them separately, but I don't want to try again!
>
> I don't think that methylphenidate is terrible with me, but I don't love the way Concerta and Ritalin LA metabolize. The forms I've tried were very short is their duration. I think the controlled release mechanisms don't always work as smoothly as they should. Concerta has 3 different releases. For all I know, only 1 or 2 "compartments" were opening. It would sure explain some things.
>
> I too metabolize medications quickly. I need to take fairly high amounts of alprozolam, modafinil, and methyfenadate for them to be effective. That's too bad since they're all controlled drugs and nobody really wants to push the dose in to the upper limits, especially with a small female.
>
> Are dexedrine spanules a controlled release formation? I have no idea what a spanule is!
>yes dexedrine is dextroamphetamine in a controled release capsule... for me they last about 5 hours but supposedly theyre supposed to last 10 or something.... adderall also has dextroamphetamine but several variations and also variations of the levo isomer as well... i didnt like adderall or ritalin but dexedrine is very smooth and clear for me and doesnt provoke any anxiety like others did... =]
Posted by jealibeanz on April 22, 2007, at 0:18:57
In reply to Re: Thinking of a med swap, posted by lymom3 on April 21, 2007, at 22:41:18
> Dexedrine spansules kicked my insomnia into high gear. Adderall worked the best for me but made me really mean. Focalin XR worked well too but made me depressed. I didn't like Metadate or Daytrana and take 60mg of Ritalin LA. It works ok but not great. I really wish the Adderall didn't make me such a total crab. Dexedrine does work well, it is related to Adderall but my body just can't tolerate it for whatever reason. I tried Strattera but it made me throw up every morning. I stuck with it for about a month and truly that is the only thing that I remember about it is how bad I felt every day. Good luck to you. How abour Ativan, have you tried that?>
No, I've never tried Ativan, only generic clonazapam, generic alprazolam, Xanax, and Xanax XR.I don't really think I have a choice anymore! I used to, but not now. I'm not really sure why I bother to learn about other treatments because my doctor seems pretty intent on keeping things as is, or leaning toward "safer" options.
I just don't know about stimulants anymore. I need them to be awake, but I haven't found anything I'm pleased with. Yet, again, I no longer feel like I have the option of switching around. I definitely don't want to suggest medications anymore. This all seems rather pointless and hopeless at the moment.
All I really have to say to my doctor right now is: "I don't like this, and this, and this." That's all. Pretty annoying/frustrating for him... and me.
I'm tired of having to put drugs in my body to fix my messed up brain, and have minimal success. What's hard also is that people tend to think I don't need anything, because I'm intelligent and have a good personality, family, life accomplishments and such ... whatever... this doesn't mean I'm well.
I'd probably have to start lying and tell people I couldn't pass high school, never had a job, and act incredibly nervous/shaky in order for anyone to take me seriously.
Here's my smile at the end of a very negative post. :)Thanks to all for the comments.
This is the end of the thread.
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