Posted by pseudoname on October 29, 2005, at 11:02:53
In reply to ADHD?, posted by zeugma on October 29, 2005, at 6:00:35
zeugma, I appreciate your post very much.
I had not heard ADHD described as reward-system related, but then, I haven't paid much attention to ADHD. (Er, no pun intended.) But this is a very interesting idea.
I've never been diagnosed with ADHD and I don't have trouble concentrating or sticking to task -- EXCEPT when anticipation of success (and the foul reaction that may follow it) scares me off.
And the only thing in 18 years of drug treatment for depression that has helped me was Ritalin! But I develop tolerance to it quickly and had to keep upping the dose, and it has a crash period when it wears off every day that's awful. I haven't tried the newer, longer-lasting versions.
I've recently tried Adderall XR, which I take sparingly and have not gotten caught in tolerance with. It also doesn't give me a bad crash afterward. I only take it on horribly depressed mornings, and I haven't been paying any attention to whether it affects the post-achievement foulness. It does not seem to improve things in the same way that Ritalin did. I will start paying attention to those aspects. Maybe I should give Ritalin another go.
> The last paragraph of your post is the giveaway. Dopamine governs immediate responses.
I've tried Wellbutrin a couple times over the years, hoping to boost the dopamine side, but except for helping me sleep much better (an unusual effect, I guess), it didn't help. Maybe I should consider combining Wellbutrin and a stimulant. Anyone have experience with that?
> Strattera has an opioid effect that made me very, very depressed after a while.
I haven't tried Strattera. I wonder what the bad opioid effect was. I don't seem to find anything Googling <strattera opioid>.
> One theory (Hermann van Praag's) hold that norepinephrine is responsible for the level of reward experienced through activities
I assume all the transmitter flavors are interconnected in most responses and that as individuals we may have a dysfunction along any particular line. Tweaking one type may catalyze others, or something like that. So I don't rule out anything. But neither SSRIs, NRIs or Wellbutrin have helped me.
Incidentally, I just found that von Praag has ideas about psychiatric diagnosis that I endorse: he's against diagnositic splintering, for the patient's subjective experience, and for focusing on functional impairments. Amen.
> Sorry, if I am incoherent, have a lot on my mind right now myself...
Far from incoherent. I appreciate you taking the time to pass these thoughts on to me. You've given me a lot to look into; I am more hopeful now.
Please take care and hang in there.
poster:pseudoname
thread:572130
URL: http://www.dr-bob.org/babble/20051024/msgs/573022.html