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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by house on April 30, 2002, at 12:05:35
I suffer from generalized anxiety, social anxiety, obsessive thoughts and I think ADD. Is there a stimulant that I can take that will help with my ADD symptoms but not aggrevate my anxiety disorders. I've been taking Klonopin for 6 months or so and notice that my short term memory is shot. Can I do anything to prevent this and if I stop taking the klonopins will my memory impove.
Thanks in advance
Posted by Ritch on April 30, 2002, at 12:44:26
In reply to Two questions regarding klonopin and stimulants, posted by house on April 30, 2002, at 12:05:35
> I suffer from generalized anxiety, social anxiety, obsessive thoughts and I think ADD. Is there a stimulant that I can take that will help with my ADD symptoms but not aggrevate my anxiety disorders. I've been taking Klonopin for 6 months or so and notice that my short term memory is shot. Can I do anything to prevent this and if I stop taking the klonopins will my memory impove.
>
> Thanks in advanceHi,
Klonopin and other benzos do wreak havoc on short-term working memory. I just take my Klonopin at bedtime and avoid taking it during the day (it has a long half-life) because of what you mentioned. You might try taking all of it at bedtime and see if you can "get thru the day" the next day without it. I take it during the day only as needed (and that isn't very often). You could stop the Klonopin and memory will improve-but even a dosage reduction or (timing as above) might be all you need. Before you try a stimulant for your anxiety disorders, you might give an "activating" SSRI a chance (at a lowdose) like Prozac i.e. It worked well for my ADHD symptoms-but I have GERD and IBS and SSRI's just french-fry my GI tract. You might try some nortriptyline (with a reduction in your Klonopin) if you can't hack SSRI's. I doubt if a stimulant by itself is going to "help" anxiety disorders much. You would need something else with it.
Mitch
Posted by JonW on April 30, 2002, at 13:18:03
In reply to Two questions regarding klonopin and stimulants, posted by house on April 30, 2002, at 12:05:35
house,
You might want to try switching from klonopin to an AD like effexor (under the care of your doctor, of course). As far as stimulants go, Provigil would be a good choice as it shouldn't make your anxiety worse and atleast one study shows it effective for ADD. With the classic stimulants, dexedrine is the kindest to me.
The stimulants are not likely to help your memory problems caused by klonopin. If you end up sticking with klonopin you could try adding an Alzheimer's med like Aricept. It's often used to combat SSRI-induced memory problems.Good luck,
Jon> I suffer from generalized anxiety, social anxiety, obsessive thoughts and I think ADD. Is there a stimulant that I can take that will help with my ADD symptoms but not aggrevate my anxiety disorders. I've been taking Klonopin for 6 months or so and notice that my short term memory is shot. Can I do anything to prevent this and if I stop taking the klonopins will my memory impove.
>
> Thanks in advance
Posted by Katalina on April 30, 2002, at 13:55:57
In reply to Two questions regarding klonopin and stimulants, posted by house on April 30, 2002, at 12:05:35
> I suffer from generalized anxiety, social anxiety, obsessive thoughts and I think ADD. Is there a stimulant that I can take that will help with my ADD symptoms but not aggrevate my anxiety disorders. I've been taking Klonopin for 6 months or so and notice that my short term memory is shot. Can I do anything to prevent this and if I stop taking the klonopins will my memory impove.
>
> Thanks in advanceHi there,
I've taken Adderall (30 mgs) for the past 4-5 months and recently added Klonopin .5 per day. I have to say the Adderall was a very good by itself as far as reducing my anxiety and making me more motivated and pleasant and able to get things done. However, adding the Klonopin has helped me relax more and took away and anxiety between Adderall doses. I also take Effexor 75 mgs, although I'm not really sure if I need that, I'm more afraid to stop than anything.
I've heard from quite a few posters that stimulants can ease anxiety. I know for me I am an entirely different person on Adderall . . . happy, efficient not so stressed out and able to do the things that would absolutely kill me to do before with no problems. That in itself reduces anxiety. I don't know if I've ever truly suffered from GAD or Social Anxiety per se, but I have always been very agitated with crowds and noise and people in general. Adderall helps me cope with those things and the Klonopin just kind of smooths things out. I don't know how Adderall would effect someone with severe anxiety problems, but I think if you have mild anxiety stemming from ADD based issues (feeling anxious when shopping because of too many choices, overwhelmed by options and then opt to do nothing), a stimulant could be a very effective anxiety reducing agent.
Just my opinion & experience of course!
Katalina
Posted by katekite on April 30, 2002, at 14:35:30
In reply to Two questions regarding klonopin and stimulants, posted by house on April 30, 2002, at 12:05:35
My pdoc was concerned about me trying stimulants because of my anxiety issues. However it turned out just the opposite of expected, ritalin is more like a heavy dose of valium than anything else. That apparently is an uncommon reaction but is not rare for people with ADD who have 'restless mental energy' instead of hyperactivity. I most likely don't really have an anxiety disorder. Just get a short acting one to begin with in case it does end up worsening anxiety, it won't last too long.
Each stimulant may be very different for you, you would have to try them all (ritalin, dex, adderall) to know how you react.
As I type I'm tapering off my klonopin. Been on it for 9 months and the cognitive effects are annoying and now with stimulants hope I can handle stress differently.
kate
Posted by katekite on April 30, 2002, at 14:48:28
In reply to Re: Two questions regarding klonopin and stimulants » house, posted by Ritch on April 30, 2002, at 12:44:26
I seem to have more GI effects with dexedrine than ritalin. Have you tried all the stimulants and if so which one was easiest on your stomach?
I also found Prozac to help my ADD symptoms a little, just a little, but more than nothing and more than the other main ssris. I also found ssris to wreak havoc on my GI.
As an aside, I really liked moclobemide (ordered from abroad). It ended up being too sedating but helped my ADD symptoms and lessened anxiety. Incidentally it had a extra effect of making sex better than normal. Have seen that in print too, not just normalizing sex but improving it over normal. And no GI effects. I'm curious now about taking it with a low dose of stimulant, heard anything about partial or reversible maois and stimulants, anyone? Probably not a good idea I suppose.
kate
Posted by JonW on April 30, 2002, at 15:17:52
In reply to stimulant side effects, oh and moclobemide » Ritch, posted by katekite on April 30, 2002, at 14:48:28
I've taken moclobemide with stims without a problem. I know many doctors combine classic MAOIs with stimulants. This is contraindicated in the literature but commonly done by experienced psydocs.
Jon
it over normal. And no GI effects. I'm curious now about taking it with a low dose of stimulant, heard anything about partial or reversible maois and stimulants, anyone? Probably not a good idea I suppose.
>
> kate
Posted by paulb on April 30, 2002, at 16:01:34
In reply to Two questions regarding klonopin and stimulants, posted by house on April 30, 2002, at 12:05:35
I posted a similar message once. In fact it was when the site had a guest in and basically the answer is no. Someone suggested provigil as this is supposed to enhance memory and alertness. Also I found Xanax to not have half the problems with memory that I found with Klonopin, really I did. Xanax is more selective for the bz site than Klonopin, targeting the anxiety receptor more.
I know less about the stimulants so cant offer any advice there. Maybe provigil?
Paulb
Posted by Ritch on April 30, 2002, at 23:27:06
In reply to stimulant side effects, oh and moclobemide » Ritch, posted by katekite on April 30, 2002, at 14:48:28
> I seem to have more GI effects with dexedrine than ritalin. Have you tried all the stimulants and if so which one was easiest on your stomach?
Yes!, I noticed that on dexedrine-a lower esophogeal spasm-like thing that SSRi's only seem to cause. However, on Adderall I didn't notice that. It had a relatively strong anticholinergic effect (the l-isomers I guess) and it seemed to "shut down" my gut. I *never* had any IBS symptoms when I was taking Adderall. I am supposed to go on a minitrial of Focalin(dexmethylphenidate) sometime....soon (whenever the pharmacy can get it-I was told it was a big paperwork hassle to even order it due to its CII status-I will check into it tomorrow). You said you didn't get GI distress from Ritalin so that is encouraging.
>
> I also found Prozac to help my ADD symptoms a little, just a little, but more than nothing and more than the other main ssris. I also found ssris to wreak havoc on my GI.
>
> As an aside, I really liked moclobemide (ordered from abroad). It ended up being too sedating but helped my ADD symptoms and lessened anxiety. Incidentally it had a extra effect of making sex better than normal. Have seen that in print too, not just normalizing sex but improving it over normal. And no GI effects. I'm curious now about taking it with a low dose of stimulant, heard anything about partial or reversible maois and stimulants, anyone? Probably not a good idea I suppose.
>
> kateThe moclo+stim thing does sound dicey. I have never tried MAOI's at all. I have a very safety-conscious pdoc. If the Focalin thing doesn't pan out I want to try selegiline, if that can't happen-I don't know-I might have to switch docs-I am tired of going through 33% of *every* year being in major depression for 25 years now....
Mitch
Posted by katekite on May 1, 2002, at 12:42:13
In reply to Re: stimulant side effects, oh and moclobemide » katekite, posted by Ritch on April 30, 2002, at 23:27:06
That's encouraging that you had less GI effects from adderall than dexedrine! I will try it for sure now.... I was going back and forth as ritalin is pretty good except my bp goes a little weird at the peak. I get tired of experimenting and just want to be stable! and then 3 weeks later after I'm stable I want to try new ones. LOL. I really like the energy of dexedrine. The spansule is too long acting for me though. Maybe adderall....
So how is your mood now? You seem pretty good in print. Sorry you have spent so much time depressed. Re the focalin and possible selegiline, I'm curious how it turns out, keep me posted. Selegiline is a neat drug. Focalin: remind me why that and not higher dose ritalin?
kate
Posted by Ritch on May 1, 2002, at 13:48:27
In reply to Re: stimulant side effects, thanks ritch, posted by katekite on May 1, 2002, at 12:42:13
> That's encouraging that you had less GI effects from adderall than dexedrine! I will try it for sure now.... I was going back and forth as ritalin is pretty good except my bp goes a little weird at the peak. I get tired of experimenting and just want to be stable! and then 3 weeks later after I'm stable I want to try new ones. LOL. I really like the energy of dexedrine. The spansule is too long acting for me though. Maybe adderall....
If the dexedrine spansule was too long-acting then I would stay away from Adderall XR. Just the regular Adderall might work Ok (it's cheaper anyhow). I just took one 5mg tab in the morning after I woke up and I felt a little *wavy* during the day, but it lasted until roughly 2 hrs before bedtime and then I crashed and slept great for about seven-eight hours and woke right up. Normally during my SAD episodes (without stimulating AD's or stimulants)I wake up early (sometimes), and drift in and out of consciousness sometimes for hours before I finally get out of bed (sleeping a total of up to 14 hrs a day) and I never ever seem to wake up all day long (perhaps a "clear spot" of about 4 hours in the early afternoon after a pot of coffee). Work is hell-rereading things over and over, making stupid mistakes, total apathy-everything is BORING, wishing that somebody would just shoot me!
>
> So how is your mood now? You seem pretty good in print. Sorry you have spent so much time depressed. Re the focalin and possible selegiline, I'm curious how it turns out, keep me posted. Selegiline is a neat drug. Focalin: remind me why that and not higher dose ritalin?
>
> kate
I feel pretty zippy right now, but that is the time of year it is. Antidepressants trigger mood cycling. Stimulants do not-does that mean ADHD not bipolar? But, I can still have mild hypomania even w/o antidepressants (but very brief and mild). I have never tried the methylphenidate family of products before, BTW. This would be the first time. Methyphenidate and amphetamines affect people differently and sometimes paradoxically from each other from what I have read here at least. IF methylphenidate gives me the focus that Adderall did w/o the nervousness-then that is probably what I will be taking for my SAD episodes.Mitch
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