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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by DiscoPuppy on July 15, 2002, at 16:10:07
. . .and I'm not sure why.
I just changed doctors. He has absolutely no problem prescribing all the Adderall I need for my ADHD but he is completely against prescribing Dexedrine.
Does anyone see any logic in this?
Posted by Gabbi on July 16, 2002, at 23:40:15
In reply to MY NEW PSYCHIATRIST DOESN'T LIKE DEXEDRINE. . ., posted by DiscoPuppy on July 15, 2002, at 16:10:07
I am fortunate to have been patient of a brilliant psychopharmacologist. He's the head psychopharmacologist at two major hospitals, takes on refactory patients, and still NEVER takes more than 30 minutes to return a phone call.
Of course all that in reality could mean nothing, lots of 'famous docs'have done horrific damage. This man however has had much success with refactory patients (me included) and prescribes dexedrine and other somewhat unorthodox med combinations which other doctors have problems with. Sorry for going on I just want to back up what I'm saying.
The point.. My G.P refused to prescribe dexedrine for me after I moved. Apparently the general concern is that it can over time permanently cause a baseline depression disorder by (I think) indirectly increasing cortisol production.
Also my Pdoc said many Dr's tend to moralize medications and have a problem with dex,and others which have an instantaneous effect on your system, and can be considered a "high", while overlooking the potential longterm therapeutic benefit of some.Your psychiatrist may also be unsure if you use "recreational" drugs such as ecstacy, which causes an explosion of dopamine, serotonin, and neuropinephrine, while very likely permanantly damaging the brains ability to produce them, and effect worsened by dexededrine.
That aside, What I gather from my Pdocs information is that if dexedrine is used to augment the usefullness of other medications or at a below 60mg dose for A.D.D there are very few side effects.
That has definately proven to be true for me, I've never been tempted to increase my dose, and it lowers my anxiety, which my G.P flatly refuses to believe.
I am still suffering the disastrous results of adhering to the very appealing sounding "fewer pills policy" of Drs'I've seen since. An insidious recurrence of my disease (major depressive disorder and ongoing battle with suicidal ideation.
(I feel that these side effects more dangerous than a medication which works) and I am simply waiting out the days until my appt, with my original Pdoc.
Thats about as much as I know, but you are not alone in your problem. Its difficult finding one psychiatrist, nevermind looking for another, but unless you can find out from him in detail what his concerns are in your particular case, I would suggest looking elsewhere.I hope that was a little help for such a long answer.
Gabbi
Posted by BekkaH on July 17, 2002, at 8:47:27
In reply to MY NEW PSYCHIATRIST DOESN'T LIKE DEXEDRINE. . ., posted by DiscoPuppy on July 15, 2002, at 16:10:07
I can't understand this. Did your doctor give a reason? I've taken Dex, Adderall and Methylphenidate, and I think Dexedrine is by far the best of the stimulants. Adderall has a much greater effect on the cardiovascular system, while Dex has more of an effect on the central nervous system. If you keep the Dex dose low and take frequent "drug holidays," there should be no problem. Adderall tends to make many people irritable. Dex does just the opposite for me. It helps my depression and it helps me cognitively, while Adderall makes me a nervous wreck. I think it's best to try a week or two of each and decide which is best for YOU. Your doctor isn't taking the meds; you are. By the way, 25% of Adderall IS dexedrine (dextroamphetamine).
Posted by Xevious on July 17, 2002, at 21:33:42
In reply to PSYCHIATRIST DOESN'T LIKE DEXEDRINE - DiscoPuppy, posted by BekkaH on July 17, 2002, at 8:47:27
Hmmm... I just got back from a rather horrible appointment with my supposedly enlightened doc. Brought up dextroamphetamine for the second time, and he responded quite negatively - my intuition suggests that it was a moral judgement - and insisted that Adderall works better for *all* adults with ADD. I stood my ground and politely pointed out that I couldn't tolerate methylphenidate AT ALL, and the side effects from the Adderall were similar in the first few hours, and that perhaps the pure dextroamphetamine would work as well as Adderall, minus the perepheral nervous system stimulation.Well, he grumbled something about never having heard that in his five years of treating ADHD, scribbled out a script for generic dextroamphetamine and left the consulting room in a huff, completely neglecting to write a renewal prescription for my hypertension medication.
Needless to say, I am currently shopping for a new physician... :(
Posted by DiscoPuppy on July 17, 2002, at 21:47:27
In reply to Re: PSYCHIATRIST DOESN'T LIKE DEXEDRINE - DiscoPuppy, posted by Xevious on July 17, 2002, at 21:33:42
Omigod, your doctor must be a twin brother (or sister) of mine. Only difference is that he did NOT write me up a script of Dexedrine. I've been helped greatly with Adderall; he's seen my papers containing history of my progress through months of counseling. I just can't stand that I'm still so damn irritable, frustrated and anxiety stricken all the time, which is why I asked him if I can go back to the Dexedrine that my old doctor prescribed me.
In any event, I suppose the benefits of having my ADHD treated with Adderall greatly outweighs the negative symptoms of my ADHD and my inability to get my doctor to prescribe me Dexedrine.
>
> Hmmm... I just got back from a rather horrible appointment with my supposedly enlightened doc. Brought up dextroamphetamine for the second time, and he responded quite negatively - my intuition suggests that it was a moral judgement - and insisted that Adderall works better for *all* adults with ADD. I stood my ground and politely pointed out that I couldn't tolerate methylphenidate AT ALL, and the side effects from the Adderall were similar in the first few hours, and that perhaps the pure dextroamphetamine would work as well as Adderall, minus the perepheral nervous system stimulation.
>
> Well, he grumbled something about never having heard that in his five years of treating ADHD, scribbled out a script for generic dextroamphetamine and left the consulting room in a huff, completely neglecting to write a renewal prescription for my hypertension medication.
>
> Needless to say, I am currently shopping for a new physician... :(
Posted by BekkaH on July 18, 2002, at 1:06:42
In reply to MY NEW PSYCHIATRIST DOESN'T LIKE DEXEDRINE. . ., posted by DiscoPuppy on July 15, 2002, at 16:10:07
It's probably just the stigma of Dexedrine and amphetamines that your doctor is scared of. Of course, Adderall has more amphetamines than Dex, but Adderall has been aggressively marketed as an ADD med, while Dex has been around for many years, and was used and abused for all sorts of NON-therapeutic purposes. If the makers of Dexedrine were smart, they'd make a high-tech, Concerta-like, sustained release version of Dexedrine, They'd repackage it and RENAME it. How about calling it DEXADDAL? They could spend millions of dollars on ad agencies and PR
people to advertise how effective it is for ADD, treatment-resistant depresssion, antidepressant augmentation, etc., and then it would become socially acceptable and doctors wouldn't be so scared to prescribe it.
Posted by BekkaH on July 18, 2002, at 1:34:55
In reply to MY NEW PSYCHIATRIST DOESN'T LIKE DEXEDRINE. . ., posted by DiscoPuppy on July 15, 2002, at 16:10:07
Hi again. Tell your un-enlightened pdoc to imagine that Dexedrine has just been repackaged, renamed and newly marketed as either "DexADDal" or "ADDedrine." Now he won't be so afraid to prescribe it.
You might also remind him that, unlike most of the ineffective, wimpogenic drugs that are being marketed (like all those SSRI Prozac wanna-be's), Dexedrine is "tried and true." It has been around for at least 50 or 60 years (correct me if I'm wrong). Dexedrine is a known quantity. We know what's good about it, and we know what's bad about it. Now contrast that with SSRI's, which have been on the market for only 10-12 years or so. Every few weeks, we learn of new adverse reactions from SSRIs, some of which might be permanent (movement disorders, for example). The "addiction" potential of Dexedrine is probably not any worse than than tolerance and poop-out that occur on nearly every other antidepressant. And, as far as "withdrawal" from Dex is concerned, it's probably not any worse than the "discontinuation syndromes" caused by WITHDRAWAL from more benign-SOUNDING drugs like Effexor and Paxil.
This is the end of the thread.
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