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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by becksA on November 22, 2004, at 10:49:57
First off, I'm BPII and am slowly starting lamictal to treat this. Because of this disorder, if the diagnosis is indeed correct, I suffer from depression. However, adderall for my ADD really helps alleviate this and make me more happy, social, comfortable all around. In the morning I take 60mg of Adderall XR at 7am. At 12 it begins to wear off, and my depression starts to hit again, and I take my second dose, 10mg of short acting adderall. I take my final dose at 4 or 5 of another 10mg of short acting.
Problem is, in the morning (I'm almost positive it's from the adderall), I feel GREAT. I'm very upbeat, social, etc. My two afternoon doses of 10mg of short acting adderall help as well, but not nearly as much.
therefore, I'm stuck with feeling 100% from 7-12, then the rest of the day I'm just 75% or so. How does dosing compare with XR and short acting versions of adderall, are the 10mg afternoon doses a bit too low compared to my 60 of XR in the morning?
Thanks very much
Posted by Laree on November 22, 2004, at 16:33:36
In reply to Adderall and Dosing help please!, posted by becksA on November 22, 2004, at 10:49:57
I have ADHD and seasonal aff. depression & have been on Adderall for about 2 years total.
Adderall XR was the first stimulant I ever took for ADHD, and at first it was extremely beneficial--I took 20 mg./a.m. and also felt way better after taking it; however, i would begin "crashing" before the end of my work day and the depression and fatigue that ensued were rough. I talked to my pdoc about it & got switched to regular (immediate-release) Adderall--20 mg./morning & 20 mg./afternoon. This allowed me to be much more flexible with regards to dosing times, and depending on how I felt that day could take the 2nd dose any time before about 3 or 4 p.m.
The regular version of Adderall was a much better fit for me. I have been on it for almost 2 years and it has been the best thing for my ADHD. Oh, and I also take Lexapro (20 mg./day) for the seasonal aff. depression. I have rarely taken the Adderall without an AD (primarily SSRI).
Best,
L.
> First off, I'm BPII and am slowly starting lamictal to treat this. Because of this disorder, if the diagnosis is indeed correct, I suffer from depression. However, adderall for my ADD really helps alleviate this and make me more happy, social, comfortable all around. In the morning I take 60mg of Adderall XR at 7am. At 12 it begins to wear off, and my depression starts to hit again, and I take my second dose, 10mg of short acting adderall. I take my final dose at 4 or 5 of another 10mg of short acting.
> Problem is, in the morning (I'm almost positive it's from the adderall), I feel GREAT. I'm very upbeat, social, etc. My two afternoon doses of 10mg of short acting adderall help as well, but not nearly as much.
> therefore, I'm stuck with feeling 100% from 7-12, then the rest of the day I'm just 75% or so. How does dosing compare with XR and short acting versions of adderall, are the 10mg afternoon doses a bit too low compared to my 60 of XR in the morning?
> Thanks very much
Posted by krem on November 22, 2004, at 18:29:35
In reply to Re: Adderall and Dosing help please! » becksA, posted by Laree on November 22, 2004, at 16:33:36
Becksa, has this good feeling in the am followed by depression in pm always been while you were taking Adderal?
I ask because I've heard of this phenomenon (probably you have too) where people with atypical depression feel best in the a.m. and gradually their mood worsens over the course of the day until it reaches it's "peak" level of depression at night. I think William Styron wrote about this in Darkness Visible.
Anyway, I don't know much about Adderal. Will your doc listen to you about this?
I really hope you feel better soon. I'm sending positive vibes your way.
Krem
Posted by anxiety_free on November 22, 2004, at 21:19:41
In reply to Adderall and Dosing help please!, posted by becksA on November 22, 2004, at 10:49:57
I think the problem could be your depression pattern, as one poster already mentioned, the adderall schedule, or both. I do an even split on my adderall, which seems to be unusual for some reason. Are you on an anti-depressant? If not, I'd push for a tricyclic. They're not usually used in BP, but you're only type II, so it shouldn't be a big deal, and they interact with amphetamines to boost them, so that's a good deal too. You might also want to try using the 20mg XRs and doing a more even split of your dose; out with the 2 10mg dosings, try 40/40 with XR only or something similar. Just an idea. Other than that...you could try spacing out your 60mg xr dose (I'm assuming you're using the 30 XR caps) or inverting the dosing, so you take the ir and then the xrs when those wear off. Just some suggestions...good luck!
Posted by mattw84 on November 23, 2004, at 1:42:06
In reply to Adderall, posted by anxiety_free on November 22, 2004, at 21:19:41
BecksA,
I have tried all sorts of different dosing schedules, etc with adderall. Firstly, I very much so disliked the XR version -- and at that, as another poster mentioned: 60 mg is a very large dose! I believe the PI sheet quotes 30 mg at the max recommended, so with your afternoon boosters you are at a very high dose.
How quickly did you taper up to your current dose?
Additionally how long how you been using adderall?
Do you take 'holidays' or even 'vacations' from adderall?
Do you take any other meds?
Have you ever abused the adderall or any other street or pharmaceutical stimulant? (This is not an accussation -- but might explain some predisposition to drug tolerant side-effects.)
On the one hand you could go all out to restore the adderall's original 'luster' and effect. Like taking a long break, adding supplements and dextromorphan. You might try requesting an increase in the dose -- but unlikely that the doc will go for that IMO. I currently take 10mg generic 3x daily, which seems to create enough anxiety and irritability for me as is -- while conversely helped me to continue diligently through college.Some medications can negate the efficacy of Adderall. I don't believe many official studies have been done to this effect. For example: combining stimulants like adderall with a sedative like a Benzo - or perhaps even a sedating AD or AP might be highly counterproductive. Best of luck!
Matt
Posted by becksA on November 23, 2004, at 12:19:54
In reply to Re: Adderall and Dosing help please!, posted by krem on November 22, 2004, at 18:29:35
krem-
no, my depression cycle isn't like that. it goes down hard around noon, then with the other doses, goes back up a bit, back to around 75% for the rest of the day. But no, it doesn't get worse and worse to the very BOTTOM at the end of the day.
Posted by becksA on November 23, 2004, at 12:23:35
In reply to Re: Adderall, posted by mattw84 on November 23, 2004, at 1:42:06
Matt, I along with that adderall dosing, I take Xanax XR 3mg, which we're going to hopefully taper off if the Lamictal I've started helps. That's it for meds.
Posted by becksA on November 23, 2004, at 12:28:20
In reply to Re: Adderall, posted by becksA on November 23, 2004, at 12:23:35
by the way, nope, no history of abuse.
(can't remember if you said anything about AD's, i've read so many posts, but I've tried every one in the book and they don't work on me) if you didn't' mention it just disregard!
thanks
Posted by CareBear04 on November 23, 2004, at 22:35:23
In reply to Adderall and Dosing help please!, posted by becksA on November 22, 2004, at 10:49:57
hey becks,
i have a similar adderall problem. i'm trying to taper off adderall because it causes too much appetite suppression, but i've been taking 30mg XR in the morning and 15 mg IR around 4 or 5. while the XR definitely doesn't last 12 hours like it's supposed to, it should last more than 5, which is what the IR time of action usually is for me. i think XR and IR dosing should be comparable, though for me, XR is significantly stronger. if XR isn't much stronger or doesn't last much longer for you, maybe you should switch to all IR if for no other reason but that XR is brand-name and much more expensive, while IR is available in generics. i did notice that generic doesn't work as well for me as brand-name IR, but insurance doesn't cover the difference or anything, so XR is much more cost-effective. have you tried any of the ritalin forms like concerta or focalin? concerta was less effective than adderall for me, and focalin is hard to find in US pharmacies, but it's supposed to be very strong. one more thought-- are you on any dopamine antagonists? i'm on xanax and klonopin and i don't think adderall and sedatives necessarily counteract each other, but when i was having bad nausea and was prescribed antiemetics, i stopped taking them because they negated the adderall effect. i think adderall releases dopamine while most antipsychotics block its release. i think dopamine is involved in nausea, so many antiemetics work by blocking it, like reglan, haldol, compazine, and others.
hope this helps some, cb
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