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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Mr.Scott on August 14, 2005, at 1:18:46
Can anyone here say they have maintained benfit from using methylphenidate or amphetamine for depression of any sort, or for chronic fatigue?Or is it a forgone conclusion that tolerance develops and either the dose is pushed, or the therapy is switched?
Interested to hear your responses.
Scott
Posted by Paulbwell on August 14, 2005, at 2:08:28
In reply to Sustained benefits from stimulants, posted by Mr.Scott on August 14, 2005, at 1:18:46
>
> Can anyone here say they have maintained benfit from using methylphenidate or amphetamine for depression of any sort, or for chronic fatigue?
>
> Or is it a forgone conclusion that tolerance develops and either the dose is pushed, or the therapy is switched?
>
> Interested to hear your responses.
>
> Scott
Iv taken Ritalin for 1.5 years and combined with Zinc and other suppliments, effectivenesss has stayed, althought dose has risen. I have read of people using Stims for many decades with effective results. An acquantaince took Desoxyn Gradumets (Methamphetamine Hcl)-Narcolepsy, 15mg tabs 4-5 for near 40 years with satisfactory results. people chasing a high not wanting ailment control often raise doses.
Posted by linkadge on August 14, 2005, at 4:36:15
In reply to Re: Sustained benefits from stimulants, posted by Paulbwell on August 14, 2005, at 2:08:28
I think that the combination of lithium and a stimulant may help to prevent tollerance.
One mechanism of stim tollerance is a lowering of brain n-acetyl-aspartate with long term use.
Lithium can reverse this effect, but will markedly reduce many of the subjective effects of a stimulant.
I don't know many good cases unfortunately. I don't know anyone who has taken it as prescribed.
Linkadge
Posted by Mr.Scott on August 14, 2005, at 14:16:20
In reply to Re: Sustained benefits from stimulants, posted by Paulbwell on August 14, 2005, at 2:08:28
Thanks!
Sometimes its difficult to differentiate the subtle initial high from the effect of antidepressant/anti-fatigue/increased concentration.But either way...I'm not interested in addiction. That will make everything 100x worse. I just hope I'm not getting myself into trouble by thinking something will work and then it won't anymore.
Scott
Posted by Mr.Scott on August 14, 2005, at 14:17:53
In reply to Re: Sustained benefits from stimulants, posted by linkadge on August 14, 2005, at 4:36:15
Hi and thanks for responding!Do you mean that most people tend to chase the high when you say most people don't take as prescribed?
Scott
Posted by linkadge on August 14, 2005, at 18:00:38
In reply to Re: Sustained benefits from stimulants, posted by linkadge on August 14, 2005, at 4:36:15
I just don't know anyone personally who has taken their stimulant as directed.
I knew a lot of people in school who were on ritalin, but many of them were buying more on the street, or crushing it to snort. I suppose they were after a high.
Linkadge
Posted by Richdawn on August 14, 2005, at 20:28:41
In reply to Sustained benefits from stimulants, posted by Mr.Scott on August 14, 2005, at 1:18:46
My son (age 22) has taken Adderall for a year and a half and has not had a dosage increase. The med is still working great to control his ADD and some depression. However he does take some drug vacations - about every 2 weeks, he doesn't take the Adderall during that weekend.
HOpe this helps
Richdawn
>
> Can anyone here say they have maintained benfit from using methylphenidate or amphetamine for depression of any sort, or for chronic fatigue?
>
> Or is it a forgone conclusion that tolerance develops and either the dose is pushed, or the therapy is switched?
>
> Interested to hear your responses.
>
> Scott
Posted by bimini on August 15, 2005, at 20:20:45
In reply to Sustained benefits from stimulants, posted by Mr.Scott on August 14, 2005, at 1:18:46
Concerta/Provigil combination has maintained the same benefit for over one year. I have taken stim holidays for single days on weekends even though my doc discouraged this.
This combo has not altered my anger and frustration dealing with pain, if this is called 'depression' nothing short of out-of-body experience will do. LOL.
bimini
Posted by Sarah T. on August 15, 2005, at 21:10:16
In reply to Re: Sustained benefits from stimulants » Mr.Scott, posted by bimini on August 15, 2005, at 20:20:45
Hi Bimini,
Why does your doctor discourage drug holidays?
S.
Posted by stan on August 16, 2005, at 0:13:08
In reply to Re: Sustained benefits from stimulants » Mr.Scott, posted by bimini on August 15, 2005, at 20:20:45
> Concerta/Provigil combination has maintained the same benefit for over one year. I have taken stim holidays for single days on weekends even though my doc discouraged this.
>
> This combo has not altered my anger and frustration dealing with pain, if this is called 'depression' nothing short of out-of-body experience will do. LOL.
> biminijust curious.....what's the rationale behind combining those two stimulants? for me provigil had such a long duration of action that i couldn't sleep -- i would lie in bed for eight hours with my eyes closed, very tired, but i don't feel like i ever feel into a deep sleep -- eventually this wore me down and completely burned me out. do you have any trouble falling asleep? what does the provigil add that concerta alone won't accomplish?
stan
Posted by bimini on August 16, 2005, at 9:51:05
In reply to Re: question for Bimini » bimini, posted by Sarah T. on August 15, 2005, at 21:10:16
> Why does your doctor discourage drug holidays?
Don't know Sarah, was told it was important to stick to a regular routine.
Concerta still has some cumulative effect after XR wears off. I do feel like a project rather than a patient.
bimini
Posted by bimini on August 16, 2005, at 10:41:03
In reply to Re: Sustained benefits from stimulants » bimini, posted by stan on August 16, 2005, at 0:13:08
> just curious.....what's the rationale behind combining those two stimulants? do you have any trouble falling asleep? what does the provigil add that concerta alone won't accomplish?
> stanStan, I'm all green behind my ears when it comes to meds, I don't know what the rationale of my docs are, seems all like guesswork to me!
The Concerta provides ability to sustain focus, for ~ 2 hours, I need to be mindful to shift attention or functioning shuts down rather quickly, I get lost and confused. If I don't take a break my brain just turns off, kind of like a standby mode.
The Provigil provides alertnes in a different way, processes like visual decoding appear to me most noticable, like it speeds up processing of input. I have visual problems understanding objects, particular with motion involved. Movement doesn't make sense and messes with my equilibrium.I have no trouble falling asleep, I have trouble staying awake. I fall asleep whithin minutes, occasionally I wake up feeling electric charges and see blobs of lights or sparks, but fall asleep again right away. My sleep of an average of 14-16 hours is now reduced to 9-10 hours, but I don't fully feel awake and time has a strange elastic attribute.
bimini
Posted by Mr.Scott on August 16, 2005, at 11:51:07
In reply to Re: Sustained benefits from stimulants » Mr.Scott, posted by bimini on August 15, 2005, at 20:20:45
Hi,
What do you take the stims for?Scott
Posted by bimini on August 16, 2005, at 12:01:20
In reply to Re: Sustained benefits from stimulants » bimini, posted by Mr.Scott on August 16, 2005, at 11:51:07
> What do you take the stims for?
Deficits caused by brain injury. MVA three years ago at age 45.
bimini
Posted by Paulbwell on August 16, 2005, at 19:38:32
In reply to Re: Sustained benefits from stimulants » Paulbwell, posted by Mr.Scott on August 14, 2005, at 14:16:20
> Thanks!
>
>
> Sometimes its difficult to differentiate the subtle initial high from the effect of antidepressant/anti-fatigue/increased concentration.
>
> But either way...I'm not interested in addiction. That will make everything 100x worse. I just hope I'm not getting myself into trouble by thinking something will work and then it won't anymore.
>
> ScottHi Mr Scott,
All I know is that in was given Ritalin 1.5 years ago by a PsyDoc, at 10mgs 2x daily, now i'm at somewhat more than that, 80mgs, 20mgs 4x daily supposedly (althought who takes their stimultants as prescribed?) and it's another pill to take to differentate my day from the norm, who knows if it's helping or not, althought having a stimulant is an addition from the Benzos i have, Dextroamphetamine seems to be where it's at (as so many say) so maybe oneday i'l try it at 5mg IR tabs- a REAL Amphetamine and all that entails, increased effectiveness and all. Double whammy of Amphetamine effects increased output AND reuptake, instead of just reuptake of Ritalin.
Posted by psychobot5000 on August 17, 2005, at 2:42:29
In reply to Re: question for Bimini » bimini, posted by Sarah T. on August 15, 2005, at 21:10:16
> Hi Bimini,
>
> Why does your doctor discourage drug holidays?
>
> S.This is my understanding of why drug-holidays are thought by many doctors and researchers to be bad. I emphasize that I am not a doctor myself, and am only passing on the information from someone who is, as best I understand it.
Medications are thought to cause stress on the body--your liver and kidneys that process them, and the rest of the body also because it must react to the effects of the drug and maintain equilibrium when medications change the balance of neurochemicals in your body, or whatever other effects they have.
It is thought to be easy to minimize these stresses on your body if dosing is consistent. Your body can thus plan for some extra release of dopamine or whatever, starting at X o'clock every day. If you take holidays, your body's planning is thrown off, creating new stress.Thus, it is thought to be best for your health if you follow the same dosing regimen every day, except when changing doses. It's worth noting that some meds liked birth-control pills have their efficacy much reduced if they are not taken consistently.
Posted by Bill LL on August 18, 2005, at 9:58:44
In reply to Re: question for Bimini (sarah T), posted by psychobot5000 on August 17, 2005, at 2:42:29
I have also read that drug holidays from stimulants are not necessary (such as weekends or non-school days).
I tried Concerta (up to 72 mg) for a couple months, but I have not tried Adderall. Concerta was good, but I prefer Provigil since I only need to take it once a day and it lasts all day. It also seems to work a little better for me in terms of concentration, mood, and anxiety relief (I also take 15 mg of Lexapro).
It's too early for me to say if it will keep working long term. I started with 200 mg of Provigil but did not get adequate anxiety relief. For me, anxiety and ADD go hand in hand. But when I raised it to 400 mg, it worked well. So I have now been on 400 mg for the past 2 months.
Hopefully it will keep working. I don't have trouble sleeping, but that may be because I take 1 mg of Lunesta at night.
Posted by bimini on August 18, 2005, at 10:22:00
In reply to Re: question for Bimini (sarah T), posted by psychobot5000 on August 17, 2005, at 2:42:29
>It's worth noting that some meds liked birth-control pills have their efficacy much reduced if they are not taken consistently.
Thanks Psychobot5000 for your logical explanation, makes a ton of sense.
bimini
Posted by bimini on August 18, 2005, at 10:38:47
In reply to Re: question for Bimini (sarah T), posted by Bill LL on August 18, 2005, at 9:58:44
>I have also read that drug holidays from stimulants are not necessary (such as weekends or non-school days).
I didn't skip because of necessity, it naturally happened as I was sleeping too long to take Concerta without throwing off my sleep rythm. I have never taken a sleeping pill, I might never wake up. Also I don't like how Concerta makes me feel, I therefore wished I could take stim as needed instead.
I take Concerta once a day and Provigil twice a day. Provigil does not last all day for me, it does not work better for concentration for me than the Concerta. Anxiety relief, that is also a paradox to me. Both Concerta and Provigil have raised my blood pressure and pulse goes zooming up, then dropping so low I fall over.
bimini
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