Shown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Shell on September 26, 2006, at 11:58:41
I have both ADHD and GAD with the occasional panic attack thrown in. Until recently, my pdoc was treating only the anxiety because he felt that was the more serious problem (Effexor, Wellbutrin, Klonopin) and, I suspect, because he thinks most of my ADHD symptoms come from anxiety and not ADHD. (I was diagnosed with ADHD about 6 years ago, long before I started seeing him. I doubt he’d have diagnosed me with it, because he has said that he thinks in most cases, ADHD-like symptoms in adults come from undiagnosed depression or anxiety disorders).
Anyway, the anxiety has not improved (in my opinion partially because untreated ADHD is stressing me), and I have begged to be allowed be put back on Concerta. He hasn’t prescribed anything for the ADHD in the year I’ve been seeing him. He finally relented and wrote a prescription for 18 mg Concerta. The problem? He now refuses to refill the Klonopin, which was the only thing I was taking that did seem to help, because one is an “upper” and one is a “downer” and if I take them together, they will, in his words, "cancel each other out."
I somehow just don’t feel (though he’s the expert, not me), that that seems right. Concerta, though it may technically be a stimulant, isn’t stimulating, but calming. I think I also remember that both Concerta/Ritalin and Wellbutrin work by inhibiting reuptake of dopamine – so if Wellbutrin is OK to take with Klonopin, why isn’t Concerta?
I’ve taken both Concerta and Klonopin together and I seem to do better than on either one alone. I know I’m not the only one here who takes a similar combination. Does anyone have any articles that I can read (or even show my doctor) so that I know I’m not crazy (OK, maybe just a little crazy!) I hate feeling like I’m always fighting him to get the medications I need. Is it me? Is it unreasonable of me to think I can take the two together? Is it that unusual? I’m beginning to rethink everything....
Posted by dmlvt on September 27, 2006, at 8:25:18
In reply to Benzos with Concerta/Ritalin/Stimulants a no-no??, posted by Shell on September 26, 2006, at 11:58:41
I take Ritalin and Ativan and I believe that the Ativan does reduce the effectiveness of the Ritalin. I described it recently as a big loop. I started on Ritalin, which helped focus but made my dysthymia/depression worse, particularly as a dose wore off late in the day. I added Cymbalta, which fixed the depression, but had sexual side effects. I added Wellbutrin, which fixed the side effects of Cymbalta, but seemed to increase anxiety. I then added Ativan, which decreased the effectiveness of the Ritalin.
So, I'm trying to go back to the starting point right now. I've cut Cymbalta to 20mg, stopped Wellbutrin, and cut back on Ativan. I'm going to try to get completely off the Cymbalta next, and then the rest.
I guess the alternative would be to increase the Ritalin, which would probably lead to another addition elsewhere, which would mean more of ...
I want off this merry-go-round.
dml
Posted by med_empowered on September 27, 2006, at 8:43:46
In reply to Benzos with Concerta/Ritalin/Stimulants a no-no??, posted by Shell on September 26, 2006, at 11:58:41
I'd say its more complicated than "they cancel each other out". An antipsychotic would cancel out a stimulant; a benzo might make it less stimulating, but the combo could work..the big problem is that upper and downer combos can be tricky, and they seem to make abuse more likely (think "Valley of The Dolls") .
But...I've known people who take benzos plus RX'd amphetamines at stable doses for both meds, long term; I doubt most shrinks would consider that sort of med combo ideal, but it can be done.
Posted by Emme on September 27, 2006, at 9:25:54
In reply to Benzos with Concerta/Ritalin/Stimulants a no-no??, posted by Shell on September 26, 2006, at 11:58:41
My pdoc has no trouble with me taking Xanax as needed along with Focalin. Careful dosing with Xanax allows me to cut down the jitteriness from the Focalin but keep some of the energy. I do not always need the Xanax. And yes, if I take too much Xanax, it will make me sleepy and counteract the Focalin. I believe it is a matter of titrating your dosages carefully to maximize the benefits of both drugs. You have to use them with some finesse.
emme
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.