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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Stewie on May 25, 2016, at 19:24:40
Hi... I'm like most people here: finding meds and having them work for a while has been a problem for longer than I thought possible. My doctor mentioned stimulants as something we could explore. I have been thinking about it for a year or more. I am reticent, because I have a nasty anxiety disorder,and my partner can now tell if I am getting close to the next dose based upon my temper! I use gabapentin and clonazepam. That is it. I have gone as far as Nardil for depression, but it was as bad as being depressed for me! I have gained 100 lbs from meds ( well... the overeating, really). So stims seem like a logical progression -- but I am really scared I will have a panic or rage attack.
Anyone care to share experiences?
Thanks...
Posted by Christ_empowered on May 25, 2016, at 19:47:23
In reply to Considering stimulant for depression, posted by Stewie on May 25, 2016, at 19:24:40
Do be careful. I would think that Ritalin or Focalin would be a good first choice over the amphetamine preparations, but...hey, I'm not an MD, much less your MD, now am I?
I found that amphetamines did help my mood, but dosage is key. Too low, you get no good out of it; too high, you run into problems. Hopefully, your doc will sit you down and talk with you about your options.
Stimulants can be very helpful. Ritalin, in particular, has long been used where fatigue is an issue, whether its from the depression, advancing age, medical issues, etc.
If you've gained a good bit of weight, stimulants might be worth considering for that reason, too. I think the amphetamines are more effective for weight loss than Ritalin or Focalin, but I imagine (again) dosage would play a big role.
Watch out for: paranoia, agitation, anger, "Ritalin Kid Syndrome" (where the dose is too high and you're hyper focused and feel...well, you'll know if it happens to you...), mood swings, and...the "crash" that some people experience when the stimulant wears off. I would think gabapentin would be good for this, should it happen to you. Klonopin might help, but more sedating meds are often more helpful...
Anyway, it is your body, your life, etc. If you're tired all the time and/or gaining weight rapidly and/or just not getting any mileage out of more standard treatments...I'd seriously consider it.I have an acquaintance...she's on seroquel and adderall. Works nicely for her. I think something like that...a more sedating, calming medication...plus the stimulant...could be something to consider. I seem to recall reading that some docs use Remeron+stimulants or something.
That's about all I have for you. Talk to your prescriber, watch the dose, and keep an eye out for that crash and other side effects.
Good luck!
Posted by rjlockhart37 on May 26, 2016, at 0:03:44
In reply to Re: Considering stimulant for depression, posted by Christ_empowered on May 25, 2016, at 19:47:23
i took dexedrine spansule for a long time, I noticed when i took it by itself it helped me focus, and get things done, when i took ativan, or xanax with it, it was more of an antidepressant effect. xanax XR with dexedrine spansule is good combination, but the only problem is when it wears off, both of them, it can have bad effects on the mood.......they used to use amphetamine/barbiturate combinations in 60's and 70's for depression, but they found out mainly after it wears off it leaves you washed out
Maybe try focalin xr, and see how that helps, dexedrine is good for the mood but when it wears off it's unpleasant
Posted by J Kelly on May 26, 2016, at 4:47:31
In reply to Considering stimulant for depression, posted by Stewie on May 25, 2016, at 19:24:40
> Hi... I'm like most people here: finding meds and having them work for a while has been a problem for longer than I thought possible. My doctor mentioned stimulants as something we could explore. I have been thinking about it for a year or more. I am reticent, because I have a nasty anxiety disorder,and my partner can now tell if I am getting close to the next dose based upon my temper! I use gabapentin and clonazepam. That is it. I have gone as far as Nardil for depression, but it was as bad as being depressed for me! I have gained 100 lbs from meds ( well... the overeating, really). So stims seem like a logical progression -- but I am really scared I will have a panic or rage attack.
> Anyone care to share experiences?
> Thanks...I have taken Ritalin for years on and off (mostly on). For me it helps with depression and anxiety. I think its because it made me feel equipped to deal with what I had to. You could always try it, if you don't like it just quit. I've never had trouble stopping it when I wanted or needed to.
Dexedrine same thing. It felt stronger to me though. If either were going to cause a problem for you with anxiety and/or rage I would think it would be the Dexedrine.
Good luck!
Jade
Posted by jonhed on May 27, 2016, at 13:00:27
In reply to Considering stimulant for depression, posted by Stewie on May 25, 2016, at 19:24:40
In sweden they're going more and more towards lisdexamphetamine instead of pure dexamphetamine.
With lisdexamphetamine you will never have a crash because of a massive undergoing metabolism.
It is basically dexamphetamine depot, but works in that way that the body does not metabolize all the dexamphetamine in the same time and that makes you have a steady serum level in your blood stream over time with just one dose a day.70mg lisdexamphetamine is like 30mg dexamphetamine, but a little different as you can expect because it's not related to one another despite having almost the same name.
I recommend it as a antidepressant for two reasons.
1. It does not aggravate your temper in the same extent that dexamphetamine does to some poeple.
2. It is not an NDRI, which in my opinion can cause panic attacks. It is a DRA = more "well being".
And as someone said, a long acting benzodiazepine in combination can be very helpful in many ways if panic attacks is present.
Posted by stewie on May 27, 2016, at 14:39:41
In reply to Re: Considering stimulant for depression, posted by jonhed on May 27, 2016, at 13:00:27
Many thanks to everyone for your truly thoughtful responses.
Posted by Horse on May 29, 2016, at 3:01:40
In reply to Re: Considering stimulant for depression, posted by stewie on May 27, 2016, at 14:39:41
Have you tried Wellbutrin? I imagine you have. I think it's a pretty good antidepressant and I found it helped with ADD symptoms. I've tons of anxiety! Right now I take Nuvigil, which helps quite a bit. No matter what form of traditional stimulants I took, I would have a yucky crash, even Vvyanse and Concerta. You won't know until you try, and one good thing about stimulants is they won't stay in your system long. If you have a bout of anxiety, you could ride it out with an extra dose of Klonopin and call it a day.
Posted by J Kelly on May 29, 2016, at 5:16:59
In reply to Re: Considering stimulant for depression » stewie, posted by Horse on May 29, 2016, at 3:01:40
> Have you tried Wellbutrin? I imagine you have. I think it's a pretty good antidepressant and I found it helped with ADD symptoms. I've tons of anxiety! Right now I take Nuvigil, which helps quite a bit. No matter what form of traditional stimulants I took, I would have a yucky crash, even Vvyanse and Concerta. You won't know until you try, and one good thing about stimulants is they won't stay in your system long. If you have a bout of anxiety, you could ride it out with an extra dose of Klonopin and call it a day.
Wow that's crazy, one dose of Wellbutrin sent my anxiety thru the roof. And I literally did ride it out with an extra dose of Klonopin!
I think Wellbutrin is one of those meds that you just have to try. My impression from my pdoc was we try it, okay didn't work, on to the next.
I think it works for a lot of people. You'll probably know early on if its of benefit or needs to be thrown it in the bin.
Jade
Posted by ed_uk2010 on May 29, 2016, at 13:12:56
In reply to Considering stimulant for depression, posted by Stewie on May 25, 2016, at 19:24:40
Stimulants were used as antidepressants before antidepressants were first 'invented'. Unfortunately, the improvement in mood and motivation in often short-lived. Anxiety might potentially decrease early in treatment, with low doses (high doses are likely to cause anxiety). In the long run, an increase is anxiety is possible.
Posted by Horse on May 30, 2016, at 1:31:09
In reply to Re: Considering stimulant for depression » Horse, posted by J Kelly on May 29, 2016, at 5:16:59
Yeah, I can understand. The first time I took it was great. A decade later, with various treatment in between, the second time seemed unbearable! Even with xanax. I think I'd be ok if I tried again.
At the start of my last two ADs, I had full panic attacks. That was new.
Posted by J Kelly on May 30, 2016, at 6:19:37
In reply to Re: Considering stimulant for depression » J Kelly, posted by Horse on May 30, 2016, at 1:31:09
> At the start of my last two ADs, I had full panic attacks. That was new.
>
>Wow that's a bit scary. Bad enough to be depressed but to have to fear a panic attack at each med trial ...I feel for ya :(
I take Zyprexa and Klonopin in addition to the Nardil so panic attacks are a thing of the past for me.
If you're up for another trial I would definitely include Nardil in the running!
Jade
Posted by Horse on May 30, 2016, at 20:36:35
In reply to Re: Considering stimulant for depression » Horse, posted by J Kelly on May 30, 2016, at 6:19:37
>
> > At the start of my last two ADs, I had full panic attacks. That was new.
> >
> >
>
> Wow that's a bit scary. Bad enough to be depressed but to have to fear a panic attack at each med trial ...I feel for ya :(
>
> I take Zyprexa and Klonopin in addition to the Nardil so panic attacks are a thing of the past for me.
>
> If you're up for another trial I would definitely include Nardil in the running!
>
> Jade
>
>
>
>I would have (I think) by now except for tramadol, which is the best treatment for neuropathy so far. I don't think Lyrica would be enough. I did discontinue for Emsam, and Emsam was great for my mood, but I'd need to put my feet up by mid afternoon. I don't know what people with chronic pain and MDD do.
Posted by Chris O on June 1, 2016, at 2:27:52
In reply to Considering stimulant for depression, posted by Stewie on May 25, 2016, at 19:24:40
Hi, Stewie,
Like you, I have a nasty anxiety disorder. I tried Adderall XR for about a week last year; the first time I had tried a stimulant. It definitely had a subtle, mood-boosting effect for me. All that I can say is that it was much easier for me to talk to people throughout the day, and I was not ruminating about my anxiety/depression as much. However, on the downside, when the drug wore off, usually around 7:00pm if I took it in the morning, there was pretty intense rebound anxiety,with a very strong racing heartbeat. There was also: incredible thirst, limp d*ck, and the need to up the dose to get desired effect, even after one week. But my "trial," if it can even be called that, was perhaps not long enough to draw any deep conclusions. I would totally give it a try if I were you. Nothing much to lose. Not hard for me to stop at all, even after a week.
Chris
Posted by Mary GG on June 15, 2016, at 0:41:44
In reply to Re: Considering stimulant for depression, posted by Christ_empowered on May 25, 2016, at 19:47:23
Wow. I am so grateful to have found this forum. My doctor and I are considering switching out my Dexedrine for Ritalin and she never told me it could help with my depression. I have severe anxiety so finding the right dose that gives me energy and focus without exacerbating my anxiety is a delicate balance. Thank you all so much for posting your experiences and suggestions.
Again, wow!
This is the end of the thread.
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