Posted by g_g_g_unit on July 30, 2010, at 5:58:33
In reply to Re: how to 'treat' this awful conglomerate of issues?, posted by Christ_empowered on July 29, 2010, at 11:25:42
Thanks for your reply. I've read some criticisms about using a stimulant in conjunction with an SSRI - things along the lines of the combo inducing a sorta zombie-ish state of focus, wherein it becomes easy to just zone out on whatever happens to be in front you.
Unfortunately, like I say, the OCD and depression are relatively severe, so I'm not left with too many options. Do you think Cymbalta would be at all effective for OCD, or would the greater NE action disturb any anti-obsessional benefits?
I'm also not terrible sure how effective the non-stimulants like Tenex would be for inattentive ADD (characterized my mental sluggishness, motivational difficulties, etc.). My general impression was that the compounds were better suited to hyperactivity.
I guess I should try to get the depression and OCD under control first and then see if I could tolerate a stimulant. I'll keep your suggestion of Cymbalta in mind. I'm a little scared of the Effexor withdrawals ...
> Sorry you're going through such a rough patch. Using an antidepressant with a stimulant has its pros and cons. The stimulant boosts the antidepressant, and the antidepressant can help mellow out the stimulant a little bit--I personally found that a reuptake inhibitor of some sort mixed with a stimulant made the stimulant less harsh and also made the time in between doses a good bit more tolerable.
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> I would think Cymbalta or Effexor would be good with a stimulant. I used to take Tofranil-PM with Adderall with good results. Cymbalta is kind of like Tofranil (I think...) in that it has balanced dual reuptake inhibition, whereas Effexor is an SSRI at lower doses and then you get dual action at higher doses and (I think) some dopamine reuptake inhibition at much higher doses. The cool thing about Cymbalta is that, unlike effexor, dosing is easy; 60mgs is the ideal dose, based on the data available. You don't have to go up and down like you would with some other medications.
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> Do keep in mind that mixing a stimulant and an antidepressant can sometimes lead to serotonin syndrome.
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> There are now non-stimulant options for ADD. You have Tenex (original, generic, and a new form specifically for ADD--I think its an XR or something), Straterra, or high doses of more activating antidepressants (Wellbutrin, Cymbalta, Effexor, etc.) w/o a stimulant.
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> You could use a non-stimulant, especially something like Tenex, along with a stimulant and other CNS drugs.
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> Good luck.
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poster:g_g_g_unit
thread:956304
URL: http://www.dr-bob.org/babble/20100720/msgs/956437.html