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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Mr.Scott on May 18, 2001, at 13:23:14
I have the usual treatment resistant depression, Anxiety disorder, and a history of ADD Dx in my youth.
My treatment regimen is currently 30mg prozac a day and 7.5 mg of Tranxene.
My doctor recently added Ritalin-SR 20mg. When I first started taking it I'd feel great.. Like a million bucks.. I can concentrate like a laser beam, I feel positive and hopeful about life (which I'm not normally), I have energy and want to just go up and talk to people and do things I am usually unable to do. Sounds great you say?
The problem is that I crash and burn, and that each successive dose "may" (it's not fully clear yet) not work as well, and that I eventually find myself in a deeper hole than I started with. I feel good but then terrible later. Really good and then like totally demoralized later. Also, It may actually make me "more" impulsive and more anxious.
I need help and advice before proceeding further..
What sayeth you?
Posted by Bill L on May 18, 2001, at 15:22:03
In reply to Depression/Ritalin question? and advice, posted by Mr.Scott on May 18, 2001, at 13:23:14
When you say you feel good, and then bad later- do you mean that you feel good in the morning then bad at night when it wears off? If so maybe you should switch to Adderal. It is similar to Ritalin but releases more gradually in the blood.
My symptoms were the same as yours exactly. I take 20 mg Celexa. Celexa is better for my anxiety than the Prozac was.> I have the usual treatment resistant depression, Anxiety disorder, and a history of ADD Dx in my youth.
>
> My treatment regimen is currently 30mg prozac a day and 7.5 mg of Tranxene.
>
> My doctor recently added Ritalin-SR 20mg. When I first started taking it I'd feel great.. Like a million bucks.. I can concentrate like a laser beam, I feel positive and hopeful about life (which I'm not normally), I have energy and want to just go up and talk to people and do things I am usually unable to do. Sounds great you say?
>
> The problem is that I crash and burn, and that each successive dose "may" (it's not fully clear yet) not work as well, and that I eventually find myself in a deeper hole than I started with. I feel good but then terrible later. Really good and then like totally demoralized later. Also, It may actually make me "more" impulsive and more anxious.
>
> I need help and advice before proceeding further..
>
> What sayeth you?
Posted by Mr.Scott on May 18, 2001, at 15:52:12
In reply to Re: Depression/Ritalin question? and advice, posted by Bill L on May 18, 2001, at 15:22:03
> When you say you feel good, and then bad later- do you mean that you feel good in the morning then bad at night when it wears off? If so maybe you should switch to Adderal. It is similar to Ritalin but releases more gradually in the blood.
>
>
> My symptoms were the same as yours exactly. I take 20 mg Celexa. Celexa is better for my anxiety than the Prozac was.
>
That is an interesting combo.. I remember Celexa being SOOO sedating, but I could see how in combination with a stimulant it might just work nicely.
Posted by Noa on May 18, 2001, at 16:15:41
In reply to Re: Depression/Ritalin question? and advice, posted by Mr.Scott on May 18, 2001, at 15:52:12
I also had the "crash" effect with Ritalin, both the regular and SR. Even the SR is not all that long acting. I now take Adderall, which not only is more effective (I feel calmer and more focused than I had with Ritalin) but I don't have the up and down swings with it. Another thing to consider is how many, and the timing of, doses you take during the day. I still have a bit of mental energy slump as the Adderall wears off (much less than with Ritalin, tho), so for me timing the doses is important, and just being aware of when my low times will be, in case of impact on work,etc.
Posted by Mr.Scott on May 20, 2001, at 23:08:28
In reply to Re: Depression/Ritalin question? and advice, posted by Noa on May 18, 2001, at 16:15:41
Thanks!
Are you taking the stimulants for depression or ADHD?
mr.scott
Posted by Noa on May 21, 2001, at 11:14:52
In reply to Re: Depression/Ritalin question? and advice, posted by Mr.Scott on May 20, 2001, at 23:08:28
> Are you taking the stimulants for depression or ADHD?
>
For depression, but it helps with symptoms that could be construed as ADD (my pdoc has wondered...). I have some history of organizational problems and distractibility, not finishing things, having difficulty knowing when to focus on the big picture and when on the details and switching back and forth as needed, etc. but whether these are from the depression/anxiety or do I really have ADD is pretty much going to remain an unanswered question for the forseeable future, because it would be so hard at this point to tease out what is what (maybe sometime in the future, the advances in imaging technology will allow for diagnostic distinctions).I am also learning to adapt around my distractibility. For example, I tend to have sensitive hearing and am easily distracted by noises and voices talking when I am trying to work. I am learning to explain to people how I process information best and to make accommodations for myself, like closing my door when I am writing--although then I have to also let people know why I have the door closed so much, etc. I also tend to tell people to email me detailed information instead of trying to tell it to me on the fly, because a) I might not remember it well enough, or b) if I try to take notes as they speak, I might not really process it well. The Adderall helps me feel calmer and more focused, but doesn't really change the distractibility at all. Perhaps you could say it helps me deal with it more calmly. But I think it does help me approach tasks better without getting overwhelmed. I still have a hard time organizing how I am going to tackle complex tasks--what do I do first, what is most important, etc.--but I think the Adderall helps me not feel overwhelmed so I am a little better at it. I still need to do a lot of learning about how to deal with this organizational problem, tho. Now that I have figured out that I have a cognitive problem with not being able to move flexibly from big picture to details and vice versa, I still have to figure out what can help that. I am working with a coworker on time management issues. We both have similar problems with time management, so we are getting together weekly to support each other in learning to do time management better. Can't say that I see much progress yet, but we just started last month.
Posted by Mr.Scott on May 21, 2001, at 21:54:05
In reply to Re: Depression/Ritalin question? and advice, posted by Noa on May 21, 2001, at 11:14:52
I just got the Rx for Adderall tonight. My doc wants me to find the dose that works best for me and gave me 20 mg tablets to start with. He said break them up and try it all different ways. What dosing schedule have you found helpful? Also, what if any other drugs do you take?
I am sorry for all the questions, but your symptoms sound remarkably similar to mine in many ways, and yes... I don't think we'll really know for some time whether it's ADD or Depression and Anxiety. Some days I'm sure it's one or the other, then I think both, the next neither. I don't care what it's called so long as something works for it.
I currently take 20mg of prozac, and have permission to take Tranxene for anxiety (but I try to avoid as I'm scared of benzos). I've tried most of the drugs out there only to find bad side effects or ineffectiveness.
Thanks for all the info!
mr.scott
This is the end of the thread.
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