View Full Version : What is the best med for people with combination ADHD & Anxiety Disorder?


Snoopy10
01-31-16, 12:23 PM
I was diagnosed with an anxiety disorder 25 years ago. I've been battling with the disorder (unsuccessfully, I might add) since then. In 2015, I became extremely depressed when my best friend was diagnosed with cancer, after losing my Mom to cancer and my Dad to a different disease just two years earlier.

My psychiatrist suggested I try Adderall for my depression short term. It was definitely episodic, he had never known me to be depressed. He knew SSRIs and such didn't work for me (I've been on everything out there. Cymbalta, Lexapro, Buspar, Zoloft, Abilify, Prozac, Gabapentin and of course, loads of Klonopin.)

The Adderall worked like a dream. It calmed me down, reduced my anxiety and kept me in the present moment, and it did lift my mood. When I told psychiatrist about the effects, we had our "ah-ha" moment. I had ADHD all along and my anxiety disorder was masking my underlying conditions. After doing lots of research and looking at my childhood, there it was. I grew up in the 70s when no one was diagnosed with anything and problem children were generally brushed under the rug.

Right now I am on 20mg of Adderall IR (split in 2) per day. I am also on some Klonopin and I take Trazadone (50mg) to sleep. I recently had some acute stress events that made my anxiety skyrocket. The Adderall still works but the anxiety is breaking through in a bad way. This sounds strange but although the Trazadone helps me sleep, I feel like it's making my ADHD symptoms worse. The biggest indication for me that I'm falling through the cracks again is my alcohol intake. When I am in control of my symptoms I don't think about alcohol. When I'm not in control, I drink to excess (like a bottle of wine on some nights) just to turn off the noise in my head. I know it is a terrible idea to drink that much but I just get desperate, and let's face it, my ADHD impulsiveness doesn't help things.

What's the best ADHD drug for people with this duel diagnosis?

My psychiatrist doesn't seem to know as much about ADHD as he does about my other issues (I know, time to get a new psychiatrist...)

Thank you for any advice you can provide.

Best,
Snoopy10

Unmanagable
01-31-16, 01:10 PM
Welcome to the community. :)

I'm curious what other supports you have in place to help you through the intense grieving process of experiencing multiple deep losses. That, on top of additional stress, creates an inner storm that can lessen the effectiveness of meds and certainly makes us continue to seek ways to drown it all out, from my experiences.

I've been prescribed many things during my journey. Some helped and some made things even worse, creating a deeper hell. I no longer take anything because of worsening side effects eventually drowning out the benefits, in each case.

The longest lasting relief I found when taking meds was in a combination of adderall ir and wellbutrin. That was the period I was able to function more consistently, the fog was lifted more than with any other medication attempts, and I was able to seek out other avenues of treatment for the rest of my list of issues needing support.

In my years of searching for answers, I've discovered so many things that had been overlooked and unaddressed by self and professionals through the years that just kept piling up and gaining momentum for an avalanche of epic proportions.

Finally finding an outlet via counseling was a saving grace in many ways. I had horrible counseling experiences in the past that were all insurance approved, and had pretty much given up on ever seeking another. But, found a community shelter that offers free counseling to anyone who has experienced sexual or domestic abuse in their lifetime, and it was the best counseling scene I've ever experienced.

Wishing you the best in finding the healing grooves that best suit you.

Snoopy10
01-31-16, 08:10 PM
Hi Unmanagable,

Thank you for your post. I have also had some bad experiences with counselors. One counselor told me that I was a pessimist and maybe if I just looked at things more positively I would get better. Another was very empathetic, helped me with breathing exercises but had the ego of skyscraper which made me feel that if I didn't keep seeing him, I would surely fail. And the list goes on and on. These were all private counselors and I paid out of pocket.

As far as my grieving process goes, I didn't even know what I was grieving for until it finally dawned upon me the other day. I don't have a plan for how to deal with it right now...but its there with me everyday.

Is it okay to just do the best we can? It sounds like you may have had some bad experiences as well, does the pain from that ever go away?

Thank you for being so kind in your response.

Snoopy10

Unmanagable
02-01-16, 11:54 AM
The pain became more manageable over time, and in so many different ways, once I was able to seek and accept them, but never totally goes away, or at least mine hasn't as of yet. Cellular memory remains.

Doing the best we can is really all we've got. Some days it feels like we'll never make it to the other side, but then we do. Not sure how, exactly, but we do. Some days, we wish we wouldn't have.

The counseling experiences I had ranged from an overly paternalistic one, to one who dozed off as I spoke, to one who appeared to be more interested in bible study than actually helping me. And NONE of them acknowledged the sexual abuse I endured as a 13 year old, and then again later in high school, and then into my early 20's. It's damn scary to see and experience first hand what passes for professionalism, knowledge, and therapy these days.

Would it be possible to set aside some time and space and dig deep to find something that makes your soul sing, then think of things that your loved ones loved, and see if you can connect some dots between the two and celebrate them every chance you get, even if it's just a few minutes in thought? Maybe your impulsiveness can be re-routed to doing more of the loving things vs. the alcohol and other not so loving things.

I have found so much joy in loving and allowing my inner child to finally bask in all the beauty I was too busy to notice in my youth, being a hearty, yet very unhealthy defender of my self-worth kept me distracted from life as I thought it should have been for way too long. Vibe as best you can with your heart flow, as it's the one truly in the know.

sarahsweets
02-01-16, 01:27 PM
This sounds strange but although the Trazadone helps me sleep, I feel like it's making my ADHD symptoms worse.
Trazodone can cause excess daytime sleepiness, dry nasal passages and throat and also have an effect on stimulants sometimes. Not always but it sounds like in your case it is.
The biggest indication for me that I'm falling through the cracks again is my alcohol intake. When I am in control of my symptoms I don't think about alcohol. When I'm not in control, I drink to excess (like a bottle of wine on some nights) just to turn off the noise in my head. I know it is a terrible idea to drink that much but I just get desperate, and let's face it, my ADHD impulsiveness doesn't help things.

You really have to watch this. Many people with adhd are also substance abusers because its a form of self medication. You may think you are only out of control with alcohol when off of adderall but lets be real... do you really want a med to keep you from drinking too much? To me its a red flag. I am an alcoholic and I am not saying you are, its just something to pay attention to.

qanda
02-01-16, 08:28 PM
My 14 yr old daughter, diagnosed ADHD and Anxiety, takes 150 mg Zoloft, goes to therapy, and takes fish oil (4 pills which total 1,000 mg EPA for ADHD). Things are going better.

cwf1986
04-28-16, 03:56 PM
I know you said SSRI's didn't work for you, but would about tricyclics? Nortiptyline and Desipramine have minimal side effects compared to other TCA's and arguably no more sides than SSRI's.

I actually just made a thread about my experience with nortriptyline. Granted, ymmv. Just something to bring up with your Psych. There are also a lot of other non-SSRI choices for depression and anxiety and combination/augmentation strategies as well.

http://www.addforums.com/forums/showthread.php?p=1806268#post1806268

Laserbeak
04-30-16, 06:10 PM
I would say Adderall and a benzodiazepine. I take Librium (chlordiazepoxide). It has a very long half life and is not very addictive compared to say Xanax (alprazolam) IR. Valium (diazepam) isn't bad either, it's very closely related to Librium. In fact, Librium was discovered completely by accident and Valium was basically the streamlined version they came up with after studying it.

Snoopy10
06-07-16, 03:48 PM
I haven't been on the site in awhile and I just realized this post was from January! How time flies.

I figure I should update since this post, what's working for me now is klonopin and Adderall & I take breaks from the Adderall on the weekends.

The trazadone was a total disaster for me, I stopped taking it. I've also since been diagnosed with migraine (I get "silent" migraines, it is a long story of how I was diagnosed but now I have a super cool MRI image of my weird looking brain!). I was put on migraine prevention medication (amitriptyline) which coincidentally is a super old antidepressant. It helped with the migraines (and particular resulting disequilibrium issue I was having) and I was able to go off after my symptoms cleared. Now I am doing acupuncture twice a week to keep the migraines under control.

Now that I have the disequilibrium issue under control, my anxiety level is a lot lower.

Anyway, that is what is working for me for right now. Probably in six more months I'll be off on some other new wacky brain chemistry adventure!

sarahsweets
06-08-16, 04:15 AM
I haven't been on the site in awhile and I just realized this post was from January! How time flies.

I figure I should update since this post, what's working for me now is klonopin and Adderall & I take breaks from the Adderall on the weekends.

The trazadone was a total disaster for me, I stopped taking it. I've also since been diagnosed with migraine (I get "silent" migraines, it is a long story of how I was diagnosed but now I have a super cool MRI image of my weird looking brain!). I was put on migraine prevention medication (amitriptyline) which coincidentally is a super old antidepressant. It helped with the migraines (and particular resulting disequilibrium issue I was having) and I was able to go off after my symptoms cleared. Now I am doing acupuncture twice a week to keep the migraines under control.

Now that I have the disequilibrium issue under control, my anxiety level is a lot lower.

Anyway, that is what is working for me for right now. Probably in six more months I'll be off on some other new wacky brain chemistry adventure!

Why do you take breaks on the weekends?

peripatetic
06-08-16, 04:24 AM
many physicians will say that it's ok to take weekend breaks. i used to sometimes so i'd eat more as i was chronically underweight. my psychiatrist has said numerous times i can take it or not on a given day. it's other things i have no flexibility with. he's also said, when i was on stimulants, that i could take just two or three instant release instead of every two hours.

so, i took breaks often on weekends because i could. and sometimes adding four to six more pills when i already have...five, i think, others, is kinda nice now and then.

unsure why the person you quoted does, but, that's why i have and i know i'm not alone and don't want him to feel like he is, so replied :)

Laserbeak
06-22-16, 06:01 AM
Update:

I just started it literally yesterday, but I'm really liking Dexedrine vs. Adderall. It doesn't seem to have the same jitteriness, anxiety, etc. associated with Adderall.

As far as anti-anxiety, I've still been taking Librium (chlordiazepoxide) for years. Although it is the oldest benzodiazepine, it's still the longest acting and one of its metabolites is ultra long-lasting and builds up in your system. That means it's less addictive since you don't feel the urge to take one every couple of hours or so plus it's never lost its effectiveness with me. Valium is also good, it's a stripped down version of Librium, but it doesn't have the ultra-long acting properties.

Phineas
06-22-16, 09:53 PM
If I take any benzo or any alcohol, the entire next day my Concerta does not work. It's very odd. On the other hand, now that I'm on ADHD meds, I have very little anxiety, and I sleep better.

BrokenWing60
09-22-17, 02:07 PM
I'm new to the Forum as of today🙂... So Hello Everyone... I too have ADD & Anxiety... Especially Social Anxiety. I have a small circle Comfort Zone, Home is my favourite place, inside my house. And I work with mostly the same people & same place, so tolerate going to work, long as not too many changes happen at once... My question is... Is there anything to help the Social anxiety or is it General Anxiety meds that would help??

WhiteOwl
10-05-17, 12:43 PM
I'm new to the Forum as of today🙂... So Hello Everyone... I too have ADD & Anxiety... Especially Social Anxiety. I have a small circle Comfort Zone, Home is my favourite place, inside my house. And I work with mostly the same people & same place, so tolerate going to work, long as not too many changes happen at once... My question is... Is there anything to help the Social anxiety or is it General Anxiety meds that would help??

Welcome to the forum! I'm new, too. I'm recently diagnosed with ADD and anxiety and just starting meds, so I'm nowhere near as knowledgeable as most of the people here. But my psychiatrist just prescribed Lexapro and told me it should help with both general and social anxiety. One of my problems is that when I talk to people, I ramble really fast and don't know when to stop talking. She said that was my anxiety and the medication would help with that. We will see!