View Full Version : I have TRD and ADD but.....


AddAnxiousMe
07-01-16, 02:09 AM
.....I'm wondering if it's really wise to stay on the Adderall that my doctor put me on almost two months ago. It does work for both conditions, but my real concern is the medication pooping out like so many others I have taken in the past. Before the addition of Adderall my main medications were/are Effexor and Valium. I also have a history of severe panic disorder and agoraphobia, so just getting me to try a stimulant was a task for my doctor. I find that with Valium and Inderal I am able to tolerate the nervousness and rapid/irregular heart beat from the Adderall, but my real concern is tolerance and loss of effectiveness, just like I had with my other meds. The Effexor and Valium still help to an extent, but not nearly like at the beginning. And getting off of either one is pure torture. In fact, I've pretty much resigned myself to the fact that I'll be on them for the rest of my life. My doctor thinks I need to be on them for life, but I think he partly says that because he knows the extreme nature of the withdrawals from either medicine and doesn't want to put me through it. But my question is; will the Adderall wind up doing the same thing? It has me feeling better now, but will it last, and will I be able to get off of it easier than the others if it doesn't last? I really hate the thought of adding another medication that I "need" to stay on, but really don't get much of a benefit from anymore. But I am very close to 47 years old and sometimes have the "who cares" attitude, just do or take whatever you have to to feel better, worry about the other things later. I think the decades of medication use have (in addition to helping me) messed up the balance of chemicals in my brain, and I worry the Adderall, with it's potent effects on dopamine and norepinephrine, may mess them up even further and make me feel horrible if it stops working and I have to stop it (if I can stop it.) I hear of people on therapeutic doses of Adderall (and other stimulants) having bouts of severe depression when stopping.
I'm sorry for the long winded post, but I'd appreciate any input. And BTW, I have been on 10mgs 2xday for almost two months. Would that be a short enough time to just stop it, or would I need to wean down?
Thanks for reading.

sarahsweets
07-01-16, 04:22 AM
but my real concern is tolerance and loss of effectiveness, just like I had with my other meds.

Dont get hung up on tolerance right now. Its to early to worry about what hasnt happened yet.

In fact, I've pretty much resigned myself to the fact that I'll be on them for the rest of my life. My doctor thinks I need to be on them for life, but I think he partly says that because he knows the extreme nature of the withdrawals from either medicine and doesn't want to put me through it.
And so what if you are on meds for life If they help you there is nothing wrong with being on them. Being dependent on meds does not mean you are addicted.

But my question is; will the Adderall wind up doing the same thing? It has me feeling better now, but will it last, and will I be able to get off of it easier than the others if it doesn't last?

Why would you want to come off of it?

AddAnxiousMe
07-01-16, 04:35 PM
Dont get hung up on tolerance right now. Its to early to worry about what hasnt happened yet.

This is true.


And so what if you are on meds for life If they help you there is nothing wrong with being on them. Being dependent on meds does not mean you are addicted.

What I really meant was that I don't want to remain on another medication that's not working very well just because the withdrawal is so terrible. For instance, the Effexor. It may be working to an extent, but if I don't switch to a different medication with SSRI activity, I simply cannot get off of it. And I have been on serotonergic medications for 24 years straight. Suppose I wanted to go on an unrelated drug, like Bupropion, and stop the Effexor? I have never tired, but my brother tried with Effexor and always winds up going back on a small dose because he suffers like a dog with anger, mood swings, anxiety, brain zaps and vertigo, etc. I don't know that I'd ever want to stop the benzos, they have been helpful, but I know it's no walk in the park stopping them either!



Why would you want to come off of it?

Again, this is a question of "if it doesn't work well anymore". My main fear with TRD is the extreme nature of it. If the Adderall depleted or altered certain brain chemicals even more and then stopped working, will my depression be worse than before? I can't bear to even think of it.

Thanks for the input, Sarah, I appreciate it. I guess I'm just wishing I could find a medication or med combo that works and continues to work (aren't we all?), so I can get on with life. Since it's happened so many times before, I guess I feel like I'm setting myself up for another let down. In fact, it was Effexor that pulled me out of the darkness when all the other SSRIs eventually failed; but then the Effexor (after a number of years) isn't working as well. But the Adderall really did wake me up in more ways then one, and I hope it continues.

I don't know if you realize this, but mental illness stinks:D.

Adenosine
07-01-16, 06:55 PM
If it occurs, tolerance to that dosage of amphetamine should be fairly easy to reverse.

In contrast to many sedatives, the withdrawals from Adderall aren't physically dangerous, but they will indeed screw with your mood horribly at sufficient doses. 20 mg/day is not necessarily sufficient, resting on the low end of therapeutic use. Of course, the original symptoms will also return, which creates problems itself.

AddAnxiousMe
07-01-16, 08:53 PM
If it occurs, tolerance to that dosage of amphetamine should be fairly easy to reverse.

In contrast to many sedatives, the withdrawals from Adderall aren't physically dangerous, but they will indeed screw with your mood horribly at sufficient doses. 20 mg/day is not necessarily sufficient, resting on the low end of therapeutic use. Of course, the original symptoms will also return, which creates problems itself.

Yeah, he has it prescribed to go up to 30mgs, but I've stuck around the 20mg mark because it's been helping my attention and keeping me out of bed all day. I figure why take more until/unless I need it. I know that the trick to coming off of stimulants is to do it slowly, so as not to shock the brain too much. Also, my BP has been high and I have had abnormal heart beats (PVCs I think) for a long time that is being aggravated by the Adderall. Inderal helps with that. Also, I have a past history of thyroid cancer, so they keep me on a high dose of Synthroid (probably why I get the abnormal beats) to help prevent recurrence. I need to see my primary doc on Monday about it. I am prone to high BP anyway, so I figure I'll give him the run down on the addition of the Adderall, so he can decide what dose of BP meds I may need. I used to be on lisinopril for high BP, but maybe a long acting beta blocker may work better with the Synthroid and Adderall mix. I guess I shouldn't be complaining about medications that people 50 years ago would love to have had access to. I guess I just get tired and would like to coast along for a long period of time symptom free (or as symptom free as possible.)
Thanks for the input.

JustfixME
07-14-16, 10:35 PM
Hey friend, I feel your pain as we all do here. I was on Adderall which frightened me, irritable, angry, going a mile a minute. We both have the same crap to deal with. I've been taking Rexulti for a month to boost Wellbutrin I guess, but what a difference. The darkness has broken, I'm ambitious, and can tolerate some family ******** now. I take Dexidrine and some people say its Adderall; they are not the same!!!
The ADD is still a nag, like forgetting, not hearing what someone just told me LOL. But the main positive here is I can see a light at the end of the tunnel...
Stay the course bro, I'm 50 and sometimes feel this is the end. Live and do what you thrive in!! My therapist/life coach is amazing, thats another key; connecting with your psychologist.
I wish you the best

AddAnxiousMe
07-15-16, 05:15 AM
Hey friend, I feel your pain as we all do here. I was on Adderall which frightened me, irritable, angry, going a mile a minute. We both have the same crap to deal with. I've been taking Rexulti for a month to boost Wellbutrin I guess, but what a difference. The darkness has broken, I'm ambitious, and can tolerate some family ******** now. I take Dexidrine and some people say its Adderall; they are not the same!!!
The ADD is still a nag, like forgetting, not hearing what someone just told me LOL. But the main positive here is I can see a light at the end of the tunnel...
Stay the course bro, I'm 50 and sometimes feel this is the end. Live and do what you thrive in!! My therapist/life coach is amazing, thats another key; connecting with your psychologist.
I wish you the best

Thanks for the post, I appreciate it very much. I went to my primary doc and have been put on BP medicine. My BP was 140/100 even without any Adderall, so I guess it's my family predisposition to hypertension rearing it's ugly head. And yesterday my psychiatrist switched me to Dexedrine, so I'm hopeful that will be as helpful without the extra nervousness the Adderall gives me. I just hope there is no problem getting it. He wrote D-Amphetamine IR 20mgs early morning and another 10mgs early afternoon. He also wrote on the script, "do not substitute with Adderall." The pharmacist didn't seen to understand what was written and asked me if I wanted the generic Adderall and not the name brand. I told her that this is only my third time filling a RX for this medication and I was always supposed to be on dexroamphetamine (Dexedrine) not Adderall. Then she says, "but have you gotten the dextroamphetamine here before?":rolleyes: I told her "he wants me on Dexedrine, not Adderall." I told her the other pharmacist just took it upon himself to give me generic Adderall even though the RX said dextroamphetamine. I explained that I didn't notice the mistake until I was already taking it. The RX bottle only said amphetamine salts on it, but in smaller print under it I noticed it said dispense for Adderall. Anyway, she still looked confused and asked for my phone number in case she has trouble getting it. She said "we never ordered this before"! I'm thinking to myself, "how long has she been a pharmacist and she's never ordered Dexedrine?!" Then she tells me it may take until next Wednesday because their orders have been slow or something. I just said okay and left. I have the feeling that she's going to call and say they don't sell an IR form of dextroamphetamine. Another poster here said that she had the same problem and it took her a month of going back to her doctor and changing pharmacies because her pharmacist still insisted (even though she provided proof to the contrary) that there isn't a IR generic Dexedrine.

I'm glad to hear that you've found a med combo that is helping you, that's great!:yes: And yes, I will continue to push ahead until I find what helps the most for me. I know there is no magic pill that gets rid of every symptom completely, but there are many meds and combos of meds that can help a great deal. My mix will be Effexor 150mgs, Valium 15mgs and Dexedrine (hopefully) 20 to 30mgs a day. I hope this will be a good mix.
Take care friend:)

Lunacie
07-15-16, 01:23 PM
Again, this is a question of "if it doesn't work well anymore". My main fear with TRD is the extreme nature of it. If the Adderall depleted or altered certain brain chemicals even more and then stopped working, will my depression be worse than before? I can't bear to even think of it.

Thanks for the input, Sarah, I appreciate it. I guess I'm just wishing I could find a medication or med combo that works and continues to work (aren't we all?), so I can get on with life. Since it's happened so many times before, I guess I feel like I'm setting myself up for another let down. In fact, it was Effexor that pulled me out of the darkness when all the other SSRIs eventually failed; but then the Effexor (after a number of years) isn't working as well. But the Adderall really did wake me up in more ways then one, and I hope it continues.

I don't know if you realize this, but mental illness stinks:D.

Sometimes when we think we are becoming tolerant to a medication, the problem is actually that we are experiencing more stress, or not eating and sleeping as well.

Or our hormones are changing. Or we are sick. Or ... as in your case ... we need meds for an entirely different problem (hypertension).

All of those can affect how well our regular meds are working for us and change over time.

KarmanMonkey
08-05-16, 11:55 AM
My current psychiatrist said it well: Are you currently better off with or without the medication? Is your current benefit of medication worth the slight risk of complications down the road?

If you're concerned about tolerance, the best strategy you have to fight it is to use the benefit you get from the meds now to build the type of self-care, structure and skills that will also help the ADD and depression. The more you're able to do to take care of yourself, the less reliant you'll need to be of the medication, and therefore the less you'll need to worry about future tolerance.

I'm with Lunacie in that sometimes what we see as tolerance to the medication is really other factors, like stress, sleep, poor self-care, or in my case simply the realisation that meds don't magically fix my life caused me to lose a lot of my optimism, and that optimism was responsible for half the benefit I got when I started the med.

AddAnxiousMe
12-17-16, 04:01 PM
My current psychiatrist said it well: Are you currently better off with or without the medication? Is your current benefit of medication worth the slight risk of complications down the road?

If you're concerned about tolerance, the best strategy you have to fight it is to use the benefit you get from the meds now to build the type of self-care, structure and skills that will also help the ADD and depression. The more you're able to do to take care of yourself, the less reliant you'll need to be of the medication, and therefore the less you'll need to worry about future tolerance.

I'm with Lunacie in that sometimes what we see as tolerance to the medication is really other factors, like stress, sleep, poor self-care, or in my case simply the realisation that meds don't magically fix my life caused me to lose a lot of my optimism, and that optimism was responsible for half the benefit I got when I started the med.

I appreciate this post and apologize for the late response. I agree that medications will never magically fix problems, I just hate adding more hard to come off of medications. I'm still on the Dexedrine and deriving benefit from it. If I skip days my main symptoms are tiredness. I can sleep ALL DAY. I only skip a day or two at a time, so I don't know how I'd feel if I tried staying off a week or so. I don't abuse my medications. I have been RX'ed Valium 15mgs a day for years now, and most of the time only take 5 or 10mgs a day. Rarely, if I feel bad enough, I take 15mgs at once. But if I take too low of a dose for too many days, I start to feel the withdrawal. Effexor is just as bad. SSRI/SNRIs and benzos are awful to come off of; and I've never come off of them, I only missed days or lowered the dose and was in misery. But I don't want to ever come off of them because they help me more than I realize. If I go down on my meds, I feel the terrible feelings again, feelings that I almost forgot the horror of before meds. I guess it just gets me down thinking that I'm "stuck" on these pills forever; that I'll never be free or "normal" again. And I also worry about getting stranded somewhere where I can't get to my meds. I can't imagine being forced to withdrawal from Effexor and Valium suddenly and completely. I remember years ago being treated with medications that were not at all (for me, anyway) hard to come off of. Meds like imipramine, Nardil, B-blockers, etc. But those medications had a lot of side effects and weren't as effective as the newer agents, so I guess I have to deal with it. It seems meds that are hard to stop are the only ones that really help.
I'm weary of the depression and anxiety all of these decades. I've been so debilitated by them, yet I always hoped that one day I'd figure things out and be able to be free of medications and doctors. I know, boo hoo hoo:rolleyes:. But of all the things that I've suffered, the loneliness (literally) has been the worst side effect. Loneliness is a hard taskmaster:(.

sarahsweets
12-17-16, 05:36 PM
I appreciate this post and apologize for the late response. I agree that medications will never magically fix problems, I just hate adding more hard to come off of medications. I'm still on the Dexedrine and deriving benefit from it. If I skip days my main symptoms are tiredness. I can sleep ALL DAY. I only skip a day or two at a time, so I don't know how I'd feel if I tried staying off a week or so. I don't abuse my medications. I have been RX'ed Valium 15mgs a day for years now, and most of the time only take 5 or 10mgs a day. Rarely, if I feel bad enough, I take 15mgs at once. But if I take too low of a dose for too many days, I start to feel the withdrawal. Effexor is just as bad. SSRI/SNRIs and benzos are awful to come off of; and I've never come off of them, I only missed days or lowered the dose and was in misery. But I don't want to ever come off of them because they help me more than I realize. If I go down on my meds, I feel the terrible feelings again, feelings that I almost forgot the horror of before meds. I guess it just gets me down thinking that I'm "stuck" on these pills forever; that I'll never be free or "normal" again. And I also worry about getting stranded somewhere where I can't get to my meds. I can't imagine being forced to withdrawal from Effexor and Valium suddenly and completely. I remember years ago being treated with medications that were not at all (for me, anyway) hard to come off of. Meds like imipramine, Nardil, B-blockers, etc. But those medications had a lot of side effects and weren't as effective as the newer agents, so I guess I have to deal with it. It seems meds that are hard to stop are the only ones that really help.
I'm weary of the depression and anxiety all of these decades. I've been so debilitated by them, yet I always hoped that one day I'd figure things out and be able to be free of medications and doctors. I know, boo hoo hoo:rolleyes:. But of all the things that I've suffered, the loneliness (literally) has been the worst side effect. Loneliness is a hard taskmaster:(.

Let go of the idea that you should get to a point where you wont need meds anymore- or that you should be able to get to a point where you wont need them. Someone told me once "everything after 'should' is sh*t."

AddAnxiousMe
12-29-16, 09:07 PM
Sarah, you always know just how to put things:D.
Thanks!

ToneTone
12-30-16, 03:20 PM
I say drop all worry about the future impact of meds. You say you have TRD, whih is treatment-resistant depression? ... Well, treatment resistant depression is hard to treat and stimulants are often used to good effect for difficult depressions.

Your job right now, as I see it, is to take as many meds as you need to feel good about your life. No need to worry about what long-term use of Adderall will do? ... Your brain is unique. I have taken Adderall and then stopped ... and I'm back on Adderall ... I'm very addictive ... from a family of addictions, and Adderall doesn't addict me one lick.

Adderall can be have an antidepressant effect for some people. Let yourself take meds that help you out of the depression. Just do that ... Experience life without depression. You deserve that. Once you are out of depression for an extended period of time, you can build in a good lifestyle and some hobbies and you will have the mental space to THINK about what YOU can do to limit the depression. More sleep or more exercise ... or social time ... or join a support group.

The feeling you have that something is wrong for you to have to take meds--ignore that ... that's depression thinking. You can make wonderful contributions to the world taking meds ... Isn't that all that matters? That you can enjoy life and not suffer so much? ... and then contribute to the lives of others in whatever way you can? ... Your condition of having to take meds is no different than someone who has high blood pressure ... or who requires a wheelchair ... or who is blind ... or who has recurrent bouts of cancer ...

We all need help and support of medicine and friends ... I mean ALL of us human beings. Depression and ADHD are my identifiable issues, but I know people who don't have those conditions who have other problems ... just as severe.

I have a close friend who has never been clinically depressed a day in her life from what I can ... has never taken an antidepressant ... doesn't have ADHD .... Well, for more than two decades she was in a horribly abusive relationship ... And she stayed in it ... when she had options ... She's no healthier or more "normal" than you are or I am.

I have an older friend who takes about 13 medications right now, including two for his mental health ... the rest are for a lot of other conditions. So what? He gets tired of going to doctors ... yes ... But he thrives and lives and has good relationships and enjoys himself in many ways ... He is no less "normal" than someone who take 2 medications ... or no medications.

Hang in there ... sending you deep compassion. You deserve it.

And just for the heck of it, I'm going to ask you: If you were to suddenly feel better tomorow .. or in the next year, what are some of your long-term goals?

Tone

AddAnxiousMe
01-06-17, 04:03 AM
I say drop all worry about the future impact of meds. You say you have TRD, whih is treatment-resistant depression? ... Well, treatment resistant depression is hard to treat and stimulants are often used to good effect for difficult depressions.

Your job right now, as I see it, is to take as many meds as you need to feel good about your life. No need to worry about what long-term use of Adderall will do? ... Your brain is unique. I have taken Adderall and then stopped ... and I'm back on Adderall ... I'm very addictive ... from a family of addictions, and Adderall doesn't addict me one lick.

Adderall can be have an antidepressant effect for some people. Let yourself take meds that help you out of the depression. Just do that ... Experience life without depression. You deserve that. Once you are out of depression for an extended period of time, you can build in a good lifestyle and some hobbies and you will have the mental space to THINK about what YOU can do to limit the depression. More sleep or more exercise ... or social time ... or join a support group.

The feeling you have that something is wrong for you to have to take meds--ignore that ... that's depression thinking. You can make wonderful contributions to the world taking meds ... Isn't that all that matters? That you can enjoy life and not suffer so much? ... and then contribute to the lives of others in whatever way you can? ... Your condition of having to take meds is no different than someone who has high blood pressure ... or who requires a wheelchair ... or who is blind ... or who has recurrent bouts of cancer ...

We all need help and support of medicine and friends ... I mean ALL of us human beings. Depression and ADHD are my identifiable issues, but I know people who don't have those conditions who have other problems ... just as severe.

I have a close friend who has never been clinically depressed a day in her life from what I can ... has never taken an antidepressant ... doesn't have ADHD .... Well, for more than two decades she was in a horribly abusive relationship ... And she stayed in it ... when she had options ... She's no healthier or more "normal" than you are or I am.

I have an older friend who takes about 13 medications right now, including two for his mental health ... the rest are for a lot of other conditions. So what? He gets tired of going to doctors ... yes ... But he thrives and lives and has good relationships and enjoys himself in many ways ... He is no less "normal" than someone who take 2 medications ... or no medications.

Hang in there ... sending you deep compassion. You deserve it.

And just for the heck of it, I'm going to ask you: If you were to suddenly feel better tomorow .. or in the next year, what are some of your long-term goals?

Tone

I am 47 years old and I have no idea:eek:. I suppose having a good friend and being able to get out more would satisfy me for now. And you're right about people battling other things in life; I myself have high blood pressure, a past history of cancer and several other ailments and surgeries.