View Full Version : Do stimulants cause post-acute withdrawal syndrome?


Tosslehoff
08-30-16, 08:15 PM
Here you go, random people on a forum. Something I would not dare speak to family or therapist, let alone friend.

I have many (diagnosed ADD, ASD, ASPD, and we're not even on the second letter of the alphabet yet) mental disorders, the fundamental of which diagnosed as high-functioning autism (no self-diagnosis BS).
From the onset I've been resistant to the idea of having autism - I have quite obvious difficulties, but I don't FEEL like I'm impaired, or broken, or wrong. I've a sample pool of one, and there's simply no way for me to ever objectively verify the diagnosis. Nonetheless, whatever the issue may be, this resulted in exceeding difficulty among peers, and my complete ignoring of other diagnoses.

As a result of this, I was also very resistant to the idea of taking ADD medications. The exact moment I turned 18, I decided that as I was now age of majority, and had no legal guardian, I could now choose my own path. First order of action? Quitting Concerta.

My mental capacity walked off a cliff for the next 3 years. Depressive episodes, perpetual anhedonia. My anxiety (which I attempted to treat, but was greeted with accusations addiction) became so severe that I stopped leaving the house. I've spent the last 5 years almost perpetually indoors. Groceries are delivered to my door, along with all essentials. As per the ASPD, I've never had many friends, but now I don't even have acquaintances. Prior to departing for greener pastures, most friends commented that it was the sporadic waves of extreme depression (for 2-12 hours with sleep as a reset, not like bipolar, nonetheless I got dark)

Honestly not even sure where I'm going with this anymore.. feelings of inadequacy tell me to hit delete what I've written here.

Does this sound like post-acute withdrawal syndrome? What happened to me? With life feeling meaningless, and suicide incompatible with my world view, I begin to dread my remaining years of life. It summons a wish for an accident to end it, to bring a conclusion to years of dredging through meaningless days. An escalation that is quite terrifying to behold.

What happened? Did stimulants cause this? I recall with accuracy that this began immediately (within the month) after quitting Concerta. I have sought help. It has rejected me.

sarahsweets
08-31-16, 04:30 AM
My mental capacity walked off a cliff for the next 3 years. Depressive episodes, perpetual anhedonia. My anxiety (which I attempted to treat, but was greeted with accusations addiction) became so severe that I stopped leaving the house. I've spent the last 5 years almost perpetually indoors. Groceries are delivered to my door, along with all essentials. As per the ASPD, I've never had many friends, but now I don't even have acquaintances. Prior to departing for greener pastures, most friends commented that it was the sporadic waves of extreme depression (for 2-12 hours with sleep as a reset, not like bipolar, nonetheless I got dark)

What do you mean by "not like bipolar?"



Does this sound like post-acute withdrawal syndrome? What happened to me? With life feeling meaningless, and suicide incompatible with my world view, I begin to dread my remaining years of life. It summons a wish for an accident to end it, to bring a conclusion to years of dredging through meaningless days. An escalation that is quite terrifying to behold.

I have never heard of post acute withdrawal syndrome. But upon searching it tends to be something associated with opiates, alcohol and benzos.

What happened? Did stimulants cause this? I recall with accuracy that this began immediately (within the month) after quitting Concerta. I have sought help. It has rejected me.
I dont think Concerta did this. I think you may need some help for anxiety and depression.

Laserbeak
08-31-16, 04:56 AM
No they do not, in the sense that quitting heroin or very heavy drinking would.

You may feel tired, because you've been running on overdrive since you've been taking the medication so you need some time to recharge your batteries. Several days off, plenty of nutritious food, and you should be OK. You may feel a psychological desire for drug, but it is not because of any physical changes to your brain structure that the drug caused, unlike the truly physically addictive drugs like heroin, alcohol, etc.

Fortune
08-31-16, 06:22 AM
Self-diagnosis isn't BS, it's often the first step someone takes to getting help for their previously unidentified problems.

As far as what you describe, it doesn't sound at all like post-acute withdrawal syndrome. It sounds like you had your stuff under control until you quit Concerta, at which point you've been steadily experiencing worse symptoms of anxiety and depression.

aeon
08-31-16, 10:56 AM
Self-diagnosis isn't BS, it's often the first step someone takes to getting help for their previously unidentified problems..

I had to quote this, because I so want to validate this.

Self-diagnosis comes with all manner of considerations, but to dismiss it out of hand is to throw out the baby with the bathwater.

:goodpost:


Cheers,
Ian

Tosslehoff
08-31-16, 02:08 PM
Apologies - to clear that up. I absolutely value self-diagnosis. I'm strictly referring to the huge community of self-diagnosed sufferers of aspergers or high-functioning autism. The majority of these people do not have it, and it makes life exceedingly difficult for those of us who do.

As for not being bi-polar, I simply mean the 'episodes' never lasted more than a few hours, whereas from what I understand classical bipolar episodes can last months, let alone more than a few hours.

Thanks to everyone for the response! I don't know what to chalk it up to. I've tried going back on the Concerta to no effect. I've tried Stratteria, IR and XR Adderall and Dexedrine, XR Ritalin, and anywhere from 36-54mg of Concerta.
I don't actually seem to subjectively experience anything from these? I imagine they'd have an objective improvement on say, an adhd test, but they've done nothing to 'control' my anxiety and depression.

Depression is a tough egg for me to swallow. Clearly, based on my original message, there are a lot of very depressive undertones. I don't actually FEEL depressed though. Life being meaningless feels more like some kind of perversion of Nihilism. There's no emotional highs or lows anymore.. infact I don't even know that I experience emotions anymore. I do nothing because there seems to be a fundamental lack of meaning to every possible action.

Joker_Girl
08-31-16, 04:13 PM
If by PAWS, you mean like a lingering depression, anhedonia (sp?), blah feelings, drug cravings etc, then I would say no, not if you are taking them at normal doses. If I don't take my meds, I just feel unmedicated, but otherwise fine. If I misplaced them and had to go without them a few days, I would be bummed out over it, but not nearly as much as my husband would be.

However in big doses, they can be "enjoyed", of course; I would say if a person was taking them in that kind of amount, there would be a crash, some time period of feeling kind of sad and out of it, an increased appetite, and drug cravings.

The same things you would expect I guess of any drug which alters your neurotransmitters; these affect dopamine, so they are "pleasure drugs".

I would expect it to be more of a thing with cocaine, crystal meth, and strong opiates. Things that cause a strong desire to take more and more of.

And avoiding getting in situations where you are tempted to want to abuse whatever because you are just...idk....bored? Seeking stimulation? I mean, on a normal day, I have no compulsion to want to do drugs, and if I drink, I shut it off after one or two...I'm just done with it, it's not worth the way I'll feel the next day. But I have a couple friends who, if we get started drinking and acting the fool, it's likely to go overboard....we can have every intention of having a girls weekend with manicures and crafting and a bottle or two of wine.....and before you know it, we have drank everything, went to the bar, scored drugs, and now it's 6 AM, and the sun is coming up and you want to die, and you say,

"OH crap, not again!" (Because we never learn)

So ya not sure what I'm talking about even anymore, but there's some point in there, I just forgot what I mean.

But no, taking adhd meds at the doses they're prescribed won't make you want to get messed up, nor will it affect your sobriety (in fact it would likely make it better, if anything). Probably even if stimulants were your drug of choice. Because you're no longer trying to self medicate, spinning your wheels and not getting anywhere.

Tosslehoff
08-31-16, 07:19 PM
Is there anything like PAWS for people who don't have the drug craving component?

I won't hesitate to admit that I was extremely ignorant growing up - it's part of having a learning disorder. The last grade of formal education that I completed was 4. It sounds like a joke, but I didn't even nail down the concept of 'thirst' until I was well into my 20s. The concept of 'drug abuse' is something that only arose after quitting the meds, but it never even crossed my mind that how I felt could be connected.. In my reference frame, 'drug abuse' is smoking marijuana. Therapeutic medicine is for therapy. It is sickening that one cannot google a medication without seeing 40 references to junkie forums.

However, one when describes what they feel when 'high' on stimulants.. I cannot help but draw a connection to how I felt growing up. I had unlimited energy. I hyperfocused to the point of health detriment, and have vivid memories of extreme pressure of speech, or flight of ideas. For all intents and purposes, I acted like I was on speed. I had friends who did all of these things with me, and chalked it up as normal. Is it possible for a child, without adhd, misdiagnosed as having adhd, to be damaged by prolonged exposure?

Fortune
08-31-16, 07:49 PM
Stimulant medications taken as prescribed are some of the safest medications around.

Tosslehoff
08-31-16, 08:19 PM
Stimulant medications taken as prescribed are some of the safest medications around.

Is this the case when given to a person with normal dopamine levels?
To my understanding, there are no comprehensive studies into this. I've spent hours on sites like researchgate to no avail, and it seems more than half of research papers end up compromised by selection bias. On all subject matters.
Can someone point me in the direction of conclusive long-term (at least 10 years) stimulant exposure studies, if such a thing exists?

Tosslehoff
09-01-16, 12:10 AM
Is there really no edit button here? Thought to add that maybe I have a slow metabolism - things like Xanax, which are supposed to be 'short term' and only last 2-3 hours, I can feel into the next day. Even at a normal dose like 1mg.

Goofycook
09-01-16, 11:08 AM
I've been on stims for 7 years. I take days sometimes weeks off with no problems. I have a friend who stopped taking ADHD meds cause a doctor told her it would shrink her brain if she kept using.

aeon
09-01-16, 12:10 PM
Is there really no edit button here? Thought to add that maybe I have a slow metabolism - things like Xanax, which are supposed to be 'short term' and only last 2-3 hours, I can feel into the next day. Even at a normal dose like 1mg.

The edit button is of limited time duration after a post.

1mg of alprazolam is in the normative range, but for what it is worth, so is .25mg. For many people, 1mg would be quite a high dose.


Cheers,
Ian

Tosslehoff
09-01-16, 08:56 PM
The edit button is of limited time duration after a post.

1mg of alprazolam is in the normative range, but for what it is worth, so is .25mg. For many people, 1mg would be quite a high dose.


Cheers,
Ian

Ah, understood. I figured I was at an entry level dose, but since I presented with panic disorder.. probably not.

BellaVita
09-02-16, 12:17 AM
Apologies - to clear that up. I absolutely value self-diagnosis. I'm strictly referring to the huge community of self-diagnosed sufferers of aspergers or high-functioning autism. The majority of these people do not have it, and it makes life exceedingly difficult for those of us who do.

You know why so many autistics are self-diagnosed?

Here are some reasons:
-An official diagnosis often can cost thousands - many don't have the money for this. Many are poor and too disabled to even be able to seek help. Due to this undiagnosed disability they are stuck with little money because they do not have the support they need - and so never are able to afford a diagnosis.
-Many autistics are targets for abuse in their family, and due to that grow up being unable to seek a diagnosis.
-Autistic females often fly under the radar, they are better at putting on an "act" in front of others, pretending to be NT. This causes an autistic burnout where they suddenly cannot function or care for themselves and life becomes very difficult. The diagnostic criteria is based on male autistics and needs to be updated for the female presentation.
-Autistic females are often misdiagnosed as having Bipolar or BPD.
-Those who are older usually are self-diagnosed because when they were growing up autism wasn't diagnosed in the way it is now.
-Those who research and know they're autistic, know they're autistic. So, many just accept this discovery as "enough" and it helps them understand themselves better and create better strategies for managing their lives. A diagnosis doesn't change the fact that someone is already autistic.

Also, people like to assume that those who self-diagnose only spend 10 minutes reading a WebMD or Wikipedia article and decide they have the disorder. This is simply not true in many cases. Most (like myself) research for hours and hours - months on end - as well as going over their childhood history and reading into the diagnostic criteria. (By the way - I had a pretty "classic" autistic childhood - and I fit the diagnostic criteria to a T)

I am a self-diagnosed autistic. I was abused growing up and was unable to get an official diagnosis, and then I was kicked off of my mother's health insurance and do not have the money to receive an official diagnosis.

And lemme tell you - there is no doubt at all in my mind and it is very obvious to those in my life that I am indeed autistic. Those around me accept that I am autistic - there's no missing that I am. And since I have their support and love, trying to come up with thousands for a diagnosis that only repeats to me what I know is not needed at this time.

Those in my life accommodate my needs - for example I can't drive and I can't work. (My husband does both) I can't even cross the street by myself because I get so overloaded by the environment. I often can't go into stores because I get overloaded by the colors and sights and sounds - so a couple people help me out with shopping. And these people love and accept me for who I am even when I rock back and forth, flap my hands, verbal stim, have my meltdowns, go mute, have sensory issues, NEED my routine, and don't mind that I have a lack in eye contact and very awkward body language and a delay when I'm searching for the correct script. (They help me by often communicating through written notes instead of in-person/verbally)

Anyway - I have found the autistic community to be very accepting of those who self-diagnose. I have found those in my life to be very accepting. There's no changing that I'm autistic, official piece of paper or not.

I hope you can understand a bit more why self-diagnosis is important for many, and that it is definitely not BS.

sarahsweets
09-02-16, 05:00 AM
Is this the case when given to a person with normal dopamine levels?
To my understanding, there are no comprehensive studies into this. I've spent hours on sites like researchgate to no avail, and it seems more than half of research papers end up compromised by selection bias. On all subject matters.
Can someone point me in the direction of conclusive long-term (at least 10 years) stimulant exposure studies, if such a thing exists?

While I havent found a long term study to cite for you, medications like ritalin amphetamines have been around for over 50 years. At the very least we would know if there was long term damage. I have taken stimulants for over 13 years and have been fine.