I have been taking Adderall XR since Nov. 2005. For the past 4 months I've been on 60mg XR in the morning. Each time I have increased dosage of Adderall, it works great for a few weeks then the scattered nature of my thoughts returns and I am unable to select a thought/idea to focus on.

Enter Risperdal - my P Doc suggested that a novel anti-psychotic would help (despite my suggestion that an SSRI for anxiety would be a better choice, as suggested by Dr. Amen's books). This resulted in odd side effects, I coudln't understand people and i could not communicate with them. There was a disconnect between my words/actions and the actions my brain wanted to perform. Not to mention the hyper-OCD result of this drug.

Next up: Geodon. Initially ok, but the hyper OCD was back, I could not move away from anything (think work straight through for 9hrs, no bathroom breaks, spending 4 hrs picking the right font).

So she added Lexapro. 3 days into Lex I got very bad tremors (very bad, couldn't handwrite anything). I called and she said to stay the course, they'd go away. Well, they didn't, they only got worse. I had to stay home a few days because the shakes were so bad. I stopped both Geodon / Lex. It's been three weeks since then, I still have essential tremors and notice random twitches in my legs and my mouth. They are like muscle spasms.

My PDoc is not providing me with any useful advice and I am very confused about what is going on, what could cause it and whether it will go away. How can I tell ? WTF!

I don't know but I beleive low levels dopamine can be a cause of tremors.

Yup. SSRIs are well known to cause tremors in high doses. Extreme tremors are what can be seen when serotonin levels are too high, like in serotonin syndrome. (My mom's friend had it once.)

Some SSRIs levels are increased by adding amphetamines. this occurs via the "2D4" enzyme in the CYP 450 Enzyme system.

If anything, amphetamines have an "antidepressant effect" (elevated mood is a well known effect), and folks can sometimes "go off" their antidepressants, once they get stable on their stimulant therapy.

Adding another drug, to reduce a side effect sounds like a BAD idea. (Especially an anti-psychotic. The newer Atypical Antipsychotics may not cause Tardive Dyskinesia [a pseudo-Parkinson's movement disorder] or Dystonic Reactions {scary to watch} -- but there are risks, like Diabetes, etc.)

What happens if you ask him if you can just take your Adderall?

I hate to see anyone taking more and more pills just to combat emerging side effects. (It sounds sorta unsafe, no?)

Maybe a drug holiday is a plan to ask yer Doc about? I mean, you know you don't normally have Tremors, or "Parkinson's", etc.

As usual: Talk to your Doctor.

She sucks, it's as if she doesn't pay attention to any of the side effects I am having, or has trouble understanding that they are unacceptable. She seems to refuse the notion that anxiety can be treated without APs, or that the current course of treatment is NOT ideal.

RE: drug holiday, well, that's what I'm trying next. Not taking any adderall for a while either to see if everything clears up. pretty bad though beause i can't follow anything.

Change doctors or get a second opinion. Adderol with Lexapro works so well for depression, anxiety, and ADHD, but I am taking 30 mg xr of adderol and that is considered a lot. I was told it is the maximum dosage. Check it out.