I'm 37 & recently diagnosed. Like many others, I was being treated for depression & what was mistakenly thought to be bipolar.

The more I read & research the more I understand & identify.

My Dr added Wellbutrin XR 150mgto my Effexor 150mg. I took that for 3 months with only a slight mood improvement & NO effect on the ADD & then she doubled it to 300mg with absolutely no effect at all.

The problem is that she told me that she won't prescribe stimulants to adult due to the "street value" & the misuse as a weightloss aide. I am desperate for help with this, my job is in jeopardy & my homelife is a mess as usual. Luckily I have a loving & supportive husband who understands.

My counselor is awesome! He has been great with helping me to develop tools to cope with my "quirks", but there are some things that I just can't seem to control.

What should I do??? <!--[if gte vml 1]><v:shapetype id="_x0000_t75" coordsize="21600,21600" o:spt="75" o:preferrelative="t" path="m@4@5l@4@11@9@11@9@5xe" filled="f" stroked="f"> <v:stroke joinstyle="miter"/> <v:formulas> <v:f eqn="if lineDrawn pixelLineWidth 0"/> <v:f eqn="sum @0 1 0"/> <v:f eqn="sum 0 0 @1"/> <v:f eqn="prod @2 1 2"/> <v:f eqn="prod @3 21600 pixelWidth"/> <v:f eqn="prod @3 21600 pixelHeight"/> <v:f eqn="sum @0 0 1"/> <v:f eqn="prod @6 1 2"/> <v:f eqn="prod @7 21600 pixelWidth"/> <v:f eqn="sum @8 21600 0"/> <v:f eqn="prod @7 21600 pixelHeight"/> <v:f eqn="sum @10 21600 0"/> </v:formulas> <v:path o:extrusionok="f" gradientshapeok="t" o:connecttype="rect"/> <o:lock v:ext="edit" aspectratio="t"/> </v:shapetype><v:shape id="_x0000_i1025" type="#_x0000_t75" alt="" style='width:12pt; height:15.75pt'> <v:imagedata src="file:///C:Documents%20and%20Settingsnlippi1Local%20Setting sTempmsohtml11clip_image001.gif" o:href="http://www.addforums.com/forums/images/smilies/confused.gif"/> </v:shape><![endif]--><!--[if !vml]-->:confused:<!--[endif]--> I've read a lot & have discussed it with an acquaintance who is a psychiatrist & a friend who is a neurologist. They think that stimulant therapy could work for me.

Thanks for your time,
Buttercup

I would say find another doctor.

It's great to hear you've found such a great counselor. It would be a pity though if you'd have to settle with the tools you've developed now if they're not enough and if you could get better results with stimulants.

Good luck and welcome to the forums!

Buttercup,

I agree that you should look for another doctor. What kind of testing have you done for your diagnosis? If there is any possibility you are bipolar as well as ADHD, you would need to go a slightly different route w/meds.

I would ask your counselor, your friends the psychiatrist and the neurologist for a referral. Is there a reason you can't go the psychiatrist that you already know?

WELCOME to the forum!

Good luck with everything!

Try being a college student just diagnosed. Yeah they were REALLY suspicious about me.

Thanks for the advice. My boss has also asked me why I can't see my Dr acquaintance. Perhaps she sees a conflict of interest due to the fact that I work with her husband.

I have an appointment with a new doc in 2 weeks. I hope I don't screw-up anything until then! The harder I try the worse it gets.

Is it possible that the current med increase from 150mg Wellbutrin XR to 300mg in exacerbating the problem?

Or is it in my head?

Thanks again,
Buttercup

Welcome to the forums, Buttercup! Stimulants have a better track record of working effectively for ADDers, so it might be worth finding a doctor who would give you a trial of stimulant medication. There are 20 to 50 percent of adults who aren't helped much by ADHD medication or who can't tolerate it -- hopefully you're not one of those. Either way -- there is a good book I'd like to recommend that I've found helpful. I had to get off my medication due to developing facial tics. Mastering Your Adult ADHD is an excellent workbook (written by Safren, Sprich, Perlman, and Otto who are professors at Harvard medical school and work with with lots of practical usable tips. This approach has been researched and found to be effective in helping reduce ADHD symptoms -- ideally it is used in addition to medication but can also be useful without if meds are not an option. They recommend that you use it with your therapist -- there is also a therapist manual available. Since you have such a good counselor, working with him on this program might be a useful option for you.


Take care,
Scattered

PS: There is a narrow window of effectiveness with ADD medications -- too much can be ineffective, just like to little. Also since you're taking two medications, that clouds things a bit. Some medications like serontonin boosters lower the dopamine available which is one of the neurotransmitters in play with ADD. For example, when I started taking Prozac, I was calmer, but I was more forgetful than when I was on Concerta alone.

I have ordered'"Driven to..." & "Delivered from Distraction". Can't wait to read them!!

My current dr has agreed to meet with my councelor & I this Thursday. I hope to make some progress.

Has anyone else felt an incredible urgency right after dx? I get the feeling of "I've suffered too long with this! I want help NOW!!!!!" It's kind of obsessive. Is this bad?

Thanks!

I agree that you should look for another doctor. What kind of testing have you done for your diagnosis? If there is any possibility you are bipolar as well as ADHD, you would need to go a slightly different route w/meds.

Gee if the amount of antidepressants she is on hasn’t sent her into some sort of orbital mania I would doubt bi-polar. I am no doctor I just know by experience {bi=polar daughter}that antidepressant normally send bi-polars into mania.






Is it possible that the current med increase from 150mg Wellbutrin XR to 300mg in exacerbating the problem?

Or is it in my head?

I doubt it is in your head especially if things began getting worse after the increase. I believe if it seems like your symptoms are getting worse after the increase then I have no reason to doubt you. I see it as a very real possibility.

Disclaimer-Drug information not to be used as a substitute for a professional opnion.

wellbutrin (http://www.drugs.com/cdi/wellbutrin_tablets.html)


Effexor (http://www.drugs.com/cdi/effexor_extended_release_capsules.html)

Although there are no drug to drug interactions I could find. One thing is you are not supposed to stop these drugs suddenly without a doctors supervision.

My personal non-professional opinion as a fellow ADDer.

Two antidepressants because she didn’t want to give an adult stimulants for ADD because of the street value wtf !!!! I would have gotten up and walked out right then and there because frankly I would have found that insulting. I haven’t a clue what the street value is and I don’t care.

I am sorry but in my honest non-professional opinion your present doctor doesn’t seem like she needs to be even treating ADD especially in adults. In my opinion as a peer this doctor should have referred you to some one else when the first antidepressant didn’t work. Your post indicates the doctor was not very up to date on adult ADD,. .

I base this statement on the following which by the way this has been known in the ADD community and among the ADD familiar medical professionals for some time now.

ADDers.org (http://www.adders.org/info74.htm)

Medication and Addiction

Psychostimulants medication when properly prescribed and monitored is effective for approximately 75-80% of people with ADHD. These medications include Ritalin, Dexedrine, Adderall, and Desoxyn. It is important to note that when these medications are used to treat ADHD the dosage is much less that what addicts use to get high. When people are properly medicated they should not feel high or "speedy, instead they will report increases in their abilities to concentrate, control their impulses, and moderate their activity level. The route of delivery is also quite different. Medication to treat ADHD is taken orally, where street amphetamines are frequently injected and smoked.

Non stimulant medications such as Wellbutrin, Prozac, Nortriptyline, Effexor and Zoloft can also be effective in relieving ADHD symptoms for some people. These medications are frequently used in combination with a small dose of a psychostimulant. Recovering alcoholics and addicts are not flocking to doctors to get psychostimulant medication to treat their ADHD. The problem is that many are hesitant for good reasons to use medication, especially psycho stimulants. It has been my experience that once a recovering person becomes willing to try medication the chance of abuse is very rare. Again the key is a comprehensive treatment program that involves close monitoring of medication, behavioral interventions, ADHD coaching and support groups, and continued participation in addiction recovery programs. ***End Quote

~underlining and bold mine~

Medication actually prevents me from using illegal drugs. By treating the symptoms I use the illegal drugs to eliminate. Naturally I was clean and off drugs for three years before being diagnosed as ADD. A big hint was when my college grades became worse after “sobriety” where as most addicts grades improved after soberity.

I am glad to hear you are seeing another one but you may want to be sure the second doctor has more up to date information about adult ADD other wise it will be another wasted trip. .

Thanks meadd823,

Very, very helpful!

My new Dr, 1st visit today is a specialist. I brought here my 1st - 9th grade report cards (don't know why I've kept them for all of these years.) & notes that I have been taking over the last 3 or 4 weeks.

She commended me on my organizational skills. Although she followed it up by mentioning that my speech was very unorganized. :rolleyes:

Queen SPAZZ! That's me.

I really like her.
I go back in 2 weeks for a follow up.

Wish me luck.

bc

re: last comment

Said your speech was unorganized, or disorganized? 'Disorganized speech' can happen in bipolar.

Unorganized in the sense that I have a point, a direction & engagement to the topic at hand. I communicate effectively, but I speak in fragments. My thoughts are complete I simply fail to finish the sentence & then continue with a new fragment.

It occurs when I begin to say some thing & the decide that it would be better stated a new way. It can happen up to 3 to 4 times. At that point I'm done & feel the need to follow up with the next point.

It is a warped sense of efficiency that is incredibly inefficient. Almost like my brain believes that language structure is superfluous.

bc