Hello everyone! First I want to say thank you for creatring a place like this. The support is wonderful and I ams o grateful to be able to have somewhere to share in the experiences of so many others who dea lwith this devastating condtion. And yes, it can be absolutely devastating, as we all too well know.

I am asking for your advice. I have an appt. with my psyciatrist early this Tues. morning, and since I have to pay $100.00 for literally 10 minutes of his time, I feel like I have to go in there 'researched' with solutons to offer him rather than the other way around. Maybe some of you understand.

But anyway, a brief history...like so many of you, I spent nearly my whole life undiagnosed with ADD, then was misdiagnosed with basic depression, then bipolar, and those medications on top of the undiagnosed ADD were devastating physically and mentally to me, until my life was basically reduced to rubble.

Finally, about 5 months ago, I received a proper diagnosis after 2 months of testing with a psychologist, and see a psyciatrist to handle the meds part. I was given Adderall XR 15mg and it was like a miracle drug. I could tell the difference from the very first day. Things seemed possible, and I had hope again, and even started to take interest in things I hadn't been able to do, such as writing and crafts, etc.

As time has gone on, the medicine is not working as well as it used to, which is terrifying enough, but I don't know if it's a tolerance or if the stressors in my life which have rose significantly are contributing to that.

The Adderall did seem to wear off quickly and within 2 weeks of first taking it I tried switching to 20mg, but that seemed to be too high a dose and made me anxious/etc. (I also have anxiety disorder. The Adderall was effective in helping that when it was working.) So I switched back to 15mg.

ANYWAY, it's been about 3 to 4 months since I started the Adderall, and I feel back to where I was before I started taking it...no focus, energy, ability to plan, etc. I saw the doc 6 weeks ago and he suggested trying two doses of the 15mg XR a day, as I read that helped people sometimes. There's perhaps a slight improvement, but I feel mostly lethargic and headachy (I've only tried it for three days so I'm not sure.)

But here's the issue and my real question, finally. I'm caught in a horrible situation/environment now which is like poison that I can't get away from, at least not for a while, which may have something to do with the lessening effects of my medcine. It's causing what I call 'situational depression' and I'm wondering which would be the better solution: should I try further changing the dosage of Adderall somehow? Or should I keep the once a day 15mg XR and temporarily add an ati-depressant until I can get out of this terrible funk these circumstances are bringing me? I must state that I am HIGHLY RESISTANT to going on an anti-depressant again because when I was misdiagnosed, I was on everything and they didn't help. They made me sicker and zombie-lke and gain weight and you know the drill. The only one that didn't turn me into a toal zombie was Wellbutrin. It didn't necessariy make me feel better, but of course I was misdiagnosed at the time.

I'm sorry this is long, I'm just trying to make sense ofthis and really need help. So I looked up Wellbutrin+Adderall to check interactions and was surprised to find a board in these forums where people who have combined the two have had good results...an improvement not only in depression, but in the effectiveness of their Adderall working.

Which sounds like the best case scenario to you to try? Any suggestions? I'm beyond desperate and would appreciate any help. Thank you so much!!

Welcome to ADDForums, saracrewe, I can't say that those meds together worked very well alone let alone together, but meds effect everyone differently and some people here swear by that combination. so I would say try for that.

Thank you for the welcome! Is there a combo/solution you've found especially useful? Appreciate any advice! :)

I take Lamictal and Dexedrine together for bipolar and ADHD.

I take zoloft with adderall

I also take 30 mg of adderall xr. My doctor had me on 100 mg of zoloft, which I cut to 50mg a month or so ago, then this past week I cut to 25mg. I've only ever taken zoloft and cymbalta and the cymbalta was only for a month. I did not like it at all.

I started on Adderall IR and moved to the xr after a month. I do like the xr better.

Why are you only getting ten minutes for this appointment? Aren't psych appointments routinely an hour?
I'd question that first. Then just tell him what you said here, circumstances causing excess stress, etc.

Thank you, Delores! I know, he seems to huste people out of his office...and I have topay OOP which really frustrates me sometimes. I've wondered if I should try to find another psychiatrist but they are in short supply and it takes forever to get an appointemnt. Plus my psychologist, who is wonderful recommended him, but I don't know.

Oh, I forgot to mention that the doc also mentioned possibly switching to Vyvanse instead, but I'm not sure...anyone tried this?

I would suggest talking with the M.D. just like you're talking with us here. Your Adderall dose, since it worked well in the beginning, may be to low. I would try the 20mg XR again and see how it works this time around. Since you are paying out of pocket going from 15 to 20 XR will cost the same for 30 capsules. And adding a antidepressant like Wellbutrin with your Adderall XR is fairly common. Just be honest with the M.D. and believe it or not a lot can be accomplished during these medication (ten minute) appointments. And if you have concerns or issues that were not addressed bring them up with your psychologist who referred you.

Almost forgot about Vyvanse. The M.D. may ask you to try this- the choice is yours. Since you already feel rushed for time and you have some other issues which you brought up, if it were me I would first try the higher Adderall dose (maybe with an antidepressant) and if this doesn't help then maybe down the road consider Vyvanse. Good luck.

Lay it all out for your Doctor. What you call situational depression could actually be anxiety and might suggest a different approach, especially if you have reason to believe the situation causing it is temporary.

I have an anxiety disorder and Dex IR turned out to be much easier on me than Adderall. Unlike Adderall I could take the proper dose without triggering anxiety. Vyvanse would have the same benefit.

Thank you all so much for your suggestions and experiences, please keep them coming! I really appreciate it. It's so frustrating not to be able to tell if environment is messing with the med's efficacy, or if it's the other way around or both.....I just don't know where to start.

Looks like Vyvanse isn't included on my insurance formulary yet so that will be out; I could mention Dexedrine since some of you seem to find it a smoother tranistion. Or perhaps I shouldn't switch at all...I hate not knowing. But thank you for your help!

I'm going in there tomorrow and feel like I don't know where to start talking...should I sum up my past and how helpful Adderall was at first as a reminder, then delve into the mess I'm living in now, then suggest the medication changes I had in mind? I just don't want to go off the 'right' med if it's wrong only because of my life circumstances interfering at the moment...part of me just feels like sitting there and sobbing 'Tell me what to do" but I guess that wouldn't be very helpful...

Do you all make a list in the order of things to cover? I always feel like I need to make a 'presentation' or something...I don't know..I just don't know where to start. Any suggestions on what you would do would be greatly appreciated. Feeling overwhelmed and panicked...

Thanks :)

Definitely don't be afraid to jot things down in a notebook and take that with you. Especially if you know you're getting hustled for time with him (*which I would still call to his attention, 100 bucks isn't chump change).

Besides if you're working from things you wrote in a notebook, he sees that you took the time to think things out and shows you're serious about managing your care.

I'm definitely a proponent of educating yourself in all health matters.

Hi Saracrewe,

Your health is not an issue that should be rushed and crammed into 10 min of a doctors' time!
It's surprising and appalling how not caring and money hungry some doctors are. Cram as many appointments as possible into the hour and make a fortune.
I would get rid of this doctor ASAP after your next appointment. Then you'll have a months refill of whatever you need and time to look for a new doctor, who gives you a whole hour. What you pay him for.
If you're insured, call your insurance and complain about this doctor.
If you're not insured and found this doc yourself, well....time to get a different one, even if it takes a few weeks to get an appointment with one.
I called about 40 doctors from the Insurance's list and got a bunch of appointments that were weeks away. Then the last one I called said he could see me the next day. So I called and cancelled the other appointments and went with him.
He's great :) Good listener. Never rushed me. I feel like he's in my team. You know, the feeling you get of a doctor who's not on your side and not co-operative? Every thing's a hassle with him/her type? Well, he's not like that thank God, because I can't stand that type.

About the Adderall losing effect, I can say that I've felt the same way at times, but after a few days of drug holidays, things seem to pick up again.
For me there are days even on Adderall, I get nothing done and things are like the way they were before, but there are much less of those compared to my life without Adderall in the past.
Not every single day is always super productive and that's OK. Because I'm looking at the big picture. I am much more productive than I used to be, more goal oriented and on top of things than before and that's what matters.
I think when it comes to any medication, we have to appreciate the good it gives us, but we can't expect it to make our lives complete or perfect all the time.
There will always be good days and not so good days, but the numbers of the good days will be more on the right medication. We just can't expect miracles from a pill alone. It's still you doing a lot of the positive thinking and going forward.

I think it's a good idea to add an anti-depressant. Wellbutrin from what I have heard is a good medication for depression, although not as strong as Prozac from what I've gathered from books and asking around.
The good thing with it is though that you can feel the effects sooner than Prozac, Zoloft and similar SSRI's. (They take about 6 weeks to build up in the brain and work- you have to give it time- but are more effective I hear)

Best of luck to you and keep us updated.

Thank you so much for your help and advice! Wonderful encouragement, Delores and Starry! :) I really appreciate it. I'm so glad I found this board.

I'll keep you updated and read up on how you all are doing as we travel through these things. Also, feel free to contact me if you ever want to talk.

Yes, I'm thinkng a family doctor where a co-pay would be next to nothing would certainly be better than paying so much money, especially when I'm pressed for finances now. I believe most GPs would be comfortable prescribing ADHD medication and others as long as they have the records from the psychiatrist proving you're requesting valid medication. Have any of you done this, moved from the high priced world of specialized medicine into family doctors once you feel your medications were balanced correctly? Why pay so much more to basically get refills? It's just frustrating trying to feel as though you got the 'right' meds that will allow you to be your best, and fearing you may be missing somethng.

Like Starry said, it's important to look at the big picture...I'll admit I'm very bad about that! :)

As soon as I find my 'magic combo' I'll let everyone know. Hang in there, and thank you! :)

By the way, I'm so glad you found a great doc, Starry! It makes a world of difference. I chanced into my wonderful psychologist (Ph.D. so he can't prescribe meds, but handles all testing, diagnoses, and counseling) the same way...he was the only one who could see me immediately to evaluate me and get me started on the process. Couldn't ask for better. That's how I ended up at my current psychiatrist...there are only 3 in the entire town and surrounding area here, and he was the only one my psychologist could get me in to see on an emergency basis once a proper diagnosis was made. Unfortunatey, the psychatrist who had to prescribe the meds doesn't accept my insurance...

I'm hoping I'm getting near the exact combo and can be comfortable that I've received the best meds and can go to a general doc soon. Good luck to everyone!

It's good to know that things are going well for you.

Hang in there.

Thanks, mspen! It's a long journey ahead still full of uncertainties, but it is wonderful to have people like you to help. Hope everything is going well.

To the OP I am glad things are going good and you are getting a lot from this site. From my experience once a person is stabalized on medication, overall doing well, etc., often these short appointments are referred to as medication appointments/ med management/ follow-up's. However, the time is not set in stone and if you have an issue bring it up. Good luck.