Hi there! I am new here and to the forums, so forgive the lengthy message and thank you in advance for any info and/or advice given!:)

I am in college, which starts the 25th and I am nervous to go back after I have had to take mini breaks or withdraw because of my ADHD, bipolar II (more depression), anxiety, PTSD syptoms and especially the medication regulation issues!!:confused:
I have been on many different medications for all of these, over the last 6 years after first being diagnosed by a psychiatrist(s), as Bipolar II and only the last 2 years as ADHD, and now I am legally disabled from all of this, I am now 33 years old.

Because of the depression I take Wellbutrin SR 150 mg 1x/day, Abilify 20mg 1x/day (mood stabilizer), Klonopin 1mg as needed (anti-anxiety med), and then the Ritalin 20mg 3-4x/ day (not the long lasting) or I guess I should say the generic name Methylin, and also take Seroquel 25 mg 1x/ night (but only as needed to help get to sleep, and I cut in half because its soooo strong for me.)

I can't seem to get regulated properly, on medications. Have spent a majority of the past 5 years basically being a guinea pig on all kinds of different medications. And now, although I have slightly better focus, and attention span, yet there is no real motivation to start or finish projects, have to really force myself to stay on task to try to finish. Knowing that I tend to procrasinate, a determined lifestyle change in thought patterns and processes have seemingly helped me a little more, to try and push past those urges to just lay down on the couch, yet still feeling that I need to be doing some things that are "on the to-do lists".:eek:

I also have slight headaches, feel somewhat like I am on a roller coaster ride when the med starts wearing off, irritable and have kind of a short fuse, until my next dose is taken and even then it only lasts 2-3 hrs, and so this happens throughout the day, (btw...I have been on Concerta before and it seemingly worked much better, but this Dr. didn't want me to be on that and the Wellbutrin SR at the same time, he feels it might instigate a manic episode, which I am not prone to have anyways...like I said before I battle more with depression) and I also seem to be itching a lot, and I have started to lose more hair than I feel is "normal". Not sure which medication is causing the side effects, like hair loss or the itching...

What side effects have you experienced with the Ritalin or any of these similar combinations??? Any replies would be very helpful, especially if you too, have a dual or multiple diagnosis and medication regulation issues. Thanks!!!:o

Hope that your life is going better today than yesterday and that tomorrow will be even better!!! Have a great Easter Sunday! Ourdestiny:):rolleyes:

Hi OurDestiny! Welcome to the forums!

I have a dual diagnosis of Bipolar and ADHD and am having medication regulation issues myself. I'm 31 and was just diagnosed recently (March 07 w. ADHD and Octoboer w. Bipolar). I have trouble tolerating a lot of meds, so I understand your frustration. I have never taken ritalin, but have heard that it can cause a "bugs crawling on your skin" type of sensation. Could this be the itching? As for the irritibility, etc. when the meds wear off, that could be due to the Ritalin as well as stimulants have a tendency to do that. The short-acting ones especially. I would call your dr. (maybe you have) and explain to him the problems you're having and see if he/she could try a different stimulant. Another thing, I would try to keep track of what time you take each med and what time of day that the problems occur. Different meds have different periods in which they're effective and reach peak plasma concentrations at different rates in your blood stream. Stimulants usually take 20 mins- 1 hr. Seroquel (I am sure of this one as I take it) takes 1 1/2 hrs. to reach peak plasma concentration. You can easily find this information if you click on the physician prescribing info. for each drug on it's website. Wikipedia probably also has this info. as well.

I have no idea if your dr. listens to you and takes your viewpoint into consideration, but you could try discussing a longer-acting stimulant again. (mine prefers them) If he/she is worried about a manic episode, maybe you could make an agreement to track your moods very carefully for the first month you're on the med. You could also tell him/her that you will stop the med immediately if you start getting manic. (easier said than done-- I speak for myself here as I'm on an unregulated upswing right now and it's hard to resist as I've been in the depressive phase since January).

Two other quick ideas:
try consulting a psycho-pharmacologist (they might be able to better figure out how to adjust your meds based on your history and reactions to each one)
you could also try finding a dr. that specializes in comorbid bipolar and ADHD. (mine does-- he actually adjusted my adderall dose before he figured out the mood stabilization situation (still a mess, because I have bizarre reactions to almost every psychotropic med. I've tried)) Fortunately, the adderall does not exacerbate my cycling in any way and it does help even when I'm manic. I have 10 years worth of journals and my mood cycles have continued in the same pattern this entire time. Some years are worse than others, but the underlying themes remain the same.

Happy Easter! Feel free to pm me any time. I completely understand the medication problems and even if I'm a wreck, I enjoy offering support and listening ears (or eyes:)) to other members of the cycling team.

It seems quite common to try and treat every condition someone has with each medication for it..

I've found that since i've been diagnosed with bipolar, the lithium is all i need. I was told that my stimulants wouldn't work with it anyway, but treating the bipolar covers the adhd better then treating the adhd covers the bipolar

With less going on in my head, i can much more easily focus, i even clean my flat without the motivation to do so that i got from stimulants.

I hated being on stimulants because i was on a very high dose and came down really hard. Its to do with how methyphenidate (ritalin) metabolises.. you always know exactly when its worn off. dexamphetamine (similar to Adderall i think, i only know generic names not american trades) is much better for coming down off.

My lithium also covers my anxiety. You could perhaps ask if theres a mood stabiliser you can go onto that is going to reduce the number of medications you need to take... My pyschiatrist believes in firstly treating the most prevelant condition, and seeing what needs to be treated once the primary condition is managed...

Hope this helps!

I'm still having a heck of a time finding meds to work. I had to taper down from a dose of 500 mg/day of Seroquel to taking it here and there for sleep because I developed hyperprolactinemia from it after 9 months of taking it. I've had 2 psychotic episodes in 2 months, the last one, just last week, was mixed and it was horrible.

So the medication cocktail update:
750mg. Depakote, 75 mg. Lamictal, 80-100mg. Adderall, 50-100mg. Seroquel, .25mg. Xanax.

I have to titrate up on the Depakote and Lamictal very slowly as I always have strange reactions to medications so have to be very cautious.

And I'm still not stable although marginally more functional than before). If the current combo doesn't work, I'm going to have to add Lithium. I'm seeing the psychiatrist tomorrow, so he'll adjust things accordingly and I hope I'll even out but not be totally flattened soon.