Are BP-II/cyclothymic patients advised not to use stimulants?

I'm informally dxed as ADD-I. I had informed my doctor that when I self-medicated with Ritalin, I got terrifying effects (euphoria for 30 minutes, followed by the worst paranoia imaginable for 4+ hours); secondly I later self-medicated with Dexedrine and found, while there was a useful increase of focus, I was also energetic and buzzed at relatively low doses. There was no mention of a mood disorder and no evaluation for one suggested.

Later on the entire self-medicating episode escalated to addiction, and then became very serious, as I was engaging in highly self-destructive behavior. Still, with full knowledge of the incident, the shrink made no mention of a mood disorder.

However, prior to the episode with drug addiction (which began at 21 years old), I was a very risk-averse person and my frequent desire for stimulation fit neatly into an ADD typical box (video game addiction, computer usage, avoidance of boring tasks like schoolwork, procrastination, etc.) At best I had latent hyperactivity in youth, mostly subsiding at around age 10-11, however what I have always had most prominently are inattentive/daydreaming symptoms.

The only official diagnoses on my records are GAD and depression, although Paxil helps significantly with both. I'm seriously considering trying a pseudo-ADD drug for inattention/amotivation now because I seem to be very sensitive to stimulants, in general, see above where I mention Ritalin and Dex. Caffeine gives me a good buzz at average doses, too.

As far as things that may fit with a mood disorder, I do tend to have a fragile mood and I'm often irritable (now, how often do I see this in ADHD people??.. a lot), I have this thing where I "have to be in the right mood" to do something boring or undesirable.. I dunno, what else to look for?

If it is Bipolar-II (or something) instead of ADD, it would be mild. I've never been talked to about a mood disorder (I've had 3 shrinks through the years). One thing that doesn't fit for ADD, with me, is strong effects from stimulants. But I don't know if that can be used as evidence for a mood disorder.

And the last thing... is Wellbutrin okay for most people with a mood disorder??

Hey Batman -- Nice to see you here.

I have actually found that a stabilzer type of med like Gabapentin or maybe Lamictal will work better without the bad crashes from ADHD meds. One of the reasons I stopped taking Adderall & Vyvanase. I would have this euphoric or buzzed feeling for 2-4 hours then have the worst paranoia & irritability imaginable.

Hey Batman,

Whoah.. yeah, it's certainly a slippery slope if you're comorbid in this department. I myself am Bp II and inattentive ADD. BP II is considered to be a milder form of Bipolar I, but in some ways.. it's just as tumultous. Bp II's generally don't have manic episodes (usuall present in Bipolar I's), but upon taking Adderall it precipitated my first manic episode-- and let me tell you.. it was a devastating one. I was hospitalized.

You mentioned Wellbutrin. Having a mood disorder and having taken Wellbutrin, I had an adverse reaction to this med as well-- severely depressed. But hey, you have to try different meds to know which one works, right?

But for sure, it's well known that great caution has to be taken when prescribing stimulants in patients who're Bipolar. It can put the heels on some pretty nasty cases of mania.

Hope this helps. Docs are well aware-- they should help more in this arena.

Hey Batman -- Nice to see you here.

I have actually found that a stabilzer type of med like Gabapentin or maybe Lamictal will work better without the bad crashes from ADHD meds. One of the reasons I stopped taking Adderall & Vyvanase. I would have this euphoric or buzzed feeling for 2-4 hours then have the worst paranoia & irritability imaginable.

I got the same exact thing when I self-medicated with these drugs, but I'm not diagnosed with a mood disorder, nor has one ever been suggested. My last shrink agreed with my idea that I have ADD-I, and he knows I have anxiety problems, but made no mention of "possible bipolar." That said...

Can we talk more about what is actually diagnostic of a mood disorder here? I've not had any suggestions that stimulants causing strong effects or paranoia is diagnostic of the bipolar spectrum... as we well know, about 20% of people with ADD do not respond optimally to medication. It could be my anxiety disorder that causes strong effects from stims, rather than a mood disorder.

I'm not convinced that I have a mood disorder.. so, why am I looking into it? Well, some people on this forum are seeing me say "I have ADD-I and stimulants tend to bring me up" and reacting with, "you might have a mood disorder instead." So, this is why i'm finally looking into it... I apologize if I didn't make myself clear on this.

Your reaction seems pretty strong for an anxiety disorder. You should get evaluated for bipolar. Ask your doctor. If he doesn't help you enough, find a new one.