View Full Version : snri (pristiq) with desoxyn . kinda long but please look if u can help at all,thanks


Yellow
05-16-09, 12:58 AM
hey desoxyn people

i am on

15mg Dex - 3x a day
50mg pristiq
.25mg-1.5mg klonopin - bedtime and/or as needed

basically, i have adhd, depression, and low anxiety

pristiq is an sn(d)ri with the majority of the mechanism focusing on serotonin, the ratio of Serotonin:Norepinephrine reuptake inhibition is 1:9, like duloxetine/cymbalta. Its dopamine reuptake inhibition is very slight, but it exists.

zoloft is an ssri that is considered to have quite potent da action in high doses (300mg i belleive), and effexor (pristiqs primary chemical) is known for potent reuptake of norepinpehrine in high doses (400mg?) with slight dopamine reuptake. im not certaion but i think effexor's SE:NE ratio is lower than pristiq's considerably something like 1:30...so that means the dopamine reuptake is even less.

but since pristiq is a basically a much better balanced and more potent and i guess 'cleaner' SNRI, would that imply that its dopamine reuptake would be more than effexors?

in any case, my point is that pristiq effects all of the transmitters that desoxyn targets...so my question is:

Can someone take pristiq with desoxyn? Would pristiq offer neuroprotection from desoxyn's toxicity? What would the effect be? and most importantly

IS ANYONE ON BOTH AN SSRI/SNRI/NDRI/SNDRI AND DESOXYN?

Pristiq and dex is a great combination, but after reading all of the desoxyn users comparison of the more subtle effect of desoxyn, i am thinking of possibly trying it in the future. i do like dex's help, but i am thinking of something a bit less stimulating while still offering wakefuleness (anti-lethargy/apathy) and concentration and focus. it seems that desoxyn provides dex's benefits without some of its undesirable side effects(such as the slight NE increase, sometime a little anxious, hence klonopin) and it lasts longer too right? instead of 3 dosings that might be something i woldnt mind down the road...anyway, im just curious about it now that ive learned about it.

i wasnt aware of its existence until really posting and discussing things in the dex forum, which has been so unbeleivably helpful for me that i honestly dont know what i would do without having found this site.

i really hate computers, internet, and like the whole concept of virtual interaction (tho i admit its kinda like a phone in a way, but stil...i just wanna hear or see someone when i talk), anyway i really am greatful for this forum and i appreciate the members sharing and honesty of their experiences because it is through that that i have been able to understand whats going on with me, learn through it, and finally getting close and closer to feeling "normal." if i didnt come to this site, i would have given up on meds that i really needed a long time ago, but the information saved me. anyway, thats off topic (obviously its 12:30am, and since i wake up at 8, the dex has long worn off and my adhd is back, reminding me to sleep...i kinda missed it, NOT! lol)

i am sensitive to stimulants. i cannot drink caffeine or energy drinks like guarana and whatever else those crazy drinks have. i have stayed far away from recreational substances like cocaine and meth for the very reasons that i stay away from legal caffeine and stimulants like this. i just am sensitive i guess.

now, i have tried all types of amphetamine brands (shire dex and adderall, barr dex and adderall, and in different variations of pill strengths, doses and release). i couldnt take adderrall of any kind because of the levo and racemic mixture: anxiogenic problems. dextroamphetamine saved me tho! :) exaggeration but really, its great. [note: i stayed away from methylphenidate because of so many bad things ive heard from posts and then science journals, it sounded like a possible health risk to me. ]

the only thing that i have stuck with is 5mg barr generic brand dextroamphetamine this far, and i intend on sticking with it if it continues to work this way for a while. i guess you can call this a combination of my interest in psychopharmacology (i HIGHLY recommend reading stephen stahl's essentials of pscyhopharmacology, i actually lent it to my psychiatrist to read as it is the newest edition and its really really informative. it has helped both me and my psych come to a combination that is as synergistic that i could hope for) combined with a pre-emptive attempt at looking at possibilities because:

tho the dex is great, i have a slight issue with it. its nothing to complain about but its something thats on my mind since i finally feel SO CLOSE to getting to feeling how ive idealized that i could. i was always resistant to meds, but reading and sites like this have changed me. anyway (sorry i realized i went offtopic again) as smooth as dex is (in comparison to adderall), i still sometimes get undesirable side effects, and klonopin helps this, but it also somewhat dulls the effectiveness.

as i said 15mg is my dose. now (under my dr's permission) i tried 20mg a few times. i think this is really my therapuetic dosing window, but at this level i feel "high". i dont like that in the same way that i do not like the PNS and anxiety side effects of adderall. at 15mg dex is hardly noticable, i just do what i have to, however, i sometimes get TOO engaged where interuption can make me irritable and i sometimes get easily annoyed with whoever did it, you know, its not cool.

also the opposite tends to happen more frequently. i feel forced into doing something that i begin or think of(that i really dont have to, such as my hobbies or a random errand or chore that has been put off because it isnt important whatsoever), i feel like i GOTTA do something.

The fluctation between these modes is not an every dose thing, but i dont like when it does happen. meanwhile, 20 mg is more effective, but i dont want to get attached to it. i dont want the euphoria or whatever else to make me an addict. i hear many get addicted to dex, and i barely take my klonopin as is for fear of addiction/dependence so to end this whole dibackle:

i want to see if desoxyn can actually do for me what it did to the others here that have switched from other amphetanine meds (for either similar or other reasons). objective is to find something that stimulates my brain without bodily desire for action. i want to be focused, interested, and engaged in my work, but i do not want to be franticaly involved. simply, i want the wakefulness, clarity, focus, and energy/motivation WITHOUT feeling like have to always move to get something done. in a phrase: relaxed focus.

So please post responses, thoughts, suggestions, ideas, any feedback on my interpretation of med responses and if this combinatino of an SNRI with desoxyn is done/safe/heard of/beneficial...

THank you for reading, and i once again, i appreciate the honesty and openness shared herein. GOODNIGHT, off to sleep...

Yellow
05-16-09, 10:40 AM
oh i forgot to add: another goal (besides the "relaxed focus") implies getting rid of the klonopin. i would much rather just take 2 meds (pristiq + desoxyn) than the 3 i am taking, i would really like to lose the benzo...i mean as with adhd meds, the abuse/addiction potential is something id rather have outa sight, outa mind. if desoxyn can give the same mental effects of dex without the physical stimulation, i think i could eliminate klonopin. its less meds, less dosing, less tax on my body (unlesss desoxyn is actually more harmful than klonopin, idk,) but to me, it would make sense to eliminate a drug if i can.

Yellow
05-18-09, 11:02 AM
MODERATOR, hello there. since no one is responding at all lol, please edit this thread title and posts so that someone might be more willing to read or respond because i think the title is not inviting and the post might be a little too long (especially for an ADD forum lol).

please change this thread title to "Desoxyn with SSRI/SNRI's"

please also edit the first post by merging it with the second, and simply put this on top of everything so that people can just read this and respond and if they want, they can read what im asking more specifically about me:

"Is it safe to take Desoxyn with an SNRI/SSRI/NRI/NDRI or any SE/NE/DA reuptake inhibitor? Does anyone take this combination? If so, what do you take, what dose, and what are the effects? Does it prevent neurotoxicity?

---------------------------------------------------------My personal history--------------------------------------------------------:"

...followed by the first post and second post (merged). Please do this if you can, and if you cant cuz its difficult or not editable please tell me, ill just make a different thread altogether. THANKS VERY MUCH, bye

hollywood
05-18-09, 11:50 AM
yellow , is pristiq sedating? I have tried cymbalta but I was so sleepy temporarily, it's hard to stick with things when they make your adhd worse.

Yellow
05-18-09, 12:24 PM
actually its not but initially it was, i was extremely drowsy for the first few days, yawning constantly for almost a week. about 3 days into it, i noticed slight mood improvement but i was tired. 5 days into it, the mood enhancement remained but i wasnt yawning as much. After a week, I had more normal energy and eventually more energy then i used to in general afterwards. Pristiq was actually great man, the only AD ive ever liked and stuck with. I hear its nothing at all like cymbalta although they have the same SE:NE reuptake ratio. give it a shot if you were hopeful about cymbalta but didnt like it. pristiq also has some dopamine reuptake inhibition, i dont know if cymbalta does (it probably might) but its not significant.

honestly, pristiq increases dopamine in the prefrontal cortex, in the way that strattera does also, but it didnt help much with ADHD, but it didnt make it worse either. so thats something to consider if u didnt like cymbalta.

What anti depressant and dose do you take now ? Are you on desoxyn or another med (and what dose)?

hollywood
05-18-09, 01:26 PM
yellow,

I currently take concerta in addition to ( wellbutrin) the problem that I have is that I metabolize fast but as you know stress and daily ruminating can cause differentials in the way your body is metabolizing , so if I were relaxed I may actually require a lower dose of time released ritalin. I hope to trial adderall xr with ir dexedrine eventually but I self assess so much now it's ridiculous and find myself always going back to concerta. Wellbutrin helps lift my depression and brings back motivation but it doesn't assist my worry thoughts that are routine on the job. While I'm at work I feel tired and fatigued, when I'm not at work I do not feel any fatigue. Additionally, while I was on cymbalta I felt happier about life, but I felt sleepy and lazy as well... it kind of put in me in a tough position because my adhd was a bit worse temporarily. I need to break out of this circle and stick with a med that will help me relax, not think based on emotion and just let my meds work without consuming myself with why can't I get out of this job and move on with my life and become smart once again. Wellbutrin helps , but a piece of the puzzle is still missing and it's annoying the crap out of me. From what I hear pristiq is similar ? So, has it helped you tremendously? The good thing about having adhd is alot of times we are not truly depressive types , but if we do get mentally stuck stimulants can cause us to ruminate about the things that are bothering us, and that is where I am currenlty. I appreciate your feedback

Yellow
05-18-09, 11:57 PM
Also as far as honesty goes, im psychotic bipolar WITH Adhd, so im not necessarily always depressed, but my adhd makes me not be able to get anything done which is depressing and then my bipolar makes everything worse. I tried antipsychotics/mood stabilizers and i will never again, they are poison that should only be used to really dull down a psychotic individual who hurts others. on the other hand, i responded nearly instantly to pristiq. it is rather strange, but within days, the improvement was profound. what it lacked was the focus/concentration/motivation, as wellbutrin lacks (my father takes wellbutrin for depression, thinking it will help with energy and focus, but hes always disappointed).

First thigns first, i think wellbutrin is not a good drug if you have any anxiety whatsoever, drop wellbutrin. if by "worry thoughts" you mean anxiety or nervousness, lose wellbutrin. i would just lost it period. if u dont have anxiety tho, and the dpression is helped by wellbutrin, think about this.

Ritalin is an (N)DRI, but its more potent and shorter acting than wlllbutrin. wellbutrin structure is similar to amphetamine and ive read of overdose cases where people took grams of wellbutrin to get an amphetamine rush and they probably did so, but it was in the emergency room. wellbutrin at significant DRI levels can cause seizurs (450mg) Ritalin on the other hand doesnt do this, My point is one ritalin and wellbutrin do the same thing (almost) but ritalin is much better for AD/HD. its supposed to be for that. wellbutrin is an antidepressant for people who dont respond to SSRI treatment, which is common. wellbutrins not for adhd at all. its for atypical depression.

if ssri's dont work, SNRI's usually do the trick, and ndris are last call, but you didnt like cymalta. I would still suggest trying pristiq cuz honestly, its too awesome not too give it a shot, i really really recommend it highly. i was totally ANTI meds, but now that ive been on pristiq for a li while, i dont even care if i never get off. ANyway, since ritalin is an NDRI for ADHD, and wellbutrin is a weak NDRI,and i mean very weak DRI,most of it works on norepinphrine, lose wellbutrin and stick with ritalin. then add in pristiq for the antidepressant. or whatever else, but ritalin is what u need for ur smytpms.

now to be honest. i say screw MPH altogether, and get DEX. it took me 4 brands (about) and pill dose experiments to get it right, but after everything, dex 5mg barr is my answer. I really cant beleive i like taking my meds now, like i dont mind at all, i used to be like "oh man now im a drug addict addicted to amphetamine and antidpressants, my life is now only headed down", but now that ive adjusted to everything, ive never felt better. PRSTIQ is the KEY COMPONENT THO. It set up the correct evnironment for dex to work, and now i have my mood/functioning monamine nerotransmitteers in check....SNRI + DOPAMINE. MY depression is stablized with the pristiq, my mania is controlled by klonopin, and my adhd, mood, and functioing is topped off by dex.

plus no neurotoxcitiy with this combo (supposedly) as excess dopamine from amphetamine gets reuptaken into norepinphrine cells causing toxicity, and then some norepinpehrine can get sucked into serotonin causin SERT toxicity, so the SNRI keeps the pumps from getting screwed up, and i think pristiq's VERY VERY slight dopamine reuptake also keeps the dex in check. you know, i dont get any rushes like the euphoria that some people talk about. i just get focused, stable, and into what i gotta do.



i switch docs like i switch cell phone numbers (thats often btw). however, with this psych, i aint goin NOWHERE. hes excellent, excellent. truly a great doctor and i didnt think these kind of psychs existed, ive only had quacks up till this guy. by quack i mean:

dr "whats wrong with you?"
me.."i dont feel well and..."
dr...."ok, heres a sample and a prescription, call me if you need to ask a questions....".
me..."um ok, can i ask a quest-"
dr..."TRY THE PRESCRIPTION AND CALL ME IF THERES AN EMERGENCY..." with a nod and a glance towards the door

now of course not exactly. i wont get into therapists, but my first psycdoc at 15/16 that my parents brought me to asked me why i was there. iwas there cuz my parents dropped me off dick. from there, he should have taken control. first of all i didnt even know what anxiety or depression was, let alone the serious problem of adhd, so i told him i got nervous alot and that i had trouble sitting still in class. so then he asks ME which of my problems I wanted to treat, as if i knew what they were anyway. DUH i was 15/16, and hes askin me what i should do? hey doc maybe do your job and try to assess the situation and treat what you think is more problematic. Celexa didnt work, paxil didnt work, and i gave up with him and his SSRI nonsense.

on to pysch 2 at 19/20: within minutes of meeting her i could tell she was going to be aproblem. now i was also ****ed off at my parents for makin me go again, but someone had spread a rumor about me, my parents heard it and i was sent to make surei was OK! well a "freind" got caught with things that he shouldnt have had byhis parents, and since i was not cool with him (we had an argument and i didnt talk to him to the point that he got caught) he pinned it on me. now this kids father knows my uncle, so when he saw him he said hows your son, he says my sons fine, why do you ask, my uncle says "oh your son and my nephew are freinds", so this dick goes "no theyre not, my son would never hang out with a kid that does --------------", so my old school uncle was like WHAT and told my mom, my mom hears, calls upa psych, tells her what " i did" and i walked into a setup. i got ****ed because i knew what was goin on, answered in ways i shouldnt, and got bipolar right then and thre: SEROQUEL. well after 2 pills, that ended that experiment (PS i found out later that despite patientdr confidentiality, and iwas over 18, she was teellin my parents EVERYTHING and she included stuff in my file that wasnt true, such as the reason i was there which came from my parents mouth, and i had to confirm this and had to amke sure she took it out of medical records cuz that could be potentially a problem if it ever came out, and i told her id sue for malpractice if she didnt take it out, as i never said it and she heard it from my mother who heard it from my uncle who heard it on hearsay...so bad time again)

psych 3: now this guys a real winner. he was from china, and he could barely speak english. i mean simply verbs, nouns, and if your lucky, and adjective. no idea how to use prepositions or construct sentences. HE could count cash very well tho. so i walk in and within 3 minutes, he assures me i have adhd. now i already knew this, but he doesnt. four minutes into the "intake" he asks me "do you want ritalin or adderall?". im like wow, this guys nuts! well i was only familiar with adderall, and i didnt know anyone who took ritalin, so i said adderall...barr adderall. BIG MISTAKE. didnt try it again.

i looked up online, found out about dex (i googled something like "Adderall without side effects" or something like that) and a post from www.dr-bob.org (http://www.dr-bob.org) came up. it explained how dexamphetamine doesnt have the other 3 adderall salts and is much smoother,cleaner, and a better experience

i printed this out brought it in and told him i wanted to try this instead. he said he NEVER HEARD OF IT, perhaps the oldest amphetamine in the world and the classical prototype of stim meds. so he looks in his little (chinese/english) drug book, and finds dextroamphetamine, looks at what the book tells him to prescribe (10mg a day) and gives me that without hesitation. this took about 4 minutes.

i tried dextrostat and it was MUCH better. however, still not right. he wouldnt help any further, no anti depressants, no benzos, no alpha blockers, not even a valerian root or diphenhydramine suggestion.

psych 4: another asian dude, he spoke english though. i walked in and he said your bipolar. heres depakote and klonopin. well depakote is pretty much wors than bipolar and i didnt even take seroquel so that was that for that. klonopin however, stops my episodes or makes them very very downtuned. its enough of a sedative and mood stabilizer instead of using an antipsych. actually first line protocal is to give manic/schizos in the middle of episodes klonopin immediately (usually, they also sometimes use lorezepam or xanax, but kpin is #1) so i found something along the way again with this guy

revist to psych 3: i told him that i wanted to go back on dex and he wanted to be paid for an intake fee (keep in mind, i didnt see him in about 4 months) to reevaluate my adhd. i didnt know what he was talking about cuz his english is really unintelligble so i said well my insurance said they would pay for 10 visits, and ive seen you about three times, so i still have 7 left, so i dont see a problem. for the first time since i met him, he smiled and began his evaluation: "why did you stop treatment? why do you think you still have adhd? how did u function without the meds? why do you need them now?" after answering these basic questions that were useless, he said "ok i still think you have adhd, heres your prescription".....i said "wait, i wanted to know if u can help my anxiety issues as well and i told him that i saw a dr in the meantime and requestedzoloft and klonopin to help my anxiety and mood. i didnt take zoloft buti head it was greaet and i was open to a new ssri, and kpin was taking .25-.5mg a day, so were talking like NOTHING at all, no tolerancebuildup no addiction or habit formation, no problems and i brought the bottle with me. he said HAHAHAHA NO. only dex....then he called me th next daytelling me that my insurance wasnt going to pay a re-eval and he said i had to pay him immediately. i said i dint know what he was talking about and i called my insurance. they explained his nonsense, that he wanted 350 dollars (instead of the 150 regular appt fee for a 5 minute session, literally) cuz he needed to make sure i still had adhd, like it goes away. so i told them hes a quack, he did no reintake and he only saw me for 5 minutes before showing me the door, i said to them dont listen to him, and they said, we thought so , thank you and dont worry about the bill, well take care ofhim. they sent him the usual visit fee and he didnt like that, he wanted the 200 from me. he called harassing me (i dont know if it was english or chinese still) but i knew he wanted money so i told him he was trying to take advantage of me and my insurance, first of all not speaking properly so i wouldnt understand that he would need extra money (for no reason), and the i told him to take a hike. he got his 150 and i never heard from him again

psych 5: finally! this guy listens, he discusses options, he doesn judge, he observes and diagnosis, and each time i go, he has more to explain the diagnosis which he said is subject to change. FINALLY, someone who agrees that i possibly dont have bipolar (tho i may be psychotic). the pristiq stops my depression totally, i dont linger in the doldrums, even when i dont take klonopin or dex. and dex activates me. Ive read a lot on psychopharmacology, and i own a few books. Stephen Stahls' essentials of psychopharmacology is considered to be one of the best "well rounded" psych med books on the market, its not the best techncal resource, but its not the worst, and hes a great writer with very nice diagrams included. anyway, by reading this, i saw the relation between my conditions, and i was able to come up with a very intelligent design scheme that my dr, who asked to borrow my book lol, confirmed and agreed to try. I HAVE NEVER BEEN HAPPIER AND IVE NEVER MADE THOSE AROUND ME HAPPIER. (also he works hand in hand with my therapist, so im gettin 2 people to work on my meds so maybe that helps)

my girlfriend feels like im the old me again, my parents love my new found interaction and communciation with them, my professors have all said what a difference ive been making from the begining of the semester to the end, which was jsut now (and i have 6 months left before i get my Masters degree so im pleasd with that). I cant say i woulda been able to do it so easily or at all without trying these different drugs, READING AND EDUCATING MYSELF, and then finding an open minded doctor who not only cares, but is willing to learn from his patients.

Bottom line hollywood: DRop Wellbutrin, stick with ritalin, and supplement the antidepressant with something else. I highly recommend pristiq, followed by zoloft (prozac also has some interesting pharmacological properties as well, but those are my choice for SNRI and SSRI). If you havent tried strattera or robaxetine, you can check it out, but i wouldnt be too hopeful. my real suggestion would be to get pristiq + dex though, pristiq is 1 tablet XR in the morning, and i take 5mg barr pills, which are the only generic dex i would ever touch.

i hope this helps a little bit, and i said a lot so if u have any specific questions, hit me up or post or whatever

btw, i was just livin on the west coast for lil while b4 comin back to the city, where u at round hollywood? thats a crazy town man, crazier than here

Yellow
05-19-09, 07:09 AM
oh btw, i noticed your post in the adderall forum or dex forum, i forgot which it was, i was gonna tell you to look at it "Wellbutrin as culprit" or something liek that, but you actually responded to it and i think you said that not only did u not like wellbutrin but you wanted to stick with adderall or dex over concerta, but u didnt cuza wellbutrin....well with that in mind, and your general reaction to it, really man, get rida wellbutrin cuz it sounds like you really dont like it, and either get back that adderall, and like i said, if anxiety is a problem, i would try dexedrine instead first if uve already tried adderall. anxiety could be greatly reduced with an SSRI/SNRI addon and can give the brain some possible neuroprotection from the dexamphetamine which should be less anxiogenic than both MPH and addy.

then of course, the reason im posting here, there's desoxyn, which supposedly gives all the improvements of dex without any residual phsycial/anxieogenic stim at all, which might side step both my usage of klonopin and possibly pristiq (i think, the less meds the better personally, and if treating one symptom totally can lessen other problems, so be it), however, what i wanna eliminate at this point is klonopin.

but in all honesty, im so pleased with pristiq's general (subtle) affect on my entire mind, that id much rather stay on pristiq and dex together than to just get desoxyn alone, which is why i want to know if i can take pristiq or an SSRI/SNRI with desoyxn. if i cant, then i dont think id even try desoxyn at this point in my life, definitely down the line if my adhd becomes more the problem than depression or anxiety as i get older and more stablizied (mayb witha career and a family?> who knows)

anyway pristiq is more valuable, and more significant to my general well being and overall health (not to mention its not toxic at all, though amphetamine isnt toxic, it definitely is taxing) on top of the fact that it makes DEX work so much better and takes away any of my worries about neurotoxicity (even if its in my head), but i did mention that taking dex inthe prescence of pristiq was the best way ive taken ANY form of ANY ADHD drug, and the combination is all that i need right now.

NOw for some reason, NO ONE seems to post much here, at least they wont respond to my simple question of this combo, and i wish the moderator would edit the post or change the title as i requested to maybe get a reponse, but hey, wucha gonna do?

ill just ask my dr at some point anyway, like i said tho pristiq and dex works so well together that i dont really need to know now (my original post said that it really was for my future use and knowledge).

dont get me wrong: im not a pristiq rep at all lol. i actually would recommend you check out zoloft. speaking of which, someone asked a very similar question as you so ill post it here, since the idiot i replied to (The original poster of this particular thread) is just a drug seeking moron trying to see if he can get a meth tweak high if he combined an SSRI+Wellbutrin+Damphetmaine, which you cant, but hes an idiot who wasted my time in replying to him cuz i thought i could help, maybe you can get benefit HOLLYWOOD:

That combination is a bad idea. period. for many reasons, but heres my first post from the original thread:

that much wellbutrin with dex might be a bad idea, like possible seizure risk. i would definitely keep wellbutrin to a low dose, since its SR, i dont think u can split those pills. i would definitely ask for a lower dose, and that might require IR or XR....just lower the wellbutrin because the dex is doing almost the same thing at a much much higher potency.

the luvox sounds fine but there might be better meds for you as far as anxiolytic/antianxiety SSRI/SNRI's ill list this from another post:

SSRIs in my order of anxiolytic strength
#1 zoloft -can be activating with SLIGHT Dopamine reuptake
#2 paxil -slight Norepinephire reuptake which can acutally increase dopamine in freontal cortex but also sedating because of anticholinergic effect, so its like a very weak SNRI
#3 luvox -if zoloft doesnt work and u dont want slight sedation from paxil, id try this
#4 prozac -it can also slightly release Dopamine and norepinpehrine, but if your taking adderall, its negligble probably
(lexapro and celexa arent for anxiety, just depression)

SNRI = Pristiq. after all my research (including reading Stahl's Essential Pscyhopharmacology) and my own trials with a few of the ssri's, i think this is the best antidepressant/anti anxiety (anxiolytic) available. i would try this first before anything else seriously. one dose, 50mg, no titration. it worked for me within 3 days, i was amazed as SSRI's didnt too much for me after a whole month.

if your anxiety is really bad, adderall wont help much for that, but DEX can solve ur ADHD without much anxiety added to it.

If I were you, I would ask about Pristiq with Dex. Instead of taking wellbutrin and luvox, pristiq does what luvox does with more NET potency with a much lower dose than ur taking, and it also has some DRI properties of wellbutrin, but at a much lower level, which is better as i said anyway. its also only XR, so you take 1 antidepressant/antianxiety pill in the morning and all u gotta worry about is dex dosing.

pristiq and dex has been the best combo ive ever seen or tried. otherwise, try zoloft and dex.

Thats my opinion: forgot that combination, specifically LOSE the wellbutrin if ur gonna take amphetamines, i wouldnt do it myself because there are better combos out there and like i said you have a potential seizure/toxic event on your hads, and try what i said...

I would reschedule with your pdoc and change ur meds immediately. if you would like to read more on why i came to these conclusions, i highly recommend buying/renting but whatever way u get it, read Stephen Stahl's Essentials of Psychopharmacology. Once u get to the depression/antidepressant section, youll wanna stop taking that stuff too. really, see if u can fix up that regimine with your current doc ASAP,like dont wait a month, call him today. otherwise u should get another doctor, im very surprised that u were prescribed those things together. its risky.

hope this helps, good luck,peace

Yellow
05-19-09, 07:34 AM
ps I dont recommend pristiq's mother/father EFFEXOR XR. ive heard too many bad things about it, and youd need over 200-300mg of Effexor xr to reach 50mg (the starting dose) of pristiq's efficacy/potency...between zoloft and effexor xr id pick zoloft, actually aside from pristiq, Zoloft is the only other SSRI (anti depressant thats a monoamine RI, but of course aside from this class, there are NaaSa's like remeron/mirtazapine and mianserin which are the next ones i would try only. anyway heres my rank of AD's according to my interest in their mechanisms

1 pristiq (best all around based on my subjective interpretation)

2 remeron (hyptoethically similar to pristiq, but it is a sedative AD to take at night instead, however, as my biology is, i dont need a sedative, but this stuffs interesting)

3 mianserin (i find it similar to remeron but inferior only because it supposedly increases NE more than remeron, and remeron has a better, well rounded mechanism)

then back to the classical, nontoxic, SSRI's

4 zoloft
5 prozac
6 paxil

hollywood
05-19-09, 09:03 AM
yellow,

You have some very interesting feedback. First allow me to clear my situation. I have tried zoloft in the past when my mother passed away( broke out in hives). Now, fast forward 4 years later and I am doing much better but the anxiety that I suffer from is mainly situational , I am your classic adhd passive -aggressive poster child. That is , in my environment I am verbal and very talkative , but in other situations I am shy and quiet. Now, regarding the wellbutrin. The only reason that I have been on wellbutrin is that it doesn't really change my feelings but it allows me more so than not to focus on whats in front of me rather than daydreaming all day long and "ruminating about associative thoughts when I'm bored" , basically googling my life away at work about the nothings of the world , which is very boring and unproductive too , I might add. I am trying to ask you these questions because I took cymbalta and I felt better, but I could not really think or function properly after a few weeks. I became lazy and tired and out of it, not so good for classic adhd. I have some anxiety at times but really it is created out of boredom, yet still anxiety is anxiety I guess no matter what the trigger is. Wellbutrin lifts my depression, thats a cold fact , but at times at larger doses can trigger anxiety sometimes... Usually only physical symptoms though, which could be a by product of overtraining in the gym. Yet , regardless again of what the trigger is the fact is that it still is a problem and it holding me back from being my true self, other than that wellbutrin many times helps work as a baseline adjunct to help me focus all day. I am interested in the differences of pristiq and cymbalta and hope pristiq does not have the sedating effect. If cymbalta did not sedate me so much it would have been perfect for me , my depressive and insecure thoughts "related to adhd depression" and I could get right out of this fund at god speed. I would like to kill the anxiety and focus on whats important and just go about my business. If pristiq was perfect for me it would be like cymbalta without the sedation. Have you heard of cymbaltas sedative qualities, and if so does pristiq not have this ?

Yellow
05-20-09, 04:42 PM
yellow , is pristiq sedating? I have tried cymbalta but I was so sleepy temporarily, it's hard to stick with things when they make your adhd worse.


yellow,

You have some very interesting feedback. First allow me to clear my situation. I have tried zoloft in the past when my mother passed away( broke out in hives). Now, fast forward 4 years later and I am doing much better but the anxiety that I suffer from is mainly situational , I am your classic adhd passive -aggressive poster child. That is , in my environment I am verbal and very talkative , but in other situations I am shy and quiet. Now, regarding the wellbutrin. The only reason that I have been on wellbutrin is that it doesn't really change my feelings but it allows me more so than not to focus on whats in front of me rather than daydreaming all day long and "ruminating about associative thoughts when I'm bored" , basically googling my life away at work about the nothings of the world , which is very boring and unproductive too , I might add. I am trying to ask you these questions because I took cymbalta and I felt better, but I could not really think or function properly after a few weeks. I became lazy and tired and out of it, not so good for classic adhd. I have some anxiety at times but really it is created out of boredom, yet still anxiety is anxiety I guess no matter what the trigger is. Wellbutrin lifts my depression, thats a cold fact , but at times at larger doses can trigger anxiety sometimes... Usually only physical symptoms though, which could be a by product of overtraining in the gym. Yet , regardless again of what the trigger is the fact is that it still is a problem and it holding me back from being my true self, other than that wellbutrin many times helps work as a baseline adjunct to help me focus all day. I am interested in the differences of pristiq and cymbalta and hope pristiq does not have the sedating effect. If cymbalta did not sedate me so much it would have been perfect for me , my depressive and insecure thoughts "related to adhd depression" and I could get right out of this fund at god speed. I would like to kill the anxiety and focus on whats important and just go about my business. If pristiq was perfect for me it would be like cymbalta without the sedation. Have you heard of cymbaltas sedative qualities, and if so does pristiq not have this ? .

The answer was answered above, so i suggest anyone includin holylwood ;) reading the thread to READ MY WHOLE POST so you can understand not only the effects of each,but the progression and combo of meds, otherwise, takin one little piece out of it wont tell you much, everything with meds is in my context,as each med experience is subjective to an individual

actually its not but initially it was, i was extremely drowsy for the first few days, yawning constantly for almost a week. about 3 days into it, i noticed slight mood improvement but i was tired. 5 days into it, the mood enhancement remained but i wasnt yawning as much. After a week, I had more normal energy and eventually more energy then i used to in general afterwards. Pristiq was actually great man, the only AD ive ever liked and stuck with. I hear its nothing at all like cymbalta although they have the same SE:NE reuptake ratio. give it a shot if you were hopeful about cymbalta but didnt like it. pristiq also has some dopamine reuptake inhibition, i dont know if cymbalta does (it probably might) but its not significant.

honestly, pristiq increases dopamine in the prefrontal cortex, in the way that strattera does also, but it didnt help much with ADHD, but it didnt make it worse either. so thats something to consider if u didnt like cymbalta.


Pristiq isnt sedating at all, i dont know bout cymbalta at all either, but understand i also took pristiq in context of klonopin, so perhaps pristiq might have been stimulating and i didnt notice much cuz of the kpin? u know what im sayin, pristiq wasnt sedating at all (minus 1st week).

CAN YOU TAKE DESOXYN + PRISTIQ (SNRI)!

mbm1512
05-21-09, 07:41 PM
" am sensitive to stimulants. i cannot drink caffeine or energy drinks like guarana and whatever else those crazy drinks have."

If this is the case, I think you should stick with something else. I take Desoxyn simply because it is more potent. When I say potent I mean that the drug is MORE relaxing for me. W/ Adhd, any stimulants have a calming effect for me. The stronger the stimulant the more relaxed I am, so while I am calm on desoxyn, anyone who wasn't adhd would go wild. Unfortunately the chemical itself is pretty damaging, and I definitely will not be on it long term. I am about to go into my senior year of college and I need a little kick in the pants from my meds, otherwise I would much rather go withouth anything (I did Cognitive Behavioral Therapy CBT through an ADHD specialist last summer and it was about 1000x more enlightening than taking any pill, I suggest everyone try a few sessions of CBT if you have ADD or ADHD, your mind is more powerful than you think and you really are in control when it comes down it it.)
Also, I have tried ALOT of different combos. I get both Adderall and Desoxyn monthly although I do not take them simultaneously, and I want to try dexedrine next the only one I haven't tried. But they are far apart from eachother. Personally, when I take adderall I get the motivation to do all the things I normally wouldn't. This is not how desoxyn effects me. Desoxyn calms me and makes me less impulsive, but does not help me focus on things I do not find stimulating. Something else that is wierd I have yet to explain is the effect on handwriting. I am a left handed ADHD kid so you can only imagine the chicken scratch that I put on paper =). The psyc first knew I was ADHD when I wrote my name down, took a small ritalin and wrote it again 45 min later. The difference was insane!!!! This still happens on Adderall, but for some reason all my notes come out just as sloppy on desoxyn than when I am on nothing. The only reason I tried it is because I have a very high tolerance for stimulants. I was needing about 90mg daily of adderall to go to school and feel how I needed to ( I was only prescribed 60) and that much adderall gave me some negative side effects to say the least. Does desoxyn have less noticeable side effects? Yes in the short term, but I dunno about the long term, which is kinda scary. Also, while I'm in college I am under my parents insurance which is a blessing because my desoxyn prescription costs... wait for it......$741 dollars monthly. Do i suggest desoxyn for most people? No probably not, I mean if it were the most effective drug for most people it would be the most prescribed which it clearly is not. I was also kind of sketched out by the fact that I was taking methamphetamine and I asked my doctor what the thought about it all. He's really smart and good with ADHD and was able to explain it perfectly. He said that methamphetamine is an easier substance to make on the streets than just amphetamine when these meth producers use stuff from the store or whatever, which is why it gets the bad rep. He said that if amphetamine was easier to make it would be the illegal one and desoxyn would probably be used more commonly as a therapeutic treatment option. Food for though I guess, I thought that was interesting at least. Also, one thing that is extremely annoying about it is that it only comes in "short acting"(which is longer lasting than short acting adderall, but not as long as XR's) and only come in 5mg pills. They are extremely small so I get like 200 of these a month. I don't struggle with abusing my meds, but if there were ever one that would be easy to abuse it would be desoxyn, which is what frightens alot of dr's I'm sure. When it all comes down to it, it is all a personal issue. I have done so much reading in the past 2 years (since i found out i had adhd) that I know what I need better than my dr does, and he realizes that which is important I think to finding the perfect combo. As for the SNRI, I'm not quite sure. Ive heard that taking a SSRI after eating chemicals like MDMA can help people not damage their brains AS MUCH. I will ask my dr. though as I have an appointment coming up. While I am on any kind of amphetamines I take a 5-htp and an L-tyrosine everymornig, which is supposed to descrease the toxicity as well. I am interested in looking into trying new combos though as well, I think for the most part it is my seratonin that needs the most tweaking. You seemed pretty knowledgeable about some things that I want to know more about, I will pm you later. I hope this helps.

Michael

mbm1512
05-21-09, 08:03 PM
I didnt notice this in my first read.

"i dont want the euphoria or whatever else to make me an addict. i hear many get addicted to dex, and i barely take my klonopin as is for fear of addiction/dependence so to end this whole dibackle:"

I don't think you need to worry about that. I was questionable too and I looked up some facts. Desoxyn comes in 5mg tabs and I personally get 200 a month. That is a total of 1000mg which is 1 gram. I read and found out that some experienced street meth users are known to take up to 1 gram intravenously at once. (Which is insane) It said though that most people take in about 200mg when doing illegal meth recreationally. That is 40 desoxyn, I don't know about you, but I would never eat 40 of anything. You will probably feel a little euphoria the first few doses, but no more than you would get off taking adderall. Of all the meds I have taken it is definitely the one that makes me most dependent. Of course I'm dependent on adderall too when I come off of it, which just makes me aggravated and irritable for a few days. But Ive never taken adderall in the morning and thought "Gee maybe I should take some more" in a few hours. However, I do often feel this subliminally with desoxyn and then I realize it and wonder why I was even thinking that. Anyone considering desoxyn should definitely consider themselves responsible. It has been enlightening in the sense that I at least know to a basic point what meth is/does. I never ever done street meth much less even seen it, but I know for sure that I will never find myself struggling with that substance after taking a pure form in a therapeutic dose. Also keep in mind that there is a strong social stigma attached to methamphetamine. Even though I am prescribed and actually need these substances to function optimally, alot of people would probably not look at you the same way if you came out and said "I'm on meth" which is blunt, but you get the picture. You sound responsible judging from your post and you just want a "cure" like the rest of us. I dunno if everyone else kind of feels this same way about desoxyn, but theres another 2 cents from me. Now im rambling, damn desoxyn.

Michael

Yellow
05-21-09, 08:22 PM
Thanks for the input. The current dex that I have definitely kills my hyperactivity and impulsivity while giving me concentration and focus. I wouldn't say it's mentally relaxing, but I definitely am physically calmer on it, if that makes sense.

My sensitivity to stimulants seems to be from nearly everything that hits anything but dopamine directly (xanthine like the coffee,guarana which acts on CNS but through adenosine, totally different than amphetamines...levoamphetamine which is mostly on PNS and norepinephrine/adrenaline...bupropion which is a very strange amphetamine and cathinone-like chemical, is a NDRI, and since its mostly NE and not DA, were again talkin PNS and not CNS, etc...u see where im going).

My current generic 5mg barr dexedrine is total CNS so far, unlike the 10mg, which acts very differently with each dose. I think barr mighta dropped some levo in there by mistake and no one's noticed, except maybe in the dex forum.

It might also have to do with the SNRI, which as you mentioned is neuroprotective with the amphetamine MDMA. There are many posts about dex+snri combo being very synergistic in that NE/PNS stimulation is negligible while SE (serotonin) toxicity is prevented. So it's something to check.

However, your experience with it sounds like it is not for me because of the cost and the very calm response. Dex is hardly noticeable to me now, so I couldn't imagine desoxyn. Plus, my doctor might not even want to prescribe it, and if the cost is like that, i don't know if the insurance will pay. Your point about long term usage is also good.

Many things to consider. I think, as I began, I'm probably just gonna stick with the dex. Though my curiosity is still wondering about the combo. You know what though, based on the MDMA and SSRI neuroprotection, I'd guess the same would apply to Desoxyn, so it would make Desoxyn almost like a slightly less stimulating Dex....so I don't know, doesn't sound too practical to take desoxyn with an SNRI.

Yellow
05-22-09, 07:30 PM
actually, it might cause serotonin toxicity. desoxyn releases sert at like 1/5 the dopamine, so thats kinda substantial, with an ssri/snri, that might bad or just totally ineffective.

merovingian
05-25-09, 11:22 AM
Yellow - Stop spamming the same question in 10 different topics on the forum, it's annoying and inconsiderate.

Vitamin C deficiency can increase exposure to neurotoxicitiy so make sure you have enough in your system in addition to the 5-htp and an L-tyrosine.

I recommend taking breaks on the weekends from desoxyn.

I'm not a doctor, here is my pretend advice which you would be advised to run by a real doctor first before making any important decisions...

As far as I understand how mdma works is that when you run too low on serotonin you start risking enzyme break down into H2O2 which is of course toxic to the brain. (my understanding of this theory maybe dated but best described here) (http://www.dancesafe.org/slideshow/slide19.html) It would seem to make sense and I have no idea if it's true but if you feel a strong "come down" from the desoxyn than you might not be producing enough serotonin or dopamine to keep up with the levels which your medications are causing them to be spent or you have been on the medication for too long without a break causing a tolerence issue. Taking weekend breaks seem to do a good job of reducing tolerence build up but I would still rotate another med/take a longer vacation every few months.

At some point one might find it easier to get desired results from some sort of ssri and/or dri combined with Desoxyn. Say you take Focalin (DRI) to intensify the dopaminergic effects relating to concentration requiring less desoxyn to get similar results. It would seem this would be the solution to reduce the seratonin dump by simply reducing the amount desoxyn and dopamine production required to achieve "optimal clinical response". The SSRI on the otherhand seems as though it may do little to curb a seratonin depletion caused by Desoxyn while on Desoxyn, however, during the phase where you are not on desoxyn the SSRI should help keep seratonin levels up reducing neurotoxicity. Also, (based on information in the link above) the SSRI may reduce the chances of serotonin transporters removing dopamine from the synapse and being broken down into H2O2. Again, that MDMA neurotoxicitiy theory could be dated.

With that said, I'd take what leads you gather here and varify any important facts before presenting it to an actual doctor.

Yellow
05-30-09, 01:54 AM
interesting points. and i posted a few times to get a response...finally got one.

thanks for the info, and i still think dex is fine for now for me after thinking more. when it doesnt work, then ill ask about this, but after this last past, i think the question is satisfied.

tom2228
06-06-09, 03:47 PM
Yellow - I just want to say thank you so much for your posts in this thread. I've realized more and more lately that the stimulants have been covering up the depression I've had for a couple months -- so severe that I simply feel nothing, devoid of pleasure, but hard to tell is there since it's been shrouded by the false sense of well-being the stimulants create. I've been too afraid to do anything about it because ADs haven't worked for me before.. "nothing will," I thought. But your posts inspired me; finally after all this time you've found something that works for you, and that gave me hope. So I called my doctor and a half hour ago just picked up my script for Zoloft -- I really think it will work for me.


I've been on Dex since switching from Adderall on 6/3; today is day 4 and it's been a beautiful calm that's helped me sort out my thoughts. Could you possibly tell me more about Zoloft (I know it's an SSRI, I've been on Lexapro and Prozac), and the Zoloft + Dex combo -- what can I expect? Thank you so much..

p.s. thanks to you too hollywood for getting the discussion started

Yellow
06-06-09, 07:47 PM
Zoloft is the best SSRI IMO. It has two unique properties: it has dopamine reuptake inhibition and high affinity for sigma-1 receptors (aside from serotonin).

It should be a great combo, I think an SNRI would be better or zoloft + strattera, to get norepinpehrine added.

try it out man. if pristiq didnt work for me, i was goin on zoloft, simply. i would have probably added strattera at some point, but def zolfot is my #1 ssri choice, i just happened to love pristiq cuz it worked faster and better than any other meds ive ever tried.

all in all, i think youll find it works well. pm me if u need more info.

Yellow
06-07-09, 02:08 AM
btw, the reason i mentioned the unique aspects is cuz 1)slight DRI might be useful, for neuroadjustments before/during/after doses, mind you, slight slgiht DRI, like i wouldnt combine dex with focalin or wellbutrin.2)the sigma enigma is called such because it has anti anxiety and anti psychotic effects that are kinda like benzos i guess. totally unrelated, but i mean, it has that subtle touch that might be of help. i also like the cartoon of the little rock/egg?

tom2228
06-07-09, 10:21 AM
Right, I've heard about its affinity for DA transporters, but would that effect be noticeable at low doses such as 25mg-50mg? I just started so I have no idea how I'll react yet, but side-effects of SSRIs have bothered me before; my Prozac dose was 10mg and still bothered me.

Another thing I'm worried about is the numbing/flattening effect I got with Lexapro and Prozac. Except, most of the reason I need an AD right now is that I'm not feeling much of anything (no pleasure, motivation, interests, nothing's affecting me be it good or bad).. will Zoloft help bring back my interests and pleasure or will it just numb the little that's left?

I've read somewhere that people on SSRIs feel greater stimulant effects of amphetamine, can you verify this? Do SSRIs + Dex have any other synergistic effects that you know of?

Yellow
06-07-09, 04:06 PM
synergy, thats subjective. zoloft has neuroprotective elements and anxioyltic effects, its activating as opposed to the sedating AD's.

your right, 50mg of zolof would hardly have much DA effect, but it might be useful for your brain's benefit (safety)

no, you dont get any greater effects, but you will have a smoother, cleaner feeling and in that sense, better effects

tom2228
06-07-09, 05:24 PM
Okay.. it's 5:20 now and i took the first pill at 9am.. i am ANGRY. I'm never angry like this. Just yelled at my mom and I love her dearly. I feel all numbed out already, like every little thing is p***ing me off, f*** it all, i dont care, etc. I felt similar to this on lexapro.. my thoughts are already messed up I feel like if i stay on this my real self will be locked in an SSRI cage and i'll be left with the numb angry kid who doesnt give a sh*t about life, people, emotions, GOOD things in life. What do i do :/

hollywood
06-07-09, 08:38 PM
it takes weeks to start working though. Placebo is in effect now, that or startup side effects. I'd ignore it and continue

Yellow
06-07-09, 10:10 PM
yeah i gota go wit hollywood on dat, one 25mg pill of zoloft wouldnt do all that man. i think u might be angry about takin the pill (as i was). took me years to accept that i needed meds, YEARS, and recently, it has taken me months to finally consistently take them as scheduled, as opposed to takin them, stoppin, startin again, etc.....

dont hate the meds..... hate yourself. just kidding lol. meds are just a tool to help, thats all man. u can always stop, and zoloft is a very safe drug, definitely one of the safest of the AD's. dont be afraid of it for any reason

EXCEPT....

if it is actually the pill, then you may have a serious issue on your hands. if tomorrow, your feelings dont change or improve a little, then i think you should get in touch with ur doctor asap, like call before the office closes and see what to do.

i wouldnt say dont take it tomorrow because im not a doc. at the sametime, not taking it since its ur second day, will have zero impact or problems at all. i would definitely give it a few days/weeks to see if things get better, dont just quit right away cuz u havent received any therapeutic effects at all..

POINT: take ur pill tomorrow as prescribed, call your doctor's office immediately and see if u can go in or at least find out whats goin on

tom2228
06-07-09, 11:01 PM
Thanks guys, I actually called my doc after I made that post, he called back 20 mins later (wow!), and we decided I'd just stop and check back with him on Tuesday once it's cleared. I think I was buggin out b/c my dex had worn off, and i stress a lot about everything if i dont take it.. once i did i calmed down and was feeling better, so I'm going to take it tomorrow morning and give it a chance to work.

I know it takes weeks to work and i know about placebo, but honestly i feel a lot different today. I went out to the movies tonight and I actually felt some emotions, I felt quicker, more interested in things, more relaxed, better focus. In fact, my focus on the movie was INCREDIBLE, very intense. The movie was Terminator, really action-packed, but honestly i felt the dex was stronger than normal. I actually came home and got started right on my homework, very unlike me.

I'm pretty sensitive to meds. Is it possible i'm getting a sneak peek to the Zoloft's therapeutic effects or are start-up effects totally different? I also began running again yesterday (tired of sitting on my a**) and ran today too, can exercize really affect things in such a short term?

Yellow
06-08-09, 01:18 AM
idk. i hope its workin already, it usually takes a while to see a difference but if youve noticed it that soon, very good. wait a while, 2 weeks+ and then report back. ull know then if theres any real diffrence, and three months is the real key. but pristiq began to work within a few days for me so it might be workin for u already...time.

hollywood
06-08-09, 10:17 AM
tom ,

you are taking zoloft though and not pristiq, also why did you start the zoloft if your adhd meds are working to perfection

tom2228
06-08-09, 09:19 PM
idk. i hope its workin already, it usually takes a while to see a difference but if youve noticed it that soon, very good. wait a while, 2 weeks+ and then report back. ull know then if theres any real diffrence, and three months is the real key. but pristiq began to work within a few days for me so it might be workin for u already...time.

yeah, i am one who changes his mind every 5 seconds so i've already promised myself to stop second-guessing and just give it a shot til at least the 23rd (my next appt). weirdly, i do feel much different already in a lot of ways (experiencing some emotions and slight return of interests) but i know the effect on my mood is yet to come. i'm very strange though, extremely metacognitive -- i am always thinking about what im thinking (and with my ADHD this never stops lol) so i notice when just a few miligrams of substance have found their way into my brain :p


tom ,

you are taking zoloft though and not pristiq, also why did you start the zoloft if your adhd meds are working to perfection

yea i understand that, there is a wealth of info on this thread tho. the dex is great, especially since i feel like myself, no side effects except appetite... but even when it's long worn off i have no appetite b/c i've lost all my interest in food and i dont feel any pleasure from eating -- which is the case with everything else. im not sad or anything, i just have no desire to do anything, ive lost touch with myself b/c i feel no depth of emotion. from the outside i look pretty happy, social and being enthusiastic, lauging, but i dont feel any pleasure or emotion from any of it.. its not even that im faking it at all -- im acting and interacting normally but for some reason my brain isn't doing any emotional processing. detatched is a good word.

before i got adhd meds i would have extreme stress and anxiety b/c i was highly motivated to do everything the best i could, but i struggled and had to work so hard to compensate for my symptoms. with the stims i can concentrate well on whatever i have to do but this now and for the past few months this has been practically useless since im not doing any of my work or studying a wink -- ive got no motivation or desire to do it, its neither stimulating nor interesting anymore. when i first started stims in december all i wanted to do was schoolwork, it made me euphoric bc i could finally do it! i want that part of me back. a plus side is i dont feel any emotional pain, just a sense of calm and false well-being, but there's no contentment or "happiness" with my life

basically: my (adhd) meds are finally working but i seem to have shut down. i am pretty much a zombie underneath the d-amp on the surface. if i were a car, its my engine is revving (the dex) but i'm stuck in neutral -- im not going anywhere even though i've got the new engine (adhd meds) that ive needed my whole life.. hopefully the zoloft will put things in motion

Yellow
06-08-09, 11:54 PM
i dont think you mentioned what brand of dex you use, but your reaction sounds like something ive felt. it came from $h!tty pills: 10mg barr. i changed to 5mg barr thanks to a thread started by a guy named lars regaurding 5mg barr, and he tried and has scripts to almost all of the different meds (generic and brand) and said that barr 5mg is as smooth as they come, as smooth as original brand name GSK dexedrine, if not better i think. i found this to be true as well, after trying about 4 or 5 brands/types.

list your medications

tom2228
06-09-09, 12:58 AM
good to know i've got the best kind then!
list: 15mg dex (5mg barr 3x daily) + 25mg sertraline (generic by greenstone)

i've been on the dex almost a week now and i hadn't reacted like that before starting zoloft on sunday.. i know 25mg has got to be too low to feel any DA reuptake inhibition but the feeling was definitely dopaminergic. it was a feeling of slight pressure behind the eyes, like i was "in the zone", quick on my words, feelings slightly amplified, listening more intently and things being more 'wow' than normal, along with the intense focus on the movie; if i tried to look to the side of the screen my vision was "pulled" back to the screen, however its worthy to note i get really into action movies. today tho we were watching a bit of Dark Night in bio class and i had that same strong focus. possibly im an idiosyncracy but i've read of people saying they felt the dopaminergic effects of zoloft the first time they've taken it and also on steady doses of 50mg... my reading speed is even up, which happened when i first started adderall.

i doubt it was the dex pills themselves because they are so damn smooth. so it's got to be either the zoloft itself (doubtful but maybe possible? i swear i feel a diff and this is day 2) or synergy between the dex + zoloft.. i read this somewhere: "SSRIs are best avoided since they may increase the central nervous system effects of CNS stimulants if the drugs are taken together."

Yellow
06-09-09, 01:12 AM
You know, I wouldn't say it's impossible for the DA reuptake to have effected you. It might have had a little tweak, lol, but I dont know. DEX is what is dopaminergic man.

hollywood
06-09-09, 10:04 AM
wow,

and you say this is all the cumulative results of having combined dexedrine and zoloft? Your reading and comprehension " processing" speed has gotten faster? Man that's crazy, I had the result with dexedrine combined with adderall but adderall didn't do much until I took it with the 5mg dexedrine tablets. I too had increased processing and had better symptom control, I wonder if it's the dexedrine tablets that is the result of this. I took zoloft once and broke out in itchy hives , so I'm not sure I can take it ever again but generally speaking antidepressants don't mix well with adhd so everytime I take one my motivation , and processing skills slow down , they don't improve. I wish I had those results with anti d's but usually they don't help my adhd .

Yellow
06-09-09, 11:04 AM
wow,

and you say this is all the cumulative results of having combined dexedrine and zoloft? Your reading and comprehension " processing" speed has gotten faster? Man that's crazy, I had the result with dexedrine combined with adderall but adderall didn't do much until I took it with the 5mg dexedrine tablets. I too had increased processing and had better symptom control, I wonder if it's the dexedrine tablets that is the result of this. I took zoloft once and broke out in itchy hives , so I'm not sure I can take it ever again but generally speaking antidepressants don't mix well with adhd so everytime I take one my motivation , and processing skills slow down , they don't improve. I wish I had those results with anti d's but usually they don't help my adhd .

yeah man, i mean, tom, were not being skeptical or anything, but such a quick change in one day....i think its dex too

tom2228
06-09-09, 03:16 PM
on paper i'd be skeptical but i can't deny the difference im feeling (and not placebo). the thing tho is that my dex dose has not changed.. i dont see how it can be the dex alone, i believe it's got to do with synergy. unless it could be that the zoloft has begun to lift some of my depression so im responding to the dex better now. when you're depressed its definitely harder to concentrate (hence nobody thought ADHD until a year after i was diagnosed w/ depression), so maybe this is almost how i'd experience dex as a normally happy person? so maybe it's got nothing to do with a synergistic combo, and w/ the zoloft my brain is kickin out the depression couch potato nd getting back to normal speeds?

hollywood, i can say my processing has indeed improved: last night i wrote an essay in under an hour (typically takes me several), today finished my precalc final 1st and in half the alotted time, was sightreading better than normal than in band, and spoke more fluently than normal on my spanish oral final exam.. but im doubtful this is going to persist. as we know SSRIs dont start to have their true effects until they downregulate your serotonin receptors and i am very highly skeptical has happened in not even 3 days. so in a couple weeks i predict things will be a lot different.

generally speaking antidepressants don't mix well with adhd so everytime I take one my motivation , and processing skills slow down , they don't improve. I wish I had those results with anti d's but usually they don't help my adhd .

this is why i was hesitant to go on an SSRI again.. on lexapro and prozac my motivation was worse and my processing skills were slow as HELL on prozac until adding adderall, it was like cognitive impairment. im expecting to experience this dumbing down again honestly, and extra worried because zoloft has the 2nd highest affinity for muscarininc blockade behind paxil. this morning, im not even kidding, i was INCHES away from getting seriously hurt because i crossed a main road w/o looking and cars in 3 directions came sliding to a halt (wet road), the closest being less than a foot from me! yes i have adhd and im impulsive but this wasn't happening before sunday.. i feel like although my processing has improved, my awareness is diminished.. f***, ive heard good things about zoloft, ppl saying its the only SSRI thats worked for them.. its still an SSRI though, and for me that means flatness and amotivation, apathy.. if this happens to me im done with this ssri bs and getting a job so my mom will order tianeptine for me.

Yellow
06-09-09, 03:57 PM
well man the only thing left i could say is (and i guess i already did but anyway) zoloft is activating, probably the most activating ssri, and i would definitely say dopamine has something to do with it, and ill get to that later.

it has hardly any affinity for any other receptors other than (in order) SERT, DA, SIGMA-1, and alpha 1- adrenoreceptors (α1 ), which is a good thing because that receptors blockade is associated with lessening hypertension, what tenex kinda does but on a diffrent site, so since your taking dex, that is a definite plus. its very minor, like it wouldnt cause hypotension, but zoloft is given to patients who do have hypertension problems.

NE is effected through SE/DA reuptake. that doesnt mean that sertraline acts on NE as strongly as SE/DA/S1/A1, but it definitely effects it through the other neurotransmitters and i beleive it has very minimal NE reuptake, but again, its there, thats also activating. it also inhibits p450 enzyme, so that might be why your experiencing a change in the dex effect. I would simply theorize based on what you say that zoloft is potentiating the dex, and you are noticing it since its so recent, and i would also conclude that the effects will stabilize the longer you take the zoloft.

im not sure what your concerned about, but zoloft is the best ssri, and the synergy you may be experiencing is a bonus on top of the others already mentioned. the only other anti depressants id bother with are pristiq and remeron, but if zoloft works, good.

btw, im sensing something, and if you are looking for anything but help, then i cant help. i hope that helps.

hope ive helped positively, for both of us, and for everyone else

tom2228
06-09-09, 09:25 PM
im not sure what your concerned about, but zoloft is the best ssri, and the synergy you may be experiencing is a bonus on top of the others already mentioned. the only other anti depressants id bother with are pristiq and remeron, but if zoloft works, good.

btw, im sensing something, and if you are looking for anything but help, then i cant help. i hope that helps.

hope ive helped positively, for both of us, and for everyone else

i'm not sure i know what you mean by "sensing something"... what i'm concerned about with zoloft is basically being on another medication that will fail to treat my depression. it seems like it's impossible with the meds we have here to get serotonergic relief -- meaning happiness, contentment, less anxiety -- without becoming numbed out from your feelings and amotivated, anhedonic, asexual... i'm scared and reluctant to take zoloft because i want to be happy and feel alive, not a content zombie who's given up on actually FEELING happiness. i refuse to end up like my mom (shes been on prozac since -- wait she's even forgotten).

i've been on: lexapro, wellbutrin, abilify, risperdal, WB again, lamictal, prozac, adderall, focalin, addy again, dexedrine, zoloft.. i've yet to find adequate relief. my first psychiatrist actually asked me to consider ECT when we were trying me on my FIRST med (lexapro).. i had just turned 16 :eek:

basically i constantly seek information b/c i just don't feel right (never really have), i want to get better, so i NEED to figure this out. i just can't ever stop thinking about it, my treatment has become my obsession. since i was 5, or can remember, i've been trying to figure out when i'll finally be 'okay'.. yes im driving myself crazy but i won't give up until things are right. its really frustrating

just a big thank you for answering my questions.. my mind won't stop until i answer them or take a sleeping pill. this forum really helps deal with the mental load, thanks again guys

hollywood
06-09-09, 09:58 PM
tom,

I can't remember if you stated if you were in college or not. I think you maybe should consider moving somewhere where it is sunny and you could start new? I just say that because maybe there are other factors that are bringing you down besides yourself, considering a life journey and following it may help you feel like you are more than just depressed and take your mind off all this stuff, sometimes your environment can really bring you down and sometimes the best med is peace of mind and a well thought task and a feeling of self worth when you do something and achieve it as you planned it. I don't know, you seem too smart to be so down on yourself. I understand adhd really is a pain, as is depression but I can't help but notice alot of depressed people become that way from others around them that are negative and it's tough to break the cycle with negativity around you. Keep your head up bro, you will find it , and many times the light at the end of the tunnel will have nothing to do with drugs , they help but they are not the answer in the end. You and your decisions do that-

Yellow
06-10-09, 10:48 AM
well in that case tom, i can only recommend those other two antidepressants for information. pristiq and remeron. if you zoloft is working, then maybe look into remeron for night time anti depressant work, its actually like a sert agonist, but its sedating for night time/insomnia depressive.

if zoloft doesnt work out for you, and the ssri's in general didnt work (and i cant see anything better than zoloft, though everyones different), then look into adding remeron for the night (so you have zoloft for day, remeron for night, which of course carries into the day) and if u dont like zoloft, maybe you wanna check out the snri.

i know what you mean by looking until you find something that works. i found what finally worked for me was pristiq and dexedrine. for you, it might be zoloft and dex, but you might need some time to check/adjust.

finally, mirtazapine (remeron) might be useful especially if u cant sleep or needd sleepin pills to sleep, and read about desvenlafaxine (pristiq) if zoloft doesnt work. but dont go into it waitin for it not to work, cuz you might miss it working that way. good luck man. peace

tom2228
06-13-09, 09:35 PM
tom,

I can't remember if you stated if you were in college or not. I think you maybe should consider moving somewhere where it is sunny and you could start new? I just say that because maybe there are other factors that are bringing you down besides yourself, considering a life journey and following it may help you feel like you are more than just depressed and take your mind off all this stuff, sometimes your environment can really bring you down and sometimes the best med is peace of mind and a well thought task and a feeling of self worth when you do something and achieve it as you planned it. I don't know, you seem too smart to be so down on yourself. I understand adhd really is a pain, as is depression but I can't help but notice alot of depressed people become that way from others around them that are negative and it's tough to break the cycle with negativity around you. Keep your head up bro, you will find it , and many times the light at the end of the tunnel will have nothing to do with drugs , they help but they are not the answer in the end. You and your decisions do that-

hollywood, your post really hit home for me. i thought about it for a while, and i even printed it out for when i went to therapy on wednesday and talked about it with my therapist.. nah im not in college yet, i just finished my junior year in high school and now that summer's begun for me i'm really going to focus on changing my life. gonna start soon seeing my therapist twice a week like i did last summer.

what you said is really spot on. since last summer i've been focusing on the meds part a whole lot, and while neuropsychopharmacologically ive come far, existentially ive lost touch. you can mess with my chemistry all you want but my soul is something different. i do need meds but really i need to find who i am, and you're exactly right about my environment. there is way too much negativity here, its hard to be stable when you have toxic energy around you. school keeps my mind occupied (stressed too) but i realize now its not necessarily the lack of structure that throws me off in the summer, but the people around me. the problem is having a need to be distracted. yea, adhd makes it really difficult to have peace of mind, but there's too much going on here that's fueling the fire and bringing me down.

you're right, i need to get away.. before med school too. when i talked to my therapist i said i'd love to start somewhere way out there, like the mountains. somewhere i can just ADD space out but it won't be "spacing out" because there's nothing i'll have to focus on. where its OK to let my mind wander. a journey would be perfect -- would stimulate my mind with excitement, allowing me to be calm, just like the meds. my mind is always on the go but the problem is i'm not going anywhere, so i get stuck, and depressed. after some time alone i'd love to go to europe and just immerse myself in a different culture, learn a couple languages (i know spanish already) and get a new perspective. two summers ago i went to poland for a month, just me and my polish cleaning lady (she's like family to us), and it was really therapeutic. perhaps i'll see if my mom will ship me off to spain this summer, i would love that.

hollywood, thank you for opening my eyes!! :)

tom2228
06-13-09, 10:09 PM
well in that case tom, i can only recommend those other two antidepressants for information. pristiq and remeron. if you zoloft is working, then maybe look into remeron for night time anti depressant work, its actually like a sert agonist, but its sedating for night time/insomnia depressive.

if zoloft doesnt work out for you, and the ssri's in general didnt work (and i cant see anything better than zoloft, though everyones different), then look into adding remeron for the night (so you have zoloft for day, remeron for night, which of course carries into the day) and if u dont like zoloft, maybe you wanna check out the snri.

i know what you mean by looking until you find something that works. i found what finally worked for me was pristiq and dexedrine. for you, it might be zoloft and dex, but you might need some time to check/adjust.

finally, mirtazapine (remeron) might be useful especially if u cant sleep or needd sleepin pills to sleep, and read about desvenlafaxine (pristiq) if zoloft doesnt work. but dont go into it waitin for it not to work, cuz you might miss it working that way. good luck man. peace

yellow, thanks for bringing up remeron! first of all, have you tried it before? i did some looking into mirtaz and it seems really promising being that it's like amphetamine but for depression, in terms of releasing 5-HT and NE like how d-amp releases DA and NE. a bunch of studies say it's more efficacious than (des)venlafaxine and all SSRIs for depression, the only issue is tolerating it. i'm not sure if i could handle the insane H1-antagonist sedation i've read about, although empirical things say higher dosages can offset the sedation b/c of more NE being released. since i'm done with school as of this week, now would be a good time to try mirtaz and sleep all day until i'm titrated. the increased appetite would actually be a huge plus for me as my depression has killed my appetite for months + add dex to the mix and i would certainly not mind the urge to eat sugar out of the bag (i've read of remeron users doing that!!) or completely stuff my face for that matter. and i'm skinny as is so i wouldn't mind a couple pounds.

i'm going to see how the zoloft goes for me, and im staying optimistic about it, but i have a feeling i'd be better off with something like mirtaz to force those monoamines out of their neurons, where they've been hiding all these years. also, having a healthy libido is a big part of feeling connected to other humans and a big part of just being a teenager in general; zoloft surely aint gonna be good for that!! i'm going to ask my doc about remeron on the 23rd.

tom2228
06-23-09, 09:23 PM
Update! Today i had my doc appointment and we d/c'd the zoloft in favor of remeron! yea, there goes my ADHD self jumping from one thing to another :) but anyway, 30mg of mirtaz at bedtime it is. starting that high because my doc agreed with me (my online reading haha) that sedation is less at higher doses, so we're skipping right to 30mg.

any specific/ interesting/ first-hand info or advice on mirtaz for me? ty in advance

Yellow
06-25-09, 02:05 PM
zoloft is still good medicine, i would have waited a while longer and maybe asked to add it, but its ur docs call really. and remeron hasnt been studied against pristiq, though it does seem to do more than the regular ssri's.

let me know how the first few days have been.

tom2228
06-25-09, 08:59 PM
tom, your goin with the remeron too, awesome. i actually would like to hear your reaction to it, because i am trying to get my girlfriend to go on remeron because she gets terrible reactions to reuptake inhibition (TCA or SS/N/DRI's) and shes tolerating antagonism with 5htp2 (buspar) tho its not doing much she says, so i have been suggesting remeron for months but the psychs arent available,her appt is on the 29th and she is going to ask for remeron. the only other thing left as far as i can tell if remeron doesnt work is nardil, but thats just as bad/worse than TCA's. to me, remeron looks awesome, and i would love the chance to try it, its just i dont need to right now. if i had insomnia, i would definitely ask for remeron.

my girlfriend has anxiety/mild depression with insomnia. so remeron would be perfect for her, if the doc gives it to her on the 29th, ill let u know her reactions, and in the meantime let me know how you react, like if you can man, log a sentence each day so i can see how it works (like "day 1 - made me sleep for 12 hours. day 2..."). im the only person i know who takes pristiq, tho ive read some threads and reviews, and your the first ive been able to talk to with remeron so these two arent as popular so sharing what u get out of it might help her.

ps i was replying as u wrote that last part about the off topic high jackin of my thread lol

zoloft is still good medicine, i would have waited a while longer and maybe asked to add it, but its ur docs call really. and remeron hasnt been studied against pristiq, though it does seem to do more than the regular ssri's.

let me know how the first few days have been.

Okay, i got your post here from the other thread so everything's all in on place! but of course this IS an ADHD forum so naturally our thoughts are all over the place :p

SO! Yeah, i know 2.5 weeks is not a very adequate med trial, but it was enough to tell that Zoloft was another shabby SSRI (IMO!) that was going to make me feel crappy.. I was actually feeling a little emotion at one point in the trial and there was mild contentment, but it ended up just numbing me out like any other SSRI and i felt worse than i did before starting it. Plus 2.5 wks was plenty time to give me sexual dysfunction, veryy bad for a 17-yr-old!!!! When my doc heard that he recommended going down to 37.5 but i said im done with SSRIs, they dont do **** for me.

That's really interesting about your girlfriend! I seem to be the same way: i haven't tried TCAs, but i've tried 3 SSRIs along with bupropion XL all of which i reacted badly to in some sort of way although it might have helped at some time. then we tried lamictal and that was actually a really great drug for my depression, if only i had had a stimulant then too (not til december) then it might've been close to perfect.. if it werent for the side-effects such as badd cognitive slowing and not processing things so also derealization and dissociation.. not good to lose yourself! We found out im really sensitive to lamictal, even went down to 25mg and side-effects were too much. but i find it veRy interesting that i had a really good antidepressant effect from it (despite feeling like a zombie!), because it has effects on i think 5HT-3 receptors by blocking them, not sure about the number but it's definitely a serotonin receptor blocker. So when i read about mirtaz i was sparked by the multi 5HT-receptor (5HT-1 and 5HT-2) blocking effect. Also awesome is its release of serotonin :eek: from 5HT-1 receptors (because antagonism of presynaptic alpha2-adrenoreceptors indirectly agonises the 5HT-1 receptor) and also its release enhancement of adrenalin at the alpha-1 adrenoreceptor (which is peripheral). So it looks (and kind of feels like, actually) it has activating properties negated/covered up by its H1 antagonism. However, the sedation is not really that bad starting at 30mg instead of 15mg! This is because the adrenalin-releasing effects offset the histamine-blocking sedation. Also GREAT for me is the increase in appetite, i can say my appetite is coming back a lil bit day by day! My emotions seem to be coming back, actually the first day on it after taking it the previous night was awesome! HEre's how day 1 went, starting from the night before:

Tuesday Night before day 1: I took the mirtaz at 10pm expecting to be knocked into sleepland but actually my legs became very restless and agitated! I couldn't sleep that way so i had to take .25mg alprazolam to help me sleep, which it did within 20mins (i love that fast effect!). I was expecting to wake up the next day after sleeping for CRAZy amounts of time such as 20hrs, which i read on forums... but.. I woke up at 6:10 AM!! I woke up kind of stimulated, looking all around me, and feeling kind of ALIVE :eek: for the first time! Was kinda cool, and i wasn't tooo sedated during the day but i could feel it, was tiring. The coolest thing was that evening at 6pm (wednesday) i went to therapy and during the session i felt so alive, i rediscovered my feelings and stuff and just i was going ADHD crAZY hyper and excited, looking aroudn everwhere and finding it more comfortable to talk with my head 3/4 upside down while lying on the couch staring at the ceiling lol! Even though i was on the Dex at the time :O Then actually, maybe this is the most awesome part: after therapy at 7:30ish i smoked some herbal products ;) and felt soo :eek::eek: if ya know what i mean. when i lay down that first night is when things started getting really cool: closing my eyes on my bed settling down, i got the SICKEST closed-eye visuals of all these patterns, shapes and colors like a kaleidoscopE!! Then i began to DREAM while awake, knowing i was awake but being inside a dreamlike trance where i could create my dream and it was very VIVID with the environment and surroundings! So i was pretty much hallucinating while awake and haivng CEVs, so coool. I just fell asleep around 11(?) into one of the dreams and it was cool!

Thursday, DAy 2 (tday): i woke up at 9am by my alarm clock and i was reallly tired, pretty sedated actually. had lots of tiredness today but i also became realllly really hyper around midday when visiting my mom's school (she teaches special ed in a middle school) and needing to walk around, move constantly and nag mom to leave even if we were going to be early for her faculty party. at the party i started getting really tired then i woke up when taking the 2nd dex dose of the day at 1pm.. then my mom's friend pickd me up to drive to my road test and i was ok energy then, not really nervous but i failed miserably lol. 120 points on the test when the highest you can get and still pass is 30 (points are added from 0 when you screw up) haha! i honestly dont know what happened that made me mess up that hard but ill take it again. Then i got verry tired after i failed and had to lie down the car ride home for over 30mins, feeling really sick like a sinus infection. i got home and rested then the dex at 5pm gave me more energy and i took a bunch of vitamins and magnesium. so i met my friend and we had more herbal matter :p and here i am. tired but still up, and closing my eyes makes things buzz and my eyes turn weirdly! i hope i'll have more visuals tonight, would be really cool.

in conclusion remeron is really something and has a lot of room to work with. that's so cool buspar is working for her, because only lamictal's SER blocking got me back up too! so definitely i'd go for remeron because you're gonna get buspar's effects by the mirtaz itself (with its blockage) but plus+ a lot of extra SER released and Epi released through the body. Absolutely no reuptake inhibition! Not to mention the H1 blocking is going to give you much improved sleep and weird/cool/stimulating/crazy dreams, something to think about. Also it's great if your appetite is cut by your depression or stimulants like dex, both the case for me.

so definitely go for it. and discuss starting at a higher dose, its pretty bearable at this level, not too sedated. 15mg would cause a lot of sedation i've read. exciting for me too to experience this!

Also why do you say Nardil over Parnate? And why do you think MAOIs are "bad"/ worse than TCAs possibly? +Mirtaz has no effect at all on MAO.

That's really great that pristiq works for you and seems to be just what you need. I hope if you run into trouble with it someday that you can find a solution in mirtaz!

EDIT: P.S. You've said you're psychotic bipolar. What is that like for you, how to you deal with the psychosis and how does it effect you? How does dexedrine affect the psychosis, does it make it worse? Also, could you please describe some of your experiences with having delusions and paranoia of stuff you rationally (but cant at the time) know isnt rational? I think i've had some delusions in the past but im not sure what constitutes ones.. this could affect my treatment if they discover some psychosis!

EDIT 2:
CRAP that is LONG!! Sry if you're the anti-reading ADHD type!

Yellow
06-26-09, 03:26 PM
yeah that post was all over the place

keep loggin the remereon if u can, if u wanna pm it or something so it doesnt bother anyone reading this off topic, but id like to hear more. the restlessness might be from a high startin dose?

dex actually helps me out, for others it can make their conditions worse, but then again, im taking it with 2 other very powerful medications that might be masking some negative potential, but i see its potential in causing a problem for someone like me

i guess the only way to deal with any problem is to let yourself. gotta make the emotional feelings of judgement compromise with the logical rational intellect, which the panopticon of surveillance that always reminds me of what happens when societal rules get ignored (aka legal ramifications) helps with. luckily that was embedded very early through strictness, so my upbringing allows me to be more consious of consequences than your "garden variety" bipolar, which in turn lets me know when i should stay away from people or situations that can turn into problems. in a word: awareness

as far as "being" bipolar, id rather not discuss experiences of psychosis, partially because i dont see much difference from normal reality, but that doesnt really matter. its not like fun, or a cool natural trip or anything if thats what your wondering. some say it is, like euphoric mania, but that has its downward slope too,momentarily you may feel untouchable and in touch with the universe, but those delusions can rapidly morph the other way.

i didnt mean for u to start nardil now. i think ur movin too fast. i meant my gf didnt tolerate the other ones i mentioned, so the only other thing aside from remeron for her case that i think is an option is nardil, for her....get me, like her specific symptoms? stick with remeron for at least a month or something, zoloft is pretty good and i dont think u gave it a chance, the side effects tend to diminish, as will remerons.

take it easy.

roodyrider
06-26-09, 06:44 PM
NO! Keep posting! I've been following this and want to add to it, but haven't had a chance. Maybe it should be moved to the antidepressant section?? I'll bet a lot of people could benefit from this type of discussion.

I'm hoping to get my story posted tonight...

Thanks! Yellow, your insight has been very helpful, and Tom, my situation is kind of like yours and Hollywood's, so I'm eager to compare notes!

roodyrider

Yellow
06-27-09, 08:11 PM
Well then tom by all means type on type on

roodyrider
06-28-09, 03:56 AM
Jeez, I keep trying to post my story but it gets so freaking long nobody could get through it, so I'll just skip it and get to the point. I've become obsessed with finding the answer, but I've got to get on with my life!

I found this thread by doing a search for Remeron--looking for alternatives to what I'm currently taking. I don't think it's for me because I don't want to eat everything in sight, but I actually need to put on a few pounds so I'm not ruling it out yet. I hadn't heard of it, I was just searching for antidepressants without sexual side effects, but I do have sleep issues too, so I'm still on the fence about it. I know there were a couple of other options besides wellbutrin, but I don't even recall at this moment what those are.

I'm a 40 year old female. I was just diagnosed ADD in Nov. 2008. I've been to countless doctors over the years because of pain issues. I kept getting antidepressants prescribed because the thing that bothered me as much as the pain was a constant feeling of lethargy and lack of physical motivation. I train horses and am a "go, go, go" type of person. I am very goal oriented and am not lazy, but that "whatever it is" is always holding me back. I'll want to be doing this or that, but just sit there sort of unable to move or I'll find stupid distractions that keep me from what I actually want to do. It's maddening as hell! I'm working at home now, so there is no structure in my life and it has really made me realize how bad I am. I've just been bouncing around between the walls of structure my whole life! I have no idea if this is depression, or just a symptom of ADD, but it's driving me insane! I've never thought of myself as depressed--I always WANT to do what I need to do, I just can't seem to make the body do what the brain wants it to.

I've at least figured out that the pain is a separate issue--that's just a consequence of my very physical lifestyle and I've got it under control. When I realized I have ADD, I thought I had it solved, and maybe I'll get there, but am just on the wrong meds, but I'm about sick of trying to figure it out. Yellow, Tom and Hollywood--you guys seem to be on the same track with the meds that I am, and if any of you has any insight, I'd love to hear it!

Here's what I know:

I was on Cymbalta before I even knew about the ADD (for pain.) I had no idea how much it did for me until I lost my insurance and had to stop taking it. It made me jump out of bed early and get moving, and I wasn't so short with people anymore. I did nothing but yawn and stretch for a week when I started it, but the stretching felt great--apparently I had a whole bunch of tension built up, because my muscles didn't stretch very well at all before that. I did end up taking it before bed and that alleviated all of the tiredness. I actually tolerated it very well compared to anything else I had tried.

The negatives of Cymbalta: cost, sexual side effects (deal breaker,) and it was a bad deal if you missed a dose--which kind of freaks me out, and cessation was hell.

I was curious if you all are having the sex issues with the seratonin drugs. You all seem to be young guys, so I'd think that wouldn't be OK with any of you either. Or do stimulants counteract the sexual side effects? I did notice that my sex life got even better with just Adderall...

I started Adderall while I was still on Cymbalta, but the overlap time wasn't enough to know whether they were any good together--but I suspect Adderall just isn't for me no matter what I take it with!

So then it was just Adderall. That's terrible. It takes away my physical motivation completely and made me bite everyone's head off. Sometimes it keeps me up all night, sometimes it knocks me out. I really don't like it at all--I've been tweaking it since November and it just isn't working.

Added Zoloft to Adderall. Not biting heads off, but still don't want to do anything. I got the kick in the pants to get moving from the Cymbalta, but I don't know why--I'm guessing it's the NE piece, since adderall doesn't do it and Zoloft doesn't do it. However, opiates really get me moving (hydrocodone a little, but oxycodone a LOT) and they do affect dopamine, so I'm confused by that and I think that's because I'm either incorrect in my assumptions about Adderall's actions, or it's that they affect dopamine differently. I haven't taken Zoloft long enough to know if the sexual side effects are back. Seems like they are, but more research is needed. :o

I'm trying to figure out where to go from here. I was thinking about Wellbutrin, but my doc didn't think it was right for someone who tends to have a short fuse and a lot of tension. Plus, he didn't want to prescribe it with a stimulant, so if I want to stay with a stimulant, it's not an option anyway. I was also thinking of doing just wellbutrin with no stimulant, or WB and Zoloft with no stim--I'd much rather be moving with no focus than focusing but not moving! I made it 40 years with ADD, I suppose I can make it 40 more. I'd just like to exhaust my options before I decide to just deal with it. I'd really prefer no drugs at all, but I guess we all would, and I'm realizing I'm probably going to have to take something.

Would the stimulant result be different if I switched to Dexedrine? I asked the doc to switch and he said no, but I was just calling in a refill. He's a general practitioner, but very intelligent and will spend time talking to you, so I'm sure if I explained myself on my next visit, he would be OK with it. I tried Concerta a couple of times unprescribed and it made me wide awake and very depressed. I hated it, so I'm not even entertaining those types.

So with cost being relevant, it seems that my options are few. Adderall and Dexedrine are my stimulant options and Wellbutrin and Zoloft seem like the best antidepressant possibilities. Is there something else I haven't discovered yet? Maybe I'd be fine with a different stimulant and no antiderpressant at all? I did all of the speed drugs when I was young and never once did they do to me what the Adderall does--but I didn't do them every day, so maybe that's the difference?

So much for my short story. I wrote a freaking book just to conclude that I don't really have any options!

Good thing I didn't go with the long version, huh?

Off to bed! Thanks for making it to the end of this thing! If anyone has suggestions, I'm all ears!

roodyrider

roodyrider
06-28-09, 04:36 AM
Yellow, I just re-read your first post and I'm optimistic again. I actually have the Stephen Stahl book--I picked it up a long time ago, but it was before I knew I had ADD, so I never got anywhere with it. The one I have is old though. If there's a newer version, I'll have to pick it up.

Apathy is a great word for what Adderall is doing to me. It's 3:30 in the morning and I was having a hard time describing things accurately. It does seem that you can get that with one stimulant, but not necessarily another, so maybe a switch will make a huge difference. The Zoloft is slightly motivating, but I'm only taking 50 mg. I'll bet the result would be totally different at a higher dose, so perhaps if the stimulant counteracts the sexual side effects, I would be OK with just Zoloft and Dex. but I know the reason my doc doesn't want to prescribe it is because of addiction potential, which of course is of concern to me as well, especially given my "conquer the world" personality.

I didn't even mention Pristiq, which I'm intrigued by as well, it just isn't an option at the moment, but I will be insured again soon, so maybe that will be a possibility too. The thing that's keeping me from the answer is that I don't know the psychopharmacology stuff as well as you do yet, but I'm very fascinated by it, so I'll keep at it. There surely is an answer for me, I'm just not the most patient person in the world!

ok, now to bed, since I swore I'd be asleep by 10 P.M.

Thanks for all of your posts--I'm going to go back through them again. I know they have gotten me closer to my answer than I would have ever been on my own!

hollywood
06-28-09, 08:47 PM
you would think that if you tolerated cymbalta well you would have stuck on that medication and added a stim. All the ssri meds will affect sex drive, cymbalta and the other various snri's are supposed to affect them less or have less sexual sides. My guess is that the NE is a good adjunct with your serotonin , so I would stick with a snri if your using an antidepressant with stim.

Yellow
06-28-09, 11:14 PM
i highly recommend exploring pristiq and remeron. you can read any of my posts on this stuff and see, maybe tom and hollywood could personally link you up cuz it was mostly discussed with them.

johnatmls
06-29-09, 02:42 AM
I took Desoxyn Gradumet from 1980 - 1993 in doses varying from 20 - 45 mg. Then I was place on dextroamphetamine SO4. It made a tremendous difference, but the real difference came when I combined a benzo Klonipin, Xanax, Tranxene, Atavan, with prosac. Recently I tried large doses of Nuvigil a new form of Provigil, and I find that it may be the best yet in terms of allowing me to concentrate without anxiety, or some of the obsessive components of dex, desoxyn, and methylphenidate. It is a non-triplicate drug, and requires less headaches to obtain. It is just as potent as dex as I stopped dex and used nuvigil and it worked just as well, which hasn't been the case with other lesser controlled substances.

hollywood
06-29-09, 09:27 AM
I have never been on the rougher meds like desoxyn or dexedrine and have only been on mph. I tried to go on provigil along with my stims but insurance wouldn't cover. From what I have heard it works well and maybe a good add on to stims ( and you may be able to lower your stim dose with it alongside ) Not sure though , the fda should clear this up and approve it if one person with adhd has success from it's use. Makes sense to me.

roodyrider
06-29-09, 02:52 PM
You know, Hollywood, when I had finished typing my post I kind of thought the same thing. But I left out major parts of the story because it's just too long! I guess I can sum it up by saying that my life had sprialed out of control. One of the reasons this happened is that I had allowed myself to become a doormat, both in my job and my relationship. When I stopped Cymbalta, it was like I woke up and said WTF?? I quit the job and ended the relationship. I really felt like being on an antidepressant had sort of "numbed" me to the point that I wasn't even me anymore, and that really scared me.

I've decided to stop what I'm doing now and start over. As I said before, I'm uninsured right now, so Cymbalta and Pristiq aren't even options at the moment. I know the SSRI isn't for me, so that's off the list. I'm still not sure I shouldn't give Wellbutrin a try.

If, in fact, there was a change in my personality from Cymbalta, it's the seratonin part because the Zoloft was doing it to me too. I'm not at a place in life where I have to sit at a desk, so I really don't need the intense focus I was getting from the adderall--it's more the kick in the pants to get going that I need. I think looking for that from a stimulant is definitely playing with fire, which is why I've decided just to skip the stimulants for now. AND, I really need to quit smoking--never going to happen on stimulants, will for sure happen with WB.

That's why I wondered if it was logical for someone who tolerated Cymbalta well, to also have success with Wellbutrin.

I've decided that adding additional medications to counteract others isn't ideal, and I'd rather live with it than go down that road, which is what keeps leading me back to Wellbutrin. I guess the only way to find out is to try it, huh?

Yellow
06-29-09, 03:53 PM
actually roody i have some good news for you that i found out from my psychiatrist actually

wyeth, the company that makes pristiq, will give you your medication for free in three month supplies if you get your dr to write you a prescription. you send it to wyeth, or they send you a form, and once they see your prescription they give you pristiq for free. go to wyeth's site to find out more, and i hope they are still doing this because they were doing it when it came out a few months ago, but try it

and if theres anything to learn from here, its definitely not to think wellbutrin will be the be all end all. i dont like wellbutrin too much, but i think its very novel and interesting and helpful for many. however, you have also prozac or paxil which are great, but you gotta try each, then of course theres luvox,but id save that as the last ssri. celexa/lexapro i wouldnt bother with. then theres high dose effexor which is almost like pristiq, but not as good, if u dont wanna try the wyeth approach.

then theres remeron and the MAOI's. nardil is one that is very good, but there are others like parnate.

you have a lot of options, and wellbutrin does nothing for ADHD or ADD btw.

hollywood
06-29-09, 04:55 PM
you just love pristiq yellow. hell you have me believing.

roodyrider
06-29-09, 07:40 PM
That's good to know about the free Pristiq. Thanks for the heads up. But the thing that strikes me is "MDD" all over the advertising--I thought "what's that?" I don't have MAJOR depression? Or is that even relevant? Or could that distinction be simply a dosage issue, like I'll eventually get to below regarding Cymbalta? I hope these questions don't sound stupid. I honestly don't know the answers.

Yellow, did you ever try Cymbalta? I didn't see that you did, but remember I'm taking no medication today so I'm veeeery sleeeepy and not all that sharp at the moment.

Hollywood, I re-read your post where you described your personality and it seems that you and I are similar in that regard. I really believe my depression comes from the frustration associated with ADD. I don't think of myself as having anxiety--I've never had a panic attack or anythiong close, but I DO go over things in my head incessantly, which really makes me lose track of what I'm doing. I have lots of tension and stress, but I wouldn't call that anxiety. If anything truly gives me anxiety, it's intolerance of boredom. Being bored and being sedated are two of my least favorite things!! Please correct me if I'm wrong about my definition of anxiety. If I'm not experiencing anxiety, then WB still looks good to me (Sorry Yellow, aka Pristiq Poster Boy, I'm not UN-convinced yet about the WB! :D) Noting those similarities between you and me, Hollywood, is what made me wonder about WB, since that seems to be working for you. That is still what you're taking, right?

Did you ever try the Cymbalta before bed? That made a huge difference for me. At first, I woke up several times during the night, but that went away. Every doc I ever saw asked if I had trouble sleeping and the answer was always "No way, it's exactly the opposite--I sleep like I'm dead!" I'd never move a muscle or remember a dream. Cymbalta made my sleep seem more normal. Hmmm... It didn't do anything for my ADD, but I was certainly more productive when I was on it than when I was not, and I think I just answered why.

There was a gal who posted on here somewhere that she breaks her Cymbalta and just takes half (mabye even less) of the beads per dose and that made a huge difference. The side effects weren't TOO bad w/Cymbalta. Maybe that would do the trick (and make it a LOT cheaper--especially if I have him prescribe 60 mg, since 60 and 30 cost the same.) Actually, wasn't that you Hollywood who commented that you didn't have time to mess with that? It would be a pain, but better than side effects!

I forgot all about Strattera. Isn't it pretty much Cymbalta without the seratonin, which is actually what I was wanting anyway.

I wonder how Tom's doing with the Remeron...

Man, I think too much!

roodyrider
06-29-09, 07:57 PM
This is a great discussion, by the way. Thanks so much you guys for your input!! I still have some Cymbalta, so I may just test the theory of breaking it up. If that works, I'll bet I can then add the Adderall back in. I'm positive I was taking too much of it looking for physical motivation. If I'm not taking too much of it, then I probably won't feel compelled to sit at the computer all day! I can at least test that theory with what is available to me now--without a trip to the doctor's office. He's muy expensivo!

Yellow
06-29-09, 08:07 PM
lol hollywood. im just tryin to help man, if she cant afford meds, wyeth gives them away for free....might as well take advantage right? especially with no insurance. and to be honest, i just dig pristiq cuz it works for me, after so many failed attempts with other meds, but i mean remeron and zoloft are just as impressive in my opinion, as is mianserin, but thast not really available so i dont mention it. i really would love to get remeron, and i just might add it at some point down the line just to check it out. i dont wanna guinea pig myself and since im takin pristiq at the same time as dex, the neuroprotection is probably way better than remeron's which would be taken at night and has a different mechanism. i dont know if remeron is nueroprotective against dex in the way that pristiq (and the ss/n/dri's are).....desvenlafaxine works for me so i work with it, ya dig?

and roody talk to hollywood about cymbalta, he knows all about it. never tried it myself and never will. dont worry about labels like MDD and so on, im on pristiq for psychotic bipolar, u know what i mean? they say not to give us stimulants or ssris but im on both and doin better than ever.

Yellow
06-29-09, 08:31 PM
Recently I tried large doses of Nuvigil a new form of Provigil, and I find that it may be the best yet in terms of allowing me to concentrate without anxiety, or some of the obsessive components of dex, desoxyn, and methylphenidate. It is a non-triplicate drug, and requires less headaches to obtain. It is just as potent as dex as I stopped dex and used nuvigil and it worked just as well, which hasn't been the case with other lesser controlled substances.


Hey can you tell us more about nuvigil? it just came out and im curious to maybe add it to dex, as in switching between dex and that for breaks, or just switching from the amphetamine familiy altogether.

roodyrider
06-29-09, 11:17 PM
Yellow--Did you never try Cymbalta just because you found Pristiq first, or was there some other reason?

hollywood
06-30-09, 12:09 AM
roody,

cymbalta was alright, felt more normal but got pretty sleepy and ended up not caring about much. Stress is a huge motivator for those with adhd and if it's not that much of a factor, one forgets what it's like to not have stress and instead have calm focus....it's the way to go trust me. Wellbutrin is a solid med, but it's not terrific for worry, worry and worry thoughts are no good....they waste time and time is all we have, this is why I entertain the thoughts of pristiq. Pristiq interest me because when I take it I don't feel too sedated but it doesnt interfere with my stims much.. I'm on wellbutrin now, but thinking of trying out pristiq. Worry is natural for adult adhd and boredom is the perfect environment for it. Do not get caught up in mdd and the labels or commercials ...adhd is a spectrum disorder and rather or not if your worry is biological it matters not, because enviroment is just as big a factor for conditioned anxiety and it needs to be eliminated... Think of treatment this way for adhd , mood plays into the environment and interferes with proper focus, if your worried or bored you cannot focus and this leads to stress. Treat your worry and anxiety as well as your adhd ...this is the path that will drive you toward success... The reason yellow likes pristiq is that it treats a broad spectrum of problems and covers more than wellbutrin does...but yes wellbutrin is solid and it's good as well, it's just not good with anxiety thats all. From what I understand if pristiq does not sedate you then it will elimate anxiety and worry.....this will make you far more productive

Yellow
06-30-09, 02:38 AM
i didnt try cymbalta for a few reasons:

1) i did find pristiq first
2) after researching everything extensively, and i mean more than most psychiatrists know about these meds, i found pristiq to be superior to cymbalta, at least as far as i understood
3)pristiq, though it is a metabolite of effexor, it is a very high dose of that very potent metabolite and its pharmacological profile is not only unique and effective, but its very promising for other reasons (which i do not feel like exapnding upon)
4) there are only a few snri's, and my research has shown me that for my purposes of combing an snri with my other medications, pristiq is the best choice
5) one dose, no titration, clincal response immediately upon first dosage...within days i felt pristiq working, i mean 3 days, and then by a week it was a different world, so since i tried so many other meds and pristiq really did work that fast, i was willin to give it my time, and its helped tremendously
6) the only other ad's i like are zoloft and mirtazapine/remeron, but zoloft doesnt have any NE adjustment and remeron is for nighttime sedation, and i dont have insomnia so....
7)pristiq's neuroprotection from the other meds i take (supposedly also reduces tolerance to some people, which i have not developed btw) is working great during the day

so im happy with my combo and i dont want and wouldnt try cymbalta because pristiq seems better. only zoloft, remeron, mianserin, or prozac as a final choice.

roodyrider
06-30-09, 03:52 AM
VERY well put!! I'm going to have to seriously ponder all of this. Pristiq and Cymbalta are BOTH probably better choices for me than WB, but it really comes down to the sex stuff. I'm just not willing to sacrifice there. At least not without exhausting every possible alternative.

Life isn't fair!

roodyrider
06-30-09, 03:56 AM
That last "Very well put" was for Hollywood--I hadn't seen your post yet Yellow. That's why I asked--I knew you'd probably have better information than me and probably my doctor!

I really can't thank you guys enough!

roodyrider
06-30-09, 04:53 AM
Well Yellow, I think you've sold me on Pristiq. With the free trial carrot dangling out there, I can't see any reason not to at least give it a try. I already know Cymbalta has the side effect I don't want, and Hollywood has convinced me that Wellbutrin may not be the best since I'm always stuck inside my head. It seems more logical for Wellbutrin to be the last resort. And I'll bet my doc will let me get started without going in since he's an hour and a half away!

Yellow
06-30-09, 09:09 AM
if u ask me, wellbutrin sucks, but thats me. i think as a chemical its very interesting with what it does, i find it very interesting actually as it is really the only NDRI that's widely available and sold as that, i mean pritsiq has slight dopamine reuptake inhibition as does zoloft, but probaly not as much as wellbutrin (though zoloft supposedly has more, its affinity for receptors isnt as strong as wellbutrin). however, its clinical and pharmacological actions i find are quite different, theoretically it looks awesome on paper, but when used i hated wellbutrin, its like a stimulant comedown without any of the benefits of the stimulant. with sexual side effects u run that risk with almost any AD, wellbutrin and NRI's the least, but its still possible. pristiq's sexual side effects didnt effect me as far as physical ability, it was simply a lessened desire or libido, but that went away after the adjustment period.

hollywood
06-30-09, 09:46 AM
yellow,

I wonder if wellbutrin works on some people as a baseline to there stimulant if in those people that wellbutrin helped if pristiq would still be a better option. I find that when I take wellbutrin my head is clear and I feel quite normal but I can get anxious, while only shortly trialing pristiq I feel a bit more calm yet less focused , yet it is too early to call regarding pristiq because being that it has serotonin this side effect is most likely temporary. I think wellbutrins dopamine reuptake facilitates me and helps this is my only question mark regarding if pristiq will be as effective. Good posts and feedback though. I do like wellbutrin but it does nothing for obsessive or ruminating patternistic conditioned thoughts. I think this is where serotonin becomes effective because once you feel calm and happy one is less likely to ruminate over negative thinking. I am still with wellbutrin but I want to try pristiq. Ha ha , tough to adjust when your a broker.

Yellow
06-30-09, 12:39 PM
the only reason i dont like wellbutrin is because of the anxiety you mentioned, if anyone takes it alone, they have all told me they get anxious, inlcuding myself. pristiq is a good med, but there are tons, like ive mentioned.

roodyrider
06-30-09, 01:18 PM
Yellow, that's the exact same way CB affected me, but it didn't go away. I read some reviews and there were a few who had that with CB but not Pristiq. That's enough motivation for me to give it a shot. The stress level is freakishly high in my life right now, but it's situational. That's why I realize WB doesn't make much sense at the moment. I need to worry about getting through crisis mode first and foremost, and if Pristiq gives me the same problems as Cymbalta, I can think about a switch to WB later on.

My relationship went to hell and there was a big, nasty breakup. We are back together, but 11 years of undiagnosed ADD has caused a big mess that has to be cleaned up. The major stressor is that we took on too much and have to get those things off our plates--NOW! I've got myself worried into a frenzy and I feel like I'm trying to put out a forest fire with a squirt gun! The "what-if" stuff is playing so much in my head right now that I'm having a really hard time being productive--at a time when I really have to be "on."

That's why I'm thinking Pristiq really would be a better way to go. If the side effects are there, I'll just have to worry about that later. Sounds like trying WB right now might just put me over the edge! My situation's a lot like yours Hollywood--I don't have a lot of time to be adjusting to medications, PLUS, I have to make a decision quickly. It's a gamble, since I know the CB activated me, and did so pretty quickly, but it looks like most people are adjusting to Pristiq very quickly too, and I adjusted to CB the same way Yellow adjusted to Pristiq, with the yawning, etc. but it only lasted a few days. So why do the Cymbalta again when I already know it's not "the one."

I'm just thinking out loud now, reaffirming my thoughts.

I think I've come to a pretty sound conclusion and you guys really helped me get there. Since I didn't have the facts that you've given me, I probably would have pondered it so long that I would have spent forever with the what if's and probably still not get it right!

THANK YOU, THANK YOU, THANK YOU!!!

hollywood
06-30-09, 03:35 PM
sounds legit roody, strange how you say cymbalta activated you. I felt okay on cymbalta but after two weeks I was getting pretty sleepy, could have been allergies. It's tough to acess when you have adhd up to your ears and have alot of stress. Remember the efficacy for treatment is much better for those with adhd when they find the proper adjunct because it takes the stress down and then you find yourself focusing well again. I wish cymbalta activated me, I found it okay at 20mg but felt a bit sleepy at times then at times I was not all that sleepy. Just tough to figure out if it was wrong but it put me right to sleep. I hate meds, but I have limited choices with adhd.

roodyrider
06-30-09, 05:31 PM
Well Hollywood, here's something really nutty to add that's blowing my mind. I divided a 60 mg Cymbalta last night like that other poster on a different thread had said. I took a third of it, shooting for 20 mg. This, of course, before Yellow had me sold on the Pristiq, or I wouldn't have even done it.

I didn't go to bed till 4:30 a.m. so I woke up pretty groggy at 11 this morning. I took a 20 mg adderall and have been totally in the groove ever since, and haven't yet needed to take any more adderall--it's only been 4 1/2 hours, but usually whatever I get from adderall, if anything, lasts maybe an hour. It's unbelievable to me that 20 mg of Cymbalta could have that effect on me immediately, but Adderall alone isn't like this at all! I had the "action" part that was missing with the Adderall alone. I also didn't get it from Adderall and Zoloft combined (if anything, that combo made it worse.) Today, I was able to say "OK, I have to do a, b, c, d," then simply do it without running around in circles or ending up sidetracked online all day--the only reason I'm on here now is lunch and waiting for a phone call, then I'll be back to business. I did have a brief period where I was pretty amped up, but yesterday I wouldn't even have felt 20 mg.

As I said before, there was a brief period when I started Adderall where it overlapped with Cymbalta, but I honestly don't even remember how long that period was, and I knew nothing at that time about supplementation. PLUS I drank tons of soda and coffee and NEVER drank water. I've changed all of that and I'm sure that's relevant.

I just hope it's not a fluke, but I really don't think it is. I guess we'll know tomorrow!

I still want to try Pristiq, and Hollywood, maybe that one will be just right for you. I guess the part I really want to understand is what causes the apparent synergy with the SNRI/stimulant combo--at least for you and me Yellow and maybe you too Hollywood. Does the stimulant take away something that the NE gives back, or is it that with Adderall primarily affecting dopamine, you're getting all bases covered? In reading the Stahl book, my conclusion about myself (again, no science background here at all, so no makin' fun of me!) was that I was deficient everywhere! And is that deficiency what makes us ADD??

Gotta run. Will tune in again later!

Yellow
07-01-09, 12:28 AM
from what hollywood says, pristiq is very different from cymbalta, again based on my experience with pristiq. if u can get the free promotional supply, try it. otherwise, maybe ask for the cheapest generic of zoloft or prozac or remeron or something. work out with the doc for ur best option and cheapest price.

HEY TOM, update us, dont just take all ur info, get what u want and disappear, YOU OWE ME this much! nah kid, just playin. hows ur medication working out so far, i think were all interested.

peace bredren

roodyrider
07-01-09, 01:11 AM
Yeah--I've been wondering about Tom too...

Prescription cost is only a temporary issue for me--ultimately, I'm just looking for the BEST treatment. It would be pretty tough to top the synergy I had today--although the second dose of adderall lessened my motivation. I suspect because I had only had the one 20 mg Cymbalta dose, and it had simply worn off by the end of the day. I went ahead and took another 20 mg of Cymbalta, and voila, I was ready to get moving again. It's really nice to be in a position where I can use myself as a lab rat and observe the results without much distraction!

I just discovered biopsychiatry.com from another thread. I'm busy flooding my brain over there...

tom2228
07-01-09, 06:36 PM
yo guys i posted a longgg post before and i dont know if it just didnt get posted yet or if it got deleted so -_-

Yellow
07-01-09, 10:50 PM
yeah, you didnt post, so post again, thanks lol

(especially cuz im outta here in a couple days)

tom2228
07-01-09, 11:33 PM
hahaha okay i will soon, i knowi have to, i just need some time to write a whole big long one again while im on vacation. all i have to say right now though is that Remeron rocks!! MIRTAZ WARRIOR!

Yellow
07-02-09, 01:10 PM
hurry up man, a quick recap of the past week trial, im off tomorrow

hollywood
07-02-09, 04:29 PM
roody,

You know they do make a 20mg of cymbalta.. It's strange because you said that you started to feel blah and then increased your cymbalta dose and you were good again... The strange thing is that I may have misjudged cymbalta , I did the same thing but didn't think of the med wearing off on me? Chemically cymbalta should be more activating and mirror a prozac with more anxiety coverage... Huh, now I'm not sure if cymbalta may have actually been helping and just wore off quickly because I was on 20mg it definitely helped me mellow out a bit , and I'm finding out when I'm mellow I focus way better. Not mellow like some stoner though. Huh maybe cymbalta is better than pristiq? It does have a better or more equal ne to se ratio-

Yellow
07-03-09, 09:40 AM
hollywood, your post is wrong and i encourage anyone following my info to ignore that. both have 1:9::se:ne and 50mg therapuetic dose compared to 20-100mg? titration window dosing + higher incidence of toxicity or adverse side effects...now youve been able to grasp enough of psychopharmacodynamics in these few months to now see cymbalta as better than pristiq? if you see that concise difference as better then questin perception. one day you say ur on this, next day your on that, getting of this and trying something else...idk man do ya thing

tom, no response still? and what i said to hollywood kinda bleeds into you too.

even after all of the replies ive bothered given you two with repetitive info, like how many times did i have to answer the same question, and now i simply asked for one reply after i said was gonna be away today, and it wasnt even for me, it was to help someone else.

my last piece of advice in this thread will be for both tom and hollywood to ignore any psychopharmacology you think you know before you confuse yourselves

aside from giving me time for my own medical introspection, i see my time here has been wasted, actually no thats wrong... when considering the benefit and betterment of others. im glad i was able to help. peace

roodyrider
07-03-09, 11:41 AM
Hey Yellow--don't feel that way. I've gotten a tremendous amount out of your posts and I know the other guys have too. Tom did say he's working on a response for us. He is probably just too busy at the moment. These stories get long and I know in my case there are so many factors to consider--it's really tough to write about it accurately while trying to be brief, yet without leaving out important details.

Hollywood, you were a little misinformed on your last post. I actually said that I there was no difference for me on Cymbalta at 60 mg or 30 mg. I started on 60, and dropped down to 30 (after quite a long time) because I had heard so many bad things about the drug in terms of liver toxicity that if I was going to be on it, I wanted to make sure I was taking as little as possible, so I bumped down to 30. That's when I realized there was no difference. The reason I commented that it had probably "worn off" in my previous post was because it was only the first day I had taken it again. I think today is day 4...

I can totally relate to Hollywood's sense of urgency--I think we are both personality types who just want the meds to work RIGHT NOW so we can get on with it. Obviously, that's what we all want, but patience is not something I was born with an abundance of, and maybe Hollywood wasn't either. It IS difficult for me to just see things through before jumping on to something else. After all, that very characteristic is a major component of what we're trying to treat here!

But Hollywood--I do agree with Yellow. You're kinda freakin' out! You said the Wellbutrin/Concerta combo is very close to perfection for you. If that's the case and you just need to reduce the anxiety, it shouldn't be that hard to find a drug to add that will help with that.

I suspect, however, that you're much like me in that you really want the BEST possible combination. Unfortunately, it seems to me that the only way to find that out is through trial and error. As I've said--it was in retrospect that I've realized Cymbalta actually works very well for me. I was so resistant to the idea of being medicated indefinitely that I just had to make sure it was absolutely necessary. That's the main reason I stopped taking it in the first place.

Now I feel that I've given it enough time (I stopped Cymbalta back in November) to realize that I probably am better off ON an antidepressant than OFF.:(:(:( It sucks, but I guess that's just reality. Because of the other negatives of Cymbalta (cost, side effects, toxicity) I will probably end up trying both Wellbutrin and Pristiq eventually just to satisfy myself that I've chosen the BEST alternative for ME. Being medicated long term is a big deal to me, and even though I've found something that works well, I'd hate to think I settled when there could be something out there that's even BETTER for my situation. But the only way to find that answer is to try the alternatives and give them enough time to really get a true sense of the results before moving on to something else.

tom2228
07-05-09, 05:57 PM
lololol guys im way too hyper to type a formal response right now (i will soon!) but all i gotsa say is REMERON IS THE ****

-Mirtaz WARRIOR

tom2228
07-05-09, 06:17 PM
holy crap i just left the same post as i did a couple days ago!
you know you have ADHD when...

roodyrider
07-05-09, 06:32 PM
Tom you ARE killing me, man!:D

I've put Remeron back on my list of strong possibilities. I've done SO much studying that it actually seems like the more you know, the more confusing it gets! The one thing I've been able to determine for sure though, is that NE is the area where I need the most improvement. So now I just need to figure out how to get that without too much influence on SE so that I don't feel numbed (like my personality has changed,) or have sexual side effects.

The potential side effects (tired during the day, insatiable appetite/weight gain) of Remeron are what initially turned me off to the idea of trying it, but I have seen over and over again in my research that keeping the dosage in the right range should alleviate that--so make sure you tell us what your dosage is.

So you have to tell us something soon. I'm making a Dr. appt. Monday!

I'm glad you're doing so well. I'm jealous!:p

tom2228
07-05-09, 11:08 PM
haha roody, sorry :D im glad you reconsidering remeron!! :D
when i saw that, about the weight gain/ appetite/ sedation about a year ago first seeing it online i was turned off majorly. i did more research recently too, with the great help/inspiration of yellow, and read that titrating up relieves sedation and weight gain, etc. and i can say that it's true! i discussed with my doc and we started on 30mg for this reason, to avoid SE's. instead of the regular 15mg start-up. i felt kinda sedated on day 1 and on some days i've been abnormally tired but it's really pretty mild. we're probably going to be going up to 45mg at the next appointment, we havent discussed it yet but i'm guessing. although it has been almost 2 wks (2 days more) and i have said before that remeron is the $#it :D it's really awesome IMO. today i went swimming and im telling you i felt happy for the first time in a long time, instead of just feeling flat or numbed "okay".. it really is great. maybe even happier than ive been in my life although the depression is still kinda there. and the best thing it's not even 2 wks yet so things will probably get even better in the next 2 weeks. also the side-effects such as tiredness and some fuzziness have seemed to have gotten better a bit so far. it can be a little stimulating actually! i've read at higher doses it can be activating, which is pretty cool as i might be venturing up there as my depression has stood strong against over 10 meds :O actually, the problem with remeron is that Americans are stupid. american docs have a dosage range of 15-45mg and recommend starting at 15mg.. stupid! considering mirtazapine's side-effect profile with respect to its pharmacodynamics, meaning knowing that lower doses produce MORE sedation/weight gain/appetite increase/etc. it becomes senseless to use the American dosages. European doctors actually start at or above 45mg, i think 60mg i read. THAT makes a lot more sense because mirtaz, unlike most other antidepressants, has LESS side-effects the higher you go, whereas SSRIs and the like ("shabby" IMO reuptake inhibitors) are gonna flatten you out, give you SE bullsh** like no libido<-- i mean come on please, sexual health is a part of a complete happiness so i consider sexual side-effects intolerable, especially since im only 17! remeron doesn't do that tho! keep goin' up and your emotions are much less likely to flatten out, you wont pack on as many lbs, much less likely to become sterile way too soon.. it can even BLOCK the serotonin-related SE's caused by other antidepressants (great adjunctive potential)!!.. and according to wikipedia there's a possible nootropic effect at higher doses?!

Yeah i'm kind of selling Remeron to anyone reading. $$ Aurapharm should hook me up! And they should hook you guys up too, but with some mirtazapine. Worth a try for anyone who's had trouble with meds.

Plus you might be especially attracted to Remeron because of its side-effects.
Have/had an eating disorder and need to gain weight? Remeron can help.
Can't sleep at night, insomniac like us all? mirtaz will put you out n give u cool dreams!
Have hyperactive ADHD and too hyper? remeron's sedation can be useful..
On ADHD stims and have no appetite?! (*cough*, ME!!) Remeron can give u munchies.
Have nausea? Remeron has anti-emetic properties b/c of its serotonin antagonism.
Can't get off 'cause of your antidepressants? mirtazapine could possibly help!

I could go on or you could just ask your doc for some ;)

Yellow, im sorry, i really do appreciate your advice and help!! Im not taking you for granted, i've just been really busy this week with vacation and cousin being over, family crap, etc.! Hope you can log on and see this and good luck to your girlfriend with her possible mirtaz adventures!

And a word on what you said, roody. I definitely agree, we people here are the type who need to know they've got the perfect med for them because we really do want to attain contentment and know we're living how we'd like our lives to be. we also crave the excitement of research and trial, stimulating conversations with doctors and watching each day as our perceptions change, cool stuff i admit. I've been doing this "meds thing" for over a year now and i started when i was *******' 15. I've been on over 10 meds ranging from antidepressants, antipsychotics, an anticonvulsant, stimulants, etc. REally frustrating when you're on a med you're not tolerating even though you get a lot of help from it, and feeling hopeless that anything else will work or that you'll be stuck trying meds for your whole life. please don't give up though, i've been really lucky in that i think i've found my ideal type of cocktail and the specific ingredients. just how to mix it all together is what i'm workin on now, getting doses right and getting rid of adverse med effects and events. I've experienced over 10 (the 10+ drugs have been combined differently) chemically-induced states of mind and ways of perceiving things.. really confusing to know which way is the best way to think/act or just how to know at all and make sense of things :O Don't give up though.

Hollywood, a note to you. I remember reading you sayin adderall XR + dex IR boosters gave you the best symptom control while it worked. i really encourage you to try dexedrine alone, if it's IR, SR, or both, because that could have been what was helping you the most. ive also seen you comment on having peripheral SE's on your most effective doeses (higher ones), but dexedrine unlike adderall is only pretty mild in respect to peripheral stimulation, and more potent so you can keep the dose "lower" even if it's just a number thing. plus it's dirt cheap (for me, 90 x 5mg barr generic (only IR brand there is besides the 10mg barr) is $5 for the month.. ******* awesome!) compared to any other ADHD stim so thats great bc you also said you're broke. it's worth a shot :D perhaps less likely to give you anxiety too? isn't that your only issue to deal with now?

...I'm finding out when I'm mellow I focus way better. Not mellow like some stoner though.
lol i have to ask, what's that second part supposed to mean. MJ actually helps me out a lot, i use it frequently, it helps me focus/ controls my energy better and can make me mellow in a good way! or improve my mood. i use it frequently for this reason.. so i think most people should be a lot more open-minded and less judging. just giving my .02 :p

good luck roody with the remeron business, good luck to all of you really and thanks for the help. keep chattin though it's a really productive thread!

roodyrider
07-07-09, 05:29 PM
Hey Tom, thanks for the update!

I couldn't get a Dr. appt. until Friday, the 10th (I know, that's not far off, but I'm so impatient!)

I stopped taking my Adderall because I hadn't taken a break since probably March (plus I didn't want to be on it when starting a new antidepressant.) The first day w/o it I was fine, now it's been 2 days of nothing but sleep! I'm not depressed or messed up in the head like if I had stopped an anti-depressant or a pain medication, I just want to sleep all the time. I will definitely be taking frequent drug holidays in the future if I continue with stimulant treatment! I'm sure you guys already know this, but I thought I'd throw it out there just FYI.

I'll let you all know how the doc visit goes--right now, I'm really leaning toward mirtazapine. Too many good possibilities not to give it a try.

Off to sleep some more...

tom2228
07-07-09, 09:41 PM
awesome, good luck with your addy withdrawal! when i was on addy i would take liek a day off or cut down all my doses for a couple days and i would just space the **** out and be mad apathetic n lethargic before i took my addy finally, and then it would take almost double time for me to feel the med b/c of the withdrawal symptoms! ive been cutting down on dex IR doses for the past 2.5 days bc ive been overfocused due to antibiotics (they drive me insane) and ive been sooo spaced and SO hyper, like ADHD: Attention-Deficit HIGH DEFINITION :p haha ive been pretty damn happy though thanks to jazzy mirtazzy (lol) i bought l-tyrosine today bc i've been literally burnt out, mad depressed (hence the remeron) b/c i feel dead inside, all worn out and i keep getting sick (hence antibiotics) and i think the stimulants are maybe too hard on my mind wearing me out. So im just trying to see if i clear my bloodstream for a couple of days have energy and hence i got l-tyrosine to make more dopamine nd norepi that was depleted from the amps.

I've been so nuts!! It's driving me crazy, is this really how hyper i am when im not depressed and off meds? Or is it stimulating me a little enough to focus but not enough to calm down? Or ive been thinking maybe they dont have to coexist, and sometimes i'm more just plain hyperactive but somewhat focused, and others completely spaced out and lethargic, depressed? But still having Combined type with hyperactivity, maybe it can be in episodes instead of coexisting. OR is that indicative of some mood disorder? If so would ADHD-related and plain unipolar depression count? Or is this just stimulation from mirtazapine while at the same time giving me memories of times when i used to think in mood-disorder ways?! Crazy theories, i know.. im just wondering though. This is why i can never focus when im off meds (or undermedicated) because my mind is everywhere, just everything catches my attention.. i think of EVERYthing! Cant shut off and turn out my own mind haha. although this is beneficial because i can "feel like", just in my current mood, that i want to go post here on ADDF.. whereas on the meds i dont attach as many emotions to my environment because my head is focused on what i need to do. There are certain things i can NOT do at all without meds like schoolwork but other things like posting here are so simple to just do and zoneeee out to! On the meds it's like our attention span is narrower not just more focused.. its liek forced focus all the time, you can't really space out if you want to without lowering your dose (or maybe its just too high for you). That's one thing i miss about being unmedicated, its that you just notice so much more and your bed can be so much more comfortable, but all that distracts you liek the fabrics you sleep with, so you can't sleep for your life and are tired all day until night when you get hyper again and have to do your work. such a different lifestyle from "normal" people, but it does cause so much anxiety, easy to get depressed, moody for no reason and negative although you kind of leave behind great things like strong emotions and attachments to the envrionment so everything has significance (pack rat!) and you are very creative just starting at a white wall. Maybe that's why my mom (crazy anxiety ADHD woman) has always wanted white walls. so she can just space out hahaha. I do miss the flight of ideas and great times just being hyper and fun!! things can be SO stimulating.. but the moodiness and depression is too much because we actually have to get $h!t done. or maybe im getting this confused slightly with depression and the mirtazapine is making me a lot happier and im noticing this. WEIRD $H!T man!!

do you think if you had all these thoughts like this that you'd be able to focus at all?


ANYWAY, good luck man, i think you're making a good choice, it may not be for you but if you keep in mind start at 30 and go up if you can or need to (read more info last night about how mirtazapine's effects on serotonin and NE can have an analgesic effect :O) i think you'll find it's the closest thing to a happy pill. i read that somewhere and i agree with it! Good luck though, today is day 14 for me and my pdoc said it starts working around 2 weeks (2-4 for max effects) and i felt it like 2 days ago a lot and some before, im really up about this med.

roodyrider
07-10-09, 05:10 PM
Well, I got Wellbutrin. When I asked about Mirtazapine, the doc just looked at me like I was crazy and said "you don't want that." That's fine--I really wanted to try them both, and this wasn't the doc I'll be staying with long term. I don't think general practitioners know enough about drugs to even be dealing with ADD at all, but the psych. I was seeing was costing a fortune--even WITH insurance, so the GP is just writing the scripts until I'm insured again.

Both Wellbutrin and Remeron have features that are very intriguing for my particular situation. Unless Wellbutrin just knocks my socks off, I'm guessing I'll eventually try Remeron too. If I'm going to have to be on an antidepressant long term, I'm willing to go through the drudgery to make sure it's the BEST possibility--not just something that works OK.

Have fun with the trippy dreams and good times! I'll probably be up all night wishing I had something to smoke--the way I treated my ADD before I knew it was ADD!:D

roodyrider
07-12-09, 04:46 PM
Holy Cow!!

Tom--I think I feel like you do now. Day 3 of WB and I'm bursting with energy. I was supposed to do 3 days of 150 mg, then up it to 300 tomorrow. I'm definitely not going to do that--at least not yet. But what I'm so excited about is that I know this is the right track. I'm at least back to being the me I remember from some time long, long ago. I'm full of energy and annoying the hell out of everyone because I can't shut up. But it's not a speedy thing, that's just me.

I can't get to sleep very easily at all, but I don't think that will be a tough fix, and I'll bet I'll end up having to add the Zoloft so I'm not all over the place, but at least I'm educated about it now, and the idea of taking multiple meds doesn't freak me out like it did before.

I was talking to a friend about this and he had a great analogy about multiple meds. He compared it to adding seasonings when you're cooking--if you get the right combo, it's perfect. We certainly don't have the rationale when cooking of "Well, I've already added one seasoning, I'd better not add anything else." So why are we like that about meds? The results work the same way too. If you're cooking, and you add the wrong stuff in the wrong combinations, it's baaaaad--whether it's cooking or medicine! But if you get the combination right--perfection. That's the goal, and I'm confident I'll get there!

I know it's only been three days, and my fingers are definitely crossed, but my gut tells me this is definitely the right track, and my gut has never let me down--not once!

I know I would have figured this out eventually. But you guys (Tom, Yellow and Hollywood in particular) as well as this entire forum are what put me on the fast track. I can't thank you enough!!!

hollywood
07-13-09, 09:01 AM
roody ,

sounds good . I've been missing in action as I just got back from the tropics.. Awesome vacation. Roody your taking wellbutrin now? I thought you were going to take pristiq? You need to fill me in on whats going on and why you opted for wellbutrin or if it's just apart of a new combo. I think wellbutrin pristiq may work well together in addition to stims. I still haven't had the chance to take pristiq yet, I should start soon...

roodyrider
07-13-09, 01:49 PM
Hey Hollywood--Lucky Dog! I was wondering what happened to you. Yellow seems to have disappeared too. Hopefully he went on vacation too and didn't just get sick of us!

I think it was a couple of things that made me go the direction I did. I was entertaining going back to Cymbalta or trying Pristiq because I was just feeling so bad, anything would have been better. I guess it was reading Tom's mirtazapine story and the Wellbutrin/Adderall thread that got me thinking I needed to go that way. Remember it was the side effects that made me dump Cymbalta in the first place. I really didn't feel like I needed much influence over seratonin. The "get up and go" part is what I was really missing, and adderall alone made that MUCH worse.

I realize that mirtaz affects seratonin, but in a different way than the SSRI/SNRIs. The big side effect I wanted to avoid isn't an issue with mirtaz, and Tom seemed to be getting plenty of "go" out of it. I also have a really tough time going to sleep, which was another reason I wanted to try it. So that's what I was really shooting for when I went to the doc on Friday. But like I said, he just looked at me like I was nuts when I mentioned mirtazapine and just gave me the Wellbutrin. Since it was my second choice, I wasn't too upset or willing to argue about it. I had read a lot of reviews and accounts on here where people had said that WB actually decreased anxiety for them, so I knew the only way to really know was to try it.

Today is day 4 of Wellbutrin. It's definitely keeping me from sleeping, but I really feel more like my old self. I was reading Tom's post (#87.) The paragraph that starts with "I've been so nuts..." actually made sense to me! I don't know if I can adequately convey what I'm trying to say, but I would describe myself as being 40 going on 20. I also was not diagnosed until recently. I think because of those things, the SSRI/SNRIs were mellowing me out TOO much. I'm also not in school and I work outdoors, so I don't think I wanted to give up as much of my hyper-ness as maybe I would if I was in school or in a job like yours. This is why I'm thinking if the WB just does too much, I can take it down a notch by adding the Zoloft and have more control of the NTs individually, rather than combining it as with the SNRIs.

So you're going to add Pristiq to WB/Concerta? I mentioned on a different thread that I thought you'd be getting double coverage that way. Yellow agreed (which made my day--made me think I'm starting to get it!) I still would think that just adding a different SSRI since you're allergic to Zoloft, that you can control the dosage of, might be a good way for you to go. Or if you go with Pristiq, dump the WB. We're on different stimulants, so we're not in exactly the same boat (I tried concerta once--I was depressed as hell and wide awake. I don't remember the dosage or anything, but I HATED that feeling and won't go there again!) but like I said, I like the idea of being able to add seratonin influence "as needed," so what if it's in a different pill?

Gotta run--I'm being lazy! It's going to be 105 tomorrow here in the heart of America. I bet I'll be online plenty then!! I actually love Kansas, but the weather SUCKS!

hollywood
07-13-09, 02:17 PM
roody ,

glad things are going well. Yeah wellbutrin works well for me but I could be a bit more calmer and it would help me in my line of work being a broker. I'm not so sure it's double coverage when you combine wellbutrin and pristiq at my dose level.... but I don't want to be overly sedated or underfocused when or if I add the pristiq....I don't think it's double coverage , and it depends on the total dosage of the meds...Still a tough call.

roodyrider
07-15-09, 11:26 AM
Hollywood--

I was just over in the anti-anxiety section and saw your posts there. This is really cracking me up how much you and I are on the same track, and we both intuitively know when we get something that's not right. I'm right with you--I'm fine with taking medicine, but don't want something I don't need, or worse, the wrong thing. Getting the wrong medicine and a wrong diagnosis took me on a 10 year tangent and I'm not very freaking happy about it!

Have you looked into Buspar? I just got to this last night and I was so tired I couldn't stay up long enough to get too much into detail about it. I'm loving the WB, but having a hell of a time getting to sleep. I'm hoping this is a side effect that will pass, but even with sleep being all jacked up, I still feel the best I've ever felt. I can't imagine what it will be like when I get the sleep part fixed!

Anyway, Buspar looked like it really could be a good one for both of us--especially you. And I suspect if I wasn't ruminating when I went to bed every night, I'd probably sleep, so it may be the one for me too. Like I said, I didn't get into it very much, but just reading the reviews on www.rxlist.com (http://www.rxlist.com) was very encouraging--especially in terms of WHY they were taking it. And I think the reason we're on these forums is because we've figured out that finding out what works for others who are similarly afflicted is where the REAL answers lie.

I intend to read more on this, but have to take care of business first. I just wanted to give you a heads up. And whoever told you to take benzos--forget it! I wouldn't go there in a billion years!!

roodyrider
07-15-09, 11:28 AM
By the way Hollywood--the only bad thing I've seen about Buspar so far is that it DOES take time to work. So if you try it, patience may be necessary. :D Although I did see people say they felt the effects immediately too.

hollywood
07-15-09, 11:49 AM
ROODY,

I work out alot , sometimes I get chest tightness from training and stimulants exacerbate this especially if I consume any caffeine, if this was eliminated things would be perfect. Thats why cymbalta was great "for physical pain" but I couldn't really function on it. Not totally sure because I was only on cymbalta for 3 weeks.... Maybe prozac, maybe buspar is the answer ... keep the info coming. I only tried pristiq for a few days, it's tough to trial these serotonin meds.. .but on the third day I had no anxiety and was really calm...

tom2228
07-15-09, 01:30 PM
Hey guys! Sry i havent replied in a while, i actually did have a long reply typed out 2 days ago but accidentally X'd and said to hell with it, ill write a new one later.. and now here we are!

roody i love your cooking analogy, its a great one that pretty much summarizes what ive been thinking about regarding meds these past few months. its pretty dead on. i think we're apprehensive about being on multiple meds or adding new ones because we don't want something that helps a little or is just good enough, we want the BEST, perfect combo that will improve our lives.. hence we've been posting on this very thread! being on multiple meds is tricky if you're aiming for the best combo. its like adding a bunch of spices to the pan and the dish is pretty good but you want to make it better next time. but the problem is its all just one finished product. youve added so many spices to the dish that now you dont know which spices to add less of, which to add more of, which to leave out completely. also, say you have spice A which is ok so you add spice B for more flavor, but what you have in the end might not just be what you thought, A+B. because A+B might be synergistic and create C. pretty soon you're all confused so you just order take-out.. but you can't do that with your brain! it can be confusing enough to try to titrate one med perfectly,and once you add another it becomes even harder bc you dont know what med is causing/doing what anymore! plus we are impatient, we want to feel great asap.. so we might add med B before we've titrated A correctly. especially with ADs, lots of waiting, and of course we are the impatient ones with adhd and all. basically its a lot of patience. but the best thing we can do for our dilemmas is research! the more we research, the more we'll (hopefully) understand whats going on, and we can get closer to perfection. it makes perfect sense to research these meds because WE know more about ourselves than our docs! we are the ones with the brain that needs help, not the doc, so we should use all we've got to help ourselves. its hard yeah, but we're on the right track by posting in this thread!

i was gonna post this the other day, im really happy for that you've got lots of energy! thats typical upon starting WB though. not to say you wont be as energetic when you get used to it, but there seems to be a "honeymoon" period with WB as ive read, where the first couple of days are a stimulant boost pretty much. you'll probably calm down a bit until you adjust and the full AD properties begin to work, and then you'll likely have more energy, motivation, and less pain. actually, ive read that WB is indicated for lower back pain! so maybe it has some special properties for pain relief more than other meds that also increase NE like SNRIs? no idea. the good thing though is that WB tends to begin working faster than other ADs so thats a plus.

if you're thinking about adding zoloft to calm you down if WB is too energizing i'd suggest adding remeron instead. if the main objective is dealing with energy levels, remeron is a much better option. with zoloft you can't guess how it will effect your energy and theres no telling whether titrating up or down on zoloft is going to make you more/less tired. with remeron though, there is a CLEAR dose-dependent effect on energy levels. i'd start on 30mg so you're not zonked out. if it's too sedating, just titrate up knowing that higher doses = less sedation. simple! plus, remeron has proven in a meta-analysis study (one big huge study compiling all the studies there are comparing one ADs efficacy to another) to be the most efficacious antidepressant there is compared to SSRIs and SNRIs (but not the best tolerated, although im gonna assume the results would be different if the people in that study had known about higher does being more tolerable!).. if you want a link just ask and ill find it.


The big side effect I wanted to avoid isn't an issue with mirtaz, and Tom seemed to be getting plenty of "go" out of it.What SE is it you're talking about? Also you said the reason you dropped cymbalta was SEs.. ive read SNRIs are generally tolerated better than SSRIs so i really dont think zoloft would be a great idea to add on if you're worried about SEs. Mirtaz is unique in respect to SEs, because it IS a serotonergic drug but it lacks the sides associated with SSRIs, especially sexual dysfunction (my worst enemy SE-wise). It seems the wikipedia article on mirtazapine has been updated! I really recommend you go read the wiki article, it's very informative! Here is a great explanation of this:

In contrast to mirtazapine, the SSRIs, SNRIs, TCAs, and MAOIs all increase the general activity of the 5-HT2A, 5-HT2C, and 5-HT3 receptors, leading to a host of negative changes and side effects, the most prominent of which include anorexia (http://en.wikipedia.org/wiki/Anorexia), insomnia (http://en.wikipedia.org/wiki/Insomnia), sexual dysfunction (http://en.wikipedia.org/wiki/Sexual_dysfunction) (impaired libido (http://en.wikipedia.org/wiki/Libido) and anorgasmia (http://en.wikipedia.org/wiki/Anorgasmia)), nausea (http://en.wikipedia.org/wiki/Nausea), and diarrhea (http://en.wikipedia.org/wiki/Diarrhea), among others. As a result, mirtazapine is often used in conjunction with these drugs to reduce their side effect profile and to produce a stronger antidepressant effect.[71] (http://en.wikipedia.org/wiki/Mirtazapine#cite_note-pmid10333982-70)[88] (http://en.wikipedia.org/wiki/Mirtazapine#cite_note-pmid16946177-87)[89] (http://en.wikipedia.org/wiki/Mirtazapine#cite_note-pmid12590402-88)[90] (http://en.wikipedia.org/wiki/Mirtazapine#cite_note-pmid12028939-89)[91] (http://en.wikipedia.org/wiki/Mirtazapine#cite_note-pmid15560319-90)[92] (http://en.wikipedia.org/wiki/Mirtazapine#cite_note-pmid18204355-91)And even more exciting, mirtazapine is indirectly dopaminergic!!

Despite its classification as a NaSSA based on its relatively weak actions at the α2-adrenergic receptor, mirtazapine's antidepressant properties are more likely to actually be mediated primarily by its far stronger blockade of various serotonin receptors (http://en.wikipedia.org/wiki/Serotonin_receptor), notably the 5-HT2C receptor.[77] (http://en.wikipedia.org/wiki/Mirtazapine#cite_note-pmid18709360-76)[78] (http://en.wikipedia.org/wiki/Mirtazapine#cite_note-pmid16433010-77)[79] (http://en.wikipedia.org/wiki/Mirtazapine#cite_note-urlwww.psychotropical.com-78)[79] (http://en.wikipedia.org/wiki/Mirtazapine#cite_note-urlwww.psychotropical.com-78) This is probably why yohimbine which is a similar-acting and even more potent α2-adrenergic receptor antagonist that lacks 5-HT2C receptor affinity has far lower antidepressant efficacy in comparison. The 5-HT2C receptor normally works to inhibit the release of the neurotransmitter (http://en.wikipedia.org/wiki/Neurotransmitter) dopamine (http://en.wikipedia.org/wiki/Dopamine) in various parts of the brain, notably in the pleasure centers (http://en.wikipedia.org/wiki/Pleasure_center) such as the ventral tegmental area (http://en.wikipedia.org/wiki/Ventral_tegmental_area) (VTA).[80] (http://en.wikipedia.org/wiki/Mirtazapine#cite_note-pmid15056702-79)[81] (http://en.wikipedia.org/wiki/Mirtazapine#cite_note-pmid17367945-80) By blocking it, mirtazapine disinhibits dopamine activity in these areas, causing a pronounced antidepressant and anxiolytic response.[82] (http://en.wikipedia.org/wiki/Mirtazapine#cite_note-pmid10762339-81) Indeed, the novel antidepressant agomelatine (http://en.wikipedia.org/wiki/Agomelatine) (Valdoxan) acts primarily as a 5-HT2C receptor antagonist and has antidepressant efficacy at least comparable to that of the SSRIs and SNRIs.[83] (http://en.wikipedia.org/wiki/Mirtazapine#cite_note-pmid12750432-82)[84] (http://en.wikipedia.org/wiki/Mirtazapine#cite_note-urlFebruary_2009:_agomelatine_.28Valdoxan.29_licen sed_in_the_EU_to_treat_major_depression-83)So theres benefit for us ADHDers too, i guess?! I DO find its easier than before to concentrate without my meds (plus remeron is noradrenergic, so that helps too.) And perhaps this 5-HT2c blockage is why lamictal really helped me focus on the highest dosages (although my memory was atrocious), as it is a 5-HT2c antagonist.. it REALLy helped me get through my junior year until i got Adderall in december!

I called my doc over the weekend b/c the sedation was still bothering me after almost 3 weeks, so he told me on sunday to wait a couple days then go up to 45mg if things didnt get better. so i gave it one day lol and took 45mg monday night. I was less sedated yesterday, and today too, which is a great thing as my energy levels highly correlate with my mood! I thought since 45mg is less sedating than the 30, it wouldnt put me out as hard at night, but interestingly these past 2 nights its put me out like a light! i'm guessing that mirtaz's antagonist effect on the 5-HT2a receptor is the cause, i've read that receptor plays a big role in sleep. it makes a lot of sense considering the antidepressant trazodone, a strong 5-HT2a antagonist, is used for sleep more than as an AD. You've also mentioned sleep is an issue for you, remeron would definitely help, not to mention my dreams are awesome! Closing my eyes in bed after my dose has kicked in is kind of psychedelic actually (especially if ive smoked that night, it seems to bring out mirtaz's psychedlic properties), i love being able to start dreaming before i fall asleep!

I really hope WB does it for you, if not though id bring it up again to your doc and bring research with you! My doc finally switched me to dex when i got all smarty-pants with him and brought in 5 pages of ADDF posts (which he didnt even read, he just went with it as soon as i handed him the highlighted packed :D)

I dont mean to be gung-ho about remeron but its a great drug. My mom actually just said to me that she's never seen me act this happy! ITs been a wonder for my anxiety, both generalized and social. The amphetamines have been amazing for my social anxiety too, and now with the remeron i can be myself around anyone. Im still depressed, which makes sense as ive had some sort depression my whole life (be it severe or mild), but im getting there. Outwardly you couldnt tell anymore, my social functioning is much better, but on the inside i still get down. Its only been 3 weeks though, and only 2 days on the new dose.. Im excited to think how good i'll feel by august :)

Hollywood how was your vacation?! Where in the tropics did you go? I think buspar would be a good trial too, its supposedly got some AD properties of its own although i havent researched it much. You mention the chest tightness.. thats one of the reasons i got off Focalin, i couldnt run without getting extremely stiff and tight in the chest too! Its definitely related to the peripheral stimulant effects of concerta, without a doubt. although focalin is less peripherally acting than concerta (b/c dextro vs. racemic MPH).. the amphetamines are supposedly less peripherally acting, especially dexedrine. i really appreciate dex because i can exercise on it without my heart going wild or getting all stiff. i think maybe you should look into dexedrine on its own b/c youve said elsewhere your AMP combo (addy XR + dex IR) gave you great symptom control.

I really hope yellow is back soon, i feel like he left on a bad note, im also curious to know how his girlfriend is doing and if she's feeling the mirtaz jazz ;)

again, sorry it took so long to respond, ill try to be more promt theres just been a lot going on this summer! also.. i apologize for the length of this post :eek:

hollywood
07-15-09, 02:08 PM
tom -

very informative post , I was in grenada , the keys and Miami. I am doing well aside from the chest tightness.... Happens everytime when I train ( sometimes its worse than others and sometimes I feel fine) but I'm a mule and will train through any pain that occurs. I was on cymbalta only 20mg maybe it is sedating in lower doses too? because it counteracting the physical stimulation that I get with concerta. Although my concerta dose is relatively high 126-144 the tightness is not interelated . I have been on that dose for 6 years and it works well for me. I am taking wellbutrin but as stated do wish to rid myself of this stiffness or pns stimulation thing. This usually occurs only after training for the day or less. It's a real pain and cymbalta killed that but also made me sleepy, wellbutrin helps my baseline coverage but does nothing for this.... I tried vyvanse that is dex and did just okay... I felt like I was on speed , didn't like that... Adderall alone doesnt do much but with dex ir boosters did well.... I wish I could just stick with concerta and eliminate this tightness issue.

selby
07-18-09, 03:05 AM
I do like wellbutrin but it does nothing for obsessive or ruminating patternistic conditioned thoughts. I think this is where serotonin becomes effective because once you feel calm and happy one is less likely to ruminate over negative thinking.

Yeah this is from two pages ago but this is SO TRUE, I couldn't find the words for it but this about sums it up for Wellbutrin. It works well in a few ways, like literally being unable to cry, or if you do, for no longer than a few seconds. I also found at first that if I was obsessing over something, I would instantly stop and move on to something else. That positive side effect only lasted for a few weeks. Now I spend hours and hours worrying and feeling bad about how I feel bad. It feels like stimulant crash amplified. Like someone else said, all the bad parts of stimulants.

So I'm thinking maybe I need to look less at anti-depressants, and more at replacing Adderall with something like Vyvanse. I've been reading it makes you less irritable and more like yourself but with good concentration still. School is coming up in a month and I need to find the right med combo Now!!! So tired of things that make everything worse. SSRI here I come.

BTW, it doesn't help when you see rave reviews for a drug, then see that the person has only been on it for a day. That means nothing!!! What about people who've been on a med for years and still like it, that's what I wanna read.

hollywood
07-18-09, 10:42 AM
yeah I would try effexor or pristiq they have studies that seem like they help adhd and worry alot , but the withdraw is crap. Maybe prozac

Yellow
07-21-09, 11:47 AM
Now i say, F|_|(/< PRISTIQ and any and all SSRI/SNRI/NDRI REUPTAKE INHIBITORS

Mixing them with desoxyn will probably give you serotonin syndrome, so the answer to the original post of this topic and thread is :

NO, YOU CANT COMBINE SSRIS OR SNRIS WITH DESOXYN, and shouldnt with dex either

http://www.addforums.com/forums/showthread.php?t=70700

Yellow
07-21-09, 11:53 AM
oh and tom, im glad remeron is working. its still the only anti depressant im actually still interested in. unfortunately, my mother got an allergic reaction to it just recently and had to stop immediately, bad bad skin rash/sores. its still a great med on paper, and if its workin for u without any problems, awesome. its the only one id ever try if i had to go on on anti depressant. IM DONE WITH REUPTAKE INHIBITORS. im now only into short term/short half life meds

Yellow
07-21-09, 12:04 PM
i forgot to add, thanks for askin about my girlfriend tom. she was denied remeron by her doctor because of her allergy to the SSRI class of stuff, though I dont see how they are related, strangely enough my mom just began it a few days ago, but stopped immediately from the rare rash that can occur

Funny, if people read my other post, the idiocy of looking at clinical risks as HYPOTHETICAL has been proven twice: with myself and now with my mother. remeron is supposed to be non toxic, and overnight she had open sores and rash ALL OVER. she coulda had epidermal necrosis if i didnt tell her to stop. so my self-diagnoses are very accurate, contrary to what others may think

as for myself, i had to learn the hard way about concurrent serotonin syndrome and effexor/pristiq withdrawal

hollywood
07-21-09, 01:31 PM
so really the best way to go if your going to try a med with serotonin is be on a ritalin or mph based stimulant . I'm thinking of trying prozac since its welll studied and safe for children and supposed to be good with stimulants and is off label for adhd.

tom2228
07-21-09, 09:03 PM
ahh, good to hear from you yellow, sorry about your SS ordeal, doesnt seem too pleasant to me. that suck's about your mom! Wow though, i had no idea that remeron even had a rare rash, i'm really surprised i haven't come across it with all the reading i've done! That's pretty foolish about your gf's doc denying her remeron though.. so she's allergic to SSRIs, remeron is not a ******* SSRI lol of course you know that though. and you said she's been on TCAs, so unless she is allergic to those too, i think the fact shes been on them is good enough evidence she's not allergic to all ADs. not that it makes much logical sense to be allergic to all ADs anyway..

yea, i understand what you mean about RIs.. theyre a real b!tch. a b!tch to start, a b!tch to come off (esp. (des)venlafaxine), a b!tch with side-effects, interactions-wise, and a huge b!tch if you've got any sort of bipolar tendencies (i know what thats like, ive had AD-induced mania but other than that i'm unipolar but who knows for sure). not to mention a b!tch when you consider how much they actually work for the trouble they put you through. they're a big investment and take at least a month out of your life for a proper trial so it makes sense not to want to deal with RIs anymore.

the good thing about remeron is it starts pretty quick. instead of waiting, with RIs, for the receptors to downregulate, remeron just blocks some of them right off the bat. actually, yellow, i think that remeron would be a good AD for you especially because of your particular flair of mental illness, i.e. psychotic bipolar. n i mean the psychotic part. i dont know if you realized this yet but mirtazapine actually has (atypical) antipsychotic properties (and i dont mean dopamine blockade). think about it. a common question is what is it that separates the atypicals from the typical APs? well, the atypicals have 5-HT antagonist properties.. as does remeron! i read about it in a study where mirtazapine was effective in treating capgras syndrome, which is pretty much a delusional disorder, and the article speculated that mirtaz was effective b/c of its antipsychotic properties. so there you have it, i haven't read anything else about it being especially useful for psychotic depression, but it would make sense.

also half-life wise, its not too bad, about 24-30 hours for men. knowing that was actually what helped me figure out last night that 45mg was too high for me. i was eager to go up to 45mg (i did 3 wks in) because i was basing my logic on paper, i.e., increased adrenergic activity at 45mg would cause less sedation. But i take back what i said about American psychiatry having it wrong and the europeans having it right starting at 45mg-60mg.. on paper the higher dose range makes more sense concerning tolerability but once i got up to 45mg i realized that 45mg is NOT better concerning antidepressant efficacy, which is the whole point of taking the drug anyway. 45mg was too much serotonin, a very familiar feeling similar to the SSRIs, except the SSRIs weren't efficacious at all, regardless of the dose. i was just apathetic, numb, and having mood swings. my mood wasn't very flat as with SSRIs but my EMOTIONS were disappearing, not good at all. 45mg actually made me more depressed because i couldnt feel much, so i would purposefully get myself down (with sad music, for example) in order to feel anything at all -- basically what cutters do but physically harmless.

anyway, the knowing the half-life came in handy to figure this all out. i knew i was going to be out last night til about 1am, so i didn't take the remeron as usual at 10pm. as the night went on, i actually began to feel better and better, and based on the half-life, i inferred this to mean that i was feeling better as the concentration of mirtazapine in my system decreased. so basically i needed to titrate down. when i got home i took 30mg instead, and today has been much better, pretty similar to how i felt last night. today i had my appointment, and we decided on 30mg, so i'll update you guys this as i adjust... today i actually feel perfect, so hopefully 30mg isnt too low once i adjust, if so i'll try 37.5.

out of the 12(?) meds i've been on, remeron kicks depression's ***** like no other! it is wonderful really. i am a bit sedated, but i don't really care because the sedation is anxiolytic and i'm pretty calm, dreamy actually. the dexedrine helps with the sedation (though normally i dont find dex very energizing because the calm it produces balances it all out) -- i guess having ADHD comes in handy (:D) because w/o a stim i dunno if i could tolerate the Remeron. i hope its not a problem when school starts (Sep.) but i'm enjoying, it kind of feels like i'm floating on a cloud! the world just feels very warm, and everything, even objects, seem to have this cartoon-like emotional coloring to them, almost animated! feels like a dream world. im actually feeling more emotions in this respect, but on the other hand negative emotions are still blunted. that has its benefits for depression, but i am a very sensitive person and i miss being able to have a good cry when i need one. for example watching TV or a movie, it's been hard for me to get emotional when i want to -- i'm a feeler, my creativity (ADD<3) allows me to get inside characters and feel as they do, this has been a bit impaired by the Remeron. but i think being overly emotional is ingrained in my personality, as a product of having depression and ADD practically since i came out the womb (lol, im amusing myself the way i put that), so i'm not really surprised im having some trouble experiencing life as people who are generally happy do. it makes sense that being happy involves not being so sensitive to everything, so maybe this isnt really a medication issue but rather a therapy issue (and im going 2x a week now b/c my therapist is moving to Santa Fe on Aug 1 :-/). wow you guys know me pretty well now! otherwise, side-effects are very mild and many of them are actually good: moderate constipation (but all that means for me is less frequent bowel movements), brain fog/ lack of awareness (dex helps but its still there), appetite increase (actually NORMAL now, balances out the dex!!), and the sedation (im not tired or fatigued at all, just less active). also, the restless legs/akathisia, which was only apparent when it kicks in at night, is gone now for the most part.

sorry guys, i know, i am very verbose!! i do have a problem simplifying and summarizing things, i tend to be too detailed -- i am very thorough though, which is good, just a lot to read i know :p

o and hollywood, i dont think the prozac is a great idea. although methylphenidate is indeed better choice than AMP regarding serotonin syndrome, MPH often interacts with SSRIs. i need to do more reading on this, but what i know now is that because MPH inhibits 2D6, as do many SSRIs (prozac and paxil the strongest; i dont recommend using them with either AMP or MPH honestly), this somehow leads to a build-up of the SSRI. my mom has been on prozac for years and started focalin some time in july.. she went NUTS. i dont think it was the focalin by itself that didn't agree with her because at first it was helpin her out a lot, she said she was "lovin' this new pill", but by ~end of june she started getting more depressed, extremely irritable, agitated, unreasonable, tried to kick me and my brother out of the house.. basically turned into a nazi and in her own words, she felt like she "wanted to bite everyone's head off" :eek: So i think it was more of a build-up reaction where the SSRI built up (and possibly the focalin too, im not quite sure how it works).. she stopped the focalin last week and she has been much better.

This part's for you Yellow: i called the doc twice about it saying her meds were interacting and he just blew me off, told me he didn't think the interaction was a factor here. BS!!!!!!

Hollywood, she was only on 7.5mg total of focalin (+ 40mg prozac), and i know you're taking a whole boatload of concerta so i do not think it's a good idea!!

so MPH + SSRIs i think is really iffy, especially since i'm not too clear on how the whole interaction works. AMP + certain SSRIs/SNRIs/whatever is a definite no-no if they are strong inhibitors of CYP2D6. Even on zoloft, which is a moderate 2D6 inhibitor, i noticed a build-up of the AMP (however not as bad as my prozac + adderall combo), which is NOT convenient or therapeutic at all, its actually toxic. and of course Yellow had a build-up rxn to pristiq + AMP.. so if you do add another AD to the concerta you must research it thoroughly and be very careful. actually, i'm pretty sure wellbutrin is a moderate 2D6 inhibitor, although im not really sure about how the interaction with MPH goes. just be careful man.

yellow, another reason mirtazapine is good for your situation: it has zero 2D6 inhibition, perfectly safe to combine with dexedrine. thank god things just work out this way!

here's a really good article about the 2D6 interactions, please read up guys, and read the comments too, the doc explains about prozac + concerta in one of them: http://www.corepsychblog.com/2008/12/add-adhd-medications-amphetamines-2d6-drug-interaction-update/

Yellow
07-21-09, 11:17 PM
hey thanks tom.

ur riught about the remeron, no reason to deny her that, but the doctors are mostly dummies, like most people

and your totally right about the 5ht2 antagonism. looks like u been readin stahl huh. thast why i find remeron so interesting, for exactly what you discovered.

now i wish the idiots in the other forum from my warning post actually read like you did, youve done the reading and it shows, and youve not only benefited from the knowledge, but youve been able to help yourself.

anyway, thanks for the supportive words and suggestions and hit my pm up if u wanna talk

and thx for the suggestion hollywood

tom2228
07-22-09, 12:56 AM
no prob yellow, happy to help if i can.

ahh, isnt that awesome about the AP properties of remeron! theres just so much about it, it really is such an interesting compound, i'll definitely PM you about it :)

i actually haven't been reading stahl, just my obsessive googling and such. but since you mentioned him, i googled stahl + mirtazapine n damn, his ***** is fascinating! i previewed some of his books on google books, simply awesome stuff, ive got to get myself to the bookstore n just veg out for a day, or at least put some of his stuff on my christmas list! i love the diagrams, theyre great.

fck them on the warning thread, you were tryin to do a good thing an show people that these "hypothetical" things actually DO happen so we should get smart and look out. the only reason i can think of why they responded like that is that they dont want to accept that their meds might not be okay together, its an "ignorance is bliss" thing, theyd rather ignore it than deal with it, n have the doc handle it for them. i get the feeling people use these meds as an easy way out n get upset when they dont fix everything for them, meds are only part of the BIG PICTURE (this big picture thing just keeps comin back up), you cant focus on them and ignore the rest, you have to look far and wide if you want to be better.

thanks dude, it means to be recognized for something you work at all the time to improve your life and to help others if you can. it feels good to know im getting somewhere on my own, its hard to grow up and keep yourself afloat, im sure you know.

hollywood
07-22-09, 09:10 AM
tom,

Yes my dose is on the upper end of concerta but it's evenly released and it's not like I desire the large dose thats just what I require to have my mind functioning and actually working I've been on a large dose since the very beginning when I first began back like 12 years ago and have been on the concerta dose for 6 years. I just started prozac and it doesn't make me tired. SSRI's are safe with mph and ritalin and don't use the same neural pathway for metabolism so there is no interference. Prozac is safe but it's all individual , and I will just have to wait and see if it works for me , well the serotonin aspect actually should calm me and lighten my mood and even out the concerta. I don't know what happened with your mom but I guess it just wasn''t the right combo but I'm giving it a shot. It's safe and been around for years like zoloft.

SuzzanneX
07-22-09, 09:22 AM
good luck

hollywood
07-22-09, 01:28 PM
appreciate it. I ditch these type of meds often. I'm not sure about prozac but it's not too sedating, not sure if thats good or bad since I'm thinking clinically if it was sedating at first once adjusted that could be good. I liked cymbalta but it was just too much after a month ( too tired) so hopefully prozac will balance things out

selby
07-30-09, 03:50 AM
so really the best way to go if your going to try a med with serotonin is be on a ritalin or mph based stimulant . I'm thinking of trying prozac since its welll studied and safe for children and supposed to be good with stimulants and is off label for adhd.

Makes sense because Paxil/Concerta was a great combo for me, just when I stopped Paxil I started having problems. I'm starting Zoloft, might switch back to Concerta while taking it...

keep us updated on the Prozac..!! :)

hollywood
07-30-09, 08:21 AM
I will starting up on 5mg of prozac so I won't get side effects.

muldoon
08-01-09, 06:55 AM
now i wish the idiots in the other forum from my warning post actually read like you did, youve done the reading and it shows, and youve not only benefited from the knowledge, but youve been able to help yourself.



Sorry to interrupt this little private convo of the holier than thou, but with all the knowledge and research you claim to do Yellow, and especially how you praise Pristiq and Dex as such a godsend combo at the beginning of this thread & yet it somehow turns into the most toxic thing you've ever done to yourself and you now despise 99% of all SSRIs, SNRIs, and serotonin agents in general, how can you call the people who don't praise you for your "WARNING" idiots?

You are not the only one on the planet taking prescription drugs who researches them before consumption. If a med or med combo sounds like it may benefit me, and my doc approves, we try it. If I feel like **** then I use common sense and tell him that I feel that way. Just because we don't obsess over every possible distantly obscure interaction does not make us mindless sheep.

I do my best to give a helpful suggestion to people that I don't think are going to throw it back in my face and insult me. But truth be told, if I were a doctor and saw you on my list of patients, I would run the other way, considering the way you talked about yours and your attitude towards them in general. If you think doctors are idiots, then don't see them. That won't help you with getting the medications that you think will help you though. And if you're anything like you are here on this board when you are sitting in their office, I wouldn't exactly look forward to dealing with you for 15 mins w/ such a condescending attitude. But if you're not like this in their office, then you're just cooperating to get what you want. So only you know what's going on. Just try showing some respect to people, whether you think you've got more medical knowledge than they do or not. It's not hard.

You do your research your way and other people will do it their way, and if a med isn't working, then a doc isn't going to hold a gun to your head and tell you to keep taking it. YOU wanted that particular med combo, YOU kept taking it, and YOU wound up with whatever the end result was. No doctor forces someone to stay on a med against their will. Yet, somehow the medicines that you chose and your doctor are to blame for the failure, not you with all of your encyclopedic pharmaceutical knowledge.

People are gonna reflect what they see in terms of treatment. If you treat others with respect the chances are you'll get it in return. Calling people "idiots" because we don't drop everything and follow YOUR advice is hypocritical because you are claiming people are dumb for blindly following a medical professional's advice. It's also hypocritical because you're implying that YOU have the end-all-be-all word in medicine and we should question what a dr prescribes or suggests. Yet, WE shouldn't question your forceful, infinitely researched posts telling us DON'T do this or DON'T do that?

I don't want to start a ****ing contest with you or your supporter. But I think I speak not only for myself but for a few others when I say that you might want to tone it down and make an attempt to not label people idiots because we don't exactly have the same way of bettering ourselves as you do. An attitude like that will not get you very far in life. Trust me, I used to have one. Not quite to your extreme but as time went on I pinpointed the source of why people avoided me, why I didn't get a job I was qualified for, and why nobody asked for my opinion on anything anymore.

muldoon
08-01-09, 07:15 AM
fck them on the warning thread, you were tryin to do a good thing an show people that these "hypothetical" things actually DO happen so we should get smart and look out. the only reason i can think of why they responded like that is that they dont want to accept that their meds might not be okay together, its an "ignorance is bliss" thing, theyd rather ignore it than deal with it, n have the doc handle it for them. i get the feeling people use these meds as an easy way out n get upset when they dont fix everything for them, meds are only part of the BIG PICTURE (this big picture thing just keeps comin back up), you cant focus on them and ignore the rest, you have to look far and wide if you want to be better.



Same thing tom. Look at all the conclusions you jump to about people who simply question what a guy posts!

Your assumptions are so far off it's ridiculous and not even worth a rebuttal. It's as if you know for a fact exactly why many of us who do quite well on our same or similar combinations asked questions first rather than bow down and take heed.

You guys be concerned about your own health, as you rightfully should. Seeing this is a support forum, offer suggestions and ask questions. If somebody takes it, cool. But if somebody respectfully declines, there is no need whatsoever for your gross over-generalization above.

hollywood
08-01-09, 10:03 AM
its true you have to look at the big picture of things, meds are just one facet on the big issue but never the less when on stressor in life is too large coupled by several other things that are far outside of your control things can happen in your brain and stress and negativity take over, and before you know it your far down the beaten path of where you should be mentally... This of course happens when you have the wrong people in your life and it happens and by chance maybe the wrong state or wrong city and next thing you know it can be the wrong employer , this is how one variable leads to another and coupled by impulsive decisions the adhd person with only adhd may find himself battling not only himself and good old adhd and attention span but many negative life forces as well. Sometimes there is nobody there, the support at that time just was not around and rather than self destruct you simpley survive and that is where depression feeds and feeds and eats one alive ... It can happen to anybody my friends and then and at this point one must sometimes and especially for the adhd mind look not only withing but for outside assistance to fix they way your mind is looking at things... You see often you can't do this by yourself or without the assistance from one of these medications... You see it calms you and puts you back at the beginning before you were angry, stressed and driven by anger seeded actions and reactions .... You see it is a systemic and mathmatic process that is now driving your mind and it's not just the adhd in the situation I just described... Sometimes it happens with one simple turn of events like the death of a loved one like a mother which happened to me.... Eventhough it was 4 years ago my mind stopped and I did nothing , denial is the malfunciton and it is the host for depression to lock right on to yourself... So please take things in stride, I'm no sap and I'm not stuck but unfortunately it took me 4 years just to wake up and start getting better. So if I would have owned up to my issue back then and took one of these medications my life may have gotten better much faster , at more a normal rate. So what I'm saying is these meds are not a quick fix they are for people with situations like what happened to me and was not my fault nor anybody elses fault , it simpley is chance and trust me it can happen to you. So please if one of these meds shortens that gap and calms you and takes you from a place that I had to go to for 3 years , then by all means swallow the pill that your doctor recommends.... .I know if I had the chance to go back and do it , well I would-
Served-

peripatetic
08-01-09, 10:07 AM
wow, tom, i'm pretty shocked at how dismissive you are of those of us who posted on the other thread.

i'm especially surprised given that your critique...

i get the feeling people use these meds as an easy way out n get upset when they dont fix everything for them, meds are only part of the BIG PICTURE (this big picture thing just keeps comin back up), you cant focus on them and ignore the rest, you have to look far and wide if you want to be better.

sounds pretty hypocritical in light of your reporting back on medication trials; e.g...

out of the 12(?) meds i've been on, remeron kicks depression's ***** like no other! it is wonderful really. i am a bit sedated, but i don't really care because the sedation is anxiolytic and i'm pretty calm, dreamy actually. the dexedrine helps with the sedation (though normally i dont find dex very energizing because the calm it produces balances it all out) -- i guess having ADHD comes in handy () because w/o a stim i dunno if i could tolerate the Remeron. i hope its not a problem when school starts (Sep.) but i'm enjoying, it kind of feels like i'm floating on a cloud! the world just feels very warm, and everything, even objects, seem to have this cartoon-like emotional coloring to them, almost animated! feels like a dream world.

in so many of the posts you sound like a kid in a candy store and certainly not like someone who thinks the medication can't fix everything. make no mistake, you are not the first person on the planet to consider a more holistic view of treatment and nobody on the other thread even remotely suggested that medications would solve everything.

thus, regarding the 'big picture', i sincerely hope that in the course of this medication/supplement tinkering you work to build the skills that might enable you to 'succeed'...maybe complete your education, retain employment, have healthy relationships, whatever success means to you.

of course, there's no guarantee that you'll be able to execute those skills without medication. in fact, it's quite harrowing to come face to face with the realization that all those routines, lists, etc that you performed pretty consistently on medication, that you spent the better part of your more than 15 years since diagnosis honing, are out the window without it, without your executive functions.

i don't believe anyone on that thread was looking for the 'easy way out' and thinks medication is the solution. and if you honestly think that anyone who's taken it for a significant amount of time has it 'easy', then you are in for quite a shock in a few years.

-peri

Yellow
08-01-09, 01:29 PM
this wasnt a private convo, anyone could read obviously... if anything was to be concealed it would have been, privately. im actually surprised ur so upset at this point (its been days/weeks?) and if u wanna report me for whatever reason, thats your privilege. this personal cyber banter is meaningless, and i got what i came for (though i had to do it all myself), and muldoon, u dont know me or my attitude. you assume too much on the posts that contain a defensive/antagonistic tone while i am still going through the end bouts of both withdrawal of pristiq/effexor and SS. still got brain zaps and ear ringing and dizzy spells and general pain,etc....youd be annoyed as well if u caught a 1 in 1,000 chance of an illness and when you told the other humans to be careful, you were only to be met with ignorant (literally) opposition. if you cut off a finger playing with a knife, and you tell someone else, "dont play with knives," and then he goes and plays with them and cuts off his finger, well....now that i think about it, who gives a ****? its his finger, not mine. (that's funny). but my warning was for people who do play with knives...

pharmacology is the pure science, psychiatry is whats applied. some things work for most, other things work for few, it all depends on u. the point of it all, the posts, the reading, the med experiments, was to get to to this:

ancedotes are enough to give a helpful warning. my "research" was for specific issues pertaining to myself, since thats the only person taking the medication, and in applying theory to practice, the experiment began well but was a failure in the end. i wasnt wrong about any of my ideas, especially trying. i wanted a non-toxic combo of medications, and i had that. individually, they are fairly benign.

SS was endogenous toxicity that came from the nontoxic combo. so i have learned that non toxic medications can become poisonously toxic in the wrong combination, and many of those who said "dont worry about taking an snri/ssri with dex" were quite wrong. my warning was to all those who have been told the same thing i was before i got into my self experiment: the risk of SS is slight when mixing dex + ssris...(false)

alongside all of that, many, as with the other thread you have come from, insist that SSRIs+AMPs are ok, and its not. after a beneficent simple warning that came during the onset of the concurrent syndromes, i was told again to ignore the SS possibility. its not a possibility, its a probability and now theres at least three or four members that know of it and acknowledge it, so im glad someone got the message.

people should know that the risk of serotonin syndrome that is often dismissed with the combination of snri's and dex is something to be considered. and with desoxyn, i can only assume it would be much worse with the higher SE release. i began this thread to get an intelligent answer from someone with experience, but since that didnt happen, i had to find out myself in an indirect way. and im even more glad it wasnt with desoxyn that i found out.

so with that said this thread should really be at an end point with this final sentence since its so off topic that i dont even know why it hasnt been closed:

MIXING SNRI's WITH AMPHETAMINES OF ANY KIND IS POTENTIALLY FATAL.

Answer to the original poster and original topic/question of this thread:

Desoxyn/Methamphetamine + SSRIs is probably the most sure and dangerous pathway to SS, because it is an even more dangerous mix than dextroamphetamine + ssris as it releases much more SE.

ALL THE BEST TO ALL

P.S. To go with "dont play with knives"..."dont take candy from strangers", watch what your doctors give you cuz it might kill you (my doc didnt think the SS chance was possible, and i found it probable)

muldoon
08-01-09, 06:50 PM
Trust me, I'm not losing sleep over it. It's just not cool to abandon a thread and resume it in another by calling the people in the first one "idiots". You're right, I don't know you, but your posts do a good job of projecting your attitude. Just like you do not know me, therefore you cannot call me or any of the others an idiot. The knives analogy? A bit dramatic IMO.

Nobody on "the other thread" insisted SSRIs + amps were ok. You say it's not ok. Yet you also acknowledge the fact that everyone reacts differently. OK. So there's a 1/1000 chance of developing SS on said combo. Why title the thread what you did? You can either share your personal experience on a particular combo and let others know about it in an equal to equal fashion, or you can flat out tell them NOT to take a combo in a thread title that could very well benefit them greatly in a "pharmacologic god to ignorant idoit" fashion. There were people who said that they were on the combo and were doing fine, and asked you to cite sources for your reason to title a thread "I have returned to give a serious warning: SNRI/SSRI + AMP=DON'T!". That doesn't equate opposition or the complete affirmation of the opposite. You also claimed you ultimately answered your own questions in this particular thread when in #17 you gave thanks for the answer you were looking for.

Like I said before, I'm sorry to hear about what happened to you. But the manner in which you go about warning people could use a bit of refining. I don't want to waste posts arguing, I just think you need to step outside of yourself for a minute and evaluate how you might be coming across to others while trying to help or warn them.

Go easy on the Pristiq withdrawal and take it slow. I imagine you're tapering off slowly to minimize the unpleasant effects. I came off of Paxil after nearly 10 years and I know how it feels. Hopefully you'll find the right medications in the shortest amount of time. Best of luck and continue to take care of yourself.

muldoon
08-01-09, 07:10 PM
...and next thing you know it can be the wrong employer...

Hollywood, I get the feeling you despise your job. What do you do for a living? Ever consider options like going back to school or obtaining an online degree? There's nothing worse than being stuck in a job that you hate.

I don't completely loathe mine, but it sure isn't what I want to do for the rest of my life and doesn't exactly stimulate me or generate any passion. It just pays the bills and keeps me insured. I am stuck w/ a mortgage, car payments, lack of spare time, etc.. But I realize that if I can move into a direction that will allow me to do something I enjoy for a living, then life would probably vastly improve. Granted, sacrifices must be made and it'll take time but I don't want to turn out a grumpy old curmudgeon who has spun his wheels daily for 44 years at a job that just enabled me to exist.

hollywood
08-01-09, 11:48 PM
muldoon..

I despise my job ... and for that matter while I'm livid , I despise the aftermath its giving me . I hate, period! Its causing me alot of problems, but I know one thing. ..... I'm still in charge of this madness.

Yellow
08-02-09, 10:47 AM
you're right about approach and tact - i ususally seem something im not for being overly (not overtly) general. i also thank you for the kind words. peace.

selby
08-07-09, 02:46 AM
Umm..

*creeps into thread*

Just wanna say that a week in, Zoloft has pretty much eliminated the dreaded amphetamine rebound/comedown anxiety/depression/irritability for me. I hope it keeps working... and that I don't die. Carry on..

*exits thread*

meadd823
08-07-09, 04:19 AM
I am not going to shut this one down but it is okay for folks to get along from time to time Actually I find it refreshing to see a bit of friendly exchange. Naturally publicly calling every one who disagrees with a specific point an idiot isn’t necessarily s good idea either. Those opinions are probably best left to private messages unless a rude awakening is what you were seeking. In other wards you asked for it so please don’t biatch

With that being said, I find it rather ironic to be rude in pointing out rudeness or to accuse while accusing others of being accusing.

If I have five donkeys in a single stall and I add one more donkey I have solved nothing . . . .I still have to many donkeys. . . in case my point is missed ADD dyslexic translation - Please do not turn this into a flame war I would like to keep this discussion peer to peer.

Remember we are all different and what is good for the goose is NOT necessarily good for the gander

Every thing that has ANY effect of the body can have a BAD one - This even includes all natural foods like wheat, apples, grapefruit as well as herbal supplements, and yes prescription medications and any number of medication combos.

There is nothing wrong with posting about a personal experience with a specific combo - There is no hard fast rule saying the occurrences of serotonin syndrome is IMPOSSIBLE with a stimulant SSRI combo –

Is it likely??? No

Is it possible???? –Yes

Did it happen to Yellow???? Only Yellow knows this. .

As far as posting about personal experiences I see no harm there. That is what forums are for however it is also worth putting forth en effort to offer enough factual information so that readers who are on the same combo can determine whether or not they have enough things in common with you that this needs to be of concern.

It isn’t fair to post as if your experience is the rule when it is obvious that your experience is the exception.

an example

Last year 5-HTP put me into mania therefore I truly understand the “need” to warn others of this possibility. When I wrote about it I also included that there is little to no research indicting this occurs because apparently it doesn't occur in enough of the population to warrant researching.

I believe it was the 5-HTP that set off the mania type symptoms because as soon as I quit taking the 5-HTP I was able to sleep more than three hours and the world at large seemed to be less interested in plotting to steal my mental power -

Oh and also try to include that I have more than one first degree relative with diagnosed bipolar that is coexistent with their ADD meaning I could easily have a "shadow syndrome" of bipolar myself. What is meant by this is that I do not technically have bipolar because I do not meet enough of the DSMV criteria for it but I do have some traits that are mild. . . .they do not interfere with my ability to function – no impairment no diagnoses type thing . . . . Even though I do not technically have bipolar I could very well have brain chemistry that is very close my bipolar relatives. After all bipolar is very genetic. I include all of this so that those reading will have "parameters" to go by to see if this warning is some thing that may apply to them.

How some thing is worded can make or break a warnings "usefulness" to the reader.

While the person offering the warning has an obligation to be as specific as possible it is entirely possible to experience some thing that hasn’t been researched – I know I have done so personally.

It is not good manners to out right deny some ones claims just because there is not sixteen medical research papers to back up the claims. Personal experiences are just that personal experiences. Some folks tend to forget that medical research covers a very narrow scope of the human experience .

hollywood
08-07-09, 10:52 AM
selby ,

glad the zoloft is helping , I'm about to try cymbalta again or pristiq ... I tried prozac and honestly only after tiny doses I felt completely strange... I'll try cymbalta or pristiq.....I doubt those two meds are much different sedation wise when compared to zoloft.

Yellow
08-07-09, 12:11 PM
i didnt call anyone specifically an idiot, whoever took it as that, whatever...if the shoe fits...but i dont have problems with anyone on the internet, this is literally virtual reality, so i dont get mad personally. for all i know, i could be talkin to a bot (those things are clever, and they can be aggravating). whatever, really, like move beyond the bull ****, its really childish at this point. take whatever positives you want and leave the nonsense behind.

however, what is not only puzzling but ****in "idiotic" is to disagree about my experience, cuz thats all these forums are for: disseminating personal experience of conditions, meds, therapy, and possibly expanding knowledge for your own growth and progression. this isnt a medical facility or adjunt to anyone's life as treatment, its your choice what you give and take here, but to refute someone else's experience because your afraid of it doesnt make sense. if someone says "dont go that way," you can still go, but keep in mind that danger might await. like what is everyone afraid of, i gave a warning that was crystal clear without implications, but if anyone took it as a personal "rule" to your life, then that only means my words were powerful.

i mean what the **** is everyone disagreeing with me about my condition? like no one has said "you dont have adhd" or "you dont have bipolar," but everyone has no hesitancy in implying "you didnt have SS" or that i am looking for a personal agenda to be met, some kind of ulterior motive, silly **** man ...on the contrary, everyone seems to be afraid of admitting "you had SS, that sucks man." dont be afraid, the unknown and unforeseeable is supposed to be off putting, and you gotta move past fear and doubt into the moment of experience through which knowledge is extracted and can be applied as power(, perhaps, it might kill you too).

visibility and transparency, whatever man. its the internet. i just cant beleive one of the more useful threads, specifically as far as medical danger goes, was totally shot down because of someone else's worries about their use of dexedrine. insincerity was the only thing that i didnt put in my thread, actually, it was the only non self-serving thread i can think of. i didnt post to ask a question for myself or get something for my own head. i made a very open and honest expose of my personal life to prevent others detriment. and instead i get called insincere (and thats idiotic, however you see it).

meaad, 5htp can do that, in high enough doses it can become psychoactively potent. with bipolar, almost anything can set off mania, which is annoying, but sometimes a risk you take to "get/feel" better. my example was a little more inclusive outside of bipolar, but im sure being bipolar didnt help the "serotonin syndrome." anyway, im almost recovered at this point from both issues. giving experience can sometimes unveil and connect issues that were overlooked in science/research, which is why you gave a warning and why i did as well. and all it was was a warning, right. (and i aint an exception, its a major drug interaction on any drug or pharmacy check, and i opened the other thread with a direct link to someone elses warning, and on top of ALL that, everyone knows the possibility is real, but pretend like its the steven-johns syndrome you have a 1% chance of getting from lamictal, id rather not take a chance of popping a fatal pill just to see, like thast where i wouldnt take a chance)

anyway, zoloft is the best SSRI, IMO.

meadd823
08-17-09, 12:02 AM
I wasn't singling any one out in my last response mostly I just wanted the BS to end without me having to be some sort of "enforcer" I perfer to interact as a peer besides this is a decently interesting topic I didn't want to shut it down.

People should be able to share personal experiences and diverse perspectives. . .no reason for any one to get there underthings in a twizzle. . . diversity is a good thing.


I can't take any SSRI's they ALL cause me to go manic - which would not be bad IF I wasn't such an unpleasant manic. . . . {damn it} I can jack with my dopamine and play with the norepinephrine and I am okay but screw with my serotonin and life gets crazy really fast. Antidepressants can do some serious stuff and many underestimate their effects on brain chemistry.

Yellow
08-17-09, 09:57 AM
Antidepressants can do some serious stuff and many underestimate their effects on brain chemistry.

I think this is the most understated aspect of antidepressants that the doctors continously fail to mention - no, purposely neglect to mention.

hollywood
08-17-09, 11:04 AM
yeah guys you are right,

but remember a depressed mind becomes , obsessed , compulsed, in a negative triad of thoughts and can lead to bad eating habits which will fatigue you or do thing in excess which can lead to symptoms . You guys are right though, but a depressed mind is something that needs changing and that is what these meds are trying to do , but they have side effects...

I know this for sure I seemingly have a tough time with any med with serotonin

Yellow
04-07-10, 11:04 PM
mania can be excellent: for instance, i havent drank more than 5 glassses of water over the past 3 days during which i havent slept at all, i did drowse in front of the tv, but i feel alive....now tomorrow, im gonna not like it...but for psychotics like myself, ssri's must go with a mood stabilizer (for me neurontin) and or a benzo (usually klonopin or ativan, for me klonopin,which is the f'n best benzo there is, lasts ALL day and u dont gotta worry about takin it wit u cuz it lingrs into th next...valium has a long half life, but is more effective as a muscle relaxer than antiepeleptic/antimanic)///


anyway, i changed my mind, i wanna try 12.5mg -25mg of zoloft with desoxyn and see how it goes