Experiences on Adderall + anxiety meds??

[willinabox]

any update to this conversation, has anyone found a drug combination which provides anxiety relief in combination with stimulant medication?

[inbetweenshades]

I've been taking Valium on and off for about 20 years. Admittedly, before I was diagnosed with ADHD about 7 years ago, it was more off than on.
Once I started taking Adderall, (back when it was still the real deal,) I did notice a slight increase in my anxiety, so I got a script for Valium and have been taking 10 milligrams a night ever since.

When I had to switch from Adderall to a plethora of things until settling on Desoxyn about a year ago, I noticed that my anxiety increased a lot, and I started having panic attacks again, which was something I hadn't had to deal with in years. At that point, my doctor prescribed me Xanax as well, to be taken "as needed."

Allow me to backtrack about 15 years for a moment. My first marriage was to a really screwed up guy, very abusive and controlling, and one night, I completely flipped on him and pulled a knife. Mind you, he probably would have killed me if I hadn't, and it was most certainly self-defense. Never the less, being the victim of abuse like I was, I thought it was somehow my fault, and went to see a doctor who prescribed me Xanax, 2 milligrams a day, which I took for a year. Eventually, I decided that I wasn't the problem, my husband was, and I quit both.
Leaving him was no big deal, but imagine my surprise when stopping the Xanax cold turkey nearly landed me in the hospital.

Since then, I have been extremely leery of Xanax, and although I do take it if I feel a panic attack coming on, otherwise, it just accumulates in my medicine chest.

The Valium however, as I said before, I take every day, and have for a long time. No doubt if I stopped it I would have to deal with tapering off, and a good deal of insomnia and grouchiness, but I think that is a small price to pay for something that keeps my anxiety at bay.
And I haven't noticed any side effects what so ever in all the time that I have taken it.

True, I don't "feel" it when I take it like I used to, but I know it's working, because I don't flip out at the drop of a hat anymore.

Everyone is different, and responds to medication differently, but for me, the combination of Valium and any medication I have tried for my ADD has worked out fine.

Hope that helps.

[Ridgerunner]

I agree with the many of your experiences, especially the post made by
SarahSweets on 7-27-11. I have two subjects to address on this target
specific thread, a comment made by SarahSweets, and my 40 years of
experience, of living with GAD, varying degrees of depression, and, my DX of ADD both 314.00 and 314.01 18 years ago.
Regarding the reference to the late Elvis Presley, (and, Johnny Cash) perhaps, even, the late Judy Garland, etc.........I have documentation, from
the state of Tennessee, where the Shelby County commission hired, Dr. Joseph Davis, from the University of Miami School of Medicine, and, former chief medical examiner for Dade County Fla (Miami) who has conducted over 20,000 autopsies......in 1994.....seventeen years after Elvis's death,
to release the "final autopsy". quote "Dr. Davis verdict, was unequivocal,
drugs did not kill Elvis Presley. His conclusion sounded like a whobbling needle caught on a scratched record. "It takes hours, to die from drugs. Elvis would have slipped into an increased state of slumber. The scene itself, told what happened to Elvis.

more quote's from page 236 of "The King and Dr. Nick" by George Nichopoulos, M.D. (2009) ISBN 978-1-59555-171-9. "then he (Dr. Davis)
added that there was no fluid in his lungs, which would have been necessary for Elvis to have died of respiratory failure due to chemicals. Dr
Davis believed Elvis death "was a textbook case of death by heart attack".

Findings: 1.6 mcg/gm of codeine, in the liver, and 2.3 mcg/ml in the kidney. further quotes, page 237, the liver normally has about 6.8 mcg/gm
concentration in a fatal overdose. He also had, morphine 0.03 mcg/ml in the serum, 0.04 mcg/gm in the liver, and 0.04 mcg/gm in the kidney. The
"diazepam metabolite, measured at 0.01 mcg/ml vs. 30 mcg/ml "a high level of benzo metabolite" It's like 1/600th of what it should have measured for a overdose.

Ethchlorvynol (Placidyl) Elvis had 7.4 mcg/ml vs avg fatal overdose for
Placidyl is 84 mcg/ml . he's not even 1/10th of what a fatal concentration
would be.

Amobarbital, Elvis had, 11 mcg/ml vs fatal cases we're looking at 100 mcg/ml. Again, he's got 1/10th of what one would consider a high dose.

Methaqualone, tissue distribution in the blood, for perhaps some of the fatal cases, can be as low as, 6.4 mcg/ml. Well, he had a concentration of
6.0 mcg/ml, so that may be consistent. "no one quantitated the tissues of
Elvis"(Bio-Science Labs in 1977, did not quantify the amounts in Elvis liver or his kidney). Elvis had a tolerance for Ludes, and taken them for years.

Demerol was found in the liver and kidney, but no concentrations, were
measured, in the blood, or the serum, during the original autopsy, nor the
Bio-Science Laboratory Report. more quotes "that report was also re-examined by a panel of distinguished toxicologists, including Dr. Kevin S.
Merigian of Memphis TN. Dr. Merigian said he did not serve on this "panel", he had earlier voiced his opinion, "The death is not the result of multiple drug ingestion". Dr Davis panel, scrutinized the Bio-Science Lab
report, "it is our view, that, death, resulted from multiple drug ingestion,
(commonly known as polypharmacy). From Dr. Merigian,I totally disagree with the Bio-Science Lab report........a person would have a better chance of of being struck by lightning, than succumbing for a cardiac arrhythmia
from drugs, in these combinations". The media had invested too much in their drug overdose theory to back down, in 1977, thus the state of Tennessee, sealed this report, until, 1994, regarding the "final autopsy".

I have read this book, several times, even gave my Psychiatrist, a copy of this book, a AMA board certified Psychiatrist, with subspeciality in what is referred to as "Addictionology". Elvis had no Amphetamines, nor any,
alcohol in his blood period. M.D's who prescribe sedative hypnotics, to their patients, know, that their patients, can get tolerant to all of these medications, that, is why, Elvis had so many drugs, in so small amounts,
(in his body) because none of the medications worked, thus the history of drug holidays, stopping them, and rotating them, etc. I applaud the comments made by thread member SarahSweets on 7-27-11.

Regarding myself, I also have a history dating back to 1971, with taking
Valium, off and on, for forty years, first 6 years non-stop, one year tapered off to zero, then, (1977), back on, 4 more years, this time, unable
to detox with willpower, required a 42 day inpatient hospital stay, "not a joy ride, especially, with a secondary off and on Methaqualone addiction,and high tolerance to both "downers". 1982 to 1990, benzo and
hypnotic free, nicotine free, alcohol free. In 1990, discovered Xanax, off and on from April 1990 to July of 1996, with once a 26 month Xanax vacation, during this time. "It took me 10 weeks to detox from 6 mg of
Alprazolam, to zero, and was the hardest drug, I have ever had to withdraw
off of in my life, this time, requiring, 12 months of outpatient treatment, with one evening group meeting plus one year of once per week one on one
psychotherapy, (no drugs..relapse prevention therapy by a MSW) nationally recognized.

IMHO, if when I got my original DX of ADD, 6/28/94, providing my academic records, from high school, and, 4 colleges, my DMV driving history, my reasons, for dropping out of undergraduate school, due to
my inability to focus and concentrate, going back to as far back as the
7th grade of middle school, my behavior, my living mother described, I
had, since around age 5 years old, "very hyperactive", my revelations, of
relatively short term interpersonal relationships, ending, abruptly, often,
with hostility, bring to my Psychiatrist, my mismatched very long work
history, (dozens of jobs, including, 1/2 dozen job firings) my SAT scores,
very low, compared to my IQ, (always ran out of time) from PSAT to SAT to
even, undergraduate courses, I took, pill free, returning to undergraduate school, at age 42. My first M.D prescribed me, Ritalin 20 mg. at wakeup, 20 mg @ 1PM, and, 20 mg, titrated for me, if needed, to take no later than
5PM, worked full time, and attended college full time, with night classes,
PLUS, quote "take one (1) mg to two (2) tabs of Klonopin by mouth three
(3) times a day, "if needed" I would have been alright, as I have had a previous DX of GAD 300.02, and, or, Dysthymic Disorder, 300.4, since age
21. "I am my own worse enemy, I graduated, from this University, within,
14 months, as, the Ritalin, gave me focusing power, to complete, the very hardest classes I had stalled for years, successfully got married, etc. however, I requested my Psychiatrist, to replace the Klonopin, to, Xanax,
not revealing to my M.D, that I had a history of a previous high tolerance, to Xanax, off and on it the previous 4 yrs, and, a history, of tolerance, to
the 1970's drugs Valium, Quaalude and another brief use of a recreational med, that might break the board rules, I will only say it was a 2 yr relationship, 1979 to 1981, with technically a C-II med, that, is derived from a plant that grows in Peru, and, Colombia, South America. My M.D. without this knowledge, switched me from the much safer, Clonazepam, to, the
requested Alprazolam. I was alright with the Methyphenidate and Clonazepam combo, but, when I switched to my urge to retry, Xanax, "a completly different subjective feeling, in my body, to the blunted, yet,
IMHO, much safer Klonopin, I developed, mood swings, why? my tolerance,
returned rapidly to this "Xanax" I knew, after a short time on it, would turn
on me, from relief of anxiety, plus frankly euphoria, to just addiction, to fight off the withdrawals, as the anti-panic medication, we all know is fast acting, when my tolerance increased quickly to 3 Xannie bars a day, I felt, the pounding heart, hot and cold flashes, and, the "mood swings" that were relating to the Xanax dosing wearing off. I could not even sleep more than 4 hours at night without taking a complete 2 mg Upjohn Xanax bar.
My new wife, a RN, saw me transform, from a balanced non-moody individual, to, a Dr. Jeckyl and Mr Hyde, with my selfish decision, to, self-medicate. To save the marriage, I entered, one year of outpatient treatment, and switched, Psychiatrists, telling, everyone to this very day, my "complete history". I am now on my 18th year using stimulants, since, the Xanax detox, have been mostly on Dexedrine Spansules, with Adderall I/R, or Dexedrine I/R, with a balanced life. My Psychiatrist, with knowledge, I had been abstinent from alcohol and nicotine, since 1983, did allow me take the semi benzo, Ambien, 10mg for 12 years, along, with a modest dose of Deseryl (Trazodone) from 1998 until 2010. Dropped, both of the latter, late in 2010, titrated in only one mg of Roche Klonopin, for one year, and, beginning, January of 2012, my Psychiatrist, was uncomfortable, to keep me on Klonopin, as frankly, "I felt no response at all to it, after the first 6 to 8 weeks, our deal, was if tolerance set, in, he would not up the dose. I currently take, the non controlled antihistimine/tranquilizer, Atarax, (hydroxyxine) up to 50 mg per day, or, 50 mg, of the Trazodone, to address, my co-morbid anxiety and depression, with IMHO, only poor to fair results. A Divorce, five years ago, caused a stubborn Major Depressive Disorder, coupled with a job firing, (not my fault, the firm fired 50% of the staff, due to the bad economy), has caused my Psychiatrist, of now 13 years, to list my DX as ADHD 314.01, and, added a co-morbid, second disorder, in my files, the year of my Divorce, (2007) of BiPolar I, 296.7 (last episode undefined) I have a great resentment over. I have developed hives, over the past 6 years, requiring, the controversial cortisteroid, Prednisone 5 mg, that I take for severe Uricaria attacks, 708.0, Other Atopic Dermatitis, 691.8, nonspecific Puritus Disorder 698.9, Angioedema
995.1, and, some symptoms of Rosacea 695.3, taking up to 20mg of Prednisone, about 130 days of each of the past 4 to 5 yrs, which has a side effect of irritability, mood swings, weight gain but 100% stops the heat on face, and incessant itching, my friends, family, and apparently Psychiatrist, have noticed, behavior change, "but my Psychiatrist was furious with me, when I disclosed to him, the use of the drug Prednisone, prescribed to me by a AMA board certified Dermatologist, and a 2nd opinion, from a AMA board certified, Allergist, M.D.(both knew I have ADD) A 70% drop in my annual income, and, having to now deal with aging parents, IMHO, both with ADD symptoms, continue to go on unmedicated, as I am now given the responsibility of managing their
rental real estate, as their health is faltering radically, with very little support from my two adult sibblings.

I am relucant to hit the"submit reply" button, due to my obvious "wall
of text".............but can't afford, anymore "talking therapy" that, I formerly had for nine years, individual and group, Cognitive Behavorial, to,
Relapse Prevention, to Dialectic Behavioral Therapy, (two years the latter) and my most recent MMPI for those of you familiar with that test, I am a
6/4. 6=95, and 4= 87, and 2=80. (Paranoid/Fear scale + Measure of Rebellion Scale/Anger scale, and the last one, "Depression" scale, with,
the norm baseline at 50, and, a score above 65, indicates some symptoms,
that may cause dysfunction. Scores above 65 indicate the measure of intensity of those symptoms. My F score was 79, making the test validity,
correct. My Myers Brigg type, is a ISFP, Beck Depression Inventory a 21, (moderately high with depressive symptoms, Enneagram a Type 4, "individualist/artistic romantic orientation toward life", and my Millon Personality Test, the MCMI-II, a expensive test, to measure any Personality Axis II traits, of the eleven DSM-III-R/DSM-IV Personality Disorders, I scored, "over the top" at 114 with "Passive Aggressive Personality Disorder" and 91 with "Self Defeating Personality Disorder" both
removed from the current Axis II DSM-IV, requiring further review. Baseline of 85 indicates, one has the bonafide complete symptom profile, as described in the DSM-IIIR.
yes, I relate with having ADD, and with both having anxiety and depression, all of my life. I may well have the very, very trendy, bipolar
disorder, but, my angle with this, is if I do, I fiercely feel it is of the
bipolar II type, and I have never had, the stereotypical "extreme Manic
behavior" I have witnessed, in several people, a experience one will never, ever forget!!! I have had two (2) previous Major Depressive Episodes, that,
were triggered with the breakup of a romantic relationship, lasting each, two full years, age 23 to 25, and again, at age 39 to 42, when I was unable to work, could not live independantly, and, both times, moved back to my parents, for financial assistance, sleeping 12 hours day. Trials, yearsago with Lithium, doses all over the place, and one dozen SSRI's and
Tri-cycle anti-depressants, failed me every time.
If I am Bipolar I co-morbid with ADD, I am the only person I have ever met, with Bipolar Disease, who has been given Ritalin, Dexedrine, and Adderall, since 1994, 99.9% of the time to this writing, in often robust doses, who did not go immediately into a Manic phase, every Bipolar male or female I know (without ADD) takes anything from Lithium 900 to 1,200mg a day, or, Seroqeul, Abilify, or Lamactil, Risperidone, or Depakote,
in robust doses, to be "normal". Any of those meds, in conservative doses, knock me out, and I become a overweight couch potato. titrating A.D.D.meds does no good, with or without, just a zombie.

Richard Gere, in the movie "Mr Jones" IMHO is a classic portrayal of one who goes Manic with his role as a "BiPolar I" troubled man, in and out of
Psych Wards. (came out in the 1990's).

[zibe36]

I just glazed over the posts so hopefully I'm not stating anything that was already mentioned.

But yes, Adderall plus anxiety/depression medication is perfectly fine. Actually, ADHD almost always presents with a co-morbid conditions such as anxiety/depression/bipolar. These MUST be treated as well. Most physicians are not aware of this and are reluctant to treat for both - choosing one or the other. This is INCORRECT. I personally have ADHD with severe anxiety and have been on Adderall 20mg XR twice daily and 1 to 2 mg of Xanax (in emergencies 3 to 4mg) - I eventually replaced Xanax with an equivalent benzo that lasts longer - all for three years with no problems at all. As a matter of fact, my anxiety level was reduced dramatically within a few weeks on the regiment.

Bottom Line:
YES. Adderall and Anti-anxiety (benzo) medications are safe a very effective.

ADHD commonly presents itself with other conditions, which need to be dealt with. If your physician is not up-to-date you MUST find one that is.
If you're stuck with a physician that doesn't keep themselves informed, come prepared with evidence and ask direct questions. It's almost impossible for the typical physician to keep on top of these conditions, so you the patient must do so, and with more authority then you might imagine.

[Chicchick]

I take Xanax as needed (usually a very small amount most days of the week, chronic high stress situation at the moment and severe panic issues), Adderall, and Wellbutrin. I actually find that if I take a Xanax, (for example if I can't sleep) when I do go to take my adderall later on, it works a LOT better. It is a good combo, but it takes a lot of responsibility to be able to handle it. I find xanax way more addictive than Adderall or Ritalin, but it is like a night and day difference for me, so I only dose .25-.5mg and I have my room mate keep an eye on me with it.

[Asteri00]

To say that "not all people" develop an addiction to benzo's I think you need to think thoroughly about this before you go on a rant. 1. You will DEFINITELY be PHYSICALLY addicted within a couple of weeks. As someone who was on the cocktail for years I can tell you the withdrawal from benzos surpasses hell. 2. If you need an "upper" then a "downer" maybe you need to see a different doctor for alternate options. Benzo's are going to have to be increased frequently.

[Chicchick]

Originally Posted by Asteri00

To say that "not all people" develop an addiction to benzo's I think you need to think thoroughly about this before you go on a rant. 1. You will DEFINITELY be PHYSICALLY addicted within a couple of weeks. As someone who was on the cocktail for years I can tell you the withdrawal from benzos surpasses hell. 2. If you need an "upper" then a "downer" maybe you need to see a different doctor for alternate options. Benzo's are going to have to be increased frequently.

I think this is true. with most psychotropic medications, a physical dependence will occur with long-term use. Benzos tend to create physical dependence much quicker than, say, an SSRI. Psychological dependence can occur with SOME meds, and Benzos are also known to create this, along with stimulants, etc.

I think the individual situation really needs to be judged, and if you can do without it, go without because in the long run the cons will outweigh the pros. Coming from someone with Panic Disorder, even I had to think long and hard about what was really going to give me more benefit. I tried many other meds BEFORE going to benzos, yet failed to find any relief from any other kind of medication for my anxiety. Any person on any scheduled substance should be watched closely by a doctor, even MORE so on a combo of scheduled substances. For mild anxiety, this is a bad idea. If the anxiety is more acute (comes on quickly, not chronic) and very severe than it might be worth a try. Your best bet is to use only when panic is severe, and even then, as low a dosage as possible. If you are going on a benzo with an XR stimulant, a med like Klonopin (unfortunately this med made me depressed, but works well for many) might be a better bet than a med that is short acting and will need to be re-administered frequently.

[gizmo1]

Originally Posted by Chicchick

I think this is true. with most psychotropic medications, a physical dependence will occur with long-term use. Benzos tend to create physical dependence much quicker than, say, an SSRI. Psychological dependence can occur with SOME meds, and Benzos are also known to create this, along with stimulants.

Actually the opposite is true. Because anti depressants target serotonin and (sometimes) norepinephrine receptors, the physical dependence process is much faster than if you take a benzo, which works on the GABA receptors.

Just think of it this way: if you take an AD for six weeks and suddenly stop, you are going to have withdrawal effects ranging from mild to extreme. But a benzo taken as directed for that short of time can almost always be discontinued without most withdrawal effects.

I've taken many benzos and many ADs I've the twenty years I've been treated for mental illness. And I can say that I've quit 8 mg a day of Xanax cold turkey than I did tapering off Paxil. Or celexa. Or Effexor. Or Wellbutrin. Etc.

ETA: I take old school Librium for those nights after my vyvanse wears off and my anxiety kicks in. During the day, however, stimulants eradicate all traces of anxiety I have. And I have a GAD diagnosis and was on every benzo for seven years straight multiple times a day.

[Chicchick]

Originally Posted by gizmo1

Actually the opposite is true. Because anti depressants target serotonin and (sometimes) norepinephrine receptors, the physical dependence process is much faster than if you take a benzo, which works on the GABA receptors.

Just think of it this way: if you take an AD for six weeks and suddenly stop, you are going to have withdrawal effects ranging from mild to extreme. But a benzo taken as directed for that short of time can almost always be discontinued without most withdrawal effects.

I've taken many benzos and many ADs I've the twenty years I've been treated for mental illness. And I can say that I've quit 8 mg a day of Xanax cold turkey than I did tapering off Paxil. Or celexa. Or Effexor. Or Wellbutrin. Etc.

ETA: I take old school Librium for those nights after my vyvanse wears off and my anxiety kicks in. During the day, however, stimulants eradicate all traces of anxiety I have. And I have a GAD diagnosis and was on every benzo for seven years straight multiple times a day.

I suppose it varies greatly on the SSRI drug taken.. I have quit Lexapro after 10 weeks with no withdrawals and Prozac after 3 years with minimal withdrawals. I have heard horror stories about people quitting paxil though... It also depends on each person's body chemistry. But I believe I made a bit of a generalization. I think it is better put to say benzos create a MUCH faster psychological dependence than an SSRI would, hence why they are much more tightly regulated. I also think that psychological dependence leads to an imagined or exaggerated physical effect. For example, if someone was on a benzo for 4 weeks and psychologically dependent, and they quit cold turkey, their knowledge of quitting and wanting the drug could lead to agitation and greatly increased tenseness and anxiety.

[adina8]

I"ve rarely written on here, but am inspired because your's is the first that addresses my issue clearly. i started with adult adhd, was prescribed ritalin but it caused me a lot of anxiety (already a VERY highstrung person) and life issues causes me extra stress. Was prescribed valium and told to take to get off of ritalin if i wanted to .I did, went back to ritalin, back and forth, and now believe I have a real anxiety if I don't take valium - only half a tablet (5mg) during the day and maybe another when the ritalin wears off.

What to do now? What do you suggest? My doc says just stay with the valium, no need to worry about addiction, but it's been close to a year now. At the same time, ritalin, 10mg IR causes me to be so jittery.

any suggestions welcome, and thx!
a

[adina8]

I could have written this entire post myself. thanks - I have been on valium for about a year and wonder if i should stop, but as you say, "issues" created serious and justified panic attacks and at the same time I AM adhd, so hence the ritalin. catch 22?
I don't know what else to do tho, stop the ritalin or the valium or just plow on.

[sarahsweets]

Originally Posted by Asteri00

To say that "not all people" develop an addiction to benzo's I think you need to think thoroughly about this before you go on a rant. 1. You will DEFINITELY be PHYSICALLY addicted within a couple of weeks. As someone who was on the cocktail for years I can tell you the withdrawal from benzos surpasses hell. 2. If you need an "upper" then a "downer" maybe you need to see a different doctor for alternate options. Benzo's are going to have to be increased frequently.

Yes physical addictiton is possible with benzos or stimulants, coffee, nictoine,benedryl,anything. Addiction is not the same as dependence. If someone is dependent on a benzo to live life functionally than I see nothing wrong with it, nor do I believe they should be shamed into thinking their some kind of drug fiend. ideally you would want to avoid something that could be addictive, but how many of us can go without coffee or cigarettes? I know that I sure cant.