Lithium and Stimulants - counter productive, necessary?

[JohnReedLOL]

I couldn't help notice that Lithium, though it calmed me down and mellowed me out, made me feel half asleep, zoned-out, and so utterly inattentive that I would walk into stop signs on campus and zone out the window for hours. So ADD worse, Hyperactivity masked, impulsivity reduced. I also couldn't help notice that Ritalin, when added to Lithium, temporarily helped with attention, but made anxiety, impulsivity, and mood swings much worse. Like wanting to kill myself worse. I switched from Ritalin to 2 weeks no meds, then 5mg Selegeline with 14 fish oil tabs. The Selegeline works - I downloaded the PEBL Conner's Continuous Performance Test 2 version 5 and TOVA for my laptop and my commission errors dropped by half and reaction time got a little more consistent. It doesn't help with impulsivity - it's a lot easier to **** me off than when I was on just Lithium, and it doesn't help with a lot of behavioral stuff - lasts from like 11AM to 10PM with a peak in the middle. I was wondering if anyone can empathize and also if it's possible to kill both the bipolar and the ADHD with 1 med. I couldn't help but notice that the meds that helped with attention - fish oil and selegeline MAOI - are like anti-bipolar depression and the meds that help with impulsivity, like Lithium and Clonidine, tranquilize and help against mania, but are no use for attention. My Psychiatrist doesn't wanna try dextroamphetamine because he says it'll be harder on me than Selegeline and maybe as hard as Ritali and I think he's right. Does Lamotrigene help with both ADHD and bipolar, both attention and impulsivity in bipolar people? Olanzapine? Anyone getting around with both Bipolar completely stabilized and ADHD symptoms cured on just one med? What do you all think?

[CheekyMonkey]

From my experience, bipolar is multifaceted and typically is treated with several medications.

Lithium can cause that zone-out feeling at first, but it is usually a temporary side effect. I would stick with it longer and see if it goes away.

Going off of your bipolar medications will most likely result in a mood shift that will probably not end well.

[mrgreyshadow]

Cheeky is right.


If I remember right, Lamotrigine was tested for adult ADHD and it resulted in statistical improvement on serial sevens (counting backwards by 7 from some number), but nothing else cognitive in relation to ADHD. As far as "crazymeds.us" and this site suggest, Lamotrigine is a weight-neutral med that's especially great for bipolar depression. It's one of two meds FDA approved to treat both mania and depression in bipolar disorder. A lot of bipolar people I know take it and it's very good for them.

As my doctor said it, if your inattention is mostly caused by mania, a mood stabilizer might be all you need. But if it is caused by ADHD mostly and only partly by mania (like.. if you could only focus before when you were manic) a mood stabilizer will make your inattention worse.

Amphetamine stimulants will likely make you more manic. They're also neurotoxic at higher doses, so you can look at this as saving you from potential neural atrophy.

Also, you mentioned clonidine. See if you can take that out of the equation and go back on ritalin. I was taking guanfacine for a while and I started noticing that it would throw me into a rage for four hours after I took it (guanfacine is a close relative to clonidine). My older brother takes it for ADHD symptoms too, and he said he has the same issue with it. He's this huge ex-marine covered in tattoos and he says it makes him start crying all of the sudden... Very bizarre. This is an anecdote, but it's possible that clonidine might be making your mania worse. Don't stop taking it until your doctor lets you, though.

I would wait a while for the Lithium to take effect. It might be that you're inattentive at first, but you eventually learn how to focus on Lithium. It may take up to a month to know if you have the complete effect. You may need a higher or lower dose, or to develop some skills. That is... If you can feel things still and you have no toxicity symptoms, you're probably not on too much Lithium.

That's all! Good luck.

[JohnReedLOL]

You guys appear to be right. Ritalin put me into a triply anxious rage, and the rebound was aweful, not to mention that it costs like 5 times more than Selegeline (levoamphetamine precursor and antidepressant). I read that guanafacine can cause manic symptoms on NIH pages about guanafacine in children of bipolar patients. If I take a lot of selegeline, I rage too. I heard Clonidine doesn't help with attention - it's just sedating - and that it doesn't make people rage like guanafacine, but guanafacine actually helps with attention a bit and Clonidine doesn't, so forget that. I'm going to try tapering down on Selegeline, but keeping fish oil. The 10PM selegeline amphetamine crash can be annoying anyway as it's followed by fast talking, racing thoughts, getting distracted mid sentance, and saying stuff without thinking. Hopefully I'd be able to do reasonably well on the PEBL online Conner's Continuous Perfoance Test and Test of Variable Attention without it, and if I can't after about a mood-neutral month, then I guess I really needed it. Thanks y'all.

[CheekyMonkey]

Originally Posted by JohnReedLOL

You guys appear to be right. Ritalin put me into a triply anxious rage, and the rebound was aweful, not to mention that it costs like 5 times more than Selegeline (levoamphetamine precursor and antidepressant). I read that guanafacine can cause manic symptoms on NIH pages about guanafacine in children of bipolar patients. If I take a lot of selegeline, I rage too. I heard Clonidine doesn't help with attention - it's just sedating - and that it doesn't make people rage like guanafacine, but guanafacine actually helps with attention a bit and Clonidine doesn't, so forget that. I'm going to try tapering down on Selegeline, but keeping fish oil. The 10PM selegeline amphetamine crash can be annoying anyway as it's followed by fast talking, racing thoughts, getting distracted mid sentance, and saying stuff without thinking. Hopefully I'd be able to do reasonably well on the PEBL online Conner's Continuous Perfoance Test and Test of Variable Attention without it, and if I can't after about a mood-neutral month, then I guess I really needed it. Thanks y'all.

Sorry you had to go through that. Finding the right med cocktail is a long and not very fun process!

[GiGi3]

mrgreyshadows - I see from your post that you take only 300mg of Lithium a day? along with ADHD meds. Both look low dose.

I take 450mg Lithium a day and it seems to help a lot. People online give me a lot of crap about the dose not being high enough. I also take 10mg Adderall XR

How long have you been on low doses and how do you feel? Is it enough? Do you ever feel like you need more?

[CheekyMonkey]

Originally Posted by GiGi3

mrgreyshadows - I see from your post that you take only 300mg of Lithium a day? along with ADHD meds. Both look low dose.

I take 450mg Lithium a day and it seems to help a lot. People online give me a lot of crap about the dose not being high enough. I also take 10mg Adderall XR

How long have you been on low doses and how do you feel? Is it enough? Do you ever feel like you need more?

I wasn't trying to make you feel bad, I was just curious.