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Old 07-01-14, 01:23 AM
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Major depression causes ADD meds to stop working

I saw a new psychiatrist this week, who told me that depression was preventing my ADD meds from working.

About 8 years ago, my ADD meds rather suddenly stopped working for me. I've continued to take them for the small effect they do have. Since they stopped working, my life has slowly unraveled, and I have tried every kind of supplement in hopes of getting the meds to work again.

So, I tried this new psychiatrist, supposed to be an ADD expert. He diagnosed major depression and said that depression can prevent ADD meds from working. I asked about hormones, he said, no, its depression. I have been depressed since my father's death at about that time, and I've been taking bupropion for that. Even so, I don't doubt his diagnosis of major depression. He added an SSRI to the mix, so we shall see if both depression and ADD improve.

The notion that depression prevents ADD meds from working surprises me; has anyone else heard of depression having this effect? I know that depression and anxiety are often comorbid with ADD, and that treatment usually addresses either/both along with ADD. Also, I realize that there is a feedback loop with symptoms of depression, anxiety, and ADD; for example, one can worsen another.

Also, I've read that SSRI's may be inadvisable with ADD meds, because serotonin competes with dopamine. But does that assume reaching and maintaining a normal level of serotonin? The doctor seems to be saying: if serotonin levels are severely depleted by major depression, then pumping up the dopamine/norepinephrine levels with ADD meds will not result in ADD symptom relief.

I hope he's right -

Thoughts/comments?
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Old 07-01-14, 04:19 AM
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Re: Major depression causes ADD meds to stop working

I dont think depression can prevent stimulants from working, I think it can f**k with you enough to make everything stop working. As far as SSRI"s go, many people take both an SSRI and stimulants together and are having no issues. Now, I take and SNRI (cymbalta) for bipolar and have no issues but maybe thats because its not an SSRI?
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Old 07-01-14, 01:51 PM
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Re: Major depression causes ADD meds to stop working

Anecdotally, depression does/can greatly reduce the efficacy of stimulant medication for me as well.

In my unique case, it seems to be that the mechanism seems to be heavily involved with sleep. In that I mean that poor sleep can induce depression for me, and that poor sleep both increases ADHD symptoms and decreases the subjective efficacy of the meds. This experience is kind of murky, as poor sleep is blamed as a symptom of depression; but for me, I'm confident that poor sleep is the primary condition, mainly due to the acute, rapid, and consistent onset of depression symptoms following poor sleep.

The whole reason I bring up sleep is because deep, non-rem sleep is the time when the body regenerates brain tissue and neurotransmitter levels - including the nor-epinephrine and dopamine that ADHD meds act on. If this mechanism doesn't occur due to something preventing deep, non-rem sleep, the catecholamines aren't there in sufficient concentration for the ADHD meds to work with.

Look into how closely sleep apnea can mimic depression and ADHD for another comparison of what I mean here.
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Old 07-01-14, 08:51 PM
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Re: Major depression causes ADD meds to stop working

Well, I was diagnosed a year ago and have been living with depression for almost 20 years and ADD meds never worked. This might be why, but then again anti depressents didn't work for my depression either.
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