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General Medication Discussion This section is to be used for general medication discussion and other medications not broken out in their own respective forums.

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Old 09-07-15, 12:15 PM
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Have stimulants nearly destroyed your life?

I've been prescribed and taking stimulants along with bupropion and other anti-depressants for over 12 years with one break from all drugs lasting 5 months. I took no medications until I was 20 years old.

Because of all the combinations, it took me quite some time to realize that the increasingly intense lows and lack of emotion and motivation I was experiencing correlated with my stimulant use.

For the majority of my medicated period I have been on dextroamphetamine and bupropion. Over the years, my dex dose was steadily increased as my productive hours on any given day decreased. My highest daily dose 50mg of dex and 450mg of bupropion.

This became a vicious circle as my emotions continued to flatten and my psych doc prescribed all manners of other drugs except SSRIs in combination with the dex and bupropion. I was eventually left in a state almost completely devoid of the ability to anticipate outcomes and joy.

During this period I was also involved in talk therapy reasoning that at least some of what I was experiencing was related to my personality and that it could be corrected.

I am now on 75mg of methylphenidate and 450 mg of bupropion and I can safely say that my brain has become dependent on stimulants in order to feel any joy and keep me functional.

I noticed no improvement when I went off stimulants and other drugs all together for approximately 5 months. The daily comedowns disappeared but I felt little or no emotional connection to anyone or anything either. And because I ran out of savings and needed to make money in order to survive I went back on stimulants so that I could at least feel something, however fleeting it was and continues to be.

My life has been made nearly redundant by what I suspect is the therapeutic use stimulants and I want to know if others have had this experience and what they did to survive and recover.

Thank you for sharing your insights and experiences.
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Old 09-07-15, 12:58 PM
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Re: Have stimulants nearly destroyed your life?

I'm sorry you have been having a tough time.

I'm a bit confused though. So are you saying that stimulants might have caused "increasingly intense lows and lack of emotion and motivation?" but also that they help you to feel any joy? Are mood swings your biggest problems?

What helped me with mood swings (or rather the emotional crash when my dose started wearing off) when I started taking dex was to dose more frequently with shorter intervals between doses, which worked quite well for me. All in all, dex has helped me immensely with emotional regulation.

I've never tried bupropion but various SSRIs and SNRIs all gave me terrible mood swings. It's only stimulants, i.e. dex, which finally stabilised my moods though I haven't tried taking both a stimulant and an anti depressant together.
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Old 09-07-15, 01:20 PM
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Re: Have stimulants nearly destroyed your life?

Just because 60 mg is the recommended limit doesn't mean everyone needs
that much. Maybe you didn't notice the numbing effect until the dose became
too high for you? It might be worth decreasing your dose by 10 mg for a week
or two, and then decrease again. When the benefits balance out with the side-
effects that you don't want you'll have hit your sweet spot.

I don't know whether the combination of dex and bupripion is a good idea or
a bad one, but when you're taking something to help with mood and you have
more trouble with your mood while taking it, maybe the mood med is the cause?


Also ... I know you don't have as much choice in medications where you live,
but Ritalin has been known as the zombie medication. It could be another med
would provide relief without the zombie side-effect?
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Last edited by Lunacie; 09-07-15 at 01:22 PM.. Reason: added thought
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Old 09-07-15, 01:30 PM
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Re: Have stimulants nearly destroyed your life?

I’m sorry to hear of your experience. I have had periods in my life where I could find no joy, and not look forward to anything.

Consider that you may be best served by a process of re-titration.

Amphetamines suppress the limbic system, so it is entirely possible your change of mood had some relation to their use. Amphetamines can also cause anhedonia, but this is very rare at prescribed clinical doses.

You mention no use of SSRIs. Are they an option? If not, have you considered adding mirtazapine to your medications?

I find that my sense of my own life being redundant/irrelevant is at its highest when I am not medicated.

60mg dextro-a, 450mg bupropion, and 15mg mirtazapine tend to improve my experience of life, the dextro-a most of all. I’ve never had the experience of decreasing efficacy or a change in dosage for that reason. And for sure, dextro-a (for me) is a superlative mood stabilizer and booster, simply the best antidepressant I have ever known.


Cheers,
Ian
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Old 09-07-15, 01:59 PM
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Re: Have stimulants nearly destroyed your life?

Quote:
Originally Posted by Fuzzy12 View Post
I'm sorry you have been having a tough time.

I'm a bit confused though. So are you saying that stimulants might have caused "increasingly intense lows and lack of emotion and motivation?" but also that they help you to feel any joy? Are mood swings your biggest problems?
Thanks for your empathy Fuzzy12. I hesitate to make a definitive causal link between my flat mood and stimulant use but it is highly correlated. I can track my mood throughout the day based on how much stimulant is in my system. The problem is that I have very little emotion when off stimulants and while on them it is very temporary (Maybe two or three hours of feeling "activated" in a day.) My emotions were more consistent before I started taking stimulants and based more on external factors than they are now.

It's hard to describe this anti-feeling I exist in most of the time. I don't feel sad. I don't feel happy. I exist in a sort of rational panic. My mind is sound and I can reason but there aren't emotions attached to my thoughts, which are necessary to perform any action. And my ability to judge how competent I will be for any occasion or task depends fully on if I'm feeling the effects of stimulants.

Quote:
What helped me with mood swings (or rather the emotional crash when my dose started wearing off) when I started taking dex was to dose more frequently with shorter intervals between doses, which worked quite well for me. All in all, dex has helped me immensely with emotional regulation.
Thanks for this insight. I tried this as well as taking Vyvanse to help regulate and my mood was still flat most of the day. My highest functioning time of day occurs between a half hour after I take an initital dose of at least 20mg of Ritalin (now) or 10mg of Dex (from 2003 to 2014) and steadily declines throughout the day. If I take a higher dose later in the day to offset the decreasing effectiveness I experience a greater crash in the evening. I get about two hours a day of feeling emotionally connected to the world around me. It has been hell for my wife especially and I'm lucky to have her and understanding friends and family.
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Old 09-07-15, 02:15 PM
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Re: Have stimulants nearly destroyed your life?

Quote:
Originally Posted by Lunacie View Post
Just because 60 mg is the recommended limit doesn't mean everyone needs
that much. Maybe you didn't notice the numbing effect until the dose became
too high for you?
I expect this was the case. And for years I thought my mood swings at the end of the day was due to a personality disorder.

Quote:
It might be worth decreasing your dose by 10 mg for a week
or two, and then decrease again. When the benefits balance out with the side-
effects that you don't want you'll have hit your sweet spot.
I really wish there was a sweet spot. I have maybe one or two hours of higher functioning in a day. The rest of the day I exist in limbo.

Quote:
I don't know whether the combination of dex and bupripion is a good idea or
a bad one, but when you're taking something to help with mood and you have
more trouble with your mood while taking it, maybe the mood med is the cause?
This is what I'm trying to determine. I tried dex without buproprion and there was no change, maybe just more intense comedowns. I suspect that I'm either suffering from what my psych doc calls "receptor fatigue" or that some long lasting or permanent damage has been done to the reward system in my brain. It could also be that my dopamine levels have been depleting as they do when we age but since I retain the capacity to feel at least some emotions when on stimulants that suggests that the total amount is not the problem.

Quote:
Also ... I know you don't have as much choice in medications where you live,
but Ritalin has been known as the zombie medication. It could be another med
would provide relief without the zombie side-effect?
I'm not sure it's for a lack of choices although I'm curious about what drugs are available to you that you think might help. I've tried anyi-psychotics like Abilify and Latuda and they led to restless leg syndrome (Which can be correlated with low levels of dopamine). Mirtzapine made me feel ill as did Lithium.
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Old 09-07-15, 02:28 PM
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Re: Have stimulants nearly destroyed your life?

I thought Adderall was banned in Canada. Those who find Ritalin/Dex to be
too numbing of the emotions sometimes do better on Adderall.

We have a recent thread about those numbing effects of stimulant meds.
But of course I can't remember which thread I'm almost remembering.
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Old 09-07-15, 02:37 PM
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Re: Have stimulants nearly destroyed your life?

Quote:
Originally Posted by aeon View Post
Iím sorry to hear of your experience. I have had periods in my life where I could find no joy, and not look forward to anything.

Consider that you may be best served by a process of re-titration.

Amphetamines suppress the limbic system, so it is entirely possible your change of mood had some relation to their use. Amphetamines can also cause anhedonia, but this is very rare at prescribed clinical doses.
Thanks for your understanding. I'm wondering if the stimulants caused my anhedonia.

As for re-titration, I'm wondering how long of a process this will be and how it can be accomplished. My psych doc doesn't know and says that my case is an anomaly. So, I'm seeking out first-hand experiences of people taking stimulants for extended periods of time to see if I am my experience is an anomaly or not.

Quote:
You mention no use of SSRIs. Are they an option? If not, have you considered adding mirtazapine to your medications?
I tried mirtzapine along with other newly released meds and they didn't have any noticeable effect. My psych doc has avoided SSRIs because of their emotional blunting effect. The only drugs that noticeably alter my mood are stimulants.

Quote:
I find that my sense of my own life being redundant/irrelevant is at its highest when I am not medicated.
And there's the crux of it and why I feel trapped. The drugs no longer work as they should and I'm left with maybe one or two hours of actual presence in a day. I'm 42 now, about to have a child, and I need this dealt with. I can't waste away any more years of my life and drag others down with my awful condition.

Quote:
60mg dextro-a, 450mg bupropion, and 15mg mirtazapine tend to improve my experience of life, the dextro-a most of all. Iíve never had the experience of decreasing efficacy or a change in dosage for that reason. And for sure, dextro-a (for me) is a superlative mood stabilizer and booster, simply the best antidepressant I have ever known.
This is very valuable information. Thank you. I may run the combination by my psych doc.

How long have you been on stimulants?

Do you not feel a dramatic shift in your mood at the end of the day?

Do the amphetamines increase your pain tolerance? My now chronic back issues may be as a result of the stimulants suppressing my brain's ability to send me pain signals. When I went off the stimulants for 5 months the chronic pain went away. And now it has returned in a bad way. I'm treating it with physiotherapy but I notice after taking the stimulants that the pain subsides while I'm on them. Again, a catch-22.

Thanks again.
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Old 09-07-15, 02:45 PM
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Re: Have stimulants nearly destroyed your life?

Quote:
Originally Posted by Lunacie View Post
I thought Adderall was banned in Canada. Those who find Ritalin/Dex to be
too numbing of the emotions sometimes do better on Adderall.

We have a recent thread about those numbing effects of stimulant meds.
But of course I can't remember which thread I'm almost remembering.
Adderall is legal in Canada and I have tried it. That was some time ago though. So, it may be worth revisiting.

My fear with taking stimulants is that I may be doing more harm than good. Ideally, I would be free of them as they may have caused more harm than good, leaving me in an emotional vacuum unable to function. I'll search for the thread on the numbing effects of stimulants. But please link to it if you see it and thanks for sharing.
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Old 09-07-15, 02:53 PM
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Re: Have stimulants nearly destroyed your life?

Quote:
Originally Posted by BreakingThrough View Post
How long have you been on stimulants?
Five years (so right from the time I was Dx). Just for further info, I am 46 years of age.

Quote:
Originally Posted by BreakingThrough View Post
Do you not feel a dramatic shift in your mood at the end of the day?
No, I do not. I find I can become irritated a bit more quickly, but Iím not so sure this is a function of the med so much as it is my need to eat something.

I did experience significant cognitive fuzz and moderate dysphoria when Concerta wore off, but I have had no problems with Dexedrine.

Quote:
Originally Posted by BreakingThrough View Post
Do the amphetamines increase your pain tolerance?
I have mildly increased endurance for exercise where my muscles would otherwise experience the typical feelings of fade and burn, but as it concerns specific pain due to injury or illness, no, I feel those like I always did (which is to say, I feel them).


Cheers,
Ian
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Old 09-07-15, 03:32 PM
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Re: Have stimulants nearly destroyed your life?

Adderall IR [is or was] not available in Canada. I've never heard anything about Adderall XR being unavailable.

To the original poster: It really does sound as if your stimulant dose is simply too high. Several of the things you said are common complaints of people who have been prescribed too high a dose and haven't realized it. That is almost certainly part of your perception of "more harm than good". The correct (lower) dose may work well.
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Old 03-17-16, 10:41 PM
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Re: Have stimulants nearly destroyed your life?

I was on 60 mg of Ritalin a day, for about 3 or 4 years, stopped for 2 and then after my son was born and I was no longer nursing, I started taking the same dosage for another 4 years. I have officially been off the Ritalin for 3 weeks now, and have an apt with a new psych dr.

I would explain how the meds would wear off at certain points, and I would literally become comatose and fall asleep by 3, so we figured out a dosage of 1-20 mg tablet in the morning, 1/2 a tablet at 10, 1 tablet at lunch time (1pm for me) and another half a tablet around 4. I don't know why it would feel like it was wearing off, but it would. Once I would steadily be taking them, I would hit very low lows.

Not wanting to get out of bed (I would put my son on the bus, or bring him to daycare and end up calling out of work) So I wouldn't take my meds that day, because I would just need my brain to slow down. it would be a ridiculous cycle, every couple of weeks I would go through that. I had been diagnosed w/ ADD from my NP, and have worked with her for about 10 years, so I trusted her judgement.

Now that I am almost 30 and my husband has recently been diagnosed w/ BPD type 1, I am starting to see how the medication truly affects someone, and honestly believe that what I was going through, the bouts of depression, being antisocial, absolutely ridiculous anxiety (obviously because I had such a high dose of amphetemines) was related to my dependence on taking the medication. I'm not sure if this helps at all, but I do feel like with out it, I have more days where I just cannot function, but is that from depression, or my ADD?

When I do have good days, they are great. I'm actually trying again, but am driving my husband crazy being unmedicated and such a lack of focus (thank goodness he was very understanding and went to marriage counseling with me, just to understand ADD from a medical standpoint). I am starting to see a counselor who refered me to a psych to do a proper eval and possibly get me on a better mood stabilizing regiment.

I hope that may have helped!

Last edited by Greyhound1; 03-19-16 at 12:33 AM.. Reason: Added breaks in wall of text for easier reading
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Old 03-17-16, 10:42 PM
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Re: Have stimulants nearly destroyed your life?

ooh I forgot to add, at the end of the day, Some days I would have the shortest fuse, not out of anger, but out of annoyance. that was one of the biggest reasons I stopped.
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Old 03-20-16, 01:13 PM
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Re: Have stimulants nearly destroyed your life?

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what I was going through, the bouts of depression, being antisocial, absolutely ridiculous anxiety (obviously because I had such a high dose of amphetemines) was related to my dependence on taking the medication.
If you were taking ritalin then you were not on amphetamines. Methylphenidate is not the same as amphetamine.

There is nothing wrong with being dependent on a medication. I am dependent on my bipolar meds, my heartburn meds, and my blood pressure meds. Its the same thing. People confuse dependence with addiction.
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Old 04-05-16, 10:27 AM
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Re: Have stimulants nearly destroyed your life?

I'm putting a link to the thread I started here because we made the changes we did as a result of my son not being able to tolerate stimulants. Maybe it can help others who don't do well on stimulants.

http://www.addforums.com/forums/showthread.php?t=176531
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