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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 08-27-12, 02:54 PM
LifesFunny LifesFunny is offline
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My Story So Far, Long Read. Advice Please!

Hi Everyone!

My name is Steve and I have just recently decided to create an account and stop lurking Moderators, feel free to move this if you feel there is a better place! So, last night I lay in bed awake, mind racing, thinking about my next appointment with my therapist and thought of how every time I speak with her I end up learning something new about myself and my condition. So having said that, I thought I would share my story with all of you with the hope that you can share some of your wisdom with me

My whole life I have wondered why I always felt a step behind everyone else, slow to adapt to changing trends. I wondered why I would always do so poorly in school despite the fact that I am far from unintelligent and never a "bad" kid. Why I could never focus on anything and finding little to no pleasure in activities due to this. Why others could easily handle multiple social relationships where as I could never relax around others. These thoughts plagued me all through my public/highschool life. I thought "Is something wrong with me? I feel like I am capable of so much more, but there is an invisible wall blocking it out"

After my first year of university (this past year) I decided it was time to address all of this and seek an answer. My anxiety reached a crippling level and I slowly became more withdrawn from anything social. So many opportunities missed due to a long track record of failure. I gave up on myself but I still felt that inner voice saying "You haven't seen anything yet" So, at the beginning of this past summer I made the vow to myself to get my life together. On the surface I may look quite normal. I am in university and have worked out for the past 4.5 years on a consistent basis. I also have a job and my own car. Underneath though, it is a constant whirlwind of negative self talk,day dreaming,brain fog, difficulty forming thoughts and constant mental bickering which is heavily accompanied by social anxiety. People have always said I am good at hiding my true self, but it had become to much.

I went to see my Dr. and told her about how I have been feeling. She made me take a quick test and from it determined that I have social anxiety with slight depression. It all made sense to me. She prescribed me Cipralex(Lexapro in the U.S.) which is an SSRI and sent me on my way. At first everything was seemingly getting better. Much more socially happy and just finding pleasure in life more. Felt so good to feel more "me" I even confronted two kids who kicked in my side door when I was home alone and chased them out with a very large knife (I have a chefs knife kit) and have to testify against them in a few months, but that's another story. This was unfortunately short lived and the Cipralex eventually just made me very apathetic to events and others around me. I also felt that my inattention and racing mind problems were still present. It also made me extremely fatigued and lethargic to the point where I would sleep 75% of my day away. So I began to do some research and decided to look into ADHD, I had always thought it a strong possibility but never pursued it (I attribute that to the ADHD ironically..) I revisited my Dr. again but this time with a new intention. Same as last time she made me fill out a questionnaire that took no more then a few minutes (I was already quite positive of this diagnosis prior to this) I know some people may say that I may not have ADHD, but me and my therapist went back through all of my old report cards that my mom kept and found extensive evidence in its favor. Teachers comments saying how I was always a good kid but seemed like I was off in another fantasy world. Below average grades but always told I could do much better if I would pay attention in class. This was a common trend. Also this meant I was ADHD-PI. Anyways, she decided (with my suggestion) that we try a stimulant.

I was now on Cipralex(for anxiety primarily) and Adderall XR(for ADHD-PI) The first few days were nothing short of amazing. I felt like the chains that were wrapped around my brain had vanished and that these medications were my "key" Once again short lived. Now I know many of you may suggest this was euphoria but I can honestly say after reading many accounts of how it feels that it was not. I just felt mentally clear and able to speak my mind effectively which lead to more personal and social success. After a few days and a bit of tinkering with my dosage (with my Dr.'s permission) I felt blah... I began to do some reading on the effect of SSRI's on stimulants and got a mixed bag of results. Some people find no interactions with either of the medications efficacy when combined while others find that the SSRI's lethargy cancels out the stimulant greatly and the stimulant cancels out the SSRI's anxiety relief. So I decided to stop taking my SSRI because digging through my past me and my therapist agreed that my social anxiety was caused largely by my ADHD-PI due to not being able to perform in social situations which then caused self-esteem issues and self doubt. So I (rather foolishly) stopped my SSRI cold turkey (after 3 months use) in hopes of allowing the stimulant to do its job properly. I also believed that since my social anxiety stems from my ADHD-PI that treating only the anxiety is essentially treating the effect and not the cause. Therefore, as long as the ADHD-PI is not treated it will continuously reinforce my anxiety.

I had moderate withdrawal symptoms from the Cipralex. Dizzyness/vertigo for a few days but nothing else really notable. I do remember one day a few weeks after stopping where I felt an emotion. And in that moment I realized that I have not "felt" anything since starting that treatment. It sent chills all over my body to feel something again, quite an eye opening experience. Not to knock on SSRI's because it did pull me out of the worst period in my life and stabilize me so to speak. I do believe however that they should not be handed out so lightly. As I said, I took a 5 minute test and got a prescription for one. Anyways, I was still taking the Adderall XR and only having minor success. It did give me physical energy but it also made me quite jittery and irritable. As far as attention goes I noticed a slight increase but I somewhat attribute that to the fact that I just felt more awake. I also made myself very aware of possible interactions with food (such as vitamin C and other acidic things) and the effects sleep and exercise had on its effectiveness. As I said I have consistently worked out for 4.5 years so that is no problem and I was getting regular sleep (few days when I took my dose to late caused insomnia). Also I hydrated like a mad man. I stocked up on cases of water and would drink more then enough a day. Eating was sort of a problem but I did my best to sneak in snacks and high protein shakes. So no worries there. Still I felt like it was just a sugar pill.

Now here is where desperation begins to take action. I began taking doses higher then what my Dr. had prescribed me and noting the effects (as I did with every dose of these medications)*Please hear me out on this, cause I know this is not recommended. I have never been the kind of person who likes being dependent on something to make them feel "normal" Things like coffee and energy drinks I always avoided not due to taste but because of this belief. Seeing countless people I know on a day when they do not have their morning coffee or whatever they need has reinforced this strongly. Also I have only been drunk a handful of times and am not a big fan of alcohol. Same goes for things like marijuana and other controlled substances. Never done them, never will. Have plenty of friends who do and that is their choice, it does not bother me. Honestly these things just aggravate my already bad symptoms. The purpose of this higher dose is to use myself as my own test subject and note how I feel. Furthermore, I find the use of these medications as anything other then medical treatment disgusting and the main reason why a lot of these medications come with a stigma. So please do not jump to conclusions here*

Now I am was not just taking the medication and then sitting there waiting for it to work. I know that is not how it works. I work at a local grocery store and ever since starting my treatment (including Cipralex) I have used this place as my "testing grounds" Essentially gauging myself in the many situations that I may face there. Things like talking to male and female co-workers, talking to customers who are complete strangers and helping them find what they need, and also problem solving abilities and just general attention/distract-ability comparisons. Honestly motivation is not something I am looking for in these medications. I feel this is a good test for myself and the medication/dose.

Sorry for getting off track, if you're still reading thank you very much So the higher dose of Adderall XR was 60mg at first (prescribed 30mg a day) and I still only felt a minor increase in symptom relief but also an increase in side effects like dry mouth,appetite suppression and worst of all, anxiety/jitters. At this point my frustration is rising. After reading so many stories of how after starting treatment for ADHD people felt like themselves and had long term success. But why not me? I was giving the medication near optimal conditions to work in yet 90% of my symptoms still ran rampant in my everyday life. I am able to identify the difference between my ADHD-PI symptoms and just normal everyday distractions and human error.

Back to researching, primarily sifting through these forums searching for some answers. This is when I fell upon Dexedrine and after reading many stories of people having the same problems I had with Adderall (physical side-effects) and then switching to Dexedrine and finding it eliminated the majority of those while enhancing the mental benefits looked very promising to me. So back to the doctors office for me where I suggested this switch. She was resistant at first and pulled out her book that contains information about ADHD, the medication used to treat it and what doses. She always consults this and as much as I trust her, I do not 100% trust a book written by a third party that have no idea about my situation and past. I have learned that we all react differently to different medications and different dosages so I had some discomfort with this. I have been meaning to ask her about seeing a psychiatrist and will make a note to remind myself for next time. Also she said she could refer me to a ADHD specialist but the closest one is 2 hours away and there are none in the city I live in. By the way I do not blame my doctor at all for her process of prescribing this stuff. She is being cautious and safe and as I said I trust her opinion. Also she was the first human to ever touch me when I was born. Always thought that was cool. I do a lot of personal research and note taking to present to her because I know this is not her specialty. I should also mention that I have had blood tests done to check for B12 and magnesium levels. Both are normal.

Can you tell I am scatter-brained yet? I did not have the intention of writing something this long. I have also been up and down more times I can count during this.

She prescribed me Dexedrine IR 5mg to be taken twice a day and as before she gave me the freedom to adjust the dose as I see fit (to a max of 50mg a day) Now this next point I feel has a big impact on where I am now. Before trying the Dexedrine I decided to give Adderall XR its one last chance and took 120mg within a 4 hour period. I of course had done research on higher doses and saw countless people taking doses at or above this who had great results that they did not have with more common doses. Decided to give the "Do I require a higher dose then others?" approach a try with only the intent of relieving symptoms. It did not really work, I felt the physical energy as always and maybe a little more focus and attention but nothing notable. The side effects were magnified as you might guess so ultimately it was not worth it. The next day I began with Dexedrine IR 5mg twice a day and felt mildly better. I shrugged this off as the withdrawal of the Adderall and continued with this dosing. After 4 days of this and no improvement I decided to try 10mg twice a day. Once again no notable difference. 15mg, nothing really but the jitters did begin again. 20mg, same thing. I have not gone higher then that. As far as side effects are concerned I have had very few it seems even when I was on Adderall. People always talk about the headaches and more often the rapid heartbeat/ raised blood pressure. I have had none of these yet they seem so common. The one day I took 60mg Adderall XR a few hours before my doctors appointment and my BP was completely normal. And with the Dexedrine I have no idea when it begins working and when it wears off because I don't have any noticeable side effects with it except for the jitters. All of this has led me to be incredibly confused and frustrated. Finally thought I was on the right track but it seems every time I feel like I am taking two steps forward, I end up taking two steps back, or sometimes more...

Lately on the Dexedrine I feel incredibly mentally sluggish, I forget things easily and am seriously struggling in social situations despite anxiety levels. I am still getting more then enough sleep, exercising when I can and eating/hydrating normally. I am generally a quite creative and witty person and have always felt that my ADHD hinders this very much/make it a fleeting moment (my main reason for seeking treatment) but lately I have been a cardboard box to talk to. I get a lot of my personal pleasure from making people laugh and telling creative silly jokes, but lately I seem to just rush every joke and end up spewing out some garbled mess that leaves people staring at me in an odd way. My jokes are so jagged and forced lately that I am uncomfortable in my own skin. Where at first the Adderall encouraged my creativity and I was very articulate. I feel like someone else has the remote to my brain and has changed it to a channel that is mostly static. I feel like I am stuck in limbo, just floating around weightless, waiting to plant my feet on solid ground. I am at a loss.

If you read all that I am very grateful to you, feels good to vent a bit. Now here are my questions that I would very much appreciate your insight into. If you want any additional details just ask and I will be pleased to answer!

Do you believe that the Cipralex(SSRI) is still playing a factor in all of this? I have been off it for over a month now.

Why have I had such little success with both Adderall and Dexedrine despite fitting the criteria that they usually help?

Whats the deal with my side-effects? Compared to others I seem to have very few. Does this mean my dose is too low? Too high? Even taking 120mg Adderall XR only caused appetite suppression, dry mouth and jitters/anxiety. No racing heart or anything like that. I have heard some people require very low doses, well I forgot to mention I did test out 1.25mg Dexedrine and 2.5mg Dexedrine with no results.

Is my condition something else? Meaning that my ADHD symptoms are really another condition that I have and don't know about.

Should I continue with these medications? Dose change? Other stimulants like Ritalin? They do make me feel slightly better then before but not nearly at a therapeutic level.

Do you think going back onto a low dose of Cipralex along with a stimulant would be beneficial? I am not very comfortable with that idea but I would like to know what you all think.

Am I just over thinking all this (guilty of this very often) and just need to let my body adjust to the medication? If that's the case then why do the benefits seem so invisible?

And lastly, why is Dexedrine making me so jittery/anxious? Is the Adderall still playing a part in my system? I have been off of it for a few weeks now.This seems quite uncommon for people and a lot of people find that these medications actually alleviate their anxiety completely.

Any advice would be very welcomed! Just ask for clarification if you need it. After lurking many treads on this forum for quite a while I have come to respect a lot of you and your desire to get better and help others get better. I hope my story helps someone else one day.

Regards,

Steve
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Old 08-27-12, 04:22 PM
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Re: My Story So Far, Long Read. Advice Please!

you should continue with these meds as prescribed, playing with them leads to trouble
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Old 08-27-12, 09:04 PM
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Re: My Story So Far, Long Read. Advice Please!

Interesting read. As a matter of perspective, is there anyone close to you that can verify the external manifestation of your internal perception? Unique as we are, I didn't notice much change internally, rather relied on my wife to see if she could see any difference. Only time I had a noticeable side effect was on the Strattera. Running up to a dose where we could see a difference, also removed my 'filters.' I can be pretty nasty, and I was. Didn't like it. But I got a bunch of stuff done!
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Old 08-28-12, 03:19 PM
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Re: My Story So Far, Long Read. Advice Please!

Thanks for the replies,

Sarahsweet I appreciate what you're saying but my Dr. is aware of these dose changes (sometimes after the fact) and she knows I have absolutely zero desire for euphoria. School starts in about a week for me so that is why my dosing and switching may appear to be quite frantic.

Freewayflyer- Actually I just got back from my Dr.'s and essentially explained the revelation I had just recently had. That being that I lean towards the hyperactive of ADHD more then I had ever thought. I just happen to not show it in such a physical way. As a kid I can remember always being on the go, driven by a motor. I would always get up during seated work and blurt out answers. But over the years as my anxiety grew and the failures I experienced with my outward hyperactivity piled up I believe it became much more internal. Meaning that it become racing thoughts rather than an overactive body. This fooled me into thinking I was much more ADHD-PI which me and my Dr. have agreed I am not. This study done by Adele Diamond was of great help in sorting through symptoms.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1474811/

It also mentions in there that hyperactive types generally respond better to the Ritalin side of the stimulant families where as the people with ADHD-PI find Adderall and its friends to be more beneficial. Having said that, me and my Dr. agree that we should give Ritalin a try, and that is where I am now. Though I am going to take a few days off and get my appetite back to normal among other things.
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Old 08-29-12, 12:40 AM
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Re: My Story So Far, Long Read. Advice Please!

I won't be reading that anytime soon, but I added it to my bookmarks, when things slow down a bit, will delve into it. thanks for info.
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Old 08-29-12, 02:45 AM
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Re: My Story So Far, Long Read. Advice Please!

Lifesfunny -- you are very observant, not everyone can make note of the many areas that drugs affect....

Quote:
Is my condition something else? Meaning that my ADHD symptoms are really another condition that I have and don't know about.
I think this is the real question. As I have observed, a diagnosis of ADD/HD is not the complete answer, science continues to learn how the brain works.

I feel you should expand your field of observation to all things like: how much sleep do you need to feel refreshed? Are you a day or night person regarding energy levels? What foods make you feel good or bad? etc.

Also, you may need to expand your research into other brain "disorders", ADD/HD should not be a catchall diagnosis.

Good luck, m
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