Long road ahead. This is my ADD story.

[ConnS]

It has been a long time since I last participated in this online community in fall of 2007/2008 just before I got my updated Adult ADD and Bipolar II diagnosis. I really want to get more involved in raising ADHD awareness and maybe share a bit of my story to see if it can help anyone.

If I remember clearly I last posted here at the time because I was desperate and didn’t know where to turn for help to get a better quality of life that included an adequate treatment plan for BOTH ADD comorbid conditions AND bipolar disorder symptoms. I have had several psychiatric admissions followed by very poor experiences with clinicians from the largest of the nine health authorities in the Canadian province of Nova Scotia, who were to no avail, unable to stabilize my mood disorder. Someone from this community and leans (learning disabilities) quickly pointed me in the right direction and I found Dr Ahmed. Never before have I had such a positive experience with a clinician. She listens to her patients, something many physicians would rather not take the time or are unwilling to do so. She is knowledgeable about her specialty and I feel she saved my life by starting me on Concerta 54MG along with another Concerta 10MG taken in the morning with Seroquel 400mg and discontinuing the Risperdal 2mg. We noticed a big improvement in the classical inattention symptoms that became therapeutically alleviated. What I thought was more important is however I became motivated and confident in myself. (not to the point of grandiosity). I never really before stimulant treatment took pleasure or satisfaction in everyday activities and I was surprised that it also helps stabilize mood. The anti-psychotic alone did not provide the comfort that I needed. My whole perception and sensation in the environment was improved and I had a much more organized and more positive outlook that carried me throughout each day. I discovered how much easier life became and just getting out of bed for starters. At present I am too fatigued and on a lot of bed rest which summarizes my entire life. In the fall of 2007 I felt the need to go back to college and have relationships and become social with my classmates. I successfully completed the school year after switching over to Adderall 15MG in January of 2008 after the Christmas break from Concerta54mg and noticed some improvement in my wellbeing and improved organization of thoughts when we increased it again to Adderall XR 20mg. It wasn’t until later that summer I suffered a drug-induced psychosis and since then repeatedly not learned my lesson yet. I required a psychiatric hospitalization and taken off all stimulant medication. Due to this admission to hospital I wanted to learn more about the brain and how to help myself and how important it is to be compliant with medication as apart of the total Psycho-social rehabilitation so I did not return to college and I decided to take psychology at the local University as soon as I got out of hospital.

The hospital had switched me over to Olanzapean 15MG in August 2008 and I initially became very comatose but today that has subsided and I do not have a “distant” look in my appearances. In September of 2008 Dr Ahmed initiated Strattera to a final dose of 40MG x 2 that I remain on today and we augmented its affects with a titrated dose up to Biphentin 40MG that we started in January of that year. This combination we found worked well and I experienced a lot of success with my studies and just feeling good about myself. The Strattera allowed me to be more clam and relaxed and more at peace with myself but without the small stimulant along with it I lacked a lot of confidence and had a poor mood and not as great cognition. I completed the fall winter and summer 2008/2009 semesters and returned to University successfully completing the fall 2009/2010 semester on a maximum dose of 50MG Biphentin (Methylphenidate Hydrochloride) before switching to back to Adderall 30mg to complete the winter 2009/2010. It was only that summer at Saint Marys University that I really appreciated myself and I finally felt proud of myself and happy for even my smallest accomplishments. I know I shouldn’t be contributing it all to a pill. But that summer in memory was the best time of my life and I really enjoyed educating and just feeling good about myself. I wasn’t on the beach like the majority of the people but I was very comfortable and happy (not hypo-manic, either )
I participated a lot in class that I would never have done in high school and the social aspect of that was very much improved. I did not have to worry about any kind of deficit in memory, being easily distracted, losing or misplacing things, disorganization, and underachievement in school like I experienced throughout my history and I could concentrate much better.

It wasn’t until February 2010 that I switched to 50MG L-lysine-D-amphetamine; sold as Vyvanse to participate in a study. This decision was made carefully but with the patient-oriented approach to my doctors ADHD clinic. I remained on 10MG of olanzapine, which was probably too low of a dose, and I should have taken my medication as prescribed at the time but its another hard lesson to learn. I did understand however I needed it and there was no problem with being compliant. I did have a say in the Vyvanse treatment option but my parents were very concerned with me having a dependency on stimulant medication and that influenced my decision too much. They were always concerned that I might abuse my medication and since our latest information on Vyvanse was that it could not be abused or misused we decided to switch to that. My new living environment may have also played a role but I ended up doing poorly in school having to withdraw from 2010/2011 semester and I remained on the medication until I was hospitalized again in May of 2011 and diagnosed with psychosis NOS. (not drug induced time) Transitioning to this drug may have come at a bad time as Dr Ahmed was moving her clinic to Ontario and we did not have regular follow-up. After I was released I decided to take part in psycho-social rehabilitation for 6 months until I graduated the program while still being maintained on the Strattera 40 x 2 that allowed me to continue my studies in University that just ended this April 2012 (living independently on my own) I am taking a much less difficult but still interesting courses now in a sociology program and I have been able to maintain a 3.5GPA taking a part time course load. It was extremely harder without the stimulant therapy in combination to keep up with the class but it felt like more genuine work in the end.

My only problem now is because of this history my new doctor is reluctant to take any risks on me in allowing me to get the most out of life. The past 4 months I have been decreased onto a more manageable maintenance 10mg dose of olzapanean along with the Strattera80MG with my doctor’s permission. I am more then complacent with but I worry that maybe this should stay at 15-20MG olanzapine with a stimulant also being prescribed in combination. I am still very fatigued and useless in the mornings until I take 500-100mg tyrosine in combination with the Strattera and this worked well since January 2012-present and I noticed a big difference in executive functioning but I think a small-prescribed stimulant in place of it might be a better and safer option without tipping the boat again or taking any kind of unnecessary supplement. I do not want history to repeat itself. If anyone can provide any recommendations or advise it would be appreciated.


- Stephen

[LillyF]

I too have problems with fatigue. This is more common in the inattentive type. According to my psychologist, it's characteristic of the subtype. One thing that I have noticed is that I need more sleep than most people. The only thing that has a worse attention span than an ADD brain is a sleep deprived ADD brain. I feel much better when I get a full 8 hours of sleep every night. I was prescribed klonopin to help me get to sleep. So far, it works wonders. You mentioned that you take Strattera. One of the biggest side effects of that medication is fatigue. It's a struggle to find the right medications that will work for you. I think we've all been there.

[ConnS]

Thanks for your comments. Yes, I am also the inattentive sub-type. The majority of the observable Hyperactivity symptoms were mostly visible when I was a child and today remain invisible. A year ago, on my last (CGI) endpoints or Conners Adult ADHD Rating Scale (CAARS) ADHD index scores before my regular doctor moved her clinic I would however self-report high impulsivity. I do not get to bench-mark myself with any kind of related index scores with the psychiatrist who I see now.

I have extreme fatigue with the Strattera 80mg. Without it though my thoughts would be too fast and unorganized and I would not be capable to concentrate and focus to a satisfactory degree that I do now. I have been on it 4 years and I feel I benefited a lot from it. The only problem is that without a stimulant prescribed in addition to it I wouldn't get up in the world and my cognition is not optimized. I would sleep nearly 15 hours on some days but still manage to go to University. At least with the Vyvanse 50mg in combination allowed me to become more social and I had a lot more motivation and got involved a lot with my church and friends, something that I have no interest to do now. I used to be much more interpersonal. However academically Vyvanse did not help much at all and my relationship with my parents went bad. I really wish that I could just end back on the Concerta54mg and Concerta18mg that I was on or the Biphentin40mg because I feel that is when I was most healthy but the health authority is "conservative at best" in prescribing it so there is not much hope it will be recommended to me as treatment.

- Stephen

[CheekyMonkey]

I'm having a hard time putting together your current medications. So you are on Stattera and Zyprexa, right? Are you on any mood stabilizer?

[ConnS]

Originally Posted by CheekyMonkey

I'm having a hard time putting together your current medications. So you are on Stattera and Zyprexa, right? Are you on any mood stabilizer?

Yes, I am CURRENTLY only on 80MG of Stattera and 10mg Zyprexa.

The Olanzapine (Zyprexa) as you know for many has been shown to be a very effective mood stabilizer and so that's what my psychiatrist thinks is sufficient. I can't help but think that I should also be on a real mood stabilizer in addition because I know my mood could be better. I understand a lot of the mood stabilizers do not work well with Strattera and I am afraid my new doctor will prescribe wellbutrin (his drug of choice) in place of it if I complain of poor or inadequate mood. On Concerta I felt I would not need this additional stabilizer.

Although it is not really important I am also on Naproxen which is used to treat pain or inflammation caused by arthritis.

-Stephen