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Old 12-06-2010, 08:51 PM   #1
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Unhappy Why can't I find the right medication!?

Hi!

I just registered to this site and this is my first time posting (it might be lengthy) so please bare with me

I am 20 years old and was diagnosed with ADHD during the September of 2010. Before being put on any medication I had all the typical symptoms of the inattentive type of ADHD. After 45 minutes of sitting down with a psychiatrist for the first time he prescribed me 30 mg's of Vyvanse. Within the first day of being on Vyvanse I was bouncing off the walls! I was cleaning my room like crazy, organizing all my school work, and even worked out for an hour. Never in my life had I felt so motivated, concentrated, and full of energy. Then night time rolled around and I started sweating, had no appetite, had the worst cotton mouth, and ended up only getting one hour of sleep. The next day I took 30 mg's of Vyvanse, as instructed, and felt all the same signs of energy and side effects as the day before but for some reason I was only able to concentrate for a couple hours then it completely went away. I thought taking another 30 mg pill was okay so I did. I continued taking two 30 mg pills of Vyvanse once a day for a month and in that time period I was able to kick *** in school but it came with some serious consequences. I was never able to sleep, I had constant dry mouth, I was beginning to get depressed and I was never hungry which lead to too much weight loss.

I then told my psychiatrist that I thought I might have been abusing my medication and told him all my side effects. After telling him this he told me I was treating it like speed and just said he was going to switch me over to 36 mg's of Concerta. After a month of being on Concerta I didn't really have any physical side effects but I was starting to become really depressed and could only find myself being able to concentrate on school work for a period of only two hours. I told my psychiatrist this so he switched me to 60 mg's of Strattera. I understood that it took about 3 - 4 weeks to actually kick in but with in that period I was no longer depressed at all but I could not focus on anything for the life of me. The 4th week became hell on earth for me. I became so tired all the time that I started taking Thermogenic Push dietary supplements once a day for energy. I became unmotivated, I never wanted to go out with friends any more, and I kept having the most negative thoughts about every thing around me.

I had to report back to my psychiatrist December 3rd but the night before I had the worst experience while on any other ADHD medication. I had started feeling depressed again as usual but then for some reason I started crying out of no where. I just could not stop crying and my mind kept racing back and forth about how my life is going no where and I kept trying to think of the last time I had been happy and I could not even remember. All I wanted to do was crawl in bed at 5 p.m. and just sleep so that the feeling would go away. The next day at my psych. appointment I told him I just had been way too depressed and anti social on Strattera and that I could not stop crying. He then prescribed me 18 mg's of Strattera for a couple of days to lean me off of it and also prescribed me 36 mg's of Concerta again but also added 20 mg's of Prozac this time.

I know this is a lengthy post but it has only been 4 days since I have had this medication switch and I have absolutely no more hope left! I can not stop crying and getting all these negative thoughts out of my head. I am not suicidal or anything but I am just not myself anymore since I have started taking ADHD medication.I either have too many side effects or am extremely depressed. I have never been this way before and am just wondering if anyone out there has experienced anything like this. People have said that ADHD medication has improved their lives greatly yet all it has done for me is made things worse. Does anyone have any suggestions on medication that could help with my concentration and laziness but not make me depressed? I know I am now taking Prozac but I am just so worried that it will make me even more depressed considering the fact that Strattera was suppose to help with my ADHD and depression and made things so much worse !

A thank you to anyone who takes the time to read this and a serious thank you to anyone who responds back! It will be greatly appreciated !

 
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Old 12-07-2010, 03:08 PM   #2
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Re: Why can't I find the right medication!?

Okay, just reading your post made me feel like a punching bag. Massive overcharge stimulants! No stimulants! Antidepressants! One! Two! and no breaks in between to ever get back to normal.

I suspect the problem with the Vyvanese is that your dosage was too high initially, even the 30 mg was too much. Operating the way you were that first day is not normal, and no human being can keep it up for any length of time. The reason it stopped working after a couple days is that you were too exhausted to function any more. In fact (Psychiatrists never tell us this but we all know it) stimulants cannot treat your ADHD if you are seriously sleep deprived.

I wish he'd just tried you on a lower dose of Vyvanese, like 10 per day, rather than switching you.

Right now, your brain may just be out of whack because you've been on so many different meds. It might help for you to stop everything for a few weeks, let your brain chemistry get back to normal, and then see what a low dose of one ADD med does.

When you take a high dose stimulant for a while, then stop, you may be depressed, fatigued or sluggish from that alone.

 
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Old 12-07-2010, 04:02 PM   #3
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Re: Why can't I find the right medication!?

Thank you so much Janewhite1 ! I really appreciate your feedback. I think I am going to try and find a new psychiatrist that will talk with me for more than 5 mins a visit and have a different insight on medication then the one I am currently seeing. The only other question I have is, is it dangerous to stop taking the 18 mg's of Strattera, 36 mg's of Concerta, and 20 mg's of Prozac cold turkey? It has been 5 days since I was prescribed the three. I really want to go with your advice and stop taking them all together for like a month then try a lower dosage of Vyvanese but I just want to be prepared for any withdraws I might have from stopping all at once. Any advice is greatly appreciated!

 
Old 12-07-2010, 04:15 PM   #4
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Re: Why can't I find the right medication!?

The Prozac and Concerta, you've been on only a few days, so there shouldn't be issues with stopping. Let him know what you are doing, though.

When are your final exams? You don't want your brain chemistry further disrupted until those are over.

The Strattera, you are in the process of tapering down, right? Stick with the initial taper-down plan. How many days did he tell you to take the 18 mg for?

 
Old 12-07-2010, 05:55 PM   #5
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Re: Why can't I find the right medication!?

My final exams are from December 11-17. I am only in one class now though because of the medication issues causing me to drop several classes.

As for the 18 mg's of Strattera, it is said to take 2 capsules every morning for 4 days, then 1 capsule every morning for 4 days then off. So today is the fourth day and tomorrow is when I would only be taking one capsule a day for four more days then off.

Any suggestions on how to approach my psychiatrist with this? I do not know what I am suppose to say because I have already told him about all my side effects with these meds. Also he only keeps me in his office for 5 mins each time I make an appointment and his appointments are extremely pricey for only lasting for 5 mins.

 
Old 12-07-2010, 10:07 PM   #6
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Re: Why can't I find the right medication!?

Hey ItalianGirl,

Jane, as always, is spot on. I too thought what a shame your shrink choose switching you to Concerta as punishment for abusing your "speed." Concerta is "speed" too, a Schedule II medication considered highly abuse prone.

Ask your doctor for forgiveness on the basis of your confession. You weren't busted. You weren't being coerced. If you hadn't told, your doctor would not have known. You told because the side-effects were not tolerable.

First, before rattling on, I must do my required black box warning: I ain't no doctor.

You can humbly ask your doctor if an IR (Immediate Release) stimulant will help with your insomnia. Vyvanse acts as an extended release formulation of d-amphetamine. An IR version would release the entire dose earlier in the day than Vyvanse taken at the same time. I think you stand the same chance as a snowball in heck of getting a Dexedrine IR prescription even if you hadn't been evil and wicked. Bad girl.

Perhaps a low dose of Adderall IR would work for you. Adderall likely will give you better efficacy than Concerta. Taken early in the day, it may not interfere with your sleep or overly suppress your appetite unless you are like Jane. Give Jane 5 mgs of decaf and Jane doesn't sleep for over a week.

I think your depression symptoms are being caused by the crash caused when your fuel (Vyvanse) runs low and can no longer maintain the "speed" you need to stay in orbit. Kaboom. Very hard, nose first, "landing." The hole in the runway is a "depression."

What if you are like Jane? What to do?

Sidebar: I spent considerable time researching the information summarized below. I have been thinking about switching one of my meds. I took the opportunity to get enough understanding to present my case to my GP. The two meds I discuss are prescribed for high blood pressure. Both have found new uses. I suspect my GP doesn't know an important difference between them.

You can ask your doctor about clonidine and guanfacine to counter your side effects. Clonidine is a2 adrenergic agonist. Guanfacine is an a2a. Since both Clonidine and Guanfacine act on a2 receptors both effectively offset the stimulant side effects of insomnia and appetite suppression. Guanfacine also acts on the a2a receptors that are heavily concentrated in the prefrontal cortex. a2a receptors help transmit signals in the system executing the functions of attention and information processing. Bingo. Guanfacine effectively improves attention and focus. In some cases guanfacine alone is used to offset ADHD symptoms. I suspect, in my case, guanfacine can be used in conjunction with Adderall to 1) offset side effects and 2) enhance Adderall's attention improving properties. Perhaps a lower dose of Adderall will be as effective.

Too good to be true. I'll let you know. I'm on Clonidine. I'm calling my doc today for a switch to guanfacine.

Bob

 
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Old 12-08-2010, 08:45 AM   #7
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Re: Why can't I find the right medication!?

Here is, in part, the memo I sent my GP.

I want to switch from clonidine to guanfacine. Here is some stuff I got from [the Internet].

Clonidine ADHD Uses

• Counters the insomnia and irritability side effects of stimulant medications
• Clonidine is a mild sedative


Guanfacine ADHD Uses

• *reduces rebound*
• improves working memory
• reduces distractibility
• improves response inhibition and attention control

A good ADHD med in itself.

The cause of my insomnia is ADHD rebound.

Proof: If I take too much Adderall too late in the day, it keeps me awake BUT continues to control my ADHD symptoms. I can do whatever I want - except sleep. I've taken a small dose of Adderall before bed to help me sleep. It works when I'm tired, near exhaustion, and dose is 10mg or less. The small dose reduces the rebound effects keeping me awake without overriding the fatigue putting me to sleep.

When ADHD rebound is the cause of my insomnia, I can't sleep, can't do nothing. I experience severe restlessness not anxiety. I get restless mind syndrome, not restless legs - literally.

I was nicely sedated when I started clonidine. It lasted less than a week. Since then my ADHD rebound and insomnia have progressively grown worse. I cannot tolerate it any longer.

Give me, give me, give me - guanfacine. <- not really in the memo.

I hate to say it cuz I wrote it. The info is golden when determining the best fix for insomnia.

Last edited by addprogrammer; 12-08-2010 at 08:46 AM. Reason: replaced proper name with generic

 
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Old 12-08-2010, 10:48 PM   #8
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Re: Why can't I find the right medication!?

I can't add much to what's been said. For clarity, Bob was suggesting Clonidine OR Guanfacine (aka Intuniv). As he explained, these meds do the same thing, so putting them together would be a mistake.

For the time being, I think the best advice is to take a step back and get off the meds. Once you've had some time to get things back to normal, try a much smaller dose of Vyvanse, as Jane suggested. Once we know how you do on one ADHD med at a reasonable dose, then we can think about adding new things.

I'm honestly not sure when the practice of starting low and working your way up disappeared, but it seems to be becoming the norm to prescribe massive doses of stimulants from the beginning, and wonder why people get high, crash, and suffer extreme side effects. As little as a couple of years ago, the proper procedure for starting a stimulant med was to start at the lowest possible dose, and work up over a matter of weeks, judging each dose for efficacy and side effects before stepping up to the next. Any good psychiatrist, or even general practitioner should know this.

The only advice I can throw your way right now is this: you're going to have to be patient. I know, for anyone with ADHD, the 'P' word is really tough to manage, but there's no way around it. Finding the right med at the right dose can take some time. It is worth the time and the effort in the end, but it can be frustrating.

You've had some of the best advice you'll find from two of the smartest and most experienced people here, listen to Jane and Bob and you won't go wrong. Best of luck.

 
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Old 12-09-2010, 04:53 PM   #9
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Smile Re: Why can't I find the right medication!?

I have been having a similar problem. I have been self-medicating with alcohol to deal with the depression, anxiety and sleepnessness caused by the meds. See my recent post. The last couple of days I decided it wasn't worth it, but after seeing the good advice on here I am reconsidering.

 
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