4support
03-11-2007, 11:47 PM
Hi friends,
My husband who has BP/ADD and is medicated with lithium, began taking (not sure why the forum won't let me post the medicine name, same as slow release Ritalin) for ADD 2 weeks ago. The first week he seemed to be fine, however over the past week he has slipped into a MAJOR depression. I honestly have never seen him this down, he tells me he is having serious feelings of hopelessness, sadness and overall depression. He says he has never felt this badly, feels empty and overwhelmed, and just sits around staring ahead and looking very out of it and sad.
We have an appt with his pdoc in 2 days. In the meantime, we decided he should probably discontinue the med until he sees him.
Is anyone on this forum familiar with the risks of mixing ADD medications with bipolar mood stabilizers? On the med leaflet, it states that major mental/mood changes which can include anxiety, irritability and depression can be a side effect and to discontinue use. Has anyone had experience with mixing these meds and if so, what has and hasn't worked to manage the moods/depression AND the ADD? Also, I've read that anti-depressants can push someone with BP into a manic episode. Can the BPers out there share their success/non-success stories with me please.
I am very worried about my husband and just keep trying to reassure him that we will continue to go the pdoc regularly until he finds the right med combo to really HELP him and make him FEEL BETTER. It's a helpless feeling for me, as I know there is really nothing I can do to pull him out of this.
Thank you for all of your help!
4support
My husband who has BP/ADD and is medicated with lithium, began taking (not sure why the forum won't let me post the medicine name, same as slow release Ritalin) for ADD 2 weeks ago. The first week he seemed to be fine, however over the past week he has slipped into a MAJOR depression. I honestly have never seen him this down, he tells me he is having serious feelings of hopelessness, sadness and overall depression. He says he has never felt this badly, feels empty and overwhelmed, and just sits around staring ahead and looking very out of it and sad.
We have an appt with his pdoc in 2 days. In the meantime, we decided he should probably discontinue the med until he sees him.
Is anyone on this forum familiar with the risks of mixing ADD medications with bipolar mood stabilizers? On the med leaflet, it states that major mental/mood changes which can include anxiety, irritability and depression can be a side effect and to discontinue use. Has anyone had experience with mixing these meds and if so, what has and hasn't worked to manage the moods/depression AND the ADD? Also, I've read that anti-depressants can push someone with BP into a manic episode. Can the BPers out there share their success/non-success stories with me please.
I am very worried about my husband and just keep trying to reassure him that we will continue to go the pdoc regularly until he finds the right med combo to really HELP him and make him FEEL BETTER. It's a helpless feeling for me, as I know there is really nothing I can do to pull him out of this.
Thank you for all of your help!
4support
Sponsor
Paige1989
03-12-2007, 12:19 AM
My psychiatrist (pdoc) told me most ADD/ADHD meds are stimulants, like a higher dose of caffeine, and that can throw you into either state. So talk to his pdoc (or have him talk to the pdoc) about Stratterra, which is the only non-stimulant ADD med.
Hope this helps,
Paige
Hope this helps,
Paige
tsohl
03-12-2007, 12:31 AM
Hello 4support,
Sorry you are already having problems with meds after things were going so well for a few days! I am not really responding directly to your post because I don't know about those ADD drugs...but I wanted to pass along something else. I would first want to get the bipolarity medicated before trying to do much with the ADD. Often it is found that when a person is properly medicated and are episode-free (in the nice even "stable" state), there is little need for all these additional, add-on drugs. Often what was thought to be ADD was really symptoms caused by hypomania. The newer trend among more recently trained pdocs is to treat the diagnosis of bipolar rather than trying to treat each of the symptoms separately. Often more than one mood stabilizer is necessary...because one works better on symptoms of depression, another works better on symptoms of mania, etc. My son was on lithium and then the pdoc would try something else almost every month, to go with the lithium. When he switched pdocs, the new one added tegretol which made him "better" but not quite 100%...so in awhile he added lamictal...and that's what he takes now...all 3 at tolerable doses!
I personally would be really cautious taking an anti-depressant until your husband is stabilized...but obviously your pdoc should be able to help you here. I would call the office first thing in the morning and ask if he should discontinue the med for ADD...and explain what is happening. No reason to wait two more days to find that out.
Hang in there. Keep reassuring your husband that it is common to have to go through a period of trial and error until you find the right meds, but that this WILL happen.
:wave: Tsohl
Sorry you are already having problems with meds after things were going so well for a few days! I am not really responding directly to your post because I don't know about those ADD drugs...but I wanted to pass along something else. I would first want to get the bipolarity medicated before trying to do much with the ADD. Often it is found that when a person is properly medicated and are episode-free (in the nice even "stable" state), there is little need for all these additional, add-on drugs. Often what was thought to be ADD was really symptoms caused by hypomania. The newer trend among more recently trained pdocs is to treat the diagnosis of bipolar rather than trying to treat each of the symptoms separately. Often more than one mood stabilizer is necessary...because one works better on symptoms of depression, another works better on symptoms of mania, etc. My son was on lithium and then the pdoc would try something else almost every month, to go with the lithium. When he switched pdocs, the new one added tegretol which made him "better" but not quite 100%...so in awhile he added lamictal...and that's what he takes now...all 3 at tolerable doses!
I personally would be really cautious taking an anti-depressant until your husband is stabilized...but obviously your pdoc should be able to help you here. I would call the office first thing in the morning and ask if he should discontinue the med for ADD...and explain what is happening. No reason to wait two more days to find that out.
Hang in there. Keep reassuring your husband that it is common to have to go through a period of trial and error until you find the right meds, but that this WILL happen.
:wave: Tsohl
Llama
03-12-2007, 03:23 AM
Hi 4support,
You might want to ask your husband's pdoc about lamictal. It is a mood stabilizer that is supposed to work well for depressive episodes in bp. It also should have a lower risk of sending someone with bp into a manic state (as opposed to the antidepressants).
I'm sorry to hear that the add meds have made your husband feel worse. I don't know what to think now considering my pdoc prob wants to start me on some kind of add med too! :confused:
You might want to ask your husband's pdoc about lamictal. It is a mood stabilizer that is supposed to work well for depressive episodes in bp. It also should have a lower risk of sending someone with bp into a manic state (as opposed to the antidepressants).
I'm sorry to hear that the add meds have made your husband feel worse. I don't know what to think now considering my pdoc prob wants to start me on some kind of add med too! :confused:
marshmallow
03-12-2007, 11:08 AM
4support I am sorry your husband is feeling so badly and problems with the meds. I cannot help with any of that but wanted to say I hope things get better for both of you real soon.
langlee
03-12-2007, 05:20 PM
Dear 4Support,
I would also ask about Lamictal. Alot of people have had great success with it, including my son. I also agree with Tsohl. I think getting the right combo of BP meds working for awhile is important before adding the ADHD drug. My son had ******** added recently and really feels a difference, but I'm not sure he would have realized it if the BP meds weren't working.
Adding new meds can be tricky. When the pdoc added an anti-depressant to my son's combo, it put him into a wailing, desolate depression. Go figure!
I will say that once the BP meds are regulated, I would try the ADHD meds again. At least for my son, the ******** was the missing ingredient in his combination and he feels tremendously more focused with it.
Good luck. Finding the right balance of meds is not an easy task, but once your husband does, he will feel tremendously better.
Always,
Hope
I would also ask about Lamictal. Alot of people have had great success with it, including my son. I also agree with Tsohl. I think getting the right combo of BP meds working for awhile is important before adding the ADHD drug. My son had ******** added recently and really feels a difference, but I'm not sure he would have realized it if the BP meds weren't working.
Adding new meds can be tricky. When the pdoc added an anti-depressant to my son's combo, it put him into a wailing, desolate depression. Go figure!
I will say that once the BP meds are regulated, I would try the ADHD meds again. At least for my son, the ******** was the missing ingredient in his combination and he feels tremendously more focused with it.
Good luck. Finding the right balance of meds is not an easy task, but once your husband does, he will feel tremendously better.
Always,
Hope
michael178
03-12-2007, 05:48 PM
I usually forget to watch for symptom changes when trying a new medication, it was nice that you could do that. With diseases with fluctuating symptomatology, like MS or bipolar, it is sometimes hard to figure out what is going on. Good job guys.
4support
03-15-2007, 02:16 PM
Hi friends, :wave:
After several days off the first ADHD med (Concerta...slow release Ritalin), my husband has came out of the depression (thank goodness!), apparently this was a chemical side effect due to this med, although rare, it appeared to have caused a slump for my husband. So we went to see his pdoc (together) last night. I liked him, this is the first time I have met him and he spent a good amount of time with us looking at the symptoms and med options for my husband. He stressed that it is most important to control the moods (he is currently on lithium), and talked with us about adding another mood stabilizer down the road if the lithium seems to be ineffective again. It worked very well for him in the beginning, but has had to be increased several times. You can only increase it so much! This reminds me of a post that Tsohl left for me a while back, about combining mood stabilizers. We aren't at that point YET, as the lithium (currently) seems to have stabilized his mood by itself. But we still have the ADHD to deal with now, as my husband still complains of not being able to focus or concentrate, follow thru on tasks, etc...It seemed to me that the pdoc was hesitant to try him on another drug for ADHD, but he did write him a script to try Adderall, which apparently is a different compound from Ritalin. We have to watch him closely, because once again it could push him into mania/depression if he does not take well to it. This is so frustrating - what are we going to do if the Adderall doesn't work and he still has trouble focusing/concentrating? I mean, how many more meds are out there that can help him with this? He insists he won't FEEL COMPLETELY WELL unless he can also get help with the ADHD. Seems tricky to balance BP with managing ADHD.
I am hesitant to believe this for good, but at the moment I believe my husband is finally somewhat accepting that he is ill and needs ongoing treatment. I know he still questions his BP diagnosis, but I have encouraged him if he does, that he should ask for yet another evaluation...and maybe even one of those brain scans in the future. His moods (mania/depression) and all the other symptoms he has exhibited for many years are seemingly obvious to everyone but himself. He still doesn't seem to remember just how bad it was when he was unmedicated and I was wondering what was going on and why his entire personality was changing.
Another good sign...he is not complaining about going to therapy, but just going on his own. I think this may also be helping him. He seems more receptive to me and seems to listen more when I talk with him. All of a sudden nothing is my fault anymore...
...but on to the present - I know it can be a long road, but I'm just praying we can find the right med combo for him SOON. I want him to be well, to be stable, to enjoy his life again.
I welcome any insight on the battle to find the right med combos for BP/ADHD. What has worked, what hasn't, what to watch for? :confused:
You are all in my thoughts, I feel so thankful to have such wonderful friends who understand on this forum!!
Love,
4support
After several days off the first ADHD med (Concerta...slow release Ritalin), my husband has came out of the depression (thank goodness!), apparently this was a chemical side effect due to this med, although rare, it appeared to have caused a slump for my husband. So we went to see his pdoc (together) last night. I liked him, this is the first time I have met him and he spent a good amount of time with us looking at the symptoms and med options for my husband. He stressed that it is most important to control the moods (he is currently on lithium), and talked with us about adding another mood stabilizer down the road if the lithium seems to be ineffective again. It worked very well for him in the beginning, but has had to be increased several times. You can only increase it so much! This reminds me of a post that Tsohl left for me a while back, about combining mood stabilizers. We aren't at that point YET, as the lithium (currently) seems to have stabilized his mood by itself. But we still have the ADHD to deal with now, as my husband still complains of not being able to focus or concentrate, follow thru on tasks, etc...It seemed to me that the pdoc was hesitant to try him on another drug for ADHD, but he did write him a script to try Adderall, which apparently is a different compound from Ritalin. We have to watch him closely, because once again it could push him into mania/depression if he does not take well to it. This is so frustrating - what are we going to do if the Adderall doesn't work and he still has trouble focusing/concentrating? I mean, how many more meds are out there that can help him with this? He insists he won't FEEL COMPLETELY WELL unless he can also get help with the ADHD. Seems tricky to balance BP with managing ADHD.
I am hesitant to believe this for good, but at the moment I believe my husband is finally somewhat accepting that he is ill and needs ongoing treatment. I know he still questions his BP diagnosis, but I have encouraged him if he does, that he should ask for yet another evaluation...and maybe even one of those brain scans in the future. His moods (mania/depression) and all the other symptoms he has exhibited for many years are seemingly obvious to everyone but himself. He still doesn't seem to remember just how bad it was when he was unmedicated and I was wondering what was going on and why his entire personality was changing.
Another good sign...he is not complaining about going to therapy, but just going on his own. I think this may also be helping him. He seems more receptive to me and seems to listen more when I talk with him. All of a sudden nothing is my fault anymore...
...but on to the present - I know it can be a long road, but I'm just praying we can find the right med combo for him SOON. I want him to be well, to be stable, to enjoy his life again.
I welcome any insight on the battle to find the right med combos for BP/ADHD. What has worked, what hasn't, what to watch for? :confused:
You are all in my thoughts, I feel so thankful to have such wonderful friends who understand on this forum!!
Love,
4support
tsohl
03-15-2007, 02:50 PM
Hey 4support,
I was wondering how things were going. Glad to see your update.
I am going to repeat a bit of what I said before. Your husband may not actually need meds for ADHD. His symptoms that he perceives as being caused by ADHD or ADD could just be symptoms of the bipolarity. If he were totally stabilized, he might not be feeling them. This is where the addition of a second or even a third mood stabilizer comes in to play. This is where some of the newer thinking comes in: if the patient is indeed stable and free of symptoms (episodes) there is less or no need for these add-on medications. Each mood stabilizer works slightly differently...i.e. one helps with mania; one helps with depressive symptoms...combined you are "neutral." This is an incredibly simplified version of what they do...but, you get the picture.
Also sometimes when a med is increased, you first have some side effects that go away in time -- things like lack of concentration, etc. So I can see why the pdoc is reluctant to automatically give him a med for ADHD. So often the symptoms of ADHD and bipolar mimic each other. I think this is all I have to say...at least for now. I need to get going as I have an appointment...I'll check back later!
I'm pleased that things are going better for you :blob_fire !!
Hugs,
Tsohl
I was wondering how things were going. Glad to see your update.
I am going to repeat a bit of what I said before. Your husband may not actually need meds for ADHD. His symptoms that he perceives as being caused by ADHD or ADD could just be symptoms of the bipolarity. If he were totally stabilized, he might not be feeling them. This is where the addition of a second or even a third mood stabilizer comes in to play. This is where some of the newer thinking comes in: if the patient is indeed stable and free of symptoms (episodes) there is less or no need for these add-on medications. Each mood stabilizer works slightly differently...i.e. one helps with mania; one helps with depressive symptoms...combined you are "neutral." This is an incredibly simplified version of what they do...but, you get the picture.
Also sometimes when a med is increased, you first have some side effects that go away in time -- things like lack of concentration, etc. So I can see why the pdoc is reluctant to automatically give him a med for ADHD. So often the symptoms of ADHD and bipolar mimic each other. I think this is all I have to say...at least for now. I need to get going as I have an appointment...I'll check back later!
I'm pleased that things are going better for you :blob_fire !!
Hugs,
Tsohl
4support
03-15-2007, 10:54 PM
Hi Tsohl,
I have to agree that I am relieved that things are at least progressing hopefully in the right direction! I do think I am conditioned to being very 'cautious' however, due to the nature of the illness. Were you like this with your son before he became stable?
Today was my husband's first day taking the Adderall, in addition to the lithium. I checked on him throughout the day and he said he was feeling pretty good, maybe a little different, but honestly I think it will take at least a week to see what happens. It was a week before the last ADHD med put him in such a slump, so we are watching carefully. What is really amazing me is how receptive he is to me now, to my suggestions and opinions. This may indicate stability, but he still complains of not being able to focus/concentrate, etc... I think what is confusing him is that he had an all-day evaluation with testing, written tests, etc...where they dx him as ADHD with BP II. So he says...if he is definetely ADHD, then why can't he take meds for ADHD to help? I have explained to him why the pdoc may have hesitated giving him another ADHD med and he at least listened. The pdoc also explained the importance of stabilizing the mood FIRST, but my husband INSISTED on having ADHD meds too. It will be interesting to see what happens. I am reading a 50/50 success rate with people taking Adderall who have BP/ADHD. So this could go either way! Another 3 weeks until the next pdoc appt.
Tonight my husband is at his therapy session and at least he is going 100% willingly now and not complaining about it. I hope it stays this way. He seems to be having some realizations. It's nice to have him back more his normal self.
More updates soon...
Hope all is well on your end!
Your Friend,
4support
I have to agree that I am relieved that things are at least progressing hopefully in the right direction! I do think I am conditioned to being very 'cautious' however, due to the nature of the illness. Were you like this with your son before he became stable?
Today was my husband's first day taking the Adderall, in addition to the lithium. I checked on him throughout the day and he said he was feeling pretty good, maybe a little different, but honestly I think it will take at least a week to see what happens. It was a week before the last ADHD med put him in such a slump, so we are watching carefully. What is really amazing me is how receptive he is to me now, to my suggestions and opinions. This may indicate stability, but he still complains of not being able to focus/concentrate, etc... I think what is confusing him is that he had an all-day evaluation with testing, written tests, etc...where they dx him as ADHD with BP II. So he says...if he is definetely ADHD, then why can't he take meds for ADHD to help? I have explained to him why the pdoc may have hesitated giving him another ADHD med and he at least listened. The pdoc also explained the importance of stabilizing the mood FIRST, but my husband INSISTED on having ADHD meds too. It will be interesting to see what happens. I am reading a 50/50 success rate with people taking Adderall who have BP/ADHD. So this could go either way! Another 3 weeks until the next pdoc appt.
Tonight my husband is at his therapy session and at least he is going 100% willingly now and not complaining about it. I hope it stays this way. He seems to be having some realizations. It's nice to have him back more his normal self.
More updates soon...
Hope all is well on your end!
Your Friend,
4support
tsohl
03-27-2007, 09:10 PM
Hi 4support,
Haven't heard from you in awhile. I was just checking in to see how things are going. I hope the meds are working for your husband....Please post and let us know what's going on in your world.
:wave: Tsohl
Haven't heard from you in awhile. I was just checking in to see how things are going. I hope the meds are working for your husband....Please post and let us know what's going on in your world.
:wave: Tsohl
jen1008
03-29-2007, 08:48 AM
I also have BP II and ADD, I have been taking Lamictal and Adderall for almost 3 years with no problems!:)
4support
04-02-2007, 11:45 AM
Hi Jen,
Thank you so much for posting...it is very helpful to talk with someone else dx as BP II / ADD, same as my hubbie. I was curious if you have ever taken another mood stabilizer with the Adderall? My husband takes Lithium and Adderall and the combo seems to be working pretty well. He has had his Lithium increased 3-4 times though over the last 3 yrs, and the next time he may have to try a new mood stabilizer, or a mix. I am hoping Lamictal would be a good option for him, but you never know until you try!
Any other insight or experience of yours relating to treatment, meds, etc...is so much appreciated. It has taken us a long time to find the best med combo for him. You said that you you've been stable for 3 yrs and that is fantastic! My husband has been stable only for a few weeks on this combo, so I'm hoping he has the same luck that you have!
All the best and thank you again for sharing!
4support
Thank you so much for posting...it is very helpful to talk with someone else dx as BP II / ADD, same as my hubbie. I was curious if you have ever taken another mood stabilizer with the Adderall? My husband takes Lithium and Adderall and the combo seems to be working pretty well. He has had his Lithium increased 3-4 times though over the last 3 yrs, and the next time he may have to try a new mood stabilizer, or a mix. I am hoping Lamictal would be a good option for him, but you never know until you try!
Any other insight or experience of yours relating to treatment, meds, etc...is so much appreciated. It has taken us a long time to find the best med combo for him. You said that you you've been stable for 3 yrs and that is fantastic! My husband has been stable only for a few weeks on this combo, so I'm hoping he has the same luck that you have!
All the best and thank you again for sharing!
4support
KissAmeGal
04-03-2007, 10:43 PM
From personal experience with my son..........he was dx'd with ADHD/ODD/BP. The ADHD meds did nothing for him but make things worse. It seemed in the beginning that he was doing good with them, but evidentally after they got in his system, it made things worse. He was also on Depakote which made him OMG!! horrible! It was to the point that i had to have him admitted to a behavioral center for a few days. From there, they took him off the Concerta, Depakote & Trazadone and started him ONLY on Abilify. it's a low dose which may need to be upped. But things are soooo much better than b4.
take care :wave:
take care :wave:
tsohl
04-03-2007, 10:59 PM
Hi 4Support,
I think I wrote this to you before. Increasingly research is finding that many who were previously thought to be ADD/ADHD are actually bipolar. When properly stabilized with one or more mood stabilizers the issues of ADD go away. Lamictal is often a good add-on to lithium. I have no idea how it works with Adderrall, but I'm sure your pdoc does...so it would be worth a try if he suggests it.
I know you asked me a question on another thread that I just noticed today, but I can't remember what it was. Something about being stabilized...do you remember?? I didn't respond because it was on someone else's post. If I can find it, I'll come back here to answer you.
I had been thinking about you and wondering how things were going, but I wasn't sure where to post an inquiry! So I'll do it here!!
Blessings,
Tsohl:wave:
I think I wrote this to you before. Increasingly research is finding that many who were previously thought to be ADD/ADHD are actually bipolar. When properly stabilized with one or more mood stabilizers the issues of ADD go away. Lamictal is often a good add-on to lithium. I have no idea how it works with Adderrall, but I'm sure your pdoc does...so it would be worth a try if he suggests it.
I know you asked me a question on another thread that I just noticed today, but I can't remember what it was. Something about being stabilized...do you remember?? I didn't respond because it was on someone else's post. If I can find it, I'll come back here to answer you.
I had been thinking about you and wondering how things were going, but I wasn't sure where to post an inquiry! So I'll do it here!!
Blessings,
Tsohl:wave:
michael178
04-04-2007, 03:17 PM
there are two types of ADD medications. The traditional med is a narcotic, like speed, it is sometimes used as a antidepressant, because it is a mood elevator. It acts on the prefrontal lobes controlling executive functioning skills like ability to organize, and execute. The other is an noepernepherine reuptake inhibiter, which changes the mix of neurotransmitters in the brain. It is considered the less dangerous of the two. But they are all fairly safe.
With all that said. I agree with Tsohl completely.
With all that said. I agree with Tsohl completely.
jen1008
04-06-2007, 09:13 AM
4Support,
I have had other meds mixed in with the Lamictal and Adderall, but not another mood stabilizer. Risperdal, Trazodone, Buspar, Klonopin, Seroquel--but the only two that have ever worked consistently have been the Lamictal and Adderall. My pdoc monitors the Adderall very closely so I don't become manic, but the depression side is worse for me anyways--If mania is your chief concern, I would be very careful with stimulants; it can turn out very bad if left unchecked. Good Luck!
~Jen
I have had other meds mixed in with the Lamictal and Adderall, but not another mood stabilizer. Risperdal, Trazodone, Buspar, Klonopin, Seroquel--but the only two that have ever worked consistently have been the Lamictal and Adderall. My pdoc monitors the Adderall very closely so I don't become manic, but the depression side is worse for me anyways--If mania is your chief concern, I would be very careful with stimulants; it can turn out very bad if left unchecked. Good Luck!
~Jen
tsohl
04-10-2007, 11:04 AM
Hello 4support,
I am just popping in to say hello. How are things going in your world? I hope the fact that we haven't heard from you in awhile is a good sign. :)
How's your husband doing on the meds? Is he continuing with the therapy?
Hang in there!
:wave: Tsohl
I am just popping in to say hello. How are things going in your world? I hope the fact that we haven't heard from you in awhile is a good sign. :)
How's your husband doing on the meds? Is he continuing with the therapy?
Hang in there!
:wave: Tsohl
tsohl
04-14-2007, 02:42 AM
Hello,
Me again--just was thinking about you and your family. How are things going???
xxxTsohl
Me again--just was thinking about you and your family. How are things going???
xxxTsohl
Lulu70
06-20-2007, 07:17 PM
Hi, I was just looking through some posts and came across yours I dont know if you got your answer but Im on depakote, effexor, and ritalin, klonapin, and i only take them when im working, becuz if i constantly took them they wear my body out, to wear i cant get out of bed, they are like speed to me.
so i dont take them as perscribed, yes they help at work but after a while im so wore out that they dont work, and im useless and usually have to go home and rest for days.....
Hope you did get your answers, i hate to see anyone suffering...
so i dont take them as perscribed, yes they help at work but after a while im so wore out that they dont work, and im useless and usually have to go home and rest for days.....
Hope you did get your answers, i hate to see anyone suffering...