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  • Adderall: annoying/weird come down effect

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    Old 06-18-2010, 03:27 PM   #16
    addprogrammer
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    Re: Adderall: annoying/weird come down effect

    If you didn't do a joint or two, you are maladjusted. I meant if addiction is a problem for you, your doctor should know. There is no reason to mention the 1/4 joint that you never inhaled. Say nothing and if asked say "no."

    Your doctor should be aware of your history and the pattern it shows. Of the three ADHD med trials, Adderall caused an anxiety reaction but not as severe as the others. The more a med affects dopamine the better you do. Where do we go from here?

    Certainly we don't move to a med that affects norepi and has no effect on dopamine such as Strattera. Your doctor sees the pattern your history displays. He also knows if his prescription audit shows too many Dexedrine prescriptions, (in PA, one is one too many), he gets harassed and could lose his license.

    My shrink readily gave me a Dexedrine prescription. The first got filled at Walmart, no fuss, no muss. The next month, I'm told they can't get it anymore. My wife called all the chains and all the mom & pops, none of them would order it for me. My wife told me one said, "are you crazy?" She came back with "No, but my husband is." I roared. Then I did my outburst, invective, rant, diatrible, haranque, tirade (ran the Theasaurus), then with virulent sarcasm, "well at least they cleared up the methamphetamine pandemic." Then did another outburst, rant, etc. etc. and keep going until I noticed my woman gone. Then I stopped and left too.

    It sucks. Vyvanse is extortion. If you got 2 or 3 hundred a month, you get protected. Otherwise, put up with the anxiety.

    What is, is.

    Bob

     
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    Old 06-18-2010, 09:53 PM   #17
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    Re: Adderall: annoying/weird come down effect

    To clarify, when I said Vyvanse isn't exactly dextroamphetamine, what I meant was, like Concerta, the pill itself is not the active ingredient. Both these meds are designed to be metabolized into the active ingredient, dextroamphetamine in the case of Vyvanse, and methylphenidate in the case of Concerta.

    I had good success with generic methylphenidate, and no effect whatsoever from Concerta. The only conclusion I've been able to pull from this is that my system doesn't metabolize the drug as expected, and thus I don't get the effect. This is why I'm very leery of Vyvanse as well, though I haven't tried it.

    If your doctor insists on a non-stimulant option for you, ask him to consider Wellbutrin. Although it's generally considered a second-line treatment for ADHD, it does affect dopamine in addition to norepinephrine. This, in my mind, makes it a better option than Strattera.

     
    Old 06-19-2010, 08:40 AM   #18
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    Re: Adderall: annoying/weird come down effect

    My husband has severe ADHD and has tried a lot of medications, but Adderall was not one that he could tolerate. The rebound effects made him so hard to live with that he just avoided coming home. He never complained of anxiety and heart palpitations. He is now taking Strattera. It doesn't give him the brain clarity that the Adderall did, but he's much easier to get along with and it's not a triplicate prescription (controlled) so its easier to get refilled. We know that his concentration and memory could be better, and we are still trying to find the ideal treatment, but this is working for us for now. There are a lot of different medications and even some new ones. You and your doctor will have to find out what works for you.

    As for the anxiety and heart palpitations, that could be from side effects, improper dosage, anxiety issues, endocrine problems, or even low blood sugar. Writing down when it happens in relation to your medication dosage, meals, etc. will better help your doctor determine what is causing the problem.

    My husband also has problems with being able to relax at night to go to sleep, so he stays up late. Then, he takes medication to sleep, and wakes up groggy and tired when the alarm wakes him. He also has a little sleep apnea. He was tested, and apparently it wasn't enough to warrant a CPAP machine. But, I have watched him snore, obstruct, and stir quite often in the morning. No wonder he can't concentrate. He also has depression and diabetes and occasionally his blood sugar dips from the insulin causing all sorts of symptoms. So, the effects you are feeling could be from a lot of things and not just your medication.

    We also saw an ADHD specialist in LA, who also suffered from ADHD and was supposed to be the best in his field. He spun the roulette wheel, and tried him on quite a few different medications. He kept us coming back, traveling several hours to see him, and kept promising to find the right one. He never did. We eventually went back to a very good internist who is now prescribing his medication. By the way, his PA is also very competent and I respect the fact that she knows her limitations and consults the books (PDR) on occasion (there are so many meds out there). If you don't trust your doctor's knowledge on the subject, and your insurance allows, perhaps your doctor can refer you to a psychiatrist who specializes in treating patients with ADHD. You might luck out.
    Hope this helps.

    Last edited by Sunsetnan; 06-19-2010 at 09:04 AM. Reason: Adding text for clarification

     
    Old 06-19-2010, 09:17 AM   #19
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    Re: Adderall: annoying/weird come down effect

    I wonder what the availability is of it in Missouri, we are the #1 state in America for meth labs lol. I just don't want to come across to my doctor that I'm just trying to get like stronger drugs or something. I've become so paranoid about that since I get treated like a criminal at the pharmacies. I'm afraid that he doesn't know enough about these meds to know the difference in all of them. Is it normal that I've gotten two prescriptions in one week? I got focalin and couldn't handle the side effects so my doc prescribed adderall. Before then I still had like 3 weeks left of my ritalin. There's all these rules about it, but she was sure handing out scripts like crazy! None of them are even useful to me lol thats the crappy thing.

    I do currently take wellbutrin SR 150mg per day. I also take citalopram at night just to balance things out I guess. But I definitely want to stay away from strattera. Nothing about it seems appealing, just doesn't seem like it's what I need. He isn't trying to insist on it but he'll probably want me to try that before dex so I'll just have to see how to handle that when it comes up!

    Do yall know which chemicals ritalin effect? My mom takes ritalin and I was telling her about our conversations on here so now she wants to know lol. Thanks everyone

     
    Old 06-19-2010, 09:25 AM   #20
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    Re: Adderall: annoying/weird come down effect

    ST22 & Thunor,

    This AM while having a relaxed breakfast with my wife I said to her in reference to ST22, "Yet another victim of legislation. The girl has a type of ADHD that is as easy as can be to medically manage. Dexedrine."

    I felt the rage building, and wife saw it coming, and told me, "you can't change city hall. Accept it."

    Now I know the source of my rage.

    The reason medication fails so often and multiple trials end up in smoke and ruins has little to do with bozo doctors. My opinion has been a source irreconcilable conflict for me. How can I more accurately see the patterns when many trained, skilled and experienced doctors can't. The consensus of opinion is "I'm just kidding myself" and my opinion is not taken seriously. It should not be. I'm wrong.

    My shrink readily prescribe Dexedrine. I couldn't get it. That is not his fault. Psychiatrists can get away with more Dexedrine prescriptions than GP's. The audit sirens and flashing red strobes go off at a higher number of Dex prescriptions per period. Busted is busted.

    We may be the only group where governmental legislation has far more control over the medication we get than our doctor's discernment made in our best medical interests.

    That, my friends, is absolute truth. That is why I hissy fit every time the ST22 experience pops up.

    Thu, Wellbutrin won't do squat for ST22.

    ST22 you can take that to the bank. Don't take a Wellbutrin presciption to the pharmacy. Wellbutrin's anxiety side effect rate is in there with Ritalin and it doesn't help as well control ADHD.

    Bye,
    Bob

     
    Old 06-19-2010, 09:44 AM   #21
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    Re: Adderall: annoying/weird come down effect

    You're right....it's totally wrong how doctors can't even prescribe what they want! Makes me really mad too! Thank you so much for all of your advice and amusing posts, the interaction with your wife is too cute I look forward to seeing more of your posts/threads in the future!

     
    Old 06-19-2010, 07:15 PM   #22
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    Re: Adderall: annoying/weird come down effect

    Bob, you know how I hate to disagree with you, so I'll keep it short and hope you'll forgive me one of these days.

    I can't say enough to describe the difference in my life that Wellbutrin has made in the last couple of months. It's like someone dug into my brain and flicked the 'concentration, motivation and self control' switch. Now I'll grant you that my dose of Wellbutrin is ludicrously high, and it is augmented with Adderall, but I simply can't get over the difference it's made, I'm not the same person.

    That said, I don't expect it will work for everyone, I simply feel that it's an option that shouldn't be entirely ignored. The fact that it treats the same neurotransmitters as the stimulants, in my mind, makes it a better option than Strattera, which does only half the job. I can't speak to anxiety, it's generally not part of my symptom set, and as such I may be overlooking it.

    Interesting side note, if you think getting Dexedrine is hard, you wouldn't believe the stories I've read of people trying to get their hands on Desoxyn, a med that is actually methamphetamine, approved in the US for treatment of ADHD, yet virtually impossible to get a scrip or find a pharmacy for. Sadly it's full on illegal in Canada.


    Sunsetnan, I'm sorry to hear your husband's story, I know well the pain of trying to find the right med. While you developed the impression that your doctor was simply spinning the medication wheel and hoping for the best, he was doing the right thing. Finding the right med for an individual can be a long and difficult process, and the only way to tell how someone is going to respond to a med is to try them on it and watch. It's taken me more than two full years (27 months) to find the right combination at the right dose, but the difference is simply outstanding (I'm trying to think of superlatives to describe it, but I'm falling short). Less than three months ago, I was convinced that I was somehow broken in a way that couldn't be fixed, and was pretty much ready to give up. I've tried every legal treatment in Canada except one at several different doses. I've mixed different meds, I've tried taking my meds at different times of the day, nothing worked consistently until my latest scrip. I'm looking forward to seeing my psychiatrist in a month to tell him how great things are going, we finally found the right combination.

    Don't get me wrong, if you and your husband feel that Strattera is the right med, then stick with it; no one save your husband and you can tell you which medication is the right one, it's all about what works for you. But if you find that you're hoping for something better down the road, don't be afraid to find a doctor that's willing to experiment, you may find that it's worth the time.

    Best of luck!

     
    Old 06-19-2010, 10:12 PM   #23
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    Re: Adderall: annoying/weird come down effect

    I'm sorry to hear about your husband's battle too. It is so hard to find the right meds since it usually takes a few weeks to know if its right or not....it takes forever! That is awesome if strattera works for him! It's probably easier to get and no one looks at him like an addict when he walks in the pharmacy to pick it up! I wish I did have the insurance to go to a psychiatrist but unfortunately I can't at the moment. My doctor seems open to try things, I just hope he knows about it lol. Just hang in there with the different docs and meds....it'll get better and if not, we're always here to listen/complain/rant with you

     
    Old 06-20-2010, 08:02 PM   #24
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    Re: Adderall: annoying/weird come down effect

    Thu,

    You should disagree with me. Wellbutrin has helped many with ADHD.

    I opinioned that ST22 wouldn't do well on wellbutrin.

    I'm working on a summary to help myself account for the differences in our ADHD group. I do better on Dexedrine. You do better on Adderall. Why?

    I'm attacking it from the cognition side. Conversion is simple. Neurotransmitters are the mechanics of cognition.

    I start with simplified definitions of the (brain) modules affecting attention. The "where is the bug" questions I ask next I can't answer. Each of us has the same subset of attention problems. If the cause is the same, we have the same extended symptom cluster and we respond to the same meds. Otherwise, we don't.

    Think of it as my hypothesis to explain the differences within our ADHD group. You are forgiven in advance if you disagree. I'll hate you if you disagree and don't disagree. I'll never learn a damn thing.

    Ready? Here goes:

    Working memory refers to the capacity to hold information “on-line” in mind for manipulation not passive maintenance. Working memory "inherits" three major memory modules. Audio, Visual-Spatial, and Integration/Sequencing. Working memory doesn't do any work. It is where the work is done.

    Central Executive controls working memory IO (Input Output) . Input comes through all 5 senses. Eyeballs convert light into electrical impulses that the brain interprets as vision. Central Executive determines the "visual objects" that go to working memory. Central Executive determines what to load from long term and other internal memory types.

    Central Executive performs attention functions on the various "file types" loaded into working memory.
    * binding information from a number of sources into coherent episodes
    * shifting between tasks or retrieval strategies
    * selective attention and inhibition

    Central Executive inherits many function modules, one of which the inhibition controller.

    If all goes well, and it certainly doesn't with me, Central Executive works over the data in working memory and outputs solved problems, action plans, behavior, social interaction, and what comes out of my mouth that I wished hadn't.

    Where is the bug(s)? Is it in working memory? Is it one of the major memory modules? Is is leaky? Does it flush too quickly or persist too long. Or is the bug in one of the many Central Executive function modules? Do I have an out of control inhibition controller? Or is it in a module outside Central Executive such as our Sensory Interface module. Is a visual or auditory processing disorder feeding garbage in to CE? Garbage in. Garbage out.

    We read with our eyes. Is Auditory or Visual memory used? The language symbols on the page are converted into language sounds in our head that are processed in working memory's auditory module.

    If you have trouble reading but have less trouble listening, where is the bug? Can't be auditory memory? Not necessarily. Reading with comprehension requires larger blocks of working memory for longer periods of time. Reading could exceed an auditory memory deficit whereas less intensive listening does not.

    I used layman's terms in a few cases to make it easier for me to understand. The summary is from 5 scholarly type documents. I eliminated most of the information and reduced the rest. I use analogous computer terms because the authors did. They drew from volumes of research that convinced me that terms such as "working memory" conceptually describe how the brain works. Our brains our highly layed where top level functions inherit many layers of functions and properties. Brains epitomize OOP - Object Oriented Programming. Our brains epitomize OOPS. That's no acronym.

    Time for sleepy.

    Bob

     
    Old 06-20-2010, 09:42 PM   #25
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    Re: Adderall: annoying/weird come down effect

    Wow, that's a handful. You've delved deeper into the problem than my current understanding of the issue can handle. It's probably going to take me a day or two to manage a cogent reply, so I'll just throw in a random thought or two.

    My understanding of ADHD is that there's a neurotransmitter shortage. In simple terms, my concept of what's going on is something along these lines. For whatever reason, many ADHD sufferers find themselves short on PEA. PEA is short for Phenethylamine, which apparently works as a neuromodulator within the central nervous system, acting to release dopamine and norepinephrine. In this way, its effects are very similar to our friend amphetamine. This shortage of PEA likewise leads to a shortage of those neurotransmitters that are controlled by it. Several studies have shown that PEA from outside sources can have the effect of dramatically improving ADHD symptoms. This would lead one to believe that PEA is the holy grail of ADHD medication, and many companies are trying to capitalize on that impression. The problem is that PEA is very rapidly metabolized by MAO B within both the digestive and nervous systems, making it virtually impossible to get into the brain without practically injecting it directly or taking MAO inhibitors, neither of which is ideal in a real world setting. As a result, we're stuck with a more stable analogue, amphetamine.

    Wow, a bit of a digression there . . . anyway, we all may or may not know that messages within the brain and CNS are transmitted by a hybrid electrical and chemical system. Simply, as I understand it, messages, once generated or passed on from the nucleus of a neuron, travel down the axon as an electric impulse. Because these messages cannot travel electrically across a synapse to another neuron, however, they are translated into a chemical signal, expressed as a release of neurotransmitters across the synapse, which are then received by the next neuron in the chain, which either acts on the message or passes it on. In this system, not enough neurotransmitters means messages die in the synapses, never reaching their ultimate destination. The end result of this situation means that a well meaning higher brain might have trouble providing guidance to a more primal lower brain, leading to a higher likelyhood to act on impulse, or to have difficulty deciding which stimulus requires attention at any given time.

    Obviously, this is probably massively oversimplified and half wrong, but this is how I've come to understand the disorder. The lack of neurotransmitters leads to spotty communication between the higher and lower brains, so the executive functions that the higher brain is responsible for, self control, motivation, attention suffer to one degree or another, depending on the severity of the shortage. To state a poor analogy: the head office is having trouble coordinating the guys in the field because there aren't enough cell towers for all the boys to get a dependable signal. Supplementation of our neurotransmitter pool, as provided by amphetamine or other similar chemicals, provides us the ability to have our brains better communicate internally and to the CNS.

    So there, it doesn't speak specifically to your post, but that's my random 40 minute thought. I really should have gone to bed instead of getting off on another tangent.

     
    Old 06-21-2010, 06:47 AM   #26
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    Re: Adderall: annoying/weird come down effect

    ST22,

    You can learn something from our nonsense (Thu and me). ADHD sufferers respond to different ADHD medications. One medication is superior to all others in my case - Dexedrine. By no means is Dexedrine top dog across the board.

    The researchers looking for better meds can drop dead or go find work elsewhere as far as I'm concerned. Our solution was discovered 100 years ago. "They've" given dextroamphetamine, a freaking inaminate chemical, personality. It's the Devil. He gonna get you. "They" are protecting us from the Devil by locking him up good. The Devil morphed into a "better" inanimate chemical called methamphetamine, short for dextromethamphetamine.

    My wife is always right. I'm always wrong. Seriously. "Accept it." cuz I'm can't change it.

    Your doctor may be able to prescribe a med that offsets Adderall's anxiety side effect. A few of the antidepressants in the SSRI class are effective anti-anxiety meds too. I forget which ones. May be Paxil. Ask your doctor.

    Even if he prescribes Dexedrine, you most likely won't be able to get it anyway.

    Bob

     
    Old 06-21-2010, 12:27 PM   #27
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    Re: Adderall: annoying/weird come down effect

    Thank you for your kind invitation for me to complain and rant. I certainly have a lot of complaints, and sometimes the stress is overwhelming for the spouse of an ADHD sufferer. I have problems with brain fog from Lupus and Fibromyalgia, so I can uniquely identify with some of my husband's problems with ADHD. And with my chronic illness and his, it makes for a challenging life with our two teenage boys. Although not officially diagnosed, we suspect our youngest will most likely need to be on medications at some point in his life for ADHD.

    It is very interesting to read your thoughts on ADHD and the different neurochemicals and mechanisms of the human mind. When we went to UCLA (twice) and he was tested extensively and diagnosed with ADHD, they did not explain the disorder nearly as detailed as you have. I have to sadly admit, we only have one book on the subject, and it's binding is full of dust. (That was not meant to reflect on my housekeeping.) Sounds like I should take a more active role in studying up on the subject.

    When my husband was on Dexadrine, he did have some trouble finding a pharmacy that carried it, but once we found one, that was a non- issue. We lived in a big city at that point. My husband simply did not prefer it as a medication choice. (I forget the reason, it was so long ago.)

    Maybe making the analogy of the roulette wheel was not fair, but it seemed as if the specialist's suggestions for changing medications wasn't very methodical nor prescribed for his specific symptoms in mind. Also, we were driving a long distance to see him, and it seemed pointless to travel all that way for a minor tweak to the dosage. (A telephone call would have sufficed.) After a while, we felt as if monetary considerations were more important to him than finding the right medication combination and dosage. That may not have been true, but that was our impression of the situation. Maybe it's time we try another psychiatrist (closer to our area) since we've recently moved.

    Even on Strattera, my husband still suffers from concentrating obsessively, taking forever to finish a project if at all, always on the go, poor judgement, acting on impulse, not learning from his mistakes, difficulty setting priorities and staying on task, etc. However, so far he has been able to keep his job, and for that we are grateful. (To be fair, he is also very intelligent, thoughtful, loving, and has a weird sense of humor.)

    I take an SSRI (Zoloft) that helps with anxiety symptoms, although I take it for other reasons. However, my husband cannot take any in this class of drugs because he goes "manic" on them, including thoughts of suicide. He takes Effexor XR and that has seemed to manage his depression (and would help with anxiety symptoms).

    I would recommend that you make sure that you eat snacks regularly, if you don't now. I know that the medications ADHD sufferers take can supress the appetite, and low blood sugar can give you similar feelings as anxiety. My husband is diabetic and must eat snacks anyway, and he has a hard problem keeping weight on. And, when his meds start wearing off in the evening, he is ravenous. Hard to know which is from the insulin or wearing off the ADHD meds.

    If you don't mind me asking on your thread, what are some of the newer meds for adult ADHD, and do you know if any of them are worth trying? I've seen a few magazine ads that claim they last longer. But, is that good if you have problems getting sleepy, like my husband? Thanks.

     
    Old 06-21-2010, 05:00 PM   #28
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    Re: Adderall: annoying/weird come down effect

    Sunset, I'm sorry I don't have time to respond properly at the moment, but I wanted to mention a couple of things.

    My intent wasn't to insinuate that you were wrong in ditching your doctor. Bob can tell you all about the fun I had finding a good one, and my opinion of the medical profession overall.

    The newer medications are generally no more than reformulations of old medications. Vyvanse is Dexedrine, Concerta is Ritalin, and any others are one or the other.

    I'll check in when I have more time, in the meantime, best of luck!

     
    Old 06-21-2010, 05:13 PM   #29
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    Re: Adderall: annoying/weird come down effect

    I do have problems concentrating obsessively.....just not on things that I need to get done! I haven't heard of new ADHD medications but I did just read a study on Mirapex being used for depression. It is usually used for parkinson's but it increases dopamine effectively in all subjects that were used (for depression). I know that was pretty random but I haven't heard of anything else really. Did you say that your husband has problems being too sleepy or problems getting to sleep? I have problems getting to sleep but I've had that long before I was on ADHD meds. I take ambien and it works very well for me and it also soothes me at night when the adderall or ritalin is wearing off.

    As for the wellbutrin....I decided to skip it yesterday just to see what happened since I'm paranoid now that I have too much norepinephrine lol. I seemed to feel happier. I wonder if it would be a good idea to start taking them every other day? I know I should ask my doctor but I just don't really want to go in and discuss something else. I already feel like a complainer! I like being able to mess around with my dosing to see what is really right for me.

     
    Old 06-21-2010, 10:32 PM   #30
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    Re: Adderall: annoying/weird come down effect

    it's probably too strong for you adderall usually raises the heat beat who don't need it but it does not wear off fast so talk to your doctor

     
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