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Does anyone out there take stimulants for either ADD or as an adjunct antidepressant? I am BPII rapid cycler. Never had full-blown mania, just occasional (not often enough IMO) hypomania.

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Yep. I'm BP I. Love my adderall for adjunct depression and countering sedation from my meds

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BP I here and I take Vyvanse (Not typically a good idea but there's reason behind this). I also have horrible ADD and have always had trouble even listening to a converesation without ADD/ADHD meds. I also take Seroquel XR 400 so I think that pretty much prevents me from tipping to the other side. Also, I think the Vyvanse helps with the Seroquel sedation and the Seroquel XR helps with the Vyvanse overstimulation. Both together with Neurontin for anxiety keep me stable, sane, and focused.

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Hey, @Mindtrip! Welcome to the boards!

I have Bipolar 2 and ADHD as well. Bipolar disorder and ADHD do occur together with a fair amount of frequency. I was diagnosed with Bipolar 2 first, and it wasn't for another 1-2 years after that until I was diagnosed with ADHD and prescribed stimulants.

When you're bipolar, and especially when you're a rapid-cycler (like I am), you need to remember not to chase hypomania or motivation. Stimulants do motivate you for the first 1-3 weeks but after that the motivation goes away. The focus and concentration usually stick around unless you need to go up on dose, but the motivation is transient. It's important not to start on stimulants and just keep increasing to keep getting more motivated. Eventually you'll max out and just be over-stimulated.

What I had to learn was first separate my mood cycles from the attention/cognitive problems. What I find is that during the "up-end" of my mood, I hardly ever have trouble with attention/cognition, and when I'm depressed, I have a significant amount of trouble. However, once I got my mood swings under control, I would still have significant problems with attention/cognition during a normal/euthymic mood (neither hypomanic nor depressed). Once I was able to actually "put a finger on this", I spoke with my pdoc about it.

It's harder in adults because normally, ADHD is diagnosed when you're in elementary school, and the pdoc can come observe. Not so easy when you're an adult lol.

We had to determine what dose of stimulants would be enough for me to be productive, but not too much to make me hypomanic. So he prescribed me Adderall 5mg immediate release. His instructions were to take 1 tablet, wait an hour, then try to do something that requires my undivided attention. Sometimes I need to do tedious audits at work that require me to review large spreadsheets. So I chose this as my task. The idea being, how many sittings does it take me to complete this task? How often do I get up for breaks? Etc.

The next day, take two tablets this time, and try to do another productive task. The purpose to determine how much is too much, and how much is JUST ENOUGH. We ended up converting to Adderall XR 20mg. But issues with feeling like a zombie in the afternoon and just having it poop out starting at like 2PM prompted me to switch to Vyvanse. I've been up and down between 40mg and 30mg since. 40mg more so in the winters and 30mg in the summer.

It is possible for people with bipolar disorder to take stimulants, it just may require a little more tuning and attention. It will also require a lot of personal insight on your part to make sure that you aren't chasing hypomania. That took a while for me to learn.

Trintellix causes dopamine release, and I think Vyvanse, being as it does the same, works synergistically with Trintellix to increase that dopamine release. I also think the Vyvanse mixes well with the Rexulti. When I added the Rexulti, I felt more calm but at the same time slightly more stimulated. I also think Depakote has allowed me to take Vyvanse and stick at a dose longer without adjusting.

Most importantly, make sure your mood swings are under control FIRST before adding a stimulant.

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as an antidepressant it definetly helps me. And I guess that means I use it when my mood isn't totally stable 

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Hello & Thanks everyone for your replies. I was prescribed Dexedrine to help me concentrate at work, as an adjunct antidepressant and also to help gain some energy, because I have CFS/ME. I can't remember if I had been diagnosed as BP yet, as for years I was told I was MDD. Years after I was diagnosed as BP, I took 2 tests online written by a highly respected psychiatrist who specialized in BP. I scored much higher on the ADD test than the BP test. I've always had trouble focusing especially when others speak, but also reading and even watching TV and movies. I tried adderal, ritilan and vyvanse and none worked as well as Dexedrine. While both my psychiatrist and neurologist think it's fine, I get attitude from other medical/dental professionals because I also take Ativan to help get to sleep and during the day for anxiety.

Iceberg have you ever gotten an attitude from anyone about taking several psychiatric drugs? I have been looking for a new psychiatrist and went to one who sounded so great on the internet and has written books about BPs and he practically hit the ceiling when he saw what I was taking. He said any psychiatrist who prescribes more than 3 drugs doesn't know what he's doing. I take 5 drugs and 1 other that's an AD but I'm taking it for migraine.

BTW, how do you put in your dx and drugs on the bottom in grey? I'm new to this forum.

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Dexedrine and Vyvanse really aren't that different. Adderall is mixed amphetamine salts containing both levoamphetamine and dextroamphetamine. Dexedrine contains just dextroamphetamine, as does Vyvanse. But Vyvanse is bound to lysine as an abuse-deterrant and also to improve pharmacokinetics (makes it last longer and come down smoother). The problem with Dexedrine is that the pH of your digestive tract can greatly affect how it is metabolized. Whereas Vyvanse is not impacted by these kinds of parameters. How much Dexedrine do you take?

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4 hours ago, Mindtrip said:

BTW, how do you put in your dx and drugs on the bottom in grey? I'm new to this forum.

Click your name at the top of the page in the right-hand corner. Click Account Settings. Then click the Signature section.

Also you will notice in the drop-down under your name that there is a Profile section where you can also list them and/or go into more depth.

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Stimulants surprisingly have never made me manic. I take them to counter the sedation of clozapine and I find them also helpful for depression. 

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@Mindtrip I think that thing about only three meds is kinda wayyyy too much of a generalization. That would mean every single doc I've had was an idiot. 

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It seems kinda like a major handicap actually. I mean if you only need ~3 meds that's great! But what does that say about the tons of us on here who take way more than that... Of course I'm not shooting the messenger (u) cuz obviously this isn't ur opinion but that seems odd to me 

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bowri,  Vyvanse may contain dextroamphetamine but I had no reaction to it at all. It was as though I hadn't taken any stimulant. Everybody's system is different and will react differently to drugs that are slightly different but in the same class. Some people think Adderal is just as good as Dexedrine, but that wasn't my experience. Could be that I'm used to the Dexedrine as I've been taking it for many years. The biggest problem with it is the looks and sometimes comments you get from other doctors, dentists, pharmacists. It's ok if you take any of the other stimulants but if you take Dexedrine some people act as though you're a drug addict taking it for fun. Thanks for telling me about how to do the signature. I'm new here but very glad I stumbled upon this forum.

 

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Iceberg, I never went back to that psychiatrist who acted as though it were MY fault that I was taking 5 drugs for psychiatric reasons. Other medical professionals have made comments that I'm taking ups and downs, acting as though I were an addict. It got to the point that I left out some of the drugs (dexedrine & morphine). I have a top-notch neurologist who is actually a consultant for other neurologists who need help and he had no problem with the number or types of drugs i was taking. Only problem with him now is that because of all the hoopla about opiates killing so many people he can no longer prescribe morphine. I have daily migraines and need it when my acute migraine drugs don't work. I ended up taking a daily dose (+ more if needed) in the hot, humid summers which make my head explode as soon as I am not inside with AC. Coincidentally, I found that taken my minimal dose in the morning gave me energy and motivation to get out of bed. I once found an article in a medical journal that said that some people need opiates for psychiatric reasons because of some kind of deficiency or brain process. I have gotten off the daily dose twice by myself by decreasing gradually, which is what I'm doing now. But I digress...

I'm glad to have found other people who take more than 3 drugs so I can relate to someone. I have a couple of BP friends who take more than 3 drugs. That psychiatrist was an asshole. He was unprofessional in other ways and just plain nasty. I practically ran out of there and never went back.

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14 hours ago, Mindtrip said:

bowri,  Vyvanse may contain dextroamphetamine but I had no reaction to it at all. It was as though I hadn't taken any stimulant. Everybody's system is different and will react differently to drugs that are slightly different but in the same class. Some people think Adderal is just as good as Dexedrine, but that wasn't my experience. Could be that I'm used to the Dexedrine as I've been taking it for many years. The biggest problem with it is the looks and sometimes comments you get from other doctors, dentists, pharmacists. It's ok if you take any of the other stimulants but if you take Dexedrine some people act as though you're a drug addict taking it for fun.

Very interesting. What I can say would make the most sense is that maybe your body actually has difficulty catalyzing the reaction to cleave the L-lysine from the dextroamphetamine. You can modify this by consuming foods that affect trypsin. Trypsin inhibitors like soy can slow down the metabolism of Vyvanse and make it last longer, just the same an inducer would cause you to metabolize it more quickly. Very interesting though. And yes I asked my pdoc about Dexedrine one time and he gave me a funny look. I can't fathom why pdocs think Dexedrine is so different from Adderall or Vyvanse. Adderall CONTAINS Dexedrine, and Vyvanse is just MODIFIED Dexedrine. So why it has this stigma among pdocs is beyond me.

14 hours ago, Mindtrip said:

Thanks for telling me about how to do the signature. I'm new here but very glad I stumbled upon this forum.

No problem! Glad I could be of assistance and welcome to the boards! We're glad to have you! :D

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Thanks for sharing your insight and knowledge about stimulants in this and your previous post. Yeah, I don't know what's up with drs. and Dexedrine. It's been around longer than any of the others. I was first prescribed it by my primary care dr. to help me concentrate at work. He asked me whether I wanted ritilan or dexedrine and I said, "Give me whichever one is cheaper." That's how I initially got it. My neurologist, who I went to about 5 years later had no problem with it nor did my former pdoc.

As far as hypomania goes, I don't find that any stimulants make me hypomanic probably because I'm taking 2 mood stabilizers. I rarely get hypomanic and because I'm an ultradian rapid cycler, if I do get hypomanic, it doesn't last long. Here's something for you to laugh about: when I'm hypomanic I buy things sometimes in stores but lately more online. By the time I get them, I'm down and I end up returning everything LOL! I don't know if I've ever been totally stable because I have other medical complications that would make anyone depressed, even a "normal" person. But before I started taking Lamictal, I was high as a kite in the AM and suicidally depressed in PM. That doesn't happen anymore. I have most trouble with anxiety for which I have taken various benzos for a long time. My current problem is that with Klonipin I can't wake up, even with 5 cups of coffee, and with Ativan I can't sleep very well.

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Can someone please tell me how to reply to a specific person's post when they have not been the last to post? Does that question make any sense? I'm having a bad day; get constant migraines and my brain is mush. I don't really seem to know how to use this forum. Feel like an idiot.

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Hi, Mindtrip. Welcome to CB. 

There are two ways you can do it. You can preface your remarks with an ampersand:

@Mindtrip

and they’ll see someone has responded. Or you can use the quote feature. Look at the bottom of any entry and you’ll see quote-edit-options underneath the text. If you hit quote:

1 hour ago, Mindtrip said:

Can someone please tell me how to reply to a specific person's post when they have not been the last to post? Does that question make any sense? I'm having a bad day; get constant migraines and my brain is mush. I don't really seem to know how to use this forum. Feel like an idiot.

Boop! You’ll get the material above.

If you have any other questions please feel free to ask me or any of the other mods. You can identify us because we’re constantly circling like buzzards. No, wait. I meant where it says “member” under your avatar, it says “inmate” or “admin” under ours. 

Gearhead (admin)

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