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now on focalin, can't mentally disengage when want to


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I started focalin on Sunday (the first ADD med I have taken). I'm still at half-dose, but raising it to full tomorrow.

I usually have no problem whatsoever wandering off mentally if I'm uncomfortable in a situation. For example, one of the new hires is prematurely presenting "solutions" that don't recognize the competence of the staff who are currently working to solve that problem. Also, a lot of stuff that people say is just boring.

I can deal with these unmedicated by missing most of the information I'm supposed to get - but I'm less uncomfortable or bored. But now, I *can't shut it off*. It's like somebody cracked open my skull and is pouring information in onto my naked brain. It's not like that all day, but it's kinda bad when it is.

I tried to just wander off in my head again, but it's like someone glued me to reality. I need to be there, but I don't want to be stuck there.

Has anyone else had this problem? What do you do to manage overly activating/upsetting or boring stimuli?

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Sometimes it takes a little while to get used to your add meds.

You may want to talk to your doctor about keeping your add meds at their current level until you get used to them?

Just a thought?

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Depending on what's going on, a nudge to your seroquel dose might help.

One of the most common problems people have with MPH based stimulants is overfocus, getting stuck on tasks. It's a problem with amphetamines too, but not near as bad.

Wrenching myself away from something I'm focused on can be hard.

"could you get my dinner out of the oven?"

"yeah, just a second, let me finish this."

five minutes later:

"hey, is that out of the oven yet?"

"yep, I'm taking it out in just a few seconds."

five minutes later:

"why do I smell something burning?"

fuck

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I had that overfocusing problem early in the morning (after it kicked in, but still early) but not the rest of the day. On the negative side I was jittery all day and so nauseated I came home early.

I listened to most of the meeting, though.

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There is a sustained release version available if you have the short acting.

With stimulants you generally want to titrate to your full dose in weekly increments to minimize side effects. If it's important you get the full effect fast, you can just deal with it.

Except part of the marketing for Focalin is that it doesn't have those side effects so they have to leave that out of the literature.

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I have the XR. I think being able to finish out the workday and afterward eat dinner wins out over titrating up that fast. Pdoc said to do it, but it's seriously not going to damage anything if I'm only a lot less distracted than usual, rather than extra a lot less distracted.

Took a nap this afternoon where I lay down feeling all focused and calmed down and woke up feeling normal. Was weird.

It really does make me think of the South Park episode.

I think I might be more fried in the evenings than I was before but there was also a taper off gabapentin and onto a low dose of topamax and that might be contributing. At least I can add and subtract in my head again now.

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I have the XR. I think being able to finish out the workday and afterward eat dinner wins out over titrating up that fast. Pdoc said to do it, but it's seriously not going to damage anything if I'm only a lot less distracted than usual, rather than extra a lot less distracted.

You're also put in the position of having to reevaluate or rework long-standing coping mechanisms. That would be a good reason to

increment dosages more slowly.

Personally, I'm a fan of keeping stimulant doses to the amount needed to get the job done (except for tasty caffeinated beverages...)

so I may be biased in the matter.

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Yeah, my conclusion after 20 mg yesterday and 10 mg today is:

- 20 mg is way too much because it made me sick enough to go home

- 10 mg is probably too much because I sat in a meeting for seven hours and was too sedated to say anything unless asked till near the end

- if this doesn't shake out by mid-next-week I'm going to ask my pdoc about trying the 5 mg dose

coping mechanisms...everything I'm trying to do outside of work is kind of gone to hell because it seems too hard by comparison now. Gotta fix that.

10 mg today was much nicer than earlier in the week.

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After talking with pdoc today, he rx'd me 5mg Adderall to try for a week, on the theory that it might not give me the same side effects as nausea, sedation, and declining mood. (I will have new and exciting side effects instead. Maybe.)

Today is my first day off the focalin and I'm flakier in meetings than I was last week but I feel worlds better.

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Today is my first day off the focalin and I'm flakier in meetings than I was last week but I feel worlds better.

Sounds like an improvement.

After talking with pdoc today, he rx'd me 5mg Adderall to try for a week, on the theory that it might not give me the same side effects as nausea, sedation, and declining mood. (I will have new and exciting side effects instead. Maybe.)

The biggest problem with the 5 mg dose is that it's way lower than the "normal" dose, even for a lot of kids. As a consequence many pharmacies may not carry it on a regular basis. They might have a big honking bottle of oxycontin on the shelf, but ... *shakes head*

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FWIW, from what I've gathered the main reason that adderall is more popular with pdocs than Dexedrine is because Dexedrine has a slightly higher potential for abuse. One reason for the higher abuse potential is because you can take more of it without feeling like crap. That also means that it has a higher potential to work right, but shire managed to spin adderall's side effects as positive selling points.

Adderall first saw life 30 years ago as a diet drug. Shire pulled it off the market and changed the name in the mid 1990s to cash in on the ADD boom. They did the same kind of thing Glaxo did with Wellbutrin and Zyban. They were able to get a new patent just by changing the name and getting a new indication. Suddenly, their 30 year old drug was a new drug with a new marketing campaign.

So what is Shire going to do now that they have run out of ways to reformulate and rebrand adderall? They are reformulating d-amphetimine to reduce the potential for abuse.

The only thing is, most research indicates that people with ADD are not likely to abuse their meds, regardless of substance abuse history.

http://blogs.webmd.com/adhd-medications-an...ug-vyvance.html

The d-amphetimine molicule is bonded to something so that it's not active until it's in the gut.

It looks like they have been more concerned about how to keep people from snorting their ADD meds than they have been with coming up with new treatments.

Bottom line, if it turns out adderall has crappy side effects, remember that it's a feature not a bug. Then change meds.

Why the hell am I awake?

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I wonder if maybe the idea is that add drugs should be so unpleasant that no one but people with add will take them.

Along those lines, I'm prepared for this to not work very well.

Is it something that people can use as needed? Or is it really something people ought to be taking every day? I don't think I've seen anything talk about that. Being medicated for this is not a necessity for me, but I am going to have to have more supports than I have now unless I get a job with much less face-to-face...

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Most side effects will get better if you take it every day but you also get a bit tolerant. There is also the potential to unlearn thought patterns learned as coping devices while unmedicated. Take a look at the assorted adult ADD literature for how that kind of thing works. I like Sari Solden.

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