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Guest newadd_guy

Hello Everyone I went to a new pdoc today and unlike some of the others we talked about all the meds I have tried for anxiety and the obsessive type of ocd. The doctor has a "hunch" I have add and other doctors have told me that is a possible. The pdoc wanted to move me back to cymbalta which worked the best for my anxiety and ocd as well ass continue klonopin.

This is the first doctor to suggest a stimulant and really say that unless I try the med there is no way to prove I have add even if I did all the testing they can do. I guess the end result with testing is that I likely would have some symptoms and they would want to try me on meds.

He talked me into at least taking the prescription for "dextroamphetamine spansules". I don't know what these are exactly but he said they were safe and it wasn't ritalin.

does anyone take these stimulants with drugs like cymbalta? I read that cymbalta works on the 2 chemicals in your brain but mostly serotonin and the doctor said the same thing. But then I read this new med works on neurepenephrine as well as the cymbalta so is that to much on that one chemical? Also if i am anxious and using the other meds is it common to take a stimulant anyway? He said I still need the cymbalta and klonopin because the anxiety and obsessing is a separate problem. Do people with add also have ocd and anxiety?

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He talked me into at least taking the prescription for "dextroamphetamine spansules". I don't know what these are exactly but he said they were safe and it wasn't ritalin.

As with most medications, it's safe if used as directed but dangerous if abused.

Even water is dangerous if you drink or inhale enough of it.

does anyone take these stimulants with drugs like cymbalta? I read that cymbalta works on the 2 chemicals in your brain but mostly serotonin and the doctor said the same thing. But then I read this new med works on neurepenephrine as well as the cymbalta so is that to much on that one chemical?

Amphetamine works primarily to release norepinephrine and dopamine. Cymbalta is a norepinephrine and serotonin reuptake inhibitor. The first causes you to actually use the chemicals instead of letting them sit in storage forever; the second keeps its targets in action longer.

So yes they both work on norepinephrine. Since you haven't told anyone how much of either you are taking and how you've been reacting to the combination, no one can give you a truthful answer as to whether it's too much for you. Even then, dosages can be adjusted.

Also if i am anxious and using the other meds is it common to take a stimulant anyway? He said I still need the cymbalta and klonopin because the anxiety and obsessing is a separate problem. Do people with add also have ocd and anxiety?

I and several other people here have taken or do take a stimulant in addition to another medication, including Cymbalta.

Stimulants more often provoke an opposite reaction in people with ADHD than in people who do not have ADHD. That is why they are prescribed in the first place. And of course there are people with ADHD and OCD and/or anxiety. Perhaps it would help if you looked up the term "comorbid condition" Anyway, a combination of problems is often worsened if one is treated and not the other(s).

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Guest newaddguy

Thanks for the info, I know that all things have risks. I guess my main concern was the sudden death warnings, I think that is one side effect that is tough to risk.

I am going to be taking 30mg of cymbalta the first week and then go up to 60mg.

klonopin is 1mg up to 3 times a day

As for the dexdrine as I guess it is called, that is 1 tablet in the morning to start, and then 2 the next day, etc. So I don't have the strength but I know they are the weak ones. The doc just said that I can take 1 for the morning and then the next day 2 and then 3, etc. He said if I feel better to stay on that dose for a couple days and then try to add another one in and see what happens. He said that if I do have add that I will actually feel better as I go up in dose and get close to the right dose and if not I will just get very hyper and feel worse.

He then said that if I do have it and say I take 4 pills one morning, and it works well, then I decide to go to 5 that if it is to much and the 4 worked good I wouldn't feel right. I asked about all of the testing and he said that in the end I have enough symptoms that they would say to try meds.

The other thing is that since I have tried a bunch of sssris and the anxiety gets better but i get tired I need something for that. the other thing is that the cymbalt worked well for my anxiety and ocd but my concentration didnt get much better.

does this sound right?

He talked me into at least taking the prescription for "dextroamphetamine spansules". I don't know what these are exactly but he said they were safe and it wasn't ritalin.

As with most medications, it's safe if used as directed but dangerous if abused.

Even water is dangerous if you drink or inhale enough of it.

does anyone take these stimulants with drugs like cymbalta? I read that cymbalta works on the 2 chemicals in your brain but mostly serotonin and the doctor said the same thing. But then I read this new med works on neurepenephrine as well as the cymbalta so is that to much on that one chemical?

Amphetamine works primarily to release norepinephrine and dopamine. Cymbalta is a norepinephrine and serotonin reuptake inhibitor. The first causes you to actually use the chemicals instead of letting them sit in storage forever; the second keeps its targets in action longer.

So yes they both work on norepinephrine. Since you haven't told anyone how much of either you are taking and how you've been reacting to the combination, no one can give you a truthful answer as to whether it's too much for you. Even then, dosages can be adjusted.

Also if i am anxious and using the other meds is it common to take a stimulant anyway? He said I still need the cymbalta and klonopin because the anxiety and obsessing is a separate problem. Do people with add also have ocd and anxiety?

I and several other people here have taken or do take a stimulant in addition to another medication, including Cymbalta.

Stimulants more often provoke an opposite reaction in people with ADHD than in people who do not have ADHD. That is why they are prescribed in the first place. And of course there are people with ADHD and OCD and/or anxiety. Perhaps it would help if you looked up the term "comorbid condition" Anyway, a combination of problems is often worsened if one is treated and not the other(s).

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Hi, Welcome!

I'm bipolar and one year ago I was complaining again to my pdoc about intrussive/obsessive thoughts, anxiety and difficulty concentrating. My pdoc put me on Cymbalta which immediately slammed the gate on my anxiety, and got control of my int./obsess thoughts with a bit of time. Oh, Cymbalta also relaxed my tense body, I was no longer achey and sore (sorry if this sounds just like the TV commercials). ;)

At the same time she said she though I had ADHD (ADD type). we didn't do any testing, but did a trial of Adderall. At its best Adderall would amazingly calm me down and focus my thoughts. Unfortunately I'm very sensitive to stimulants, e.g. caffeine, Sudafed, and it began to wreck my sleep.

I switched to something else and I can't remember now. arrgh. it's in my script below. signature. It helps a lot. not as good as Adderall at its best, but at least it doesn't get me wired.

Give it a try. Don't worry too much about formal ADHD testing. In the end results are what matter, and that comes thru trial and error with meds.

good luck.

a.m.

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My pdoc put me on Cymbalta which immediately slammed the gate on my anxiety, and got control of my int./obsess thoughts with a bit of time.

That is really good to hear. I'm cross-tapering onto Cymbalta from Zoloft. It would be ever so lovely if it not only helped with depression, but with the intrusive thoughts, too.

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Guest newaddguy

What is the difference in Adderall, Concerta, Focalin, Ritalin, Dexidrine and Vesvayne? Is one safer then the other and what is all the new stuff about sudden death? I don't get that? I know that all meds have risks, but that is sort of a big one.

I have read about each of these meds, but I don't get what the difference is from one to the other and if dexidrin is in fact dextroamphetamine and works great, why is Ritalin always used the most?

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hey,

I'm no expert in this stuff, and I know how frustrating it can be to try and find answers online, but I just wanted to make sure that you'd checked out http://crazymeds.us/ (different from crazyboards all together) - lots of clear info explained really well, and not run by drug companies (yay!)

hope it helps some if you haven't discovered it already,

m

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Guest newaddguy

So when I talked to the pdoc he offered dextroamphetamine spansules because he likes that the most. So what is adderall? The main components look thes same? so I am lost even more now.

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So when I talked to the pdoc he offered dextroamphetamine spansules because he likes that the most. So what is adderall? The main components look thes same? so I am lost even more now.

It depends on whether you're dealing with the name-brand Adderall or the generic.

Look. Even with a small molecule like amphetamine, there are enough atoms involved that how they are put together makes a large difference in what reactions the molecule participates in, and how fast they go, what the material dissolves in, and what happens when it does so. And many of these chemicals don't dissolve so well in acidic aqueous solutions to begin with. Also, changing various sub-units of a molecule can change the effects and side-effects a little or a lot.

With amphetamine, there can be a left- (levo-, l-) handed, or right-(dextro- , d-) handed arrangement of chemical subunits or function groups around a single cabon atom.

Oxidizing a specific carbon on that chemical backbone to add a hydroxyl group yields ephedrine (and pseudoephedrine) which attaches to most of the same receptors in the body, but either doesn't cross the blood-brain barrier or can't fit all of the same receptors as amphetamine if it does. Bye-bye mood effects, cognitive benefits.

Oxidize a bit more to get a ketone group, yielding cathinone, and the ability to cross over to the brain comes mostly back but it's still a poor fit.

dextroamphetamine and l-amphetamine - same chemical, different conformation. d,l-amphetamine is a mixture of the two that's not cheap to separate even if one's slightly more useful than the other. Find a proper explanation of chirality somewhere and this will make more sense.

Play some games with the chemical to create a salt, say a hydrochloride or sulfate, and the solubility gets better and the material is more amenable to absorption.

Add chemical groups to alter some of the effects, and you can get benzamphetamine and methamphetamine (depends on what you add where).

So depending on brand vs. generic, you could have a mixture of salts, and/or mixture of symmetries, and maybe some benzamphetamine thrown in because it's also approved for the same things and the company might have had it in production. And the FDA allows some variation in the amount and in the release kinetics among formulations.

All different, mostly the same, the differences in effects - if any - depends entirely on you.

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Guest newaddguy

So even though adderall has dextroamphetamine it still isn't the same. I guess I am just curious as to why the pharmacies tell me adderall and concerta is so much used and dexidrine isn't

So when I talked to the pdoc he offered dextroamphetamine spansules because he likes that the most. So what is adderall? The main components look thes same? so I am lost even more now.

It depends on whether you're dealing with the name-brand Adderall or the generic.

Look. Even with a small molecule like amphetamine, there are enough atoms involved that how they are put together makes a large difference in what reactions the molecule participates in, and how fast they go, what the material dissolves in, and what happens when it does so. And many of these chemicals don't dissolve so well in acidic aqueous solutions to begin with. Also, changing various sub-units of a molecule can change the effects and side-effects a little or a lot.

With amphetamine, there can be a left- (levo-, l-) handed, or right-(dextro- , d-) handed arrangement of chemical subunits or function groups around a single cabon atom.

Oxidizing a specific carbon on that chemical backbone to add a hydroxyl group yields ephedrine (and pseudoephedrine) which attaches to most of the same receptors in the body, but either doesn't cross the blood-brain barrier or can't fit all of the same receptors as amphetamine if it does. Bye-bye mood effects, cognitive benefits.

Oxidize a bit more to get a ketone group, yielding cathinone, and the ability to cross over to the brain comes mostly back but it's still a poor fit.

dextroamphetamine and l-amphetamine - same chemical, different conformation. d,l-amphetamine is a mixture of the two that's not cheap to separate even if one's slightly more useful than the other. Find a proper explanation of chirality somewhere and this will make more sense.

Play some games with the chemical to create a salt, say a hydrochloride or sulfate, and the solubility gets better and the material is more amenable to absorption.

Add chemical groups to alter some of the effects, and you can get benzamphetamine and methamphetamine (depends on what you add where).

So depending on brand vs. generic, you could have a mixture of salts, and/or mixture of symmetries, and maybe some benzamphetamine thrown in because it's also approved for the same things and the company might have had it in production. And the FDA allows some variation in the amount and in the release kinetics among formulations.

All different, mostly the same, the differences in effects - if any - depends entirely on you.

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Guest notnewaddguyanymore

I went to a new pdoc today after years of not knowing what was wrong and she said wthout a doubt I have a "whopping case" of add along with a fair amount of GAD.

So I have cymbalta 60mg right now, klonopin 3mg per day prn, and now adderall 5mg tablets. Take 2.5 in the morning for a day or two, then 2.5mg twice per day, then 5mg morning and 2.5mg for a few days, then up to 5mg twice a day leading up to 10mg a day until my next appt.

So how is adderrall compared to the rest?

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So even though adderall has dextroamphetamine it still isn't the same.

Of course not. The United States includes California. California is not the United States.

I guess I am just curious as to why the pharmacies tell me adderall and concerta is so much used and dexidrine isn't

You're confusing yourself.

Concerta is a different chemical - methylphenidate under a brand name label.

Adderall (dextroamphetamine saccharate, dextroamphetamine sulfate, amphetamine aspartate, and amphetamine sulfate) and Dexedrine (dextroamphetamine sulfate) are brand name formulations with differing active ingredients.

*sigh*

You're not getting this, are you?

Here's the game and the setup:

One box with 4 different colored glass marbles, one box with a single color of glass marbles. Some people play a better game when they can choose which marbles to bet, and some can only cope with one. The kid from down the block favors aggies.

Some of the other kids on the block play jacks instead, and we haven't even dealt with the

kids who like to line up their wooden blocks, not plastic - that's wrong, all in a very specific order that you fell asleep

the last time one of them tried to explain the system.

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Guest newaddguy

Thanks for all the info. Well I have to start somewhere and since today - per my other posts, the doctor I first saw gave me the dextroamphetamine, but wrote the prescription in a way to take 5 - 15mg tablets per day. So after trying 5 pharmacies near me finally one had it and then the pharmacist wouldn't fill it because he felt it was to strong since I have never taken one of these meds. So I wound up keeping an appt with a pdoc that was supposed to be very good and she was, needless to say I am now taking the cymbalta which I have been for a week now - I had taken it twice previously.

So I start adderall tomorrow along with the cymbalta and keep taking the klonopin as needed.

What does everyone think about this combo?

I went to a new pdoc today after years of not knowing what was wrong and she said wthout a doubt I have a "whopping case" of add along with a fair amount of GAD.

So I have cymbalta 60mg right now, klonopin 3mg per day prn, and now adderall 5mg tablets. Take 2.5 in the morning for a day or two, then 2.5mg twice per day, then 5mg morning and 2.5mg for a few days, then up to 5mg twice a day leading up to 10mg a day until my next appt.

So how is adderrall compared to the rest?

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So when I talked to the pdoc he offered dextroamphetamine spansules because he likes that the most. So what is adderall? The main components look thes same? so I am lost even more now.

I guess I am just curious as to why the pharmacies tell me adderall and concerta is so much used and dexidrine isn't

From my understanding, the basic idea is that adderall is a differently structured mixture of similiar components which in general has been shown to be more tolerable by patients than dexedrine (in order to be sure of how it effects you though you'll just have to trial it, unfortunately). Seemingly small differences in how very similiar or identical drugs 'work' in your body can make a big difference as to the number of, and how unpleasant side effects are.

Nullotrooper, do you mind if I ask if you are on adderall or another stimulant? How much? Peace.

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Nullotrooper, do you mind if I ask if you are on adderall or another stimulant? How much? Peace.

5 mg generic adderall, 2/day, plus 25 mg desipramine, 2/day. The latter is prescribed as an AD, but as a strongly noradrenergic TCA it can also be used for ADHD. Also, caffeine as needed.

The amphetamine salts have proven to be far more helpful for keeping vasomotor rhinitis in check than anything else I've taken, so that establishes a baseline for me. I do worry a bit about tolerance. And, well, it can be a bit sedating at some dosages.

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New to Adderall 5mg rx in the morning going to 2x per day on Wednesday. Is it possible for this to make you tired? Or could it be an ssri I take - prozac? I have tried zoloft and that kept me up all night then off to lexapro which made med tired as hell. Prozac works ok for the anxiety and now with adderall added I am wornderin if that is what is making me tired during the day.

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New to Adderall 5mg rx in the morning going to 2x per day on Wednesday. Is it possible for this to make you tired? Or could it be an ssri I take - prozac? I have tried zoloft and that kept me up all night then off to lexapro which made med tired as hell. Prozac works ok for the anxiety and now with adderall added I am wornderin if that is what is making me tired during the day.

The stimulants and noradrenergic antidepressants can make a small number of people far more likely to fall asleep whether they are tired or not.

Whether Adderall made YOU more tired during the day? Maybe, maybe not. You are on Prozac, which has a list of side effects that includes insomnia and drowsiness, and you haven't mentioned how long you were on it without feeling overly tired before the Adderall was added to your schedule. You also haven't mentioned whether your sleep has been affected or not, by the medications or changes in your life.

For example, if you started Prozac at the end of last term and picked up the Adderall at the start of the new term, it may only be a coincidence that you're more tired now than when you were on break. Staying up later because of work, added stress, worrying about being on a stimulant - not the stimulant's fault.

Are you more tired all day, like you would be from insomnia or a long-acting SSRI? Or is it all hitting about 5-8 hours after taking the stimulant - what people call "crashing"? Or are you feeling wiped out a couple of hours after lunch and you're only worrying about it now?

5mg Adderall a day generally isn't very much. Then again you could weigh a third of what I do, or three times as much. And no one knows how much Prozac you're taking except you and your doctor...

You see that's why we tell people to discuss their symptoms and side effects with their doctor - even the minor symptoms - because there's more to all this than you're likely to realize.

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Guest newaddguy

Going on 1 week of adderall, seems Ok and I guess it seems to be calming my brain down.

I am on 10mg twice a day right now, is that alot? How much is the dose for this? They likely will switch me to the long lasting.

I do notice the loss in appetite which is good for me since the ad made me gain weight and along with the lethargic feeling.

How do they keep you on this if you are in your 30's and you have to be on it for years to come? Is it safe, i know heart docs likely wouldn't like stims as you get older.

how safe is it to take when excercising?

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I am on 10mg twice a day right now, is that alot?
I think that's the norm.

How much is the dose for this? They likely will switch me to the long lasting.

I do notice the loss in appetite which is good for me since the ad made me gain weight and along with the lethargic feeling.

I don't know what the typical dosage is for the XR version since I only take the IR version. Sorry.

How do they keep you on this if you are in your 30's and you have to be on it for years to come?
Basically if you are ADD/ADHD and the doc thinks you need it, they keep you on it. I'm going to be 35 this year and don't see being taken off of it anytime soon/ever.

Is it safe, i know heart docs likely wouldn't like stims as you get older.
I have mitral valve prolapse and I'm on 20 mg three times a day and have been since 2000 or 2001. I can't really remember without looking through my paperwork. I get a yearly check-up though.

how safe is it to take when excercising?
I used to exercise strenuously for 2 hours a day while taking it before my joints started to riot against me. I would check with my doctor first though before starting any exercise program though. Just my opinion.
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Guest newaddguy

thx,

that makes me feel much better, I am the same age.

How about sleeping, I am only gonna pull like 6 hours tonight and I still want to take the meds, I guess many people might not get the 8 hour luxury.

I am on 10mg twice a day right now, is that alot?
I think that's the norm.

How much is the dose for this? They likely will switch me to the long lasting.

I do notice the loss in appetite which is good for me since the ad made me gain weight and along with the lethargic feeling.

I don't know what the typical dosage is for the XR version since I only take the IR version. Sorry.

How do they keep you on this if you are in your 30's and you have to be on it for years to come?
Basically if you are ADD/ADHD and the doc thinks you need it, they keep you on it. I'm going to be 35 this year and don't see being taken off of it anytime soon/ever.

Is it safe, i know heart docs likely wouldn't like stims as you get older.
I have mitral valve prolapse and I'm on 20 mg three times a day and have been since 2000 or 2001. I can't really remember without looking through my paperwork. I get a yearly check-up though.

how safe is it to take when excercising?
I used to exercise strenuously for 2 hours a day while taking it before my joints started to riot against me. I would check with my doctor first though before starting any exercise program though. Just my opinion.

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