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comorbid bipolar and inattentive ADHD anyone?


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I have bipolar disorder and ADHD (combined type, which means I also have the inattentive version, heh.)

I am on a mood stabiliser and a stimulant. Stims can mess with your moods but not necessarily on a 'mood episode' scale (although yes that risk is there too.) Finding the right meds, including the right stims, is huge.

When I flipped into a dysphoric hypomania in March and had to do a brief stint of IP treatment I was taken off my stimulant only for the duration of my IP stay while they tried to get me back down to Earth. Once I was stabilised and at home again I was given the go-ahead to re-start my Concerta by my pdoc.

YMMV.

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I have both schizoaffective, bipolar type and inattentive ADHD. I do not take stimulants because my pdoc fears it will cause psychosis. I slide very easily into psychosis, so this is probably for the best. She says I've been successful in life despite my ADHD, so she doesn't see the point in adding more meds when I'm already coping very well with the ADHD. Sometimes, I do wish I had a magical pill that could make me focus (who knows if stims would do that for me), and sometimes I do struggle with my ADHD. But, I'd rather not risk psychosis. 

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  • 1 month later...

*raises hand* Right here, chica. I have been diagnosed with ADHD (combined) when I was, ey, 5? However I was the hyperactive-psycho-kindergartener who stood on tables screaming at the top of my lungs into a crayon pretending I was Pat Benatar. Oh, yeah. And when I was older I was diagnosed with BP 2 disorder. Fun stuff.

 

I was on stimulants for a while, some abrasive (Ritalin, Ritalin LA, Adderall, Adderall XR, Concerta) and some non-abrasive (Strattera). The only stims I rly had a problem with changing my moods were the extended release oldschool abrasive stimulants. Rital LA and Adderall XR were poinson to my moods, causing a bit of mixedness and hypomania. Luckily Im pretty safe taking other stims.

 

I would be careful though with any stimulant, considering in a lot of people with Bipolar Disorders, they are suseptable to psychosis and stimulants can agitate that. My BP reared mostly to the hypomanic side rather than psychotic side so I have been lucky and not had to deal with that, but it is always wise to be careful. Especially diving into a med of unknown territory.

 

<3 Charlie

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  • 2 weeks later...
  • 1 month later...

I do have both. I take 36mg of Concerta daily. I find it helpful to my moods, rather than harmful. Both my pdoc and I believe it has helped pull me out of the depression of the past year. She says there is increasing evidence for a role of stimulants in bipolar disorder, even in the absence of AD/HD.

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I have to add two more things.  Having my ADHD medicated drastically helps with my anxiety and depression, just in general (not speaking of mood episodes here.)

 

My ADHD medication also actually does help with my depressive episodes and so forth.  Since my depression responds to my mood stabilizer so well, I don't see my pdoc putting me on an antidepressant of any kind, not with the amount of methylphenidate I take and so forth.

 

In my most recent depressive episode I apparently decided that it wasn't worth it to take my stimulant medication, among other "bright" ideas I had at the time (though I cut myself slack since I did do other things I was supposed to do, like keep myself safe and contact medical professionals, go IP, etc.)  While it was the upping of my mood stabilizer that finally lifted my suicidal depression, I do know that things while I was IP drastically changed for me on the day that they put me back onto my Concerta.  While I was still suicidally depressed, I tend to have the "mixed features" going on so I tend to have energy anyway -- the stimulant at least had me able to focus on stuff so I wasn't getting so frustrated and even more depressed at my inability to focus.  I started interacting with others on the ward.  That sort of thing.

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I have to agree Mirazh, after I had been diagnosed with Bipolar Disorder, my psychiatrist had been reluctant to prescribe a stimulant, but I had pleaded that I had been on one since I was 17 or almost 4 years. The stimulants give me the focus I need, and I find it helpful at keeping me focused and productive. My mood stabilizer does a great job at preventing mania, although many times, I feel that I need more of the focusing effects to get through my day, but of course you need to start low. I've tried Concerta before, and didn't find it as useful as Adderall, and generally prefer the amphetamine based medication. If worse comes to worse you can try some of the non-stimulants for ADHD/ADD such as Strattera, Intuniv, Kapvay (although the last two won't be of much help if you are primarily inattentive) or some of the milder stimulants such as Focalin or a lower dose of a pro-stimulant such as Vyvanse. I've had experiences with many ADHD treatments, and find that I generally don't become out of control while I use the medication with a mood stabilizer...Good luck and keep us updated.

 

I'm now on Abilify and Adderall but formerly I was on Invega with Adderall. 

Edited by Forbidden91
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  • 4 weeks later...

I have both. I have only just started taking Vyvanse every day - before it was supposed to be for those days that my meds made me groggy but I noticed an improvement in clarity of thinking and general productiveness so I asked my psychiatrist if I could experiment by taking it every day and see if it makes a difference. So far it hasn't seemed to make me swing one way or the other. Adderall used to make me hypomanic.

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  • 2 weeks later...

I'm bipolar 2 with a sloppy ADHD/PI diagnosis (though I think it's closer to "sluggish cognitive tempo"). 

 

The real struggle is telling the difference between being depressed and being unproductive. I'll start a day feeling good but by the end I will feel like crap because I've gotten nothing done on my list and haven't even done any of the things I'm reputed to enjoy. Anyway. It's confusing.

 

I have no advice for you on meds. The docs I've seen don't have a very sophisticated view of ADHD, the bipolar comes first, and when I'm hypomanic, I'm very productive, so it's a confused blur. Ritalin gave me energy, but not drive. I'm trying to talk my doc into Vyvanse or Provigil. 

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if so, what are you on? and do stimulants mess with your moods? i just got diagnosed moderate inattentive ADHD, and am waiting on my doctor to decide the best route of medication for me. just wondering if anyone else out there has both diagnoses.

I use to take Ritalin but because of my blood pressure I was switched to Wellbutrin.  The Ritalin worked better; but the wellbutrin works okay.

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  • 3 weeks later...

I have both and I've tried dex and ritalin and they burn out at the end of the day and mess with mood. Wellbutrin has been a pretty good substitute - similar stim effect. But I've also tried Modafinil/Alertec and I find it's a really great mood brightener and add focussing med with no burnout but potential for insomnia, plus pretty expensive. There are quite a few studies out now suggesting that Modafinil is effective as a mood stabilizer for bipolar. 

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