Posted by Peter on May 16, 2003, at 19:09:24
Hi everyone:
I'm in one of those transitional periods where I'm taking a ridiculous number of pills multiple times a day, because I'm reducing some and increasing others, etc.
My current regime is as follows: 10mg strattera (started it a week ago); 10mg prozac; 50mg lamictal; 35mg adderall divided bid(15+20); 2mg klonopin; 15mg temazepam; 5mg ambien; 25mg trazadone. I think that's it-I might have missed something.
Anyway, I've been on and off adderall for a few years. I also go on and off of SSRI's, changing brands each time. I was taking zoloft 100mg with adderall XR 20mg and depakote 750mg, then replaced the depakote with lamictal. I went up to 100mg of lamictal over a few months, but it started having a wierd synergy w/ the zoloft, so I weaned of the zoloft (that was a terrible withdrawel-doc had me do it all in a week). Then the lamictal started cavering me w/ a 'wet blanket' that negated the adderall effects, so he had me cut the lamictal in 1/2 and I've been on 50mg ever since.
I had a major depressive episode, so we decided that I'd start Prozac (the only SSRI I hadn't yet tried) at a low dose (10mg). I've been on that combo, with everything else, for many months now.
But my mood began to destabilize throughout each day, and my doc decided that the adderall was sort of raising my dopamine temporarily and then my DP would drop to sub-normal levels. I'd get cranky, my SP would increase, etc.
So, he's having me gradually replace the adderall w/strattera. He's also having me reduce the klonopin significantly, since I was up to 3mg at bedtime WITH temaepam and ambien. The ambien 10mg started degradating my sleep quality, so we cut it in half and added 25mg trazadone with the goal of replace some of the sedatives w/ the trazadone. So far, I've reduced from 2.75mg klonopin to 2mg daily. Ambien is at 5mg, temaz. at 15mg, and traz. at 25mg.
Within the 1st few days of starting the 10mg strattera, the effects were similar to when I began Prozac-My sleep/wake cycle improved drastically and I started getting more consistent energy levels and motivation. In fact, it seemed to make me a bit manicky at the start-pressured speech, etc. I also decreased adderall from 40mg to 35mg within that first week.
Then, out of nowhere, my mood got worse; my sleep cycle was better, but my SP got worse- I started getting ultra self-conscious and paranoid around crowds, and began to isolate in my apartment again.
Pdoc said it might be a synergy between the prozac and strattera that got me too wound up and now it's causing anxiety. But at the same time, my drive/motivation has plummeted, and I dip into depressive episodes. Also, my short-term memory got terrible, and I'd forget things mid-sentence.
I suggested that perhaps I should revisit adderall XR, since I remember it's action to be smoother; it seems that my lethargy, SP, and inner restlesness really comes about during that period in between adderall doses. While the Adderall is working, I get calm and focused; so, I thought, maybe if I had a more long-acting, smoother stim, it would help my general state.
But we decided against it because he said it really isn't worth it - wouldn't affect anything.
He said I should continue reducing the adderall by another 5 mg, and if, within a few days, my symptoms don't subsude, we'll try dropping the prozac for a few days(he said since it's so long-acting, I can drop the whole 10mg and the blood-level will gradually go down over a few days) to see if it's synergy with the strat. is in fact the problem.
Sorry for all this; I'm just trying to get everything clear in my head. It continues to be a long journey of guessing-games.
Can anyone verify if this seems like a good plan? Could there really be a negative prozac/strattera synergy like this? What about stratettera in general-anyone find that it is as good as adderall or other stims, in terms of focus, calm, and motivation? Anyone taking similar meds? Thanks-just want to vent and interact.
Peter
poster:Peter
thread:227129
URL: http://www.dr-bob.org/babble/20030514/msgs/227129.html