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Dr. Bob is Robert Hsiung, MD,
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Posted by medlib on May 7, 2002, at 5:18:46
In reply to ritalin trial to counteract depakote side effects, posted by Krazy Kat on May 6, 2002, at 14:07:17
Hi KK--
Please forgive me for not knowing your med history, but there's a gaggle of ACs/"mood stabilizers" out there. I believe that some of the newer ones (i.e.,Trileptal, Lamictal, Topamax) are supposed to be less sedating. Have you tried any of them? Btw, all mood stabilizers are reputed to do a better job of putting a lid on the "highs" than on lifting the "lows", at least for most people.
I'm not bipolar (double depression), but I found Ritalin very helpful for anergia, anhedonia, etc. I used to take 20 mg. 3x/day, which is not a huge amount for unipolars, but might be for bipolars. Recently, my pdoc added Wellbutrin to my mix, but I found that 400 mgs of Well SR plus Ritalin triggered EPS (both affect dopamine). Since Well worked better for me, I ended up ditching the Ritalin. It's weird how varied reactions to different stims can be. Adderall gave me terrible headaches and Dexedrine Spansules put me to sleep! I had such difficulty believing that dex could be soporific that I tried it for a whole week--took an involuntary nap within 30 minutes after each dose.
Good luck with your musical meds ride. I think I'll get off the carousel of change for awhile; going around in circles is beginning to make me dizzy. Wish I'd kept a journal or log; I'm having difficulty remembering every med I've tried, much less why I stopped each one.
Feeling "deja vu all over again"---medlib
Posted by Krazy Kat on May 7, 2002, at 14:49:58
In reply to a a aaaaaaakkkk more to read » Krazy Kat, posted by susan C on May 6, 2002, at 17:18:53
mouse with glasses:
that's so funny, because i found that article earlier on in my research on bp disorder.
that was one reason it made no sense to me to only be on depakote, but it does seem to be the correct thing for me - the ad's caused mania, then i dropped into a heavy suicidal but energetic depression.
i'll be able to say in a year or so, right? :)
the sedative qualities of depakote are very apparent in me, though, so it's nice to see others have needed something to counteract that.
have you ever tried ritalin (or another stim) + depakote?
kat with an ear horn
Posted by Krazy Kat on May 8, 2002, at 11:25:02
In reply to ritalin trial to counteract depakote side effects, posted by Krazy Kat on May 6, 2002, at 14:07:17
I am tired today - slept very long and late last night. Does Ritalin have to be taken first thing in the morning to get up, like Provigil did? I need to check into this, b/c I'm sure not getting up on my own.
I'm realizing this is a very low dose (10mg/day). I imagine it needs to be raised. How does one suggest that with a controlled substance without sounding like a "druggie"? Interesting thought...
Still, it is helping a little. Wonder why so tired?
- kk
Posted by IsoM on May 8, 2002, at 12:45:41
In reply to Wed. 5/8 - day 3-1/2 - low dose?, posted by Krazy Kat on May 8, 2002, at 11:25:02
KK, I feel much more tired when I'm on regular stims. I really need them to get going. Have to take them first thing in the morning or I just want to turn around & crawl back into bed. For me, that's the normal reaction to them. My adrafinil doesn't do that for me - makes it much easier to get up n the morn even when I don't take it first thing.
Posted by Krazy Kat on May 8, 2002, at 14:21:25
In reply to Ritalin with Depakote » Krazy Kat, posted by medlib on May 7, 2002, at 5:18:46
Medlib:
Thanks for your input!
Lamictal made me ill both times i tried it and topamax was the worst in sedation (i tried it at various doses for about 6 months). - go figure. :)
AD's I've tried (that I can recall):
Celexa - didn't SEEM to do much
Welbutrin - could not tolerate at all - i was a BITCH - sorry, B**** ;)
Prozac - worked BUT this is where i, and pdoc, realized that the AD's were causing mania.
I think there were one or two others... hmmm, memory has suffered.i think my pdoc was loathe to have me on a stabilizer w/o an ad, but it seems to be the best thing thus far. i certainly can't be on an ad w/o a "heavy" stabilizer (neurontin was too mild) - i get suicidal. it's all so interesting.
Interesting, too, about the Dexedrine. I'm learning one's Dr. really has to be willing to listen to the patient and not follow the 'common' reactions to things. I seem to fall into an "odd reaction" category.
I, too, am going to try and stick this combo out for a little while. Since the Depakote provides stability, I plan on playing with the Ritalin dose and give it a fair run.
took two 5mg tablets closer together today and am now feeling better.
- kk
Posted by Ritch on May 8, 2002, at 23:38:54
In reply to Re: Ritalin with Depakote » medlib, posted by Krazy Kat on May 8, 2002, at 14:21:25
> Medlib:
>
> Thanks for your input!
>
> Lamictal made me ill both times i tried it and topamax was the worst in sedation (i tried it at various doses for about 6 months). - go figure. :)
>
> AD's I've tried (that I can recall):
>
> Celexa - didn't SEEM to do much
> Welbutrin - could not tolerate at all - i was a BITCH - sorry, B**** ;)
> Prozac - worked BUT this is where i, and pdoc, realized that the AD's were causing mania.
> I think there were one or two others... hmmm, memory has suffered.
>
> i think my pdoc was loathe to have me on a stabilizer w/o an ad, but it seems to be the best thing thus far. i certainly can't be on an ad w/o a "heavy" stabilizer (neurontin was too mild) - i get suicidal. it's all so interesting.
>
> Interesting, too, about the Dexedrine. I'm learning one's Dr. really has to be willing to listen to the patient and not follow the 'common' reactions to things. I seem to fall into an "odd reaction" category.
>
> I, too, am going to try and stick this combo out for a little while. Since the Depakote provides stability, I plan on playing with the Ritalin dose and give it a fair run.
>
> took two 5mg tablets closer together today and am now feeling better.
>
> - kk
Hi KK,I told somebody about an upcoming trial of Focalin (dexmethylphenidate) a ways back. The pharmacy didn't get it until recently (just a few tabs). Well, I have been trying a little here and there over the last few days. So, here is a personal experience comparison/contrast with Adderall/Dexedrine: Adderall had the most anticholinergic effects (dry mouth), worked great for attentive probs. and bipolar depression (w/o cycling), BUT made me too uptight, but slept great/only taking Neurontin with it. Dexedrine didn't help focus much at all-in fact I made more mistakes at work than I did without it. Also, I noticed that when it wore off the *crash* was more mood-involved (I felt depressed). The dexmethylphenidate has a duration less than Dexedrine (about 2 hrs.), but when it wears off I don't feel "down", just tired. Dosewise, I found that individual 2.5mg doses are plenty (that would be 5mg Ritalin-wise). I tried one single 5mg dose and it was *too* much. I just felt nervous. No euphoria or mood elation at all, which was strange because I noticed a mild mood elevation with dexedrine or Adderall when I started taking it. It faded over a few days, but it was there nevertheless. This Focalin stuff "feels" somewhat like low-dose Effexor without the serotonergic side effects (heartburn-diarrhea), but seems to lack any anxiolytic effect.
Mitch
Posted by Krazy Kat on May 11, 2002, at 14:52:18
In reply to Re: Ritalin with Depakote » Krazy Kat, posted by Ritch on May 8, 2002, at 23:38:54
i don't think i'm taking this correctly. i take 5 mg as soon as i wake up, @ 9:00 am, then 5 mg around 1:00.
it seems to have a Really short half life for me - i only get about 2 hours of help in energy and motivation from it. and those are both only slightly improved. but there is still a slight improvement.
so, my guess is, it needs to be raised to 10 mg, three times a day?? does sr ritalin work?
also, i can tell when it's wearing off - get irritable and tired. i crash.
that's frustrating b/c pre-depakote i was a mood machine and i don't want to go back and forth t/o the day again.
but, i took 100 mg of provigil one afternoon and it caused the same anxiety/kind of over-emtions it had before. i was ready to cry at anything. freaked out because i had to cross a bridge... strange.
so, i really guess it's out.
- kk
Posted by Ritch on May 11, 2002, at 17:57:37
In reply to trial continues - sat., may 11th, posted by Krazy Kat on May 11, 2002, at 14:52:18
> i don't think i'm taking this correctly. i take 5 mg as soon as i wake up, @ 9:00 am, then 5 mg around 1:00.
>
> it seems to have a Really short half life for me - i only get about 2 hours of help in energy and motivation from it. and those are both only slightly improved. but there is still a slight improvement.
>
> so, my guess is, it needs to be raised to 10 mg, three times a day?? does sr ritalin work?
>
> also, i can tell when it's wearing off - get irritable and tired. i crash.
>
> that's frustrating b/c pre-depakote i was a mood machine and i don't want to go back and forth t/o the day again.
>
> but, i took 100 mg of provigil one afternoon and it caused the same anxiety/kind of over-emtions it had before. i was ready to cry at anything. freaked out because i had to cross a bridge... strange.
>
> so, i really guess it's out.
>
> - kk
Hi Kk,Yes, it does have a *very* short half-life. I have tried dexmethylphenidate off and on over the last week or two and 2 hrs. is about what I experience with that. You could ask your doctor about 18mg tabs of Concerta (once in the AM). It is supposed to release gradually and steadily up to about 6-8 hrs. post-dosing and then a very gradual dropoff over another 6-8hrs. I haven't tried that yet. I hear it is quite pricey $$$. The dexmethylphenidate (Focalin) certainly is $$$ as well. I get this feeling when I see pdoc in a few weeks I will be back on a tricyclic for ADHD symptoms (nortriptyline or possibly imipramine). Unless, I get a generic script for methylphenidate and take small doses every two hours all day long! The up/down in energy level is not good-I will agree with you there. I don't feel depressed when it wears off I just feel kind of clueless and tired.
Mitch
Posted by Phil on May 11, 2002, at 18:28:13
In reply to Re: trial continues - sat., may 11th » Krazy Kat, posted by Ritch on May 11, 2002, at 17:57:37
My posts will be nice. Sorry about the ones that weren't. I know this area and wanted to answer.
That's a tiny dose. I took 40 mg a day for years. Split into 4 doses throughout the day. If I wanted to actually stay awake at night, I'd take another 10mg.
Recently switched to Adderall XR and take 30mg twice a day. Not only a cool looking capsule but it really works for around 5 hours or so for me.
I like it. Time released Ritalin sucks. Haven't tried Concerta. Good luck.
Posted by Krazy Kat on May 11, 2002, at 18:32:01
In reply to Re: trial continues - sat., may 11th » Krazy Kat, posted by Ritch on May 11, 2002, at 17:57:37
this really helps me. i knew you were doing a trial as well, and have actually seen some info online re: your med when i did research re: ritalin.
Cytomert (did i get hat right?) is an interesting suggestion. i thought of it as well, as it is not controlled, and from the little research i did, seemed to be well-tolerated.
you have mentioned that you have trouble with being "grouchy", am i right? i do, too, and frankly, as a woman, it just isn't tolerated. i swear i was born to be a man. or is that a myth now, too - are men supposed to be pleasant all the time as well? :)
if i could live in my closet and only converse with my animals and never leave the house, i'd be o.k.:) I (underlined) don't care if i'm cranky (hubby does though). :)
- kk
Posted by Krazy Kat on May 11, 2002, at 19:41:41
In reply to Re: kk..sorry, posted by Phil on May 11, 2002, at 18:28:13
and only meant concern before.
also, i go through super-sensitive times and over-analyze things ...
but anyhow, thanks for the info. it really helps.
- kk
Posted by Phil on May 11, 2002, at 19:47:04
In reply to phil - i like your nice posts..., posted by Krazy Kat on May 11, 2002, at 19:41:41
We're very much alike so we push each others buttons. Just a theory.
Posted by Ritch on May 11, 2002, at 22:34:23
In reply to wow, thanks for your input » Ritch, posted by Krazy Kat on May 11, 2002, at 18:32:01
> this really helps me. i knew you were doing a trial as well, and have actually seen some info online re: your med when i did research re: ritalin.
>
> Cytomert (did i get hat right?) is an interesting suggestion. i thought of it as well, as it is not controlled, and from the little research i did, seemed to be well-tolerated.
>
> you have mentioned that you have trouble with being "grouchy", am i right? i do, too, and frankly, as a woman, it just isn't tolerated. i swear i was born to be a man. or is that a myth now, too - are men supposed to be pleasant all the time as well? :)
>
> if i could live in my closet and only converse with my animals and never leave the house, i'd be o.k.:) I (underlined) don't care if i'm cranky (hubby does though). :)
>
> - kk
The med is Cylert (pemoline). Elizabeth is the one that has experience with that one. I think it has been withdrawn from the US because of paranoid liver concerns. Phil likes the Adderall, and my pdoc mentioned a possible trial of Adderall XR 10mg AM, next time around if the methylphenidate family of products is a big bust. The "regular" Adderall made me too nervous, but I wan't also taking GABA-ergic medications like lowdose Depakote and Klonopin.Hey, Depakote just does magic for my hostility-what can I say? I have charted the heck out of it and the hostility seems to be "background" to some extent-independent of other meds triggering it.
I think that in the cubicle world of data slavery we now live in, if you aren't on meds to control your hostility you probably won't be working in the data slave trade much longer.
When I worked *outside* and was self-employed a decade ago, you didn't crap on people like is commonly done nowadays and if you did, everyone knew about it and you got your punishment. Nowadays it just a steady slow excrement shower, instead of the big wallops that got dealt with a "piece" at a time. Now it is psychic meterology.
Hang in there,
Mitch
Posted by Phil on May 11, 2002, at 22:43:50
In reply to Re: wow, thanks for your input » Krazy Kat, posted by Ritch on May 11, 2002, at 22:34:23
Depakote could probably help me but it's the one that can cause priapism, no? I need rest. Tonight I'm SE phobic.
Posted by Ritch on May 12, 2002, at 0:40:06
In reply to Re: interesting take on things » Ritch, posted by Phil on May 11, 2002, at 22:43:50
> Depakote could probably help me but it's the one that can cause priapism, no? I need rest. Tonight I'm SE phobic.
Nope, that is trazodone that causes that one!
Posted by Phil on May 12, 2002, at 6:08:10
In reply to Re: interesting take on things » Phil, posted by Ritch on May 12, 2002, at 0:40:06
I have always gotten those 2 confused. I feel better already.
Posted by Krazy Kat on May 12, 2002, at 10:57:20
In reply to Re: wow, thanks for your input » Krazy Kat, posted by Ritch on May 11, 2002, at 22:34:23
Make sure you save those observations, Mitch. They should go onto the company intranet when you leave someday! ;)
I am very fortunate in that I have not had to sit in a cubicle for two years. But I am having to apply for disability now, and it is killing my ego.
I guess I'm mixing up two meds. Dr. just left a message to increase Ritalin up to 20 mg a day, and if that works, we'll go on to Concerta.
Thanks, again.
- kk
Posted by Ritch on May 12, 2002, at 17:33:07
In reply to the cubicle world... » Ritch, posted by Krazy Kat on May 12, 2002, at 10:57:20
Posted by dove on May 13, 2002, at 9:57:57
In reply to the cubicle world... » Ritch, posted by Krazy Kat on May 12, 2002, at 10:57:20
I would add that I have done quite well on Adderall at 40MGS for at least three (3) years now. Ritalin done did me the fly-n-crash-dive sort of thingy, very-very bad on the mind, soul and body. I tried Adderall XR, didn't find any significant difference except for less daytime dosing, which caused me to forget to take it completely.
The regular Adderall gives me a very smooth and definitively non-edgy stimulation, no crash-dives! And I'm now taking the generic with cheap and sweet success!
dove
Posted by Krazy Kat on May 13, 2002, at 12:07:56
In reply to Re: Input ... Ritalin, posted by dove on May 13, 2002, at 9:57:57
Posted by BarbaraCat on May 16, 2002, at 14:55:34
In reply to the cubicle world... » Ritch, posted by Krazy Kat on May 12, 2002, at 10:57:20
Hi Kat,
I've also applied for disability and just got turned down the first time. Hired a lawyer and am appealing - the usual b.s. you have to go through. I can relate about the ego degrading thing very well. But the thought of having to go back to those cubicles to make a living - argghhh!! Good luck and let me know how it goes for you. - Barbara> Make sure you save those observations, Mitch. They should go onto the company intranet when you leave someday! ;)
>
> I am very fortunate in that I have not had to sit in a cubicle for two years. But I am having to apply for disability now, and it is killing my ego.
>
> I guess I'm mixing up two meds. Dr. just left a message to increase Ritalin up to 20 mg a day, and if that works, we'll go on to Concerta.
>
> Thanks, again.
>
> - kk
Posted by krazy kat on May 17, 2002, at 10:45:31
In reply to Re: the cubicle world and disability » Krazy Kat, posted by BarbaraCat on May 16, 2002, at 14:55:34
thanks, Barbara - I almost missed your post.
it's eating at me. i'm extrememly weepy at times when the stim i'm taking wears off, and the stress of applying for disability is really getting to me. it's not even that i can't survive w/o it - we've made it thus far (though barely) - it is my ego. i feel like a failure to myself, to my husband. i'm trying to reassure myself and be realistic, but it's tough.
thanks again.
- kk
Posted by BarbaraCat on May 17, 2002, at 11:20:18
In reply to the cube - thanks » BarbaraCat, posted by krazy kat on May 17, 2002, at 10:45:31
Why is your ego suffering so badly? Is it that you're embarassed about the 'disabled' label? Or feeling bad cause you're feeling bad? It's probably the depression talking, huh? I sure have no qualms whatsoever about receiving disability. I put in my time, my money, and the system is supposedly there to help us, so heck, I need it's help. For me, it's not so much degrading as just a pain in the butt with all the paperwork and bogus assigned doctor consultations. But it's just a game and I'll play it otherwise the cubicles await.
> thanks, Barbara - I almost missed your post.
>
> it's eating at me. i'm extrememly weepy at times when the stim i'm taking wears off, and the stress of applying for disability is really getting to me. it's not even that i can't survive w/o it - we've made it thus far (though barely) - it is my ego. i feel like a failure to myself, to my husband. i'm trying to reassure myself and be realistic, but it's tough.
>
> thanks again.
>
> - kk
Posted by krazy kat on May 17, 2002, at 12:23:24
In reply to Re: the cube - thanks » krazy kat, posted by BarbaraCat on May 17, 2002, at 11:20:18
Posted by Dr. Bob on May 18, 2002, at 1:43:44
In reply to Re: the cube - thanks » krazy kat, posted by BarbaraCat on May 17, 2002, at 11:20:18
> Why is your ego suffering so badly? ...
Sorry to interrupt, but could posts that don't have to do with medication go to Psycho-Social-Babble? Here's a link to make it easy to continue this thread there:
http://www.dr-bob.org/babble/social/20020517/msgs/24011.html
Thanks,
Bob
This is the end of the thread.
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