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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by cybercafe on April 1, 2003, at 0:39:33
i'm curious about your experience taking a stim + antidepressant ... was your doc really skeptical at first? did he take a lot of convincing/trying other stuff?
i am having trouble trying to figure out why other bipolars are doing fine on amphetamines + antidepressants, but my doc is convinced either an amphetamine or ritalin + ssri would cause mania/psychosis/something bad though i have no history of mania/psychosis :(
Posted by Ritch on April 1, 2003, at 9:26:34
In reply to Ritch, posted by cybercafe on April 1, 2003, at 0:39:33
> i'm curious about your experience taking a stim + antidepressant ... was your doc really skeptical at first? did he take a lot of convincing/trying other stuff?
>
> i am having trouble trying to figure out why other bipolars are doing fine on amphetamines + antidepressants, but my doc is convinced either an amphetamine or ritalin + ssri would cause mania/psychosis/something bad though i have no history of mania/psychosis :(
Trial#1: Added 2.5mg dexedrine 2x daily to small Celexa dose for attentional problems. Result: Dexedrine reduced anxiety in some ways, helped me to stay awake during the day, slept OK on it later, BUT didn't help focus like Adderall or desipramine did. However, it made it easy to NOT take any Celexa. (this idea was *tolerable*-it just didn't work like we thought it might)Trial#2: Added Adderall (5mg) to small Effexor dose. Focus was good (always has been with Adderall), but Adderall's residual anxiety was a little rough despite the Effexor. (this idea *worked*, but it was intolerable).
The dexedrine add (to Celexa) was my pdoc's idea. The Adderall+Effexor was my idea. Both bombed for different reasons. ):
Oh yeah, there is Trial#3: Wellbutrin+Ritalin. Whew-way too much anxiety there!
Oh yeah, there is Trial#4: Focalin+Celexa: Now that one WORKED (while it was working that is). But, Focalin costs a fortune, made me tic when the drug peaked, and it wears off completely after about 90 minutes.
Now that makes me wonder if Concerta+Celexa would work or maybe Concerta+Effexor..... NAH.
I can't tolerate a standard dose of any SSRI. I'm not taking any SSRI or Effexor right now. All the doses of SSRI in the trials I listed were very very small. I DO clearly get manic symptoms on SSRI's at doses even approaching standard ones. Stims don't cause that, however. You would have to try it to see if it would do it unfortunately. Some pdocs are paranoid that if their patients get hypomanic on a medication they won't report it and want to continue to take it! Just a thought there.
Posted by cybercafe on April 1, 2003, at 20:08:30
In reply to Re: Ritch » cybercafe, posted by Ritch on April 1, 2003, at 9:26:34
> > i'm curious about your experience taking a stim + antidepressant ... was your doc really skeptical at first? did he take a lot of convincing/trying other stuff?
> >
> > i am having trouble trying to figure out why other bipolars are doing fine on amphetamines + antidepressants, but my doc is convinced either an amphetamine or ritalin + ssri would cause mania/psychosis/something bad though i have no history of mania/psychosis :(
>
>
> Trial#1: Added 2.5mg dexedrine 2x daily to small Celexa dose for attentional problems. Result: Dexedrine reduced anxiety in some ways, helped me to stay awake during the day, slept OK on it later, BUT didn't help focus like Adderall or desipramine did. However, it made it easy to NOT take any Celexa. (this idea was *tolerable*-it just didn't work like we thought it might)
>
> Trial#2: Added Adderall (5mg) to small Effexor dose. Focus was good (always has been with Adderall), but Adderall's residual anxiety was a little rough despite the Effexor. (this idea *worked*, but it was intolerable).
>
> The dexedrine add (to Celexa) was my pdoc's idea. The Adderall+Effexor was my idea. Both bombed for different reasons. ):
>
> Oh yeah, there is Trial#3: Wellbutrin+Ritalin. Whew-way too much anxiety there!
>
> Oh yeah, there is Trial#4: Focalin+Celexa: Now that one WORKED (while it was working that is). But, Focalin costs a fortune, made me tic when the drug peaked, and it wears off completely after about 90 minutes.
>
> Now that makes me wonder if Concerta+Celexa would work or maybe Concerta+Effexor..... NAH.
>
>
> I can't tolerate a standard dose of any SSRI. I'm not taking any SSRI or Effexor right now. All the doses of SSRI in the trials I listed were very very small. I DO clearly get manic symptoms on SSRI's at doses even approaching standard ones. Stims don't cause that, however. You would have to try it to see if it would do it unfortunately. Some pdocs are paranoid that if their patients get hypomanic on a medication they won't report it and want to continue to take it! Just a thought there.
>
>
>thanks for your reply ritch, much appreciated :)
Posted by Ritch on April 1, 2003, at 23:02:37
In reply to Re: Ritch, posted by cybercafe on April 1, 2003, at 20:08:30
> > > i'm curious about your experience taking a stim + antidepressant ... was your doc really skeptical at first? did he take a lot of convincing/trying other stuff?
> > >
> > > i am having trouble trying to figure out why other bipolars are doing fine on amphetamines + antidepressants, but my doc is convinced either an amphetamine or ritalin + ssri would cause mania/psychosis/something bad though i have no history of mania/psychosis :(
> >
> >
> > Trial#1: Added 2.5mg dexedrine 2x daily to small Celexa dose for attentional problems. Result: Dexedrine reduced anxiety in some ways, helped me to stay awake during the day, slept OK on it later, BUT didn't help focus like Adderall or desipramine did. However, it made it easy to NOT take any Celexa. (this idea was *tolerable*-it just didn't work like we thought it might)
> >
> > Trial#2: Added Adderall (5mg) to small Effexor dose. Focus was good (always has been with Adderall), but Adderall's residual anxiety was a little rough despite the Effexor. (this idea *worked*, but it was intolerable).
> >
> > The dexedrine add (to Celexa) was my pdoc's idea. The Adderall+Effexor was my idea. Both bombed for different reasons. ):
> >
> > Oh yeah, there is Trial#3: Wellbutrin+Ritalin. Whew-way too much anxiety there!
> >
> > Oh yeah, there is Trial#4: Focalin+Celexa: Now that one WORKED (while it was working that is). But, Focalin costs a fortune, made me tic when the drug peaked, and it wears off completely after about 90 minutes.
> >
> > Now that makes me wonder if Concerta+Celexa would work or maybe Concerta+Effexor..... NAH.
> >
> >
> > I can't tolerate a standard dose of any SSRI. I'm not taking any SSRI or Effexor right now. All the doses of SSRI in the trials I listed were very very small. I DO clearly get manic symptoms on SSRI's at doses even approaching standard ones. Stims don't cause that, however. You would have to try it to see if it would do it unfortunately. Some pdocs are paranoid that if their patients get hypomanic on a medication they won't report it and want to continue to take it! Just a thought there.
> >
> >
> >
>
> thanks for your reply ritch, much appreciated :)
>
>
Hey, no problem. I was just thinking this afternoon that SSRI's should be Schedule II substances for folks like me instead of stims!
This is the end of the thread.
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