![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 16 to 40 of 40. Go back in thread:
Posted by 3 Beer Effect on May 17, 2002, at 13:43:50
In reply to drugs for previous drug abusers, posted by katekite on May 16, 2002, at 10:24:56
Katekite,
If I were a psychiatrist or doctor I don't think I would prescribe Ritalin, Adderall, Focalin, or Dexedrine/Dextrostat to a previous Cocaine, Speed/Crystal Methamphetamine, or multiple-drug abuser.From personal experience, the temptation to abuse these drugs for former drug abusers & sometimes even plain old alcoholics is great.
A big problem is that all of the Schedule II ADD stimulants are very easy to abuse & they are very powerful drugs.
All one has to do is save up a few days worth of medication (40+ mg Adderall, or 60+ mg Ritalin), crush them up with a credit card or better yet the available everywhere otc "pill pulverizer" and snort them in a manner similar to powder Cocaine hcl with a dollar bill (dirty) or as a cleaner method they use a shortened unused Slurpee straw, empty pen tube, or even a rolled up post-it note.I think the street name for Ritalin is "West Coast", while College Kids call it "Vitamin R" or "Rit". Oddly enough, on the 'street', intranasal Ritalin with either oral Zoloft (Zoomers) or pentazocine (T's & Rits/Poor Man's Heroin) are sometimes (though rarely) used combinations. Generally, ADD stimulants (with the exception of Desoxyn) are derided as "kiddy drugs" in the ghetto & aren't being sold by/diverted to traditional drug dealers. The people doing the dealing are children or college kids with ADD prescriptions who obviously dislike (children are said to experience dysphoria on Ritalin/Adderall) or don't need/have too much of the medication in the case of college kids.
Granted, these medicines do not offer anywhere near the euphoria of crack cocaine or crystal methamphetamine.
BUT, the major draw & temptation to misuse/abuse these ADD stims is that they are easily available, & pharmaceutically pure so you know what you are getting, while street drugs like Cocaine & Speed are adulterated/cut with all sorts of things from Ephedrine, Caffeine, Procaine, Benzocaine, Vitamin b-12, laxatives, baking soda, & even strychnine (a very dangerous stimulant also used as a rat poison!).Also, business professionals & college students can abuse these stims (intranasally or orally) to gain a competitive work/academic edge without any obvious external symptoms of drug abuse & without the danger/risk of arrest that comes with going to the ghetto to buy street drugs out in public from armed & very paranoid drug dealers.
From personal experience, Ritalin & Adderall in adequate dosages intranasally produce an much longer lasting "high" that roughly parallels the "high" from the "cut/highly diluted" poor quality 'powder' Cocaine hcl available in most areas of the US (excluding of course areas close to Mexico with higher quality cocaine especially Southern California, & also AZ, NM, Texas-south of San Antonio, & the port cities of Houston & Miami, FL).
Adderall in high enough doses causes mild visual hallucinations, & Adderall combined with Ritalin intranasally produces a double whammy effect of extensive dopamine release & blocking of its reuputake causing a "high" with euphoric & somewhat hallucinogenic properties that is very close or equal to the powerful street drugs intranasal methamphetamine hcl or relatively 'uncut' powder cocaine hcl like that available in Mexico border cities, but thankfully, no one has seemed to figure this out yet. But I would guess the risk of adverse (hypertensive) effects of this combination is great- much greater than Adderall or Ritalin alone.
The new ADD stimulant, Focalin, eliminates half of Ritalin-all of which is the inactive isomer & so is basically useless/filler, retaining only the active d-isomer, & has no color additives & a limited amounts of dilutents/inactive ingredients & if abused intranasally would probably be much more potent in its effects than Ritalin.
Very surprisingly, Dexedrine & Dextrostat are arguably stronger than Adderall when taken orally, but intranasally are less effective probably because they are much more diluted with inactive ingredients (A 5 mg Dexedrine pill contains 13.8 mg of sucrose along with 4 other inactive ingredients/dilutents, & a 10 mg Dextrostat pill is about equal to the size of a 30 mg Adderall pill indicating that it contains a large amount of inactive ingredients/dilutents. I don't know if these (50+ year old pills) have always contained so many inactive ingredients- I do know that many years ago Dexedrine was once available in 10 mg pills & in an elixir form that was discontinued a few years back. Perhaps the makers of Dexedrine & Dextrostat learned from the speed epidemic of the late 1960s & diluted the pills enough so that when an attempt at intranasal abuse is made, the bulky inactive ingredients greatly slow the absorption into the bloodstream, thus greatly reducing the high & making intransal abuse almost pointless.
I think the best choice for a former stimulant drug addict would be Wellbutrin SR since street drug use is self-medication often for both depression & adult add, & Wellbutrin SR often clears up both, but its risk of abuse is low.
Another good choice, would be Concerta. Concerta cannot really be abused intranasally, & there have been reports of failed attempts at this by adolescents.
Other possible choices would include Adderall XR or Dexedrine Spansules, but only assuming that the pellets inside the capsules cannot be grinded up into a dry powder (which I don't know the answer to & haven't read anything on this).
Perhaps, the best thing would be to educate the former drug abuser on the futility on intranasal abuse. For example, the intranasal abuse of Ritalin by college kids in order to study & focus better is self-defeating, because Ritalin only lasts for one hour intranasally, while if swallowed on an empty stomach provides about 3.5 hours of efficacy. Tolerance to Ritalin skyrockets when used intranasally at a ridiculous rate. But with a proper oral regimen, tolerance to Ritalin (or Adderall) is a slow process easily fixed by taking stimulant breaks on weekends or stimulant holidays.
But remember, drugs like Ritalin & Adderall can be abused orally, so everyone should be careful when taking ADD stimulants. Anytime you are "saving up", or "taking double doses" it often begins a viscious circle of last minute procrastination of work/study/deadlines that you often meet successfully for the first few times (by escalating the dosage), but eventually this sporadic dosage escalation induces 'pyschological dependence' & tolerance- you find that your prescribed dose no longer works as well as it used to & you begin to believe that you won't be able to work or study even normally, without the x dose of Ritalin/Adderall that helped you meet that deadline/cram/stay up all night in the past.
So remember that even though Ritalin/Adderall/Dexedrine etc are not "physically" addictive, they are still powerful DEA Schedule II Drugs [the same class as prescription Cocaine, Desoxyn (methamphetamine hcl), Seconal, Oxycontin, Dilaudid ("drugstore heroin"), Percocet, Morphine etc.] that some, especially adults, can become "psychologically" addicted to resulting in dose escalation & abuse. So remember to periodically take weekend breaks (Ask yourself if really need that Ritalin on a Friday afternoon/night) & when tolerance builds take a week off "a stimulant holiday".
3 Beers.....
Posted by Elizabeth on May 17, 2002, at 17:07:50
In reply to ADD stimulants similarities to Cocaine Meth. » katekite, posted by 3 Beer Effect on May 17, 2002, at 13:43:50
I think it's important to recognize that the reason some people like drugs such as cocaine and meth is that these drugs are actually treating symptoms of a mental disorder such as ADD or depression. The problem is that stimulants can cause euphoria (and people usually become tolerant to this effect after a short time), so if there isn't a doctor monitoring you, then you risk becoming dependent on them. Still, I don't think that people who have ADD should be denied effective treatment simply because they abused stimulants at some point in the past. This is the kind of decision that has to be made on an individual basis, IMO. (Same with opioids or benzos.)
Of course, there are some people who will just be toooooo tempted if you hand them a script for a bottle of Adderall. It's hard to predict, but I'm sure there are cases where it would be better to try milder stimulants (Cylert, Provigil, phentermine, etc.) and see if they work. But remember that different people have different experiences; not all who use stimulants recreationally become addicts, and there are lots of people who once abused stimulants who nonetheless can use them responsibly as medications.
> A big problem is that all of the Schedule II ADD stimulants are very easy to abuse & they are very powerful drugs.
I have to disagree with that in regard to Ritalin. Some high school and college kids seem to get a kick out of it, but I think that most people who'd previously been taking amphetamine or cocaine would not be impressed by Ritalin.
> All one has to do is save up a few days worth of medication (40+ mg Adderall, or 60+ mg Ritalin), crush them up with a credit card or better yet the available everywhere otc "pill pulverizer" and snort them in a manner similar to powder Cocaine hcl with a dollar bill (dirty) or as a cleaner method they use a shortened unused Slurpee straw, empty pen tube, or even a rolled up post-it note.
You know you're cheap when...!
> I think the street name for Ritalin is "West Coast", while College Kids call it "Vitamin R" or "Rit".
"Ritalin" was what I always heard. And the people who used it when I was in college were mainly looking for a way to pull an all-nighter -- it wasn't considered a party drug. (And yes, some folks did snort it.)
> Oddly enough, on the 'street', intranasal Ritalin with either oral Zoloft (Zoomers) or pentazocine (T's & Rits/Poor Man's Heroin) are sometimes (though rarely) used combinations.
Pentazocine (Talwin) is *nothing* like heroin. It's a kappa agonist/mu antagonist. If a heroin addict takes it, it will trigger withdrawal symptoms. And as for Zoloft...well, we all know how absurd that one is.
Kids these days have pretty low standards when it comes to getting high. I mean, some people will take *anything*. Ahh, the power of the placebo effect!
> But I would guess the risk of adverse (hypertensive) effects of this combination is great- much greater than Adderall or Ritalin alone.
The most serious risk of stimulant overdose is probably paranoid psychosis, actually.
> I think the best choice for a former stimulant drug addict would be Wellbutrin SR since street drug use is self-medication often for both depression & adult add, & Wellbutrin SR often clears up both, but its risk of abuse is low.
Unfortunately, a lot of people find that Wellbutrin isn't very effective for ADD.
> So remember that even though Ritalin/Adderall/Dexedrine etc are not "physically" addictive ...
I think I disagree with this. Stimulant withdrawal is real and definitely sucks, although it doesn't make you downright sick (like opioid withdrawal) or cause seizures (like benzo or barb withdrawal). And of course, people who abuse stimulants almost always develop tolerance (the other definitive characteristic of addiction). There's more to stimulant dependence than just nonspecific psychological "cravings."
> ... they are still powerful DEA Schedule II Drugs ...
The FDA is the regulatory agency that does the scheduling (the DEA is a law enforcement agency). But anyway, the FDA has often made poor decisions. The Schedule in which the FDA places a drug should not be considered proof of the drug's abuse potential. (Remember, these are the guys who made Meridia a controlled substance while the almost-identical Effexor is not. I could list dozens of other silly things the FDA has done, but you get the point.)
> So remember to periodically take weekend breaks (Ask yourself if really need that Ritalin on a Friday afternoon/night) & when tolerance builds take a week off "a stimulant holiday".
I don't think that people using stimulants for ADD or narcolepsy typically become tolerant. As for skipping a couple days, I'd expect that to result in withdrawal symptoms (once again, there *is* a specific and well-defined stimulant withdrawal syndrome). It might be something good to try, but I don't think it's necessary for everyone.
-elizabeth
Posted by katekite on May 17, 2002, at 22:22:05
In reply to Re: psychostimulant treatment for former abusers » 3 Beer Effect, posted by Elizabeth on May 17, 2002, at 17:07:50
Apparently Wellbutrin is only effective for about 30% of adult ADDers, whereas the stimulants work for 80-90 % depending on the reference.
It would be a shame to keep someone with ADD from functioning because of concern over addiction. Yes addiction is real. Yes people with ADD can abuse their medication. But will they? Who is to say that? That's extremely individual and the decision should be up to the doctor and the patient and the patient's family.
I'm off of ritalin for a week right now for a medical test. I hate it. My functional status just sucks. I don't think I should take weekends off... maybe a week once a year, but not every weekend. ADD is a pervasive condition that affects all of life, it is not a work-disorder. I barely can organize myself to pee before I burst -- pretty basic issue that doesn't go away at night or on weekends.
Yes, people with ADD who are past drug users should try Wellbutrin first. But not only Wellbutrin, if it doesn't work.
The new non-stimulant atmoxetine should be out this year as an alternative for past addicts. No one will know until its been out for a while whether it actually works.... but the option is good to have.
kate
Posted by Zo on May 18, 2002, at 3:31:16
In reply to Re: psychostimulant treatment for former abusers, posted by katekite on May 17, 2002, at 22:22:05
Okay, it's not a pstim. . .but it has an amazing effect, opening up and organizing a part of my brain that Dexedrine (and Adderall) never touched. When added to Dex, I should say. . . for me.I keep seeing this argument over and over again, on the board. . .Who IS it that is getting high off Dexedrine? In these teeny-tiny ADD amounts? Certainly not anybody *with* ADD, certainly not anyone in *need* of dopamine, it's just bringing us up to normal! Organizing. Giving that Executive Function a little kick so it can *try* and keep up with that racing, funny, non-linear space cadet of a Right Brain.. . .You get my point. I hope. ..
Zo
Posted by MomO3 on May 21, 2002, at 16:23:58
In reply to Re: Adderall help, posted by DiscoPuppy on May 14, 2002, at 18:16:05
I know a couple people with current drug problems that have been prescribed adderall... for the one guy I am thinking of, his wife is upset because he won't party with her anymore. Adderall has taken away his DESIRE to do coke.
Posted by Phil on May 21, 2002, at 19:34:08
In reply to Re: Adderall help, posted by MomO3 on May 21, 2002, at 16:23:58
Boy, they are a high functioning couple. 8^D
I used to abuse coke and meth years ago and agree w/ the self-medicating idea. My pdoc, when I told him I did coke in my younger years and it helped me focus, etc. He used that as a reason to put me on Ritalin. I have never abused any psych med and don't think it's a problem for ex abusers. There will be exceptions but a sharp doc will know it.
I wouldn't prescribe stims to anyone who is actively doing coke, obviously. But, the guy probably forgot to mention it. My .02.
Posted by Christina on May 22, 2002, at 12:30:06
In reply to Re: Adderall help, posted by MomO3 on May 21, 2002, at 16:23:58
His wife needs to get a real life.
I can understand that... Adderall has almost wiped out my obsession with over-eating.
It has been wonderful.
Posted by Elizabeth on May 22, 2002, at 13:56:30
In reply to Re: psychostimulant treatment for former abusers, posted by katekite on May 17, 2002, at 22:22:05
> Apparently Wellbutrin is only effective for about 30% of adult ADDers, whereas the stimulants work for 80-90 % depending on the reference.
That's interesting, although it comes as no surprise that WB doesn't work. (What's the placebo response rate?) Can you provide sources for me to look at? Also, do you happen to know what the stats are for kids?
Lately Effexor has been pushed for ADD. I doubt it's any better than WB, but who knows? Imipramine and other TCAs used to be considered options as well, but I'd hesitate very much to give those to kids (plus I'm skeptical as to whether they even work).
> I'm off of ritalin for a week right now for a medical test. I hate it. My functional status just sucks. I don't think I should take weekends off... maybe a week once a year, but not every weekend. ADD is a pervasive condition that affects all of life, it is not a work-disorder.
For a long time ADD was considered a childhood disorder, and lately stimulants have been thrown at any kid who's "difficult" for teachers. Because of the "treatment first, diagnosis second" methodology that has become so common lately (especially in amateur psychiatric diagnosis!), the assumption is that if stimulants help, then ADD must be the cause of their bad behavior. Stimulants do sometimes decrease the behavior, but I don't think that childhood violence and other serious misbehavior are necessarily (or even usually) indicative of ADD.
Anyway, that was a sidetrack, but the point I was going to make was that a lot of these kids who are a handful in school are fine when they're at home, which is a clear sign that they probably *don't* have ADD -- the problem, whatever it is, only manifests in one area of their lives, not in a variety of settings. It's more likely that this school-limited mishbehavior is related to a difficulty adapting to the requirements of a school environment, I would guess.
> I barely can organize myself to pee before I burst -- pretty basic issue that doesn't go away at night or on weekends.
Well, *that's* something that imipramine could help with, at least!
> Yes, people with ADD who are past drug users should try Wellbutrin first. But not only Wellbutrin, if it doesn't work.
There are other options, too, such as clonidine (and of course the TCAs and Effexor). I don't know if they've ever been studied, but I'd expect MAOIs to be very effective in ADD, more so than the TCAs and the newer ADs. And as Zo points out, modafinil is an option...if you have good insurance!
(Zo: why do you not consider Provigil to be a "pstim?" It's not a phenethylamine, but I'd call it a psychostimulant. And no, I don't know who is getting high on Dexedrine etc. A sometime-professor of mine said that when he tried amphetamine as a med student, he became "quasi-psychotic," although others used it for staying-awake purposes.)
> The new non-stimulant atmoxetine should be out this year as an alternative for past addicts. No one will know until its been out for a while whether it actually works.... but the option is good to have.
Do you mean atomoxetine? AFAIK, it's just another monoamine (NE) reuptake inhibitor. I know that it's been found effective for ADD in several studies -- we'll see if that result is borne out in "real life." :-)
-elizabeth
Posted by katekite on May 22, 2002, at 17:15:12
In reply to Re: psychostimulant treatment for former abusers, posted by Elizabeth on May 22, 2002, at 13:56:30
Yes sorry atomoxetine. I agree too, that there are lots of alternatives to stimulants.
That 30% figure came directly from the mouth of my nerdy psychiatrist.... so I don't have a reference, although with him I'm sure there is one somewhere. He said, and I have seen too, most journal articles quoting a much higher success. He says that is often transient or just not tolerated in the dose needed.
I agree kids are overmedicated. One really needs to adhere to diagnosing it only when the attentional and impulse problems are pervasive throughout life.
I also have read about really really little kids getting the diagnosis, say, at 2 or 3. That's pretty crazy.
kate
Posted by azurebay on May 22, 2002, at 18:35:43
In reply to ADD stimulants similarities to Cocaine Meth. » katekite, posted by 3 Beer Effect on May 17, 2002, at 13:43:50
> Katekite,
> If I were a psychiatrist or doctor I don't think I would prescribe Ritalin, Adderall, Focalin, or Dexedrine/Dextrostat to a previous Cocaine, Speed/Crystal Methamphetamine, or multiple-drug abuser.Love the name 3Beers (and hi Ketekite):
However I disagree with you regarding former substance abusers and the prescribing of ADD/ADHD medications. Granted, it may be questionable in some situations, even this one. But you must know the research behind ADD/ADHD(?)
An extremely high percentage (depending on which study you read, but in almost every single one where substance abuse is related to ADD...), the person has little if ANY desire to abuse the neurostimulant. In fact, it is quite the opposite response.
The bottom-line question of importance, yet again, is getting THE correct diagnosis by a psychiatrist, not a GP or any other doc.
I can tell you with absolute, one-hundred-percent certainty that I, as a former substance abuser, did not in the least manner have any tendiency to abuse neurostimulant medication. And I never have, in going on three-something years. It was like a feeling of, "Finally... wow I can function half-normal!"
Ya, I certainly discovered other comorbid problems underneath the ADD, but with the right psychiatrist they, too, are now like night and day compared to even two years ago.
So, I totally challenge the idea that substance abusers will abuse psychostimulant medications, assuming they are properly diagnosed with true ADD/ADHD. And I believe the vast majority of research confirms that point.
Smiles Always,
Azure
>
> From personal experience, the temptation to abuse these drugs for former drug abusers & sometimes even plain old alcoholics is great.
>
> A big problem is that all of the Schedule II ADD stimulants are very easy to abuse & they are very powerful drugs.
> All one has to do is save up a few days worth of medication (40+ mg Adderall, or 60+ mg Ritalin), crush them up with a credit card or better yet the available everywhere otc "pill pulverizer" and snort them in a manner similar to powder Cocaine hcl with a dollar bill (dirty) or as a cleaner method they use a shortened unused Slurpee straw, empty pen tube, or even a rolled up post-it note.
>
> I think the street name for Ritalin is "West Coast", while College Kids call it "Vitamin R" or "Rit". Oddly enough, on the 'street', intranasal Ritalin with either oral Zoloft (Zoomers) or pentazocine (T's & Rits/Poor Man's Heroin) are sometimes (though rarely) used combinations. Generally, ADD stimulants (with the exception of Desoxyn) are derided as "kiddy drugs" in the ghetto & aren't being sold by/diverted to traditional drug dealers. The people doing the dealing are children or college kids with ADD prescriptions who obviously dislike (children are said to experience dysphoria on Ritalin/Adderall) or don't need/have too much of the medication in the case of college kids.
>
> Granted, these medicines do not offer anywhere near the euphoria of crack cocaine or crystal methamphetamine.
> BUT, the major draw & temptation to misuse/abuse these ADD stims is that they are easily available, & pharmaceutically pure so you know what you are getting, while street drugs like Cocaine & Speed are adulterated/cut with all sorts of things from Ephedrine, Caffeine, Procaine, Benzocaine, Vitamin b-12, laxatives, baking soda, & even strychnine (a very dangerous stimulant also used as a rat poison!).
>
> Also, business professionals & college students can abuse these stims (intranasally or orally) to gain a competitive work/academic edge without any obvious external symptoms of drug abuse & without the danger/risk of arrest that comes with going to the ghetto to buy street drugs out in public from armed & very paranoid drug dealers.
>
> From personal experience, Ritalin & Adderall in adequate dosages intranasally produce an much longer lasting "high" that roughly parallels the "high" from the "cut/highly diluted" poor quality 'powder' Cocaine hcl available in most areas of the US (excluding of course areas close to Mexico with higher quality cocaine especially Southern California, & also AZ, NM, Texas-south of San Antonio, & the port cities of Houston & Miami, FL).
>
> Adderall in high enough doses causes mild visual hallucinations, & Adderall combined with Ritalin intranasally produces a double whammy effect of extensive dopamine release & blocking of its reuputake causing a "high" with euphoric & somewhat hallucinogenic properties that is very close or equal to the powerful street drugs intranasal methamphetamine hcl or relatively 'uncut' powder cocaine hcl like that available in Mexico border cities, but thankfully, no one has seemed to figure this out yet. But I would guess the risk of adverse (hypertensive) effects of this combination is great- much greater than Adderall or Ritalin alone.
>
> The new ADD stimulant, Focalin, eliminates half of Ritalin-all of which is the inactive isomer & so is basically useless/filler, retaining only the active d-isomer, & has no color additives & a limited amounts of dilutents/inactive ingredients & if abused intranasally would probably be much more potent in its effects than Ritalin.
>
> Very surprisingly, Dexedrine & Dextrostat are arguably stronger than Adderall when taken orally, but intranasally are less effective probably because they are much more diluted with inactive ingredients (A 5 mg Dexedrine pill contains 13.8 mg of sucrose along with 4 other inactive ingredients/dilutents, & a 10 mg Dextrostat pill is about equal to the size of a 30 mg Adderall pill indicating that it contains a large amount of inactive ingredients/dilutents. I don't know if these (50+ year old pills) have always contained so many inactive ingredients- I do know that many years ago Dexedrine was once available in 10 mg pills & in an elixir form that was discontinued a few years back. Perhaps the makers of Dexedrine & Dextrostat learned from the speed epidemic of the late 1960s & diluted the pills enough so that when an attempt at intranasal abuse is made, the bulky inactive ingredients greatly slow the absorption into the bloodstream, thus greatly reducing the high & making intransal abuse almost pointless.
>
> I think the best choice for a former stimulant drug addict would be Wellbutrin SR since street drug use is self-medication often for both depression & adult add, & Wellbutrin SR often clears up both, but its risk of abuse is low.
>
> Another good choice, would be Concerta. Concerta cannot really be abused intranasally, & there have been reports of failed attempts at this by adolescents.
>
> Other possible choices would include Adderall XR or Dexedrine Spansules, but only assuming that the pellets inside the capsules cannot be grinded up into a dry powder (which I don't know the answer to & haven't read anything on this).
>
> Perhaps, the best thing would be to educate the former drug abuser on the futility on intranasal abuse. For example, the intranasal abuse of Ritalin by college kids in order to study & focus better is self-defeating, because Ritalin only lasts for one hour intranasally, while if swallowed on an empty stomach provides about 3.5 hours of efficacy. Tolerance to Ritalin skyrockets when used intranasally at a ridiculous rate. But with a proper oral regimen, tolerance to Ritalin (or Adderall) is a slow process easily fixed by taking stimulant breaks on weekends or stimulant holidays.
>
> But remember, drugs like Ritalin & Adderall can be abused orally, so everyone should be careful when taking ADD stimulants. Anytime you are "saving up", or "taking double doses" it often begins a viscious circle of last minute procrastination of work/study/deadlines that you often meet successfully for the first few times (by escalating the dosage), but eventually this sporadic dosage escalation induces 'pyschological dependence' & tolerance- you find that your prescribed dose no longer works as well as it used to & you begin to believe that you won't be able to work or study even normally, without the x dose of Ritalin/Adderall that helped you meet that deadline/cram/stay up all night in the past.
>
> So remember that even though Ritalin/Adderall/Dexedrine etc are not "physically" addictive, they are still powerful DEA Schedule II Drugs [the same class as prescription Cocaine, Desoxyn (methamphetamine hcl), Seconal, Oxycontin, Dilaudid ("drugstore heroin"), Percocet, Morphine etc.] that some, especially adults, can become "psychologically" addicted to resulting in dose escalation & abuse. So remember to periodically take weekend breaks (Ask yourself if really need that Ritalin on a Friday afternoon/night) & when tolerance builds take a week off "a stimulant holiday".
>
> 3 Beers.....
Posted by kazoo on May 23, 2002, at 22:56:43
In reply to ADD stimulants similarities to Cocaine Meth. » katekite, posted by 3 Beer Effect on May 17, 2002, at 13:43:50
> So remember that even though Ritalin/Adderall/Dexedrine etc are not "physically" addictive, they are still powerful DEA Schedule II Drugs [the same class as prescription Cocaine, Desoxyn (methamphetamine hcl), Seconal, Oxycontin, Dilaudid ("drugstore heroin"), Percocet, Morphine etc.] that some, especially adults, can become "psychologically" addicted to resulting in dose escalation & abuse. So remember to periodically take weekend breaks (Ask yourself if really need that Ritalin on a Friday afternoon/night) & when tolerance builds take a week off "a stimulant holiday".
^^^^^^^"Benzedrine...Dexedrine ...strong caffeine, I need apomorphine; Hallucination horrors, that's what I got ..."
From a song entitled "Hallucination Horrors" by The Fugs, Great, Great Grandfathers of the Punk movement.Bubble gum is psychologically addicting as well as television.
You could choke on the gum, or commit acts of violence "AS SEEN ON TV".
What should'a, could'a, would'a we do?kazoo
Posted by noelle on May 23, 2002, at 23:19:43
In reply to Re: ADD stimulants similarities to Cocaine Meth., posted by kazoo on May 23, 2002, at 22:56:43
I thought your explanation of abuse of Adderal very enlightening and familiar. If you abuse a stimulat does that automatically mean you have been misdiagnosed? I mean it used to work fine. I know I have a mood disorder, basically periodic depression, however I have 3 cousins with Bi-polar disorder. Ya I guess I could try to dive into this with my psychiatrist but it seems they are always guessing
nole
Posted by Zo on May 24, 2002, at 17:03:07
In reply to Re: psychostimulant treatment for former abusers, posted by Elizabeth on May 22, 2002, at 13:56:30
Is it within the realm of possiblity this could be efficacious (sp?) Elizabeth? Perhaps in the clarity of treating depression, yes. But I can't imagine that Effexor could be said to treat ADD in any other way. I was on Effexor for four years before I stumbled on the ADD dx and Dexedrine, and that was the real beginning of a working brain. Of course I was also, unbeknownst, BP II. What do you think of it as an ADD med? I'd hate to see people waste their time. .(Did you ever get my email reply?)
Zo
Posted by Chrissy on June 29, 2002, at 11:42:52
In reply to Re: Effexor for ADD?? Can't imagine » Elizabeth, posted by Zo on May 24, 2002, at 17:03:07
27 year old female here who has been on Prozac for the last 8 years. Saw a Psychiatrist for the first time 2 years ago. Diagnosed with Bipolar. Tried many meds, Ended up coming back to Prozac due to bad side effects or weight gain from other meds. Was at one time up to 60mg of Prozac. One thing I've always complained of over the years was my lack of motivation to get anything done. Simple things like taking a shower. My brain always seemed overwhelmed by little tasks. Always tired. On Every medication I was on, I always fealt this way. (although they helped greatly in other areas such as depression, mild social anxiety etc.) Finally I started reading about Adult ADD. Crying when I saw how much I related to this. Doctor agree'd to let me try Ritalin. Even though I'm known to abuse alcohol. I'm also a big coffee drinker and moderate cigarette smoker. (although I always said I could take a nap after drinking lots of coffee) Ritalin drastically made a difference. Little things aren't so overwhelming. I've never fealt a feeling of wanting to abuse Ritalin. The feeling I get from it is not a "high" feeling. Doctor said if I wanted to up it 5 mg twice a day just to see if there was a difference I could. when i did, it fealt like it was too much so I backed down. It's almost like the ritalin gets me physically going, but my mind stays at a regular pace. Does this make sense? I have a long ways to go. I have free college that I have yet to take advantage of, and I plan on enrolling this fall. Fingers crossed! (Will I actually do it??) Any one know if there are any downsides to taking the Prozac(20 mg) and Ritalin(10 mg twice a day) together?
Posted by henryO on June 30, 2002, at 3:41:52
In reply to Re: Ritalin user, posted by Chrissy on June 29, 2002, at 11:42:52
I hear alot of myself in your message Chrissy. I spent years on Prozac. Everybodyelse said I was better on it, but I felt barely barely better. I was just dragging myself around. For me Ritalin made an instant as well as a huge difference. I love Ritalin, it has changed my life. But it "pooped out" in a few months. So I quit the Ritalin and was back to being miserable. Then after much trial and error we, my doctor and I, tried an augmentation med called Visken (or Pindolol). It helped. I felt better. It removed the pain. I was up to a 5 on a scale of 1 to 10. Then I asked to be put back on Ritalin and changed over to Concerta wich is a sustained release mechanism for Ritalin. It is smoother, has less peaks and valleys than the straight quick release tablets. So after some months I was talking to my doctor and I said "if this is as good as I am ever going to feel, I'll take it. I'm not in pain, thank you." then I added "after alI, I don't expect euphoria" he surprised me by saying something to the effect that "you're wrong, you are supposed to feel really good" So we added a fourth med to the cocktail another augmentation med called Resperidal. I take less of it now than when I first began it, but I feel now like I think I am supposed to feel. I am telling you all this because it does make one want to cry when you look at all the time and pain we struggled with to get better. Don't quit trying if you hit some setbacks. There were a lot of other meds I tried along the way that I didn't like. I left them out of my long story. I used to feel a bit concerned about the number of meds I take. But I have come to see it as a packaging issue. My combo works for me. I sometimes wonder what school would have been like for me if I had the meds then that I have now. Good luck.
Posted by MomO3 on July 2, 2002, at 12:15:08
In reply to Re: Adderall help » MomO3, posted by Christina on May 22, 2002, at 12:30:06
I would tend to agree that his wife needs something..., but she has 3 children (boys) at home in a small house, with very little extra money. Since she does not have a college education, finding a job that would cover the expense of daycare for 3 is unrealistic. He works full-time, and deals a little on the side to make ends meet.
In her defense, she is not a crack mom who is sitting in a trailer not taking care of her kids. She HAS a real life that is a 24/7 job, she works damn hard all day, and at night when the kids are asleep she occasionally wants a little pick me up.
As a mother of three at home myself, I can tell you that even with the most beautiful, wonderful kids... having one 3 yr old can drive you to drink, having two other little ones can put you over the edge. The sleep deprivation for any child under 18 months is a cause for psychiatric concern, but after being pregnant and nursing for 4+ years - when you've finally got your body back you might want to party a little bit too!
Don't judge that which you don't understand.
> His wife needs to get a real life.
>
> I can understand that... Adderall has almost wiped out my obsession with over-eating.
>
> It has been wonderful.
Posted by Jay Beck on June 3, 2003, at 11:33:03
In reply to Adderall help, posted by Peter on November 3, 2001, at 13:57:19
just some overall comments on this disscusion
i currently take 20mg adderal XR daily
my thoughts on ADD and the use of Stimulants
1. If you abuse adderal it means you have a drug problem, it doesnt mean you don't have ADD
-i used to abuse adderal and i am very ADD (i also am a drug addict)2. Stimulants are the most effective way to deal with ADD. ALL other treatments are less effective. (thats not what drug-pamplets/FDA says but its defently the truth)
3. ADD is "slightly" overdiagnosed, not the insane amount of overdiagnosis that is heard.
4. all of the anti-ADD/anti-Amphetimine crap that seems to be going around recently is created by government propaganda (FDA) to stop or significantly lower the amount of available abusable prescription drugs in the drug market.
(the same case for opiates and benzos) this insane bashing of prescription amphetimines will create the same problem for people with ADD getting adderal as anxiety sufferors getting benzos.
Posted by aazospiro on March 25, 2004, at 17:38:16
In reply to Re: Ritalin user, posted by Chrissy on June 29, 2002, at 11:42:52
> 27 year old female here who has been on Prozac for the last 8 years. Saw a Psychiatrist for the first time 2 years ago. Diagnosed with Bipolar. Tried many meds, Ended up coming back to Prozac due to bad side effects or weight gain from other meds. Was at one time up to 60mg of Prozac. One thing I've always complained of over the years was my lack of motivation to get anything done. Simple things like taking a shower. My brain always seemed overwhelmed by little tasks. Always tired. On Every medication I was on, I always fealt this way. (although they helped greatly in other areas such as depression, mild social anxiety etc.) Finally I started reading about Adult ADD. Crying when I saw how much I related to this. Doctor agree'd to let me try Ritalin. Even though I'm known to abuse alcohol. I'm also a big coffee drinker and moderate cigarette smoker. (although I always said I could take a nap after drinking lots of coffee) Ritalin drastically made a difference. Little things aren't so overwhelming. I've never fealt a feeling of wanting to abuse Ritalin. The feeling I get from it is not a "high" feeling. Doctor said if I wanted to up it 5 mg twice a day just to see if there was a difference I could. when i did, it fealt like it was too much so I backed down. It's almost like the ritalin gets me physically going, but my mind stays at a regular pace. Does this make sense? I have a long ways to go. I have free college that I have yet to take advantage of, and I plan on enrolling this fall. Fingers crossed! (Will I actually do it??) Any one know if there are any downsides to taking the Prozac(20 mg) and Ritalin(10 mg twice a day) together?
0!!!!!!!!!!I have experienced everything you have have just decribed, I too had have tried numerous SSRI's and other AD's and consumed coffee like it was going to go out of production anytime.wow!
Posted by Chrissy on March 26, 2004, at 5:56:45
In reply to Re: Ritalin user,YOUR STORY IS SOO FAMILIAR!!!!!!!, posted by aazospiro on March 25, 2004, at 17:38:16
Wow, it's been a couple years since I wrote that.
I just turned 29, and let me tell since I wrote things got better, than worse, then beter again. I switched to Adderall and prozac only. However the PDoc wanted to add a mood stabelizor due to some depressive episodes and anger still. Depakote first...got ill, Lithium...Got very Ill!!!! years ago I tried wellbutrin, busporian and topomax and they made me feel ill. why such a bad response to mood stabelizors? I'm DONE with them. I still feel the best I've ever felt. I'm actually on a somewhat high dose of adderall 50 mg XR and also 80 mg of prozac-all daily. This has been the best treatment for me thus far...I'll post again later. By the way...how old are you?
Chrissy
Posted by aazospiro on March 27, 2004, at 19:05:19
In reply to Re: Ritalin user,YOUR STORY IS SOO FAMILIAR!!!!!!! » aazospiro, posted by Chrissy on March 26, 2004, at 5:56:45
I'll post again later. By the way...how old are you?
> ChrissyHi Chrissy I am 29 in a about 2 weeks.
On imipramine 12.5 mg and goign up to 25 mg slowly. I look foward to your future posts.
Posted by francesco on March 28, 2004, at 12:53:36
In reply to Re: Ritalin user,YOUR STORY IS SOO FAMILIAR!!!!!!! » Chrissy, posted by aazospiro on March 27, 2004, at 19:05:19
I've tried Imipramine at low dose (10mg) for adult adhd but I've found it too agitating. Did you experience the same side effect ? Thanks
Posted by aazospiro on March 28, 2004, at 20:46:13
In reply to Re: Ritalin user,YOUR STORY IS SOO FAMILIAR!!!!!!! » aazospiro, posted by francesco on March 28, 2004, at 12:53:36
Hi Fransesco,
Actually I broke a 25 mg tablet in half and took it for 2 nights and to my suprise I was as calm as a cucumber. #rd night I took 25 mg, and was alittle groggy the next day for about half hour and then very clam but stimulated. I really think NE reuptake inhibition is good for me, the only thing is that the orthostatic hypotension, which feels like dizzy and heavy-headed when i egt up is more prominent with the 25 mg nocte. I dont know if it will subside. I was actually thinking of venlafaxine at really low dose [37.5 mg] but to my dismay it only affects 5-HT reuptake at that low dose. :-(((. And there is no nortriptyline and no protriptyline and no desipramine available here
Damn! And if/when Strattera become available, its going to be really $$$$$$$$$$$$$$$$$$Do you know if desmethylvenlafaxine affects more of NE reuptake than its parent compound?
Thanks very much for the tips on my previous posts.
Hope to hear ur response soon
Posted by francesco on March 29, 2004, at 0:42:38
In reply to Re: Ritalin user,YOUR STORY IS SOO FAMILIAR!!!!!!!, posted by aazospiro on March 28, 2004, at 20:46:13
I really think NE reuptake inhibition is good for me, the only thing is that the orthostatic hypotension, which feels like dizzy and heavy-headed when i egt up is more prominent with the 25 mg nocte. I dont know if it will subside.
I've take TCAs for years and effects like these are tend to subside as your body adjusts to it. I've read a schedule for Desipramine that you could use for Imipramine as well(it's in the psychobabble tips): try 10mg (12,5 it's the same) for the first days. Then, only after, if you don't feel you're helped enough, go on with 20mg for other ten days (and so on). The purpose is trying to find the minimal efficacious dose for you. There are some adult with ADHD that can do very well on low doses of TCAs but you won't know if you reach too early the upper doses. Hope this helps
I was actually thinking of venlafaxine at really low dose [37.5 mg] but to my dismay it only affects 5-HT reuptake at that low dose. :-(((. And there is no nortriptyline and no protriptyline and no desipramine available here
> Damn! And if/when Strattera become available, its going to be really $$$$$$$$$$$$$$$$$$
>
> Do you know if desmethylvenlafaxine affects more of NE reuptake than its parent compound?I don't know what desmethylvenlafaxine is, don't bother about desipramine etc., Imipramine is considered first choice TCA for aduld adhd.
If it doesn't work we will think about something else ;-) Where do you live ?Best Wishes and let us know
Francesco
Posted by Chrissy on April 1, 2004, at 16:52:27
In reply to Re: Ritalin user,YOUR STORY IS SOO FAMILIAR!!!!!!! » Chrissy, posted by aazospiro on March 27, 2004, at 19:05:19
Did imiprimine make you gain weight? It did for my mom and sister in the past...I can't even look at a pill that makes you gain weight...cause I've always gained with others (paxil..etc) What exactly are you taking the imiprimine for? I know that there is a third medication missing from my daily mix. I have a hard time getting rid of anxiety..espec. at night...I have xanax...and usually break off a little piece..or half...but I don't want to build a tolerance..Mood stabelizors make me feel ill, and I can't take anything with weight gain side effects....any suggestions? By the way are you male or female? You never sign your posts!
Chrissy
Posted by aazospiro on April 1, 2004, at 20:44:02
In reply to Re: Ritalin user,YOUR STORY IS SOO FAMILIAR!!!!!!!, posted by Chrissy on April 1, 2004, at 16:52:27
> Did imiprimine make you gain weight? It did for my mom and sister in the past...I can't even look at a pill that makes you gain weight...cause I've always gained with others (paxil..etc) What exactly are you taking the imiprimine for? I know that there is a third medication missing from my daily mix. I have a hard time getting rid of anxiety..espec. at night...I have xanax...and usually break off a little piece..or half...but I don't want to build a tolerance..Mood stabelizors make me feel ill, and I can't take anything with weight gain side effects....any suggestions? By the way are you male or female? You never sign your posts!
> ChrissyI am male. 29yrs. Well I took imipramine 12.5 mg for 14 days and it made into a lamb. But killed my sexual apetite TOTALLY. Caffeine tablets are definitely better. I will go to my doc soon. Maybe ritalin maybe better.
Mood stabilizers make me eat and eat and eat. paxil and the other ssri's make me numb irritable
and even more restless.nasty stuff. I've always drank lotsa coffee but when i took a 200 mg caffeine tablet about 3 weeks ago and then half an hour later sat quietly and relaxed and anxiety and worry free, I WAS EXTREMELY ALARMED. I figured it would have sent me through the roof.
what a shock that was
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.