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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Schess81 on July 19, 2006, at 22:34:59
It was about 3 years ago, but I took adderall daily for nearly a year straight.(I was taking paxil also at the time) I felt great (probably too great) but eventually it stopped working, and I also began feel really lousey when it wore off- typically in the evening.
Since then, my depression has been worse, although I don't know if there is a direct correlation. My depression is so severe, I'm always tempted to go back to stimulants, but am afraid that in the longterm they do more harm than good. Has anyone had success taking stimulants for depression, lasting longer than a couple years?
Posted by rjlockhart on July 19, 2006, at 23:52:37
In reply to Stimulants for depression, any long-term success?, posted by Schess81 on July 19, 2006, at 22:34:59
I was on stimulants Adderall and Dexedrine for 9 years, for the first couple of years it was stable, but at the end it got a little out of control, i would start to take more after it wore off, i would be so incredibly depressed and, i mean it felt like i would just start crying in dispair on how low i was. I had to get off it.
At night my night treatment for the stupid stimlant insomnia was 4mg of Clonazepam (a very potent benzodiepine) and temazepam. This is like taking uppers and then downers.
It was not like this in the beggining. I was very stable on my medication, didnt take it over and over again. It just wore and i didnt care, but after some years it started to bother me.....
In the end, i was on 40mg of dexedrine before i went to mental hospital, i would take it every morning and post here on psychobabble alot.
It was absolutly devesting to be pulled off it. My mother took me off it. I cant describe what psychological chaos i went through, i had rages at my mom during that time.
But back to what we are talking about. Yes it can lift depression, but it wears off and needs frequent dosing, and eventually you have to take breaks.
This is my story..
rj
Posted by Tom Twilight on July 20, 2006, at 7:00:40
In reply to Stimulants for depression, any long-term success?, posted by Schess81 on July 19, 2006, at 22:34:59
Stimulants should be used with caution in depression I think.
I believe my use of Dex has given me long term anxiety issues that I never had before.
Having said that, in the right dose and used cautiously I think they can help.
I don't think they make a good "stand alone" treatment for depression, and be careful if your anxious!
Posted by Oppycat on July 22, 2006, at 14:54:32
In reply to Stimulants for depression, any long-term success?, posted by Schess81 on July 19, 2006, at 22:34:59
> It was about 3 years ago, but I took adderall daily for nearly a year straight.(I was taking paxil also at the time) I felt great (probably too great) but eventually it stopped working, and I also began feel really lousey when it wore off- typically in the evening.
> Since then, my depression has been worse, although I don't know if there is a direct correlation. My depression is so severe, I'm always tempted to go back to stimulants, but am afraid that in the longterm they do more harm than good. Has anyone had success taking stimulants for depression, lasting longer than a couple years?I started augmenting Parnate with Ritalin about 5 years ago when Parnate started to poop out after about 13 years. Ritalin was not a panacea, but definitely helped in allowing me to function for the next couple of years. Of course, I had to increase the dosage a couple of times. I switched to Adderall a couple of years ago when I decided to take something stronger. I have been taking the Adderall XR for the past year or so at a dose of 40 mg daily in the morning.
Again, it was not a panacea, but generally made the difference between functioning as a contributing member of society or not at all. In the past 9 months, I've tried several other antidepressants with limited or no success, but Adderall has been a trusted partner with all of them. My current pdoc, whom I've been seeing for a little over a year now, isn't particularly thrilled with stimulants or MAOIs. Fortunately, she does listen to reason and humors me to some extent. In any event, I've just eliminated lexipro from a combination of lex, remeron, ativan, and adderall. I also reduced the remeron to 15 mg, because any higher dosage magnified all of my vices, including eating, drinking, and smoking. Fortunately, I've kept the Adderall at 40 mg.
I don't have ADHD and I'm not bi-polar, which gives me an almost opposite reaction to stimulants. I get a boost in mood and energy, but tend to lose focus and act somewhat scatter-brained. It's always been my long term intention to eliminate the stimulants, but until my depression goes into remission again, they are a necessary evil. Sorry for the long-winded reply, but that's what the adderall does,lol, much to my girlfriend's chagrin, although she is a bit manic herself.
Michael
Posted by Schess81 on July 22, 2006, at 20:25:19
In reply to Re: Stimulants for depression, any long-term success?, posted by rjlockhart on July 19, 2006, at 23:52:37
RJ/Matt,
How long did you spend on the 40mg daily dose, until you began to take more of it later in the day? Also, do you think since stopping it you've had any long-term increase in depression? Sorry for all the questtions.
Brian
Posted by Schess81 on July 22, 2006, at 20:39:48
In reply to Re: Stimulants for depression, any long-term success?, posted by Tom Twilight on July 20, 2006, at 7:00:40
I guess my fear is that I worsened my depression in the long-term by my adderall use. Although, I don't think I have any long-term axiety issues from the stimulant use- was that what eventually prompted you to discontinue? Or did the anxiety surface only when you stopped?
Posted by Schess81 on July 23, 2006, at 1:49:42
In reply to Re: Stimulants for depression, any long-term success? » Schess81, posted by Oppycat on July 22, 2006, at 14:54:32
Thanks for your reply, I did find it encouraging. I'd like to ask, since you take the adderall xr in the morning, do you find it difficult to do things in the evening?
Well, I must agree that if it can allow me to at least be semi-functional member of society, I ought to give an anti-depressant/stimulant combo another try, reguardless of the negatives.
Posted by Oppycat on July 24, 2006, at 12:30:38
In reply to Re: Stimulants for depression, any long-term succe » Oppycat, posted by Schess81 on July 23, 2006, at 1:49:42
> Thanks for your reply, I did find it encouraging. I'd like to ask, since you take the adderall xr in the morning, do you find it difficult to do things in the evening?
>
> Well, I must agree that if it can allow me to at least be semi-functional member of society, I ought to give an anti-depressant/stimulant combo another try, reguardless of the negatives.I'm glad my reply had some value. Although my energy level seems to drop somewhat around 3:00 pm or so, I really don't feel too poorly in the evening. Of course, I don't do a lot and I'm usually good for about 3 glasses of wine per evening. That's something I need to reduce or, perhap, eliminate, but that's another issue. There definitely seems to be a synergy with adding a stimulant to an AD, at least for me. It's really interesting because virtually all AD's cause hyperanxiety in me at a therapeutic level or below, but for some reason, stimulants cause no anxiety for me. I've yet to find a reasonable explanation for this. I would still love to use the stimulants on a prn basis instead of regularly. Hopefully, I'll achieve that someday.
Michael
Posted by rjlockhart on July 24, 2006, at 22:38:05
In reply to Re: Stimulants for depression, any long-term succe » rjlockhart, posted by Schess81 on July 22, 2006, at 20:25:19
The 40mg lasted for 3 hours
I started redosing about 7 years into it, it was the last 2 that was the worst.
Stimulants can make you feel your going insane if you misuse them.
Too much dopamine, and dopamine deleption
Matt
Posted by laima on July 25, 2006, at 11:35:50
In reply to Re: Stimulants for depression, any long-term succe, posted by rjlockhart on July 24, 2006, at 22:38:05
Matt,Do you know if "dopamine depletion" can be reversed or fixed, and if so, how? I ask because I've used ritalin for a few years, and it's sure not acting in the same way it used to, for me. Ie- it can still keep me awake, but I now fixate on things more, or merely am awake, while simultaneously being spaced out, unmotivated. The anti-depressent effect has faded, too. I've started to get a little concerned over what might be going on.
Thanks.
Laima
>
> Too much dopamine, and dopamine deleption
>
> Matt
Posted by rjlockhart on July 25, 2006, at 13:57:01
In reply to Re: Stimulants for depression, any long-term succe » rjlockhart, posted by laima on July 25, 2006, at 11:35:50
Ritilin can produce a zombie like effect at lower doses, plus tolerance. The reason it causes dopamine "resting" which causes you not to react as naturally as you usally do.
Dopamine depletion is very doubful, i experienced dopamine depletion, belive me when you have it, you feel lifeless, and it stays like that for days. This is usally caused by abuse of amphetamines, which use all of up of the dopamine in the terminals. Dopamine depletion feels devestating at severe. I taken Adderall, Dexedrine, they all are amphetamines. They produce a euphoria, but after time they become abused depending on that person.
I doubt Ritilin does, Ritilin is rough. It causes alot of sorts symptoms, zombie symptom, crying, Dexedrine is sometimes better, but has a more direct effect on dopamine.
How high of a dose are you on ritilin? just asking
Take Care
Matt
Posted by Schess81 on July 25, 2006, at 16:31:01
In reply to Re: Stimulants for depression, any long-term succe » Schess81, posted by Oppycat on July 24, 2006, at 12:30:38
I beleive the reason amphetamines are thought to cause dopamine depletion is because of the way it effects dopamine in the brain. Amphetamine tricks the cell to dump large amounts of dopamine into the synapse. However, prolonged high dose use can deplete you brains dopamine stores, which RJ is decribing. Ritilin may not cause this because it acts as more of a dopamine re-uptake inhibitor, similair to an ssri but instead affecting dopamine, keeping more of it in the synapse longer.. However, both amphetamine and ritilin cause a down regulation of dopamine receptors on the receiving cells, as they react to the increase of dopamine they are receiving. This is what is thought to cause tolerance, as the brain adapts to the effects of the stimulants. After being off the drugs for sometime receptor density goes back to normal, but in the meantime it can be a very miserable experience. (this is one of the theories behind drug addiction). Also, it is sometimes discussed here that taking dopamine amino acid precursors like DPLA may also help with dopamine depletion, but I dunno.
What I am phobic about is the long term, unknown adaptations or damage etc. that may result from stimulant use, expecially for depression. In depression, when tolerance to stimulants builds, I think it obvioulsly puts one in a much worse situation than any recreational user would be in. But if only tolerance was the problem, taking a few days off here and there would be able to fix the problem. However stimulants can 'poop-out,' cause longterm anxiety, insomnia, and be unpleasant when they wear off- none of these problems is explained by simple tolerance models. Ive actually been thinking of trying something milder like provigil, perhaps it could be effective and have less side effects.
I wish the exact mechanisms of severe refractory depression was better understood, because it seems whatever I do my brain wants to fight back to its equalibrium, which unfortunaltely seems to be depression. Anyway, I dont mean to be so negative, but I guess I'm just.. depressed.
Posted by laima on July 25, 2006, at 17:27:53
In reply to Re: Stimulants for depression, any long-term succe, posted by rjlockhart on July 25, 2006, at 13:57:01
Hi Matt,
I'm actually only using 20mg or ritalin, because I am also taking another medication which could make a higher dose trouble. I used to take much more in the past.
But with either dose, I am still feeling certain that I've developed some kind of tolerance or other issue. Even 5mg used to be dramatically enlivening and helpful, once.I actually do think I've experienced some of what you describe as occuring from amphetamine use- which worries me now even more.
The only genuine amphetamine I ever tried was dexedrine, but it didn't agree with me at all- instant agitation/paranoia disaster, even at the lowest possible dose. I'm reluctant to try any of the others now.
Thanks for your interesting information.
Laima
> Ritilin can produce a zombie like effect at lower doses, plus tolerance. The reason it causes dopamine "resting" which causes you not to react as naturally as you usally do.
>
> Dopamine depletion is very doubful, i experienced dopamine depletion, belive me when you have it, you feel lifeless, and it stays like that for days. This is usally caused by abuse of amphetamines, which use all of up of the dopamine in the terminals. Dopamine depletion feels devestating at severe. I taken Adderall, Dexedrine, they all are amphetamines. They produce a euphoria, but after time they become abused depending on that person.
>
> I doubt Ritilin does, Ritilin is rough. It causes alot of sorts symptoms, zombie symptom, crying, Dexedrine is sometimes better, but has a more direct effect on dopamine.
>
> How high of a dose are you on ritilin? just asking
>
> Take Care
>
> Matt
Posted by noelle on July 30, 2006, at 17:27:34
In reply to Re: Stimulants for depression, any long-term success?, posted by rjlockhart on July 19, 2006, at 23:52:37
Although this my work for some people, if you really have refractory depression it can make things worse. Adderall was my demize, and I haven't been the same since. It took more and more and then stopped working and I seemed to have permanently damaging my dopamine receptor because I had horrible ahedonia after. I would always try it agian and again looking for that same break in depression that it initially gave me. My advise try it just realize it might make other medications less able to work
Noelle
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