New to Adderall, having constant mood changes?
Question:
*i am also taking 60mg of Cymbalta*
I will feel 'normal' for a short period of time, such as 10 to 15 minutes, then i will spiral down suddenly and feel very depressed and not want to move or talk, then it leaves in a few minutes, and i will either be normal or feel 'good'.
My assumption is that with the XR i go through a short withdrawal, more medicine is released, gets me out of my depression and makes me feel 'good'. Maybe when it starts to run out thats when i start to feel depressed? I feel trapped because i know with the XR i have a long way (many hours) until i get clean. Would regular Adderall work better, or would i have to take it more often?
But i do find that if i occupy myself with a task and not think about it, the depression is less frequent and goes away quicker. Is this the intention of the medication? Stay focused or be depressed?
Answers:
I have been on a number of stimulant medications for treatment of my ADHD, all with varied success. I have also taken stimulant medication to augment the other meds that I take for depression. Dexedrine has worked the best of all that I have tried. But now the Adderal--------
I am on a lot of medication to treat my depression. I tried Adderal for about a month, and during that time, my depression worsened. This was noticed both by my wife and the psychologist that I was seeing. Then when I went off of the Adderal my mood lifted considerably.
Sometimes the meds have what is called a paradoxical result - meaning that they do the opposite of what they are to do. Your spiralling downward concerns me as it seem to be happening so quickly right after you take it - it could be a reaction to the medication and something you should definately talk with your doctor about. You can ask your pharmacist as well as they have ready access to the technical data. I would encourage you to do that soon, and not do anything different with your meds until you do contact your doctor.
There is the also the tendency to experiance a rebound effect from meds, especially those that wear off quickly. I found that when I first started taking Dexedrine, that about 5 hours after I last took it, I would get real agitated, and angry. I started taking smaller dosages more frequently and that helped. I no longer have that difficulty even when taking the larger dosages. It would seem that my body is adjusting to it. Also, as a general rule, Dexedrine tends to have a softer effect.
If your medication is appropriate, you should notice that you can stay focused better, have more energy, be more task oriented and that your mood improves.
As far as your observation that when you occupy yourself and not think about it that your depression is less frequent, that makes sense to me. For one thing, you are distracting yourself, and getting out of the "feeling mode" so as to speak. Also, I have found that because of my depression, I have a great tendency to withdraw, (in fact I have spent about 6 years doing it until last fall) and so I need to make an effort to get involved or reinvolved with people and outside things. We humans need to have a source of meaning, mastery and membership (belonging) in order to be fulfilled in life. Depression impacts those things greatly.
I hope this is helpful, and I wish you well.
Don't know - I'm off it and I'm supposed to be doing work now.
It's a GREAT hangover remedy though.
I am currently taking 45mg of Adderall XR daily, along with bupropion (Wellbutrin). That combination has been noted to have good results for ADHD symptoms in some adults. My 8-year old son is on 10mg of dextroamphetamine XR for his ADHD. I've observed, both in my little boy and in myself, that there is a sort of "coming down" from the medication later in the day, around mid-afternoon. He is noticeably more moody, easily upset, and is restless and wants to do something but can't think of anything he'd like to do. For myself, I am aware of feeling a kind of let-down, a little depressed or out of sorts. I've read and heard of similar effects for others on stimulant medications.
First of all, as with a lot of medications, you need to give your body some time to adjust to it; it could be a month or two before you can tell if this is going to be your norm or if it was just the initial adjustment period. Yes, if you took regular Adderall you would have to take it more often because you need to keep the level of medication in your system steady during the day for it to have the best results. That's why I asked the doctor for extended-release, both for my son and for me; we only have to remember to take one dose in the morning. For a lot of people with ADHD, remembering several doses throughout the day has not proved successful. Within a couple of hours, the wearing-off of the medication is gone, and it's just something I expect and put up with for now. Our doctor has suggested taking my son off the medication for the weekends, since he takes it primarily to help him be calmer and focused in school. We've been doing that all year, and even though it means he's hyperactive and bouncing off the walls on the weekends, I feel better seeing him be himself, full of energy and excitement.
Actually, I've done that for myself some weekends too, since it's more crucial during the week to try to have my focus at its optimum. You might ask your doctor about taking breaks from your medication a day or two every week, if you find that it helps to have some "normal", non-medicated time. That is an advantage of stimulant medication for most people; it has an effect quickly and it wears off quickly, so it shouldn't be a problem to take a day off from time to time.
I know some adults do take anti-depressants to counteract the effect of stimulant medication; I can't speak personally for how well that works, because I didn't want to add more medication to what I was already taking. A few things you can do to help sound really simple, but studies have shown them to be effective (I read Prevention magazine a lot for current information on health and medical science). Exercise is very important for helping regulate your moods; I've found that I do better in general if I'm getting in at least a good half-hour walk 4 or 5 days a week. Studies have shown that 30 minutes of exercise can have as powerful an effect as a dose of anti-depressants; brisk exercise releases chemicals in your body that help lower cortisol(stress hormone) and help you feel calmer and elevate your mood. Getting regular sleep, and enough of it, can make a difference, too; these may sound like really obvious things to do but your physical health is connected to your emotional and mental health. I know that when I feel better physically, I'm not as likely to be stressed or moody or down.
Some of the side effects can't be avoided for a lot of people; they're just going to be there for as long as you take that medication. That's why it ultimately is an individual choice as to how anyone is going to deal with the symptoms of ADHD; some people respond wonderfully to meds, some have a moderate response and/or negative side effects, and some people do not respond to the medications. I don't know how many other medications your doctor has had you try before the Adderall or if this is your first one, but think about what benefit you want from treatment, what side effects you're willing to put up with, and how many different ones you're willing to try.
Before I was on Adderall, I was prescribed Ritalin, then Strattera. The Ritalin had no result; the Strattera had no result and it had very negative side effects. This is the only one so far that has had at least a moderate result. If I decide to go off of Adderall at some point, I don't know that I'll experiment with any more medications; there are a number of adults with ADHD now who are choosing to go the non-medication route and practice building strategies for daily life. That takes a lot of work, but I've read comments by some of these people that they prefer to be in control, to not be medicated and to feel like themselves.
It is very important to be under the care of a doctor who listens to you and uses your input to help make choices for the best treatment for you; if you feel that what you're on is not good for you or the side effects are too much for you to take, you need to be able to talk to your doctor. If he or she dismisses your concerns and doesn't really listen, then you need to find another doctor; you need to listen to your instincts and find a doctor you trust, so that you can be an active partner in your health care.
I know this is a long answer; I've struggled with the characteristics of ADHD for all of my life, long before I was diagnosed with it as an adult, and I know it's a frustrating process to try to find somethiing to help you with it. I've read 30 or 40 books on the subject over the last few years, and a few have been really informative and helpful. Thomas Hartmann has written several good books about it. One of my favorites to recommend is "Delivered from Distraction" by two doctors, Edward Hallowell and John Ratey. They have not only studied and treated ADHD for years, they both have it themselves, so they can write from a personal point of view as well as a clinical one. It's informative, encouraging, and often funny(we have to be able to laugh at ourselves sometimes to get through things!). I hope some of this helps; hang in there!
The medicines with extended release times usually are quite gentle in releasing the meds. Ask your psychiatrist what's going on. You may have something else, like a rapid cycling Bipolar Disorder, or something else.
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