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Inattentive ADD/LD Updates--No Progress...

add anxiety

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#1 whiteelephant

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Posted 25 June 2019 - 12:02 AM


Just wanted to post my updates now that I've tried things for a couple of months.  I have not noticed much change.  And I've tried many medications, nootropics, therapy, exericse.  Not sure what to do. I kind of baffle everyone.

 

Labs: I had high HPHPA.  Took Vanco.  Levels decreased.  Still left with attention/mood/anxiety issues.  Had low vitamin C.  Poor CYP2D6 metabolizer. I did get 23and me done, but unclear to what value the SNPs can be navigated and made actionable.  I've heard  many mixed opinions, and my MD only regards them as valuable when looking at pharmacodynamics.

 

Context: Made it to college where my hard work and systems broke down and I was diagnosed with ADD/depression/anxiety.  I map to Amen's Brain type 8 if that's a helpful comparison.  I have trouble planning out my thoughts before getting them onto the page.  It's easier for me to think in blocks/chunks of text than be driven by ideas.  This creates a mess when planning my life.  Hard to integrate and learn from prior knowledge/experiences. I can't focus on a larger direction.  I often rehash issues because I have such a poor memory.  I also meander when thinking about topics, can't just pick out the relevant details, but end up wading through a lot of noise.

 

On the other hand, I've had sporadic success.  It's sporadic and I can't implement the systems I need to achieve consistent professional stability and success.  My brain is like etch a sketch.  If I can get someone/something to prompt me, I can sort of think more organized and coherently.  As an adult, these prompts aren't really that feasible to generate and maintain a healthy level of functioning/self feedback.  I can't just go around blurting out thoughts and handing terrible papers for people to review.  I wish I could process more of my own raw thoughts with less effort.  I can't take advantage of therapy because I am so near term focused/frustrated.  Same thing happens with a hurt knee.  I can't stick with the process and see that there's something else ahead.  For my attention issues, there really hasn't been anything else. 

 

Anxiety/Emotionally, I have a terrible self esteem, negativity and frustration tolerance with my attention issues. I get really hopeless/discouraged.  But an event can shift/refocus my attention, for better or worse.  So prompt based.

 

Overall approaches:

 

I try working with an add specialist and my anxiety issues are hard to address.  Or I try dealing with an anxiety specialist and my add issues aren't addressed.  No specialist has been able to reasonably look at both. And everything is prolonged trial and error. 

 

In the past several years I've tried:

Combo of Pristiq/Intuniv --Intuniv seemed to help initially, but I could never go past 2 mg as I get hypotensive. 

Combo of Pristiq Intuniv/Strattera--Seemed to help, but strattera introduced crying jags when I get frustrated. Had to stop at 40 mg Strattera because of exercise induced tachycardia/and high baseline HR.  Went off intuniv and Pristiq to minimize tachycardia and the amount of drugs.

Adderall--Way too anxious

Concerta--helped but way too hyperfocused and anxious, didn't help with executive function that much

Wellbutrin--Made way too anxious, slightly helped.

Concerta/Prozac--Too hyped up, couldn't focus.  Organization troubles still largely apparent

 

 

 

Currently:

Memantine-21 mg (with 10 days between 7 mg dose increases).  Been on this for a month.  Hard to appreciate any drastic difference.

Strattera-40 mg

Aetonolol-25 mg

 

At best, anything I've tried has helped 15% for my attention and 40% mood.  At this rate, to get a 70% symptom improvement, I'd have to be on quite a few meds. Since I can't focus, I can't really evaluate the subtle improvements with each addition either.  They're not huge.  They're subtle at best. 

 

1. What are people's thoughts on strattera?

2. What else could I try for the ability to plan/think long term?

3. What else for managing the emotional frustration that's so constant?

 



#2 jack black

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Posted 26 June 2019 - 05:48 PM

i had to look up the HPHPA. not sure if a valid concept (need to read more).

 

sorry that nothing is helping you much.

i have no answers to your questions, but i'm also trying memantine. this is my 2nd week and i just went from 5mg/day to 10mg/day. i plan to rump to 20mg, as this is the dose i saw published in a few studies. i do feel more energy, and more positive emotions/self esteem. maybe a bit more motivation (this one is a very tricky part to fix).

 

this is my 2nd time trying memantine. last time, it was 2 years ago, and after initial improvements, i stopped feeling anything and stopped it. but i didn't go all the way to 20mg. i stopped at 10mg. i was also experimenting with a variety of things at that time. now, my everyday stack is fairly stable.

 

please post any progress.



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#3 whiteelephant

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Posted 26 June 2019 - 11:13 PM

Did anything help with attention issues?  What has helped for those with more learning disability/neurotypical type executive function?  Strattera just doesn't seem to be cutting it.  But I think I'm on the dose as high as it can go with the teariness.  I just wish I wasn't so situation/prompt dependent, and could hold onto/plan goals more. 



#4 DrewMichael21

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Posted 27 June 2019 - 01:18 AM

Did anything help with attention issues?  What has helped for those with more learning disability/neurotypical type executive function?  Strattera just doesn't seem to be cutting it.  But I think I'm on the dose as high as it can go with the teariness.  I just wish I wasn't so situation/prompt dependent, and could hold onto/plan goals more. 

 

1. Welcome to the Club, Hopefully your not at my stage or god have mercy on your soul.  What no one is telling you is that their will come a day when the meds won't have their same effectiveness even with med breaks. This means you may just have to live with it.  People think it's this permanent thing but psychiatry is still in it's infancy in actually truly treating the cause of the problem. All you can do is manage it the best you can, all neuro-chemicals have DMU. Feel free to ignore me if you don't want to listen. As for myself..I will probably study this disorder for the rest of my life..Hopefully I can solve the problems of ADHD medication paradox. We need new innovations that simply do not exist at this time in history. It's a shame because we will probably not live to are fullest potential without something absolutely innovative.  Once you reach my point no amount of experimentation will matter or perspective change, all you do is manage it and that is it.



#5 Reformed-Redan

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Posted 27 June 2019 - 03:38 AM

Look to bump up your dose to 80mg of Strattera. Only thing that consistently works for my ADD-PI. Also, don't get into the roller-coaster that are amphetamines. People with ADD have a predisposition to abusing those drugs.


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#6 DrewMichael21

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Posted 27 June 2019 - 04:04 AM

Look to bump up your dose to 80mg of Strattera. Only thing that consistently works for my ADD-PI. Also, don't get into the roller-coaster that are amphetamines. People with ADD have a predisposition to abusing those drugs.

 

1. I second this, Just stay away from them period unless your the hyperactive type. Amphetamines will lower your already Low aroual state to a worse baseline than before and you will build dependency upon them. Obviously, you are technically dependent upon extrinsic motivation to complete a task but it's important that it will probably leave you off worse in the long run unless you have zero to no side-effects and  your functioning is improved at the sweet-spot.  Stimulants have to be used responsibly otherwise it's a slippy slope. 







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