51 replies to this topic

[orangish]

Okay. So months after I try yet another med combo and assess the trajectory of my life, it is really undeniable that I have processing problems and a slowness of processing that medicine doesn't address yet. I am trying to find my own techniques to address this, as science has shown the brain can be improved.

The sad reality is that I don't think I can do this without medicine. I am not just looking for a pill to get super-phenomenal concentration abilities, I'm looking to get on level-ground, to wake up and take for granted that my mind can tackle conversations etc. Albeit, I have done well in school and am at a good uni., but I am always afraid that I or another will find out that I cannot achieve this level of life, that my concentration prevents me from functioning at a certain level of thinking, of working of relating to people.

Right now, I am on tegretol and wellbutrin (just switched from xr to 300 xl and eventually will be at 450 xl). I'm not looking for advice to replace that of my doctor, I'm sort of at my last ditch here. What I find out about my mind or what my mind cannot be will determine where I apply my effort, what disappointments I will have to accept without even trying.

The reason I mention facing the impossible before discovering that the impossible is impossible because there might be biological inevitabilties and I would face the same realization that I have today in twenty years of unsuccessful career pursuits.

So, my question(s):
Has anyone come across any research on more inattentive type attention deficits? Anyone have any idea of what better combo of drugs or what drugs might work effectively for this type?

[luv2increase]

http://www.asktheint...isorder_ADD.asp

"Classic ADD is characterized by both hyperactivity and inattentiveness. It is usually quite easy to treat by a combination of a high protein diet, aerobic exercise, a stimulant such as Adderall or Ritalin, and possibly the supplement of L-Tyrosine. Often an anti-depressant is used as well.

Inattentive ADD lacks the hyperactivity, but people who suffer from it have a difficult time focusing and are often very scattered. As with the classic type the prefrontal cortex is involved. The treatment for inattentive ADD is usually exactly the same as the classic type."

It sounds like you have the anti-depressant down. Talk to your doctor about taking a stimulant such as adderall or ritalin to combine with that. Instead of thinking in your mind that drugs are the only way to go to fix your head, try other things such as listed above such as aerobic exercise, high-protein diet, etc... Read the whole article. It talks about chiropractic care also. You should definitely try fish oil and give it a month or two to determine whether or not it is helping.

You sound as if you have a very negative attitude towards your supposed illness. If you think more positive about things and life in general, that may help a lot! If you constantly worry about this, it will probably make it worse. Having a lot of stress will cause anyone to have attention problems and others which mimic add.

If I were you, I'd take/do:

Multi-Vitamin
Calcium Magnesium
3-5g Fish oil daily
Wellbutrin
Ritalin or Adderall (Last Resort)
Engage in an aerobic exercise program
Get plenty of sleep
Meditation
Practice positive thinking
Try not to think so negatively
Try not to over worry about life and your future 24/7 (it'll only drive you crazy)

[medievil]

i would use ritalin as your first resort, attack the cause of add right away!!

later add in the rest of the above suggestions ^^

[jdog]

I lost my internet connection and consequently a large bit of my original response. I'll just jot down the basics of my ideas.

Man, how I can sympathize with your situation.

Do a search for 'Sluggish Cognitive Tempo' - a subtype of Inattentive ADD. See if that helps answer any questions.

A thing as simple as a diagnosis will help crystallize the existence of your difficulties as something not just 'in your head' so-to-speak. It will also enable you to shift the burden of responsibility of having not been able to meet the expectations you've placed on yourself, onto something largely outside of your direct control; your unique biochemical makeup.

I empathize with your career difficulties. Keep in mind though; it's just one piece of a large, masterpiece of a puzzle. I'm sure you've heard this before, but find what you love to do, and the happiness will follow. Also, for what it's worth, as much as you may be convinced that all your answers might lie in a pill, I will be very surprised if that is indeed the case.

“The trees that are slow to grow bear the best fruit.” – Moliere

[blarger]

I really dont think anything is wrong with you other than being trapped in a loop of autoanalysis. You need less free time/more real life responsibilities where you dont have the luxury of thinking about your thinking.

[Mixter]

Good advice. Additionally, keep listening to yourself, without getting frustrated from
that: If you're experiencing being kind of uncomfortable up to anxious about every exam
success, or generally have a bad/sad mood, there may be gaba and serotonin imbalances
involved, that the wellbutrin and the rest cannot fix. Exercise and the other lifestyle and
thinking changes can, and if they fail at that, boost said neurotransmitters with st. johns
wort and gabaergic noot's.

In my (subjective) experience, I think even if your noradrenaline/dopamine is fine (the
major problem to which ADD is classically attributed), then gaba/serotonin deficiency
may gnaw at your concentration and learning skills. With negative imbalance in the
inhibitory neurotransmitters, thinking isn't slowed down, but unreliable and erratic,
which can be much worse. I'd think that the combination of very erratic thinking and
memory problems despite use of cholinergics, esp. when combined with agitation and
excess worrying, always points to a lacking of the inhibitory neurotransmitters.

IMO there doesn't have to be a huge trade-off between thinking speed and thinking
correctness/consistence, as long as you can keep the inhibitory neurotransmitters in
balance. Getting out of balance is pretty easy with nootropic supplementation, but
also easy reversible. But especially with deeper underlying problems, like actual ADD,
whatever balancing measures are taken, should always be combined with lifestyle,
xercise, time management. I have no concrete studies to back it up as this is very
subjective, but I think at least some of this figures

[orangish]

All--
Thanks for the constructive advice. I don't really want to up a mood stabilizer which would address the Gaba piece. Nor do I solely want to focus on med's, but it's difficult to take on other responsibilties with the inconsistency that can come from my thinking (would mean I would take on mindless pursuits but that would be at the expense of my other committments which require thinking that isn't predictable). Unless over the years I've grown so attentive to my inattentiveness that I block out the possibility of taking advantage of my sluggish cognitive tempo.

jdog--I most certainly checked out the sluggish part. Based on what you wrote, I assume that you have some firsthand contact with this so-called biological tendency. Barkley's article was particularly depressing. The only reason I research this currently is so that I know what odds I'm up against, certainly as no excuse. The explanation offers a way to realize the deeprootedness of what I'm up against and the true meaning of gradual change and hopefully not the meaning of impossible change.

[thereverend5]

I'd stop finding different addictions if I were you, it won't help anything.

[jdog]

All--
Thanks for the constructive advice.  I don't really want to up a mood stabilizer which would address the Gaba piece.  Nor do I solely want to focus on med's, but it's difficult to take on other responsibilties with the inconsistency that can come from my thinking (would mean I would take on mindless pursuits but that would be at the expense of my other committments which require thinking that isn't predictable).  Unless over the years I've grown so attentive to my inattentiveness that I block out the possibility of taking advantage of my sluggish cognitive tempo. 

jdog--I most certainly checked out the sluggish part.  Based on what you wrote, I assume that you have some firsthand contact with this so-called biological tendency.  Barkley's article was particularly depressing.  The only reason I research this currently is so that I know what odds I'm up against, certainly as no excuse.  The explanation offers a way to realize the deeprootedness of what I'm up against and the true meaning of gradual change and hopefully not the meaning of impossible change.

I know you're not looking for an excuse, and I hope you don't interpreting that I'm suggest you use a diagnosis as such. However, from my own personal experience, for so long, it seemed as though I were just 'banging my head aginst the wall,' trying to find out where my difficulties were stemming from. Finding an actual clinical diagnosis was in a way, comforting.

I think you need to keep researching until you reach a point where you're fully satisfied. Also, from my personal experience, as well as from my philosophical perspective, I think 'impossible' and 'change' are contradictory to each other.

[graatch]

You need to look into CBT. Negative thought patterns and neurochemistry: a feedback loop. Depression is causative of attention deficit disorder. I read your away messages sometimes. You just can't think like that and expect an improvement in your symptoms.

So is sleep deprivation. Fucked-up sleeping patterns are causative of ADD. How are your sleep patterns? Go look at trouble and ATB's sleep posts on mindandmuscle.

Do you get good morning light? Sunlight? Vitamin D? Do you stay up late at night staring at a blue-light computer screen?

How is your diet?

Are you an ectomorph? Endomorph?

Do you meditate? Exercise? Take omega-3 fats?

Do you have allergies? Have 'em bad?? What about other autoimmune symptoms?

Are you socially isolated, lacking in daily, regular meaningful connections with people around you? Social isolation is causative of ADD symptoms.

Why are you on carbemazepine? You are a manic-depressive? Prone to hypomania?

----

Sir I'm dealing w/ my own issues these days and haven't had, heh, much energy to chat with you. I really recommend you try posting again, and search on mindandmuscle, not to insult this nice forum but you'll probably get more there, and research the posts of user "trouble" extensively on avantlabs, ironaddicts, and mindandmuscle if you've got some time.

I know firsthand how absolutely fucking frustrating this is -- there are a lot of great things I know I could do in the world if I could find the energy within myself. But I constantly feel stymied by this slowed-down piece of biohardware I hooked down the tubes.

My plan in a few months is to kick the dexedrine (should take about 14 days to recovery to a base inattentive state, IIRC from my own experience and the reports of others) and kick the exercise into high gear.

Low dopaminergic tone is a serious problem ... might want to look up the posts of user Frangible on that.

Don't be discouraged by my knowledge of these avenues and the fact I'm still ADD -- for a long time I was in a situation -- at my mom's house, lightyears away from the people I know and any source of activity or stimulation other than a laptop -- that pretty much prevented me from following these paths. Things are improving but I still need to kick the dexedrine -- the dependence makes one very, very ADD on the off-days.

In the far future, I'm really looking forward to a meeting a doctor friend who will putAzilect (rasagiline) on my insurance (massive fucking nerve growth factor boost, should be excellent) and even ladostigil. Mmm...ladostigil. That reminds me, MAO-inhibitors may be something you want to try if you tend towards flattened affect (from your msgs and posts it seems like you might).

Wellbutrin, btw, probably displays stimulant reverse tolerance: i.e., improvement of dopaminergic responding. i.e., Things might get better.

Don't despair, I've been where you are and I've also been much better. Really, look into what I recommended. There are a lot of things you can work on, and this field is still opening up.

[graatch]

Do you often find yourself experiencing signs of ... let's say, cognitive overload? A dirty, tired feeling behind the eyes, is how I feel it sometimes. Strong fatigue. And a definite drop in concentrative powers, mood, energy.

This is glutamate toxicity. Not uncommon in certain types ... people who, let's say, notice a lot about the world. Someone like you I think.

Constantly being in a state of glutamate toxicity probably leads to ADD.

If so you might want to look into low doses of (interchangeably) oral GABA (500mg-2g), theanine, inositol (650mg or so), and/or a little taurine (1.5 g or so), whenever you feel this burnt-out way, or whenever you feel that your NA is going but the DA isn't following up so well in its footsteps ... ie anxiety.

[graatch]

Ohh ... or are you taking the tegretol as an anticonvulsant? Very interesting. Got epilepsy? What kind?

Note that by way of anecdote and people I know manic-depression drugs can leave the bipolar personality at a constant "depressed" state ... some others are left constantly hypomanic, lucky motherfuckers. High doses of lithium have been associated w/ excitotoxicity ... while, low doses of lithium (5-15mg absorbed?) may be an important nutrient and help with preventing the NMDA neurotoxicity described above.

[graatch]

You should test for heavy metals, and get some good tests of fucking thyroid function for god's sakes.

Here is a good thread to start for you:
http://www.mindandmu...showtopic=25559

I'd pay good mind to the excellent posts of blarger and trouble.

As far as vitamin supplementation goes, basics IMO are indeed magnesium (250mg citrate or glycinate possibly, at every meal and before bed) and 30mg zinc (fights prolactin). Crucial, these. Lack of magnesium (which affects most of the U.S. populace) is implicated in ADD. Fish oil, etc...

[graatch]

http://www.beatcfsandfms.org/ <------------ Worth examining

[blarger]

I'm the same blarger who made that post on MandM way back when... I forgot all about it. I would now add that from years of personal experience and experimentation, and as is recommeneded by almost all holistic practitioners and systems, that mental/physical/emotional health is more strongly dependent upon robust digestive function even more than diet specifics or exercise. While obviously interdepedent, some people, like myself and I imagine many others, have poor digestion no matter what is eaten or how much exercise performed.

[luv2increase]

Are you saying that a colon cleanse and possibly a liver cleanse along with a good probiotic supplement may help cfs etc...?

[orangish]

Tegretol is for some presumed mood problems that emerge when I am on anti-depressants and stimulants. I get this bliss/jitter/feelingofwinninghthelottery/orbeingwatsonandcrick. Sometimes not intense, sometimes yes.

Thanks for your massive posts, graatch. Certainly, I understand your situation. My only stimulation is my coursework, my computer and occasionaly wander out to see friends. That let me tell you, is equally if not more depressing. I can act very childish, can be very passive, require friends to pull along the conversation. I'm trying to fix this part, and have planned to go see a cbt specialist to get out of inside some habits. It's been like this pretty much always, except in high school when I got involved in extracurric's (on the road to intensive college, with a notsogood homelife). My environment is really unideal as I haven't found a way to get out of my parents' house yet and they both have their own frustrations and problems.

But these things I will probably figure out more on my own, though it is hard to get out of this feeling of disgusting recluse. The more perplexing part could be getting on the right meds. I still suffer from significant inattentiveness--not sure how much add there is in there....MAOI? I get depressed when I try and figure out things that I care about and can't really distinguish what is important to me--feel trapped and hopeless, or when I try and relate to people differently (and actually not be so passive). I'm not sure if these things are difficult, if I'm in a state, or verging on impossible with my attention issues.

The way I pull out is when i have hope that I can get my studies tamed, when I can rest assured that I am on something of a route towards a future and not simply flitting my time here and there for distraction from what I cannot do.

[ikaros]

Have you tried tyrosine yet?

[graatch]

Would you say social difficulties are more a function of anxiety, or...not being able to focus/"pull" the conversation out of yourself/make things "flow" ... or a combination somewhere between the two?

That is, are things easier for you when you're relaxed in the company of those friends, much more difficult with a friend at a bar, say?

Social anxiety, at least, is a learned reponse than can be unlearned.

The wellbutrin doesn't seem to help things so much, eh?

I took wellbutrin for a time and found it troublesome for intellectual work due to a general "stoned" feeling which may be related to anticholinergic activity. I've heard this fades w/ time however.

Did you try lower dosages w/ the stimulants and antidepressants? I do notice you're not on SSRI anymore, which for one reason or another I think may be a good idea. As far as stimulant medication goes, the hypomanic feelings tend to fade, but of course these can be problematic in the long run for many reasons.

Sure, a MAOI may be worth looking at. I like the EMSAM patches. You may encounter the same sort of problem w/ mild euphoria on these though.

I really encourage you to look into the sort of things I mentioned above ... inflammation, social situation, diet, trouble's posts, sleep cycles (very important), and yes, gut health.

-------

Thanks to blarger for mentioning that. I don't know about the liver/colon detoxes but I do know the basics are:

- lots of good, varied plant fiber. both cruciferous and leafy green veggies, at every meal
- probiotic supplementation
- stress control
- maybe some tmg
- good diet otherwise

Anything I missed?

This relates back to the issues of inflammation (which antagonizes mental activity) and the general absorption of micronutrients needed for good functioning, among other things. It's all connected.

The liver is your detoxification engine and it needs to be kept healthy.

Another good supplementation recommendation for most people might be ~500mg NAC, between meals, with vit.C and sam-E and maybe KR-ALA.

Stress control, stress control, stress control, daily walks, etc.

[luv2increase]

Do your medications even help you? Were you worse off before you were medicated? Maybe you should just quit taking all scripts and only take a multi, fish oil, and cal magnesium supplement. Do that with an aerobic exercise program, and I bet you that you'll be feeling great.

I seriously think your meds are making you worse.

[graatch]

Also, don't listen to luv2increase. Bit of a joker, this fellah

EDIT: It's indeed true you may want to drop stimulants altogether when you're ready -- and the sooner the better. They're the opposite direction you want to go in the long run -- calm but focused, and not in need of such meds. This isn't totally plausible for most people during classtime, and his irrational hatred of the uppers in general is unfounded. They do have psychiatric value, and they do pull a whole lot of people through their shit. Remember, dopaminergic stimulants show reverse tolerance.

I think our above poster would love to blame this whole situation on the psychiatric institution (which is fucked, surely). No ... aerobic exercise + fish oil isn't a front-line treatment for a reason. [thumb]

[luv2increase]

Also, don't listen to luv2increase.  Bit of a joker, this fellah

EDIT:  It's indeed true you may want to drop stimulants altogether when you're ready -- and the sooner the better.  They're the opposite direction you want to go in the long run -- calm but focused, and not in need of such meds.  This isn't totally plausible for most people during classtime, and his irrational hatred of the uppers in general is unfounded.  They do have psychiatric value, and they do pull a whole lot of people through their shit.  Remember, dopaminergic stimulants show reverse tolerance.

I think our above poster would love to blame this whole situation on the psychiatric institution (which is fucked, surely).  No ... aerobic exercise + fish oil isn't a front-line treatment for a reason.  [thumb]

Hmmm... A joker and a fellah huh? Show some respect. We are not children here.

This talk a little about aerobic exercise and add etc...
http://www.smart-kit...y/add-and-adhd/
Seems to me "aerobic exercise" exerts effects similar if not the same as stimulants do; therefore, exercise may possibly be a viable alternative to stimulants.

Just type in fish oil and add and adhd, a whole host of stuff will come up about it. You don't have to take my work, go look for yourself. I guess no one should listen or "try" any of the solutions that the proponents of natural therapy come up with, right???

There is a host of info about fish oil & aerobic exercise benefiting both mood and alleviating add adhd symptoms. I think that the original poster needs a boost in both these regards.


It seems to me that was he is doing now IS NOT WORKING. What is the harm with trying a natural route if the non-natural route doesn't seem to be getting anywhere? Of course, he hasn't tried the stims yet, and we all know that they will probably work, but to what opportunity cost??? His health later in life, and a whole host of other things could possibly be negatively affected from using these stims to battle this.

"It's indeed true you may want to drop stimulants altogether when you're ready" He isn't even taking them yet!

"No ... aerobic exercise + fish oil isn't a front-line treatment for a reason." What are you getting at here? I hope it is that the psychiatric institution would not be able to "PROFIT" off of this disorder due to these "alternative" therapies in which they wouldn't see a dime off. If there is some other so-called reason, I am completely unaware to it.

"They're the opposite direction you want to go in the long run" I agree with this as already stated.

"I think our above poster would love to blame this whole situation on the psychiatric institution" Now what would make you go and say something like that?

Could you please tell me why he shouldn't listen to me. You seem very ignorant my friend. This being a little harsh, but in situations like this, reality checks are needed.

[orangish]

Oh geeze. Thank you all for your well-intentioned and very vociferous suggestions. No need to break out into voiced disagreement.

I have tried the natural route. The med's I am on help somewhat, really only about 30% at most. I do feel stoned sometimes, and it really is hard to get my mind into gear unless I have an assignment.

I think that my social problems are a combo. of anxiety and pulling my unfocused mind into a focused situation. A LARGE part of my problem stems from how I am geared to want to do things in order to be recognized, so I will always be trying to key into what is admired/popular/recognized in general (impressing, impressions, sort of young of me, I know). Harder (not impossible) for me to take into consideration peoples' emotioms/wants/interests. My interests are too based on the fads of repute and this contributes to anxiety and this contributes partly to my not developing interests. I also think I have trouble figuring out what to spend my time doing and commit to things, but there is also some anxiety.

[medievil]

meds just slow the uptake of dopamine, attacking the cause of add right away

plz all bullshitters claiming those meds are bad should shut up..

"show reverse tolerance"
yup

@orangish

one question for you, do you have problems in "sports"
like coordination problems

[nootropicpete1]

here is why drugs are not as good as they may seem - http://www.adhdvideo.org/


orangish, let me get your email, we both have the same exact type of ADD

[orangish]

Just pm me, dude. I don't have any great suggestions though and I think you're best getting on the road to getting yourself some good help. Can send you some links so you don't squander time trawling the internet.

Consider yourself fortunate in some senses as despite the misery this disorder is causing you're having a lot of early insight.


@medievel
I had coordination problems when trying to play the violin/piano. This is partly why I had to put the instruments aside. While I could learn to play by rote (sadly this rote bit was my huge talent for awhile), getting my left and right movements synchronized was difficult.

In sports...
I would just play based on luck. When I played tennis,I would close my eyes and just hope that my racket could slam the ball (and the best was when it managed to land on the opponent ). But this becomes excaberated in complicated situations. I'm not sure if I exactly can reflect that well on my sports experience.
Trying to learn to dance though, this was one of the most difficult things in my life. I absolutely couldn't coordinate the movements of my body while reversing the instructions of the instructor to make sense of the way they should go. Anyways...what do you think?

If there are any lurking suggestions out there, I am all ears. I study about 12 hours everyday 5 days a week and this means that research in certain fields might be difficult or impossible for me...unless I get my business together over the summer or take time off before grad. school and transform myself.

[orangish]

Well not 12 hours. But a lot.

[graatch]

Quick reply: Orangish, if you haven't picked up "Delivered From Distraction" by Hallowell (I think Sanction suggested it on the other forum) you might do so.

A good basic text in general, but you might gaze with especial (and skeptical, I know) interest upon the section titled "Cerebellar Stimulation". Your problems with coordination may provide a link.

And strange as it might sound (maybe it sounds just right, if you know a little about the factors in play here) the research for feedback I have done shows people w/ generally excellent results. There is some good research around -- though more must be done.

I aim to pick up the $400 "Learning Breakthrough" program upon which the DORE methods were based, as I don't have the money and I'm not in a location where I can go to their clinics.

Hope you're putting a smile on, doing well, etc Talk soon.

[theta]

http://www.pubmedcen...i?artid=1474811

Dexedrine and Desoxyn will have the highest efficacy for inattentive ADHD. It would be nice if non-stimulants had much use in treating it but its mostly wishful thinking.

[graatch]

Dexedrine and Desoxyn will have the highest efficacy for inattentive ADHD. It would be nice if non-stimulants had much use in treating it but its mostly wishful thinking.

I think if you raise energy levels (exercise, vitamins, fish oil, bacopa ... perhaps a maoi?) then an inattentive could potentially respond better to methylphenidate or ... amineptine ... without requiring the additional adrenergic affinity of the amphetamines. Just a thought.

Remember that it's a spectrum we speak of.

I fell off with the balance board (heh), but it was giving me interesting results after doing it for a couple of months. There are some very positive responders on the addforums.com ... many pieces of the affliction seems to be addressed. Focus, attention, confidence, processing speed. I had to move into school but I'm going to be picking it up again soon.