7 replies to this topic

[TSX TypeR]

Hello people,

I have struggled with ADHD like symptoms in addition to perpetual brain fog, mild depression, and mild sleeplessness for years now and I am tired of doctors prescribing medication that will cure one problem at the expense of another. I've heard of mineral, chemical and hormone imbalances causing similar problems and was wondering what kinds of tests could I ask my doctor for. I've heard of blood tests, urine tests and saliva tests which I have asked my doctor about, he seemed to know about the blood test but was clueless on any saliva tests and urine tests that could be done.

Maybe someone could kindly provide with ideas on tests to search for so I could bring those up at the doctors office next time?

[Tom_]

Provided you are eating an even remotely reasonable diet, are not suffering from any 'physical' symptoms, pass a basic phsyical (blood pressure, BMI under 40) and a standard blood panel (LFTs, TFTs, F/CBC, BMP & fasting glucose) return without abnormalities then further examination is a pointless waste of money - you have a neuropsychiatric syndrome and it should be treated as such. However the above tests SHOULD have been done. Its unlikely you have any physical disorder causing the depressive symptoms even more so if you are under 50.

If the ADHD symptoms have not been clear from at least the age of 7 then you don't have the disorder.

May I ask you a few questions?

How old are you?
Male/female?
How much do you weigh and how tall are you? Preferably in cm/meters and kg.
Are you suffering from any 'physical' disorders of any description for more than 2 weeks?
Do you have any unexplained 'physical' symptoms?
Have you had a basic blood test? If you know the results can you post them.
How long have you had the symptoms?
What are the symptoms? The adhd - is it just attentional problems or hyperactivity as well? What do you mean by 'brain fog'? What kind of depression symptoms do you have? Do you feel sad? Unmotivated? anhedonic? Suicidal?
How long has the sleeping been a problem? How severe would you describe it? Under 30mins to get to sleep, under and hour, 2 hours...? What time do you get to sleep on an average night? Do you exhibit any abnormal behaviour while asleep? Move around in bed a lot, wake up lots, snore very loudly or seem to gasp while asleep?
Is there any history of mental or physical illness within the family? What disorder?
What treatments have you tried for your symptoms - try to provide as many details as possible - what doses for how long, was it taken in combination with other drugs etc...
Do you/have use drugs recreational? What, for how long?

[TSX TypeR]

I'm a 170cm tall, 67-72kg, 24 year old male, and really a secondary reason for me asking this question is that I get muscle cramps and muscle twitches from time to time. Also, my weight will plumpet from 72 to 67kg in just a month and a half of not working out (haven't observed this in any of the people around me). Since, I don't seem to have a problem getting to 72kg only a problem keeping it (I believe my diet is reasonable), that led me to believe that there may be an imbalance at play.

I did just get a blood test yesterday and I can definately say there wasn't a fasting glucose in there. But, I can ask for it.

Symptoms:
Depression - 5 years, there was a brief 2 month period of no depression a year a ago.

Sleeplessness - both trouble falling and staying asleep for as long as I can remember, but I finally seem to be getting a hold on that.

ADHD (just attentional) - Also for as long as I can remember (possibly prevented my success in team sports when I was young)

What I call brain fog is a state of very mild confusion and slowed thought processes. - 4 years

There is no know history of mental illness in my family.

Treatments :
Adderall - ADHD : Caused possible hypomania, mood improves and thoughts speed up until the crash begins then the anxiety and numbness set in. Also, disturbs sleep if taken to close to bed and increases muscle twitches. 10-20mg taken as needed.

Valium - sleep/muscle twitches : makes it easier to fall asleep, reduces muscle twitches, improves mood, more talkative. 5mg taken as needed.

Wellbutrin - depression/ADHD : improves mood for the first few days then the noticeable effect goes away. Also, Reduces memory and changes the way my body uses hydration (don't feel as thirsty), disturbs sleep and increases muscle twitches. Started at 75mg for a week, then 150mg for another week, then 300mg for 3 months.

Only used Alcohol socially from 5 years ago until last year, binged at a frequency of 1 night every 1.5 months. Never used any other drugs.

Edited by TSX TypeR, 18 July 2013 - 06:13 PM.

[Tom_]

People often change by as much as a Kilo in a day. I've lost 16kg in four weeks. The amount of weight you have lost is not indicative of a problem.

You aren't overweight - fasting glucose isn't necessary.

You need to get off the diazapam. Benzo's have a place in psychiatry but that's for acute problems.

The first step is vanquishing the depressive disorder. Then another evaluation can be made and any symptoms you are left with can be chased down individually, although I suspect you have been suffering from depressive symptoms for a lot longer than you realize and that is the main cause of your symptoms.

The first place to start is usually an SSRI. However you have been symptomatic for a long time and suffer from insomnia. Low dose Mirtazapine (15mg) at night will help you sleep and acts as a potent antidepressant (one of the best). If after two weeks you don't notice much improvement increase the dose to 30mg. After four weeks you can reevaluate its effectiveness if its had no impact what so ever its time to consider switching, combining or using an adjunct otherwise you can keep it at the same dose or increase it to 45mg. The higher the dose the less sedating - in general.

The most common side effects from Mirtazapine are somnolence and increased appetite. Sometimes for the first few weeks Mirtazapine can make you very groggy though out the day but this tends to ware off quickly. Its worth waiting til week 3 to see if it will.

[TSX TypeR]

People often change by as much as a Kilo in a day. I've lost 16kg in four weeks. The amount of weight you have lost is not indicative of a problem.

Wow, you lost 16kg of muscle in a month without being sick?!

You need to get off the diazapam. Benzo's have a place in psychiatry but that's for acute problems.

I apologize, don't think I was clear on my use of Valium, it's mainly for muscle twitches and even then I only use maybe twice a month.

The first place to start is usually an SSRI. However you have been symptomatic for a long time and suffer from insomnia. Low dose Mirtazapine (15mg) at night will help you sleep and acts as a potent antidepressant (one of the best). If after two weeks you don't notice much improvement increase the dose to 30mg. After four weeks you can reevaluate its effectiveness if its had no impact what so ever its time to consider switching, combining or using an adjunct otherwise you can keep it at the same dose or increase it to 45mg. The higher the dose the less sedating - in general.

Never heard of that one, how likely is it to cause uncontrollable fat gain?

[Tom_]

No I've lost 16kg (now 18kg) of body weight in about 5 weeks - not the same as muscle. I don't seem to be suffering any ill effects, I do in fact appear to be slightly stronger. Once or twice a month isn't a problem - sorry about that.

Mirtazapine is commonly prescribed. It is fairly likely to cause weight gain - primarily fat. However the weight gain is caused by increased appetite, if you feel you can control your appetite (lots of healthy snacks, starch...) awesome, if not taking a mild stimulant an hour to two before you eat could reduce food intake

[TSX TypeR]

Do you have any unexplained 'physical' symptoms?
Have you had a basic blood test? If you know the results can you post them.
How long have you had the symptoms?

A little after post the original post it was found that my thyroid was a little swollen with a few swollen lymph nodes in the area, the doctor only tested for T4 which was normal. About 2 week later, a specialist tested for TSH levels and found that they were "a little low".

This seems like an isolated incident, but since I was looking for and imbalance that might be causing mental problems and since they've found one that could do just that, I thought I would just add this bit of information.

[Tom_]

t3 is an effective antidepressant adjunct and prescribed for hypothyroidism