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ADHD (+anxiety+dysthymia) - Ready to try medication

adhd anxiety depression selegiline deprenyl guanfacine strattera introduction

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#61 z4l

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Posted 02 October 2017 - 04:44 PM

Thanks for the info Stinkorninjor. For sure, the norepinephrine is to blame for the increased saliva cortisol levels. Not sure what that means for long-term use of atomoxetine, however. If you're not careful and it throws your HPA systems out of whack, does that mean people have a higher rate of developing things like autoimmune disorders or diabetes down the line? I'm trying not to become a cyberchondriac here (actually it's probably too late for that), but reading up on HPA axis stuff makes me worried that whatever changes I'm doing my system might affect me negatively down the line, especially since I have some susceptible genes (my mom had hypothyroidism and my sister recently developed an extremely rare autoimmune disorder).

 

Okay, past that, w/r/t being functional during the foggy luteal phase of my period, maybe I'm using the wrong approach here. I didn't know that Shatavari was a MAO inhibitor when I first tried it -- I just stumbled across the name when I was researching hormonal balance herbal supplements and my natural food store happened to sell the powder so I bought it. Given that MAO inhibitors effect MAO production for weeks, maybe I'm better off supplementing dopaminergics that quickly run through your system (Ritalin, Modafinil) instead of stupidly, ill-advisedly, and desperately taking Shatavari and Deprenyl. Because if the MAO inhibition is still in effect while I'm in the second week of my follicular phase, when estrogen is at its highest, it gives me the jitters and heart problems.

 

Maybe I shouldn't do any adaptogens at all, just focus on the basics and see where I'm at in two months time. Uggggh.



#62 z4l

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Posted 02 October 2017 - 05:00 PM

Also Stinkorninjor, have you found any gleaning insights about SCT from recent studies? I haven't been keeping up to date on research on that subject. Let us know how your RBX trialling goes. I don't quite recall at the moment the exact differences between the two differences -- ATX has the additional NMDA antagonism and messing around with opioid receptors, right? Have you considered that maybe your own HPA axis is or was messed up and that might explain your different reactions with the two drugs? I hate menstruation with a vengeance but at least it gives me a monthly sense of how healthy (or unhealthy) I am.



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#63 Mind_Paralysis

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Posted 02 October 2017 - 07:11 PM

Also Stinkorninjor, have you found any gleaning insights about SCT from recent studies? I haven't been keeping up to date on research on that subject. Let us know how your RBX trialling goes. I don't quite recall at the moment the exact differences between the two differences -- ATX has the additional NMDA antagonism and messing around with opioid receptors, right? Have you considered that maybe your own HPA axis is or was messed up and that might explain your different reactions with the two drugs? I hate menstruation with a vengeance but at least it gives me a monthly sense of how healthy (or unhealthy) I am.

Oh yes, there's a distinct possibility there - because I suffer from occupational burnout as well - I just haven't, because of SCT, gotten my butt into gear and actually tested my hormones - would be interesting to see if there are something off there... Curious about my testosterone as well.

 

HPA-axis dysfunction is often found within ADHD, I believe me, GetoutofBox, Jack_Black and Devinthayer talked a bit about this in the past - however, we came to the conclusion as some ADHD-researchers have, that the bigger dysfunction is actually a result OF ADHD and not a central part of the disease - similar disruptions have been noted in people with anxiety and burnout as well, I believe, and it's then as a result of tremendous stress - and it's really stressful to be an ADHD-er. These alterations of the HPA-axis sometimes disappear when effective medication is implemented however, which made us think it was secondary.

 

The same definitively applies to SCT as well - not easy being slow.

 

Btw, perhaps you should consider utilising some form of contraception-pills which alter your hormonal cycle? For instance, my sister has a form of Endometriosis, or similar disease, and her pains are absolutely grueling - she reduced these pains, and other PMS-symptoms dramatically by going on Desogestrel - a progesterone-analogue. Could not you try this as well?

 

 

And yeah, I suggest trying low-dose dopaminergics, going back to basics, trying some more relaxation-stuff than meditation (I recommend yoga, or just laying down and more or less sleeping) - can you somehow remove some of the stress in your life? I understand you have personal problems right now that can't be helped, but perhaps there are some other things to try as well?

 

Another option is of course to start a group buy of the drug AM-101 - the active component of Paracetamol/Acetaminophen and then using that... it removes emotion - if you don't get upset, you won't be stressed, is my thinking.

 

Heck, I'd join that group buy! If I was function I'd lead the group buy - do a f***-load of marketing for it! Because it's an SCRI - Selective Cannabinoid Reuptake Inhibitor, so I could probably get some of the pot-heads from around the world interested in it! = )

 

 

You're correct regarding the differences between ATX and RBX btw - RBX is much more selective, and therefore in theory better - however, it seems to affect auto-receptors differently as well... and the NMDA-antagonism is actually probably very useful for anxiety - most NMDA-antagonists are actually powerful anxiolytics.



#64 Finn

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Posted 03 October 2017 - 05:46 AM

 

 

Another option is of course to start a group buy of the drug AM-101 - the active component of Paracetamol/Acetaminophen and then using that... it removes emotion - if you don't get upset, you won't be stressed, is my thinking.

 

 

 

 

 

I think you mean AM404.

 

https://en.wikipedia.org/wiki/AM404

 

 

AM-101 is esketamine formulation for tinnitus, branded Keyzilen.

 

http://www.aurismedi...ndidates/am-101

 

http://www.aurismedi...tember-2017.pdf


Edited by Finn, 03 October 2017 - 05:50 AM.

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#65 Mind_Paralysis

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Posted 03 October 2017 - 09:38 AM

 

 

 

Another option is of course to start a group buy of the drug AM-101 - the active component of Paracetamol/Acetaminophen and then using that... it removes emotion - if you don't get upset, you won't be stressed, is my thinking.

 

 

 

 

 

I think you mean AM404.

 

https://en.wikipedia.org/wiki/AM404

 

 

AM-101 is esketamine formulation for tinnitus, branded Keyzilen.

 

http://www.aurismedi...ndidates/am-101

 

http://www.aurismedi...tember-2017.pdf

 

 

Frack! Man, my memory is terrible... yes, you are quite correct.



#66 CWF1986

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Posted 05 October 2017 - 07:27 AM

I'm sorry if this has been mentioned already, but since ritalin and concerta work for you, what about adding something to make them more tolerable?

 

You have the two alpha agonists clonidine and guanfacine.  Kapvay and Intuniv respectively are the FDA approved preparations for ADHD.  Clonidine is fantastic if you have sleeping issues.  Guanfacine can be taken in the day for most.  Both frequently help people with the anxiogenic and PNS side effects of stimulants.  They also help modulate NE activity in the prefrontal cortex so they directly help with adhd too.  At least in theory.  

 

There's also combining a stimulant with an SSRI to smooth things out.  I used to take catapress (IR clonidine), then Intuniv, but quit them because they took too much emotion away.  They also took my restlessness away and I've learned how to harness it productively over the years so that's not a good thing for me.  But the SSRI Lexapro helps with stimulant sides and helps a lot with anxiety and depression along side nortriptyline.  

 

Theanine helps smooth out stimulants a good bit for me.  I'm sensitive to its effects so I don't go higher than 100mg at one time and even a cup of hot black tea will chill me out.  I take it on an as needed basis.

 

There are a couple of primarily NRI antidepressants not mentioned that aren't typically as anxiogenic as strattera or reboxetine.  There's Desipramine and Nortriptyline.  The former is most often activating and the latter more anxiolytic and sedating to some.  Desipramine is a very potent NRI.  It does have anticholinergic properties, but that might actually help with anxiety and depression.  Or it could just make the medicine intolerable.  Hard to say until you try it.  

 

I previously mentioned I take nortriptyline.  It does good things for anxiety and depression.  But it does help some with adhd.  It doesn't help me get motivated or started on anything, but it does help me focus and once I'm on a task I can stay on that task and follow through.  For motivation I take adderall.  I tried vyvanse and it made me feel really nice, but it didn't help me get anything done so I went back onto the adderall.  

 

I know you said you didn't want to try amphetamine, but for many people they have fewer side effects from amphetamine then they do methylphenidate.  I just think it might be premature to consider amphetamine a boogey man until you've tried it.  

 

In fact, a very important part of selegeline's effects come into play because some of it converts into levo-methampetamine.  Being the levo enantiomer of methampetamine means it'll effect NE more than just the dextro or even a racemic blend like you'd find on the street.  Many people try Resagaline which does the same thing as selegeline except it does not convert into anything meaningful and I've read plenty of anecdotal reports from people who after trying selegeline with success and then try resagiline say that resagaline doesn't help them.  So in a way, you've already tried methamphetamine!  Just some food for thought for you. 

 

But if Strattera is working great for you, then more power to you!  It's hard to argue against success.  I tried it way back in high school and I couldn't form cohesive thoughts and emotions.  It was like an animalistic mentality.  It was awful for me so I'm a bit biased against it to tell you the whole truth.  


Edited by CWF1986, 05 October 2017 - 07:43 AM.


#67 z4l

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Posted 07 October 2017 - 06:23 PM

Oh yes, there's a distinct possibility there - because I suffer from occupational burnout as well - I just haven't, because of SCT, gotten my butt into gear and actually tested my hormones - would be interesting to see if there are something off there... Curious about my testosterone as well.

 

HPA-axis dysfunction is often found within ADHD, I believe me, GetoutofBox, Jack_Black and Devinthayer talked a bit about this in the past - however, we came to the conclusion as some ADHD-researchers have, that the bigger dysfunction is actually a result OF ADHD and not a central part of the disease - similar disruptions have been noted in people with anxiety and burnout as well, I believe, and it's then as a result of tremendous stress - and it's really stressful to be an ADHD-er. These alterations of the HPA-axis sometimes disappear when effective medication is implemented however, which made us think it was secondary.

 

The same definitively applies to SCT as well - not easy being slow.

 

Btw, perhaps you should consider utilising some form of contraception-pills which alter your hormonal cycle? For instance, my sister has a form of Endometriosis, or similar disease, and her pains are absolutely grueling - she reduced these pains, and other PMS-symptoms dramatically by going on Desogestrel - a progesterone-analogue. Could not you try this as well?

 

 

And yeah, I suggest trying low-dose dopaminergics, going back to basics, trying some more relaxation-stuff than meditation (I recommend yoga, or just laying down and more or less sleeping) - can you somehow remove some of the stress in your life? I understand you have personal problems right now that can't be helped, but perhaps there are some other things to try as well?

 

Another option is of course to start a group buy of the drug AM-101 - the active component of Paracetamol/Acetaminophen and then using that... it removes emotion - if you don't get upset, you won't be stressed, is my thinking.

 

Heck, I'd join that group buy! If I was function I'd lead the group buy - do a f***-load of marketing for it! Because it's an SCRI - Selective Cannabinoid Reuptake Inhibitor, so I could probably get some of the pot-heads from around the world interested in it! = )

 

 

You're correct regarding the differences between ATX and RBX btw - RBX is much more selective, and therefore in theory better - however, it seems to affect auto-receptors differently as well... and the NMDA-antagonism is actually probably very useful for anxiety - most NMDA-antagonists are actually powerful anxiolytics.

 

 

1. Re: HPA axis dysfunction - I really wish I'd learned about this years ago. It is seriously eye-opening. Same with the HPG axis, since I clearly have some hormonal imbalance. I am finally going to bite the bullet and get a full hormonal panel done. My health care plan provides a little money towards integrative health/naturopathic treatments so I'm going to take advantage of it. The trouble with treating HPA axis problems through adaptogens is that since we're all dysfunctional in different ways, if my problem is let's say, adrenal-related and my ovaries are also overproducing androgens, that might explain why I have cystic ovaries and why Ashwagandha helped me out so much but still caused me to break out. Until I know the results of the tests it might be best to hold off experimenting with more adaptogens and focus on the daily diet/lifestyle stuff.

 

2. I strongly oppose treating this issue with synthetic hormones. I tried a few different birth control pills in adolescence and they all made me extremely crazy. I couldn't stop yelling at everyone. My skin broke out and my PMS symptoms did not go away. My body is clearly very sensitive to hormones. Since my cycles are clockwork regular, I don't think synthetic pills are the answer here, but thanks for the recommendation. I know they work for a lot of women.

 

3. I'm going to add a gentle yoga exercise to my mornings and evenings and drink a chamomile/lavender tea before bed. Hoping that does the trick. The personal problems are things I have to basically work on. They're things that I can only fix slowly in the long-term, but I also need to be cognitively sharp to do it, and whatever adrenal stress/problems I'm having right now makes it incredibly difficult during the luteal phase. Again, it boils down to me being impatient, which is why I'm so desperate to try adaptogens. Fixing what's wrong with my body through diet, stress management, and so on will take time, many months, even, before I see a difference. I need to fix my personal and professional life ASAP (or go into debt and be even more miserable). Being a freelancer suuuuucks. I can't phone it in for a while, as I try to fix other aspects of my life. It's simply not an option.

 

4. I forgot to mention that I fixed my back problem all by my damn self. I was sick of my unhelpful GP prescribing more NSAIDs and being told to do more back stretches and sit in the hot tub. So instead I went into hyperfocus research mode and looked at different kinds of back pain. I guessed that it was the sacroiliac (SI) joint, did some more research into physiotherapy for the SI joint, and I found this website (http://www.do-it-you...pain-relief.com) that teaches some very basic muscle-tension relieving exercises commonly found in physiotherapy. I'm not going to lie, the website looks shady as hell, and it looks like it was built in 1997, but the guy is not trying to sell anything. It's a very bare-bones introduction to the physiology of joint pain and the instructional videos are really easy to follow and you don't need anything (except possibly a tennis ball). Of course I'd read about using foam rollers and the like before, but I didn't understand the science behind it or know that the muscles involved in SI joint pain are actually the hips and thighs (and it's the opposite side of your body. So if it's your left SI joint, you'd need to do the exercise on the right side of your body). I basically cured 8 months of back pain in one afternoon and I do these tension-releasing exercises once a week. I'm now getting back into a moderate exercise regimen, which in the next few weeks I hope will also help with the HPA dysfunction.

 

5. I believe Atomoxetine's mild NMDA antagonism is providing the anxiety support here. It's hard to know for sure since I've never tried Memantine. If it is true that Atomoxetine has SSRI activity, I don't feel it. On every SSRI/SSNRI drug I've tried (Zoloft, Pristiq, Cymbalta) I immediately lost feeling in my lady parts, and that's never happened on Atomoxetine. The emotional effect I got on SSRIs was blunting (unhelpful), whereas the effect I get from Atomoxetine is to feel more grounded. Like I mentioned earlier, I still feel my emotions, but I'm capable of not overreacting  and I can compartmentalize them for a little while and unpack them later. It's essentially cured the Rejection Sensitivity Dysphoria aspect of ADHD for me. Which is such a relief onto itself. So my theory is it's NMDA antagonism, OR... It could be Atomoxetine has such a mild effect on both SRI and NMDA antagonism they're providing some synergistic value without dipping into emotional blunting territory. Not sure.

 

6. I'm not going to try any additional drugs for a while. Sticking to my basic vitamin/mineral stack and once I get test results back I may report them here and ask y'all for some more advice. and once I've figured out all of THAT, if I still need an additional cognitive boost i'll order some Modafinil. My pdoc won't prescribe stimulant meds atop the Atomoxetine, unfortunately. Given the many benefits I get from ATX I'm kind of terrified to stop it and try other drugs only to go back on it and have it pooping out on me. I know that Ritalin and caffeine only offer short-lived benefits and they make me anxious, whereas ATX's side effects have been uh, at least manageable (even if it did take months for me to realize I was undereating, though I'm fixing that now), and at least I get anxiety support on it. For now, ATX will have to suffice. I don't want to change too many variables here anyway, and I don't think that switching meds will fix the underlying HPA/HPG axis problems, anyhow. 

 

7. I just want to give a quick shout out to everyone who's responded. Thank you for your help and suggestions. I know I haven't responded to all the posts, but I do want to say that all of the advice I've gotten and from reading this forum for years has been such a tremendous help.


Edited by z4l, 07 October 2017 - 06:32 PM.

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#68 CWF1986

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Posted 08 October 2017 - 06:16 AM

SI joint!  That's splendid!!!

 

I mean... not that you have to suffer through that, but it's something have to work through because I went retarded doing some deadlifts and let my form fly through the window.  That was back in 09.  I would say I'm 95% symptom free now so long as I do regular maintenance.  I post a lot on a weight lifting/fitness site and I actually have a notepad file that I saved to copy and paste whenever someone mentions SI joint issues.

 

I had a 455lb deadlift and 365lb squat at the time of the injury.  Immediately post injury, deadlifting an empty bar hurt.  Getting in and out of a car hurt.  Walking hurt.  I couldn't squat a bar, I had to do lunges with db's.  

 

In 5 months, my squat was at pre-injury levels.  In 10 months, my deadlift was as pre-injury levels.  In about 2 years, I was almost entirely symptom free so long as I did regular maintenance.

 

Anyway, the following is the contents of that notepad file.  I have a hard time imagining you won't find at least one thing useful from there.

 

 

I've like tractioning.  I'll set up a band up high, loop it around my ankle, lie down with my leg at a 45 degree angle up and out and kind of wiggle my hip around until the SI pops back into place.  I really only find it useful if it's out of place, but it can still nag you while it's where it should be just because of inflammation.  
 
For long term SI health, I found using minamalist footwear like 5 fingers or the Adidas minimus to be very helpful.  I was landing with too hard a heel strike to let it heal and this taught how not to.  
 
Clamshells might help shuttle blood in there and teach proper movement.  
 
I like really light and easy goblet squats and 1 leg stiff legged db deadlifts.  You're just trying to stretch things out and ingrain proper movement patters, maybe get a light pump sometimes but that's not even necessary.  
 
Be sure to stretch out your piriformis.  Also get a soft ball and work it into your entire hip complex.  Stretch and do soft tissue work on your hip flexors.  Sometimes they pull on your hip in a way that irritates the SI.  
 
For SI the stuff on this link: http://thelowback.co...x.htm#exercises The manual correction will work if you use a band set anchored up high too, just be sure to get the angle right. 
 
These vids helped me too. For us weightlifters, you'll need to use a bit more than pressure from your hands. http://www.do-it-you...urself-join... 
 
I do this after first warming up the area with general light exercises. When my SI clicks out of place and I'm having a lot of trouble popping it back into place I'll cross friction by placing a broom into a corner and lean the tight ropy parts of my hip close to the SI into the round part of the broom and hold it gently moving it into there for a minute or so. I do this only if lax ball work and stretching and tractioning doesn't fix the problem because it does cause a good bit of inflamation and soreness and tenderness. The premise is that you're basically opening up tight tissue and reinflaming the area but having it inflamed where the SI should be so your body can build back the correct way. Followed by lying clams and very strict one leg db romanian deadlifts and bird dogs with a very slow tempo to make sure it's in the right place after loosening things up. Do not take anti-inflammatories. You actually want it to keep your SI there while it heals. 
 
Google 'band man dave tate' and you'll see a couple of things for band tractioning for the lower back. 
 
 
Good luck!
 
Have you ever had blood levels to check for thyroid function?  Sometimes, depression symptoms are caused by thyroid issues.  I bring it up since we're now mentioning the HPA axis.  Even if you decide to go natural, a blood panel can help you figure what kind of natural medicines you want to take.  Notice I said natural medicines.  They should be treated with the same respect you give to prescriptions.  I'm not trying to be mean, it's just that kind of stuff can cause permanent damage if not managed correctly.  I knew a woman who took dhea to lose fat and her skin was permanently thicker and rougher.  Not so cool.  Maybe you can find a good naturopath?  I know that sounds like a lot of money... but over the long term it'll probably save money over a more or less educated shotgun approach.  
 
What I know for sure is that ADHD'ers are almost always deficient in magnesium and zince.  Fish oil is particularly important for this too... and your hair, and your skin, and your heart, and your general brain health, and metabolic and body comp health.  So if adhd isn't enough reason to take fish oild, there's plenty more reasons to add to it :)
 

P.S.  

I know not everyone is as obsessed with strength, muscle, and athleticism as I am so feel free to ask me any questions you might have the recommendations from my notepad or anything about fixing up your SI joint in general.  

 
 

 

 

 


Edited by CWF1986, 08 October 2017 - 06:26 AM.

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#69 CWF1986

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Posted 08 October 2017 - 06:24 AM

Please delete post mod.  Accidental quote of last post of mine directly above.  Sorry and thank you.  

 

 

 


Edited by CWF1986, 08 October 2017 - 06:25 AM.






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