13 replies to this topic

[mandible]

I listened to an audio book about ADHD meds from Charles Parker.

He says that if a person has depression and ADHD and only takes antidepressants the ADHD will get worse cause

SSRI lower dopamine. If on the other hand the person only takes stimulants and no antidepressants then the depression

will get worse cause the stimulants lower serotonin!

 

This sounded really frightening. I feel worse now after listening to his book. He says a lot of helpful things and gets into stuff which

usually pdocs don't really care about like for example how medication effectivity can be affected by all kinds of things such as thyroid

issues, adrenal fatigue, allergies, gluten intolerance, pituitary issues. He comes up with a long list of things which can all cause antidepressants

to not work.

But the problem is that it's basically impossible to find a doctor who is well verses in all these things!

This means you're pretty much screwed if you're depressed and meds don't work cause it could be 100 different things which all play a role.

This is so damn frustrating and discouraging!

 

Anyway but what worries me now is that stimulants lower serotonin.

Does this mean that even though no SSRI/SNRI which I ever took actually helped my depression I still need to take one in order to prevent

ritalin or dexedrine from lowering my serotonin levels even more!?

 

My pdoc advised me to trial dexedrine, which I'm currently doing, without any additional antidepressant to see how it works.

This makes sense so that I can clearly tell wether something's from dexedrine or not. But now I think what if taking dexedrine on its own

will lower serotonin and make me even more depressed?

 

But when I was taking ritalin on its own I can't really say it made me more depressed.

Edited by mandible, 21 February 2015 - 01:50 AM.

[Reformed-Redan]

It's pretty complex. But, the basics are that stimulants tend to raise dopamine globally while SSRI's tend to raise serotonin selectively. I would definitely not rely on stimulants to solve your depression. If anything you'll become very dependent on them to keep you going and stay motivated. If you have depression then I think you only stand to BENEFIT from SSRI's. If you want to add stimulants as a adjunct to the SSRI, then that is your decision; but, make sure your letting your pdoc know about all your issues!

 

EDIT: Answering your main question, "Do ADHD stimulants make coexisting depression worse?"

 

I'm going to say, yes. Stimulants tend to make depression worse for a number of reasons. The main reason for me saying so is that stimulants are a quick "fix" to a complex problem. Having depression entails many things and stimluants will just make you feel jacked up and ready to face adversity. BUT, if you have a legitimate reason to take ADHD medications, such that you actually have ADHD, then OK. But, my point is that in no way should stimulants be used as a replacement for more proven medications for depression and caution should be taken if depression is an issue already while taking ADHD meds.

Edited by redan, 21 February 2015 - 02:27 AM.

[mandible]

No, I don't want to take stims as a cure for depression. I want them for adhd.

Ritalin also never made me feel any less depressed. Maybe I would have had to take higher doses. I usually took no more than 20mg that was already the max I could tolerate without feeling jittery.

I don't know if dexedrine works against depression. So far I only took 2.5 mg and didn't feel anything. Dexedrine is more intimidating than Ritalin imo. I worry more about health risks and side effects.

 

But if dexedrine would make me feel less depressed and more energetic when I take it then this wouldn't be bad. Then at least I had something which works as an antidepressant and could be taken

whenever needed. This would still be better than being on an antidepressant which doesn't work.

 

I am also planning to try out other antidepressants but there's not very much left except TCA and MAOI.

And when I go on a TCA I can't take ritalin or dexedrine cause they wouldn't mix well with it. This is a problem.

When you have depression and adhd then you have even less options.

[Reformed-Redan]

No, I don't want to take stims as a cure for depression. I want them for adhd.

Ritalin also never made me feel any less depressed. Maybe I would have had to take higher doses. I usually took no more than 20mg that was already the max I could tolerate without feeling jittery.

I don't know if dexedrine works against depression. So far I only took 2.5 mg and didn't feel anything. Dexedrine is more intimidating than Ritalin imo. I worry more about health risks and side effects.

 

But if dexedrine would make me feel less depressed and more energetic when I take it then this wouldn't be bad. Then at least I had something which works as an antidepressant and could be taken

whenever needed. This would still be better than being on an antidepressant which doesn't work.

 

I am also planning to try out other antidepressants but there's not very much left except TCA and MAOI.

And when I go on a TCA I can't take ritalin or dexedrine cause they wouldn't mix well with it. This is a problem.

When you have depression and adhd then you have even less options.

Ritalin was at some point in the past advertised as an antidepressant, I believe. So, if Ritalin works for you along with an AD, then I'd stick to it. I'm not a doctor; but, Lexapro is the best AD out there. Unfortunately, I became very restless and aggressive on it for some reason. Your milage may vary.

[β-Endorphin]

I not sure why people tend to jump to the conclusion that depression is caused by low serotonin. The most potent potent SSRIs are no more effective than placebo in mild-moderate depression. Granted, they are better than placebo in severe depression, but even then the difference is marginal. Based on the typical symptoms, I would think that depression is mainly caused by a dopamine deficiency, as most symptoms seem to line up with this(Anhedonia, ADHD symptoms, fatigue, little to no motivation etc.)

 

Anyways, in terms of Stimulants lowering serotonin, this depends on the stimulant. Ritalin does lower serotonin, however Amphetamine(Dexedrine) actually acts as a serotonin releasing agent, although not as potently as its actions on dopamine/norepinephrine. I feel like amphetamine is a more balanced stimulant than Ritalin, because at least it has some action on serotonin, versus Ritalin which has none. Interestingly, in studies done on using Amphetamine for depression, Amphetamine+SSRI was more effective than amphetamine or SSRI alone. 

 

 

[mandible]

How much dexedrine to do take as single dose?

 

But what happens to serotonin levels when the dexedrine wears off?

 

Also what sucks is that amphetamines + ssri supposedly carry a serotonin syndrome risk. This scares me. I'd really like to try dexedrine + ssri. Ssri alone doesn't work for me. Ssri + ritalin also doesn't work.

[Reformed-Redan]

How much dexedrine to do take as single dose?

 

But what happens to serotonin levels when the dexedrine wears off?

 

Also what sucks is that amphetamines + ssri supposedly carry a serotonin syndrome risk. This scares me. I'd really like to try dexedrine + ssri. Ssri alone doesn't work for me. Ssri + ritalin also doesn't work.

I would not worry about a serotonin syndrome with Dexedrine + SSRI. There have not been any reports of serotinin syndrome with Dexdrine+an SSRI, to the best of my knowledge. 

[mandible]

Hello,

maybe not with dexedrine but certainly with adderall + venlafaxine and adderall and dexedrine are more or less the same.

[Mind_Paralysis]

I would suggest you try out a combination of Focalin and Intuniv.

 

The depressing side-effects of methylphenidate seems to stem mostly from the Levo-rotary isomer, and the ADHD-beneficial effects mainly from the dextro-rotary isomer - Focalin is nothing but pure dexmethylphenidate - compared to Ritalin, which is 50/50 levo-dexo.

 

Methylphenidate overall probably won't help much with depression, but at least Focalin is less likely to worsen it.

Now, here's where Intuniv comes in - it's an alpha-2-agonist, which means it blocks the norepinephrine in your brain - if you take an NDRI such as Focalin/Ritalin etc, your N will go up more than it should, but Intuniv will block it, removing some of the side-effects. Intuniv ( guanfacine) is also a potent serotonin-agonist, so it should affect anxiety and depression to some extent. It is more or less proven to affect anxiety at the very least, so I would definitely recommend it.

[mandible]

Hi, unfortuinately focalin is not available where I live only dexedrine.

 

Guanfacine is only for heart patients afaik. My insurance wouldnt cover it. This sucks. I'd have tried it.

Edited by mandible, 22 March 2015 - 01:36 AM.

[Mind_Paralysis]

That sucks, dude. : ( Your Dr SHOULD be able to import Focalin via license tho' - if they're willing to do the effort.

 

If you want an alternative to Guanfacine, then check out Cannabigerol:
 

http://en.wikipedia....ki/Cannabigerol

 

Unlike guanfacine it antagonises Serotonin, but, it does seem to be part of the beneficial mood-effects of cannabis still. Alas, synthetic CBG is super-expensive, however, if you can find some italian hemp, a newer breed, it actually contains high levels of CBG.

 

I'm working with an aquiantance of mine to try and hybridize it with a strain that has higher cannabinoid-production, in order to create a LEGAL, non-psychoactive, medical strain of cannabis. It'll take a looong time tho', but it's doable - GW Pharma in the UK has created one such strain.

[mandible]

Hi, I dont want to use any herbs or canabis. Seems to dangerous to me cause of interactions with prescription drugs.

If there was a drug based on herb where you know all interactions and side effects then I'd try it.

[NinefingerJoe]

I can personally attest that yes, amphetamines can worsen pre-existing depression.

It's all got to do with getting caught up in negative circular thinking.

[mandible]

How much amphetamine did you take and which one?