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Q: Should I consider Adderall?
I am 23 years old and have been a manic depressive since I was apx.
12. After many years of trying many different drugs nothing works. I take 150mg
of Effexor at night and 37 1/2 in the morning. I have no energy at all and I am
a single mom to a 2 yr old. Today a friend suggested I try one of his Adderall
and for the first time in a very long time I was happy and I didn't snap or
scream at my daughter (which only throws into sharp contrast that I am quite a
beast on any other given day) I just want to sleep all the time. I have even
been talked to by my boss at work for falling asleep on the job because I simply
can't keep my eyes open. Should I consider Adderall for myself? I just felt so
good and calm and I know my daughter appreciated it. I really can't tell you how
nice it was...the sun was shining brighter the grass was greener and I could
love my 2 yr old just for being her usual mis-behaving 2 yr old self. One more
added thought. I live in a very economically depressed area with very few
knowledgable people around, and even a few Dr.s I have spoken with are so behind
on these newer drugs and don't seem to be quite with it...I just really need
some sort of point to leap from at this point. Thank you very much for this
site, and I hope to hear from you.
Always Sleepy,
Sarah
Dear Sarah
Well, first you should make sure your thyroid has been tested and is all right
(your TSH should be below 3; read about
thyroid and bipolar
if the number is higher than that).
Then, we should wonder whether you should really be back "on the map" of
recommended treatment approaches for bipolar disorder, if that's really what you
have (Effexor alone is an off-the-map treatment; here are
some "map" references).
One of those on-the-map treatments might address your "sleepy all the time",
especially if that was a manifestation of a bipolar depression component of your
illness.
After all that has been discussed, you could consider Adderall based
on your experience. Surely that's going to stay on your mind after the
experience you had with it. You just have to remember that using a stimulant,
without a mood stabilizer, and with an antidepressant, is probably even farther
off the map. In general, the long-term goal of bipolar disorder is not to treat
the mood or symptom of the moment, but to get them gone and keep them from
coming back. There are some treatments out there with evidence that they can
do this. I'd start by looking there; I think that's safer than a "let's try
this" strategy that has not been studied or shown to be useful in maintaining
long-term mood symptom control. Good luck with that.
Dr. Phelps
Published July, 2004
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