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Author Topic: Adderall for anxiety?  (Read 170 times)

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Offline comoso

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Adderall for anxiety?
« on: August 21, 2014, 07:48:28 PM »
http://mentalhealthdaily.com/2013/03/03/adderall-for-anxiety-disorders-a-counterintuitive-treatment-option/

Anyone tried or had success?  Insights, thoughts?  I was an adrenaline junky for 41 years.  I had a massive panic attack a year ago and high anxiety since then.  I take klonopin and zoloft.  They pull me down and I don't like the down feeling.  It's never been me.  Wondering about changing to this.

Ian, I'm sure you can help me with this thought...?
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Re: Adderall for anxiety?
« Reply #1 on: August 21, 2014, 08:10:42 PM »
I had a massive panic attack a year ago and high anxiety since then.  I take klonopin and zoloft.  They pull me down and I don't like the down feeling.  It's never been me.  Wondering about changing to this.

It may help with social anxiety if it stimulates those affected into being more outgoing which seems to be what is being canvassed in the article. But I'd be treading much more carefully with panic disorder.

I suggest you first try going without the Klonopin as it is probably the main driver of the down feeling. If Zoloft is falling short in controlling anxiety levels then either up the dose, or if you're already taking the recommended maximum 200mg (some do well at even higher doses), then consider switching to another AD which might be more effective.

If you're unwilling to cut back on the Klonopin, or change the Zoloft then consider supplementing it with <=75mg of Wellbutrin. It is a very stimulating antidepressant which would be nearly as effective as Adderal in that regard, but your doctor is more likely to be more comfortable prescribing it and it may counter some SSRI side-effects too, especially the hit on the libido.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Online AncientMelody

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Re: Adderall for anxiety?
« Reply #2 on: August 21, 2014, 08:19:58 PM »
I think changing medication is an excellent idea if you aren't feeling well. So is adding additional treatment options if you aren't already doing so, which I'll mention in more detail in a moment. However......I personally don't feel that a competent medical practitioner would choose adderall as the next option after you have tried only zoloft and klonipin. In particular, this article suggest it has only shown some success in SOCIAL anxiety, so unless that is your particular diagnosis, I'd think again before opening that can of worms. Especially since you've had panic attacks.

So what are other options? Another SSRI, one that is more stimulating than zoloft. Prozac would fit the bill. Most psychiatrists will try a second SSRI before moving out of that class though it may not always be the case. Even then, they are more likely to go for something like Cymbalta or Effexor before venturing out into other medication classes that generally have a higher risk profile. Buspar is another potential choice, either added to an SSRI or by itself.

I know it's tempting to try something with a "novel" mechanism of action but so far most of those haven't fared better in studies than the SSRIs and benzos.

If you wanted to try a novel approach that is safer (and more common) than adderall, there is a medication called guanfacine (Intuniv) sometimes used for ADHD restlessness that a small yet substantial number of people have had success with for their anxiety. or propranolol for the purely physical anxiety symptoms (won't affect the mental aspect, but it can settle down panic)

I'll follow-up this post with some good non-medication strategies that can be helpful to add on to your treatment if you haven't yet, but my daughter wants to play so I'll do that in a bit!
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Online AncientMelody

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Re: Adderall for anxiety?
« Reply #3 on: August 21, 2014, 08:31:18 PM »
Non-med suggestions: Exercise. This is a huge one. It can be very helpful to alleviate anxiety. When I was having morning panic attacks, exercise could sometimes "burn off" the excess energy and calmed me down.

Fish oil supplements can be very helpful as well.

Therapy, in particular cognitive behavioral therapy or acceptance & commitment therapy.

And Ian has a good point re: the klonipin. I took it for a week and I felt quite low on it.
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Offline comoso

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Re: Adderall for anxiety?
« Reply #4 on: August 21, 2014, 08:35:41 PM »
Meds tried -

Cymbalta, Buspar, Xanax, Paxil, Lexapro, now on 50mg zoloft and 1 mg klonopin daily.

I tried to go up to 75 mg zoloft and headaches were like they were on lexapro which caused me to go off.  I still get headaches nearly daily, but is it zoloft or anxiety.  I don't know.  I just know I've suffered long enough and I'm ready to move on.

Also, maybe pertinent to the conversation.  I used phentermine on and off for weight loss for about 15 years.  Was I treating my anxiety disorder and not knowing it, effectively, with a stimulant?

I've been in therapy for a year with a CBT therapist.  Weekly visits.  I've seen a psychiatrist biweekly for 6 months.  I walk about 6-10 miles per day so I get the exercise thing down. 
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Online AncientMelody

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Re: Adderall for anxiety?
« Reply #5 on: August 21, 2014, 09:42:22 PM »
Probably more likely that the anxiety disorder had not kicked in full-bore as opposed to phentermine treating it especially if it was off an on.

Good for you on the exercise! That's quite a good amount you do. I'm sorry that you're not finding a happy medium yet, it's tough. Make sure you get a basic physical done and see about your doc doing some blood work to check on your thyroid, blood counts, etc.  I understand where you're coming from, I am on prozac 20 mg and it helps. 40 helped significantly more but I can't tolerate the side effects and I'd rather not get back on the med carousel, but I can certainly see why you want to try something else with frequent headaches. That said, adderall can commonly cause headaches too.

Good luck with whatever next step you take and keep us informed. Ahh, and before I forget, sometimes hormones can be related to anxiety and mood symptoms especially for females, so might not hurt to talk to your doc about tat possibility too
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Offline comoso

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Re: Adderall for anxiety?
« Reply #6 on: August 22, 2014, 08:04:50 AM »
Thanks for the suggestions, AM, I really appreciate your effort.  I've had the full workup a couple of times in the past year.  I've had stress test, EKG, and ultimately a heart cath to prove to me I wasn't dieing.  I've had thyroid checked, I had a catscan.  I forget how many tests have been ran.  Basically, I know nothing is wrong with me physically.  My anxiety is much better than a year ago.  I just need to quit worrying and continue recovering.  When I was told to read that article by a friend, I did and it raised questions.  I figured you guys would be the best people to ask.  I don't see my psychiatrist for 2 more weeks. 

Anyway, Thanks.  I'm just one of the lucky ones that SSRI's don't seem to help too much.  Thank goodness for Klonopin otherwise, I'd be unemployed by now.
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Re: Adderall for anxiety?
« Reply #7 on: August 22, 2014, 08:36:02 AM »
Cymbalta, Buspar, Xanax, Paxil, Lexapro, now on 50mg zoloft and 1 mg klonopin daily.

The antidepressants are all serotonergic which may cause headaches in some because they can affect blood vessel tone, constriction and dilation. This is much less likely to be a problem with norepinephrine, aka noradrenaline, reuptake inhibiting antidepressants such as the tricyclics desipramine and nortriptyline. They would definitely be worth a try, especially desipramine which usually produces few of the typical tricyclic side-effects.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline comoso

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Re: Adderall for anxiety?
« Reply #8 on: August 22, 2014, 11:40:05 AM »
Can you taper straight to them?
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Online AncientMelody

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Re: Adderall for anxiety?
« Reply #9 on: August 22, 2014, 11:54:43 AM »
It's safe to transfer straight over but sometimes preferred to transition over a week or two to ease in. Say. 25 mg of Zoloft and half dose of the new med, then increase the new med after your last dose of zoloft
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