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  #1  
Old 04-01-07, 11:55 AM
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adderal & Hypomania = Bipolar?

Quick background. Diagnosed with Depression 3 years ago, on Effexor. Still felt like something was wrong was diagnosed with innatentive ADD. Started taking Adderal 3 months ago and it was awesome. I felt like all of my problems were solved. I could read, felt smart, social back to what I felt was my true self. About 2 weeks ago I started to get very depressed (again), even though i'm still on the Effexor.

I started to do a lot of reading and think i've been hypomanic for the last 2 months and now am becoming depressed again. I've wanted to take more adderal to just feel good but know that is wrong so I completely threw it out (not sure if that was smart or not).

I'm starting to think the Addderal actually triggered hypomania and that i'm actually BiPolar instead of just depressed with ADD.

Has anyone else had this situation? Is this a reasonable thought? I'm seeing my pdoc on Wednesday to discuss but right now i'm pretty confused and very week and i'm sure also going through adderal withdrawl.

Any help or comments would be greatly appreciated
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Old 04-01-07, 07:33 PM
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Well, stimulant medications are famous for triggering hypomanic/manic episodes in bipolar patients, even those that have not been previously diagnosed. It is still possible for some to take stimulants after adding mood stabilizers (I can) but for some this is not possible.

There is a very strong one-way comorbity between bipolar and ADHD (more bipolars seem to have ADHD than those who don't). It may be that you have both and will need to treat both.

We have a very supportive bipolar community here at ADDF so please let us know how things turn out for you! Tell the docs what you have observed, since it is quite possible to have both disorders.

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Old 04-01-07, 07:59 PM
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Welcome Jkron!

Like my buddy CF..I also have ADD & BPDII. I was diagnosed with ADD 1994, and then depression 2 years later. I just never quite felt right. Last year, I hit a hypomanic wall that was extremely uncomfortable, and very out of character for me. No sleep and spending way to much money. I tracked the up's and downs..went to my PDOC and he diagnosed me with BPDII.

Started me out on Lamicatal, and I came off the Adderall XR 40mg during that time. I was off about a month or so, waiting for the mood stabilizer to build a level. Then I was able to add the Adderall back in. But it's cut in 1/2 to 20mgs now.

I am still titrating up on the Lamictal, and the ADderall can trigger hypomania, esp under extreme stress situations.

Please keep a journal , and take it wiht you. Like CF said. It' a common Co-morbid ....there are plenty of us here who can help and support you should you need it.

Please let us know how it goes...
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Old 04-02-07, 08:55 AM
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I appreciate the responses. I'm seeing my pdoc on Wednesday so hopefully i'll get some answers. All I know is that right now i'm exhausted and just want to sleep.
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Old 04-02-07, 08:58 AM
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Actually one last question. I know that being hypomanic is not great, but as with many others I did like the feeling of being energized etc.. With mood stabilizers like Lamicatal how does that make you feel? I know that might sound weird, but one of my big concerns is that i'm going to be a zombie, have no feelings etc..
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Old 04-02-07, 10:56 AM
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Nope it's not a weird question at all. For several reasons, it's also most of our fears.

One of the hardest reasons to treat, Bipolars of all spectrums is because the mania is umm fun? well it is in the beginning until you crash. But it's enough to make most of us..not want the fun to be "spoiled" by meds.

No the Lamictal has never made me feel like a Zombie.
Acutally the only difference I felt after week 3 , and up to 50mg, was a sense of more balanced moods?
The only Zombie effect I had was when I was taking them at night, to "avoid" the possible side effects and found out that this was making me very tired in the morning? So I switched it to taking them mid morning and I have no side-effects at all..

I also worried about it effecting my creative outlets. I love to write...and it didn't. The only thing it did, was help me balance out how long I did write or stay on the computer writing, by enabling me to "turn off the hypomanic hyperfocus and stop before 4am on a work night.

So for me it's been wonderful. For most of the people I know who take it, or just started it's been a very good thing. I hope it is for you too.

Let us know okay?
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Old 04-02-07, 10:57 AM
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You will not lose your ability to feel emotions, but you will lose the extreme highs and lows that characterize BiPo. I know hypomania feels great (sometimes) but BiPo is a progressive disorder...and hypomania can rapidly devolve into extreme irritability and sometimes rage attacks. Since you have been taking Effexor, I presume you are already familiar with the extreme depression phases that also characterize BiPo.

Many BiPos miss hypomania but some of us don't because we understand that it is not a natural state...and it does NOT feel good to the people around us that we know and love. I remember how much I used to get done during hypomanic phases and how wonderful I sometimes felt, like I was on top of the world, and that life was really special. I also remember how much I baffled my family, how easily I would be provoked into irritability and just how truly nasty I could be then. I remember the price I paid for these times; the extreme tiredness and lethargy, the crushing depression and the pain I put my family through when I felt hopeless and wished to die (in spite of the Cymbalta that I had been taking).

Besides, the milder forms of BiPo can at any time flip the switch over into BPI and bring with that true manias that can manifest as psychotic episodes. I am sure you don't need me to elaborate just how dangerous that might potentially be!

I firmly believe that all forms of BiPo should be treated. I accept that I will be medicated against this disorder for the rest of my life. I will do it for my family and I will do it for me. AS good as I might feel during hypomania I realize that it is NOT a normal state of being (recent example before titrating up on Lamictal: My husband lost his job and that fear provoked a hypomanic episode. NOBODY ought to be elated at a time like that! I was a big, fat annoyance to my hubby and unable to support him emotionally because I was riding that wave of hypomania...do you see?).

Please let us know how the doc appt. goes? And good luck to you. We will be here regardless what the doctor says.
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Old 04-02-07, 07:48 PM
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I'm your opposite (antidepressants with thorazine will still make me insane) stimulants however seems to aid in the bipolar component to my diagnoses
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Old 04-03-07, 12:44 PM
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Mspen,

I can't take antidepessants, either? Zoloft make me do the thorazine shuffle?
Can't just take the Stims either, makes me hypomanic...

Ergo the mood stablizer's...first, after blood level...low dose of the stims...

I am noticing after 4 weeks up to 150mg, I might need to titrate the Adderall up a little more? I took it all this week..and well still feeling very ADDish..LOL...

Will talk to doctor...and see what he thinks?

CF anything like this for you yet?
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Old 04-03-07, 01:46 PM
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I had to switch from Concerta to Dex spansules. Seems that my dose of Concerta (the only dosage that works) may have been responsible for triggering my hypomania due to excess anxiety. Apparently my anxiety attacks and agoraphobia began after I went back on Concerta (I am no good with time frames, but its all on my chart...go doc W!).

I cannot take SSRI/SSNRI class antidepressants either...they make me madly manic. Quite extreme. Often!

I am currently tirating up on the Dex but ya know what? It does look like I will need to up my dex dose beyond the "normal exchange rate" from Concerta to Dexadrine. I suspect that is due to the jump up in Lamictal, naturally.
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Old 04-03-07, 07:14 PM
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My advice if there's legit hypomanic symptoms is to not take another dose. I refuse to try a "new" SSRI when it comes out regardless of what trial shows a half percent less chance for mania or not. I tried wellbutrin and after a week I thought I was a psychic that was getting abducted by aliens and I believed it too.
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Old 04-03-07, 07:28 PM
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Not a great fan of the SSRI's either Mspen. I will stick with the mood stabilizers. I haven't had any major hypomanic episodes linked specifically with just the Adderall. I still track my up's and down's and from the history, several have been off of the Adderall which up until recently I was taking PRN. And a couple were on Adderall, but boosted or possibly triggerd by "large stressors" going on at the time. Ie teenager on the rampage unmedicated. And unforeseen financial bumps" which put me in a dizzy.

So I have been back on my regular dose, and nothing. Except now, I feel more ADD?

So who know's I will talk to the doc and see what he thinks. Interesting that CF and I started around the same time on Lamictal, and are tirtrating about the same and both seem to be having the same issue.

Which kind of goes to the saying, and why they want you to come off of the ADD meds and stabalize you for the BPD first. Then you can see if it was ADD truly or BPD? Always mindful to treat the Bipolar first then address the ADD. Makes sense. I did it, that's how we came to the conclusion, that yep I am def ADD too! Now we have a curious balancing act to do here. Balance the BPDII out, and ADD without triggering severe symptoms of both.

Oh boy, what fun.
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Old 04-03-07, 08:46 PM
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OH yes Hope just loads of fun! Its a very tricky balancing act these days, it seems, but it is SOP for them to treat the BP the best they can then add stimulants for the ADHD.

Of course my doc never took me off stimulants, just decreased them, because without them I am too freaking wonky to remember to even TAKE Lamictal...
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Old 04-04-07, 06:10 PM
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Yes it's seems to be tricky....

I have been feeling really Addish for the last week...today was not exception...except now I am getting irritated with myself.

So after my lovely client meeting tomorrow, and my lunch. I will take 40mg ..and see where it goes?

All the time I have been back on my Adderall, I have "felt" and noticed the "desired" effects. For the last week, I have felt like I have taken nothing?
I don't really even have the side-effects that "always" seem to stay, like the dry mouth? The total loss of appetite, or if I take it late...any Rebound?
Interesting, huh?

So here I go...permission of course from my lovely pdoc...yipee,,at least if I hit hypomania....I only have to work 2 hours Friday...and off I go into the ozone...yipee.....
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Old 04-04-07, 09:03 PM
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OK - diagnossis is in. Bipolar II.

Officially stoping Adderall until Bipo is under control. Starting to take Lamactil and Seroquil and we will see how it goes. Any of you guys have any experience with these meds?
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