Well, it's been awhile

I'm not sure how much more I am going to post on this blog. It seems I have settled into a medicinal routine that works for me. I am now on 60mg of Strattera and 5mg of Lexapro once a day. My productivity is good, virtually no side effects have occured, and I fell good.

I hope others do as well.

For all I know this may change as I am moving the family across country this summer and will need to find a new therapist for prescriptions, but after all the research I've done, I feel good about what my options are.

Strattera is probably not the right drug for me either

Oh well.

It's been 3 weeks and while the stimulant aspect of the drug has been helpful, it is also somewhat distracting - and the rest of the benefits do not seem to have kicked in.

I had to cut back the dose to the original 40mg because it seemed to raise my blood pressure - especially the bottom number. I tried to give blood and for the first time ever, I was rejected by the Red Cross because my blood pressure was too high. That was at 80 mg and a week ago. The next morning I went back to 40mg.

I still feel the stimulant pushing me and sometimes focusing me, but there are times when the ADHD block is just so great I have to get help from others to figure a project out. That never used to happen prior to the last two years.

Maybe Wellbutrin is the answer. Maybe nothing will work for me - 10% do not respond to medication, I'm told.

Oh well.

The first annoying side effects of Strattera set in last night

Insomnia. It's not a problem I generally familiar with. Usually I sleep like a rock.

Last night was different though. I couldn't get to sleep until after 11:30, and then awoke at about 2:30. I tossed and turned for about 45 minutes and then decided to not bother my wife ant more.

I grabbed a laptop and went down to the dining room to look up the known side effects of Strattera. What I found was interesting. For the first few weeks of taking Strattera you can expect nausea, light insomnia, and a dull headache among others. I had some nausea over the weekend, and was experiencing a dull headache as I read the material.

After I confirmed that these side effects should dissipate as my body became used to the drug, I got up and poured a couple of fingers of Maker's Mark, grabbed a clementine, and moved on to CNN.com and NYT.com to see what was happening in the world. When the drink was done it was about 4:15 AM and I was finally feeling sleepy again.

I went back to bed and got up at 7:00. I'm a bit groggy from lack of sleep today, but it isn't too bad at this point. We'll see how the day progresses.

Overall though, Strattera seems to be helping. The stimulant effect isn't overbearing and I expect the additional benefits to start fading in within a week.

It has now been 8 days since I started taking Strattera and most people expect it to take 3 to 4 weeks to really make a difference.

Strattera's on the job

The prescription was approved at 5:30 PM yesterday, and I took the first dose at 8:00 AM this morning. The way Strattera is designed users start with half a dose (40 mg) once a day for the first 3-4 days, then the dose is doubled. Once doubled, users can opt to take 80 mg once a day or 40 mg twice a day. I will definately take 80 mg once a day.

Strattera is a stimulant, don't let anyone tell you otherwise. It may not work the same way as amphetamines, but it is still a stimulant. It still feels a bit speedy, but not like the Ritalin did - so far it is far more containable. Still, it is something I'll have to get used to.

I hope it works. If it doesn't I'll be a bit up the creek.

Still waiting on Strattera

I turned the prescription in on Friday evening. I found out Saturday morning that it was rejected because prior authorization was needed and so I needed to call my doctor. I traded voicemails with him on Saturday and got him everything he needed, but then we find out that the authorization center is open on weekends, so he had to wait until today, Monday, to see what's going on.

At this moment - 4:00 PM on Monday, it still has not been approved.

I have no idea what the hold up is.

Sometimes I hate BC/BS Carefirst.

Wow, things only get better, NOT!

Now I'm bi-polar too!

Well it seems that's the case. I am mildly, I believe, bi-polar, in addition to being ADHD. I am, once again, not to surprised. However, I think it is the ADHD that has been more of a hindrance to me personally and professionally, so I opted to focus on that first.

It seems that even a lose dose of Ritalin seems to build up a speedy effect in me and push me to mild mania. Ritalin is a dopamine reuptake inhibitor. So it seems that drugs that work on dopamine, the stimulants, probably won't work for me - although they do help a bit until I build to a mania.

Other main choices are Wellbutrin and Strattera. Wellbutrin works as a serotonin reuptake inhibitor AND a norepinephrine reuptake inhibitor as well. Many of the anti-depressant drugs also work as serotonin reuptake inhibitors and have a tendency to push people with bi-polar disease to mania as well.

So, that seemed like a bad choice as well.

That leaves Strattera. Strattera is simply a norepinephrine reuptake inhibitor. From what we can tell, the Doctor and I, there have been no studies looking at Strattera and mania.

So, by process of elimination, I chose Strattera in the hope that it will help my ADHD, not push me into mania, and help me control some of the depressive sides of being bi-polar.

I start tomorrow. Unfortunately, they say it takes 2 to 3 weeks to really kick in and help.

We shall see.

Ritalin seems to be helping somewhat

I'm still not right, but I'm a lot better than I was without it. The wall is not gone, but I can work around it where I couldn't on Monday. The wired feeling is greatly reduced and I can work now.

I still think there is a better drug for me out there - probably not an amphetimine - maybe Straterra or Concerta.

I'll see what the Doctor says this Friday morning.

So, Ritalin does help some, that's obvious

At this low 10mg dosage, I can feel some beneficial effects of Ritalin. My day is more structured already. The wall that I felt was blocking me yesterday is mostly down. I am communicating and remembering better. I am better focused. So far the speediness of the Ritalin hasn't bugged me, though I am feeling slightly more wired.

I am curious as to how this will progress throughout the day.

Ritalin: It's back!

Starting Tuesday morning I will once again try half a tablet (10mg) of Ritalin either once or twice a day. After talking to my doctor, we decided to try this until we meet on Friday to see if we can get some of the benefits of Ritalin that seemed to be missing today - leaving me somewhat paralyzed with regards to work and easily distracted with negative thoughts and actions.

My wife wants the "speedy" me back

I guess that Ritalin did have some positive effects. My wife has commented twice in the last two days about how I am more sarcastic again, and not as nice as when I was on Ritalin. On top of that all the negative thoughts and feelings about my work have come storming back this morning.

It's like there is a wall in front of my forehead. I know what I need to do, but it is stressing me out so much that this wall blocks my ability to do it. I have to figure out ways around the wall to do bits and pieces at a time. This becomes a tedious process that makes it hard to work with my boss on these issues. I get overcome with guilt and the defensive, and she justs wants the project done.

She is completely in the right, but I can't seem to figure out how to get past the wall.

DAMN!

I need some sort of help soon.

I need a new medication

As bad as Ritalin was for me, it helped in some ways. All the bad feelings are coming back now that I've been off the drug a few days. I hope to get a new prescription tomorrow, but I was put on an antibiotic (Z-Pack) on Friday for a sinus infection/possible bronchitis. My GP wants me to wait until it runs its course - next Friday - before I start a new medication for ADD.

I'm not sure I can wait that long.

New stresses are being introduced into my life.

I need something.

The Ritalin is still fighting with me

It has now been about 28 hours since my last 10mg dose of ritalin and I can still feel it in my system. This is both good and bad.

The good is that a little of the medication's focus power is still there, and helping me prepare for my day. The bad is that the buzz is still distracting me - I am still in a speed haze and am having a hard time moving from project to project.

Since I have to teach later this afternoon, this is particularly bad.

Oh well. I'll have a weekend off from the drug and then onto a new one next week.

The Doctor called

I was able to speak to the doctor today about my issues with Ritalin. It seems as if it is quite odd for the drug to act as it did for me.

The short end is that he told me to stop taking it and to contact him on Monday about trying something else.

I only took a half a tablet (10mg) today at 8:00 AM and I still feel it wiring my body 8 hours later.

I hope the next option works better.

The Dosage Issue - Ritalin

When I was diagnosed with ADD I was told there were 4 or 5 different medications that could be used for treatment. Of those 3 were amphetamines. Not every drug works for every person, so often patients try a number of drugs at different dosages until they find the one that works well for them. 10% of the ADD community are unable to find medications to help them.

I was started on Ritalin - the most prescribed ADD drug.

My prescription was for 20mg tablets and I was told to take them 3 times a day as needed. I was instructed to start with half a tablet (10mg) and see how it felt. If there was no effect, move to a whole tablet (20mg) and check again. If there still seemed to be no effect, move to one and a half tablets (30mg) and try that.

Well, I'm a big guy - 6' and 250 pounds - and I've taken a lot of drugs in my life, so, having no way to cut the tablets when I picked the prescription up at the pharmacy in the doctors building, I immediately took one tablet (20mg) and got into my car and went back to work. An hour later, I couldn't feel any change so I cut a pill and took another half. Then the buzz set in and I was a new person. Focused yet reflective. It was very nice except for the wired feeling in the background.

Saturday and Sunday were the same. Everything seemed to be going well at 1.5 doses, 3 times a day. Monday was different. My abilities started to slide around Noon, and I became more and more speedy and less focused. Tuesday I reduced the dose to one tablet and things improved again for about 2/3 of the workday and then again started to slide. Wednesday was unfocused and in a speed haze - somewhat nice buzz but dangerous for an ex substance abuser.

I took it down to a half a tablet today and still feel speedy and weird. My focus is poor, and I hope I can reach the doctor today so I can change to a different drug ASAP.

We'll see what tomorrow brings.

Ritalin is definitely not the drug for me

I've now started my 7th day on Ritalin, and I hope it is my last - day on Ritalin, not last day ever. I believe this week has been my worst week in awhile, It started out great - The drug seemed to help last Friday at work, and really seemed to make a difference over the weekend. I was able to be more calm and patient with my kids, and much more organized around the house. By Monday afternoon, however, the drug was really pulling me back down. I was having negative thoughts again - quite often, and having a hard time focusing again.

More than that, I was simply too full of speed. I woke up Tuesday morning with what can only be described as a speed hangover. I reduced the dose and tried again.

It was better for most of the day on the lower dosage, but by Tuesday night, I was simply exhausted from the effects of the speed. I tried the same dosage on Wednesday and felt myself sliding down into a drug haze. Not the help I was looking for. The Counselor I go to suggested I immediately call the Doctor she had referred me to and get the medication changed.

She said I shouldn't feel the drug, but should feel more confident and focused. I wasn't feeling anything but the drug by that point, and was a bit scared that I was really enjoying the haze occasionally.

I called, and waited, and waited, and waited. While I was waiting I decided to reduce the dosage again. That seemed to help somewhat, but I started developing a low grade frontal lobe headache - well, at least it was directly behind my forehead, so I assume that's the frontal lobe.

At 9:00 PM the doctor finally called. Unfortunately, I only know that from the brief message I received on my answering machine when I couldn't find what my kids had done with the phone.

He said he would try and reach me today. I'm waiting again for his call, focused only on this blog and nothing else right now - working of the lower dosage of Ritalin.

I'm still speedy, and it is driving me crazy - a one week speed binge is really tiring and grating.

A response to a friend's question re: ADD simply being a square peg in a round hole world problem

I think that's a fair question.  I believe that many people have some of the symptoms attributed to ADD.  The difference to me is that I have virtually all of them and at a level that as made it difficult to interact with some portions of my daily life.  For some reason the symptoms have gotten worse for me in the last year or my coping mechanisms have begun to fail.



Either way, what is an occasional annoyance to most becomes a long term hindrance to some.



Many folks with ADD interrupt people regularly, finish others sentences, and have a hard time waiting.  Those are more of my symptoms.  They sound minimal and that many people do them - they do.  However, I regularly interrupt and try to contribute to my wife's phone conversations when I can only hear one side.  I  try and finish everyone's - from my kids to my students to my boss - sentences, mostly correctly and sometimes wrong.  Waiting in line for people writing checks in grocery stores kills me.  Lines behind moronic drivers makes me very tense.



All of these overwhelm me.  I have gotten by for years.  Now that they are really starting to plague me, treatment makes sense.



Many ADD suffers use their inherent ability to make huge intuitive leaps - which drives linear thinking people nuts - to great advantage once other symptoms are controlled by medication.



That said, I repeat, Ritalin is a weird drug.

Another response to a different friend's question re: ADD being a kids ailment only

ADD is a weird disorder.  I have always had trouble with sustained concentration and follow through on tasks - unless they are highly interesting to me.  Beyond that those who have ADD hear a constant flow of information running through their heads - at a level to distract.  In my case, and probably others, my brain feels the need to acknowledge and affirmatively note everything within my vision.  Starting in about 1971 I started self medicating with marijuana and alcohol in attempt, largely successfully, to quell the din.  This medication approach lasted about 15 years before I quit everything all together.  About 1991 I started drinking again, but very modestly - one glass of something 3 or 4 nights a week - every few weeks  I'd drink more on one night.



Over the years I developed strong coping mechanisms.  For some reason, probably advancing age, these mechanisms have failed me in the last year.  I have failed to finish projects timely a number of times - for

no good reason except that they bored me, and I have developed a much shorter temper at work and , what worries me the most, at home.



I went for counseling on anger management.  It was there through a discussion of my past that they came to suspect a long past of undiagnosed ADD - I am just above the age where they started really looking for it in kids.  For example, I was the classic underachiever - even before I started self medicating.  I was tested in the 99+% for IQ, but was a constant C or lower student.  When I focused I could do anything, but rallying the will to focus on anything long enough was very difficult.  I remember High School Biology.  I was completely uninterested and a D student except for the one 9 week period when we studied genetics - I got a A for the term.  In addition, folks with ADD are 50% more likely than the general population to have substance abuse

problems.  I fit a lot of categories.



So anyway, these counselors sent me to an ADD/Substance Abuse guy and he analyzed me and came up with the diagnosis that I was 9 out of 9 under the clinical evaluation of Attention Deficit, and 8 out of 9 under the

Hyperactivity analysis - I don't fidget.  Children are diagnosed as ADD or ADHD with 7 out of 9 of the characteristics, and adults sometimes at 6 out of 9.



So, now I begin to explore the realm of ADD drugs to see if one can improve my life.



What a long strange trip.

ADD and me - the beginning

Today is February 2, 2005. Last Friday, January 28, 2005, I was diagnosed as ADD or ADHD and put on Ritalin. This is my story.

I'm 48, married with two young children, a professional librarian with two advanced degrees. I have risen to management at an institution of higher education. Over the past year I have begun to struggle professionally and personally.

After snapping at my kids, my wife and my boss, I sought counseling for Anger Management issues. Within the first session the Counselor believed I was possibly ADD and suggested I meet with her Director an ADD specialist. That meeting was a week ago. The Director firmly believed I was ADD impaired - probably not a good word or one she would use, but how I feel about now - and referred me to a specialist with ADD and Substance Abuse.

Substance abuse you ask? What an interesting specialty. It turns out that folks with ADD have about a 50% higher rate of substance abuse than the general public. It kind of explains the self medicating - to turn of the brain noise - I turned to in 9th grade. Marijuana calmed me and made the din in my head quieter. More on that later.

Seems that after chatting with me and taking notes the doctor was able to make a clinical diagnosis that I met 9 out of 9 of the conditions of Attention Deficit and 8 out of 9 for Hyperactivity.

This wasn't a huge shock to me, I had assumed for years that I probably had some ADD causing me problems. I was surprised at how severely ADD I seemed to be.

I was put on Ritalin immediately. This is one weird drug, and it isn't for me. I expect I'll be moving to a different option soon.

Anyway, I plan to use this blog to detail my experiences coming to terms with having ADD and to look back at my life and the behavior patterns in my life that maybe should have signaled me earlier so that others might recognize these patterns and seek assistance.

I look forward to a dialogue.