Seeking opinions--started adderall

[sunflower1776]

Hello! I used to be on these forums a few months ago but under the substance abuse section, but now I have a question for mental health. A little background--I have bipolar II and anxiety. I am also a recovering opiate addict. I did an inpatient detox 4 months ago for 4 days but have relapsed numerous times since then. I just ended a 3 1/2 week relapse--11 days clean this time around. The longest I've made it before is 23 days.

I've been on every antidepressant there is and a variety of mood stabilizers and antipsychotic with no success. Basically I'm one of those 'treatment resistant' people. Now I'm on Lamictal 200mg daily and Geodon 120mg daily. I also take 1mg xanax as needed up to 3mg/day (not addicted to xanax--need it for the anxiety-never had a problem with abusing it). I also take lunesta 3-4mg nightly for sleep. Lastly, I take suboxone which is used to help with the opiate addiction. I have both a therapist who I see weekly and a psychiatrist I've been seeing pretty much weekly for teh last 3 months as well. He didn't know about several of my relapses including my most recent, but I came clean to him last week and we're working on my meds now.

With my bipolar II, it is more chronic depression than anything. Actually there are times I wonder if I'm really bipolar or not since I don't experience the mania part--I guess you could say I am hypomanic, but I"ve been self-medicating for years with opiates. I have been on the psych meds for years also. The ones I'm on now are working really well so nothing is going to change there. When I told him last week that I had started using again several times over the past 2 months he asked me point blank (while I'm sitting there crying) what it is about the pills and the way they make me feel that I don't feel when I'm not taking the pills. He has said to me in the past I'm a drug addict because I'm bipolar and have never been treated appropriately.

I told him last week and again this week when we talked that the pain pills make me feel motivated, give me energy, just make me feel good. So, he decided to try adding adderall to my meds. He said I'm probably going through opiate fatigue and need to jump start my system again. He started me on 10mg 3x/day. I took my first one late yesterday afternoon and no more after that because of it being too late (didn't want to be up all night). I didn't take the one first thing this a.m. because I don't get out of bed until noon and I wanted to sleep. Tomorrow I plan on taking the a.m. one and just trying to go back to sleep after (sleep is important to me). I took 10mg when I woke up today, around 12. About an hour after I took it I was exhausted! I was out doing errands and literally couldn't keep my eyes open. By the time I was done it technically was time for me to take my next one (4-6 hours apart), but I really needed to take a nap (I usually don't take naps). I slept until 6 p.m. Knowing I'd be up tonight because of taking a late nap I took one at 6 after my nap. I do have energy now, not that severe exhaustion. Im a little irritable, but that's also part and parcel for me.

So, after this long drawn out post, my questions to all of you knowledgeable people are these--have you used adderall and are you bipolar? How has it worked? Do you also have dual-diagnosis with substance abuse? I guess overall am I doing a good thing by adding this to my med regimen. I trust my doctor 100%--he is nationally known and specializes in both addiction and bipolar.

I myself am very intelligent and well educated and work in the medical field, so I know a lot about different medications. I know he is using the adderall in a kind of off label use since it's mostly for ADHD/ADD and narcolepsy. His point is to make me feel the way I do when I'm on opiates so that I can start getting my life back (I'm not working, living with my parents, had to leave my job because of drug use--had been there 5 years, had to move home because of drug use....the typical story of an addict). I need that motivation and drive to get back out there and start my life over clean and sober. I'm working on my master's degree and that is the only thing that I do to get through the day. I at least need the energy to get out and volunteer--anything to get out of the house. I'm not at the point mentally where I can get another job right now.

Sorry this is so long and if you'd read this far I really appreciate your time. I know we're all on here to try to help each other so any words of wisdom, advice, encouragement, etc., is greatly appreciated. Even if you want to tell me I'm making a huge mistake with my meds I'll listen to that as well!

Thanks in advance!
Sunflower

[historyteach]

Hi, Sunflower,
Welcome to the MH forum of SR!

I'm glad you trust your doc and that he's a well respected doc to boot.
Many docs use meds off label. It only means that the FDA hasn't yet approved it for a particular reason. But, that doesn't mean it doesn't work for that reason. If it's working, well, that's all that matters, right?

Others should come along to share their own ESH. I wish you the best. Let us know how it goes, ok? We care.

Shalom!

[jurneyman]

SunFlower, I am Bi-Polar II, with a dual diagnosis of substance abuse, and have been taking Lamictal, and Adderall, plus trying other anti-depressants. It is going to be up to you to discipline yourself, and decide how much and how important is sleep to you. It seems everything in your day revolves around your ability to sleep. Which is fine if you need it, but motivating yourself is going to be very difficult if it is the lessor of your priorities, and to want it just when it is convenient. It still looks like you still want the drugs or medications to do everything for you. Getting clean and learning to live and function without the use of drugs can be very hard, and it takes a lot of effort on your part, so It is up to you. Thinking about doing something, and actually doing it are what should be looked at. If you want to change you are going to have to be responsible for your own future.

[scott]

Sunflower,

I am bipolar II (or 2.5) depending on who's scale you use with a dual diagnosis of substance abuse co-morbidity of ADHD.

Basically, I cannot tell you what the doctor is thinking but I don't think he is giving you the adderall for ADD/ADHD. My guess is he may be thinking you have chronic fatigue but as stated before, I'm not a doctor and we are not supposed to give medical advice. He is probably trying to start you on it for those fatigue issues however, for those of us with ADD/ADHD we usually get all uppity, anxious, irritable, agitated etc. because of our inability or frustration in controlling our thinking or our inability to focus and accomplish things we set out to do. When you give someone with ADHD a stimulant like adderall we calm down. I have not taken adderall before but currently I've tried strattera and was allergic and have now started wellbutrin xl for my ADHD. I cannot tolerate most antidepressants like yourself appropriately. Most antidepressants I've tried either make me 10x MORE depressed, or the side effects are so bad that I can't tolerate to continue with the treatment.

Perhaps, you should do some research into ADD/ADHD to see if you might fit into that type of condition. Again, I'm not trying to offend you by saying that you have this condition but simply stating that it may be a possibility because of how you are reacting to the strong stimulant.

Also, you may just need to take a bigger dose, who knows.

Best of luck to you in your fight! Hope the doctor will continue to help you! I'm pretty sure I would benefit from the xanax or adderall as well, but my doc won't give them to me because of the history of substance abuse. And my drug of choice was also opiates. God Bless